bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the ploidy of Gracilariopsis lemaneiformis at both the cellular and genomic level1
Authors: Chen Haihong , Feng Xiaoqing , Jiang Minjie , Xiao Baoheng , Zhang Jingyu , Zhang Wei , Hu Yiyi , Sui Zhenghong
Published: May 2020

The determination of the ploidy level of an organism is a prerequisite for studies of evolution, cellular function, and genomic construction. Identification of the ploidy of the economically important red alga Gracilariopsis lemaneiformis has been hindered by its small genome and large number of chromosomes. Therefore, in the current study, PloidyNGS, a tool that calculates the number of reads supporting different alleles at each position along the genome sequence, and fluorescence in situ hybridization coupled with tyramide signal amplification (TSA‐FISH) were used to clarify the ploidy of G. lemaneiformis. In addition, flow cytometry (FCM) was used to estimate the ploidy of different somatic cells. The PloidyNGS results showed that most of the alleles in the gametophyte were monomorphic, whereas the TSA‐FISH results showed that one hybridization signal was observed in gametophytic nuclei and two in tetrasporophytic nuclei when the nuclei were hybridized by single copy gene probes. These results confirmed that G. lemaneiformis is a haploid in the gametophytic generation and diploid in the sporophytic generation. Moreover, the FCM result suggested that G. lemaneiformis was not an endopolyploid. Based on previous studies, we hypothesize that the nuclear number is important for the cellular differentiation and function of this species. We also suggest that G. lemaneiformis evolved from a paleopolyploid, the genome of which has been diploidized, and that traces of genomic doubling are no longer apparent. Thus, this study provides important evidence for further studies on the evolution and genomes of red algae.
Meloxicam ameliorates the systemic inflammatory response syndrome associated with experimentally induced endotoxemia in adult donkeys
Authors: Mendoza Garcia Francisco Javier , Gonzalez‐De Cara Carlos , Aguilera‐Aguilera Raul , Buzon‐Cuevas Antonio , Perez‐Ecija Alejandro
Published: May 2020

Background

Little information is available about endotoxemia in donkeys. Characterizing the systemic inflammatory response (SIRS) to lipopolysaccharide (LPS) in donkeys would provide valuable clinical and therapeutic information. The effects of meloxicam on endotoxemia have not been studied in this species.

Objectives

To study the pathophysiology and gene expression associated with experimentally induced endotoxemia, and evaluate the effects of meloxicam on experimentally induced endotoxemia in donkeys and in equine monocyte cultures.

Animals

Six healthy adult female donkeys.

Methods

Endotoxemia was induced by an IV infusion of LPS for 30 minutes. Animals either received 20 mL of saline or 0.6 mg/kg of meloxicam IV after LPS infusion. The experiments lasted 6 hours. Blood samples were collected serially for hematology, serum biochemistry, interleukin measurement, and leukocyte gene expression analysis. Vital signs were recorded throughout the study. Monocyte cultures were used to test the effects of meloxicam on LPS‐activated monocytes.

Results

Lipopolysaccharide induced fever, leukopenia, and neutropenia of similar magnitude in both groups, but meloxicam attenuated increases in plasma lactate, tumor necrosis factor‐alpha (TNFα), and interleukin 1β concentrations compared to controls. No differences were detected between groups for cytokine mRNA expression. Furthermore, meloxicam decreased TNFα release in LPS‐activated monocyte cultures.

Conclusions and Clinical Importance

Meloxicam could be a feasible option for the treatment of endotoxemia and SIRS in donkeys. Additional studies are necessary to investigate possible meloxicam‐related posttranscriptional regulation and to compare this drug with other nonsteroidal anti‐inflammatory drugs (NSAIDs) in animals with endotoxemia.
A Novel Method of SimultaneousIn SituDecompression of Lateral Calcaneal Bulge and Subtalar ArthrodesisViaa Single Incision for Malunion After Calcaneal Fractures
Authors: Zhang Tao , Chen Wei , Yu Guangrong , Zhang Xuebin , Zhang Yingze
Published: May 2020

Objective

The aim of this study was to introduce a novel method of simultaneousin situdecompression of lateral calcaneal bulge and subtalar arthrodesis via a single incision for malunion after calcaneal fractures and evaluate the feasibility of this method.

Methods

From September 2010 to October 2011, six patients (five males and one female) with malunion and delayed heel pain after conservative treatment of displaced intra‐articular calcaneal fractures were included in our study. The mean age of the six patients was 32.9 years (range, 25–71 years). Patients were treated with this novel technique at our department and the functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scores during follow‐up. Information of the six patients including surgical data and pre/postoperative function scores were retrospectively analyzed using SPSS 19.0 statistical software.

