bluuebunny/crossref_metadata_2025 huggingface dataset:
Low absorption of silicon via foliar in comparison to root application has an immediate antioxidant effect in mitigating water deficit damage in sugarcane
Authors: Teixeira Gelza Carliane Marques , de Mello Prado Renato , Rocha Antonio Márcio Souza
Published: May 2021

High root absorption of silicon (Si) in sugarcane plants that accumulate the element attenuates water deficit‐induced damage. However, there is a lack of research to identify whether the low relative absorption of Si via leaf spraying compared to root application has an immediate antioxidant effect on plants under water restriction. For this purpose, the objective of this research was to evaluate the effect of Si applied via leaf spraying and via nutritive solution (root) in mitigating the damage caused by short‐term water deficit induced by PEG‐6000 in pre‐sprouted sugarcane seedlings. The treatments were arranged in a 3 × 2 factorial scheme, consisting of the forms of Si supply: via nutrient solution (SiR) (2.0 mmol/L), via foliar spraying (SiL) (3.4 mmol/L) plus the absence of Si (−Si), combined with the presence (−0.6 MPa) and absence of water deficit, arranged in randomized blocks with 6 repetitions. The experiment was developed in a hydroponic system, in which Si was initially supplied during the seedling production phase; subsequently, water deficit was induced with PEG‐6000 for a period of 72 hr. Plants under water deficit increased the accumulation of Si with the supply of the element via root application and via foliar spraying by 2118% and 98%, respectively, in comparison to the absence of Si. However, although Si foliar absorption was relatively low in comparison to the root, the physiological effects in relieving water deficit‐induced stress were equal to or even higher than those of root application. In conclusion, the amount of Si absorbed by the plant is not a major factor to induce an antioxidant defence response to mitigate the immediate effects of water deficit, since the two forms of application of Si were similar. Si foliar spraying promotes physiological and biochemical effects that alleviate damage done water deficit short term, even on plants with an active absorption mechanism such as sugarcane.
Sulfasalazine, a potent suppressor of gastric cancer proliferation and metastasis by inhibition of xCT: Conventional drug in new use
Authors: Zhuang Jinfu , Liu Xing , Yang Yuanfeng , Zhang Yiyi , Guan Guoxian
Published: May 2021

The aim of this study was to explore the role of sulfasalazine on proliferation and metastasis in gastric cancer by inhibition of xCT. The relationships between clinical characteristics and xCT expression were analysed. An immunohistochemical staining assay and Western blot were performed among gastric cancers and normal gastric tissues. qPCR and Western blot were also used to evaluate the mRNA and protein expression in the normal gastric cell and eight gastric cancer cells, respectively. CCK‐8 and colony formation assays were used to evaluate the effect of sulfasalazine on the proliferation and colony formation ability of three gastric cancers. The effect of sulfasalazine on the migration and invasion abilities of three cancer cells was assessed by the Transwell assay. xCT protein is up‐regulated in gastric cancer specimens and cells. Three gastric cancer cells with high, medium and low expression of xCT were selected for the following analyses. CCK‐8 assays revealed that sulfasalazine could attenuate the proliferation of HGC‐27 and AGS. Also, the colony formation assay revealed that sulfasalazine might attenuate the colony formation ability in HGC‐27 and AGS cells. Plus, the Transwell assays demonstrated that sulfasalazine might attenuate the migration and invasion abilities in HGC‐27 and AGS cells. In conclusion, higher expression of xCT is associated with advanced tumour stage and poor overall survival of gastric cancer. Sulfasalazine can attenuate the proliferation, colony formation, metastasis and invasion of gastric cancer in vitro. Further study is required to validate our findings.
Characterization of Commiphora wightii based bioactive edible film and its efficacy for improving the storage quality of meat products
Authors: Sharma Radhika , Bhat Zuhaib F. , Kumar Arvind , Kumar Sunil , Bekhit Alaa El‐Din A. , Naqvi Zahra
Published: May 2021

Commiphora wightii based bioactive edible film was developed for the preservation of meat products. Maltodextrin and alginate‐based edible films were developed using different levels of C. wightii namely, 0.25% (T1), 0.50% (T2), 0.75% (T3) and 0.0% (control) and were characterized (thickness (mm), solubility (%), transparency and moisture content (%)) and assessed for their efficacy for improving the storage quality of meat products during refrigerated storage using chicken nuggets as a meat model system. The chicken nuggets were wrapped in the edible films, packaged under vacuum, and stored at refrigeration temperature (4 ± 1°C) for 60 days. The samples were taken on 0, 15, 30, 45 and 60th day and evaluated for various storage quality parameters. Addition of C. wightii increased (p < .05) total phenolic (mg/g Gallic acid equivalents) and total flavonoid contents (mg/g Quercetin equivalents) and reduced free fatty acids (% oleic acid), TBARS (mg malondialdehyde/kg) and microbial counts [total plate, psychrophilic, yeast/mold, and anaerobic counts (log10 cfu/g)] while improving the sensory quality of the products. Addition of C. wightii increased (p < .05) the thickness (mm), opacity and moisture content (%) whereas decreased the solubility (%) of the films. The C. wightii based edible film significantly (p < .05) improved the lipid oxidative and microbial stability of the model meat product during refrigerated storage. The present results suggest that C. wightii based edible film can be used commercially in the meat industry for improving the storage quality of the meat products.
The prevalence of potential drug–drug interactions in adults with intellectual disability
Authors: McMahon M. , Hatton C. , Bowring D. L. , Hardy C. , Preston N. J.
Published: May 2021

Background

There is a high use of medications in adults with intellectual disability (ID). One implication of taking multiple medications is the potential for drug–drug interactions (DDIs). However, despite this being well highlighted in the mainstream literature, little is known about the incidence or associations of DDIs in the ID population.

