bluuebunny/crossref_metadata_2025 huggingface dataset:
Predisposing factors for bacterial mastitis in ewes
Authors: Vasileiou Natalia G. C. , Mavrogianni Vassiliki S. , Petinaki Efi , Fthenakis George C.
Published: July 2019

Objective of this review paper is the appraisal of predisposing factors for bacterial mastitis in ewes. Factors that predispose ewes to mastitis can be classified into non‐animal‐related factors (environmental and climatological factors, housing, nutrition, milking practices) and animal‐related factors (anatomic, genetic, litter size—ethological factors, number and stage of lactation period, health problems). There are clear management—environment—animal interactions in mastitis development in ewes, which underline its multifactorial nature. Research and studies regarding risk factors are important, in order to develop strategies for their elimination, control or correction. Control measures for bacterial mastitis, which attempt to eliminate predisposing factors for infection, can thus be developed and implemented.
Cauliflower ear among Finnish high‐level male wrestlers and judokas is prevalent and symptomatic deformity
Authors: Manninen Iida‐Kaisa , Blomgren Karin , Elokiuru Rauno , Lehto Mika , Mäkinen Laura K , Klockars Tuomas
Published: July 2019

Our research aimed to study the prevalence, concerns, and treatment practices related to cauliflower ear among Finnish wrestlers and judokas. In total, 32 Finnish wrestlers and 31 judokas completed a questionnaire at training sessions or at a competition. All participants were adults competing at the national or international levels. We also took lateral digital photographs of participants’ ears. A senior author graded the overall appearance of the auricles on a scale from 0 to 5 (0 = normal auricle, 5 = extreme cauliflower ear). Cauliflower ear was more prevalent among male athletes (84%, 46/55) than female athletes (0%, 0/8, P < .001). Almost all (96%) had sought treatment for an auricular hematoma. The most prevalent treatment modality was needle aspiration (96%). Most (76%) had received treatment from individuals not representing the healthcare profession. Only one athlete reported receiving successful treatment. No complications from treatment were reported. Almost all participants (96%) reported some symptom from the cauliflower ear, typically pain. None regretted their cauliflower ear(s), and 41% of athletes with cauliflower ear considered it desirable. Cauliflower ear is a common and symptomatic deformity among high‐level Finnish wrestlers and judokas. Despite the symptoms, it is accepted and sometimes even desired among the athletes.
“Danger, Will Robinson!” The challenges of social robots for intergroup relations
Authors: Vanman Eric J. , Kappas Arvid
Published: July 2019

Society's increasing reliance on robots in everyday life provides exciting opportunities for social psychologists to work with engineers in the nascent field of social robotics. In contrast to industrial robots that, for example, may be used on an assembly line, social robots are designed specifically to interact with humans and/or other robots. People tend to perceive social robots as autonomous and capable of having a mind. As such, they are also more likely to be subject to social categorization by humans. As social robots become more human like, people may also feel greater empathy for them and treat robots more like (human) ingroup members. On the other hand, as they become more human like, robots also challenge our human distinctiveness, threaten our identity, and elicit suspicion about their ability to deceive us with their human‐like qualities. We review relevant research to explore this apparent paradox, particularly from an intergroup relations perspective. We discuss these findings and propose three research questions that we believe social psychologists are ideally suited to address.
Naturally better? A review of the natural‐is‐better bias
Authors: Meier Brian P. , Dillard Amanda J. , Lappas Courtney M.
Published: July 2019

People are frequently exposed to products and services that are labeled natural (e.g., Nature Made Vitamins or GoJo Natural Orange Hand Cleaner). The frequency with which this label is used suggests that it delivers an advantage in marketing and sales. Our review examines the preference for and perception of naturalness and reveals that people have a bias for items described as natural in many domains including foods, medicine, beauty products, cigarettes, and lighting. These preferences abound even when the natural item is identical or not objectively better than the non‐natural or synthetic item. We believe this bias may be driven by a natural‐is‐better default belief as well as the belief that natural items are safer than non‐natural items. Although a bias for natural items is apparent, this literature is in its infancy, and we suggest three areas that will help build and refine the empirical research base and theory: the measurement of behavior, the examination of individual differences, and the development of methods for reducing the bias. A better understanding of the naturalness bias relevant to these areas will lead to a more comprehensive understanding of the area, including factors that may cause and reduce it.
Combined association of recipient killer cell immunoglobulin‐like haplotype AA and donor HLA‐C*07 gene with BK virus associated nephropathy in kidney transplant patients
Authors: Kovacevic Vojtusek Ivana , Burek Kamenaric Marija , Ivkovic Vanja , Bulimbasic Stela , Marekovic Ivana , Coric Marijana , Bosnjak Zrinka , Grubic Zorana , Zunec Renata
Published: July 2019

