bluuebunny/crossref_metadata_2025 huggingface dataset:
Medication safety knowledge, attitude, and practice among hospital pharmacists in tertiary care hospitals in Saudi Arabia: a multi-center study
Authors: AL-Mutairi Azizah , AlFayyad Isamme , Altannir Youssef , Al-Tannir Mohamad
Published: July 2021

Background

Pharmacovigilance (PV) demarcates all actions involving the detection and prevention of adverse drug reactions (ADR) for marketed drugs. However, ADRs are considerably underreported worldwide and continue to be a major concern to health care systems. This study aims to assess the knowledge, attitude, and perception of hospital pharmacists regarding medication safety concerning PV and ADRs across multiple tertiary care centers around Saudi Arabia.

Methods

This cross-sectional study was conducted between July 2019 and January 2020. Pharmacists working in the tertiary care centers of Riyadh City, Saudi Arabia were asked to participate in the study. A self-administered questionnaire was used to conduct this study, it consisted of: 63 questions out of which 19 questions were knowledge-based, 15 were attitude-based, and 29 were practice-based questions.

Results

A total of 350 pharmacists were distributed and 289 agreed to participate, giving a response rate of 82.6%. Most pharmacists were aware of the concept of VP and its functions (96.5%) and (87.2%), respectively. Moreover, 90% said that ADR can be preventable and non-preventable. However, the findings revealed inadequate knowledge about the overall PV field, where the majority of the pharmacists failed to correctly answer questions related to independent ADRs treatment, Augmented drug reaction, the international location of ADR, and the World Health Organization “online database” for reporting ADRs. Moreover, incomplete and/or wrong answers were recorded for questions that included single or multiple correct answers. Regarding the participants” attitude, 96.9% were interested in ADR reporting, agreeing that ADR is important to enable safe drug usage. Although a general positive attitude was recorded, pharmacists have stated that the three main barriers that hinder reporting ADRs are: unavailability of information about ADRs, lack of awareness about the need to report ADRs, and lack of time. Concerning practice, 69.2% said they received training in ADRs reporting, and 70% have reported ADRs more than once a week.

Conclusion

Surveyed pharmacists from Riyadh hospitals showed narrow knowledge of the PV field. However, a positive attitude and satisfactory practice was observed among pharmacists. These findings warrant the need for educational programs and an encouraging environment for ADR reporting to increase ADR reporting rates and support PV activities in Saudi Arabia.
Efficiency evaluation of BRICS’s national innovation systems based on bias-corrected network data envelopment analysis
Authors: Alnafrah Ibrahim
Published: July 2021

The very limited studies that tried to measure the efficiency of national innovation systems (NISs) in BRICS economies were limited to the assumption that the innovation process at national level consists of one stage only and got different and conflicting results. Therefore, this study endeavours to measure the efficiency of sub-processes within the BRICS’s NISs and identify where the system failure lies in each NIS. Bias-corrected network data envelopment analysis (DEA) is used to measure the efficiency of total NIS and the efficiency of the other sub-processes within the system: (1) knowledge production process (KPP), and (2) knowledge commercialization process (KCP). The results showed that NISs in BRICS economies suffer from low performance in commercializing their outputs of universities and research organizations. While, on the other hand, their performance in creating scientific and technical knowledge is good in comparison to other studied countries. We suggest that the reason behind this imbalance is the network system failure associated with weak institutions and high uncertainty in the economy. In this study, we argue that the problem in BRICS NISs is not a problem of resources, but it is a problem of system management and institutions. Some bridging policies are suggested to be adopted by BRICS economies to improve their innovation performance and overcome the system failure of weak links between universities and industry.
Household food security among Hadza hunter-gatherers in Mkalama district, Tanzania
Authors: Safari John Godfrey , Nkua Aron Joseph , Masanyiwa Zacharia Samwel
Published: July 2021

Background

Food insecurity is a widespread public health concern in many communities of sub-Saharan Africa. This study involved the Hadza hunter-gatherers of Tanzania, the only ethnic group in the country that has traditionally subsisted on hunting and gathering. In recent years, however, these communities have adopted mixed foraging economies. Information on how this change affects household food security is rather limited. The aim of this study was to assess the status of food security and the factors influencing household food security in the Hadza hunter-gatherer communities.

Methods

A cross-sectional study of 200 households was conducted in Mkalama district, Tanzania. Sampled householders represented individuals whose livelihood is mainly dependent on foraging (n = 129), beekeeping (n = 30) and farming (n = 41). Food security was measured by assessing food availability (Months of Adequate Food Provisioning (MAHFP)), food access (Household Food Insecurity Access Scale (HFIAS)) and food utilization (Dietary Diversity Scores (DDS)).

Results

Mean MAHFP was lower (p = 0.000) in predominantly foraging households (8.4 ± 1.1) compared with those involved in beekeeping (8.7 ± 1.6) or farming (9.6 ± 1.9). Based on HFIAS indicator, the prevalence of food insecurity varied with the household’s main activity (83.0% foraging, 46.7% beekeeping and 26.8% farming). Further, regression analyses show that the farming households were more likely to be food secure than the foraging households (OR = 10.7, p = 0.01). Dietary diversity scores also varied significantly with household’s main activity. About 65% of households (86% foraging, 63.3% beekeeping and 2.4% farming) consumed diets below the critical value of ≤ 4 food groups 24 h prior to survey. Social demographic characteristics and livelihood options are strong predictors of household food security.