Methods

This study describes the prevalence, patterns and associations of potential DDIs in a total administrative sample of adults with ID known to services in Jersey. Demographic, health‐related and medication data were collected from 217 adults known to ID services. Data were collected using a face‐to‐face survey. The Anatomical Therapeutic Chemical classification system was used to categorise medications, and Stockley's Drug Interaction Checker was used to classify potential DDIs. Drug–drug pairings were considered to be of clinical significance if they were to be ‘avoided, adjusted, monitored or required further information’.

Results

Potential DDIs of clinical significance were common. Exposure to potential DDIs of clinical significance was associated with being female, taking more than five medications (polypharmacy), living in residential care and having more health conditions. A simple regression was used to understand the effect of number of prescribed medications on potential DDIs of clinical significance. Every prescribed drug led to a 0.87 (95% confidence interval: 0.72–1.00) increase in having a potential DDI of clinical significance.

Conclusion

Adults with ID who live in residential care, who are female, exposed to polypharmacy and have more health conditions may be more likely to have potential DDIs of clinical significance. Urgent consideration needs to be given to the potential of DDIs in this population given their exposure to high levels of medication.
Subjective cognitive abilities correlate with poor sleep among day‐shift and night‐shift nurses
Authors: Veal Britney M. , Mu Christina X. , Small Brent J. , Lee Soomi
Published: May 2021

Experimental studies have shown that sleep deprivation may lead to worse performance on cognitive tests. However, few studies have considered how sleep is associated with perceived cognitive performance in the daily lives of hospital nurses who require high cognitive abilities to deliver high‐quality patient care. The current study examined the relationship between sleep and subjective cognition in nurses, and whether the relationship differed by work shift and workdays. Sixty in patient nurses working full‐time (M = 35 years; 39 day‐shift nurses, 21 night‐shift nurses) reported their sleep characteristics and daily subjective cognition using ecological momentary assessment for 14 days. Concurrently, objective sleep characteristics were measured with a sleep actigraphy device for 14 days. Using multilevel modelling, results indicated that at the within‐person and between‐person level, better sleep quality and higher sleep sufficiency were associated with better subjective cognition at the daily‐level and on average. Moderation analyses indicated at the within‐person level, better sleep quality and longer time in bed were associated with better next‐day cognition; these associations were stronger for night‐shift nurses compared with day‐shift nurses. At the between‐person level, better sleep quality and higher sleep sufficiency were also associated with better subjective cognition overall; these associations were significant for day‐shift nurses, but not for night‐shift nurses. The sleep—subjective cognition relationships were more apparent on workdays versus non‐workdays. Findings suggest that sufficient sleep recovery is important for nurses' reports of daily and overall cognitive functioning. Night‐shift nurses' subjective cognitive abilities may be more protected on days following better sleepquality and more sufficient sleep.
Role of Visible Light on Skin Melanocytes: A Systematic Review
Authors: Chauhan Aparna , Gretz Norbert
Published: May 2021

In the last few years, the focus of phototherapy has shifted toward the visible (400–700 nm) part of the electromagnetic spectrum of light. Lately, it has been demonstrated that visible light (VL) can have both beneficial and detrimental effects, especially on the skin. Previously and until now, the most harmful effects on the skin are associated with ultraviolet radiation (UVR). After exposure to natural light, the most evident and immediate change is observed on skin pigmentation. Various wavelengths within the visible spectrum have been reported to alter skin pigmentation. However, the underlying mechanisms are incompletely understood so far. The article aims to shed light on the progress made in the photobiology field (photobiomodulation, PBM) to study the role of visible light on skin melanocytes.
Fine me if you can: Fixed asset intensity and enforcement of environmental regulations in China
Authors: Cao Xun , Deng Qing , Li Xiaojun , Shao Zijie
Published: May 2021

Why do some firms face more environmental regulatory actions than others? We present a theory focusing on firm‐fixed asset intensity. High fixed asset intensity makes a firm less mobile. A less mobile firm cannot present a credible exit threat, making it more susceptible to stringent enforcement. Analysis of key‐monitored firms in Jiangsu province, China of 2012–2014 shows that higher fixed asset intensity is associated with more pollution levies and a higher chance of receiving a punitive action. This result holds in a battery of robustness checks and an instrumental variable analysis. Furthermore, our 2018 online survey of Chinese firm managers shows that those from high fixed asset intensity firms indeed consider their firms less mobile and they pay more environment‐related operating costs. Finally, data from 2004 Chinese Firm‐Level Industrial Survey demonstrate that fixed asset intensity is positively associated with pollution levies in a national sample of 201,926 manufacturing firms.
Trade, emissions, and regulatory (non‐)compliance: Implications of firm heterogeneity
Authors: Chang Juin‐Jen , Cheng Yi‐Ling , Peng Shin‐Kun
Published: May 2021