Kidney transplant recipient killer cell immunoglobulin‐like receptors (KIR) genotype and HLA‐C status of their donors have been separately associated with BK virus‐associated nephropathy (BKVAN) and BK virus infection. Our aim was to determine whether different combinations of recipients KIR genes and donor HLA‐C ligands influence the risk of BKVAN. Retrospective case‐control study included 23 recipients with BKVAN and 46 recipients with persistently negative BK virus. Donor HLA‐C*07 positivity was associated with lower odds for BKVAN, recipients bearing KIR haplotype AA or lacking any activating KIR genes were more frequent in BKVAN while recipient/donor combination HLA‐C*07 negative/KIR AA positive was significantly associated with BKVAN. Our study complements and confirms results from several previously published studies, suggesting potential clinical usefulness.
DELAY OF GERMINATION 1‐LIKE 4 acts as an inducer of seed reserve accumulation
Authors: Sall Khadidiatou , Dekkers Bas J. W. , Nonogaki Mariko , Katsuragawa Yoshihiko , Koyari Ryosuke , Hendrix David , Willems Leo A. J. , Bentsink Leónie , Nonogaki Hiroyuki
Published: July 2019

More than 70% of global food supply depends on seeds. The major seed reserves, such as proteins, lipids, and polysaccharides, are produced during seed maturation. Here, we report that DELAY OF GERMINATION 1‐LIKE 4 (DOGL4) is a major inducer of reserve accumulation during seed maturation. The DOGL family proteins are plant‐specific proteins of largely unknown biochemical function. DOGL4 shares only limited homology in amino acid sequence with DOG1, a major regulator of seed dormancy. DOGL4 was identified as one of the outstanding abscisic acid (ABA)‐induced genes in our RNA sequencing analysis, whereas DOG1 was not induced by ABA. Induction of DOGL4 caused the expression of 70 seed maturation‐specific genes, even in germinating seeds, including the major seed reserves ALBUMIN, CRUCIFERIN and OLEOSIN. Although DOG1 affects the expression of many seed maturation genes, the major seed reserve genes induced by DOGL4 are not altered by the dog1 mutation. Furthermore, the reduced dormancy and longevity phenotypes observed in the dog1 seeds were not observed in the dogl4 mutants, suggesting that these two genes have limited functional overlap. Taken together, these results suggest that DOGL4 is a central factor mediating reserve accumulation in seeds, and that the two DOG1 family proteins have diverged over the course of evolution into independent regulators of seed maturation, but retain some overlapping function.
Salmonellosis detection and evidence of antibiotic resistance in an urban raccoon population in a highly populated area, Costa Rica
Authors: Baldi Mario , Barquero Calvo Elías , Hutter Sabine E. , Walzer Chris
Published: July 2019

Wild animals are involved in zoonotic disease transmission cycles. These are generally complex and poorly understood, especially among animals adapted to life in human ecosystems. Raccoons are reservoirs and effective carriers for infectious agents such as Salmonella throughout different environments and contribute to the transference of resistance genes. This study examined the presence of circulating Salmonella sp. in a population of raccoons in a tropical urban environment and evaluated resistance to antibiotics commonly used to treat salmonellosis. A total of 97 raccoons of different ages and sex were included in this study. 49% (38–60 CI) of the faecal samples were positive for Salmonella spp. The study identified 15 circulating serovars with the most prevalent being S. Hartford (7/15), S. Typhimurium (4/15) and S. Bovismorbificans (4/15). These serovars correspond to the serovars detected in humans with clinical symptoms in Costa Rica. 9.5% of the Salmonella strains recovered demonstrated ciprofloxacin resistance, and 7.1% showed resistance to nalidixic acid. This study provides evidence of multiple Salmonella serovars circulating in a population of urban raccoons in Costa Rica. Furthermore, the study confirms the existence of antimicrobial resistance to two antibiotics used to treat human salmonellosis. The findings emphasize the role of the raccoon as a reservoir of Salmonella in the Greater Metropolitan Area of Costa Rica (GAM) and stress the need for active monitoring of the presence and possible spread in antibiotic resistance due to this peri‐domestic carnivore.
Importancia del Gobierno Corporativo en las sociedades financieras populares en México
Authors: Torres Grimaldo José Alfredo , Cano Morales Abel María
Published: July 2019

El sector de ahorro y crédito popular en México se ha caracterizado por una baja participación en el sistema financiero; sin embargo, a principios de este siglo mostró un gran dinamismo en medio de un entorno regulatorio débil que llevó a la proliferación de supuestas cajas de ahorros. Para el año 2001, México tenía 630 entidades de ahorro y crédito con más de dos millones de miembros. Por lo tanto, era esencial regular este sector a través de la Ley de Ahorro y Crédito Popular del 4 de junio de 2001, además de reformar la Ley General de Sociedades Cooperativas. Hoy es necesario el compromiso de las empresas para que cumplan las regulaciones sobre Gobierno Corporativo y que los administradores y gerentes de las Sociedades Financieras Populares –SOFIPO– integren las prácticas de Gobierno Corporativo, en forma regular y recurrente, en su estrategia de crecimiento, fortalecimiento y permanencia en el sector.
Aspiration in fricative and nasal consonants: Properties and detection
Authors: Rabha Saswati , Sarmah Priyankoo , Prasanna S. R. Mahadeva
Published: July 2019

