bluuebunny/crossref_metadata_2025 huggingface dataset:
Phytochrome A and its Functional Manifestations in Etiolated and Far‐red Light‐grown Seedlings of the Wild‐type Rice and its Hebiba and Cpm2 Mutants Deficient in the Defense‐related Phytohormone Jasmonic Acid
Authors: Sineshchekov Vitaly , Koppel Larissa , Riemann Michael , Nick Peter
Published: October 2020

Interaction between phytochromes and hormones is becoming one of the major issues in plant photophysiology. In this work, effects of defense‐related jasmonic acid (JA) on phytochrome A (phyA) were investigated by fluorescence spectroscopy making use of two JA biosynthesis mutants of rice: cpm2 with the inactivated gene allene oxide cyclase and hebiba with additional genes deleted. Constant far‐red light (FRc) mediated by phyA reduced its content in the wild type (WT) and mutants, and brought about domination of its light‐stable pool (phyA″) in WT and light‐labile pool (phyA′) in the mutants. Pulsed FRp was much less effective. This FR effect classifies as primarily HIR with a low fluence threshold; it comprises inhibition of phyA biosynthesis, stimulation of phyA″→phyA′ transformation and phyA′ destruction. In the mutants, phyA suppresses [Pchlide] under FRp (VLFR) and stimulates it under FRc (HIR); these effects are lacking in WT. Similarly, phyA suppresses roots'growth under FRp in the mutants but not in WT. These JA mutant features suggest that JA reduces the phyA functional activity primarily in its phyA″ form mediating HIR. This modulating JA action on phyA functions under FR limiting their extreme manifestations may have contributed to the evolutionary advances of the land plants.
Nitrate reduction capacity is limited by belowground plant recovery in a 32‐year‐old created salt marsh
Authors: Tatariw Corianne , Mortazavi Behzad , Ledford Taylor C. , Starr Sommer F. , Smyth Erin , Griffin Wood Abigail , Simpson Loraé T. , Cherry Julia A.
Published: October 2020

Human activities have decreased global salt marsh surface area with a subsequent loss in the ecosystem functions they provide. The creation of marshes in terrestrial systems has been used to mitigate this loss in marsh cover. Although these constructed marshes may rapidly recover ecosystem structure, biogeochemical processes may be slow to recover. We compared denitrification and dissimilatory nitrate reduction to ammonium (DNRA) rates between a 32‐year‐old excavation‐created salt marsh (CON‐2) and a nearby natural reference salt marsh (NAT) to assess the recovery of ecosystem function. These process rates were measured at 5 cm increments to a depth of 25 cm to assess how plant rooting depth and organic matter accumulation impact N‐cycling. We found that, for both marshes, denitrification and DNRA declined with depth with the highest rates occurring in the top 10 cm. In both systems, N‐retention by DNRA accounted for upwards of 75% of nitrate reduction, but denitrification and DNRA rates were nearly 2× and 3× higher in NAT than CON‐2, respectively. Organic matter was 6× lower in CON‐2, likely due to limited plant belowground biomass production. However, there was no response to glucose additions, suggesting that the microbial functional community, not substrate limitation, limited nitrate reduction recovery. Response ratios showed that denitrification in CON‐2 recovered in surficial sediments where belowground biomass was highest, even though biomass recovery was minimal. This indicates that although recovery of ecosystem function was constrained, it occurred on a faster trajectory than that of ecosystem structure.
Environmental justice in urban greening for subtropical Asian cities: the view from Taipei
Authors: Mabon Leslie
Published: October 2020

Whilst an extensive body of literature exists on the environmental justice implications of urban greening in North America, Europe and to an extent Australasia, there are fewer analogous studies for tropical zone Asian city contexts. Given increasing global interest in the potential for urban greenspace to contribute to resilience in the face of environmental change and the higher vulnerability of Asian cities to environmental shocks, this is a notable gap. In response, this paper evaluates the contours of environmental justice debates within urban greenspace planning for one subtropical Asian city—Taipei. Through analysis of newspaper reporting on urban greenspace planning within Taipei, the potential and limitations of greenspace planning in contributing to equitably delivering benefits from urban greenspace towards resilience are assessed. Findings suggest that claims to environmental injustice in greenspace debates within Taipei follow broadly similar lines to controversies in Europe and North America. Nevertheless, the need for specific knowledge to understand the different ecosystem services provided by tropical zone ecosystems, and the potential for conflicts over greenspace versus development to be heightened in dense Asian city settings, are highlighted as potential areas where environmental justice debates in an Asian urban greening context may differ from Western cities.
The novel HLA‐B*15:555 allele identified in a healthy Brazilian individual
Authors: Cita Rafael F. , Mendes Maristela F. , Nogueira Diones P. , Souza Tonny L. , Stelet Vinícius N.
Published: October 2020

Identification of the novel HLA‐B*15:555 allele that differs from HLA‐B*15:17:01 at one position in exon 2.
The novel HLA‐A allele, HLA‐A*01:353
Authors: Loginova Maria , Kutyavina Svetlana , Paramonov Igor
Published: October 2020