Conclusion

All indicators used to assess food security point to high level of food insecurity in households mainly subsisting on foraging compared with beekeeping and farming. The primary dependence on foraging is associated with a longer period of food shortage, high prevalence of food insecurity conditions and low consumption of food varieties. Livelihood diversification coupled with provision of agricultural support services is necessary for the development of a secure future of the Hadza communities.
COVID-19-related violence trend data challenges & a resource for injury researchers
Authors: Rochford Hannah I. , Brooks Kaleb , Berg Mark , Peek-Asa Cori
Published: July 2021

Published works have raised concerns that certain violent behaviors and firearm acquisition have encountered dramatic increases since the onset of COVID-19. While these works provide important preliminary insights, they lack the empirical robustness necessary to inform a targeted societal response. Having the ability to perform the research needed to support evidence-based policy requires that data at national, state and local-levels be accessible and of sufficient quality. While related, robust data sources do arguably exist, their availability may come long after the window for effective prevention and intervention efforts has closed or may otherwise present with quality limitations, leaving populations at risk for various forms of violence without the support of protective policies.

The University of Iowa Injury Prevention Research Center and the Public Policy Center has compiled a compendium of secondary data sources in an effort to promote exploration of relationships between the COVID-19 pandemic and rates of injury and violence. The forms of violence and firearm-related behavior that were identified as being at risk for amplification given the social stress, economic stress and isolation associated with the public health emergency period included: firearm acquisition, firearm violence, intimate partner violence and family violence.
Response of a hydrothermal system to escalating phreatic unrest: the case of Turrialba and Irazú in Costa Rica (2007–2012)
Authors: Rouwet D. , Mora-Amador R. , Ramírez C. , González G. , Baldoni E. , Pecoraino G. , Inguaggiato S. , Capaccioni B. , Lucchi F. , Tranne C. A.
Published: July 2021

This study presents the first hydrogeochemical model of the hydrothermal systems of Turrialba and Irazú volcanoes in central Costa Rica, manifested as thermal springs, summit crater lakes, and fumarolic degassing at both volcanoes. Our period of observations (2007–2012) coincides with the pre- and early syn-phreatic eruption stages of Turrialba volcano that resumed volcanic unrest since 2004, after almost 140 years of quiescence. Peculiarly, the generally stable Irazú crater lake dropped its level during this reawakening of Turrialba. The isotopic composition of all the discharged fluids reveals their Caribbean meteoric origin. Four groups of thermal springs drain the northern flanks of Turrialba and Irazú volcanoes into two main rivers. Río Sucio (i.e. “dirty river”) is a major rock remover on the North flank of Irazú, mainly fed by the San Cayetano spring group. Instead, one group of thermal springs discharges towards the south of Irazú. All thermal spring waters are of SO4-type (i.e. steam-heated waters), none of the springs has, however, a common hydrothermal end-member. A water mass budget for thermal springs results in an estimated total output flux of 187 ± 37 L/s, with 100 ± 20 L/s accounted for by the San Cayetano springs. Thermal energy release is estimated at 110 ± 22 MW (83.9 ± 16.8 MW by San Cayetano), whereas the total rock mass removal rate by chemical leaching is ~ 3000 m3/year (~ 2400 m3/year by San Cayetano-Río Sucio). Despite Irazú being the currently less active volcano, it is a highly efficient rock remover, which, on the long term can have effects on the stability of the volcanic edifice with potentially hazardous consequences (e.g. flank collapse, landslides, phreatic eruptions). Moreover, the vapor output flux from the Turrialba fumaroles after the onset of phreatic eruptions on 5 January 2010 showed an increase of at least ~ 260 L/s above pre-eruptive background fumarolic vapor fluxes. This extra vapor loss implies that the drying of the summit hydrothermal system of Turrialba could tap deeper than previously thought, and could explain the coincidental disappearance of Irazú’s crater lake in April 2010.
Chemical-free recovery of crude protein from livestock manure digestate solid by thermal hydrolysis
Authors: Tasaki Ken
Published: July 2021

