bluuebunny/crossref_metadata_2025 huggingface dataset:
Why do delays to diagnosis and treatment of lung cancer occur? A mixed methods study of insights from Australian clinicians
Authors: Malalasekera Ashanya , Dhillon Haryana M. , Shunmugasundaram Chindhu , Blinman Prunella L. , Kao Steven C. , Vardy Janette L.
Published: April 2020

Aims

Delays in lung cancer diagnosis and treatment can impact survival. We explored reasons for delays experienced by patients with lung cancer to identify themes and strategies for improvement.

Methods

We used national timeframe recommendations and standardized definitions to identify General Practitioners and specialists caring for 34 patients who experienced delays in our previous Medicare data linkage study. Clinicians participated in a survey and interview, including qualitative (exploratory, open‐ended questions) and quantitative (rating scales) components. Exploratory content analysis, cross‐case triangulation, and descriptive statistics were performed. Krippendorff's coefficient was used to assess level of agreement between clinicians and patients, and among clinicians, on perceived delays.

Results

Overall, 27 out of 50 (54%) eligible clinicians participated (including 11 respiratory physicians and seven medical oncologists). Dominant themes for perceived causes of delay included referral barriers, limited General Practitioner (GP) awareness of subtle clinical presentations, insufficient radiology interpretation, and lack of cancer coordinators. “Unavoidable” delays may occur due to clinical circumstances. Awareness and uptake of referral and timeframe guidelines were low, with clinicians using professional networks over guidelines. There was no consistent agreement on perceived delays between patients and clinicians, and among clinicians (Krippendorff's coefficient .03 [P = .8]).

Conclusions

Strategies for minimizing avoidable delays include efficient GP to specialist referral and more lung cancer coordinators to assist with patient expectations and waitlist management. Clinicians’ reliance on experience, rather than guidelines, indicates need to review guideline utility. Raising awareness of benchmarks and unavoidable barriers may recalibrate perceptions of “delays” to diagnosis and treatment of lung cancer.
TCRs with segment TRAV9‐2 or a CDR3 histidine are overrepresented among nickel‐specific CD4+ T cells
Authors: Aparicio‐Soto Marina , Riedel Franziska , Leddermann Melanie , Bacher Petra , Scheffold Alexander , Kuhl Heiner , Timmermann Bernd , Chudakov Dmitriy M. , Molin Sonja , Worm Margitta , Heine Guido , Thierse Hermann‐Josef , Luch Andreas , Siewert Katherina
Published: April 2020

Background

Nickel is the most frequent cause of T cell–mediated allergic contact dermatitis worldwide. In vitro, CD4+ T cells from all donors respond to nickel but the involved αβ T cell receptor (TCR) repertoire has not been comprehensively analyzed.

Methods

We introduce CD154 (CD40L) upregulation as a fast, unbiased, and quantitative method to detect nickel‐specific CD4+ T cells ex vivo in blood of clinically characterized allergic and non allergic donors. Naïve (CCR7+ CD45RA+) and memory (not naïve) CD154+ CD4+ T cells were analyzed by flow cytometry after 5 hours of stimulation with 200 µmol/L NiSO4., TCR α‐ and β‐chains of sorted nickel‐specific and control cells were studied by high‐throughput sequencing.

Results

Stimulation of PBMCs with NiSO4induced CD154 expression on ~0.1% (mean) of naïve and memory CD4+ T cells. In allergic donors with recent positive patch test, memory frequencies further increased ~13‐fold and were associated with markers of in vivo activation. CD154 expression was TCR‐mediated since single clones could be specifically restimulated. Among nickel‐specific CD4+ T cells of allergic and non allergic donors, TCRs expressing the α‐chain segment TRAV9‐2 or a histidine in their α‐ or β‐chain complementarity determining region 3 (CDR3) were highly overrepresented.

Conclusions

Induced CD154 expression represents a reliable method to study nickel‐specific CD4+ T cells. TCRs with particular features respond in all donors, while strongly increased blood frequencies indicate nickel allergy for some donors. Our approach may be extended to other contact allergens for the further development of diagnostic and predictive in vitro tests.
Impact of the 2016 ASE/EACVI Guidelines on diastolic function reporting in routine clinical practice
Authors: Gopalakrishnan Prabhakaran , Biederman Robert
Published: April 2020

Objective

To evaluate the impact of 2016 ASE/EACVI guidelines on Diastolic Function (DF) reporting during routine clinical practice.

Methods

Transthoracic echos performed 9 months before and 18 months after the 2016 guidelines (DF2016) were retrospectively analyzed.

Results

Twenty thousand eight hundred forty three echos performed between July 1, 2015, and September 30, 2017, were analyzed. Quarterly trends showed a stable proportion of normal DF (nDF), diastolic dysfunction (DD), indeterminate DF (DF‐I), and nonreported DF (DF‐NR) for 3 quarters preceding DF2016. After DF2016 release, reporting of DD decreased by 57% (P < .001), nDF increased by 76% (P < .001), DF‐NR increased by 266% (P < .001), and DF‐I did not change significantly (P = .40). Grade 1 DD decreased by 64% (P < .001), grade 2 DD decreased by 51% (P < .001), and grade 3 DD did not change significantly (P = .18). Provider level analysis showed increased heterogeneity in grade 1 DD reporting and decreased heterogeneity in DD grades 2 or higher, after DF2016. Systolic dysfunction reporting remained relatively stable (22%→21%→20%) compared to a significant decrease in isolated DD (35%→21%→10%).