HLA‐A*01:353 differs from A*01:01:01:01 by a mutation at nucleotide 728.
Bilateral temporal dacryops in a cat
Authors: Maggio Federica
Published: October 2020

A 1‐year‐old Maine Coon female spayed cat was presented for a 7‐week history of bilateral pinkish masses located over the dorsotemporal conjunctival quadrants. Ophthalmic examination revealed the presence of bilateral temporal, slightly hyperemic, subconjunctival masses, fluctuant, and nonpainful. The remainder of the ocular examination was unremarkable. Ultrasound biomicroscopy and B‐scan ultrasonography confirmed the presence of a bilateral cavitated and tubular structure, extending within the temporal orbit, with anechoic fluid‐like content. Surgical removal was performed. Histopathology described the lesions as lacrimal gland tissue, markedly infiltrated by inflammatory cells, associated with cavitated structures filled with proteinaceous debris, and lined by flattened bilayered cuboidal epithelial cells. Bilateral adenitis of unknown origin and dacryops of the temporal lacrimal glands were diagnosed. Both surgical sites healed uneventfully, and no recurrence was reported on either eye during a 12‐month follow‐up period.
Hydroponic Chlorophytum comosum cultivating in distinct nutrient concentration, combined with biofilm treating eutrophic water bodies
Authors: Pan Fanghui , Wang Youbao , Gui Yanan
Published: October 2020

Phytoremediation technology using aquatic plants combined with microorganisms in constructed ecological floating bed (EFB) is increasingly applied to remediate eutrophic water. Utilizing the hydroponic Chlorophytum comosum, in combination with biofilm developed in polymeric fibrous carriers from sequencing batch reactor (SBR), to fabricate EFB, was implemented to reduce pollution and improve water quality for eutrophic water. The results indicated that the hydroponic C. comosum with long root and leaf, rich Chlorophyll, low cell membrane permeability and strong antioxidant activity enzymes was obtained through different nutrient concentration test. The combination of the hydroponic C. comosum and the biofilm developed in polymeric fibrous carriers could remove 75% chemical oxygen demand (CODCr), 61% permanganate index (PI), 50% total nitrogen (TN) and 57% total phosphorus (TP). Specially, the combination group exhibited higher removal efficiency of CODCr, PI and TN, compared with the sole biofilm group or the sole hydroponic C. comosum group. The result demonstrated that the combination of hydroponic C. comosum and the biofilm to construct the EFB was capacity to repair the eutrophic Huajin River.
Table grapes irrigation with treated municipal wastewater in a Mediterranean environment
Authors: Abi Saab Marie Therese , Zaghrini Joanna , Makhlouf Hassane , Fahed Salim , Romanos Dany , Khairallah Yara , Hajjar Celine , Abi Saad Roula , Sellami Mohamed Houssemeddine , Todorovic Mladen
Published: October 2020

This study investigated the effect of different water quality regimes [Freshwater (FW), treated wastewater (TW) and alternating FW and TW (FW‐TW)] on drip‐irrigated table grape yield, quality and microbial contamination. Water and soil samples were analysed. In addition, grape samples were harvested for quantitative and qualitative evaluation. The results showed that the plants irrigated with TW and those irrigated with alternating FW and TW gave 19.57 and 14.95% higher marketable yield, respectively, than plants irrigated with FW. Total soluble sugars, total titratable acidity and sweetness ranged, respectively, between 18.43–20.13, 0.69–0.81% and 21.52–29.19, and were within the desirable levels for table grape harvest. In addition, there was no significant difference in terms of total phenols and mineral composition of berries, leaves, peduncle and pedicels. Finally, table grapes did not present any bacterial contamination which confirm the importance of the adopted irrigation regime for a safe wastewater reuse in agriculture.
Celebrating 20 years of FOCIS
Authors: Roncarolo Maria Grazia , Anderson Mark S.
Published: October 2020

FOCIS leaders discuss the challenges and opportunities that lie ahead for the society.
Potent Synergistic Interactions between Lopinavir and Azole Antifungal Drugs against Emerging Multidrug-Resistant Candida auris
Authors: Eldesouky Hassan E. , Salama Ehab A. , Lanman Nadia A. , Hazbun Tony R. , Seleem Mohamed N.
Published: October 2020

The limited therapeutic options and the recent emergence of multidrug-resistant
Candida
species present a significant challenge to human medicine and underscore the need for novel therapeutic approaches. Drug repurposing appears as a promising tool to augment the activity of current azole antifungals, especially against multidrug-resistant
Candida auris
. In this study, we evaluated the fluconazole chemosensitization activities of 1,547 FDA-approved drugs and clinical molecules against azole-resistant
C. auris
.
The Lymphocytic Scavenger Receptor CD5 Shows Therapeutic Potential in Mouse Models of Fungal Infection
Authors: Velasco-de Andrés María , Català Cristina , Casadó-Llombart Sergi , Martínez-Florensa Mario , Simões Inês , García-Luna Joaquín , Mourglia-Ettlin Gustavo , Zaragoza Óscar , Carreras Esther , Lozano Francisco
Published: October 2020

