bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical care nurses' perception of care coordination competency for management of mechanically ventilated patients
Authors: Alsharari Abdalkarem F. , Aroury Ammar M. , Dhiabat Mohammad H. , Alotaibi Jazi S. , Alshammari Farhan F. , Alshmemri Mohammed S. , Alnawwar Mohammed A.
Published: January 2020

Aims and Objectives

To evaluate nurses’ care coordination competency for mechanically ventilated patients in intensive care units (ICUs) of Saudi Arabia (SA).

Background

ICUs are increasingly using multidisciplinary approach to provide critical care. Functionality gaps remain within these teams preventing optimum performance, including a lack of adequate care coordination in the management of mechanically ventilated (MV) patients.

Design

A cross‐sectional survey of ICU nurses working across 20 hospitals in SA.

Methods

The Nurses’ Care Coordination Competency Scale (NCCCS) survey for MV patients was administered to all the nurses to assess their care coordination competence. The data were analysed using Student's t test, ANOVA and linear regression. Reporting of this research follows STROBE guidelines.

Results

A total of 254 nurses participated in the survey. The overall NCCCS mean score was 3.94 (±0.69) out of a 5‐point scale. Also, the “promoting team cohesion factor (Factor 1)” had a mean score of 3.90 (±0.77), the “understanding care coordination needs factor (Factor II)” had a mean score of 4.00 (±0.77), the “aggregating and disseminating information factor (Factor III)” had a mean score of 4.05 (±0.76), and the “devising and clearly articulating the care vision factor (Factor IV)” had a mean score of 3.78 (±0.87). The mean overall NCCCS score was 4.10 among Indians, 3.98 among Filipinos and 3.81 among Saudi nationals.

Conclusion

There were a high overall score and subscale scores of nurses’ care coordination competence for mechanically ventilated patients, but few gaps were identified in some of the items.

Relevance to Clinical Practice

The results provide information on the status and gaps in ICU nurses’ care coordination competencies to address the needs of mechanically ventilated critically ill patients. The NCCCS can be utilised as an educational tool for nurses who are new to the ICU work environment.
Nurses' attitudes regarding the importance of families in nursing care: A cross‐sectional study
Authors: Østergaard Birte , Clausen Anne M. , Agerskov Hanne , Brødsgaard Anne , Dieperink Karin B. , Funderskov Karen F. , Nielsen Dorthe , Sorknæs Anne D. , Voltelen Barbara , Konradsen Hanne
Published: January 2020

Aims and objectives

To investigate attitudes towards family involvement in care among a broad sample of Danish nurses from all sectors and healthcare settings.

Background

Evidence suggests that nurses hold both supportive and less supportive attitudes about involvement of family members in the care of patients, and the existing findings are limited to specific healthcare contexts.

Design

A cross‐sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology for reporting observational studies.

Methods

Using snowball sampling, the Families' Importance in Nursing Care‐Nurses' Attitudes questionnaire was initially administered to a broad, convenience sample of Danish registered nurses through social media: Facebook interest groups and the homepage of the Danish Family Nursing Association. These nurses were encouraged to send the invitation to participate in their network of nursing colleagues. Complete data sets from 1,720 nurses were available for analysis.

Results

In general, the nurses considered the family as important in patient care. Nurses who held master's and doctorate degrees scored significantly higher than nurses with a basic nursing education. Nurses who had had experience with illness within their own families tended to score higher on the family as a conversational partner subscale than those without this experience. Nurses with the longest engagement within hospital settings scored significantly lower than those with the longest engagement within primary health care and/or psychiatry.

Conclusions

Families are considered important in nursing care. Younger nurses with a basic education, short‐term engagement at a hospital and no experiences with illness within their own families were predictors of less supportive attitudes towards including the family in nursing care.

Relevance to clinical practice

Clinical leaders and managers should promote education on the importance of active family involvement in patient care in clinical practice and undergraduate education. More focus on collaboration with families in the hospital setting is needed.
Factors influencing the implementation of Epilepsy Specialist Nurse role: Using the Consolidation Framework for Implementation Research
Authors: Higgins Agnes , Murphy Rebecca , Downes Carmel , Varley Jarlath , Begley Cecily , Elliott Naomi
Published: January 2020

Background

Research to support the added value of including Epilepsy Specialist Nurses as members of the multidisciplinary team is developing, yet little information exists on factors influencing the translation of these roles into practice.

Aim

To describe the enabling and inhibiting factors to the implementation of the Epilepsy Specialist Nurse role in the Republic of Ireland.

Methods

A qualitative design involving semi‐structure interviews, observation and analysis of documents, such as portfolios was used. The sample included 12 Epilepsy Specialist Nurses, 24 multidisciplinary team members, and 35 individuals with epilepsy and family members. Data were analysed using the Consolidation Framework for Implementation Research. Reporting rigour is demonstrated using the COREQ checklist (See Appendix S1).