This paper provides the implications of firm heterogeneity for the environment. In autarky, raising emission tax generates an average productivity gain and favors efficient firms in the sense that their output expands. Although some of these efficient firms discharge more emissions, some may discharge less. While trade liberalization raises outputs, global emissions do not necessarily increase. A unilateral increase in emission tax not only decreases the outputs in this country but also decreases its average productivity under sufficiently high trade openness. Trade liberalization reduces global emissions under tax harmonization but it may generate more global emissions under tax competition.
A sense of being rejected: Patients’ lived experiences of cancelled knee or hip replacement surgery
Authors: Caesar Ulla , Hansson‐Olofsson Elisabeth , Karlsson Jon , Olsson Lars‐Eric , Lidén Eva
Published: May 2021

Background

Growing care queues, reduced access to care and cancelled surgery are realities for some patients being treated with total hip or knee replacement surgery in Sweden.

Most of the patients on the waiting lists have experienced pain and limited motion for a varying period of time, with a negative effect on their everyday lives. Overbooked surgical schedules are already contributing to the lengthy waiting times, but, with the addition of cancellations, longer waiting times will increase still further and may affect patients’ well‐being.

Methods

In the present study, we aimed to illuminate the experience of having planned surgery cancelled, based on narratives from 10 participants. The interview transcriptions were analysed using a phenomenological hermeneutic approach.

Results

The comprehensive analyses revealed that the participants described the agony of being deselected and the additional impression of being excluded. Metaphors of being damaged and feeling physical pain were used and the interpretations referred to the cancellations as unpleasant. Additionally, the important relationship and the trust between the health workers and the patient were negatively affected by the cancellation.

Conclusion

After the cancellation, the participants expressed being vulnerable and from their perspective the cancelled surgery affected them deeply; in fact, much more than the healthcare workers appeared to understand. Therefore, information around the cancellation must be given respectfully and with dignity, in a dialogue between the patient and the healthcare workers. Taken together, to enable an opportunity to be involved in the continued care. The cancellations should be seen as an interruption, in which the patients’ chance of living a pain‐free, active life is postponed.
A moderated mediation model linking transactive memory system and social media with shared leadership and team innovation
Authors: Ali Ahsan , Wang Hongwei , Bodla Ali Ahmad , Bahadur Waseem
Published: May 2021

This study examines how and to what extent social and technological factors promote shared leadership that leads to team innovation in knowledge work teams. It hypothesizes that a transactive memory system influence team innovation and shared leadership conduits the relationship between them. Additionally, the relationship effectiveness between the transactive memory system and shared leadership increases with the use of social media by team members. Time‐lagged, multi‐sourced data are collected from the information technology industry in China. In addition, we used a network‐based measure to assess the level of shared leadership in teams. Empirical analysis found support for the hypotheses of this study. The results reveal that transactive memory system is a significant predictor of team innovation and the shared leadership channels the relationship between transactive memory system and team innovation. Furthermore, use of social media by team members amplifies the relationship between transactive memory system and shared leadership. The implications of the study are discussed in the later sections.
Structural change and economic development in the Islamic Middle East 700–1500: Population levels and property rights
Authors: Shatzmiller Maya
Published: May 2021

Economic historians have recently treated Islamic institutions as “growth retarding,” “averse to change,” “path dependent,” “lacking creative destruction” and “extractive” rather than “inclusive” and blamed their failure to change for the underdevelopment of the Middle East. This paper argues for a different approach to Islamic institutions which implies that they boosted economic growth. The paper explores changes in economic structures, a transition in population levels from high to low and a transition to individual property rights and provides economic indicators of growth. Articulated via Islamic law, legally sanctioned birth control and women's property rights were instrumental in assuring low fertility rates and equitable and well‐distributed income in the population. The paper concludes theoretically and empirically that Islamic institutions were innovative, amenable to change and efficient.
“Like if you Get a Hotel Bill”: Consumer Logic, Pay‐to‐Stay, and the Production of Incarceration as a Public Commodity*
Authors: Friedman Brittany , Fernandes April D. , Kirk Gabriela
Published: May 2021

Neoliberal governance has become a defining feature of our social world, fast‐tracking the commodification of human interaction, particularly within capitalist economies. Neoliberalism’s intensification of capitalist social relations shifted social institutions such as education, healthcare, and criminal justice to resemble profit‐oriented enterprises. A preeminent consequence of this shift for the administration of criminal justice is the rapid expansion of monetary sanctions in the form of pay‐to‐stay fees. Our article contributes to scholarship on neoliberal governance and social institutions by exploring how lawmakers justify and frame the imposition and recoupment of pay‐to‐stay fees. We draw from a novel dataset compiled by the authors on pay‐to stay in the state of Illinois, which consists of state‐level pay‐to‐stay statutes, transcripts of legislative debates on the ratification of pay‐to‐stay statutes, and 102 civil complaints from 1997 to 2015 initiated on behalf of the Illinois Department of Corrections against currently and formerly incarcerated people to compel the payment of pay‐to‐stay fees. Our analysis suggests that in the era of neoliberal governance, consumerism is an institutional logic that lawmakers draw from to adopt pay‐to‐stay as a legal template in an effort to foster a producer–consumer relationship between incarcerated people and the state, thereby producing incarceration as a public commodity.
Identification of the novel HLA‐DQB1*05:275 allele by next‐generation sequencing
Authors: Bouthemy Charlène , Ralazamahaleo Mamy , Visentin Jonathan , Fort Marylise , Congy‐Jolivet Nicolas
Published: May 2021