Invasive fungal diseases represent an unmet clinical need that could benefit from novel immunotherapeutic approaches. Host pattern recognition receptors (e.g., Toll-like receptors, C-type lectins, or scavenger receptors) that sense conserved fungal cell wall constituents may provide suitable immunotherapeutic antifungal agents. Thus, we explored the therapeutic potential of the lymphocyte class I scavenger receptor CD5, a nonredundant component of the antifungal host immune response that binds to fungal β-glucans.
Prospective validation of a virtual clinic pathway in the management of choroidal naevi: the NAEVUS study Report no. 1: safety assessment
Authors: Al Harby Lamis , Ali Zaria , Rajai Azita , Roberts Stephen A , Peto Tunde , Leung Irene , Gray Jane , Hay Gordon , Arora Amit K , Keane Pearse A , Cohen Victoria M L , Sagoo Mandeep , Balaskas Konstantinos
Published: October 2020

Background

Choroidal naevi are a common incidental finding prompting specialist referrals to ocular oncology. Rarely, such lesions have sufficient suspicious features to diagnose a small melanoma. The aim of the study is to show that ‘virtual’ imaging-based pathways are a safe and efficient option to manage such referrals.

Methods

A prospective cohort study at the Manchester Royal Eye Hospital and Moorfields Eye Hospital between June 2016 and July 2017 of the management decision of 400 patients reviewed by an ophthalmologist in a face-to-face consultation (gold standard) supported by fundus photography, optical coherence tomography, autofluorescence (AF) and B-mode ultrasound. The images were also read independently by blinded graders (non-medical) and blinded ophthalmologists, and a management decision was made based on image review alone (virtual pathway). The two pathways were compared for safety.

Results

The agreement for management decisions between face-to-face and virtual pathways was 83.1% (non-medical) and 82.6% (medical). There were more over-referrals in the virtual pathway (non-medical 24.3%, medical 23.3% of gold standard discharge) and only two under-referrals (10.5% of gold standard referrals), both borderline cases with minimal clinical risk. The agreement for risk factors of growth (orange pigment, subretinal fluid, hyper-AF) ranged between 82.3% and 97.3%.

Conclusions

We prospectively validated a virtual clinic model for the safe management of choroidal naevi. Such a model of care is feasible with low rate of under-referral. An over-referral rate of almost 24% from the vitrual pathway needs to be factored into designing such pathways in conjunction with evidence on their cost-effectiveness.
Olympic competition climbing: the beginning of a new era—a narrative review
Authors: Lutter Christoph , Tischer Thomas , Schöffl Volker Rainer
Published: October 2020

Climbing as a competition sport has become increasingly popular in recent years, particularly the sub-discipline of bouldering. The sport will debut in the Tokyo Summer Olympic Games. National and international competitions have three disciplines:lead(climbing with rope protection),bouldering(climbing at lower heights with mattress floor protection) andspeed(maximum speed climbing on a standardised route in 1-on-1 mode). There is also a ‘combined mode’ of all three disciplines (combined) which forms the Olympic competition format; all competition formats are held on artificial walls. Existing literature describes a predominantly low injury frequency and severity in elite climbing. In comparison to climbing on real rock, artificial climbing walls have recently been associated with higher injury rates. Finger injuries such as tenosynovitis, pulley lesions and growth plate injuries are the most common injuries. As finger injuries are sport-specific, medical supervision of climbing athletes requires specific medical knowledge for diagnosis and treatment. There is so far little evidence on effective injury prevention measures in top athletes, and antidoping measures, in general, requiring further work in this field. An improved data situation regarding high-performance climbing athletes is crucial to ensure that the sport continues to be largely safe and injury-free and to prevent doping cases as extensively as possible.
Changes in the quality of care of colorectal cancer in Estonia: a population-based high-resolution study
Authors: Reima Heigo , Soplepmann Jaan , Elme Anneli , Lõhmus Mari , Tiigi Rena , Uksov Denis , Innos Kaire
Published: October 2020

Objectives

Large disparities in colorectal cancer (CRC) management and survival have been observed across Europe. Despite recent increases, the survival deficit of Estonian patients with CRC persists, particularly for rectal cancer. The aim of this study was to examine diagnostic, staging and treatment patterns of CRC in Estonia, comparing clinical data from 1997 and 2011.

Design

Nationwide population-based retrospective study.

Setting

Estonia.

Participants

All incident cases of colon and rectal cancer diagnosed in 1997 and 2011 identified from the Estonian Cancer Registry. Clinical data gathered from medical records.

Outcome measures

Differences in diagnostic, staging and treatment patterns; 5-year relative survival ratios.

Results

The number of colon cancer cases was 337 in 1997 and 498 in 2011; for rectal cancer, the respective numbers were 209 and 349. From 1997 to 2011, large increases were seen in the use of colonoscopy and lung and liver imaging. Radical resection rate increased from 48% to 59%, but emergency surgeries showed a rise from 18% to 26% in colon and from 7% to 14% in rectal cancer. The proportion of radically operated patients with ≥12 lymph nodes examined pathologically increased from 2% to 58% in colon cancer and from 2% to 50% in rectal cancer. The use of neoadjuvant radiotherapy increased from 6% to 39% among stage II and from 20% to 50% among patients with stage III rectal cancer. The use of adjuvant chemotherapy in stage III colon cancer increased from 42% to 63%. The 5-year RSR increased from 50% to 58% in colon cancer and from 37% to 64% in patients with rectal cancer.