Conclusion

The 2016 guidelines update has impacted DF reporting patterns significantly. The likelihood of reporting DD decreased significantly, especially for grades 1 and 2. Inter‐provider heterogeneity in DF reporting improved for grades 2 and 3 but worsened for grade 1. There was more than threefold increase in failure to report DF, suggesting a decrease in provider confidence.
In vitro synergy of eugenol on the antifungal effects of voriconazole against Candida tropicalis and Candida krusei strains isolated from the genital tract of mares
Authors: Sharifzadeh Aghil , Shokri Hojjatollah
Published: April 2020

Background

Due to the limited range of antifungals available to treat genital Candida infections and the emergence of resistant isolates, attention has focused on the antifungal potency of natural compounds with promising biological properties.

Objectives

To examine whether eugenol synergises the in vitro efficacy of voriconazole against Candida strains isolated from the genital tract of mares.

Study design

In vitro experiment.

Methods

The antifungal activity of eugenol and voriconazole was evaluated using the broth microdilution assay (CLSI‐ M27‐A3). Synergism of eugenol and voriconazole against genital Candida isolates was evaluated by the microdilution checkerboard method.

Results

Minimum inhibitory concentration (MIC) values for eugenol and voriconazole ranged from 400 to 800 µg/mL and 1 to 8 µg/mL, respectively, for C. tropicalis isolates, and from 200 to 400 µg/mL for eugenol and 2 to 16 µg/mL for voriconazole against C. krusei isolates. Eugenol decreased the arithmetic mean MIC for voriconazole against C. tropicalis and C. krusei isolates from 2.66 to 0.46 µg/mL and 7.77 to 0.41 µg/mL respectively. The fractional inhibitory concentration index (FICI) values for the eugenol‐voriconazole combination ranged from 0.25 to 0.88 and 0.19 to 0.63 for C. tropicalis and C. krusei isolates respectively. A synergistic effect of eugenol in combination with voriconazole was observed for 83.3% of C. tropicalis and 77.7% of C. krusei isolates. Antagonistic activity was not seen in any of the isolates tested.

Main limitations

Since in vitro antifungal susceptibility tests are not systematic analyses, any selection bias could influence the results. In addition, in vitro susceptibility does not uniformly predict clinical success in vivo.

Conclusions

Eugenol showed fungistatic and fungicidal effects against genital Candida isolates and, in combination, synergised the antifungal effects of voriconazole. The eugenol‐voriconazole combination can lay the foundation for a therapeutic approach against isolates in which azole resistance has increased over time.
Moving targets: Target groups of active labour market policies and transitions to employment in Europe
Authors: Fredriksson Daniel
Published: April 2020

This study drew on recurrent debates related to labour market mobility among the unemployed and those outside the labour force and asked to what extent active labour market policies (ALMP) increase employment in these two groups. By utilising new programme‐level data on ALMP, the study analysed the impact of core programmes directed towards registered unemployed; peripheral programmes that target the inactive part of the working age population; and mixed programmes targeting both groups. The programme data were combined with individual‐level panel data from the European Survey on Income and Living Conditions and analysed using multilevel analysis. The main results show that both resources devoted to programmes and their size were related to employment transitions. Transitions among the unemployed were mainly associated with spending on core programmes, whereas the inactive seemed to benefit from increased spending on all types of programmes, as well as increased scope of mixed programmes.
Influenza vaccine effectiveness among outpatients in the US Influenza Vaccine Effectiveness Network by study site 2011‐2016
Authors: Balasubramani Goundappa K. , Nowalk Mary Patricia , Sax Theresa M. , Suyama Joe , Bobyock Emily , Rinaldo Charles R. , Martin Emily T. , Monto Arnold S. , Jackson Michael L. , Gaglani Manjusha J. , Flannery Brendan , Chung Jessie R. , Zimmerman Richard K.
Published: April 2020

Background

Influenza vaccination is recommended for all US residents aged ≥6 months. Vaccine effectiveness (VE) varies by age, circulating influenza strains, and the presence of high‐risk medical conditions. We examined site‐specific VE in the US Influenza VE Network, which evaluates annual influenza VE at ambulatory clinics in geographically diverse sites.

Methods

Analyses were conducted on 27 180 outpatients ≥6 months old presenting with an acute respiratory infection (ARI) with cough of ≤7‐day duration during the 2011‐2016 influenza seasons. A test‐negative design was used with vaccination status defined as receipt of ≥1 dose of any influenza vaccine according to medical records, registries, and/or self‐report. Influenza infection was determined by reverse‐transcription polymerase chain reaction. VE estimates were calculated using odds ratios from multivariable logistic regression models adjusted for age, sex, race/ethnicity, time from illness onset to enrollment, high‐risk conditions, calendar time, and vaccination status‐site interaction.

Results

For all sites combined, VE was statistically significant every season against all influenza and against the predominant circulating strains (VE = 19%‐50%) Few differences among four sites in the US Flu VE Network were evident in five seasons. However, in 2015‐16, overall VE in one site was 24% (95% CI = −4%‐44%), while VE in two other sites was significantly higher (61%, 95% CI = 49%‐71%; P = .002, and 53%, 95% CI = 33,67; P = .034).