Results

The average operation time between wire insertion and incision suture was 42.2 ± 11.5 min (range, 25–56 min). The blood loss in all patients was all less than 50 ml each. The average fluoroscopy time was 25.7 ± 11.6 s (range, 11–43 s). No wound‐related and other short‐term complications were recorded. Six patients who were included in our study were followed for an average period of 66.2 ± 4.7 months (range, 60–73 months). There was no patient lost to follow up. Heel pain was observed to be greatly improved preoperatively in all of the six patients. All patients restored to normal activity of life after surgery. Radiological evidence of fusion was observed in five patients. The average fusion time of these five patients was 3.5 months (range, 2–4 months). The remaining one failed to achieve fusion and the hardware removal was performed due to screw tail irritation. This patient was satisfied with the final outcomes subjectively after removal of hardware. The mean AOFAS scores at 24 months postoperative were 82.0 ± 7.0, which was greatly improved compared to preoperative (44.8 ± 10.7) (P < 0.05). The preoperative VAS pain scores were decreased from 5.8 ± 1.5 to 2.6 ± 1.4 at 24 months postoperative (P < 0.05) and slightly decreased to 2.0 ± 1.7 at 48 months postoperative (P < 0.05). No surgery‐related complications were observed in any of the patients.

Conclusions

The novel technique can effectively relieve the heel pain, prompt functional recovery, decrease the incidence of complications, simplify the surgical procedure, and shorten the learning curve. Therefore, the technique is a feasible and worthwhile alternative in treating malunion after calcaneal fractures.
Intravenous cannula placement in children for induction of general anesthesia: Prospective audit and identification of success factors
Authors: Hügel Celine , Chen James , Poznikoff Andrew K. , West Nicholas C. , Reimer Eleanor , Görges Matthias
Published: May 2020

Background

Approaches to pediatric induction of anesthesia vary widely. While oral sedative premedication and inhalational induction are common, total intravenous anesthesia is becoming increasingly popular. Total intravenous anesthesia without anxiolytic premedication, which is the most commonly used technique in our hospital, requires intravenous (IV) cannula placement in an awake child.

Aims

To quantify the success rate of IV cannula placement in 1 or 2 attempts and to identify success factors and barriers.

Methods

With ethical approval and written informed consent from participating anesthesiologists, a prospective audit of IV cannulation was undertaken over a 1‐month period. The attending anesthesiologist captured basic demographics, IV insertion characteristics, setting, distraction techniques, the behavior of the child, number of attempts, and success/failure. A logistic regression model for successful IV cannulation was created. Anesthesiologists and procedural suite nurses participated in semi‐structured interviews to identify success factors, barriers, and teaching approaches.

Results

Data from 984 cases were analyzed. IV induction was planned in 562 cases, and IV cannulation was successful in 90% of these patients. Anxiolytic premedication was given in 6% of cases. Observations indicated that 64% of children were pain‐ and reaction‐free, and 90% experienced minimal or no reaction. Predictors for success included older child's age and child behavior at first encounter. Qualitative interview data from 13 participants suggested success factors included effective distraction, preparing the family for IV induction, parental presence, support of the operating room team, effective use of local analgesic cream, adapting the approach to the individual child, and the anesthesiologist's efficiency. Barriers included needle phobia, uncooperative child, anxious parents, ineffective use of analgesic cream, and unfavorable anatomy. Distraction techniques varied by age and developmental stage of the child.

Conclusions

Cannulation for planned IV induction is feasible for most children, enabling increased use of total intravenous anesthesia as an institutional anesthetic strategy.
Prospective, Multicenter Feasibility Study to Evaluate Differential Target Multiplexed Spinal Cord Stimulation Programming in Subjects With Chronic Intractable Back Pain With or Without Leg Pain
Authors: Fishman Michael A. , Calodney Aaron , Kim Philip , Slezak Jan , Benyamin Ramsin , Rehman Atiq , Soto Eliezer , Yang Thomas , Hacobian Asteghik , Griffith Lee , Yu Cong , Vallejo Ricardo
Published: May 2020

Objective

This prospective, open‐label, multicenter study evaluated the feasibility of spinal cord stimulation (SCS) therapy programming for chronic low back pain that uses multiple electrical pulsed signals (Differential Target Multiplexed).

Methods

Twenty‐five SCS candidates with low back pain equal to or greater than lower limb pain were enrolled at 7 sites in the United States. The subjects evaluated standard and Differential Target Multiplexed programs, each for 4 ± 1 days. A commercially available SCS trial system was used for standard SCS therapy programming. During the trialing of the multiplexed programs, implanted temporary leads were connected to an investigational external trial stimulator system.

Results

Twenty subjects concluded the study. The mean baseline numeric pain rating scale (NPRS) score for low back pain was 7.4, with a mean age of 62.4 years and mean pain duration of 18.0 years. Significant relief in back pain was observed for both treatments, with significantly better response with multiplexed programming. At the end of the trial period, subjects reported a reduction in their mean NPRS score from baseline to 4.2 after standard programming and to 2.4 after Differential Target Multiplexed programming. The difference between standard and multiplexed programming was significant. The responder rate for low back pain relief was 50% for standard programming and 80% for Differential Target Multiplexed programming. Eighty‐five percent of subjects who evaluated both programming approaches preferred Differential Target Multiplexed SCS.