HLA‐DQB1*05:275 differs from DQB1*05:01 by one nucleotide substitution in codon 224 in exon 4.
The roles of English in Afghanistan
Authors: Coleman Hywel
Published: May 2021

This paper examines the roles the English language is expected to play in contemporary war‐torn Afghanistan. It identifies 12 roles – some functional, others aspirational. English has a role to play in the development of Afghanistan, albeit limited, and it is believed to provide a means of escape, both literally and metaphorically. On the other hand, in some sections of society, English is seen negatively. In other contexts, English is required to play a neutral role between the two national languages. Analysis of the way that English is used in aspirational contexts suggests a parallel with shamanistic language: it does not need to be understood but, for its audience, the intended beneficiaries, that does not make it any less effective as a symbolic language, at least in the short term. In the longer term, however, as promised benefits fail to appear, English may increasingly be perceived negatively.
Who let the dogs In? An epidemiological study quantifying domestically sourced and imported dogs in Southern Ontario, Canada
Authors: Julien Danielle A. , Sargeant Jan M. , Filejski Catherine , Harper Sherilee L.
Published: May 2021

Dogs are reservoirs for many zoonoses. In southern Ontario, Canada, minimal data exist on the sources from which domestic dogs are acquired (i.e., domestic or imported). The objectives of this study were to (1) describe the proportions of domestically sourced and imported dogs in southern Ontario, Canada, (2) describe the characteristics of newly acquired dogs including their province/country of origin, accompanying health documentation and respondent opinion regarding disease risks from different sources, and (3) determine whether a difference in the proportion of imported dogs exists between rural and urban households in southern Ontario, Canada. We conducted a cross‐sectional observational study using an online questionnaire. A total of 2,006 respondents (1,002 rural and 1,004 urban), each representing one household, participated. Over the previous seven‐year period, 731 (36.44%, (731/2,006)) respondents domestically sourced at least one dog, with 684 providing information regarding 962 dogs. Domestically sourced dogs were frequently puppies three to five‐month‐old (25.05%, (241/962)), male (51.87%, (499/962)), from a breeder (30.98%, (298/962)), and sourced from within Ontario (92.93%, (894/962)). As self‐reported by respondents, 63.52% (484/762) of domestically sourced dogs greater than 3 months were vaccinated against rabies. Over the same period, individuals from 55 of 2,006 households (2.74%) imported at least one dog. Imported dogs were frequently under three months of age (29.09%, 16/55)), male (58.18%, (32/55)), and found via a breeder (32.73%, (18/55)). Most imported dogs originated from the USA (52.73%, (29/55)). Rabies vaccination in dogs three months and older is provincially required in Ontario and is also required for canine importation into Canada; however, some imported dogs over three months were unvaccinated (7.69%, (3/39)). The odds ratio for importing at least one dog in urban households compared with rural households was 1.93 (95% CI: 1.03–3.62) when controlling for number of household occupants and gross household income.
Analysis Method of Nonsynchronous Vibration and Influence of Tip Clearance Flow Instabilities on Nonsynchronous Vibration in an Axial Transonic Compressor Rotor
Authors: Han Le , Wei Dasheng , Wang Yanrong , Jiang Xianghua , Zhang Xiaojie
Published: May 2021

The relationship between the tip clearance flow (TCF) and the blade vibration in the lock-in region was numerically investigated on a transonic rotor. Both the bending (1B) and torsional (8th) modes were analyzed under 0 ND. The time marching method and a single-passage model were used, which were verified by citing and comparing with the results in references. The phase of the TCF (referring to the phase difference between the unsteady pressure caused by the TCF and the blade vibration) changed with the frequency ratio in the lock-in region. The strength of the TCF was influenced slightly by the blade vibration amplitude. A separation method of the unsteady pressure caused by the TCF and the blade vibration was developed and verified at different conditions. The unsteady pressure of nonsynchronous vibration (NSV) was separated into the components of the TCF and the blade vibration under the 1B and 8th modes. The unsteady pressure component of the TCF changed little with the vibration amplitude and mainly existed in the tip area. The unsteady pressure component of the blade vibration was larger at part spans and its distribution depended on the modal shape and the vibration amplitude. The unsteady pressure components of the TCF and the blade vibration determined the aerodynamic work/damping in the lock-in region. The aerodynamic work components of the TCF and the blade vibration increased linearly and at a rate of the square with the vibration amplitude, respectively. TCF was dominant in the initial stage of vibration. With the vibration amplitude increasing, the aerodynamic work done by the unsteady pressure component of the blade vibration gradually caught up. The aerodynamic damping of the TCF changed with the phase of the TCF. TCF provided positive damping at some phases and negative damping at other phases. In the initial stage of vibration, the system was stable at the phases TCF providing positive damping and unstable at the phases of negative damping. NSV occurred only when TCF provided negative damping and the unsteady pressure component of the blade vibration provided positive damping. If the aerodynamic damping of the blade vibration was negative, the vibration would be enlarged until failure. Regardless of other damping forms, the maximum amplitude of NSV can be obtained by calculating the balance of the aerodynamic work. For the 8th mode, the limit amplitude under 0 ND was 0.0926%C, which corresponded to vibration stress of about 60 MPa.
{100}-textured piezoelectric Pb(Zr,Ti)O3 films: Influence of Pb content in the PbxTiO3 seed layer on the electrical properties of chemical solution deposited Pb(Zr,Ti)O3
Authors: Kotru Sushma , Batra Vaishali , Zhong Jian
Published: May 2021