Results

While there was overwhelming support for the role, barriers and enablers were identified across all domains of the Consolidation Framework for Implementation Research. Enablers included national policies and guidelines, leadership from senior nursing and medical colleagues, climate of learning and mentorship, networking opportunities, infrastructural supports and competence of Epilepsy Specialist Nurses. Barriers included the limited consideration of service expansion and the increasingly complex nature of clinical cases on workload capacity. Deficits in infrastructural supports, challenges in relation to role preparation, role implementation and role responsibility, including concerns around lone practitioner models and concerns that the role was a cost‐saving measure, also emerged as potential barriers to future sustainability.

Conclusion

The Consolidation Framework for Implementation Research offers researchers a pragmatic typology for analysing interrelationships between enabling and inhibiting factors that impact implementation of advanced practice roles, across different evidence sources, disciplines and boundaries.

Relevance to clinical practice

In order to secure role sustainability, managers need to address the rate of service expansion, models of role development, deficits in supports and perceived motivations for role development on the quality, acceptability and sustainability of services provided.
Insider Investment Horizon
Authors: AKBAS FERHAT , JIANG CHAO , KOCH PAUL D.
Published: January 2020

We examine the relation between insiders’ investment horizon and the information content of their trades with respect to future stock returns. We conjecture that an insider's investment horizon establishes a benchmark for expected patterns of continued trading behavior and thus helps identify unexpected insider trades, which should be more informative in efficient markets. Consistent with this conjecture, the trades of short‐horizon insiders are both more unexpected and more informed, on average, than those of long‐horizon insiders. Short‐horizon insiders and their firms also tend to display characteristics that are associated with a greater focus on short‐termism.
Outcomes of preterm infants born with marginal viability in a University Hospital in Thailand
Authors: Piriyapokin Nuttha , Chuthapisith Jariya , Emrat Kanuengnit , Nuntnarumit Pracha
Published: January 2020

Aim

Reports of the outcomes of infants born with marginal viability in developing countries are limited. This study aimed to determine the mortality rate and major disabilities of extremely preterm infants.

Methods

A retrospective cohort with a prospective part of neurodevelopmental assessment was performed in infants born at 23–25+6 weeks' gestational age (GA) who received active resuscitation and were admitted to neonatal intensive care unit during 2005–2015. Surviving infants were recruited for neurodevelopmental assessment including cognition, gross motor and neurosensory disorders. Major disability was defined as one of the following: severe cognitive impairment, severe cerebral palsy, blindness or deafness.

Results

A total of 67 infants were enrolled (8, 22 and 37 in the 23, 24 and 25 weeks' GA groups, respectively). The overall mortality rate before discharge was 26%. Infants in the 23 and 24 weeks' GA groups had a significantly higher mortality rate than did those in the 25 weeks' GA group (42 vs. 10%). Of 50 survivors (aged 2–12 years), 3 and 2 had blindness and deafness, respectively. Cognitive function assessment in 37 survivors showed that 4 (11%) and 15 (40%) had severe and borderline cognitive impairment, respectively. Death or major disability was found in 100, 63 and 38% in the 23, 24 and 25 weeks' GA groups, respectively.

Conclusion

In our centre, infants born at 23–24 weeks had a much higher chance of death or major disability than those born at 25 weeks' GA. Given such information, active management should be offered together with the family's involvement.
Complex patterns of differentiation and gene flow underly the divergence of aposematic phenotypes in Oophaga poison frogs
Authors: Ebersbach Jana , Posso‐Terranova Andrés , Bogdanowicz Steven , Gómez‐Díaz Mónica , García‐González Ma. Ximena , Bolívar‐García Wilmar , Andrés José
Published: January 2020

Hybridization and introgression can have complex consequences for both species evolution and conservation. Here, we investigated the origin and characteristics of a putative hybrid zone between two South American poison dart frog species, Oophaga anchicayensis and the critically endangered Oophaga lehmanni, which are heavily sought after on the illegal pet market. Using a combination of phenotypic (49 traits) and genomic (ddRADseq) data, we found that the putative hybrids are morphologically distinct from their parental species and confirmed genomic signatures of admixture in these populations. Several lines of evidence (hybrid indices, interspecific hybrid heterozygosity, genomic clines, comparisons with simulated hybrids and demographic modelling) support the conclusion that these populations are not comprised of early‐generation hybrids and thus, they probably did not arise as a result of illegal translocations associated with wildlife trafficking. Instead, they probably represent an independent lineage which has persisted through isolation and has only relatively recently re‐established gene flow with both parental species. Furthermore, we detected signals of differential introgression from parental species into these hybrid populations which suggest relaxed stabilizing selection on these aposematic colour morphs, potentially via context‐dependent female choice. These populations thus provide a fascinating window into the role of hybridization, isolation and female choice in the diversification of South American poison dart frogs. In addition, our results underline the importance of landscape conservation measures to protect, not only known localities of nominal species, but also the phenotypic and genomic variation harbored by admixed lineages which represent crucial repositories for the impressive diversity in this system.
A systematic review of digital badges in health care education
Authors: Noyes Julie A. , Welch Patrick M. , Johnson Jason W. , Carbonneau Kira J.
Published: January 2020

Objectives

A challenge to competency‐based medical education is the verification of skill acquisition. Digital badges represent an innovative instruction strategy involving the credentialing of competencies to provide evidence for achievement. Despite increasing interest in digital badges, there has been no synthesis of the health care education literature regarding this credentialing strategy. The present authors proposed to address this gap by conducting the first systematic review of digital badges in health care education, to reveal pedagogical and research limitations, and to provide an evidence‐based foundation for the design and implementation of digital badges.