Conclusion

In this difficult‐to‐treat patient population, subjects reported significant reduction in chronic back pain when using multiplexed programming. A randomized clinical trial is needed to confirm the results from this feasibility study.
Integrating management techniques to restore subtropical forests invaded by Hedychium coronarium J. Köenig (Zingiberaceae) in a biodiversity hotspot
Authors: Machado Marcela Xavier , Castellani Tânia Tarabini , de Sá Dechoum Michele
Published: May 2020

The restoration of areas invaded by non‐native plants is challenging as invasive plants may affect both biotic and abiotic components of ecosystems, leading to impacts that constrain recolonization by native species after invaders are eliminated. In such a scenario, restoration techniques as topsoil transposition might accelerate colonization by native species in forests. Hedychium coronarium J. Koenig (Zingiberaceae) is a Himalayan herbaceous rhizomatous plant recognized as invasive in several countries. This study aimed to experimentally evaluate the response of plant assemblages to topsoil transposition on a site invaded by H. coronarium after chemical control. Four treatments were applied: chemical control integrated with topsoil transposition, chemical control of H. coronarium alone, topsoil transposition alone, and no intervention (control). Plots were evaluated prior to the application of treatments and then monthly for 11 months after treatments. Parameters were measured for H. coronarium (number of ramets, ramet height, and cover) and other species (species richness, abundance, and cover). Plots treated with chemical control (regardless of topsoil transposition) were similar in terms of all parameters measured and species composition, with dominance of herbs and shrubs. Plots managed solely with topsoil transposition had lower species richness, abundance, and cover, but more diverse life‐forms, being equally rich in climbers, trees, and herbs. Chemical control was effective to control invasion by H. coronarium and increase species richness and abundance on the managed site. Topsoil transposition promoted colonization by species that might accelerate restoration.
Is emigration of workers contributing to better schooling outcomes in Nepal?
Authors: Datt Gaurav , Wang Liang Choon , Badji Samia
Published: May 2020

This paper presents evidence on how emigration for work affects schooling outcomes for primary and secondary school‐age children in Nepal. Using an instrumental variable strategy exploiting past migration network, we show that the identified effects critically depend on how schooling outcomes are measured. While conventional measures of school attendance indicate no impact, our new set of schooling status and schooling gap measures reveals significant impacts. Schooling status measures reveal favorable impacts for girls, and for emigration to India. Schooling gap measures reveal favorable effects of all emigration on schooling outcomes for girls and of emigration to other countries for boys.
A test for Gaussianity in Hilbert spaces via the empirical characteristic functional
Authors: Henze Norbert , Jiménez‐Gamero María Dolores
Published: May 2020

Let X1,X2,… be independent and identically distributed random elements taking values in a separable Hilbert space . With applications for functional data in mind, may be regarded as a space of square‐integrable functions, defined on a compact interval. We propose and study a novel test of the hypothesis H0 that X1 has some unspecified nondegenerate Gaussian distribution. The test statistic Tn = Tn(X1,…,Xn) is based on a measure of deviation between the empirical characteristic functional of X1,…,Xn and the characteristic functional of a suitable Gaussian random element of . We derive the asymptotic distribution of Tn as n→∞ under H0 and provide a consistent bootstrap approximation thereof. Moreover, we obtain an almost sure limit of Tn and the limit distributions of Tn under fixed and contiguous alternatives to Gaussianity. Simulations show that the new test is competitive with respect to the hitherto few competitors available.
A negative binomial thinning‐based bivariate INAR(1) process
Authors: Zhang Qingchun , Wang Dehui , Fan Xiaodong
Published: May 2020

This article considers a bivariate INAR(1) process based on an extension of the negative binomial thinning operator by prespecifying the distribution of the innovations. The dependence is introduced through the innovation components. The existence, uniqueness, strict stationarity, ergodicity, and some probabilistic properties of the process are derived. The estimation methods of conditional least squares and conditional maximum likelihood are considered. Some numerical results of the estimates are presented by simulation study. An application to crime data set is provided.
A last Resort Approach to (Number) Feature Inheritance1
Authors: Chou Chao‐Ting Tim , Fernández‐Salgueiro Gerardo
Published: May 2020

In this paper, we assume Chomsky's (2005, 2007, 2008) feature inheritance framework as an attempt to explain the correlation between the presence of C and agreement/finiteness on T in English. We argue, however, against one of its critical assumptions, namely, that T is a head deprived of φ‐features (i.e., a mere feature receptacle as put by Richards 2007). The proposal of this paper is three‐fold. First, based on the possibility of ellipsis in different infinitival contexts, we argue that there are two types of T heads in English: the one used inECMcontexts, containing no φ‐features, and the other occurring in finite/control/raising clauses andfor‐infinitives, which contains (at least) a person feature. Second, even though finite clauses,for‐infinitives, and control clauses are all headed by C, only the T head in finite clauses displays full agreement. We show that maintaining the feature inheritance hypothesis in the face of this challenge leads us to further distinguish two types of C heads in English: only the C head infor‐infinitives is φ‐complete, whereas that in finite/control clauses hosts only an inherent number feature. Finally, after reviewing the problems with existing motivations for Chomsky's feature inheritance hypothesis, we advance a novel approach to feature inheritance in which only the number feature is inherited as a last resort strategy to form a φ‐complete head for Case valuation in a phase.
Characterization of the novel HLA‐DQA1*01:49 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Locatelli Franco , Blouin Laura , Visentin Jonathan
Published: May 2020

HLA‐DQA1*01:49 differs from HLA‐DQA1*01:01:01:06 by one nucleotide substitution in codon 9 in exon 2.
Reference by Deference: The Real Semiotic Profile of Indexicals and Their Context
Authors: Perrin Denis
Published: May 2020