In this work, the influence of Pb content (x = 1.0, 1.05, 1.1, and 1.2) in a 0.02M PbxTiO3 (PxT) seed layer on {100}-texture percentage and electrical properties of Pb1.1(Zr0.52,Ti0.48)O3 (PZT) films was investigated. The 0.02M concentration of the PxT seed layer chosen for the present work was based on our previous work on the optimization of solution concentration (0.02, 0.05, 0.1, and 0.2M) of the PxT seed layer on the texture percentage of 190 nm PZT thin films. The chemical solution deposition method was used to deposit 1.3 μm thick PZT films on Pt (111)/TiO2/SiO2/Si substrates. X-ray diffraction studies demonstrated the dependence of {100}-texture percentage (TP) and grain size of PZT films on Pb content in the PxT seed layer. TP was observed to affect the dielectric and ferroelectric properties of these films. PZT films grown on the P1.05T seed layer showed a maximum value for both TP (97%) and peak height. Piezoelectric measurements were performed using cantilevers prepared with Pt top and bottom electrodes. PZT films grown on the P1.05T seed layer showed a maximum transverse piezoelectric coefficient of −13.3 C/m2. Current studies, coupled with our previous work, suggest that the use of a seed layer PxT and the optimization of Pb content in the seed layer are promising routes to achieve {100}-textured PZT films with higher piezoelectric parameters.
Toward practical stratospheric aerosol albedo modification: Solar-powered lofting
Authors: Gao Ru-Shan , Rosenlof Karen H. , Kärcher Bernd , Tilmes Simone , Toon Owen B. , Maloney Christopher , Yu Pengfei
Published: May 2021

Solar-powered lofting makes stratospheric aerosol injection viable with the existing aircraft fleet.
A slip law for hard-bedded glaciers derived from observed bed topography
Authors: Helanow Christian , Iverson Neal R. , Woodard Jacob B. , Zoet Lucas K.
Published: May 2021

Numerical simulations of glacier slip over diverse hard beds indicate Coulomb slip behavior like that of deformable beds.
Neutron tomography of Van Leeuwenhoek’s microscopes
Authors: Cocquyt Tiemen , Zhou Zhou , Plomp Jeroen , van Eijck Lambert
Published: May 2021

To make the microscopes with which he pioneered microbiology, Van Leeuwenhoek used a lens design from an unexpected source.
Programmable two-dimensional nanocrystals assembled from POSS-containing peptoids as efficient artificial light-harvesting systems
Authors: Wang Mingming , Song Yang , Zhang Shuai , Zhang Xin , Cai Xiaoli , Lin Yuehe , De Yoreo James J. , Chen Chun-Long
Published: May 2021

A class of POSS-containing 2D nanocrystals was developed to offer high stability, biocompatibility, and programmability.
Insights into the molecular mechanism of amyloid filament formation: Segmental folding of α-synuclein on lipid membranes
Authors: Antonschmidt Leif , Dervişoğlu Rıza , Sant Vrinda , Tekwani Movellan Kumar , Mey Ingo , Riedel Dietmar , Steinem Claudia , Becker Stefan , Andreas Loren B. , Griesinger Christian
Published: May 2021

Aggregation intermediates of Parkinson’s disease–related α-synuclein on liposomes are structurally characterized by NMR.
Dual activity of anthocyanidin reductase supports the dominant plant proanthocyanidin extension unit pathway
Authors: Jun Ji Hyung , Lu Nan , Docampo-Palacios Maite , Wang Xiaoqiang , Dixon Richard A.
Published: May 2021

Separate activities of anthocyanidin reductase generate epicatechin starter and extension units of proanthocyanidins.
CMV, MHC-E, and the quest for an unconventional AIDS vaccine
Authors: Walker Bruce D.
Published: May 2021

A genetic alteration in cytomegalovirus caused by an inversion-deletion event during tissue culture passage opens an unconventional path toward an HIV vaccine.
A Novel Series of Indole Alkaloid Derivatives Inhibit Dengue and Zika Virus Infection by Interference with the Viral Replication Complex
Authors: Fikatas Antonios , Vervaeke Peter , Meyen Eef , Llor Nuria , Ordeix Sergi , Boonen Ine , Bletsa Magda , Kafetzopoulou Liana Eleni , Lemey Philippe , Amat Mercedes , Pannecouque Christophe , Schols Dominique
Published: May 2021

