bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-Wide Association Study Meta-Analysis for Parkinson’s Disease Motor Subtypes
Authors: Alfradique-Dunham Isabel , Al-Ouran Rami , von Coelln Rainer , Blauwendraat Cornelis , Hill Emily , Luo Lan , Stillwell Amanda , Young Emily , Tan Manuela , Liao Calwing , Hernandez Dena G. , Pihlstrom Lasse , Grosset Donald , Shulman Lisa M. , Liu Zhandong , Rouleau Guy A. ,   International Parkinson’s Disease Genomics Consortium (IPDGC), Nalls Mike A. , Singleton Andrew B. , Morris Huw , Jankovic Joseph , Shulman Joshua M.
Published: June 2020

OBJECTIVE

To discover genetic determinants of Parkinson disease (PD) motor subtypes, including Tremor Dominant (TD) and Postural Instability/Gait Difficulty (PIGD) forms.

METHODS

In 3,212 PD cases of European ancestry, we performed a genome-wide association study (GWAS) examining two complementary outcome traits derived from the Unified Parkinson’s Disease Rating Scale (UPDRS), including dichotomous motor subtype (TD vs. PIGD) or a continuous tremor / PIGD score ratio. Logistic or linear regression models were adjusted for sex, age of onset, disease duration, and 5 ancestry principal components, followed by meta-analysis.

RESULTS

Among 71 established PD risk variants, we detected multiple suggestive associations with PD motor subtype, includingGPNMB(rs199347, psubtype= 0.01, pratio= 0.03),SH3GL2(rs10756907, psubtype= 0.02, pratio= 0.01),HIP1R(rs10847864, psubtype= 0.02),RIT2(rs12456492, psubtype= 0.02), andFBRSL1(rs11610045, psubtype= 0.02). A PD genetic risk score integrating all 71 PD risk variants was also associated with subtype ratio (p = 0.026, ß = −0.04, 95% CI = −0.07, 0). Based on top results of our GWAS, we identify a novel suggestive association at theSTK32Blocus (rs2301857, pratio= 6.6×10−7), which harbors an independent risk allele for essential tremor.

CONCLUSIONS

Multiple PD risk alleles may also modify clinical manifestations to influence PD motor subtype. The discovery of a novel variant atSTK32Bsuggests a possible overlap between genetic risk for essential tremor and tremor-dominant PD.
Structure of the Bacterial Ribosome at 2 Å Resolution
Authors: Watson Zoe L. , Ward Fred R. , Méheust Raphaël , Ad Omer , Schepartz Alanna , Banfield Jillian F. , Cate Jamie H.D.
Published: June 2020

Continuing advances in cryo-electron microscopy (cryo-EM) demonstrate the promise it holds for revealing biological structures at chemical resolution, in which noncovalent interactions, RNA and protein modifications, and solvation can be modeled accurately. At present, the best cryo-EM-derived models of the bacterial ribosome are of the large (50S) ribosomal subunit with effective global resolutions of 2.4-2.5 Å, based on map-to-model Fourier shell correlation (FSC). Here we present a model of theE. coli70S ribosome with an effective global resolution of 2.0 Å, based on maps showcasing unambiguous positioning of residues, their detailed chemical interactions, and chemical modifications. These modifications include the first examples of isopeptide and thioamide backbone substitutions in ribosomal proteins, the former of which is likely conserved in all domains of life. The model also defines extensive solvation of the small (30S) ribosomal subunit for the first time, as well as interactions with A-site and P-site tRNAs, mRNA, and the antibiotic paromomycin. The high quality of the maps now allows a deeper phylogenetic analysis of ribosomal components, and identification of structural conservation to the level of solvation. The maps and models of the bacterial ribosome presented here should enable future structural analysis of the chemical basis for translation, and the development of robust tools for cryo-EM structure modeling and refinement.
bioPROTACs establish RAS as a degradable target and provide novel RAS biology insights
Authors: Lim Shuhui , Khoo Regina , Juang Yu-Chi , Gopal Pooja , Zhang Huibin , Yeo Constance , Peh Khong Ming , Teo Jinkai , Ng Simon , Henry Brian , Partridge Anthony W.
Published: June 2020