Methods

A systematic search of the medical education literature from January 2008 to March 2019 was conducted using MEDLINE, Web of Science, CAB Abstracts and ScienceDirect. Included studies described digital badges in academic or professional medical education programmes in any health care profession. Included studies were appraised and quality assessment, methodological scoring, quantitative analysis and thematic extraction were conducted.

Results

A total of 1050 relevant records were screened for inclusion; 201 full text articles were then assessed for eligibility, which resulted in the identification of 30 independent papers for analysis. All records had been published since 2013; 77% were journal articles, and 83% involved academic health care education programmes. Scores for quality were relatively moderate. Thematic analyses revealed implications for the design and implementation of digital badges: learner characteristics may moderate student outcomes; the novelty effect can negate the value of digital badges, and educators may overcome instruction‐related challenges with digital badges using design and implementation strategies such as the creation of badging ecosystems.

Conclusions

The results indicate a growing momentum for the use of digital badges as an innovative instruction and credentialing strategy within higher education and provide evidence for outcomes within a learner‐centred, competency‐based model of medical education. There is a paucity of research to support the design and implementation of this credentialing system in health care education. The potential benefits necessitate future high‐quality analyses reporting institutional, patient and workplace‐based outcomes to evaluate the effectiveness and moderating conditions of digital badges.
TRANSPARENT TESTA GLABRA1 (TTG1) regulates leaf trichome density in tea Camellia sinensis
Authors: Sun Binmei , Zhu Zhangsheng , Liu Renjian , Wang Limei , Dai Fengling , Cao Fanrong , Liu Shaoqun
Published: January 2020

Plant leaf trichomes are both essential for taxonomy and participate in plant resistance to biotic and abiotic stresses. In the tea plant, teaf trichomes vary significantly among different varieties, ranging from leaves with high trichome density to relatively glabrous leaves. Leaf trichomes provides crucial diagnostic characters for tea identification and taxonomy. In addition, trichomes are a valued trait in tea production; leaf trichomes are generally considered to be associated with improved taste. However, the molecular mechanisms of trichome formation and the genetic control of trichome density in tea plants remain unknown. In this study, we identified a gene named TRANSPARENT TESTA GLABRA1 (CsTTG1), which encodes a WD‐repeat protein and is associated with trichome formation in tea. The results also showed that CsTTG1 is particularly highly expressed in the top bud, which is consistent with trichome formation in this tissue. CsTTG1 encodes a protein localized in both the nucleus and the cytoplasm. In addition, the transcription level of CsTTG1 was related to the length and/or density of the trichomes in different tea cultivars with diverse leaf trichome densities and overexpressing CsTTG1 increased the number of trichomes in Arabidopsis thaliana. Collectively, our results indicate that CsTTG1 is involved in regulating trichome formation in general and that the expression level of CsTTG1 is related to trichome density in tea plants. Our results may facilitate research on tea taxonomy and the adaptation of tea to its habitats.
T‐cell receptor diversity as a prognostic biomarker in melanoma patients
Authors: Charles Julie , Mouret Stephane , Challende Isabelle , Leccia Marie‐Therese , De Fraipont Florence , Perez Solene , Plantier Nadia , Plumas Joel , Manuel Manuarii , Chaperot Laurence , Aspord Caroline
Published: January 2020

There is increasing evidence that T‐cell receptor (TCR) repertoire diversity can be a predictive biomarker of immune responses in cancer patients. However, the characteristics of the T‐cell repertoire together with its prognostic significance in melanoma patients and impact on disease progression remain unknown. We investigated the combinatorial TCR repertoire diversity by semi‐quantitative multi‐N‐plex PCR in peripheral blood samples from 44 melanoma patients together with seven matched metastatic lymph nodes and explored its potential predictive value on clinical prognosis. The diversity was quantified by calculating both richness (number of different specificities) and evenness (relative abundance of the different specificities). Our results revealed that a higher TCR repertoire diversity in blood of patients was associated with a longer PFS, while divpenia (low repertoire diversity) was linked with poor prognosis. The diversity was significantly higher in patients undergoing late relapse and long survival compared to patients who progressed rapidly. Interestingly, the TCR repertoire diversity in tumor may have a potential prognostic value. Thus, our study highlights that the TCR repertoire diversity is a prognostic indicator of clinical outcome in patients with melanoma.
Setting precedent: Initial feature variability affects the subsequent precision of regularly varying sound contexts
Authors: Todd Juanita , Frost Jade , Fitzgerald Kaitlin , Winkler István
Published: January 2020