Here, we identified a novel class of compounds which demonstrated good antiviral activity against dengue and Zika virus infection. These derivatives constitute intermediates in the synthesis of indole (ervatamine-silicine) alkaloids and share a tetracyclic structure, with an indole and a piperidine fused to a seven-membered carbocyclic ring.
Epidemiology and Transmission of Carbapenemase-Producing
Enterobacteriaceae
in a Health Care Network of an Acute-Care Hospital and Its Affiliated Intermediate- and Long-Term-Care Facilities in Singapore
Authors: Aung Aung-Hein , Kanagasabai Kala , Koh Jocelyn , Hon Pei-Yun , Ang Brenda , Lye David , Chen Swaine L. , Chow Angela
Published: May 2021

Movement of patients in a health care network poses challenges for the control of carbapenemase-producing
Enterobacteriaceae
(CPE). We aimed to identify intra- and interfacility transmission events and facility type-specific risk factors of CPE in an acute-care hospital (ACH) and its intermediate-term and long-term-care facilities (ILTCFs).
Fifteen-minute consultation: Decision-making pathway for neonatal vascular access
Authors: Osmond Elizabeth , Williams Nicholas
Published: May 2021

Newborn infants admitted for neonatal intensive and high dependency care are reliant on intravenous therapy for medications, hydration and nutrition. Adopting a structured approach to gaining neonatal vascular access can improve efficiency and potentially reduce complications. In this article, we discuss an algorithm for decision-making in neonatal vascular access.
Appendiceal adenocarcinoma with breast metastases
Authors: Davies Timothy , Chouari Tarak , Ray Christopher , Elgammal Suzanne
Published: May 2021

Malignant lesions of the vermiform appendix make up a rare subset of colorectal cancer. While colorectal cancer frequently metastasises to the liver, lung, regional lymph nodes and peritoneum, metastasis to the breast is extremely rare. Here, we describe the case of an 84-year-old woman who had the incidental finding of appendiceal adenocarcinoma following emergency laparoscopic appendectomy. She declined further operative or adjuvant treatment for her disease. She represented 1 year later with metastatic appendiceal adenocarcinoma disease to her left breast. A simple mastectomy for symptomatic treatment was performed. In this report, we describe the first case of appendiceal adenocarcinoma metastases to the breast. Due to its rarity, there is a paucity of evidence related to the management of this condition. The limited evidence is reviewed and discussed.
Quality of care for tuberculosis and HIV in the private health sector: a cross-sectional, standardised patient study in South Africa
Authors: Boffa Jody , Moyo Sizulu , Chikovore Jeremiah , Salomon Angela , Daniels Benjamin , Kwan Ada T , Pai Madhukar , Daftary Amrita
Published: May 2021

Background

South Africa has high burdens of tuberculosis (TB) and TB-HIV, yet the quality of patient care in the private sector is unknown. We describe quality of TB and TB-HIV care among private general practitioners (GPs) in two South African cities using standardised patients (SPs).

Methods

Sixteen SPs presented one of three cases during unannounced visits to private GPs in selected high-TB burden communities in Durban and Cape Town: case 1, typical TB symptoms, HIV-positive; case 2, TB-specified laboratory report, HIV-negative and case 3, history of incomplete TB treatment, HIV-positive. Clinical practices were recorded in standardised exit interviews. Ideal management was defined as relevant testing or public sector referral for any reason. The difference between knowledge and practice (know-do gap) was assessed through case 1 vignettes among 25% of GPs. Factors associated with ideal management were assessed using bivariate logistic regression.

Results

511 SP visits were completed with 212 GPs. Respectively, TB and HIV were ideally managed in 43% (95% CI 36% to 50%) and 41% (95% CI 34% to 48%) of case 1, 85% (95% CI 78% to 90%) and 61% (95% CI 73% to 86%) of case 2 and 69% (95% CI 61% to 76%) and 80% (95% CI 52% to 68%) of case 3 presentations. HIV status was queried in 35% (95% CI 31% to 39%) of visits, least with case 1 (24%, 95% CI 18% to 30%). The difference between knowledge and practice was 80% versus 43% for TB and 55% versus 37% for HIV, resulting in know-do gaps of 37% (95% CI 19% to 55%) and 18% (95% CI −1% to 38%), respectively. Ideal TB management was associated with longer visit time (OR=1.1, 95% CI 1.1 to 1.2), female GPs (3.2, 95% CI 2.0 to 5.1), basic symptom inquiry (2.0, 95% CI 1.7 to 2.3), HIV-status inquiry (OR=11.2, 95% CI 6.4 to 19.6), fewer medications dispensed (OR=0.6, 95% CI 0.5 to 0.7) and Cape Town (OR=2.2, 95% CI 1.5 to 3.1). Similar associations were observed for HIV.