Unlike aspiration in stops, occurrence of aspiration in non-stop consonants is quite rare. Most of the languages that have aspirated non-stop consonants are low-resource languages. Hence, data driven, quantitative, and statistical analysis of their aspiration phenomena is fairly limited. Rabha and Angami are considered in this study, as previous studies have confirmed the existence of aspiration contrast in fricatives and nasals. This study reports the acoustic characteristics of aspiration in stops, fricatives, and nasals. Among them, distinguishing the aspirated fricatives and aspirated nasals from their unaspirated counterparts is a challenging task. A set of acoustic features is proposed to automatically detect the presence of aspiration in fricatives and nasals. Acoustic features, such as vocal tract constriction (VTC), normalized autocorrelation peak strength (NAPS), strength of excitation (SoE), and variance of successive epoch intervals (VSEI) are used to detect aspiration in fricatives and nasals. These features are extracted from zero-frequency filtered signal of the speech sounds, as it preserves the aspiration information. Results show that VTC, NAPS, and SoE can detect aspiration in nasals, whereas SoE and VSEI can detect aspiration in fricatives. The proposed method improves the performance of an automatic phoneme recognizer by reducing the confusion between aspirated and unaspirated counterparts.
Performance of five ultrasonic transducers modified for efficient atomization
Authors: Matsuura Hiroshi , Furukawa Hiromitsu , Tanikawa Tamio , Hashimoto Hideki
Published: July 2019

Performance of five ultrasonic transducers modified with different shapes of electrodes is investigated for efficient atomization. A circular silver electrode, which is conventionally used as standard on a transducer, is chemically replaced with five shapes of silver electrodes (circular, toroidal, singlet, doublet, and cross). Each electrode reflects its precise shape on the water surface and statically forms characteristic three-dimensional geometry of a water column. The modified electrode also affects the dynamics of this water column, generating two types of wobbling on the column and inducing three types of atomization depending on the shape of the electrodes. Statistical analysis indicates that the shape of the electrode on an ultrasonic transducer affects the speed of atomization, showing that the singlet electrode exhibits the highest speed of atomization (4 mg/s). The mechanisms of atomization are analyzed from the viewpoint of energy transformation with reference to mass transformation of the oscillating liquid, indicating that the vibration energy of the transducer is transferred to the water film through resonance, consuming this vibration energy with four kinds of energy such as kinetic energy of atomized mists and work function of atomization, which are defined in this study. This analysis clarifies why the speed of atomization increases with a decreasing amount of water on the transducer. Application of the appropriate shape of an electrode will greatly contribute to the fields of engineering, medicine, and biology where various types of atomization are highly desired as the situation demands.
Analysis of thermal and viscous boundary layers in acoustic absorption by metallic foam
Authors: Cops Mark J. , McDaniel J. Gregory , Magliula Elizabeth A. , Bamford David J.
Published: July 2019

A method for estimating acoustic absorption in foams is presented using a combination of micro-computed tomography, finite element analysis, and boundary layer loss theory. In the method, the foam is assumed to be rigid framed and the viscous and thermal boundary layers at the fluid and frame interface are assumed to be small compared to foam dimensions. The boundary layer losses are approximated using an infinite planar model. The method is demonstrated for a commercially available open-cell metallic foam and allows for absorption to be estimated without determination of any intermediate variables that are required in existing methods. Enhancement of sound absorbing properties by selection of foam properties, such as porosity and pores per inch, is discussed. Furthermore, predicted absorption trends agree with other published models and experimental data. A simplified, two-dimensional geometry is presented in which the assumptions of this method are analyzed.
Bridge-Building for Social Transformation in Sport for Development and Peace
Authors: Svensson Per G. , Loat Richard
Published: July 2019

The need for new and evidence-based solutions for mobilizing stakeholders and resources in sport for development and peace (SDP) is increasingly emphasized in a number of recent policy documents including the Kazan Action Plan and a set of publications by the Commonwealth Secretariat. This paper provides a response to these calls for the development of mechanisms and toolkits to support multistakeholder collaboration. We draw on our combined experiences in SDP research, practice, and funding to identify how multistakeholder initiatives in SDP can be better leveraged. Specifically, we discuss how Brown’s (2015) five elements of bridge-building for social transformation, namely, compelling and locally relevant goals; cross-boundary leadership systems; generative theories of change; systems enabling and protecting innovation; and investment in institutionalizing change, apply in the SDP domain. The practical framework we have outlined provides a common ground and starting point to build upon for generating improved synergies among a multitude of stakeholders.
Noncompetitive inhibitors of TNFR1 probe conformational activation states
Authors: Lo Chih Hung , Schaaf Tory M. , Grant Benjamin D. , Lim Colin Kin-Wye , Bawaskar Prachi , Aldrich Courtney C. , Thomas David D. , Sachs Jonathan N.
Published: July 2019

A small molecule that noncompetitively inhibits TNFR1 could be optimized to treat inflammatory diseases.
Slow growth causes bacterial persistence
Authors: Kaldalu Niilo , Tenson Tanel
Published: July 2019