This article aims at proposing an account of the linguistic meaning (or: character) of pure indexicals (indexicals, for short). On its core theoretical proposal, a deference mechanism is built into the meaning of indexicals, and this mechanism defers the task of reference to contextually‐given designation relations. The basic motivation for this claim is that the contexts of tokening of indexicals, be they perceptual or discursive, are rich semiotic entities that provide designation relations that pre‐exist the interpretation of such indexicals. The latter, on my suggestion, would thus be deferential devices through which language exploits these semiotic elements of contexts. I make a case for this deferentialist image by first taking issue with intentionalism and token‐reflexivism concerning the use of indexicals in face‐to‐face communication. I argue for the possibility of indexicals having perceptual reference, claiming that intentionalism can account only for a pragmatic content that is sometimes added to the semantic content, but not for the semantic content itself, and that token‐reflexivism gives norms for the perceptual reference of indexicals, but not the reference operation itself. I then proceed to extend deferentialism to indexical expressions in general on the one hand, and to anaphoric uses of pure indexicals on the other.
Epidemiology and cost of Lyme disease‐related hospitalizations among patients with employer‐sponsored health insurance—United States, 2005–2014
Authors: Schwartz Amy M. , Shankar Manjunath B. , Kugeler Kiersten J. , Max Ryan J. , Hinckley Alison F. , Meltzer Martin I. , Nelson Christina A.
Published: May 2020

An estimated 300,000 cases of Lyme disease occur in the United States annually. Disseminated Lyme disease may result in carditis, arthritis, facial palsy or meningitis, sometimes requiring hospitalization. We describe the epidemiology and cost of Lyme disease‐related hospitalizations. We analysed 2005–2014 data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Databases to identify inpatient records associated with Lyme disease based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes. We estimated the annual number and median cost of Lyme disease‐related hospitalizations in the United States in persons under 65 years of age. Costs were adjusted to reflect 2016 dollars. Of 20,983,165 admission records contained in the inpatient databases during the study period, 2,823 (0.01%) met inclusion criteria for Lyme disease‐related hospitalizations. Over half of the identified records contained an ICD‐9‐CM code for meningitis (n = 614), carditis (n = 429), facial palsy (n = 400) or arthritis (n = 377). Nearly 60% of hospitalized patients were male. The median cost per Lyme disease‐related hospitalization was $11,688 (range: $140–$323,613). The manifestation with the highest median cost per stay was carditis ($17,461), followed by meningitis ($15,177), arthritis ($13,012) and facial palsy ($10,491). Median cost was highest among the 15‐ to 19‐year‐old age group ($12,991). Admissions occurring in January had the highest median cost ($13,777) for all study years. Based on extrapolation to the U.S. population, we estimate that 2,196 Lyme disease‐related hospitalizations in persons under 65 years of age occur annually with an estimated annual cost of $25,826,237. Lyme disease is usually treated in an outpatient setting; however, some patients with Lyme disease require hospitalization, underscoring the need for effective prevention methods to mitigate these serious cases. Information from this analysis can aid economic evaluations of interventions that prevent infection and advances in disease detection.
KATP channels modulate cerebral blood flow and oxygen delivery during isocapnic hypoxia in humans
Authors: Rocha Marcos P. , Campos Monique O. , Mattos João D. , Mansur Daniel E. , Rocha Helena N. M. , Secher Niels H. , Nóbrega Antonio C. L. , Fernandes Igor A.
Published: May 2020

Key points

ATP‐sensitive K+ (KATP) channels mediate hypoxia‐induced cerebral vasodilatation and hyperperfusion in animals.

We tested whether KATP channels blockade affects the increase in human cerebral blood flow (CBF) and the maintenance of oxygen delivery (CDO2) during hypoxia.

Hypoxia‐induced increases in the anterior circulation and total cerebral perfusion were attenuated under KATP channels blockade affecting the relative changes of brain oxygen delivery.

Therefore, in humans, KATP channels activation modulates the vascular tone in the anterior circulation of the brain, contributing to CBF and CDO2 responses to hypoxia.

ATP‐sensitive K+ (KATP) channels mediate hypoxia‐induced cerebral vasodilatation and hyperperfusion in animals. We tested whether KATP channels blockade affects the increase in cerebral blood flow (CBF) and the maintenance of oxygen delivery (CDO2) during hypoxia in humans. Nine healthy men were exposed to 5‐min trials of normoxia and isocapnic hypoxia (IHX, 10% O2) before (BGB) and 3 h after glibenclamide ingestion (AGB). Mean arterial pressure (MAP), arterial saturation (), partial pressure of oxygen () and carbon dioxide (), internal carotid artery blood flow (ICABF), vertebral artery blood flow (VABF), total (t)CBF (Doppler ultrasound) and CDO2 were quantified during the trials. IHX provoked similar reductions in and , while MAP was not affected by oxygen desaturation or KATP blockade. A smaller increase in ICABF (ΔBGB: 36 ± 23 vs. ΔAGB 11 ± 18%, p = 0.019) but not in VABF (∆BGB 26 ± 21 vs. ∆AGB 27 ± 27%, p = 0.893) was observed during the hypoxic trial under KATP channels blockade. Thus, IHX‐induced increases in tCBF (∆BGB 32 ± 19 vs. ∆AGB 14 ± 13%, p = 0.012) and CDO2 relative changes (∆BGB 7 ± 13 vs. ∆AGB −6 ± 14%, p = 0.048) were attenuated during the AGB hypoxic trial. In a separate protocol, 6 healthy men (5 from protocol 1) underwent a 5‐min exposure to normoxia and IHX before and 3 h after placebo (5 mg of cornstarch) ingestion. IHX reduced and , but placebo did not affect the ICABF, VABF, tCBF, or CDO2 responses. Therefore, in humans, KATP channels activation modulates vascular tone in the anterior rather than the posterior circulation of the brain, contributing to tCBF and CDO2 responses to hypoxia.
Shared Zones of Optimal Functioning: A Framework to Capture Peak Performance, Momentum, Psycho–Bio–Social Synchrony, and Leader–Follower Dynamics in Teams
Authors: Filho Edson
Published: May 2020