Conclusion

With few exceptions, site‐specific VE estimates aligned with each other and overall VE estimates. Observed VE may reflect inherent differences in community characteristics of the sites and highlights the importance of diverse settings for studying influenza vaccine effectiveness.
Experimental strategy to determine nitrogen catalytic behavior of high‐temperature woven ceramics
Authors: Meyers Jason M. , Owens Walten P. , Fletcher Douglas G.
Published: April 2020

New vehicle deceleration strategies have led to the development of deployable thermal protection systems with woven fabric outer layers that can withstand the harsh aerothermal environment of planetary entry. In this work, we present an experimental strategy for testing fabric samples and a method to determine nitrogen catalytic efficiency, γN, from two‐photon laser‐induced fluorescence measurements of recombining nitrogen atoms near the sample surface. Measurements were made on other silicon carbide materials to better understand the influence of the fabric structure and porosity on catalytic recombination. The three test materials studied were a monolithic α‐SiC, a CVD β‐SiC, and a single‐ply, Hi‐Nicalon β‐SiC fabric layup. Extracted catalytic efficiencies for atomic nitrogen recombination for monolithic α‐SiC, CVD β‐SiC, and single‐ply β‐SiC fabric are (6.18 ± 1.55) × 10−4 (at 1460 K), (3.59 ± 0.90) × 10−3 (at 1500 K), and (8.34 ± 2.19) × 10−4 (at 1675 K), respectively. This would categorize these materials as low‐catalytic materials for nitrogen atom recombination in this temperature range.
Collateral injury of the conduction system during catheter ablation of septal substrate in nonischemic cardiomyopathy
Authors: Muser Daniele , Santangeli Pasquale , Castro Simon A. , Liang Jackson J. , Enriquez Andres , Liuba Ioan , Magnani Silvia , Garcia Fermin C. , Arkles Jeffrey , Supple Gregory G. , Lin David , Schaller Robert D. , Kumareswaran Ramanan , Zado Erica , Tschabrunn Cory M. , Dixit Sanjay , Frankel David S. , Callans David J. , Marchlinski Francis E.
Published: April 2020

Introduction

In patients with nonischemic cardiomyopathy (NICM) little is known about the clinical impact of catheter ablation (CA) of septal ventricular tachycardia (VT) resulting in the collateral injury of the conduction system (CICS).

Methods and Results

Ninety‐five consecutive patients with NICM underwent CA of septal VT. Outcomes in patients with no baseline conduction abnormalities who developed CICS (group 1, n = 28 [29%]) were compared to patients with no CICS (group 2, n = 17 [18%]) and to patients with preexisting conduction abnormalities or biventricular pacing (group 3, n = 50 [53%]). Group‐1 patients were younger, had a higher left ventricular ejection fraction and a lower prevalence of New York Heart Association III/IV class compared to group 3 while no significant differences were observed with group 2. After a median follow‐up of 15 months, VT recurred in 14% of patients in group 1, 12% in group 2 (P = .94) and 32% in group 3 (P = .08) while death/transplant occurred in 14% of patients in group 1, 18% in group 2 (P = .69) and 28% in group 3 (P = .15). A worsening of left ventricular ejection fraction (LVEF) (median LVEF variation, −5%) was observed in group 1 compared to group 2 (median LVEF variation, 0%; P < .01) but not group‐3 patients (median LVEF variation, −4%; P = .08) with a consequent higher need for new biventricular pacing in group 1 (43%) compared to group 2 (12%; P = .03) and group 3 (16%; P < .01).

Conclusions

In patients with NICM and septal substrate, sparing the abnormal substrate harboring the conduction system provides acceptable VT control while preventing a worsening of the systolic function.
Plasma iron concentrations and systemic inflammatory response syndrome in neonatal foals
Authors: Sanmartí Júlia , Armengou Lara , Viu Judit , Alguacil Eduardo , Civit Sandra , Ríos José , Jose‐Cunilleras Eduard
Published: April 2020

Background

Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published.

Objectives

To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker.

Animals

Forty‐seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non‐SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal foals were also included.

Methods

Observational prospective study. Data were summarized by mean and its 95% confidence interval and absolute frequency and percentage for quantitative andqualitative variables. One‐way ANOVA, ANCOVA (group and age effects) and Dunnett as posthoc analysis were used to compare plasma iron concentration among groups.

Results

Neonatal foals with SIRS did not have had any statistically significant different plasma iron concentrations compared to non‐SIRS (P = .56) and stud farm control group (P = .99), 172.8 μg/dL (95% CI; 126.0‐219.6), 193.1 μg/dL (139.1‐247.2), and 181.8 μg/dL (171.3‐192.4), respectively. Plasma iron concentration had a large variability in healthy neonatal foals, and was negatively correlated with age in hospital controls (rho = −0.387) and sick neonatal foals (rho = −0.598) (P < .001).