Formation of
Salmonella
persister cells depends on slow growth (Pontes and Groisman in 30 July 2019 issue).
Long-Term Effects on QT Prolongation of Pretomanid Alone and in Combinations in Patients with Tuberculosis
Authors: Li Hanbin , Salinger David H. , Everitt Daniel , Li Mengchun , Del Parigi Angelo , Mendel Carl , Nedelman Jerry R.
Published: July 2019

Concentration-QTc modeling was applied to pretomanid, a new nitroimidazooxazine antituberculosis drug. Data came from eight phase 2 and phase 3 studies.
Molecular Surveillance of Drug Resistance of Plasmodium falciparum Isolates Imported from Angola in Henan Province, China
Authors: Zhou Ruimin , Yang Chengyun , Li Suhua , Zhao Yuling , Liu Ying , Qian Dan , Wang Hao , Lu Deling , Zhang Hongwei , Huang Fang
Published: July 2019

Angola was the main origin country for the imported malaria in Henan Province, China. Antimalarial drug resistance has posed a threat to the control and elimination of malaria. Several molecular markers were confirmed to be associated with the antimalarial drug resistance, such as
pfcrt
,
pfmdr1
,
pfdhfr
,
pfdhps
, and
K13.
This study evaluated the drug resistance of the 180 imported
Plasmodium falciparum
isolates from Angola via nested PCR using Sanger sequencing.
Organization of the Skin Immune System and Compartmentalized Immune Responses in Infectious Diseases
Authors: Quaresma Juarez Antonio Simões
Published: July 2019

The skin is an organ harboring several types of immune cells that participate in innate and adaptive immune responses. The immune system of the skin comprises both skin cells and professional immune cells that together constitute what is designated skin-associated lymphoid tissue (SALT). In this review, I extensively discuss the organization of SALT and the mechanisms involved in its responses to infectious diseases of the skin and mucosa.
Consumer Safety Considerations of Skin and Oral Microbiome Perturbation
Authors: McBain Andrew J. , O’Neill Catherine A. , Amezquita Alejandro , Price Laura J. , Faust Karoline , Tett Adrian , Segata Nicola , Swann Jonathan R. , Smith Adrian M. , Murphy Barry , Hoptroff Michael , James Gordon , Reddy Yugandhar , Dasgupta Anindya , Ross Tom , Chapple Iain L. , Wade William G. , Fernandez-Piquer Judith
Published: July 2019

Microbiomes associated with human skin and the oral cavity are uniquely exposed to personal care regimes. Changes in the composition and activities of the microbial communities in these environments can be utilized to promote consumer health benefits, for example, by reducing the numbers, composition, or activities of microbes implicated in conditions such as acne, axillary odor, dandruff, and oral diseases.
Introduction to Measurement of Avidity of Anti-Coxiella burnetii IgG in Diagnosis of Q Fever
Authors: Luciani Léa , L’Ollivier Coralie , Million Matthieu , Amphoux Bernard , Edouard Sophie , Raoult Didier
Published: July 2019

Due to the atypical serological profile of some patients with primary Q fever infection who do not develop IgM against
Coxiella burnetii
, we developed an avidity test to distinguish recent or past infections. We tested 39 serum samples by immunofluorescence with conventional assay and after urea treatment from 26 patients at different stages of the disease.
Immunization of BLT Humanized Mice Redirects T Cell Responses to Gag and Reduces Acute HIV-1 Viremia
Authors: Claiborne Daniel T. , Dudek Timothy E. , Maldini Colby R. , Power Karen A. , Ghebremichael Musie , Seung Edward , Mellors Elizabeth F. , Vrbanac Vladimir D. , Krupp Katharine , Bisesi Abigail , Tager Andrew M. , Knipe David M. , Boutwell Christian L. , Allen Todd M.
Published: July 2019

Advances in the development of humanized mice have raised the possibility of a small-animal model for preclinical testing of an HIV-1 vaccine. Here, we describe the capacity of BLT humanized mice to mount broadly directed HIV-1-specific human T cell responses that are functionally active, as indicated by the rapid emergence of viral escape mutations. Although immunization of BLT mice with the conserved viral Gag protein did not result in detectable prechallenge responses, it did increase the magnitude and kinetics of postchallenge Gag-specific T cell responses, which was associated with a modest but significant reduction in acute HIV-1 viremia. Additionally, the BLT model revealed immunization-associated increases in the plasma concentrations of immunomodulatory cytokines and chemokines that correlated with more robust T cell responses. These data support the potential utility of the BLT humanized mouse for HIV-1 vaccine development but suggest that additional improvements to the model are warranted.
Physiology and Distribution of Archaeal Methanotrophs That Couple Anaerobic Oxidation of Methane with Sulfate Reduction
Authors: Bhattarai S. , Cassarini C. , Lens P. N. L.
Published: July 2019