By bridging the literature on shared mental models and the individual zones of optimal functioning, the author advances a new framework called the shared zones of optimal functioning. The shared zones of optimal functioning is a probabilistic methodology designed to (a) capture optimal and suboptimal performance experiences in teams, (b) track team momentum through the analysis of within-team performance fluctuations, and (c) estimate within-team psycho–bio–social synchrony and leader–follower dynamics (i.e., leader–follower dichotomy, shared leadership). To test the shared zones of optimal functioning framework, three dyadic juggling teams were asked to juggle for 60 trials, while having their performance, arousal, pleasantness, and attentional levels recorded. Ordinal logistic regression, frequency counts, and cross-correlation analyses revealed that each team showed idiosyncratic affective and attentional levels linked to optimal performance, team momentum patterns, and leader–follower dynamics. The implications of these findings for the development of high-performing teams and specific avenues of future research are discussed throughout.
Importance of Frequency and Intensity of Strength Training for Reduced Musculoskeletal Pain in the Back, Neck–Shoulder, and Arm–Hand Among Physical Therapists
Authors: Ezzatvar Yasmín , Calatayud Joaquín , Andersen Lars L. , Casaña José
Published: May 2020

Background: Musculoskeletal pain (MP) is common among health care professionals, including physical therapists (PTs). The physically demanding nature of their work might contribute to increase MP rates. Strength training has a positive effect on musculoskeletal health and MP. However, no studies have evaluated the association of strength training during leisure time on MP among PTs. This study aims to analyze the association between frequency and intensity of strength training during leisure time and MP in the back, neck–shoulder, and arm–hand among PTs. Methods: Data on MP and intensity and frequency of strength training were obtained using a questionnaire responded by 1006 PTs. The odds for having lower level of MP as a function of intensity or frequency of the strength training were estimated using binary logistic regression. Results: High-intensity strength training showed strong associations with lower intensity of MP in neck–shoulder (odds ratio = 5.08; 95% confidence interval, 1.36–18.92), arm–hand (odds ratio = 5.22; 95% confidence interval, 1.11–24.51), and back (odds ratio = 5.22; 95% confidence interval, 1.41–19.28). However, frequency and lower intensities were not significantly associated with MP in any body part. Conclusions: High-intensity strength training is strongly associated with lower levels of MP in arm–hand, neck–shoulder, and back, whereas no association was found with frequency or lower intensities.
Self-induced spin glass state in elemental and crystalline neodymium
Authors: Kamber Umut , Bergman Anders , Eich Andreas , Iuşan Diana , Steinbrecher Manuel , Hauptmann Nadine , Nordström Lars , Katsnelson Mikhail I. , Wegner Daniel , Eriksson Olle , Khajetoorians Alexander A.
Published: May 2020

A structurally ordered spin glass

Spin glasses that form in disordered materials such as magnetic alloys have locally varying magnetic patterns, and their spin relaxation occurs over time scales spanning many orders of magnitude. Kamber
et al.
used spin-polarized scanning tunneling microscopy to image the magnetism on the (0001) surface of thick, single-crystal films of neodymium as a function of temperature and magnetic field. Despite the lack of structural disorder, they found a spectral distribution of degenerate magnetic wave vectors, or
Q
states, that exhibited spatiotemporal variation. In this spin-Q glass, pockets of nearly degenerate spin spiral states formed with varying periodicity. Ab initio electronic structure coupled to atomistic spin dynamics calculations suggests that the double hexagonal closed packed crystal structure in neodymium drove strongly frustrated magnetism that created these pockets.

Science
, this issue p.
eaay6757
Control of zeolite pore interior for chemoselective alkyne/olefin separations
Authors: Chai Yuchao , Han Xue , Li Weiyao , Liu Shanshan , Yao Sikai , Wang Chong , Shi Wei , da-Silva Ivan , Manuel Pascal , Cheng Yongqiang , Daemen Luke D. , Ramirez-Cuesta Anibal J. , Tang Chiu C. , Jiang Ling , Yang Sihai , Guan Naijia , Li Landong
Published: May 2020

Zeolites that prefer alkynes

Alkenes such as ethylene and propene must be separated from alkynes before they can be converted in polymers. Drawbacks in current methods, such as hydrogenation of alkynes producing unwanted alkanes, has spurred interest in sorption separation methods. Zeolites have generally been inefficient, given the similar sizes and volatilities of the molecules. Chai
et al.
incorporated atomically dispersed divalent transition metal cations into faujasite zeolite and found that the nickel-containing analog efficiently removed alkynes from olefins through chemoselective binding at open nickel(II) sites. At ambient conditions in the presence of water and carbon dioxide, the zeolites retained separation selectivities of 100 and 92, respectively, for acetylene over ethylene and propyne over propylene for 10 adsorption-desorption cycles.