Conclusions and Clinical Importance

Plasma iron was not a useful marker of SIRS in neonatal foals and was not associated with outcome.
Certified Coronavirus Immunity as a Resource and Strategy to Cope with Pandemic Costs
Authors: Eichenberger Reiner , Hegselmann Rainer , Savage David A. , Stadelmann David , Torgler Benno
Published: April 2020

A pandemic is not only a biological event and a public health disaster, but it also generates impacts that are worth understanding from economic, societal, historical, and cultural perspectives. In this contribution, we argue that as the disease spreads, we are able to harness a valuable key resource: people who have immunity to coronavirus. This vital resource must be effectivelyemployed, it must becertified, it must besearchedfor, it must befound, and it may even beactively produced. We discuss why this needs to be done and how this can be achieved. Our arguments not only apply to the current pandemic but also to any future rapidly spreading, infectious disease epidemics. In addition, we argue for high awareness of a major secondary, nonbiological crisis arising from the side effects of societal and economic pandemic reactions to actual or imagined health risks. There is a risk that the impacts of the secondary crisis could outweigh that of the biological event.
Falling Between the Cracks: Discrimination Laws and Older Women
Authors: McLaughlin Joanne Song
Published: April 2020

Theories and evidence suggest that older women may experience unique discrimination for being both old and female in the workplace. To provide a remedy for this type of discrimination — known as intersectional discrimination — legal scholars argue that age and sex discrimination laws must be used jointly and acknowledge intersectional discrimination (age‐plus‐sex or sex‐plus‐age discrimination) as a separate cause of action. Nonetheless, in general, courts have declined to do so even though older women are protected under both age and sex discrimination laws. This raises a concern that age discrimination laws may be ineffective, or less effective in protecting older women. I test this implication by estimating the differential effect of age discrimination laws on labor market outcomes between older women and older men. My findings show that age discrimination laws did far less to improve labor market outcomes for older women than for older men. These results may explain the persistent findings of discrimination against older women in the existing literature and support the legal scholars' argument that older women's intersectional discrimination must be recognized as a separate cause of action.
Asset pricing with heterogeneous beliefs and illiquidity
Authors: Muhle‐Karbe Johannes , Nutz Marcel , Tan Xiaowei
Published: April 2020

This paper studies the equilibrium price of an asset that is traded in continuous time between N agents who have heterogeneous beliefs about the state process underlying the asset's payoff. We propose a tractable model where agents maximize expected returns under quadratic costs on inventories and trading rates. The unique equilibrium price is characterized by a weakly coupled system of linear parabolic equations which shows that holding and liquidity costs play dual roles. We derive the leading‐order asymptotics for small transaction and holding costs which give further insight into the equilibrium and the consequences of illiquidity.
Socially adaptive belief
Authors: Williams Daniel
Published: April 2020

I clarify and defend the hypothesis that human belief formation is sensitive to social rewards and punishments, such that beliefs are sometimes formed based on unconscious expectations of their likely effects on other agents – agents who frequently reward us when we hold ungrounded beliefs and punish us when we hold reasonable ones. After clarifying this phenomenon and distinguishing it from other sources of bias in the psychological literature, I argue that the hypothesis is plausible on theoretical grounds and I show how it illuminates and unifies a range of psychological phenomena, including confabulation and rationalisation, positive illusions, and identity‐protective cognition.
Pivotal Events Driving Organizational and Institutional Transformation
Authors: Cutcher‐Gershenfeld Joel
Published: April 2020

For the Ford Motor Company and the United Automobile Workers Union, fifty‐six pivotal events over three decades add up to a transformation in organizational and institutional arrangements. Compared to much of the literature on critical moments, which involves micro analysis of turning points in a single negotiation, this is a meso and macro study where deeply embedded cultural assumptions were “on the table” and, where effectively resolved, constituted an organizational or institutional pivot. Many pivotal events were planned, either as part of a formal negotiation or a large‐scale change initiative, requiring intentionally orchestrated critical moments. Others were unplanned and called for improvisational critical moments. The pivotal events also included situations where transformative potential was present, but the results fell short of the potential—a circumstance (noting what could have happened, but didn’t) that is not usually documented in the literature on critical moments. Not all critical moments in negotiations result in a pivotal event, let alone an organizational or institutional transformation, but this paper documents ways to connect the dots across these micro, meso, and macro levels of analysis.
New parameter for quantifying bolus transit with high‐resolution impedance manometry: A comparison with simultaneous esophagogram
Authors: Gong Eun Jeong , Choi Kyungmin , Jung Kee Wook , Pandolfino John. E. , Kim Do Yeon , Yoon In Ja , Seo So Young , Koo Hyun Sook , Na Hee Kyong , Ahn Ji Yong , Lee Jeong Hoon , Choi Kee Don , Kim Do Hoon , Song Ho June , Lee Gin Hyug , Jung Hwoon‐Yong , Myung Seung‐Jae , Kim Nayoung , Joo Segyeong
Published: April 2020

Background

Esophageal bolus transit can be assessed using esophagogram or high‐resolution impedance manometry (HRIM). The three‐dimensional volume of inverted impedance (VII) has been developed to quantify the residual bolus between each swallow through spatiotemporal analysis. However, this novel metric has not been validated against simultaneous esophagogram.

Methods

A total of nine healthy volunteers (Seven males, aged 19‐45 years) were prospectively evaluated with HRIM and barium esophagogram. In addition, 21 symptomatic patients (12 males, aged 20‐85 years) without major motility disorder were also included. The VII was estimated from HRIM data using MATLAB program and was compared with residual bolus volume in the esophagus estimated from simultaneous esophagogram.