Protein is becoming an increasingly important resource for a variety of commercial applications. Yet, a large volume of protein is being wasted. Notably, livestock manure solids have a significant content of protein which is not only underutilized, but prone to runoff and eventual breakdown to reactive nitrogen compounds, contributing to eutrophication. It would be desirable to remove protein before it causes environmental hazards and then convert it to value-added commercial applications. We have developed a novel thermal hydrolysis process (THP) to extract crude protein from livestock manure solid, or manure digestate solid (MDS) in particular, without the use of any chemical. We demonstrate the versatility of our new process to control the molecular weight (MW) distribution of the extracted protein hydrolysate (PH). The antioxidant activity of the crude protein hydrolysate (CPH) has been examined through Oxygen Radical Absorbance Capacity Assay. The results have shown that our CPH had its antioxidant capacity against the peroxyl radical similar to that of vitamin E and exhibited almost 7 times as strong inhibition against the hydroxyl radical as vitamin E. We also evaluated the nutritional value of our PH by analyzing its amino acid composition and the MW distribution through amino acid analysis, SDS-PAGE, and MALDI-TOF mass spectroscopy. The characterizations have revealed that the PH recovered from MDS had 2.5 times as much essential amino acids as soybean meal on dry matter basis, with the MW distribution ranging from over a 100 Da to 100 KDa. Finally, the protein powder was prepared from the extracted CPH solution and its composition was analyzed.
Optimizing reconstruction parameters for quantitative 124I-PET in the presence of therapeutic doses of 131I
Authors: Fanchon Louise M. , Beattie Bradley J. , Pentlow Keith , Larson Steven M. , Humm John L.
Published: July 2021

Background

The goal of this work was to determine the quantitative accuracy and optimal reconstruction parameters for 124I-PET imaging in the presence of therapeutic levels of 131I. In this effort, images were acquired on a GE D710 PET/CT scanner using a NEMA IEC phantom with spheres containing 124I and increasing amounts of 131I activity in the background. At each activity level, two scans were acquired, one with the phantom centered in the field of view (FOV) and one 11.2 cm off-center. Reconstructions used an ordered subset expectation maximization algorithm with up to 100 iterations of 16 subsets, with and without time-of-flight (TOF) information. Results were evaluated visually and by comparing the 124I activity relative to the scan performed in the absence of 131I.

Results

131I within the FOV added to the randoms rate, to dead time, and to pile-up within the detectors. Using our standard clinical reconstruction parameters, the image quality and quantitative accuracy suffered at 131I activities above 1.4 GBq. Convergence rates slowed progressively in the presence of increasing amounts of 131I for both TOF and nonTOF reconstructions. TOF reconstructions converged more quickly than nonTOF but often towards erroneous concentrations. Iterating nonTOF reconstructions to convergence produced quantitatively accurate images except for the off-center phantom at the very highest level of background 131I tested.

Conclusions

This study shows that quantitative PET is feasible in the presence of large amounts of 131I. The high randoms fractions resulted in slow reconstruction convergence and negatively impacted TOF corrections and/or the accuracy of TOF information. Therefore, increased iterations and nonTOF reconstructions are recommended.
Isometric Strength Database for Muscle Maximal Voluntary Endurance Field Tests: Normative Data
Authors: Janik Frédérick , Toulotte Claire , Seichepine Anne Laure , Masquelier Bernadette , Barbier Fabienne , Fabre Claudine
Published: July 2021

Background

Different field tests are used to evaluate muscle capacity, in particular maximal voluntary isometric endurance. However, although there are some normative values for a few muscle endurance tests, these do not consider the weight, height, gender, or age of individuals, which are well-known factors that influence muscle performance.

Hypothesis/Purpose

The purpose of this study was to investigate the test–retest reproducibility of eight field tests and establish muscle endurance norms, in a healthy population, based on their anthropometric characteristics, which could allow the optimal evaluation of the entire muscle function in a quick manner.

Design

Case series.

Methods

This study was conducted in two phases. The first phase was to check the reproducibility inter- and intra-assessor for eight isometric muscle field tests on 20 volunteer subjects aged 40.9 ± 11.6 years old (age range, 21–58 years). The second part was to establish muscle maximal voluntary isometric endurance norms according to these tests on a total of 400 healthy participants grouped by age (50 males and females in each of the age brackets, 20–29; 30–39; 40–49; 50–59 years old, for a total of 200 males and 200 females).

Results

The intra- and inter-assessor reproducibility tests are good for all muscle measurements (the intraclass correlation coefficients varied between 0.915 and 0.996 and the coefficient of variation between 3.6 and 11.8%). The area under the receiver operating characteristic curves demonstrates a good sensibility with values greater than 0.7 for each test. Each muscle belt presents same ratio regardless of the age and gender group. The simultaneous multiple regression analyses highlight that the anthropometric characteristics of subjects influence significantly the performance of isometric tests.

Conclusion

This study has permitted establishing prediction equations in a healthy population according to their anthropometric characteristics as well as agonist/antagonist ratios for eight muscle isometric field tests after demonstrating a good reproducibility of all tests.
Delayed tracheal extubation after cardiac surgery due to cardiogenic ventilator auto-triggering: a case report
Authors: Takekawa Daiki , Uchida Satoshi , Hirota Kazuyoshi
Published: July 2021

Background

Ventilator auto-triggering is associated with poor outcomes. Herein, we present a case of delayed tracheal extubation after cardiac surgery due to cardiogenic auto-triggering.

Case presentation

A 73-year-old male with chronic constrictive pericarditis underwent radical pericardiectomy. After confirming hemodynamic stability, we conducted spontaneous breathing trial (SBT) with a flow-trigger sensitivity of 1 L/min. As his respiratory rate (RR) increased to more than 60 breaths/min and tidal volume decreased to less than 100 mL, this SBT was considered a failure. Next morning, SBT was reperformed and the result was unchanged. However, we noticed that his heart rate and RR were the same and suspected auto-triggering caused by cardiogenic oscillations. We changed ventilator mode from flow triggering to pressure triggering of −2 cmH2O and he was uneventfully extubated.