In marine anaerobic environments, methane is oxidized where sulfate-rich seawater meets biogenic or thermogenic methane. In those niches, a few phylogenetically distinct microbial types, i.e., anaerobic methanotrophs (ANME), are able to grow through anaerobic oxidation of methane (AOM). Due to the relevance of methane in the global carbon cycle, ANME have drawn the attention of a broad scientific community for 4 decades.
Translocation of Dense Granule Effectors across the Parasitophorous Vacuole Membrane in
Toxoplasma-
Infected Cells Requires the Activity of ROP17, a Rhoptry Protein Kinase
Authors: Panas Michael W. , Ferrel Abel , Naor Adit , Tenborg Elizabeth , Lorenzi Hernan A. , Boothroyd John C.
Published: July 2019

When
Toxoplasma
infects a cell, it establishes a protective parasitophorous vacuole surrounding it. While this vacuole provides protection, it also serves as a barrier to the export of parasite effector proteins that impact and take control of the host cell. Our discovery here that the parasite rhoptry protein ROP17 is necessary for export of these effector proteins provides a distinct, novel function for ROP17 apart from its known role in protecting the vacuole. This will enable future research into ways in which we can prevent the export of effector proteins, thereby preventing
Toxoplasma
from productively infecting its animal and human hosts.
The Glycosylphosphatidylinositol-Anchored
DFG
Family Is Essential for the Insertion of Galactomannan into the β-(1,3)-Glucan–Chitin Core of the Cell Wall of Aspergillus fumigatus
Authors: Muszkieta Laetitia , Fontaine Thierry , Beau Rémi , Mouyna Isabelle , Vogt Marian Samuel , Trow Jonathan , Cormack Brendan P. , Essen Lars-Oliver , Jouvion Gregory , Latgé Jean-Paul
Published: July 2019

The fungal cell wall is a complex and dynamic entity essential for the development of fungi. It is composed mainly of polysaccharides that are synthetized by protein complexes. Enzymes involved in postsynthesis polysaccharide modifications, such as cleavage, elongation, branching, and cross-linking, are essential for fungal life. Here, we investigated in
Aspergillus fumigatus
the role of the members of the Dfg family, one of the 4 GPI-anchored protein families common to yeast and molds involved in cell wall remodeling. Molecular and biochemical approaches showed that DFG members are required for filamentous growth, conidiation, and cell wall organization and are essential for the life of this fungal pathogen.
Combined Antifungal Resistance and Biofilm Tolerance: the Global Threat of Candida auris
Authors: Kean Ryan , Ramage Gordon
Published: July 2019

The enigmatic yeast
Candida auris
has emerged over the last decade and rapidly penetrated our consciousness. The global threat from this multidrug-resistant yeast has generated a call to arms from within the medical mycology community. Over the past decade, our understanding of how this yeast has spread globally, its clinical importance, and how it tolerates and resists antifungal agents has expanded.
Effectiveness of intermittent screening and treatment for the control of malaria in pregnancy: a cluster randomised trial in India
Authors: Kuepfer Irene , Mishra Neelima , Bruce Jane , Mishra Vinit , Anvikar Anupkumar R , Satpathi Sanghamitra , Behera Prativa , Muehlenbachs Atis , Webster Jayne , terKuile Feiko , Greenwood Brian , Valecha Neena , Chandramohan Daniel
Published: July 2019

Background

The control of malaria in pregnancy (MiP) in India relies on testing women who present with symptoms or signs suggestive of malaria. We hypothesised that intermittent screening and treatment for malaria at each antenatal care visit (ISTp) would improve on this approach and reduce the adverse effects of MiP.

Methods

A cluster randomised controlled trial comparing ISTp versus passive case detection (PCD) was conducted in Jharkhand state. Pregnant women of all parities with a gestational age of 18–28 weeks were enrolled. Women in the ISTp group were screened with a rapid diagnostic test (RDT) for malaria at each antenatal clinic visit and those in the PCD group were screened only if they had symptoms or signs suggestive of malaria. All RDT positive women were treated with artesunate/sulfadoxine–pyrimethamine. The primary endpoint was placental malaria, determined by placental histology, and the key secondary endpoints were birth weight, gestational age, vital status of the newborn baby and maternal anaemia.

Results

Between April 2012 and September 2015, 6868 women were enrolled; 3300 in 46 ISTp clusters and 3568 in 41 PCD clusters. In the ISTp arm, 4.9% of women were tested malaria positive and 0.6% in the PCD arm. There was no difference in the prevalence of placental malaria in the ISTp (87/1454, 6.0%) and PCD (65/1560, 4.2%) groups (6.0% vs 4.2%; OR 1.34, 95% CI 0.78 to 2.29, p=0.29) or in any of the secondary endpoints.

Conclusion

ISTp detected more infections than PCD, but monthly ISTp with the current generation of RDT is unlikely to reduce placental malaria or impact on pregnancy outcomes. ISTp trials with more sensitive point-of-care diagnostic tests are needed.
Possibilities for interprofessional learning at a Swedish acute healthcare ward not dedicated to interprofessional education: an ethnographic study
Authors: Hägg-Martinell Ann , Hult Håkan , Henriksson Peter , Kiessling Anna
Published: July 2019

Objectives

Almost all healthcare today is team-based in collaboration over professional borders, and numerous students have work-based learning in such contexts. However, interprofessional learning (IPL) in clinical settings has mostly been systematically explored in specially designed contexts dedicated to interprofessional education (IPE). This study aimed to explore the possibilities for IPL activities, and if or how they occur, in an acute ward context not dedicated to IPE.