Key results

A total of 80 swallows (24 in controls and 56 in patients) were analyzed. Results from the VII method were concordant with the bolus transit pattern estimated from the esophagogram in 91.3% (73/80) of swallows. The correlation between quantitative data from VII and the volume of residual bolus estimated from esophagogram was strong in both groups with a Pearson's correlation coefficient of 0.805 for healthy volunteers and 0.730 for symptomatic patients. The intraclass correlation coefficient of VII between the three swallows within a subject was 0.901 in healthy subjects and 0.705 in patients, indicating a modest reliability of this method.

Conclusions and inferences

The newly developed VII method is a reliable method in assessing residual bolus volume in the esophagus based on comparison with bolus volume estimated from simultaneous esophagogram.
Cardiopulmonary resuscitation in pediatric pectus excavatum patients—Where is the heart?
Authors: Jang Young‐Eun , Park Jung‐Bin , Kang Chang-Hyun , Park Samina , Kim Eun‐Hee , Lee Ji‐Hyun , Kim Hee‐Soo , Kim Jin‐Tae
Published: April 2020

Background

In children with pectus excavatum, the posteriorly depressed sternum compresses and displaces the heart. However, the currently recommended compression site and depth for cardiopulmonary resuscitation have not been studied in this population.

Aim

This retrospective study investigated the location of the center of ventricles with the largest cross‐sectional area to determine the optimal site and depth for chest compressions in pediatric pectus excavatum patients.

Methods

Chest computed tomography images of 94 pediatric pectus excavatum patients before and after correction surgery were compared with normal patients. The caudal displacement of the ventricles was calculated by dividing the length of sternum by the length from the suprasternal notch to the transverse level of the largest cross‐sectional area of the ventricles. The proportional leftward deviation of the center of the ventricles from the midline versus transverse diameter of the thorax was calculated. The remaining internal thickness was calculated at the midline assuming the recommended compression depth of one‐third of the anterior to posterior diameter.

Results

Compared with the normal population (mean = 81% [SD = 10.3%]), pediatric pectus excavatum patients showed caudal displacement of ventricles before (98.2% [15.1%], 95% CI of mean difference; 13.7%‐20.5%, P < .001) and after correction (100.4% [13.5%], 95% CI of mean difference; 16.2%‐22.5%, P < .001). Compared with the normal population (6.9% [2.7%]), pediatric pectus excavatum patients showed leftward deviation of ventricles before (16.2% [5.5%], 95% CI of mean difference; 8.2%‐10.4%, P < .001) and after correction (13.3% [4.8%], 95% CI of mean difference; 5.3%‐7.3%, P < .001). The remaining internal thickness assuming the recommended chest compression was <10 mm in 54/94(57.4%) and 18/94 (19.1%) of pediatric pectus excavatum patients before and after correction, respectively.

Conclusions

Pediatric pectus excavatum patients showed significant caudal displacement and leftward deviation of the ventricles compared with the normal population despite correction surgery and the currently recommended compression site and depth might injure intrathoracic structures without effective cardiac compression during cardiopulmonary resuscitation.
Rockin' in rhythm, growth dynamics of the peat moss Sphagnum
Authors: van Es Sam W.
Published: April 2020

The genus Sphagnum is an essential component in the formation and maintenance of high latitude peatlands, bogs and mires. The species grows in dense, extended mats of agglomerated shoots that allow it to retain water necessary for its growth. These mats are partly responsible for maintaining the right conditions for other species in these wetlands to thrive. In this issue of Physiologia Plantarum, Mironov et al. (2020) monitored the growth of Sphagnum riparium for a period of 4 years and revealed three distinct growth rhythms: a seasonal temperature dependent, a circalunar and a third one, synchronized with the circalunar. This synchronised nature of Sphagnum growth could contribute to its position as a key species in the maintenance of peatlands.
Testing the validity and reliability of the doping willingness in sport scale
Authors: Stanger Nicholas , Whitaker Lisa , Backhouse Susan H.
Published: April 2020

Although research investigating doping in sport is burgeoning, there is still a lack of proxy measures of doping behavior that have undergone extensive psychometric testing. To address this issue, we modified a previously used measure of doping willingness in sport and tested aspects of validity and reliability across four studies. In Study 1, we provided support for the face and content validity of the items, and then found support for the factor structure of the scale in a sample of athletes (N = 205) using confirmatory factor analysis. In Study 2, we collected data from an independent sample of athletes (N = 236) to provide further evidence for the factor structure of the scale using confirmatory factor analysis as well as provided evidence for concurrent and discriminant validity. In Study 3, a further independent sample of athletes (N = 144) completed the scale and provided support for discriminant and predictive validity of the scale. In Study 4, we collected data from a further independent sample (N = 74) to provide support for the test‐retest reliability, and stability of items. Lastly, a confirmatory factor analysis was conducted on the samples across Studies 3 and 4, and the composite sample across all four studies which provided further support for the factor structure of the final 8‐item scale. Taken together, these findings provide psychometric support for the scale to be used to measure the willingness of athletes to use banned substances to help facilitate future research investigating doping in sport.
Combining physical performance and Functional Movement Screen testing to identify elite junior Australian Football athletes at risk of injury
Authors: Jones Stephen C. , Fuller Joel T. , Chalmers Samuel , Debenedictis Thomas A. , Zacharia Andrew , Tarca Brett , Townsley Alex , Milanese Steve
Published: April 2020