Science
, this issue p.
1002
Synthesis of proteins by automated flow chemistry
Authors: Hartrampf N. , Saebi A. , Poskus M. , Gates Z. P. , Callahan A. J. , Cowfer A. E. , Hanna S. , Antilla S. , Schissel C. K. , Quartararo A. J. , Ye X. , Mijalis A. J. , Simon M. D. , Loas A. , Liu S. , Jessen C. , Nielsen T. E. , Pentelute B. L.
Published: May 2020

Fully synthetic whole proteins in reach

Solid-phase peptide synthesis of homogeneous peptides longer than about 50 amino acids has been a long-standing challenge because of inefficient coupling and side reactions. Hartrampf
et al.
used an automated chemistry platform to optimize fast-flow peptide synthesis and were able to produce fully synthetic single-domain proteins (see the Perspective by Proulx). The targets included proinsulin and enzymes such as barnase and a version of HIV-1 protease containing multiple noncanonical amino acids. Refolded peptides were nearly indistinguishable from recombinant proteins, and the synthesized enzymes had activity close to that of their ribosomally synthesized counterparts. This method will enable fast, on-demand synthesis of small proteins with a vastly expanded pool of precursor amino acids.

Science
, this issue p.
980
; see also p.
941
The will to act when the data are dire
Losing Earth: A Recent History
Nathaniel Rich
Farrar, Straus and Giroux, 2019. 224 pp.
Authors: Milam Erika Lorraine
Published: May 2020

Then and now, American politicians have failed to heed scientific warnings
Africanised honey bee sting-induced ischaemic stroke
Authors: Ramlackhansingh Anil Frank , Seecheran Naveen
Published: May 2020

The Africanised honey bee, vernacularly known as the ‘killer bee’, is a hybrid of the western honey bee species. These bees tend to be more aggressive with a greater tendency for swarm formation. Their stings are frequently encountered with a broad spectrum of clinical manifestations, ranging from local to systemic effects, even with recorded fatalities. We report a case of an elderly man, who experienced a cerebrovascular event confirmed by neuroimaging within 24 hours after a multitude of Africanised honey bee stings.
Financial ties between leaders of influential US professional medical associations and industry: cross sectional study
Authors: Moynihan Ray , Albarqouni Loai , Nangla Conrad , Dunn Adam G , Lexchin Joel , Bero Lisa
Published: May 2020

Objective

To investigate the nature and extent of financial relationships between leaders of influential professional medical associations in the United States and pharmaceutical and device companies.

Design

Cross sectional study.

Setting

Professional associations for the 10 costliest disease areas in the US according to the US Agency for Healthcare Research and Quality. Financial data for association leadership, 2017-19, were obtained from the Open Payments database.

Population

328 leaders, such as board members, of 10 professional medical associations: American College of Cardiology, Orthopaedic Trauma Association, American Psychiatric Association, Endocrine Society, American College of Rheumatology, American Society of Clinical Oncology, American Thoracic Society, North American Spine Society, Infectious Diseases Society of America, and American College of Physicians.

Main outcome measures

Proportion of leaders with financial ties to industry in the year of leadership, the four years before and the year after board membership, and the nature and extent of these financial relationships.

Results

235 of 328 leaders (72%) had financial ties to industry. Among 293 leaders who were medical doctors or doctors of osteopathy, 235 (80%) had ties. Total payments for 2017-19 leadership were almost $130m (£103m; €119m), with a median amount for each leader of $31 805 (interquartile range $1157 to $254 272). General payments, including those for consultancy and hospitality, were $24.8m and research payments were $104.6m—predominantly payments to academic institutions with association leaders named as principle investigators. Variation was great among the associations: median amounts varied from $212 for the American Psychiatric Association leaders to $518 000 for the American Society of Clinical Oncology.

Conclusions

Financial relationships between the leaders of influential US professional medical associations and industry are extensive, although with variation among the associations. The quantum of payments raises questions about independence and integrity, adding weight to calls for policy reform.
Invasive breast cancer and breast cancer mortality after ductal carcinoma in situ in women attending for breast screening in England, 1988-2014: population based observational cohort study
Authors: Mannu Gurdeep S , Wang Zhe , Broggio John , Charman Jackie , Cheung Shan , Kearins Olive , Dodwell David , Darby Sarah C
Published: May 2020

Objective

To evaluate the long term risks of invasive breast cancer and death from breast cancer after ductal carcinoma in situ (DCIS) diagnosed through breast screening.

Design

Population based observational cohort study.

Setting

Data from the NHS Breast Screening Programme and the National Cancer Registration and Analysis Service.

Participants

All 35 024 women in England diagnosed as having DCIS by the NHS Breast Screening Programme from its start in 1988 until March 2014.

Main outcome measures

Incident invasive breast cancer and death from breast cancer.