The task of making sense of the world around us is supported by brain processes that simplify the environment. For example, repetitive patterns of sensory input help us to predict future events. This study builds on work, suggesting that sensory predictions are heavily influenced by first impressions. We presented healthy adults with a sequence comprising three sounds each differing from the other two on three dimensions; for simplicity A, B and C. These three sounds were arranged in blocks where two were equally common and one was rare, and the probabilities rotated creating three different block types (i.e., probabilities, A < B = C, B < A = C, C < A = B). Sequences included two of each block type with three versions—one starting with A < B = C, one with B < A = C and one with C < A = B. The common tone evoked responses in any given block were highly suppressed consistent with the auditory system predicting regular events, while the rare tone in each block elicited a larger response signaling a prediction error. However, results indicated that the auditory system assessed the configurations in which the two common tones were adjacent in space (within the three locations used) as less volatile compared to when they were highly separate. When the more volatile environment was encountered at the beginning of the sequence, all deviance‐related responses were significantly lower in amplitude. Results suggest that the representation of a stimulus configuration is affected by the estimate drawn from the initial context, expanding our notion of the nature of primacy bias to include powerful effects of initial feature variance.
Multiply Robust Causal Inference with Double-Negative Control Adjustment for Categorical Unmeasured Confounding
Authors: Shi Xu , Miao Wang , Nelson Jennifer C. , Tchetgen Tchetgen Eric J.
Published: January 2020

Unmeasured confounding is a threat to causal inference in observational studies. In recent years, the use of negative controls to mitigate unmeasured confounding has gained increasing recognition and popularity. Negative controls have a long-standing tradition in laboratory sciences and epidemiology to rule out non-causal explanations, although they have been used primarily for bias detection. Recently, Miao and colleagues have described sufficient conditions under which a pair of negative control exposure and outcome variables can be used to identify non-parametrically the average treatment effect (ATE) from observational data subject to uncontrolled confounding. We establish non-parametric identification of the ATE under weaker conditions in the case of categorical unmeasured confounding and negative control variables. We also provide a general semiparametric framework for obtaining inferences about the ATE while leveraging information about a possibly large number of measured covariates. In particular, we derive the semiparametric efficiency bound in the non-parametric model, and we propose multiply robust and locally efficient estimators when non-parametric estimation may not be feasible. We assess the finite sample performance of our methods in extensive simulation studies. Finally, we illustrate our methods with an application to the post-licensure surveillance of vaccine safety among children.
Elicitation of prior probability distributions for a proposed Bayesian randomized clinical trial of whole blood for trauma resuscitation
Authors: Jansen Jan O. , Wang Henry , Holcomb John B. , Harvin John A. , Richman Joshua , Avritscher Elenir , Stephens Shannon W. , Truong Van Thi Thanh , Marques Marisa B. , DeSantis Stacia M. , Yamal Jose‐Miguel , Pedroza Claudia
Published: January 2020

BACKGROUND

Whole blood trauma resuscitation is conceptually appealing and increasingly used but lacks evidence. A randomized controlled trial is needed but challenging to design. A Bayesian approach might be more efficient and more interpretable than a conventional frequentist design. We report the results on an elicitation meeting to create prior probability distributions to help develop such a trial.

METHODS

In‐person expert elicitation meeting, based on Sheffield Elicitation Framework methodology. We used an interactive graphical tool to elicit the quantities of interest (24‐hour mortality and certainty required). Two rounds were conducted, with an intervening discussion of deidentified responses. Individual responses were aggregated into probability distributions.

RESULTS

Fifteen experts participated. The pooled belief was that the median 24‐hour mortality of trauma patients with hemorrhagic shock treated with component therapy (the current standard of care) was 19% (95% credible interval [CrI], 6%‐45%), and the median 24‐hour mortality of those treated with whole blood, 16% (95% CrI, 5%‐39%). The pooled prior distribution for the relative risk had a median of 0.84 (95% CrI, 0.26‐3.1), indicating that the expert group had a 64% prior belief that whole blood decreases 24‐hour mortality compared to component therapy.

CONCLUSIONS

Experts had moderately strong beliefs that whole blood reduces the 24‐hour mortality of trauma patients with hemorrhagic shock. These data will assist with the design and planning of a Bayesian trial of whole blood resuscitation, which will help to answer a key question in contemporary transfusion practice.
Unemployment governance, labour cost and earnings management: Evidence from China
Authors: Beladi Hamid , Cheng Chen , Hu May , Yuan Yuan
Published: January 2020

This study investigates the effect of labour cost on earnings management based on the panel data of listed firms in China. We use the average wage of employees in firm level as the proxy for labour cost. Firms with rising labour cost become more likely to engage in negative earnings management to conceal profits or report losses. The effect becomes more significant in state‐owned enterprises, labour‐intensive enterprises, firms in high unemployment‐rate regions and firms with political connections. Further research finds that, under the institutional background of Chinese unemployment governance, firms get more government subsidies and tax preferences and reduce the excessive employment through negative earnings management. To a certain extent, this weakens the policy effect of unemployment governance. Overall, our conclusions are meaningful to the reform of unemployment governance, the standardisation of earnings management behaviour, the improvement of the government subsidy policies and the improvement of the efficiency of public resource allocation.
Potential of a coevolved rust fungus for the management of Himalayan balsam in the British Isles: first field releases
Authors: Ellison C A , Pollard K M , Varia S
Published: January 2020