The Functional Movement Screen (FMS) and physical performance testing are often suggested to be related to sports injury risk. This study explored if the combination of FMS and physical performance testing improved identification of non‐contact injury risk over FMS testing alone in an elite junior Australian football cohort. Over a 3‐year period, 573 players completed pre‐season injury history questionnaires, FMS, physical performance testing (20‐m sprint, vertical jump, planned agility testing, and shuttle run test), and subsequent in‐season injury surveillance. Results: Neither previous injury or FMS score <14 were related to an increased risk of subsequent injury in isolation. The combination of FMS composite score ≤14 and previous injury moderately increased the risk of injury (Hazard ratio [HR] = 2.22 [1.09‐4.54]). None of the physical performance measures improved the ability to predict injuries based on FMS composite score. FMS asymmetry was only associated with injury when combined with previous injury and vertical jump performance. Players with ≥1 FMS asymmetry and history of previous injury experienced a large increase in injury risk when vertical jump was poor (HR = 4.26 [1.35‐13.42]) or good (HR = 3.17 [1.08‐9.29]). Players with a combination of a good vertical jump, no previous injury, and no FMS asymmetries were also at moderately increased risk of injury (HR = 3.41 [1.11‐10.42]). No physical performance tests improved the ability to identify non‐contact injury risk using an FMS composite score threshold. However, a U‐shaped relationship between vertical jump and injury risk was identified with both poor and good vertical jump height associated with a moderate‐large increase in non‐contact injury risk in the presence of ≥1 asymmetrical FMS sub‐test.
On the Aperiodic Signal Amplification by Rescaled Vibrational Resonance in Fractional-Order Duffing Oscillators
Authors: Jia Pengxiang , Leng Yonggang , Yang Jianhua
Published: April 2020

In the former works of Yang et al., they put forward two vibrational resonance (VR) methods in fractional Duffing oscillators to amplify the weak harmonic character signal with arbitrary high-frequency. Moreover, the aperiodic character signal is also a common signal form in practical engineering. For the “fast-changing” aperiodic character signal in time domain, the classical VR method is difficult to amplify it effectively. To solve this problem, an aperiodic signal amplification method based on rescaled VR in fractional-order Duffing oscillators is proposed. Take the bipolar binary random signals with arbitrary minimal pulse width as an example, the rescaled VR under the overdamped and underdamped conditions can be realized by matching the signal parameters and system parameters effectively, and the amplification of aperiodic signal can be achieved.
Design and evaluation of personal audio systems based on speech privacy constraints
Authors: Wallace Daniel , Cheer Jordan
Published: April 2020

Personal audio refers to the generation of spatially distinct sound zones that allow individuals within a shared space to listen to their own audio material without affecting, or being affected, by others. Recent interest in such systems has focussed on their performance in public spaces where speech privacy is desirable. To achieve this goal, speech is focussed towards the target listener and a masking signal is focussed into the area where the target speech signal could otherwise be overheard. An effective masking signal must substantially reduce the intelligibility in this region without becoming an annoyance to those nearby. To assess these perceptual requirements, listening tests were carried out using two examples of loudspeaker arrays with different spatial aliasing characteristics, to determine the impacts of different masking signal spectra on speech intelligibility and subjective preference. The results of these tests were used, alongside objective and subjective metrics, to form a design specification for private personal audio systems.
Sablefish (Anoplopoma fimbria) produce high frequency rasp sounds with frequency modulation
Authors: Riera Amalis , Rountree Rodney A. , Agagnier Lucas , Juanes Francis
Published: April 2020

Sablefish sounds, named rasps, were recorded at two captive facilities in British Columbia and Washington State. Rasps consisted of highly variable broadband trains of 2 to 336 ticks that lasted between 74 and 10 500 ms. The 260 rasps that were measured contained frequencies between 344 and 34 000 Hz with an average peak frequency of 3409 Hz. The frequency structure of ticks within rasps was highly variable and included both positive and negative trends. This finding makes sablefish one of the few deep-sea fish for which sounds have been validated and described. The documentation of sablefish sounds will enable the use of passive acoustic monitoring methods in fisheries and ecological studies of this commercially important deep-sea fish.
Engineering an empire
Authors: Wade Lizzie
Published: April 2020

Ingenious water management helped the ancient Wari state expand throughout the Andes. Why couldn't it survive a drought?
Meeting fisheries, ecosystem function, and biodiversity goals in a human-dominated world
Authors: Cinner Joshua E. , Zamborain-Mason Jessica , Gurney Georgina G. , Graham Nicholas A. J. , MacNeil M. Aaron , Hoey Andrew S. , Mora Camilo , Villéger Sébastien , Maire Eva , McClanahan Tim R. , Maina Joseph M. , Kittinger John N. , Hicks Christina C. , D’agata Stephanie , Huchery Cindy , Barnes Michele L. , Feary David A. , Williams Ivor D. , Kulbicki Michel , Vigliola Laurent , Wantiez Laurent , Edgar Graham J. , Stuart-Smith Rick D. , Sandin Stuart A. , Green Alison L. , Beger Maria , Friedlander Alan M. , Wilson Shaun K. , Brokovich Eran , Brooks Andrew J. , Cruz-Motta Juan J. , Booth David J. , Chabanet Pascale , Tupper Mark , Ferse Sebastian C. A. , Sumaila U. Rashid , Hardt Marah J. , Mouillot David
Published: April 2020

A complex landscape for reef management

Coral reefs are among the most biodiverse systems in the ocean, and they provide both food and ecological services. They are also highly threatened by climate change and human pressure. Cinner
et al.
looked at how best to maximize three key components of reef use and health: fish biomass, parrotfish grazing, and fish trait diversity. They found that when human pressure is low, all three traits can be maximized at high conservation levels. However, as human use and pressure increase, it becomes increasingly difficult to promote biodiversity conservation. At some levels of human impact, even the highest amount of protection is not able to maximize biodiversity conservation.