Mutations to RAS proteins (H-, N-, and K-RAS) are amongst the most common oncogenic drivers and tumors harboring these lesions are some of the most difficult to treat. Although the recently discovered covalent small molecules against the KRASG12Cmutant have shown promising efficacy against lung cancers, traditional barriers remain for drugging the more prevalent KRASG12Dand KRASG12Vmutants. Targeted degradation has emerged as an attractive alternative approach but for KRAS, identification of the required high-affinity ligands continues to be a challenge. Another significant hurdle is the discovery of a hybrid molecule that appends an E3 ligase-recruiting moiety in a manner that satisfies the precise geometries required for productive polyubiquitin transfer while maintaining favorable drug-like properties. As a tool to gain insights into the advantages and feasibility of KRAS targeted-degradation, we applied the bioPROTAC approach. This workflow centers on the intracellular expression of a chimeric protein consisting of a high-affinity target-binding domain fused to an engineered E3 ligase adapter. We generated a series of anti-RAS bioPROTACs that span different RAS isoform/nucleotide-state specificities and leverage different E3 ligases. Overall, our results provide definitive evidence for the degradability of RAS proteins. We further elucidate the functional consequences of RAS degradation, the susceptibility and degradation kinetics of various mutant KRAS, and the prevalence of different nucleotide-states in WT and mutant KRAS. Finally, if delivery challenges can be addressed, anti-RAS bioPROTACs will be exciting candidates for clinical development.
Factors impacting e-learning in health sciences education: a protocol for systematic review and meta-analysis
Authors: Regmi Krishna , Jones Linda
Published: June 2020

E-learning has been widely used in higher education as it provides better access to learning resources online, utilising technology – regardless of learners’ geographical locations and timescale – to enhance learning. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, there is very limited evidence. This protocol aims to assess the effects of e-learning factors that impact on health sciences education (HSE). We will conduct a systematic review meta-analysis research of both randomised controlled trials and non-randomised controlled trials. Seven databases – MEDLINE, EMBASE, Allied & Complementary Medicine, DH-DATA, PsycINFO, CINAHL, and Global Health – will be searched, from 1980 through 2020. The PRISMA-P checklist will be used while preparing this protocol. Two reviewers will independently screen the papers and extract data. We will utilise the JBI quality appraisal tools for quantitative and qualitative studies, and Mixed Methods Appraisal Tool appraisal tools to assess the quality. A narrative synthesis, using thematic analysis, will be conducted for the included studies. If sufficient data are available, the random-effects model for meta-analysis will be performed to measure the effect size of e-learning on health sciences education or the strengths of relationships. The outcome of this review will provide a useful checklist of potential factors to develop an e-learning approach in HSE. This might provide a basis for developing the best methods of e-learning in education so that e-learning policy in education and learning settings in the HSE context could be administered effectively, efficiently and equitably.
A Metapopulation Network Model for the Spreading of SARS-CoV-2: Case Study for Ireland⋆
Authors: Humphries Rory , Spillane Mary , Mulchrone Kieran , Wieczorek Sebastian , O’Riordain Micheal , Hövel Philipp
Published: June 2020