Results

By December 2014, 13 606 women had been followed for up to five years, 10 998 for five to nine years, 6861 for 10-14 years, 2620 for 15-19 years, and 939 for at least 20 years. Among these women, 2076 developed invasive breast cancer, corresponding to an incidence rate of 8.82 (95% confidence interval 8.45 to 9.21) per 1000 women per year and more than double that expected from national cancer incidence rates (ratio of observed rate to expected rate 2.52, 95% confidence interval 2.41 to 2.63). The increase started in the second year after diagnosis of DCIS and continued until the end of follow-up. In the same group of women, 310 died from breast cancer, corresponding to a death rate of 1.26 (1.13 to 1.41) per 1000 women per year and 70% higher than that expected from national breast cancer mortality rates (observed:expected ratio 1.70, 1.52 to 1.90). During the first five years after diagnosis of DCIS, the breast cancer death rate was similar to that expected from national mortality rates (observed:expected ratio 0.87, 0.69 to 1.10), but it then increased, with values of 1.98 (1.65 to 2.37), 2.99 (2.41 to 3.70), and 2.77 (2.01 to 3.80) in years five to nine, 10-14, and 15 or more after DCIS diagnosis. Among 29 044 women with unilateral DCIS undergoing surgery, those who had more intensive treatment (mastectomy, radiotherapy for women who had breast conserving surgery, and endocrine treatment in oestrogen receptor positive disease) and those with larger final surgical margins had lower rates of invasive breast cancer.

Conclusions

To date, women with DCIS detected by screening have, on average, experienced higher long term risks of invasive breast cancer and death from breast cancer than women in the general population during a period of at least two decades after their diagnosis. More intensive treatment and larger final surgical margins were associated with lower risks of invasive breast cancer.
The good and the bad: using C reactive protein to distinguish bacterial from non-bacterial infection among febrile patients in low-resource settings
Authors: Escadafal Camille , Incardona Sandra , Fernandez-Carballo B Leticia , Dittrich Sabine
Published: May 2020

C reactive protein (CRP), a marker for the presence of an inflammatory process, is the most extensively studied marker for distinguishing bacterial from non-bacterial infections in febrile patients. A point-of-care test for bacterial infections would be of particular use in low-resource settings where other laboratory diagnostics are not always available, antimicrobial resistance rates are high and bacterial infections such as pneumonia are a leading cause of death. This document summarises evidence on CRP testing for bacterial infections in low-income and middle-income countries (LMICs). With a push for universal health coverage and prevention of antimicrobial resistance, it is important to understand if CRP might be able to do the job. The use of CRP polarised the global health community and the aim of this document is to summarise the ‘good and the bad’ of CRP in multiple settings in LMICs. In brief, the literature that was reviewed suggests that CRP testing may be beneficial in low-resource settings to improve rational antibiotic use for febrile patients, but the positive predictive value is insufficient to allow it to be used alone as a single tool. CRP testing may be best used as part of a panel of diagnostic tests and algorithms. Further studies in low-resource settings, particularly with regard to impact on antibiotic prescribing and cost-effectiveness of CRP testing, are warranted.
Cohort profile: the LHIV-Manitoba clinical cohort of people living with HIV in Manitoba, Canada
Authors: McClarty Leigh M , Cheuk Eve , Ireland Laurie , Kendall Claire , Bibeau Christine , Loeppky Carla , Kasper Ken , Keynan Yoav , Blanchard James , Becker Marissa
Published: May 2020

Purpose

The LHIV-Manitoba cohort was developed as a way to provide a comprehensive source of HIV-related health information in the central Canadian Prairie province of Manitoba. The cohort will provide important information as we aim to better understand local HIV epidemiology and address key knowledge and practice gaps in HIV prevention, treatment and care programming in the province.

Participants

In total, 890 individuals, aged 18 or older and living or receiving HIV care in Manitoba are enrolled in the cohort. A complete clinical dataset exists for 725 participants, which includes variables on sociodemographic characteristics, comorbidities and co-infections, self-reported HIV exposure categories and HIV clinical indicators. A limited clinical dataset exists for an additional 165 individuals who were enrolled posthumously. 97.5% of cohort participants’ clinical records are linked to provincial administrative health datasets.

Findings to date

The average age of cohort participants is 49.7 years. Approximately three-quarters of participants are male, 42% self-identified as white and 42% as Indigenous. The majority of participants (64%) reported condomless vaginal sex as a risk exposure for HIV. Nearly one-fifth (18%) of participants have an active hepatitis C virus infection and the cohort’s median CD4 count increased from 316 cells/mm3 to 518 cells/mm3 between time of entry into care and end of the first quarter in 2019.

Future plans

The LHIV-Manitoba cohort is an open cohort, and as such, participant enrolment, data collection and analyses will be continually ongoing. Future analyses will focus on the impact of provincial drug plans on clinical outcomes, determinants of mortality among cohort participants and deriving estimates for a local HIV care cascade.
Public satisfaction with the healthcare system in China during 2013–2015: a cross-sectional survey of the associated factors
Authors: Zhang Jing Hua , Peng Xinxin , Liu Chengkun , Chen Yijun , Zhang Hongmin , Iwaloye Ojo Olukayode
Published: May 2020

Objective

We explore how public satisfaction with the healthcare system in China varies with social and economic factors, especially regional variations and changes during 2013–2015.

Design

Population-based, cross-sectional survey performed between July 2013 and July 2015.

Setting

General population of China during 2013–2015.

Participants

A total of 15 969 participants (women=49.4%, sample-weighted average age=51.9).