Conclusions

Major improvements were seen in the diagnostics, staging and treatment of CRC in Estonia contributing to better outcomes. Increase in emergency surgeries highlights possible shortcomings in timely diagnosis and treatment.
Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis
Authors: Hasan Taimoor , Ainscough Tom S , West Jane , Fraser Lorna Katharine
Published: October 2020

Objective

This systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.

Data sources

PubMed, MEDLINE, CINAHL, EMBASE and Web of Science.

Methods

Observational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.

Outcome measures

Included studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.

Results

Thirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.

Conclusions

Obesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.

PROSPERO registration number

CRD42018091752
Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis
Authors: Wen Shuqin , Yin Jia , Sun Qiang
Published: October 2020

Objective

To assess the effectiveness of social support on treatment success promotion or lost to follow-up (LTFU) reduction for patients with drug-resistant tuberculosis (DR-TB).

Design

We searched Pubmed, Web of Science, Embase, Scopus and Medline databases until 18 June 2020 for interventional or mixed-method studies which reported social support and treatment outcomes of DR-TB patients. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. Random-effects meta-analysis was performed to calculate the OR and 95% CI for the effects of social support on the improvement of treatment outcomes and the heterogeneity and risk of bias were assessed.

Setting

Low-income and middle-income countries.

Participants

DR-TB patients.

Outcomes

Treatment success is defined as the combination of the cured and treatment completion, and LTFU is measured as treatment being interrupted for two consecutive months or more.

Results

Among 173 articles selected for full-text review, 162 were excluded through independent review (kappa=0.87) and 10 studies enrolling 1621 DR-TB patients in eight countries were included for qualitative analysis. In these studies, the most frequently introduced social support was material support (10 studies), followed by informational (eight studies), emotional (seven studies) and companionship support (four studies). Seven studies that reported treatment outcomes in both intervention arm and control arm are qualified for meta-analysis. An encouraging improvement on treatment success rate (OR: 2.58; 95% CI: 1.80 to 3.69) was found when material support was integrated into social support packages and no heterogeneity was observed (I1 of 0%, Q test p=0.72). Reduction on LTFU rate (OR: 0.17; 95% CI: 0.05 to 0.55) was also noted when material support was available but substantial heterogeneity was found (I2 of 80%, Q test p=0.002).

Conclusion

Material support appeared feasible and effective to improve treatment success for DR-TB patients combined with other social support interventions.

PROSPERO registration number

CRD42019140824.
Attitudes and willingness toward out-of-hospital cardiopulmonary resuscitation: a questionnaire study among the public trained online in China
Authors: Jiang Yi , Wu Bangsheng , Long Long , Li Jiaxing , Jin Xiaoqing
Published: October 2020

Objectives

The incidence of bystander cardiopulmonary resuscitation (CPR) is low in China. CPR training could improve public attitudes and willingness, but at present, the attitudes of the public after online training are unclear. This study investigated individual attitudes towards CPR, the willingness to perform it in emergencies along with the main obstacles and the overall effects of online training.

Design

Questionnaires were distributed to investigate the public attitudes and willingness towards performing bystander CPR.

Setting

Questionnaires were accessible after the online course ‘First Aid’.

Participants

1888 students who attended ‘First Aid’ from December 2019 to 1 January 2020 and then completed the questionnaire voluntarily.

Results

The majority understood CPR (96.7%) and displayed a willingness to learn (98.4%) and to disseminate CPR knowledge (82.0%). Characteristics associated with more positive attitudes included women, the 26–35-year olds and those in medical-related occupations (p<0.05). Only 34.8% had CPR training before. Most people would willingly perform CPR on a close family member. Compared with the standard CPR (S-CPR), the public preferred chest compression-only CPR (CO-CPR) (p<0.01). The top three obstacles to performing CO-CPR were lack of confidence (26.7%), fear of harming the victim (23.4%) and causing legal trouble (20.7%), while regarding S-CPR, fear of disease transmission (22.9%) ranked second. Women, those in poor health and in medical-related occupations, were more likely to perform CPR (p<0.05). The confidence to perform CPR was improved remarkably after online training (p<0.05).

Conclusions

The overwhelming majority of respondents showed positive attitudes and willingness towards CPR. In some cases, there is still reluctance, especially towards S-CPR. Obstacles arise mainly due to lack of confidence in administering CPR, while online CPR training can markedly improve it. Therefore, we should focus on disseminating CPR knowledge, targeting those who are less willing to perform CPR and helping overcome their obstacles by online training.
Anxiety levels, precautionary behaviours and public perceptions during the early phase of the COVID-19 outbreak in China: a population-based cross-sectional survey
Authors: Qian Mengcen , Wu Qianhui , Wu Peng , Hou Zhiyuan , Liang Yuxia , Cowling Benjamin J , Yu Hongjie
Published: October 2020

Objective

To investigate psychological and behavioural responses to COVID-19 among the Chinese general population.