We present preliminary results on an all-Ireland network modelling approach to simulate the spreading the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), commonly known as the coronavirus. In the model, nodes correspond to locations or communities that are connected by links indicating travel and commuting between different locations. While this proposed modelling framework can be applied on all levels of spatial granularity and different countries, we consider Ireland as a case study. The network comprises 3440 electoral divisions (EDs) of the Republic of Ireland and 890 superoutput areas (SOAs) for Northern Ireland, which corresponds to local administrative units below the NUTS 3 regions. The local dynamics within each node follows a phenomenological SIRX compartmental model including classes of Susceptibles, Infected, Recovered and Quarantined (X) inspired from Science 368, 742 (2020). For better comparison to empirical data, we extended that model by a class of Deaths. We consider various scenarios including the 5-phase roadmap for Ireland. In addition, as proof of concept, we investigate the effect of dynamic interventions that aim to keep the number of infected below a given threshold. This is achieved by dynamically adjusting containment measures on a national scale, which could also be implemented at a regional (county) or local (ED/SOA) level. We find that – in principle – dynamic interventions are capable to limit the impact of future waves of outbreaks, but on the downside, in the absence of a vaccine, such a strategy can last several years until herd immunity is reached.
Deducing the Dose-response Relation for Coronaviruses from COVID-19, SARS and MERS Meta-analysis Results
Authors: Zhang Xiaole , Wang Jing
Published: June 2020

The fundamental dose-response relation is still missing for better evaluating and controlling the transmission risk of COVID-19. A recent study by Chu et al. has indicated that the anticipated probability of viral infection is about 12.8% within 1 m and about 2.6% at further distance through a systematic review and meta-analysis. This important information provides us a unique opportunity to assess the dose-response relation of the viruses, if reasonable exposure dose could be estimated. Here we developed a simple framework to integrate the a priori dose-response relation for SARS-CoV based on mice experiments, and the recent data on infection risk and viral shedding, to shed light on the dose-response relation for human. The developed dose-response relation is an exponential function with a constant k in the range of 6.19×104 to 7.28×105 virus copies. The result mean that the infection risk caused by one virus copy in viral shedding is about 1.5×10−6 to 1.6×10−5. The developed dose-response relation provides a tool to quantify the magnitude of the infection risk.
The conformational analyses of 2-amino-N-[2-(dimethylphenoxy)ethyl]propan-1-ol derivatives in different environments
Authors: Nitek Wojciech , Kania Agnieszka , Marona Henryk , Waszkielewicz Anna M. , Żesławska Ewa
Published: June 2020

Four crystal structures of 2-amino-N-(dimethylphenoxyethyl)propan-1-ol derivatives, characterized by X-ray diffraction analysis, are reported. The free base (R,S)-2-amino-N-[2-(2,3-dimethylphenoxy)ethyl]propan-1-ol, C13H21NO2, 1, crystallizes in the space group P21/n, with two independent molecules in the asymmetric unit. The hydrochloride, (S)-N-[2-(2,6-dimethylphenoxy)ethyl]-1-hydroxypropan-2-aminium chloride, C13H22NO2
+·Cl−, 2c, crystallizes in the space group P21, with one cation and one chloride anion in the asymmetric unit. The asymmetric unit of two salts of 2-picolinic acid, namely, (R,S)-N-[2-(2,3-dimethylphenoxy)ethyl]-1-hydroxypropan-2-aminium pyridine-2-carboxylate, C13H22NO2
+·C6H4NO2
−, 1p, and (R)-N-[2-(2,6-dimethylphenoxy)ethyl]-1-hydroxypropan-2-aminium pyridine-2-carboxylate, C13H22NO2
+·C6H4NO2
−, 2p, consists of one cation and one 2-picolinate anion. Salt 1p crystallizes in the triclinic centrosymmetric space group P\overline 1, while salt 2p crystallizes in the space group P41212. The conformations of the amine fragments are contrasted and that of 2p is found to have an unusual antiperiplanar arrangement about the ether group. The crystal packing of 1 and 2c is dominated by hydrogen-bonded chains, while the structures of the 2-picolinate salts have hydrogen-bonded rings as the major features. In both salts with 2-picolinic acid, the specific R
1
2(5) hydrogen-bonding motif is observed. Structural studies have been enriched by the generation of fingerprint plots derived from Hirshfeld surfaces.
Intermolecular interactions and disorder in six isostructural celecoxib solvates
Authors: Bond Andrew D. , Sun Changquan C.
Published: June 2020