Primary outcome measure

Public satisfaction with the healthcare system, defined as ‘being satisfied’ if a respondent’s satisfaction score is ≥70 points.

Results

The 2-year mean of the satisfaction score of the sample is 68.5 out of 100 points and the score in 2015 is higher than 2013 by 3.5 points. Senior respondents (OR=1.19, p<0.001), rural respondents (OR=1.23, p=0.009) and those with higher socioeconomic status are more likely to report being satisfied. Internal migrants (OR=0.75, p<0.001) and those with a higher level of education are less likely to report being satisfied. Total health expenditure as percentage of gross domestic product and density of hospital beds have a significantly positive association with satisfaction (OR=1.13, p<0.001). Meanwhile, the government’s share in total healthcare expenditures has a moderately negative association with satisfaction (OR=0.97, p<0.001). In rural areas, the density of hospital beds has a positive association with satisfaction (OR=1.26, p=0.002). The Northeast region and Shanghai (OR=0.49, p<0.001; OR=0.71, p=0.034) are less likely to report being satisfied and this remained unchanged in 2015.

Conclusion

There are considerable disparities in public satisfaction with the healthcare system in China, associated with demographic and socioeconomic characteristics, regional locations, urban–rural environment, and regional health resource abundance. Actions are recommended to improve satisfaction with the public healthcare system, especially in the Northeast region of China.
Tracing frequent users of regional care services using emergency medical services data: a networked approach
Authors: Maruster Laura , van der Zee Durk-Jouke , Hatenboer Jaap , Buskens Erik
Published: May 2020

Objectives

This study shows how a networked approach relying on ‘real-world’ emergency medical services (EMS) records might contribute to tracing frequent users of care services on a regional scale. Their tracing is considered of importance for policy-makers and clinicians, since they represent a considerable workload and use of scarce resources. While existing approaches for data collection on frequent users tend to limit scope to individual or associated care providers, the proposed approach exploits the role of EMS as the network’s ‘ferryman’ overseeing and recording patient calls made to an entire network of care providers.

Design

A retrospective study was performed analysing 2012–2017 EMS calls in the province of Drenthe, the Netherlands. Using EMS data, benefits of the networked approach versus existing approaches are assessed by quantifying the number of frequent users and their associated calls for various categories of care providers. Main categories considered are hospitals, nursing homes and EMS.

Setting

EMS in the province of Drenthe, the Netherlands, serving a population of 491 867.

Participants

Analyses are based on secondary patient data from EMS records, entailing 212 967 transports and 126 758 patients, over 6 years (2012–2017).

Results

Use of the networked approach for analysing calls made to hospitals in Drenthe resulted in a 20% average increase of frequent users traced. Extending the analysis by including hospitals outside Drenthe increased ascertainment by 28%. Extending to all categories of care providers, inside Drenthe, and subsequently, irrespective of their location, resulted in an average increase of 132% and 152% of frequent users identified, respectively.

Conclusions

Many frequent users of care services are network users relying on multiple regional care providers, possibly representing inefficient use of scarce resources. Network users are effectively and efficiently traced by using EMS records offering high coverage of calls made to regional care providers.
The RECARDINA Study protocol: diagnostic utility of ultra-abbreviated echocardiographic protocol for handheld machines used by non-experts to detect rheumatic heart disease
Authors: Francis Joshua Reginald , Fairhurst Helen , Whalley Gillian , Kaethner Alex , Ralph Anna , Yan Jennifer , Cush James , Wade Vicki , Monteiro Andre , Remenyi Bo
Published: May 2020

Introduction

Rheumatic heart disease (RHD) causes significant morbidity and mortality in young people from disadvantaged populations. Early detection through echocardiography screening can facilitate early access to treatment. Large-scale implementation of screening could be feasible with the combination of inexpensive standalone ultrasound transducers and upskilling non-expert practitioners to perform abbreviated echocardiography.

Methods and analysis

A prospective cross-sectional study will evaluate an abbreviated echocardiography screening protocol for the detection of latent (asymptomatic) RHD in high-risk populations. The study will evaluate the diagnostic accuracy of health worker conducted single parasternal long axis view with a sweep using handheld devices (SPLASH) (Philips Lumify S4-1 phased array transducer). Each participant will have at least one reference test performed on the same day by an expert echocardiographer. Diagnosis of RHD will be determined by a panel of three experts, using 2012 World Heart Federation criteria. Sensitivity and specificity of the index test will be calculated with 95% CIs, to determine diagnostic accuracy of a screen-and-refer approach to echocardiography screening for RHD. Remote review of SPLASH images obtained by health workers will facilitate evaluation of the sensitivity and specificity of an alternative approach, using external review of health worker obtained SPLASH images to decide onward referral.

Ethics and dissemination

Ethics approval was obtained from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, for the project to be carried out in Timor-Leste (HREC 2019-3399), and in Australia, following review by the Aboriginal Ethics subcommittee (HREC 2019-334). Ethical and technical approval was granted in Timor-Leste, by the Institute National of Health Research Ethics and Technical Committee (1073-MS-INS/GDE/VII/2019). Study results will be disseminated in the communities involved in the study, and through peer-reviewed publications and conference abstracts.

Trial registration number

The Australia New Zealand Clinical Trials Registry (ACTRN12620000122954).