Design, setting and participants

We conducted a population-based mobile phone survey between 1 February and 10 February 2020 via random digit dialling. A total of 1011 adult residents in Wuhan (n=510), the epicentre and quarantined city, and Shanghai (n=501) were interviewed. Proportional quota sampling and poststratification weighting were used. Multivariable logistic regression models were used to investigate perception factors associated with the public responses.

Primary outcome measures

We measured anxiety levels using the 7-item Generalised Anxiety Disorder Scale (GAD-7) and asked respondents to report their precautionary behaviours before and during the outbreak.

Results

The prevalence of moderate or severe anxiety was significantly higher (p<0.001) in Wuhan (32.8%) than Shanghai (20.5%). Around 79.6%–88.2% residents reported always wearing a face mask when they went out and washing hands immediately when they returned home, with no discernible difference across cities. Only 35.5%–37.0% of residents reported a handwashing duration above 40 s as recommended by the WHO. The strongest predictor of moderate or severe anxiety was perceived harm of the disease (OR 1.8, 95% CI 1.5 to 2.1), followed by confusion about information reliability (OR 1.7, 95% CI 1.5 to 1.9). None of the examined perception factors were associated with odds of handwashing duration above 40 s.

Conclusions

Prevalence of moderate or severe anxiety and strict personal precautionary behaviours was generally high, regardless of the quarantine status. Our results support efforts for handwashing education programmes with a focus on hygiene procedures in China and timely dissemination of reliable information.
Formative independent evaluation of a digital change programme in the English National Health Service: study protocol for a longitudinal qualitative study
Authors: Cresswell Kathrin , Sheikh Aziz , Dean Franklin Bryony , Krasuska Marta , Nguyen Hung , Hinder Susan , Lane Wendy , Mozaffar Hajar , Mason Kathy , Eason Sally , Potts Henry , Williams Robin
Published: October 2020

Introduction

Many countries are launching large-scale, digitally enabled change programmes as part of efforts to improve the quality, safety and efficiency of care. We have been commissioned to conduct an independent evaluation of a major national change programme, the Global Digital Exemplar (GDE) Programme, which aims to develop exemplary digital health solutions and encourage their wider adoption by creating a learning ecosystem across English National Health Service (NHS) provider organisations.

Methods and analysis

This theoretically informed, qualitative, longitudinal formative evaluation comprises five inter-related work packages. We will conduct a combination of 12 in-depth and 24 broader qualitative case studies in GDE sites exploring digital transformation, local learning and mechanisms of spread of knowledge within the Programme and across the wider NHS. Data will be collected through a combination of semistructured interviews with managers, implementation staff (clinical and non-clinical), vendors and policymakers, plus non-participant observations of meetings, site visits, workshops and documentary analysis of strategic local and national plans. Data will be analysed through inductive and deductive methods, beginning with in-depth case study sites and testing the findings against data from the wider sample and national stakeholders.

Ethics and dissemination

This work is commissioned as part of a national change programme and is therefore a service evaluation. We have ethical approval from the University of Edinburgh. Results will be disseminated at six monthly intervals to national policymakers, and made available via our publicly accessible website. We will also identify lessons for the management and evaluation of large-scale evolving digital health change programmes that are of international relevance.
Exploring how people with dementia can be best supported to manage long-term conditions: a qualitative study of stakeholder perspectives
Authors: Rees Jessica Laura , Burton Alexandra , Walters Kate R , Leverton Monica , Rapaport Penny , Herat Gunaratne Ruminda , Beresford-Dent Julie , Cooper Claudia
Published: October 2020

Objectives

To explore how the self-management of comorbid long-term conditions is experienced and negotiated by people with dementia and their carers.

Design

Secondary thematic analysis of 82 semi-structured interviews.

Setting

Community settings across the United Kingdom.

Participants

11 people with dementia, 22 family carers, 19 health professionals and 30 homecare staff.

Results

We identified three overarching themes: (1) The process of substituting self-management: stakeholders balanced the wishes of people with dementia to retain autonomy with the risks of lower adherence to medical treatments. The task of helping a person with dementia to take medication was perceived as intermediate between a personal care and a medical activity; rules about which professionals could perform this activity sometimes caused conflict. (2) Communication in the care network: family carers often communicated with services and made decisions about how to implement medical advice. In situations where family carers or homecare workers were not substituting self-management, it could be challenging for general practitioners to identify changes in self-management and decide when to intervene. (3) Impact of physical health on and from dementia: healthcare professionals acknowledged the inter-relatedness of physical health and cognition to adapt care accordingly. Some treatments prescribed for long-term conditions were perceived as unhelpful when not adapted to the context of dementia. Healthcare professionals and homecare workers sometimes felt that family carers were unable to accept that available treatments may not be helpful to people with dementia and that this sometimes led to the continuation of treatments of questionable benefit.