Design and setting

Between 2011 and 2013 ethnographic observations were performed of medical and nursing students’ interactions and IPL during early clerkship at an acute internal medicine ward in Sweden. Field notes were taken and analysed based on the framework of IPE:learning with, from and about.

Participants

21 medical, 4 nursing students and 30 supervisors participated.

Results

Learning with—there were no organised IPE activities. Instead, medical and nursing students learnt in parallel. However, students interacted with staff members from other professions.Learning from—interprofessional supervision was frequent. Interprofessional supervision of nursing students by doctors focused on theoretical questions and answers, while interprofessional supervision of medical students by nurses focused on the performance of technical skills.Learning about—students were observed to actively observe interactions between staff and learnt how staff conducted different tasks.

Conclusion

This study shows that there were plenty of possibilities for IPL activities, but the potential was not fully utilised or facilitated. Serendipitous IPL activities differed between observed medical and nursing students. Although interprofessional supervision was fairly frequent, students were not learning with, from or about each other over professional borders.
Risk scores identifying elderly inpatients at risk of 30-day unplanned readmission and accident and emergency department visit: a systematic review
Authors: Schwab Camille , Hindlet Patrick , Sabatier Brigitte , Fernandez Christine , Korb-Savoldelli Virginie
Published: July 2019

Objectives

The aim of this systematic review was to describe and analyse the performance statistics of validated risk scores identifying elderly inpatients at risk of early unplanned readmission.

Data sources

We identified potentially eligible studies by searching MEDLINE, EMBASE, COCHRANE and Web of Science. Our search was restricted to original studies, between 1966 and 2018.

Eligibility criteria

Original studies, which internally or externally validated the clinical scores of hospital readmissions in elderly inpatients.

Data extraction and synthesis

A data extraction grid based on Strengthening the Reporting of Observational Studies in Epidemiology and Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis statements was developed and completed by two reviewers to collect general data. The same process was used to extract metrological data of the selected scores.

Quality assessment of the included studies

Assessment of the quality and risk of bias in individual studies was performed by two reviewers, using the validated Effective Public Health Practice Project quality assessment tool.

Participants

Elderly inpatients discharged to home from hospital or returning home after an accident and emergency department visit.

Results

A total of 12 studies and five different scores were included in the review. The five scores present area under the receiving operating characteristic curve between 0.445 and 0.69. Identification of Senior At Risk (ISAR) and Triage  Risk Screening Tool (TRST) scores were the more frequently validated scores with ISAR being more sensitive and TRST more specific.

Conclusions

The TRST and ISAR scores have been extensively studied and validated. The choice of the most suitable score relies on available patient data, patient characteristics and the foreseen clinical care intervention. In order to pair the intervention with the appropriate clinical score, further studies of external validation of clinical scores, identifying elderly patients at risk of early unplanned readmission, are needed.

PROSPERO registration number

CRD42017054516.
Short-term weight gain among preschool children in rural Burkina Faso: a secondary analysis of a randomised controlled trial
Authors: Dennis Elena G , Sie Ali , Ouermi Lucienne , Dah Clarisse , Tapsoba Charlemagne , Zabre Pascal , Bärnighausen Till , O'Brien Kieran S , Lebas Elodie , Keenan Jeremy D , Oldenburg Catherine E
Published: July 2019

Objectives

Nutrition has profound effects on children’s health outcomes and is linked to weight gain and cognitive development. We used data from a randomised controlled trial to evaluate the prospective associations between dietary, socioeconomic and demographic factors and short-term weight gain during the lean season in a rural area of Burkina Faso.

Design

Prospective cohort data arising from a randomised controlled trial of the effect of antibiotic distribution on child growth and intestinal microbial diversity.

Setting

Two rural communities in Nouna District, Burkina Faso.

Participants

246 children aged 6–59 months living in the study communities were enrolled in the study.

Primary and secondary outcome measures

Anthropometric measurements, including weight and height, were obtained at baseline and 1 month.

Results

Of 246 children, the median weight for wasted children at baseline (weight-for-height z-score <−2) was 9.7 kg (IQR 8.65–10.8) and the weight of non-wasted children was 12.8 kg (IQR 10.9–14.75). Food insecurity was significantly associated with decreased weight gain velocity (mean difference −0.03 g/kg/day, 95% CI −0.06 to −0.006, p=0.04).

Conclusion

Experiences of household food insecurity before the beginning of the lean season were associated with decreased weight gain in children in rural Burkina Faso during the lean season, although the mean difference was small. Understanding the relationship between timing of food insecurity and anthropometric outcomes may help to develop policies and health programme that address both of these issues.

Trial registration number

NCT03187834.
Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study
Authors: Maclean Miriam Jennifer , Sims Scott Anthony , O'Donnell Melissa
Published: July 2019

Objectives

To determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups.

Design

A longitudinal, population-based record-linkage study.

Participants

All children in Western Australia (WA) with birth records between 1990 and 2009.

Outcome measures

Mental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013.