Conclusion

We experienced a case of delayed tracheal extubation after cardiac surgery due to cardiogenic auto-triggering. Auto-triggering can be reduced by changing ventilator trigger mode.
Determinants of COVID-19 vaccine acceptance in the Arab world: a cross-sectional study
Authors: Kaadan M. Ihsan , Abdulkarim Joud , Chaar Maher , Zayegh Obada , Keblawi Mouhammed Ali
Published: July 2021

Background

The Arab region is highly affected by the COVID-19 pandemic. Local governments have already started to act against the disease. However, only a few countries provided COVID-19 vaccination. Compliance with vaccination is a major topic affecting proper coverage. Thus, we aim to explore vaccine acceptance among Arab populations, and compare it with the global numbers.

Methods

An internet-based survey using social media platforms was conducted, targeting adults who were able to read and understand Arabic, had access to the internet, and from all 22 Arab league countries. Due to the response rate variation between participants, the countries were grouped into four categories based on their income: Low income, Lower-middle income, Upper-middle income, and High-income economies. Data about demographics, previous COVID-19 infection, and vaccine acceptance tendency were collected and analyzed using Chi-squared (χ2) test and Logistic regression.

Results

A total of 870 participants completed the survey. 59.3% of the participants were male, 53.3% were between 25 and 44 years, and 69.9% were Arabs who live inside of their home country. The COVID-19 vaccine acceptance rate was 62.4%. A significant higher tendency toward vaccination was identified in males (65.4%, P = 0.04) and people living outside their home countries (67.9%, P = 0.02). However, age group, level of education, and previous COVID-19 infection were all factors with insignificant effect. Citizens of High-income countries were more likely to accept the vaccine (70.2%).

Conclusions

Less than two-thirds of Arabs are compliant with COVID-19 vaccination. This proportion is relatively lower than the global rate. It is important to develop strategies to promote vaccine acceptance and reach the ideal coverage needed to achieve efficient immunization.
Moral Distress Among Oncology Social Workers
Authors: Guan Ting , Nelson Krista , Otis-Green Shirley , Rayton Makeeta , Schapmire Tara , Wiener Lori , Zebrack Brad
Published: July 2021

PURPOSE:

Literature on moral distress among oncology social workers (OSWs) is sparse. The aim of the current study was to examine the prevalence of moral distress and its domains of influence, and to identify demographic and work-related characteristics associated with moral distress among OSWs.

METHODS:

Data came from the Oncology Social Work Competencies, Opportunities, Roles, and Expertise survey, conducted from August to September 2020 (during the COVID-19 global pandemic). Data collected included demographic information (eg, age, sex, and race) and work-related characteristics (eg, job position, organization type, work setting, employment status, salary, years in the profession, and OSW-C certification). Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals. Tests of association, including multivariate linear regression, were conducted to achieve the research aims.

RESULTS:

Total moral distress scores on the Measure of Moral Distress for Healthcare Professionals (range 0-432) for 745 OSWs ranged from 1 to 273, with an average score of 74.0. The three highest indicators of moral distress were observed in the patient or family experience domain. Higher levels of moral distress were associated with younger age, being a direct service provider, provision of inpatient cancer care, and more years in the profession.

CONCLUSION:

OSWs are experiencing moral distress. Institutional investments in professional education and support of OSWs are needed to mitigate and possibly prevent moral distress experienced by cancer care providers and thus ensure the delivery of quality psychosocial care for patients with cancer and their families.
Adrenal Vein Sampling in a Patient With Primary Hyperaldosteronism and Severe Contrast Allergy
Authors: Prins Margaretha L M , Ballieux Bartholomeus E P B , Meijer Onno C , Pereira Alberto M , Nijhoff Michiel F
Published: July 2021

We report on a case of a 50-year-old female patient with primary hyperaldosteronism, in whom adrenal venous sampling was required to differentiate between unilateral and bilateral disease. Because of a history of severe allergy to iodinated contrast media, premedication with glucocorticoids was indicated. Exogenous glucocorticoids, however, can affect measurements of serum cortisol. To avoid this potential confounding effects on the cortisol assay, we decided to use dexamethasone instead of prednisolone or hydrocortisone. A high-dose adrenocorticotropin (ACTH) stimulation test with the simultaneous use of dexamethasone revealed an adequate adrenal cortisol response. ACTH-stimulated adrenal venous sampling showed reliable results, which provided a solid basis for further clinical decision-making.
A Processed Electroencephalogram–Based Brain Anesthetic Resistance Index Is Associated With Postoperative Delirium in Older Adults: A Dual Center Study
Authors: Cooter Wright Mary , Bunning Thomas , Eleswarpu Sarada S. , Heflin Mitchell T. , McDonald Shelley R. , Lagoo-Deenadalayan Sandhya , Whitson Heather E. , Martinez-Camblor Pablo , Deiner Stacie G. , Berger Miles
Published: July 2021

BACKGROUND:

Some older adults show exaggerated responses to drugs that act on the brain. The brain’s response to anesthetic drugs is often measured clinically by processed electroencephalogram (EEG) indices. Thus, we developed a processed EEG–based measure of the brain’s resistance to volatile anesthetics and hypothesized that low scores on it would be associated with postoperative delirium risk.