In 2014, the rust fungus Puccinia komarovii var. glanduliferae, native to the foothills of the Himalayas from Kashmir to Western Nepal, became the first fungal agent to be released into Europe for the classical biological control of a non‐native weed. The target, Impatiens glandulifera or Himalayan balsam, is a prolific invader of riparian habitats in Europe and North America. During the period 2015–2018, a strain of the rust from India was released at a total of 36 sites, in 17 counties in England and Wales. There was limited field infection in 2015 and inoculation experiments conducted under controlled conditions revealed significant variation in the susceptibility of plant populations to the rust, with some showing immunity. Subsequently, a second strain of the rust from Pakistan was released in 2017 and was found to infect a different cohort of Himalayan balsam populations. The rust mass production methodology, and field inoculation and monitoring protocol, are detailed, and plants were tested for susceptibility to both rust strains prior to field release. Levels of foliar infection at selected sites in 2017 and 2018 are presented, as well as seedling infection rates in the spring of 2019. The results show that the rust is able to overwinter and establish populations in stands of Himalayan balsam in England. The issues involved with measuring the impact of the biological control agent are discussed.
L-spaces, taut foliations, and graph manifolds
Authors: Hanselman Jonathan , Rasmussen Jacob , Rasmussen Sarah Dean , Watson Liam
Published: January 2020

If $Y$ is a closed orientable graph manifold, we show that $Y$ admits a coorientable taut foliation if and only if $Y$ is not an L-space. Combined with previous work of Boyer and Clay, this implies that $Y$ is an L-space if and only if $\unicode[STIX]{x1D70B}_{1}(Y)$ is not left-orderable.
Effect of Feedstock Properties on Extrusion of High Aspect Ratio Microbi-Lumen Tubes
Authors: Kuriakose Sandeep , Parenti Paolo , Annoni Massimiliano
Published: January 2020

The micro-extrusion of feedstock is a promising and emerging technology for manufacturing very high length to thickness aspect ratio metallic microcomponents which are not feasible for conventional metal processing methodologies or commonly used feedstock processing technologies. Extrusion of high aspect ratio microcomponents using metallic feedstock confronts the challenges of achieving a continuous extrusion without any breakage, the geometrical accuracy, surface finish and structural properties for the component which are required for the micro-application, during micro-extrusion process. The type of metallic powder, powder size, type of binder, and binder properties are very decisive in making the extrusion process feasible for the micro-application. The influence of feedstock properties on micro-extrusion of high aspect ratio microcomponents are still unknown in case of micro-extrusion of feedstock. In this research work, the effect of type of feedstock on micro-extrusion is studied by extruding microbi-lumen tubes using biocompatible steel feedstocks AISI316 L and 17-4PH at two different aging states (no aging and 1.5 years aging). The geometrical features of the extruded bi-lumen tubes, surface roughness and structural properties are analyzed using three-dimensional (3D) focus variation microscopy, differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). The analysis showed that feedstock type affects the feasibility of extrusion and geometrical size to a great extent. An average Sa roughness deviation from 1.73 to 4.57 μm was observed for feedstocks 17-4PH and AISI316 L. The study also confirms that binder properties and aging of the feedstocks also have to be taken into account for maintaining the surface finish and structural properties in case of metallic feedstock extrusion of high aspect ratio bi-lumen tubes.
On the Optimal Control of a Rolling Ball Robot Actuated by Internal Point Masses
Authors: Putkaradze Vakhtang , Rogers Stuart
Published: January 2020

The controlled motion of a rolling ball actuated by internal point masses that move along arbitrarily shaped rails fixed within the ball is considered. Application of the variational Pontryagin's minimum principle yields the ball's controlled equations of motion, a solution of which obeys the ball's uncontrolled equations of motion, satisfies prescribed initial and final conditions, and minimizes a prescribed performance index.
Analysis of Whirling Vibration Due to Morton Effect by Using Frequency Transfer Function Model in Journal Bearings
Authors: Yabui Shota , Chiba Jotaro , Suzuki Takafumi , Tomimatsu Shigeyuki , Inoue Tsuyoshi
Published: January 2020