Science
, this issue p.
307
Metabolomics and mass spectrometry imaging reveal channeled de novo purine synthesis in cells
Authors: Pareek Vidhi , Tian Hua , Winograd Nicholas , Benkovic Stephen J.
Published: April 2020

Signs of a metabolon in action

Eukaryotic cells have a heterogeneous cytoplasm, with compartments large and small, membrane bound or not. Enzymes that catalyze the de novo synthesis of purine nucleotides, which are needed in rapidly dividing cells, are known to assemble into loosely associated, multienzyme structures called purinosomes, but the extent to which these structures are metabolically active has been less certain. Pareek
et al.
performed metabolomics to trace how purines are synthesized within purinosomes and used sophisticated mass spectrometry imaging to directly observe hotspots of metabolic activity within frozen HeLa cells (see the Perspective by Alexandrov). They found evidence for metabolic channeling between enzymes, which limits equilibration of intermediates formed in purinosomes with the bulk cellular metabolite pool. This process occurs specifically within purinosomes associated with mitochondria, because the input metabolites, glycine, aspartate, and formate, come from mitochondrial metabolism. Such channeling may help cells control the ratio and abundance of purine nucleotides.

Science
, this issue p.
283
; see also p.
241
Granzyme A from cytotoxic lymphocytes cleaves GSDMB to trigger pyroptosis in target cells
Authors: Zhou Zhiwei , He Huabin , Wang Kun , Shi Xuyan , Wang Yupeng , Su Ya , Wang Yao , Li Da , Liu Wang , Zhang Yongliang , Shen Lianjun , Han Weidong , Shen Lin , Ding Jingjin , Shao Feng
Published: April 2020

Granzyme A lights a fire

Cytotoxic T cells and natural killer cells use several strategies to kill infected or transformed cells. One such pathway entails the delivery of a family of serine proteases called granzymes to target cells through perforin-mediated pores to induce a form of programmed cell death called apoptosis. Zhou
et al.
show that granzyme A cleaves and activates gasdermin B (GSDMB), a central player in the highly inflammatory cell death process known as pyroptosis (see the Perspective by Nicolai and Raulet). GSDMB expression was highly expressed in some tissues and could be up-regulated by interferon-γ. Enforced expression of GSDMB in cancer cells enhanced tumor clearance in a mouse model, suggesting that this pathway may be a target for future cancer immunotherapies.

Science
, this issue p.
eaaz7548
; see also p.
943
Large contribution from anthropogenic warming to an emerging North American megadrought
Authors: Williams A. Park , Cook Edward R. , Smerdon Jason E. , Cook Benjamin I. , Abatzoglou John T. , Bolles Kasey , Baek Seung H. , Badger Andrew M. , Livneh Ben
Published: April 2020

A trend of warming and drying

Global warming has pushed what would have been a moderate drought in southwestern North America into megadrought territory. Williams
et al.
used a combination of hydrological modeling and tree-ring reconstructions of summer soil moisture to show that the period from 2000 to 2018 was the driest 19-year span since the late 1500s and the second driest since 800 CE (see the Perspective by Stahle). This appears to be just the beginning of a more extreme trend toward megadrought as global warming continues.

Science
, this issue p.
314
; see also p.
238
A dual light-driven palladium catalyst: Breaking the barriers in carbonylation reactions
Authors: Torres Gerardo M. , Liu Yi , Arndtsen Bruce A.
Published: April 2020

Lighting the way coming and going

Catalysts accelerate chemical reactions by breaking existing bonds and then forming new ones. Often, the factors that favor the first process can muddle the second one, constraining a catalyst's generality. Torres
et al.
found that visible light excitation of a palladium complex can facilitate both the breaking and making of carbon-halogen bonds (see the Perspective by Kathe and Fleischer). The reaction specifically forms acid chlorides by carbonylation of a wide variety of alkyl or aryl bromides and iodides. These products in turn can react further to form amides and esters.