METHODS:

We defined the Duke Anesthesia Resistance Scale (DARS) as the average bispectral index (BIS) divided by the quantity (2.5 minus the average age-adjusted end-tidal minimum alveolar concentration [aaMAC] inhaled anesthetic fraction). The relationship between DARS and postoperative delirium was analyzed in 139 older surgical patients (age ≥65) from Duke University Medical Center (n = 69) and Mt Sinai Medical Center (n = 70). Delirium was assessed by geriatrician interview at Duke, and by research staff utilizing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument at Mt Sinai. We examined the relationship between DARS and delirium and used the Youden index to identify an optimal low DARS threshold (for delirium risk), and its associated 95% bootstrap confidence bounds. We used multivariable logistic regression to examine the relationship between low DARS and delirium risk.

RESULTS:

The relationship between DARS and delirium risk was nonlinear, with higher delirium risk at low DARS scores. A DARS threshold of 28.755 maximized the Youden index for the association between low DARS and delirium, with bootstrap 95% confidence bounds of 26.18 and 29.80. A low DARS (<28.755) was associated with increased delirium risk in multivariable models adjusting for site (odds ratio [OR] [95% confidence interval {CI}] = 4.30 [1.89–10.01]; P = .001), or site-plus-patient risk factors (OR [95% CI] = 3.79 [1.63–9.10]; P = .003). These associations with postoperative delirium risk remained significant when using the 95% bootstrap confidence bounds for the low DARS threshold (P < .05 for all). Further, a low DARS (<28.755) was associated with delirium risk after accounting for opioid, midazolam, propofol, phenylephrine, and ketamine dosage as well as site (OR [95% CI] = 4.21 [1.80–10.16]; P = .002). This association between low DARS and postoperative delirium risk after controlling for these other medications remained significant (P < .05) when using either the lower or the upper 95% bootstrap confidence bounds for the low DARS threshold.

CONCLUSIONS:

These results demonstrate that an intraoperative processed EEG–based measure of lower brain anesthetic resistance (ie, low DARS) is independently associated with increased postoperative delirium risk in older surgical patients.
A-Prefixing in Linguistic Atlas Project Data
Authors: Burkette Allison , Antieau Lamont
Published: July 2021

This article discusses the linguistic, social, and geographic distribution of a-prefixing data in the Linguistic Atlas Project (LAP) of North America. Over 3,800 instances of the a-prefix were extracted for analysis from the LAP interview data of 1,527 speakers from across the United States, collected between 1931 and 2006. While the LAP a-prefix data do not generally deviate from patterns observed in the sociolinguistic literature, they do offer a more nuanced picture of infrequent prefixed forms, including uncommon constructions and verbs that appear as a-prefixed forms less frequently. A-prefixers in LAP tended to be White men, although it should be noted that 30–47% of the female speakers in four of the surveyed LAP projects also used this feature. The geographic distribution of the feature suggests that the a-prefix is not Southern so much as it is Eastern, with pockets of lesser and greater usage as one moves westward across the country. Additionally, the data cast the a-prefix as a rural phenomenon, rather than as a strictly Southern one, which opens the door to discussions of the feature as a means of indexing participation in (or affinity for) a rural lifestyle. Overall, this article demonstrates that LAP data are a tremendous resource and a key piece of the puzzle of understanding regional and social variation.
Genome-Wide Heritability Estimates for Family Life Course Complexity
Authors: Van Winkle Zachary , Conley Dalton
Published: July 2021

Sequence analysis is an established method used to study the complexity of family life courses. Although individual and societal characteristics have been linked with the complexity of family trajectories, social scientists have neglected the potential role of genetic factors in explaining variation in family transitions and events across the life course. We estimate the genetic contribution to sequence complexity and a wide range of family demographic behaviors using genomic relatedness–based, restricted maximum likelihood models with data from the U.S. Health and Retirement Study. This innovative methodological approach allows us to provide the first estimates of the heritability of composite life course outcomes—that is, sequence complexity. We demonstrate that a number of family demographic indicators (e.g., the age at first birth and first marriage) are heritable and provide evidence that composite metrics can be influenced by genetic factors. For example, our results show that 11% of the total variation in the complexity of differentiated family sequences is attributable to genetic influences. Moreover, we test whether this genetic contribution varies by social environment as indexed by birth cohort over a period of rapid changes in family norms during the twentieth century. Interestingly, we find evidence that the complexity of fertility and differentiated family trajectories decreased across cohorts, but we find no evidence that the heritability of the complexity of partnership trajectories changed across cohorts. Therefore, our results do not substantiate claims that lower normative constraints on family demographic behavior increase the role of genes.
Engineering life in synthetic systems
Authors: Oriola David , Spagnoli Francesca M.
Published: July 2021