Conclusion

The process of substituting self-management evolves with advancement of dementia symptoms and relies on communication in the care network, while considering the impact on and from dementia to achieve holistic physical health management. Care decisions must consider people with dementia as a whole, and be based on realistic outcomes and best interests.
‘Case of the month’: a novel way to learn from endoscopy-related patient safety incidents
Authors: Ravindran Srivathsan , Matharoo Manmeet , Shaw Tim , Robinson Emma , Choy Matthew , Berry Philip , O'Donohue John , Healey Chris J , Coleman Mark , Thomas-Gibson Siwan
Published: October 2020

Patient safety incidents (PSIs) are unintended or unexpected incidents which can or do lead to patient harm. The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) acknowledges that PSIs should be reviewed by endoscopy services and learning shared among staff. It is recognised that more could be done to promote shared learning as outlined by the JAG ‘Improving Safety and Reducing Error in Endoscopy’ strategy. The ‘Case of the month’ series aims to provide a broad selection of cases and subsequent learning that can be shared among services and their workforce. This review focuses on five case vignettes that highlight a variety of PSIs in endoscopy. A structured approach, based on incident analysis methodology, is applied to each case to categorise PSIs and develop learning points. Learning is directed toward the individual, team and healthcare organisation. A selection of methods to disseminate learning at local, regional and national levels are also described.
Representing young men’s experience of anorexia nervosa: a French-language case study
Authors: Jones Katie
Published: October 2020

This article analyses two young adult (YA) novels about young men’s experience of anorexia nervosa (AN), within the dual contexts of medical humanities research into literary depictions of illness, and the broader field of YA literature about AN. While emphasising the importance of diverse literary narratives in order to raise awareness of the prevalence of AN in men and boys, and to contribute to the reduction of stigma, it also considers current research into the potentially harmful triggering effects of AN literature on vulnerable readers. It identifies Anne Percin’sPoint de côté(Side Stitch) (2006) and Simon Boulerice’sJeanne Moreau a le sourire à l’envers(Jeanne Moreau Has An Upside-Down Smile) (2013) as examples of good practice in AN literature, due to their thematic focus on male experience, and because they employ narrative strategies that disrupt reader identification with the anorexic character, and avoid focusing directly on potentially triggering descriptions of anorexic ideas and behaviour. They also contribute to diversifying the portrayal of AN via non-judgmental portrayal of lesbian, gay, bisexual, and transgender (LGBT) themes, a topic absent from equivalent YA novels currently available in English. The article further argues that literature—including fiction—contributes to the overall social and cultural discourse surrounding specific illnesses and is likely to affect patients’ real-world experiences, but that it is a specific kind of discourse in its own right, which demands to be read with the appropriate tools. Its detailed analysis of narrative voice alongside thematic content demonstrates how specific approaches from the field of literary studies may complement empirical research into literature and its place within mental health discourse.
Leaflet blade epidermis and its taxonomic significance in 13 species of Bignonieae (Bignoniaceae) from Pico do Jabre, Paraíba, northeast of Brazil
Authors: Lopes-Silva Rafael Francisco , Silva Anauara Lima e , Santos Ednalva Alves Vital dos , Agra Maria de Fátima
Published: October 2020

Bignonieae is the largest tribe of Bignoniaceae, with 21 genera and 393 species of lianas and shrubs that are 1–3-foliolate with the terminal leaflet modified as tendrils. We examined the micromorphologies of the epidermis from the leaflet blade of 13 species of Bignonieae belonging to Amphilophium, Anemopaegma, Bignonia, Cuspidaria, Dolichandra, Fridericia, Pyrostegia, Tanaecium, and Xylophragma, from Pico do Jabre, Paraíba, Brazil. These are lianas except for Tanaecium parviflorum (shrub). We sought to identify the epidermal leaflet parameters to support their taxonomy, subject to great similarities between their vegetative characters, mainly in species of the same genus and related genera. Analyses were performed using light and scanning electron microscopy, and showed five types of epicuticular waxes, four cuticle types, three epidermal cell anticlinal wall types, and nonglandular and glandular trichomes. Hypostomatic leaves showed 10 different types of stomata, with stomatal indices from 6.21% (Bignonia ramentacea) to 23.52% (Tanaecium parviflorum), and stomatal densities from 76 stomata/mm2 (Pyrostegia venusta) to 752.9 stomata/mm2 (T. parviflorum). The presence of raphides in Amphilophium crucigerum and styloids in Fridericia pubescens constitute the first records for these genera. Epidermal micromorphology provided a set of distinctive characters with which to separate these species, representing an additional tool to support their taxonomies, as well as that of tribe Bignonieae.
Morphoanatomical and biochemical changes in Zeyheria tuberculosa exposed to glyphosate drift
Authors: Freitas-Silva Larisse de , Castro Naila Diniz e , Campos da Silva Luzimar
Published: October 2020