In recent years, rotating machinery has been required to operate at high rotational speeds for high efficiency. However, with increase in the rotational speed, the rotating machinery may become unstable. One cause of unstable vibrations is the Morton effect that occurs in journal bearings. Thus, developing a mathematical model to predict the Morton effect is desirable to avoid the occurrence of such unstable vibrations. In this study, a model based on a frequency response that can quantitatively evaluate the Morton-effect-induced vibrations in rotating machinery supported by a journal bearing was developed. Experimental data were collected for modeling by using an experimental rig. Using the experimental data pertaining to the journal position in the journal bearing and temperature of the journal, a model for the Morton effect was established based on the frequency responses. From a control engineering viewpoint, the journal bearing was considered to be a proportional differential controller. In addition, the Morton-effect-induced vibrations were considered as a new bending mode of a rotating shaft, caused by thermal differences. Subsequently, the developed model was evaluated in the frequency domain. The characteristics of the vibrations, determined using the proposed model, exhibited good correlation with those corresponding to experimental data. The experimental data agreed well with the predicted results, and the results demonstrated the usefulness of the proposed method for predicting the Morton effect.
Numerical Study of the Behaviors of Ventilated Supercavities in a Periodic Gust Flow
Authors: Huang Renfang , Shao Siyao , Arndt Roger E. A. , Luo Xianwu , Wang Yiwei , Hong Jiarong
Published: January 2020

We conducted a numerical simulation of ventilated supercavitation from a forward-facing cavitator in unsteady flows generated by a gust generator under different gust angles of attack and gust frequencies. The numerical method is validated through the experimental results under specific steady and unsteady conditions. It is shown that the simulation can capture the degree of cavity shape fluctuation and internal pressure variation in a gust cycle. Specifically, the cavity centerline shows periodic wavelike undulation with a maximum amplitude matching that of the incoming flow perturbation. The cavity internal pressure also fluctuates periodically, causing the corresponding change of difference between internal and external pressure across the closure that leads to the closure mode change in a gust cycle. In addition, the simulation captures the variation of cavity internal flow, particularly the development internal flow boundary layer along the cavitator mounting strut, upon the incoming flow perturbation, correlating with cavity deformation and closure mode variation. With increasing angle of attack, the cavity exhibits augmented wavelike undulation and pressure fluctuation. As the wavelength of the flow perturbation approaches the cavity length with increasing gust frequency, the cavity experiences stronger wavelike undulation and internal pressure fluctuation but reduced cavitation number variation.
Best Practices for Administering Attitudes and Beliefs Surveys in
Physics
Authors: Madsen Adrian , McKagan Sarah B. , Sayre Eleanor C.
Published: January 2020

Physics faculty care about their students learning physics content. In addition, they usually hope that their students will learn some deeper lessons about thinking critically and scientifically. They hope that as a result of taking a physics class, students will come to appreciate physics as a coherent and logical method of understanding the world, and recognize that they can use reason and experimentation to figure things out about the world. Physics education researchers have created several surveys to assess one important aspect of thinking like a physicist: what students believe that learning physics is all about. In this article, we introduce attitudes and beliefs surveys and give advice on how to choose, administer, and score them in your classes. This article is a companion to “Best Practices for Administering Concept Inventories,” which introduces and answers common questions around concept inventories, which are research-based assessments of physics content topics.
Age- and Sex-Related Differences in the Maximum Muscle Performance and Rate of Force Development Scaling Factor of Precision Grip Muscles
Authors: Corrêa Talyene G.C. , Donato Stephanie V.S. , Lima Kauê C.A. , Pereira Ronaldo V. , Uygur Mehmet , de Freitas Paulo Barbosa
Published: January 2020

The aim of this study was to explore the effects of age and sex on the rate of force development scaling factor (RFD-SF) and maximum performance (i.e., maximum grip force [GFMax] and maximum rate of grip force development [RGFDMax]) of precision handgrip muscles. Sixty-four subjects, allocated in four groups according to their age and sex, were asked to hold an instrumented handle with the tip of the digits and perform two tests: maximum voluntary contraction and RFD-SF tests. In the maximum voluntary contraction test, GFMax and RGFDMax were assessed. In the RFD-SF test, the subjects generated quick isometric force pulses to target amplitudes varying between 20% and 100% of their GFMax. The RFD-SF and R2 values were obtained from the linear relationship between the peak values of the force pulses and the corresponding peak values of the rate of force development. Younger adults and males produced higher GFMax and RGFDMax and presented higher R2 and RFD-SF than older adults and females, respectively. No correlations between GFMax and RFD-SF and between RGFDMax and RFD-SF were observed.
Imperceptible magnetic sensor matrix system integrated with organic driver and amplifier circuits
Authors: Kondo M. , Melzer M. , Karnaushenko D. , Uemura T. , Yoshimoto S. , Akiyama M. , Noda Y. , Araki T. , Schmidt O. G. , Sekitani T.
Published: January 2020

Imperceptible magnetic sensor matrix system realizes real-time mapping of 2D magnetic field distribution.
Long-gap peripheral nerve repair through sustained release of a neurotrophic factor in nonhuman primates
Authors: Fadia Neil B. , Bliley Jacqueline M. , DiBernardo Gabriella A. , Crammond Donald J. , Schilling Benjamin K. , Sivak Wesley N. , Spiess Alexander M. , Washington Kia M. , Waldner Matthias , Liao Han-Tsung , James Isaac B. , Minteer Danielle M. , Tompkins-Rhoades Casey , Cottrill Adam R. , Kim Deok-Yeol , Schweizer Riccardo , Bourne Debra A. , Panagis George E. , Asher Schusterman M. , Egro Francesco M. , Campwala Insiyah K. , Simpson Tyler , Weber Douglas J. , Gause Trent , Brooker Jack E. , Josyula Tvisha , Guevara Astrid A. , Repko Alexander J. , Mahoney Christopher M. , Marra Kacey G.
Published: January 2020