Six isostructural crystalline solvates of the active pharmaceutical ingredient celecoxib {4-[5-(4-methylphenyl)-3-(trifluoromethyl)pyrazol-1-yl]benzenesulfonamide; C17H14F3N3O2S} are described, containing dimethylformamide (DMF, C3H7NO,1), dimethylacetamide (DMA, C4H9NO,2),N-methylpyrrolidin-2-one (NMP, C5H9NO,3), tetramethylurea (TMU, C5H12N2O,4), 1,3-dimethyl-3,4,5,6-tetrahydropyrimidin-2(1H)-one (DMPU, C6H12N2O,5) or dimethyl sulfoxide (DMSO, C2H6OS,6). The host celecoxib structure contains one-dimensional channel voids accommodating the solvent molecules, which accept hydrogen bonds from the NH2groups of two celecoxib molecules. The solvent binding sites have local twofold rotation symmetry, which is consistent with the point symmetry of the solvent molecule in4and5, but introduces orientational disorder for the solvent molecules in1,2,3and6. Despite the isostructurality of1–6, the unit-cell volume and solvent-accessible void space show significant variation. In particular,4and5show an enlarged and skewed unit cell, which can be attributed to a specific interaction between an N—CH3group in the solvent molecule and the toluene group of celecoxib. Intermolecular interaction energies calculated using thePIXELmethod show that the total interaction energy between the celecoxib and solvent molecules is broadly correlated with the molecular volume of the solvent, except in6, where the increased polarity of the S=O bond leads to greater overall stabilization compared to the similarly-sized DMF molecule in1. In the structures showing disorder, the most stable orientations of the solvent molecules make C—H...O contacts to the S=O groups of celecoxib.
Non-work-related rejection of temporary members
Authors: Kristensen Anette Kaagaard , Kristensen Martin Lund
Published: June 2020

Purpose

This paper aims to highlight the social dynamics associated with the interaction between temporary and permanent organizational members in non-work-related situations. This view contrasts with previous studies which predominantly focus on work-related situations. Inspired by Goffman's dramaturgical metaphor, a perspective which emphasizes the influence of social regions on group membership as well as the ritual foundation of everyday social interactions is developed.

Design/methodology/approach

This paper’s methodological foundation is a constructivist grounded theory study of 15 undergraduate nursing students' experiences as temporary members during their clinical placements.

Findings

Temporary members arrive at their new organization with an expectation of attending non-work-related situations on similar terms as permanent members. However, they do not expect to be treated as new colleagues. They experience being excluded and ignored, which makes them feel humiliated, denied recognition and deprived of their dignity.

Originality/value

Illuminating social dynamics related to backstage access provides valuable insights to studies of the relationship between temporary and permanent organizational members. Furthermore, redirecting the analytical focus from social dynamics associated with work-related situations to non-work-related ones provides new perspectives on moral exclusion by emphasizing the ritual foundation and its close connection to moral concepts such as dignity and recognition.
Classification of malicious insiders and the association of the forms of attacks
Authors: Glancy Fletcher , Biros David P. , Liang Nan , Luse Andy
Published: June 2020

Purpose

The authors argue that the current studies about malicious insiders confuse the fact that malicious attacks belong to two different categories, namely, those that launch instrumental attacks and expressive attacks. The authors collect malicious insider data from publicly available sources and use text-mining techniques to analyze the association between malicious insiders’ characteristics and the different types of attack.

Design/methodology/approach

The authors investigated the relationship between personality characteristics and different types of malicious attacks. For the personality characteristics, the authors use the same method as Liang et al. (2016), which extracted these characteristics based on a keyword-characteristic dictionary. For different types of malicious attacks, two raters rated each case based on criteria modified from criminology research to determine the degree of expressiveness and instrumentality.

Findings

The results show that malicious insiders who are manipulative or seeking personal gain tend to carry out instrumental attacks. Malicious insiders who are arrogant tend to conduct expressive attacks.

Research limitations/implications

This study uses third party articles to identify the personality characteristics of known malicious insiders. As such, not all personality characteristics may have been reported. Data availability was an issue.