Results

Compared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders.

Conclusions

Young people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.
Psychometric properties of the Georgian version of Hospital Survey on Patient Safety Culture: a cross-sectional study
Authors: Gambashidze Nikoloz , Hammer Antje , Manser Tanja
Published: July 2019

Objectives

To study the psychometric properties of the Georgian version of the Hospital Survey on Patient Safety Culture (HSPSC-GE).

Design

Cross-sectional study.

Setting

Three Georgian hospitals.

Participants

Staff of participating hospitals (n=579 responses, response rate 41.6%).

Primary and secondary outcome measures

Psychometric properties (Model fit, internal consistency, construct validity) of the instrument, factor structure derived from the data.

Results

HSPSC-GE demonstrated acceptable construct validity but highly limited internal consistency (Cronbach’s alpha 0.35–0.87). Confirmatory factor analysis with the original 12-factor model resulted in poor model fit (root mean square error of approximation (RMSEA)=0.06; standardised root mean square residuals (SRMR)=0.08; comparative fit index (CFI)=0.74; goodness of fit index (GFI)=0.81; Tucker-Lewis Index (TLI)=0.70). Accounting for reversed item bias resulted in improved fit indices. Exploratory factor analysis resulted in an alternative five-factor model including only 19 items, but with satisfactory model fit (RMSEA=0.07; SRMR=0.07; CFI=0.90; GFI=0.89; TLI=0.88).

Conclusions

The HSPSC-GE as a whole demonstrated poor psychometric properties. However, a number of dimensions demonstrated acceptable internal consistency and reliability. Our results indicated presence of reversed item bias, which may be inherent to the original instrument design of the HSPSC and should be taken into account while interpreting or comparing results, as well as in analyses of psychometric properties of the instrument. Nevertheless, the HSPSC-GE provides first insights in hospital patient safety culture (PSC) in Georgia and we recommend using it in its full form to facilitate deeper analysis and further development of PSC in Georgian healthcare.
CAM-type femoroacetabular impingement in male elite junior cross-country skiers and non-athlete controls: a cross-sectional MRI study
Authors: Sveen Simen Andreas , Martin R Kyle , Alhaug Eivind , Engebretsen Lars
Published: July 2019

Objectives

Cross-country (CC) skiing consists of two main techniques: classic and skating. Hip motion during the skating technique is similar to that in ice skating and is considered a risk factor for femoroacetabular impingement (FAI) in ice hockey players. We aimed to compare the presence of CAM-type FAI in a cohort of elite junior CC (EJCC) skiers with a control group of non-athlete (NA) high school students.

Methods

Observational cohort study: EJCC skiers and NAs were recruited from a sports school and a regular high school, respectively. Baseline demographics and training history were obtained via a questionnaire. Bilateral hip MRI was performed and the alpha angle was measured in three planes. CAM deformity was defined as an alpha angle>55° on at least two MRI planes per hip.

Results

A total of 20 EJCC skiers and 10 NAs participated. All participants were male, aged 16–19 years. Average training volume was 528.10±68.34 hours per year for the EJCC skiers compared with 153.50±57.09 for the NAs (p<0.001). The prevalence of CAM deformity in at least one hip on MRI was 50% in both groups (10 CC skiers and 5 NAs). The average alpha angles were 52.4±6.1° in the EJCC group and 52.5±4.9° in the NA group (p=0.94).

Conclusion

Radiographic evidence of CAM-type FAI was not more common in the CC skiers compared with NAs. The type, rather than volume or intensity of training, maybe a more important risk factor for the development of CAM-type FAI in young athletes.
Clinical Characteristics and Protective Factors in Patients with Acute Myocardial Infarction Undergoing in-Hospital Myocardial Free Wall Rupture: A Single-Center, Retrospective Analysis
Authors: Lou Bowen , Luo Yongbai , Hao Xiang , Sun Lizhe , Deng Yangyang , Guo Manyun , Liu Junhui , Zhou Bo , Yuan Zuyi , She Jianqing
Published: July 2019

Myocardial free wall rupture (MFWR) refers to laceration of the heart ventricle or atria, which is a rare but fatal complication of acute myocardial infarction (AMI). In this study, we aim to identify the clinical characteristics and protective factors of free wall rupture after myocardial infarction. This is a single-center, retrospective observational analysis. The study screened all patients admitted to the cardiology department of the First Affiliated Hospital of Xi'an Jiaotong University between January 2013 and April 2018. The biochemical, clinical, angiographic and echocardiographic features of these patients were then collected and analyzed. Among the 5946 screened patients with AMI, 23 patients with a diagnosis of MFWR after AMI were enrolled in the present study. 18 (78.3%) patients were diagnosed with acute ST segment elevated myocardial infarction and the remaining 5 (21.7%) have acute non-ST segment elevated myocardial infarction. Early-phase MFWR happened in 12 (52.2%) and late-phase accounted for 8 (34.8%) in total. Late-phase MFWR had lower left ventricle ejection fraction value (45.8%±5.6% vs 63.0±3.8%, p<0.001) as compared with early-phase. Patients who survived from MFWR has higher ACE inhibitor/angiotensin II receptor blocker (ACEI/ARB) and β-blocker coverage in the in-hospital treatment of AMI (ACEI/ARB: 100.0% vs 35.3%, p=0.014; β-blocker: 100.0% vs 47.1%, p=0.048). The present study provides evidence for better understanding of the clinical characteristics and protective functions in MFWR after AMI. Reduced cardiac function is correlated with higher incidence of later phase free wall rupture. Higher ACEI/ARB and β-blocker coverage in the AMI treatment strategy is associated with lower MFWR incidence.
Ethical dangers of facial phenotyping through photography in psychiatric genomics studies
Authors: Kong Camillia
Published: July 2019