A polycaprolactone conduit containing growth factor–encapsulated microspheres repairs 5-cm median nerve defects in rhesus macaques.
Deep phenotyping during pregnancy for predictive and preventive medicine
Authors: Paquette Alison G. , Hood Leroy , Price Nathan D. , Sadovsky Yoel
Published: January 2020

Deep phenotyping during pregnancy offers an opportunity to define the antecedents of lifelong health and wellness and to improve pregnancy outcomes.
Fourteen-Day Bactericidal Activity, Safety, and Pharmacokinetics of Linezolid in Adults with Drug-Sensitive Pulmonary Tuberculosis
Authors: Diacon Andreas H. , De Jager Veronique R. , Dawson Rodney , Narunsky Kim , Vanker Naadira , Burger Divan A. , Everitt Daniel , Pappas Frances , Nedelman Jerry , Mendel Carl M.
Published: January 2020

Linezolid is increasingly used for the treatment of tuberculosis resistant to first-line agents, but the most effective dosing strategy is yet unknown. From November 2014 to November 2016, we randomized 114 drug-sensitive treatment-naive pulmonary tuberculosis patients from Cape Town, South Africa, to one of six 14-day treatment arms containing linezolid at 300 mg once daily (QD), 300 mg twice daily (BD), 600 mg QD, 600 mg BD, 1,200 mg QD, 1,200 mg three times per week (TIW), or a combination of isoniazid, rifampin, pyrazinamide, and ethambutol.
Extension of Pharmacokinetic/Pharmacodynamic Time-Kill Studies To Include Lipopolysaccharide/Endotoxin Release from Escherichia coli Exposed to Cefuroxime
Authors: Thorsted Anders , Tano Eva , Kaivonen Kia , Sjölin Jan , Friberg Lena E. , Nielsen Elisabet I.
Published: January 2020

The release of inflammatory bacterial products, such as lipopolysaccharide (LPS)/endotoxin, may be increased upon the administration of antibiotics. An improved quantitative understanding of endotoxin release and its relation to antibiotic exposure and bacterial growth/killing may be gained by an integrated analysis of these processes. The aim of this work was to establish a mathematical model that relates
Escherichia coli
growth/killing dynamics at various cefuroxime concentrations to endotoxin release
in vitro
.
Persistent Transmission of Shigellosis in England Is Associated with a Recently Emerged Multidrug-Resistant Strain of Shigella sonnei
Authors: Bardsley Megan , Jenkins Claire , Mitchell Holly D. , Mikhail Amy F. W. , Baker Kate S. , Foster Kirsty , Hughes Gwenda , Dallman Timothy J.
Published: January 2020

Whole-genome sequencing has enhanced surveillance and facilitated detailed monitoring of the transmission of
Shigella
species in England. We undertook an epidemiological and phylogenetic analysis of isolates from all cases of shigellosis referred to Public Health England between 2015 and 2018 to explore recent strain characteristics and the transmission dynamics of
Shigella
species. Of the 4,950 confirmed cases of shigellosis identified during this period, the highest proportion of isolates was
Shigella sonnei
(54.
P3N-PIPO Interacts with P3 via the Shared N-Terminal Domain To Recruit Viral Replication Vesicles for Cell-to-Cell Movement
Authors: Chai Mengzhu , Wu Xiaoyun , Liu Jiahui , Fang Yue , Luan Yameng , Cui Xiaoyan , Zhou Xueping , Wang Aiming , Cheng Xiaofei
Published: January 2020

Potyviruses include numerous economically important viruses that represent approximately 30% of known plant viruses. However, there is still limited information about the mechanism of potyviral cell-to-cell movement. Here, we show that P3N-PIPO interacts with and recruits CI to the PD via the PIPO domain and interacts with P3 via the shared P3N domain. We further report that the interaction of P3N-PIPO and P3 is associated with 6K2 vesicles and brings the 6K2 vesicles into proximity with PD-located CI structures. These results support the notion that the replication and cell-to-cell movement of potyviruses are processes coupled by anchoring viral replication complexes at the entrance of PDs, which greatly increase our knowledge of the intercellular movement of potyviruses.
Special educational needs, social care and health
Authors: Jay Matthew A , Gilbert Ruth
Published: January 2020