Conclusions

Private providers ideally managed TB more often when a diagnosis or history of TB was implied or provided. Management of HIV in the context of TB was less than optimal.
Forest malaria: the prevailing obstacle for malaria control and elimination in India
Authors: Ranjha Raju , Sharma Amit
Published: May 2021

Despite the decrease in malaria mortality and morbidity, it remains a significant public health problem in India. India is targeting malaria elimination from the country by 2030. Different areas in India are in different phases of malaria elimination. The emerging resistance in vectors as well parasite have added necessity to accelerate the malaria elimination programme. Forested areas remain the foci for malaria transmission due to favourable human and environmental factors. Here, we analysed the longitudinal data from 2000 to 2019 to see the trends in forest malaria in India. Population living in forested areas are major malaria contributors. From 2000 to 2019, ~32% of malaria cases and 42% of malaria related deaths were reported from forested districts which represent only ~6.6% of the total Indian population. Increasing insecticide resistance, a high percentage of submicroscopic infections and challenging to test and treat communities are the crucial components of the prevailing obstacles of forested malaria. To achieve the elimination goal, efforts should be intensified with more resources diverted to the forested areas. Malaria control in forested areas will bring fruitful results for malaria control in India.
Arrhythmogenic right ventricular cardiomyopathy: a focused update on diagnosis and risk stratification
Authors: Bosman Laurens P , te Riele Anneline S J M
Published: May 2021

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterised by fibrofatty replacement of predominantly the right ventricle and high risk of ventricular arrhythmias and sudden cardiac death (SCD). Early diagnosis and accurate risk assessment are challenging yet essential for SCD prevention. This manuscript summarises the current state of the art on ARVC diagnosis and risk stratification. Improving the 2010 diagnostic criteria is an ongoing discussion. Several studies suggest that early diagnosis may be facilitated by including deformation imaging (‘strain’) for objective assessment of wall motion abnormalities, which was shown to have high sensitivity for preclinical disease. Adding fibrofatty replacement detected by late gadolinium enhancement or T1 mapping in cardiac MRI as criterion for diagnosis is increasingly suggested but requires more supporting evidence from consecutive patient cohorts. In addition to the traditional right-dominant ARVC, standard criteria for arrhythmogenic cardiomyopathy (ACM) and arrhythmogenic left ventricular cardiomyopathy (ALVC) are on the horizon. After diagnosis confirmation, the primary management goal is SCD prevention, for which an implantable cardioverter-defibrillator is the only proven therapy. Prior studies determined that younger age, male sex, previous (non-) sustained ventricular tachycardia, syncope, extent of T-wave inversion, frequent premature ectopic beats and lower biventricular ejection fraction are risk factors for subsequent events. Previous implantable cardioverter-defibrillator indication guidelines were however limited to three expert-opinion flow charts stratifying patients in risk groups. Now, two multivariable risk prediction models (arvcrisk.com) combine the abovementioned risk factors to estimate individual risks. Of note, both the flow charts and prediction models require clinical validation studies to determine which should be recommended.
Self-reported physician attitudes and behaviours towards incarcerated patients
Authors: Pierre Kevin , Rahmanian Kiarash P , Rooks Benjamin J , Solberg Lauren B
Published: May 2021

Physicians anecdotally report inquiring about incarcerated patients’ crimes and their length of sentence, which has potential implications for the quality of care these patients receive. However, there is minimal research on how a physician’s awareness of their patient’s crimes/length of sentence impacts physician behaviours and attitudes. We performed regression modelling on a 27-question survey to analyse physician attitudes and behaviours towards incarcerated patients. We found that, although most physicians did not usually try to learn of their patients’ crimes, they often became aware of them. We observed associations between awareness of a patient’s crime and poor physician disposition towards their patients and between physicians’ poor dispositions and lower reported quality of care. These associations suggest that awareness of a patient’s crime may reduce quality of care by negatively impacting physicians’ dispositions towards their patients. Future quantitative and qualitative studies, for example, involving physician interviews and direct patient outcome assessments, are needed to confirm these findings and further uncover and address hurdles incarcerated patients face in seeking medical care.
Patients, clinicians and open notes: information blocking as a case of epistemic injustice
Authors: Blease Charlotte , Salmi Liz , Rexhepi Hanife , Hägglund Maria , DesRoches Catherine M
Published: May 2021

In many countries, including patients are legally entitled to request copies of their clinical notes. However, this process remains time-consuming and burdensome, and it remains unclear how much of the medical record must be made available. Online access to notes offers a way to overcome these challenges and in around 10 countries worldwide, via secure web-based portals, many patients are now able to read at least some of the narrative reports written by clinicians (‘open notes’). However, even in countries that have implemented the practice many clinicians have resisted the idea remaining doubtful of the value of opening notes, and anticipating patients will be confused or anxious by what they read. Against this scepticism, a growing body of qualitative and quantitative research reveals that patients derive multiple benefits from reading their notes. We address the contrasting perceptions of this practice innovation, and claim that the divergent views of patients and clinicians can be explained as a case of epistemic injustice. Using a range of evidence, we argue that patients are vulnerable to (oftentimes, non-intentional) epistemic injustice. Nonetheless, we conclude that the marginalisation of patients’ access to their health information exemplifies a form of epistemic exclusion, one with practical and ethical consequences including for patient safety.
Exercise prescription improves exercise tolerance in young children with CHD: a randomised clinical trial
Authors: Callaghan Sinead , Morrison Margaret Louise , McKeown Pascal P , Tennyson Christopher , Sands Andrew J , McCrossan Brian , Grant Brian , Craig Brian G , Casey Frank A
Published: May 2021

Objective

The main objective of this study was to ascertain if a structured intervention programme can improve the biophysical health of young children with congenital heart disease (CHD). The primary end point was an increase in measureable physical activity levels following the intervention.