Science
, this issue p.
318
; see also p.
242
Anthropogenic megadrought
Authors: Stahle David W.
Published: April 2020

Human-driven climate warming worsens an otherwise moderate drought
Daniel S. Greenberg (1931–2020)
Authors: Norman Colin
Published: April 2020

Incisive science journalist and commentator
Kaposi’s Sarcoma-Associated Herpesvirus Lytic Replication Is Independent of Anaphase-Promoting Complex Activity
Authors: Elbasani Endrit , Gramolelli Silvia , Günther Thomas , Gabaev Ildar , Grundhoff Adam , Ojala Päivi M.
Published: April 2020

DNA viruses have evolved complex strategies to gain control over the cell cycle. Several of them target APC/C, a key cellular machinery that controls the timely progression of the cell cycle, by either blocking or enhancing its activity. Here, we investigated the activity of APC/C during the lytic replication cycle of KSHV and found that, in contrast to that of KSHV's close relatives EBV and HCMV, KSHV lytic replication occurs while the APC/C is active. Perturbing APC/C activity by depleting a core protein or the adaptor proteins of the catalytic domain, and hence interfering with normal cell-cycle progression, did not affect virus replication. This suggests that KSHV has evolved to replicate independently of the activity of APC/C and in various cell cycle conditions.
Can autonomy support have an effect on type 2 diabetes glycemic control? Results of a cluster randomized controlled trial
Authors: Yun Qingping , Ji Ying , Liu Shenglan , Shen Yang , Jiang Xuewen , Fan Xinyi , Liu Jingnan , Chang Chun
Published: April 2020

Objectives

To assess whether social support or autonomy support intervention for patients with type 2 diabetes can achieve glycemic control at the end of intervention, and to test whether the glycemic control effect can be maintained for a long time.

Research design and methods

In this cluster randomized controlled trial, 18 community healthcare stations (CHSs) were randomized to the following: (1) usual care group (UCG) offering regular public health management services, (2) social support group (SSG) providing 3-month social support intervention based on problem solving principles, and (3) autonomy support group (ASG) offering 3-month autonomy support intervention based on self-determination theory. A total of 364 patients registered in the CHSs were enrolled into either of the three groups. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were diabetes self-management (DSM) behaviors. Assessment was conducted at baseline and at 3 and 6 months.

Results

Patients in ASG achieved better HbA1c reduction at the end of intervention (0.53% or 7.23 mmol/mol, p<0.001) than those in the UCG and successfully maintained it up to 6 months (0.42% or 5.41 mmol/mol, p<0.001). However, patients in SSG did not experience significant change in HbA1c at 3 or 6 months when compared with patients in UCG. Besides, patients in both the SSG (0.12, p<0.05) and ASG (0.22, p<0.001) experienced improvement in exercise at 3 months. Patients in ASG sustained improvement in exercise up to 6 months (0.21, p<0.001), but those in the SSG did not.

Conclusions

Autonomy support for patients with type 2 diabetes could help achieve glycemic control at the end of intervention and successfully maintain it up to 6 months. These findings indicate that autonomy support has positive long-term effects on DSM behaviors and glycemic control and can be recommended in future diabetes intervention programs.

Trial registration number

ChiCTR1900024354.
Eye care providers’ emerging roles in early detection of diabetes and management of diabetic changes to the ocular surface: a review
Authors: Richdale Kathryn , Chao Cecilia , Hamilton Marc
Published: April 2020

US adults visit eye care providers more often than primary healthcare providers, placing these doctors in a prime position to help identify and manage patients with prediabetes and diabetes. Currently, diabetes is identified in eye clinics in an advanced stage, only after visible signs of diabetic retinopathy. Recent ophthalmic research has identified multiple subclinical and clinical changes that occur in the anterior segment of the eye with metabolic disease. The corneal epithelium exhibits increased defects and poor healing, including an increased risk of neurotrophic keratitis. Increased thickness and stiffness of the cornea artificially alters intraocular pressure. There is damage to the endothelial cells and changes to the bacterial species on the ocular surface, both of which can increase risk of complications with surgery. Decreased corneal sensitivity due to a loss of nerve density predispose patients with metabolic disease to further neurotrophic complications. Patients with diabetes have increased Meibomian gland dysfunction, blepharitis and reduced tear production, resulting in increased rates of dry eye disease and discomfort. Early detection of metabolic disease may allow eye care providers to be more proactive in recommending referral and intervention in order to reduce the risk of blindness and other diabetes-related morbidity. Continued research is needed to better understand the time course of changes to the anterior segment and what can be done to better detect and diagnose patients with prediabetes or undiagnosed diabetes and provide improved care for these patients.
Terrain park feature compliance with Québec ski area safety recommendations
Authors: Audet Olivier , Macpherson Alison K , Valois Pierre , Hagel Brent E , Tremblay Benoit , Goulet Claude
Published: April 2020

Objectives

The primary objective of this paper is to examine terrain park (TP) feature compliance with recommendations from a ski area industry guide (are TP features compliant with the guide?) and determine factors that could be associated with TP feature compliance in Québec ski areas (do factors influence TP feature compliance?), Canada. These recommendations on the design, construction and maintenance are provided by the Québec Ski Areas Association Guide.

Methods

A group of two to four trained research assistants visited seven ski areas. They used an evaluation tool to assess the compliance of 59 TP features. The evaluation tool, originally developed to assess the quality of TP features based on the guide, was validated in a previous study. Compliance was calculated by the percentage of compliant measures within a given feature. The potential influence of four factors on compliance (size of the TP, size of the feature, snow conditions and type of feature) were examined using a mixed-effects logistic regression model.

Results

The average TP feature compliance percentage was 93% (95% CI 88% to 99%) for boxes, 91% (95% CI 89% to 94%) for rails and 89% (95% CI 86% to 92%) for jumps. The logistic regression showed that none of the four factors examined were associated with TP feature compliance with the guide.

Conclusion

Our results suggest that TP features are highly compliant with the guide in Québec ski areas.