Better understanding of the proportion of children who ever receive special educational needs (SEN) provision or social care services during school years is highly relevant for healthcare as reductions in one or more of these services could impact on healthcare. Using the National Pupil Database linked to the all-of-England children looked after return and children in need census, we estimated the cumulative incidence of SEN status among (1) children ever in care during school, (2) children in need but not care, and (3) neither. We observed a very high proportion of children who were in care or need during school years had SEN provision at some point (83% and 65%, respectively), and that a high proportion of children in neither of these groups did so, too (37%). Healthcare, SEN provision and social care services focus on a similar population of children. Better integration of these services could lead to synergies and cost-efficiencies and better support for these children and their families.
Development of a combined paediatric emergency department and observation unit
Authors: Lim Czer Anthoney Enriquez , Oh Julie , Eiting Erick , Coughlin Catherine , Calderon Yvette , Barnett Barbara
Published: January 2020

Background

Recent trends towards more cost-efficient and patient-centred treatment are converging to provide opportunities to improve the care of children. Observation units are hospital areas dedicated to the ongoing evaluation and management of patients for a brief period of time for well-defined conditions. We describe the implementation of a paediatric observation unit (POU) adjacent to a paediatric emergency department (PED) in an urban, academic, community hospital.

Methods

Staffing models were designed to provide paediatric services to patients in both the PED and POU. Admission criteria, workflow and transfer guidelines were developed. Quality improvement initiatives were undertaken and evaluated. Unit throughput, patient outcomes and patient satisfaction data were collected and analysed.

Results

Over a 2-year period, there were 24 038 patient visits to the PED. Of these, 1215 (5.1%) patients required admission. Seven hundred and seventy-seven (64.0%) of these children were admitted to the POU. One hundred and nineteen (15.3%) of these patients were subsequently converted to inpatient hospitalisation. The average length of stay (LOS) was 25.7 hours in 2017 and 26.5 hours in 2018. Ten patients returned to the PED within 72 hours of discharge from the POU and four were readmitted. Patient satisfaction scores regarding ‘likelihood to recommend’ improved from the 36th to the 92nd percentile rank over a 1-year period. Close monitoring of patient outcomes allowed for the adjustment of admission guidelines, increased unit census and optimised utilisation.

Conclusion

A combined PED-POU has been successful at our institution in meeting benchmark goals set for LOS and conversion rates. In addition, quality improvement interventions increased patient census and improved patient satisfaction scores while reducing the inpatient burden on the referring children’s hospital.
Scientific challenges for precision public health
Authors: Kee Frank , Taylor-Robinson David
Published: January 2020

The notion of ‘precision’ public health has been the subject of much debate, with recent articles coming to its defence following the publication of several papers questioning its value.

Critics of precision public health raise the following problems and questionable assumptions: the inherent limits of prediction for individuals; the limits of approaches to prevention that rely on individual agency, in particular the potential for these approaches to widen inequalities; the undue emphasis on the supposed new information contained in individuals’ molecules and their ‘big data’ at the expense of their own preferences for a particular intervention strategy and the diversion of resources and attention from the social determinants of health.

In order to refocus some of these criticisms of precision public health as scientific questions, this article outlines some of the challenges when defining risk for individuals; the limitations of current theory and study design for precision public health; and the potential for unintended harms.
Minimal evidence of disease activity (MEDA) in relapsing-remitting multiple sclerosis
Authors: Prosperini Luca , Mancinelli Chiara , Haggiag Shalom , Cordioli Cinzia , De Giglio Laura , De Rossi Nicola , Galgani Simonetta , Rasia Sarah , Ruggieri Serena , Tortorella Carla , Pozzilli Carlo , Gasperini Claudio
Published: January 2020

Objective

This study aimed to define the minimal evidence of disease activity (MEDA) during treatment that can be tolerated without exposing patients with relapsing-remitting multiple sclerosis at risk of long-term disability.

Methods

We retrospectively collected data of patients followed up to 10 years after starting interferon beta or glatiramer acetate. Survival analyses explored the association between the long-term risk of reaching an Expanded Disability Status Scale≥6.0 and early clinical and MRI activity assessed after the first and second year of treatment. Early disease activity was classified by the so-called ‘MAGNIMS score’ (low: no relapses and <3 new T2 lesions;medium: no relapses and ≥3 new T2 lesions or 1 relapse and 0–2 new T2 lesions;high: 1 relapse and ≥3 new T2 lesions or ≥2 relapses) and the absence or presence of contrast-enhancing lesions (CELs).

Results

At follow-up, 148/1036 (14.3%) patients reached the outcome: 61/685 (8.9%) withlowscore (reference category), 57/241 (23.7%) withmediumscore (HR=1.94, p=0.002) and 30/110 (27.3%) withhighscore (HR=2.47, p<0.001) after the first year of treatment. In thelowscore subgroup, the risk was further reduced in the absence (49/607, 8.1%) than in the presence of CELs (12/78, 15.4%; HR=2.11, p=0.01). No evident disease activity andlowscore in the absence of CELs shared the same risk (p=0.54). Similar findings were obtained even after the second year of treatment.

Conclusions

Early marginal MRI activity of one to two new T2 lesions, in the absence of both relapses and CELs, is associated with a minor risk of future disability, thus representing a simple and valuable definition for MEDA.
‘Master My Demons’: art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress
Authors: Berberian Marygrace , Walker Melissa S , Kaimal Girija
Published: January 2020

This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term.