Methods

Patients aged 5–10 years with CHD were identified and invited to participate. Participants completed a baseline biophysical assessment, including a formal exercise stress test and daily activity monitoring using an accelerometer. Following randomisation, the intervention group attended a 1 day education session and received an individual written exercise plan to be continued over the 4-month intervention period. The control group continued with their usual level of care. After 4 months, all participants were reassessed in the same manner as at baseline.

Results

One hundred and sixty-three participants (mean age 8.4 years) were recruited, 100 of whom were male (61.3%). At baseline, the majority of the children were active with good exercise tolerance. The cyanotic palliated subgroup participants, however, were found to have lower levels of daily activity and significantly limited peak exercise performance compared with the other subgroups. One hundred and fifty-two participants (93.2%) attended for reassessment. Following the intervention, there was a significant improvement in peak exercise capacity in the intervention group. There was also a trend towards increased daily activity levels.

Conclusion

Overall physical activity levels are well preserved in the majority of young children with CHD. A structured intervention programme significantly increased peak exercise capacity and improved attitudes towards positive lifestyle changes.
Efficacy of parasternal block to decrease intraoperative opioid use in coronary artery bypass surgery via sternotomy: a randomized controlled trial
Authors: Bloc Sébastien , Perot Brieuc P , Gibert Hadrien , Law Koune Jean-Dominique , Burg Yannick , Leclerc Didier , Vuitton Anne-Sophie , De La Jonquière Christophe , Luka Marine , Waldmann Thierry , Vistarini Nicolas , Aubert Stéphane , Ménager Mickaël M , Merzoug Messaouda , Naudin Cécile , Squara Pierre
Published: May 2021

Objective

This study aims to assess the effect of a preoperative parasternal plane block (PSB) on opioid consumption required to maintain hemodynamic stability during sternotomy for coronary artery bypass graft surgery.

Methods

This double-blind, randomized, placebo-controlled trial prospectively enrolled 35 patients scheduled for coronary artery bypass graft surgery under general anesthesia with propofol and remifentanil. Patients were randomized to receive preoperative PSB using either ropivacaine (PSB group) or saline solution (placebo group) (1:1 ratio). The primary endpoint was the maximal effect-site concentration of remifentanil required to maintain heart rate and blood pressure within the recommended ranges during sternotomy.

Results

Median maximum concentration of remifentanil necessary to maintain adequate hemodynamic status during sternotomy was significantly reduced in PSB group (4.2 (2.5–6.0) ng/mL) compared with placebo group (7.0 (5.2–8.0) ng/mL) (p=0.02). Mean maximum concentration of propofol used to control depth of anesthesia was also reduced (3.9±1.1 µg/mL vs 5.0±1.5 µg/mL, PSB vs placebo, respectively; p=0.02). This reduction in propofol consumption during sternotomy enabled a more adequate level of sedation to be maintained in patients (minimum patient state index was 11.7±8.7 in placebo group and 18.3±6.8 in PSB group; p=0.02). PSB reduced postoperative inflammatory response by limiting concentrations of proinflammatory cytokines IL-8, IL-18, IL-23, IL-33 and MCP-1 measured in the first 7-day after surgery (p<0.05).

Conclusions

Preoperative PSB reduced the maximum concentrations of remifentanil and propofol required to maintain hemodynamic stability and depth of anesthesia during sternotomy.

Trial registration number

NCT03734159.

Sébastien Bloc, M.D.1,2; Brieuc P. Pérot, Ph.D.3; Hadrien Gibert, M.D.1; Jean-Dominique Law Koune, M.D.1; Yannick Burg, M.D.1; Didier Leclerc, M.D.1; Anne-Sophie Vuitton, M.D.1; Christophe De La Jonquière, M.D.1; Marine Luka, L.S.3; Thierry Waldmann, M.D.4; Nicolas Vistarini, M.D.4; Stéphane Aubert, M.D.4; Mickaël M. Ménager, Ph.D.3; Messaouda Merzoug, Ph.D.2; Cécile Naudin, Ph.D.2; Pierre Squara, M.D.2,5
Starting grassroots initiatives to foster equity, diversity, and inclusivity in the Chemistry Department at the University of Alberta
Authors: Chiorean Sorina , Oakley Meagan S. , Sinclair Jocelyn
Published: May 2021

The University of Alberta Working for Inclusivity in Chemistry (UAWIC) group was formed in 2017 to increase equity, diversity, and inclusion in the Department of Chemistry. With the goals of fostering a community amongst department members and retaining a diverse graduate student population, UAWIC has created initiatives addressing equity, diversity and inclusivity, professional development, and promoted visibility of diversity within the department. Training students how to overcome systemic barriers and providing platforms to share experiences will help aspiring chemists prepare for future career paths and develop a network of mentors and colleagues.