The second EMBO-EMBL Symposium ‘Synthetic Morphogenesis: From Gene Circuits to Tissue Architecture’ was held virtually in March 2021, with participants from all over the world joining from the comfort of their sofas to discuss synthetic morphogenesis at large. Leading scientists from a range of disciplines, including developmental biology, physics, chemistry and computer science, covered a gamut of topics from the principles of cell and tissue organization, patterning and gene regulatory networks, to synthetic approaches for exploring evolutionary and developmental biology principles. Here, we describe some of the high points.
Modulation of Microtubule Properties and Functions by Encapsulation of Nanomaterials Using a Tau-Derived Peptide
Authors: Inaba Hiroshi , Matsuura Kazunori
Published: July 2021

Microtubules (MTs) are hollow cytoskeletons with typically 15 nm inner diameter, which are crucial for various cellular activities including structural support, transport, and cell division. Because of their importance in cells and their unique structural properties, MTs are recognized not only as important targets for cell manipulation but also as interesting components for material applications. However, a methodology for modulation of the properties and functions of MTs is not established. The outside of MTs is historically well-studied, however, the inside of MTs is a recently emerged area. Since various proteins have been recently found inside MTs and are recognized as modulators of MTs, the MT interior has great potential as a reaction field for artificial modulation of the properties and functions. To demonstrate proof-of-concept, we developed Tau-derived peptides that bind to the inner surface of MTs for molecular encapsulation. In this account, we overview the properties of MTs and recent MT-related research, in particular about the inside of MTs, and our approach to encapsulate nanomaterials for modulation of MTs using Tau-derived peptides. The encapsulation of nanomaterials is a new concept for artificial modulation of MTs and would provide insight into the understanding of MTs and cellular and material applications.
Using maternal and neonatal data collection systems for coronavirus disease 2019 (COVID-19) vaccines active safety surveillance in low- and middle-income countries: an international modified Delphi study
Authors: Pingray Veronica , Belizán María , Matthews Sarah , Zaraa Sabra , Berrueta Mabel , Noguchi Lisa M. , Xiong Xu , Gurtman Alejandra , Absalon Judith , Nelson Jennifer C. , Panagiotakopoulos Lakshmi , Sevene Esperanca , Munoz Flor M. , Althabe Fernando , Mwamwitwa Kissa W. , Rodriguez Cairoli Federico , Anderson Steven A. , McClure Elizabeth M. , Guillard Christine , Nakimuli Annettee , Stergachis Andy , Buekens Pierre
Published: July 2021

Background: Given that pregnant women are now included among those for receipt coronavirus disease 2019 (COVID-19) vaccines, it is important to ensure that information systems can be used (or available) for active safety surveillance, especially in low- and middle-income countries (LMICs). The aim of this study was to build consensus about the use of existing maternal and neonatal data collection systems in LMICs for COVID-19 vaccines active safety surveillance, a basic set of variables, and the suitability and feasibility of including pregnant women and LMIC research networks in COVID-19 vaccines pre-licensure activities. 

Methods: A three-stage modified Delphi study was conducted over three months in 2020. An international multidisciplinary panel of 16 experts participated. Ratings distributions and consensus were assessed, and ratings’ rationale was analyzed. 

Results: The panel recommended using maternal and neonatal data collection systems for active safety surveillance in LMICs (median 9; disagreement index [DI] -0.92), but there was no consensus (median 6; DI 1.79) on the feasibility of adapting these systems. A basic set of 14 maternal, neonatal, and vaccination-related variables. Out of 16 experts, 11 supported a basic set of 14 maternal, neonatal, and vaccination-related variables for active safety surveillance. Seven experts agreed on a broader set of 26 variables.The inclusion of pregnant women for COVID-19 vaccines research (median 8; DI -0.61) was found appropriate, although there was uncertainty on its feasibility in terms of decision-makers’ acceptability (median 7; DI 10.00) and regulatory requirements (median 6; DI 0.51). There was no consensus (median 6; DI 2.35) on the feasibility of including research networks in LMICs for conducting clinical trials amongst pregnant women.

Conclusions: Although there was some uncertainty regarding feasibility, experts recommended using maternal and neonatal data collection systems and agreed on a common set of variables for COVID-19 vaccines active safety surveillance in LMICs.
Understanding the Value of Fulfillment Flexibility in an Online Retailing Environment
Authors: DeValve Levi , Wei Yehua , Wu Di , Yuan Rong
Published: July 2021

Problem definition: Fulfillment flexibility, the ability of distribution centers (DCs) to fulfill demand originating from other DCs, can help e-retailers reduce lost sales and improve service quality. Because the cost of full flexibility is prohibitive, we seek to understand the value of partially flexible fulfillment networks under simple and effective fulfillment policies. Academic/practical relevance: We propose a general method for understanding the practical value of (partial) fulfillment flexibility using a data-driven model, theoretical analysis, and numerical simulations. Our method applies to settings with local fulfillment (i.e., order fulfillment from the originating DC) prioritization and possible customer abandonment, two features that are new to the fulfillment literature. We then apply this method for a large e-retailer. We also introduce a new class of spillover limit fulfillment policies with attractive theoretical and practical features. Methodology: Our analysis uses dynamic and stochastic optimization, applied probability, and numerical simulations. Results: We derive optimal fulfillment policies in stylized settings, as well as bounds on the performance under an optimal policy using theoretical analysis, to provide guidelines on which policies to test in numerical simulations. We then use simulations to estimate for our industrial partner that a proposed fulfillment network with additional flexibility equates to a profit improvement on the order of tens of millions of U.S. dollars. Managerial implications: We provide an approach for e-retailers to understand when fulfillment flexibility is most valuable. We find that fulfillment flexibility provides the most benefit for our collaborator when gross profits are high relative to fulfillment costs or centrally held inventory is low. Also, we identify the risks of myopic fulfillment with additional flexibility and demonstrate that an effective spillover limit policy mitigates these risks.