When glyphosate is applied, some of the herbicide can reach adjacent vegetation and impact the natural plant community structure and diversity over the long term. This study evaluated the response of leaves of Zeyheria tuberculosa (Vell.) Bureau ex Verl. (Bignoniaceae) to the herbicide glyphosate. Plants were exposed to aerial applications of the herbicide at concentrations of 0, 360, 720, 1080, or 1440 g acid equivalent (a.e.)·ha−1. The concentrations of shikimic acid in leaves of the herbicide-treated plants were always higher than the controls. Visual symptoms became apparent four days after the application of 720 g·ha−1. Glyphosate induced an increase in malondialdehyde in Z. tuberculosa leaves. The lowest levels of chlorophyll a were found for the three last applied doses, and protein content decreased with the glyphosate treatment. Necrosis was observed on the epidermis and in the mesophyll. Glandular trichomes were also plasmolyzed. On the midrib there was plasmolysis of non-lignified cells. Micromorphologically, there were cell plasmolysis and rupture of glandular trichomes. Thus, glyphosate is phytotoxic to Z. tuberculosa by causing biochemical, anatomical, and morphological changes. The morphoanatomical injuries found on Z. tuberculosa were severe, suggesting that the presence of glyphosate can irreversibly affect this species and compromise its survival.
Power-law Genesis: Strong coupling and Galileon-like vector fields
Authors: Petrov P. K.
Published: October 2020

A simple way to construct models with early cosmological Genesis epoch is to employ bosonic fields whose Lagrangians transform homogeneously under scaling transformation. We show that in these theories, for a range of parameters defining the Lagrangian, there exists a homogeneous power-law solution in flat space-time, whose energy density vanishes, while pressure is negative (power-law Genesis). We find the condition for the legitimacy of the classical field theory description of such a situation. We note that this condition does not hold for our earlier Genesis model with vector field. We construct another model with vector field and power-law background solution in flat space-time, which is legitimately treated within classical field theory, violates the Null Energy Condition (NEC) and is stable. Upon turning on gravity, this model describes the early Genesis stage.
SOCIAL RESPONSIBILITY AMONG INFORMAL ENTREPRENEURS: EVIDENCE FROM MEXICO
Authors: VILLANUEVA CRISTIAN E. , ANGELES ADRIANELA , REVILLA LUZ CECILIA
Published: October 2020

Social responsibility (SR) has been widely studied within formal organizations, especially in large companies in developed countries. However, studies about SR in the informal sector is still insufficient. Addressing this gap is relevant for developing countries where informality is becoming extensive and is growing faster than the formal economy. This research has two main objectives: (1) determine whether in an informal economy context, entrepreneurs could perform SR and (2) if it is possible to have SR, to examine critically the way informal entrepreneurs perform it. To achieve these objectives, this study conducted 50 face-to-face, semi-structured interviews with informal entrepreneurs (IEs) in Mexico City. The outcome of this research shows evidence that IEs can perform SR in an implicit form, despite their adverse and vulnerable conditions.
Stratigraphic controls on hydrocarbon recovery in clastic reservoirs of the Norwegian Continental Shelf
Authors: Aliyuda Kachalla , Howell John , Hartley Adrian , Ali Aliyuda
Published: October 2020

A number of geological and engineering parameters influence and control the performance and ultimate recovery from an oil reservoir. These are commonly interlinked and the relative importance of each can be difficult to unravel. These variables include geological parameters such as depositional environment, which has long been considered to be a key factor influencing the production characteristics of fields. However, quantifying the importance of any single factor, such as depositional environment, is complicated by the impact of the other variables (geological and engineering) and their numerous interdependencies.

The main aim of this study is to unravel the impact of the depositional environment and primary facies architecture on reservoir performance using an empirical study of oilfields from the Norwegian Continental Shelf. A database of 91 fields, with a total of 7.8 Bbbl (billion barrels) of oil in place, has been built. Within this a total of 93 clastic reservoirs were classified into three gross depositional environments: continental, paralic/shallow marine and deep marine. The reservoirs were further classified into eight depositional environments in order to provide further granularity and to capture their depositional complexities. A further 28 parameters which capture other aspects that also impact production behaviour, such as reservoir depth, fluid type and structural complexity, were recorded for each reservoir. Principal component analysis (PCA) was utilized to explore the importance of sedimentological-dependent variables in the dataset, and to determine the parameters that have the strongest influence on the overall variability of the dataset. PCA revealed that parameters associated with field size and depth of burial had the most influence on recovery factor. Gross depositional environment and other stratigraphic-dependent parameters were the most significant geological factors. Fluid properties, such as API gravity and average gas/oil ratio, were unexpectedly among the less important parameters.
A Challenging Reality: Transitioning from the classroom to e-learning among English language learners
Authors: Floyd Joel
Published: October 2020

In the wake of COVID-19, both K-12 and post-secondary institutions have had to transition from traditional learning in the classroom to teaching and learning through various online and or e-learning platforms. With such an abrupt transition, it's important for educators to explore the effectiveness of e-learning among their student populations. Moreover, this narrative discussion is facilitated by a program director who oversees an adult education English as a second language program located in Atlanta, Georgia. The director maintains the opinion that various modes of online learning are not the best learning method for all student populations and specifically adult English language learners. In addition, the discussion gives a brief overview of English language learners and their challenges with e-learning instructional methods in this school's adult education ESL program.
Neural Development of Memory and Metamemory in Childhood and Adolescence: Toward an Integrative Model of the Development of Episodic Recollection
Authors: Ghetti Simona , Fandakova Yana
Published: October 2020