Practical implications

Understanding if different personality characteristics lead different types of attacks can help managers identify employees who exhibit them and mitigate an attack before it occurs.

Social implications

Malicious insider attacks can have devastating results on businesses and employees. Help to identify potential malicious insiders before they act, may prevent undue harm.

Originality/value

This study used 132 cases of none malicious insiders to examine their attack objectives. No other study that the authors know of used that many cases.
Trickle-down effect of benevolent leadership on unethical employee behavior: a cross-level moderated mediation model
Authors: Rui Jiang , Xinqi Lin
Published: June 2020

Purpose

Conducting research on the relationship between benevolent leadership and unethical employee behavior can help us find solutions to reduce unethical employee behavior. This paper also discusses how the benevolent manager leadership can be transmitted to the employee's unethical behavior through the benevolent supervisor leadership and the moderating effect of LMX and ethical climate.

Design/methodology/approach

Through a questionnaire survey of 406 pairs of leaders, supervisor and employees, the authors use data aggregation test, confirmatory factor analysis, descriptive statistics and multilevel model (HLM) to test our hypothesis.

Findings

(1) Manager supervisor leadership is negatively related to unethical employee behavior, (2) benevolent supervisor leadership mediates the relationship between benevolent manager leadership and unethical employee behavior, (3) LMX positively moderates the relationship between benevolent manager leadership and benevolent supervisor leadership and moderates the mediating effect of benevolent supervisor leadership, and (4) ethical climate positively moderates the relationship between benevolent supervisor leadership and unethical employee behavior and moderates the mediating effect of benevolent supervisor leadership.

Originality/value

First, based on previous studies, this study further proves that benevolent leadership is a popular positive leadership among the three dimensions of paternalistic leadership that extends its influence to unethical employee behavior. Second, the study traces the source of the benevolent leadership of employees' supervisors and reveals the action mechanism of how benevolent manager leadership affects unethical employee behavior (trickle-down effect). LMX and the ethical climate provide the organizational context of the trickle-down effect and the occurrence of unethical employee behavior.
Chronic traffic noise increases food intake and alters gene expression associated with metabolism and disease in bats
Authors: Song Shengjing , Chang Yang , Wang Daiping , Jiang Tinglei , Feng Jiang , Lin Aiqing
Published: June 2020

Anthropogenic noise exposure has deleterious effects on the foraging ecology of many animals. However, the effects of chronic anthropogenic noise on food intake and health condition in wildlife remain largely unknown.

We tested whether traffic noise exposure over multiple days would change food intake and would have effects on the health of Asian particoloured bats. We broadcast traffic noise to the bats of two noise‐exposure groups (group A, five bats; group C, six bats) and broadcast silence files to the bats of two control groups (group B, five bats; group D, six bats) for 12 days. We measured the changes in food intake, body weight and concentration of faecal triiodothyronine (T3) and thyroxine (T4) in groups A and B. We compared the transcriptional profiles in brain, kidney and liver tissues between bats in groups C and D.

The bats exposed to traffic noise had a significantly higher daily food intake and a significantly greater body weight than bats in control group during the period of playback. Faecal T3 and T4 were higher in the noise‐exposure group after playback had been on for more than 1 day.

We found a total of 169 differentially expressed genes (DEGs) between noise‐exposure and control groups. Some DEGs related to stress response were upregulated in the bats exposed to noise. The 169 DEGs were mainly enriched in Gene Ontology (GO) terms associated with metabolism, fundamental cellular processes, stress response and immune response. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways affected by noise exposure were linked with metabolism, disease, apoptosis, autophagy, phagosome and ribosome.