History: This paper has been accepted as part of the 2019 Manufacturing & Service Operations Management Practice-Based Research Competition.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2021.0981 .
Selling Virtual Items in Free-to-Play Games: Transparent Selling vs. Opaque Selling
Authors: Jiao Yifan , Tang Christopher S. , Wang Jingqi
Published: July 2021

The market for online games is huge, but research on the economics of online game operations remains nascent. In this paper, we focus on “free-to-play” online games in which a game provider offers players an option to purchase game-specific virtual goods (items) for improving their winning chances before the game begins. Because selling virtual items is the main revenue stream in free-to-play games, it is important for game providers to find ways to entice players to purchase virtual items. We observe that some game providers disclose the opponent’s skill level before the game begins by using a “transparent selling” mechanism to sell virtual items, whereas others conceal this information from the players. This observation motivates us to examine whether and when game providers should adopt transparent selling. By analyzing a game-theoretical model that involves one game provider and two competitive players, we obtain the following results. First, when the price of the virtual goods is endogenously determined by the game provider, we find that transparent selling is not effective: it is optimal for the provider to adopt “opaque selling” by concealing the opponent’s skill level information from players. However, opaque selling hurts the player’s welfare. Second, when the selling price is exogenously given, transparent selling dominates opaque selling when the given price is high. Our results identify the conditions under which transparent selling dominates opaque selling.
Opportunity, support and understanding: the experience of four early trainee nursing associates
Authors: Dainty Andrew David , Barnes Donna , Bellamy Erica , Kyte Nicola , Berry Katie
Published: July 2021

Aims:

This study aimed to capture the lived experience of some of the first trainee nursing associates (TNAs) during the pilot of the role in the January 2017 cohort of TNAs, based at the University of Derby.

Methods:

A convenience sampling approach was used to recruit participants to this phenomenological study. In-depth, semi-structured interviews were carried out with four participants to capture the experience, as lived by the first cohort of TNAs. Transcripts were transcribed verbatim and were analysed using interpretive phenomenological analysis.

Results:

Analysis suggests that the participant experience was characterised by six themes, namely: challenges relating to NA training; developing new skills; opportunity; the importance of support; impact of the NA role; and understanding the NA role.

Conclusion:

This study adds to our understanding relating to the lived experience of some of the first TNAs taking up training for this role within healthcare, and highlights some of the factors that were most pertinent, according to the lived experience of the trainees themselves. The authors hope that the findings of this study will prove useful for those considering taking up training for the role, or indeed establishments considering implementing the role with their settings.
The importance of the hospital playroom
Authors: Stonehouse David
Published: July 2021

This article discusses the important role that playrooms provide for children when they are in hospital, either as inpatients, outpatients or even as visitors. Following an introduction highlighting the importance of play, the background to hospital playrooms will be identified. Links to the Nursing and Midwifery Council code will then be made, before discussing and highlighting the clear benefits of having designated and bespoke children's playrooms.

However, there is a cautionary note: not all playrooms are being used for the purpose they were designed for. This other inappropriate use can prevent children from accessing playrooms when they need them, or even worse, are being subjected to clinical procedures within them. This will be highlighted and discussed.

Finally, the role of the support worker and nursing associate will be made clear in how they can support children in accessing play opportunities within their clinical areas.
An audit of the British Thoracic Society asthma discharge care bundle in a teaching hospital
Authors: Awli Yawoa Foli , Addis Gulen
Published: July 2021

Background:

The UK asthma mortality rate has risen by 33% over a decade. The national enquiry into 195 asthma-related deaths revealed that most of these deaths were preventable. The Asthma Discharge Care Bundle (ADCB) is recommended for use when discharging patients with an acute asthma attack and/or exacerbation.

Aim:

To review the implementation of the British Thoracic Society (BTS) bundle in a teaching hospital.

Methods:

A 12-month retrospective audit was conducted on 86 adult patients treated for asthma attacks.

Findings:

The results of the audit indicated that the hospital has complied with the ADCB. In total, 85% of patients had their inhaler technique checked, but 62% of them were not provided with any written inhaler use instructions. The respiratory clinical nurse specialists were more compliant with most of the bundle statements than the medical team.