Memory and metamemory processes are essential to retrieve detailed memories and appreciate the phenomenological experience of recollection. Developmental cognitive neuroscience has made strides in revealing the neural changes associated with improvements in memory and metamemory during childhood and adolescence. We argue that hippocampal changes, in concert with surrounding cortical regions, support developmental improvements in the precision, complexity, and flexibility of memory representations. In contrast, changes in frontoparietal regions promote efficient encoding and retrieval strategies. A smaller body of literature on the neural substrates of metamemory development suggests that error monitoring processes implemented in the anterior insula and dorsal anterior cingulate cortex trigger, and perhaps support the development of, metacognitive evaluationsin the prefrontal cortex, while developmental changes in the parietal cortex support changes in the phenomenological experience of episodic retrieval. Our conclusions highlight the necessity of integrating these lines of research into a comprehensive model on the neurocognitive development of episodic recollection.
New investigator editorial: the osteopathic medical student perspective on research
Authors: Persand Dhandevi , Maddie Nicole
Published: October 2020

Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/behind-the-bench-episode7/ .
The Effect of Atopy in the Prevalence of Contact Sensitization: The Experience of a Greek Referral Center
Authors: Tagka Anna , Lambrou George I. , Nicolaidou Electra , Gregoriou Stamatios G. , Katsarou-Katsari Alexandra , Rigopoulos Dimitrios
Published: October 2020

Contact dermatitis is a well-known skin condition, which is related to stimuli and environmental exposure to chemicals, affecting all ages as well as both genders. In the present work, we attempt to investigate the patterns of contact sensitization, with respect to the personal history of atopy (AT), in Greece in a large number of allergens, using patch testing. The retrospective analysis included clinical routine data of 1978 patients collected from 2014 to 2016 in the Laboratory of Patch Testing, National Referral Centre of Occupational Dermatoses. Sensitization, in all cases, was tested with 28 allergens of the European baseline series as adjusted to our local circumstances and clinical experience. A total population of 1978 patients was evaluated, with a male-to-female ratio of 0.45 (1359 females/619 males). From our patient cohort, 693 (35%) patients were evaluated with a history of atopy, while 1285 (65%) were nonatopic. The five most prevalent allergens in the total population without AT were nickel sulphate 5% (15.47%), fragrance mix (I) 8% (9.10%), balsam of Peru (6.47%), cobalt chloride 1% (4.70%), and thiomersal 0.1% (4.10%). Respectively, in the total population with AT, the five most prevalent allergens were nickel sulphate 5% (10.36%), fragrance mix (I) 8% (5.11%), balsam of Peru (3.29%), thiomersal 0.1% (3.03%), and cobalt chloride 1% (2.78%). Contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease. Further studies should be directed towards that end, in order to facilitate more effective health policies.
Unstimulated Serum Thyroglobulin Levels after Thyroidectomy and Radioiodine Therapy for Intermediate-Risk Thyroid Cancer Are Not Always a Reliable Marker of Lymph Node Recurrence: Case Report and a Lesson for Clinicians
Authors: Foppiani Luca , Sola Simona , Cabria Manlio , Bottoni Gianluca , Piccardo Arnoldo
Published: October 2020

Over 50% of patients with papillary thyroid carcinoma (PTC) have cervical lymph-node metastasis on diagnosis, and up to 30% show nodal recurrence after surgery plus radioactive iodine (131I) (RAI) therapy. The combination of ultrasonography (US) and fine-needle aspiration cytology (FNAC) and the measurement of thyroglobulin (Tg) in washout fluid are cornerstones in the diagnosis of nodal metastasis. In the absence of anti-Tg antibodies, unstimulated serum thyroglobulin (Tg) levels are generally a reliable marker of recurrent disease, and 18F-FDG positron emission tomography (PET)/computed tomography (CT) plays an important role in the imaging work-up. We report the case of a 65-year-old man evaluated for a large multinodular goitre which caused compressive symptoms; the dominant nodule in the left lobe presented suspicious features on US. Thyroid function showed subclinical hypothyroidism, calcitonin was normal, serum thyroglobulin levels were low, and anti-thyroid antibodies were absent. The prevalent left nodule showed an intense uptake on 18F-FDG PET/CT but proved benign at FNAC. On the basis of the suspicious clinical and imaging features, total thyroidectomy was performed. Histology revealed a tall-cell variant of PTC with scattered expression of Tg and diffuse high expression of cytokeratin (CK) 19; RAI therapy was performed. Within 6 years of surgery, left laterocervical lymph-node recurrence was twice detected (first at levels II and III, then at levels IV and VI) by US and 18F-FDG-PET/CT and was confirmed by FNAC. Tg levels in the washout fluid proved clearly diagnostic of metastasis only in the second, larger, recurrence, whereas serum Tg levels (in the absence of anti-Tg antibodies) always remained undetectable on L-thyroxine therapy. Surgery was performed on both recurrences, and histology confirmed lymph-node metastasis of PTC. Immunohistochemical expression of Tg and CK 19 was similar to that of the primary tumour. No further relapses have occurred to date. Posttherapy (surgery and RAI) unstimulated serum Tg levels may not be a reliable marker of nodal recurrence in patients with differentiated thyroid cancer (DTC) that produces low amounts of Tg.