Psychiatric genomics research protocols are increasingly incorporating tools of deep phenotyping to observe and examine phenotypic abnormalities among individuals with neurodevelopmental disorders. In particular, photography and the use of two-dimensional and three-dimensional facial analysis is thought to shed further light on the phenotypic expression of the genes underlying neurodevelopmental disorders, as well as provide potential diagnostic tools for clinicians. In this paper, I argue that the research use of photography to aid facial phenotyping raises deeply fraught issues from an ethical point of view. First, the process of objectification through photographic imagery and facial analysis could potentially worsen the stigmatisation of persons with neurodevelopmental disorders. Second, the use of photography for facial phenotyping has worrying parallels with the historical misuse of photography to advance positive and negative eugenics around race, ethnicity and intellectual disability. The paper recommends ethical caution in the use of photography and facial phenotyping in psychiatric genomics studies exploring neurodevelopmental disorders, outlining certain necessary safeguards, such as a critical awareness of the history of anthropometric photography use among scientists, as well as the exploration of photographic methodologies that could potentially empower individuals with disabilities.
Endovascular treatment decision in acute stroke: does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey
Authors: Ospel Johanna Maria , Kashani Nima , Wilson Alexis T , Fischer Urs , Campbell Bruce C V , Sylaja Pillai N , Yoshimura Shinichi , Rabinstein Alejandro A , Turjman Francis , Mitchell Peter , Kim Byung Moon , Cherian Mathew P , Heo Ji Hoe , Baxter Blaise W , Podlasek Anna , Foss Mona , Menon Bijoy K , Almekhlafi Mohammed A , Demchuk Andrew M , Hill Michael D , Saposnik Gustavo , Goyal Mayank
Published: July 2019

Background and purpose

Differences in the treatment practice of female and male physicians have been shown in several medical subspecialties. It is currently not known whether this also applies to endovascular stroke treatment. The purpose of this study was to explore whether there are differences in endovascular treatment decisions made by female and male stroke physicians and neurointerventionalists.

Methods

In an international survey, stroke physicians and neurointerventionalists were randomly assigned 10 case scenarios and asked how they would treat the patient: (A) assuming there were no external constraints and (B) given their local working conditions. Descriptive statistics were used to describe baseline demographics, and the adjusted OR for physician gender as a predictor of endovascular treatment decision was calculated using logistic regression.

Results

607 physicians (97 women, 508 men, 2 who did not wish to declare) participated in this survey. Physician gender was neither a significant predictor for endovascular treatment decision under assumed ideal conditions (endovascular therapy was favored by 77.0% of female and 79.3% of male physicians, adjusted OR 1.03, P=0.806) nor under current local resources (endovascular therapy was favored by 69.1% of female and 76.9% of male physicians, adjusted OR 1.03, P=0.814).

Conclusion

Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.
Budget impact analysis of PCSK9 inhibitors costs from a community payers’ perspective in Apulia, Italy
Authors: Brunetti Natale Daniele , De Gennaro Luisa , Tricarico Lucia , Caldarola Pasquale
Published: July 2019

Introduction

Despite established clinical efficacy of PCSK9 inhibitors (PCSK9i) in reducing cardiovascular events, their cost still represents a big matter of debate. We therefore sought to estimate possible impact of PCSK9i therapy from a community taxpayers’ perspective with a budget impact analysis based on data coming from two randomised trials (FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk), ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab)).

Methods

The analysis focused on Apulia region, South-Eastern Italy (4 million inhabitants). Costs per cardiovascular event saved were calculated from randomised trials data and annually indexed per Apulia’s inhabitants.

Results

On the base of actual cost in Apulia, individual costs per saved adverse event ranged from €0.12 to €0.78, with just €1 annually spent per Apulia’s inhabitant, 2–8.3 events could be avoided thanks to the use of PCSK9i.

When considering high-risk subgroups (baseline cholesterol levels >100 mg/dL, multivessel coronary disease), the annual cost per Apulia’s inhabitant for one death avoided was more than halved to €0.19 and the cost for a saved major adverse cardiovascular event was €0.07. With €1 annually spent per Apulia’s inhabitant, 10.9–15 major adverse cardiovascular events and 5.3 deaths could be saved.

Conclusions

When considered from a large taxpayers’ community perspective, relevant costs per cardiovascular event saved with PCSK9i may turn into very small individual costs per year. The selection of high-risk subgroups may further reduce individual costs.