Conclusion:

The findings highlighted the need for asthma education sessions for all health professionals with emphasis on record-keeping skills.
Teaching acute hospital staff and students about patient flow
Authors: Wall Olivia , O'Sullivan Eleanor
Published: July 2021

Good patient flow in an acute hospital is concerned with ensuring patients experience minimal delays throughout the hospital journey, from the emergency department to the wards, outpatients and to a suitable discharge destination. Good flow requires effective processes, staff buy-in and staff education. This study aimed to explore ways in which this topic is currently taught in an Irish acute hospital group. Participants were recruited to engage in semi-structured interviews about their experience of teaching patient flow. Following qualitative data analysis using a structured analysis guide, five main themes were identified: current methods, unstructured nature of teaching, frustration with frequency, dissemination of teaching/learning and opportunities for improvement. Recommendations from this study could be used to support a formalised approach to teaching this topic in the future. The use of the Teaching for Understanding framework and Universal Design for Learning principles are strongly advocated to support the development of a nationwide module, to structure the topics to be taught and provide guidance on how to effectively and efficiently teach this topic in Ireland.
Errors and omissions in deprivation of liberty authorisation forms
Authors: Griffith Richard
Published: July 2021

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the impact of errors and omissions in the forms required to lawfully authorise a deprivation of liberty under the Mental Health Act 2005
Understanding safety culture
Authors: Foster Sam
Published: July 2021

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the question of what makes a pro-safety ‘culture’ within an organisation, and how it can be developed
Run-through training: a trainee and trainer perspective
Authors: Brierley CA , Sandler PJ
Published: July 2021

A run-through training pilot has been conducted in orthodontics during which trainees completed 2 years of higher training in the same units in which the first 3 years of specialist training was conducted. This article outlines a trainee and trainer's experience of run-through training in orthodontics.

CPD/Clinical Relevance: Young dentists hoping to pursue orthodontic specialist training would be aware of the different training pathways available.
The continued development of multiple supernumerary teeth: do they influence orthodontic treatment?
Authors: Oliver Graham , Hamilton Sean , Read Natalie , Atack Nikki
Published: July 2021

Supernumerary teeth occur in approximately 1–2% of the population. Multiple supernumerary teeth are less common and usually associated with certain medical conditions. Most supernumeraries develop at a similar time to the normal series; however, this article describes the presentation and management of three patients who developed multiple supernumerary teeth during active orthodontic treatment in the permanent dentition.

CPD/Clinical Relevance: These cases show development of multiple supernumerary teeth in the both the maxilla and mandible demonstrating a variation of types and effects on the dentition. In particular, multiple supernumeraries in the anterior maxilla and supplementals in the mandibular premolar regions highlight that supernumerary teeth may develop a considerable time after the development of the permanent dentition. These can develop during orthodontic treatment. Consideration, therefore, may be given to closer and longer monitoring of dental development in patients with multiple supernumerary teeth.
Misbehaving mandibular canines
Authors: Hameed Othman , Grewal Sukhraj S , Taylor Nigel G
Published: July 2021

The incidence of permanent canines failing to erupt in the mandible is not as common, and, therefore, not as well reported, as that in the maxilla. Mandibular canines have important functional and aesthetic purposes and knowledge of this uncommon condition is essential for those involved with the management of these cases. This article explores the aetiology, assessment and treatment options available to manage this condition, using examples from treated cases within our department.

CPD/Clinical Relevance: An understanding of the aetiology, assessment and various treatment options available to manage impacted and transmigrated mandibular canines will inform better treatment planning.
History of interceptive orthodontics
Authors: Tsipkis Alan , Noar Joseph
Published: July 2021

Interceptive orthodontics refers to all interventions and treatments that can be performed during the primary or mixed dentition with the aim of eliminating or minimizing dento-alveolar and skeletal disharmonies that can interfere with the normal growth and development of occlusion, function, aesthetics and the psychological wellbeing of children. The main purpose of interceptive orthodontics is to prepare an environment that will not interfere with the occlusal development in order to reduce the future need for prolonged complex mechanical orthodontic treatment. According to the American Association of Orthodontics the most suitable age for screening the paediatric population for interceptive intervention is 7 years of age.

CPD/Clinical Relevance: To review the progress made in the field of interceptive orthodontics and discuss the current principles of early orthodontic intervention.
Psikolojik Sağlamlık için Koruyucu Faktörler Ölçeği Türkçe Formunun Geçerlik ve Güvenirliği
Authors: TANKO Çiğdem , EKŞİ Füsun , HATUN Osman , EKSİ Halil
Published: July 2021

Bu çalışmanın amacı, Psikolojik Sağlamlık için Koruyucu Faktörler Ölçeği’ni (PSKFÖ) Türkçeye uyarlamak ve psikometrik incelemesini yapmaktır. Araştırmanın katılımcıları 256 bireyden (% 65’i kadın) oluşmaktadır. Katılımcıların yaş ortalaması 30.78’dir. Araştırmada öncelikle ölçeğin dilsel eş değerlik çalışmaları yapılmıştır. PSKFÖ’nün yapı geçerliği için Doğrulayıcı Faktör Analizi (DFA) yapılmıştır. DFA sonucunda ölçeğin orijinal formdaki gibi üç boyutlu ve 15 maddeli yapısının doğrulandığı ve Türkçe formun iyi uyum değerlerine sahip olduğu görülmüştür (χ2 / sd = 1.99; p