Synthesis and applications. Our results suggest that bats exposed to chronic traffic noise while roosting may need more energetic intake and have a greater motivation to forage than others not exposed to noise, probably as a result of a stress response. Furthermore, chronic traffic noise may increase the risk of metabolic dysregulation, immune disorders and other diseases. Management measures for reducing noise disturbance, for example, implementing sound barriers, are essential.
Expression of ribosomal protection protein RppA is regulated by a ribosome‐dependent ribo‐regulator and two mistranslation products
Authors: Cai Xia , Zhan Yunda , Cao Zhanglei , Yan Bing , Cai Jun
Published: June 2020

Gene expression is tightly controlled by transcription factors and RNA regulatory elements, including trans‐acting small RNAs, cis‐regulatory riboswitches and ribosome‐dependent ribo‐regulators. In the present study, we demonstrated that a ribosome‐dependent ribo‐regulator and two mistranslation products co‐regulate rppA (encoding a ribosomal protection protein) expression in Bacillus thuringiensis BMB171. The leader RNA of the rppA gene controls rppA expression via translation of leader ORF1 resident in its sequence. In the presence of chloramphenicol, a +1 frameshift product (ORF2) and a stop codon readthrough product (ORF3) of ORF1 emerged. ORF3 exerted a negative effect on rppA expression. By contrast, the ORF2 promoted rppA expression. The regulation mode identified in the present study will lead to a deeper understanding of bacterial gene expression.
Understanding the Role of Profession in Multidisciplinary Team Innovation: Professional Identity, Minority Dissent and Team Innovation
Authors: Mitchell Rebecca , Boyle Brendan
Published: June 2020

Organizational teams are capable of addressing complex and multifaceted problems through innovative solutions, but their capacity to innovate is far from guaranteed. The quest to address this dilemma has yet to explore the interactive roles of professional and team identification; a surprising omission as both professional and team identification have been separately shown to play an important role in determining team innovation. Responding to this research gap, we explore the potential for professional identity salience to enhance or undermine healthcare team innovation through minority dissent, and argue that team identification is capable of differentiating between these two contrasting effects. Our survey‐based study of 63 US healthcare teams supports our moderated mediation model, which provides evidence of the potential complementarity of different forms of identification and opens an opportunity for teams to reap the benefits, as well as avoid the detriments, typically associated with each form.
Lively Lands: The Spatial Reproduction Squeeze and the Failure of the Urban Imaginary
Authors: Ghertner D. Asher
Published: June 2020

This article argues that the theoretical invisibility of non‐privatized land tenures constitutes a failure of the urban imaginary, which restricts the ability to forge less commodified urban futures. The article explicates two attributes of non‐privatized land—fungibilityandcombinatoriality—that produce an urban land nexus capable of fostering pro‐poor agglomeration economies and generating socialities that exceed the model of the separative self that is hegemonic in more propertied settings. Fungibility, it shows, externalizes supportive economies of production and reproduction into surrounding neighborhoods by shifting the boundaries and terms of usufruct without cadastral oversight or regulation. Combinatoriality—a hybrid formulation of combined territories and combined territorialities—describes overlapping forms of access to land or demarcations of legitimate land use, either competitive or reciprocal. Together, these two attributes of non‐privatized land systems produce a propinquity requirement for economic production, or a social density and liveliness more limited in privatized land markets. Through a diagnostic analogy with the simple reproduction squeeze characteristic of subsistence agrarian settings, it charts how anurbanspatial reproduction squeeze—felt globally in dense, rising‐rent environments across the global North and South—generates subsistence needs that mixed‐tenure environments are uniquely capable of fulfilling and that can provide inspiration for radical housing struggles elsewhere.
The contextual effect of trust on perceived support: Evidence from Roma and non‐Roma in East‐Central Europe
Authors: Sendroiu Ioana , Upenieks Laura
Published: June 2020

In recent years, trust has been conceptualized as an important source of social capital, setting off cross‐disciplinary research on both the benefits and predictors of trust at the individual and contextual level. In this paper, we turn to the individual outcomes of living in a trustful context, and explore the relationship between trust, itself one of the main components of social capital, and social support, seen as one of the most important effects of social capital. In particular, we ask how social capital—and the relationship between trust and social support—functions in the context of unequal societies. We model perceived support as an outcome across three levels, from no support to proximate to distal support, and using a cross‐national study of Roma and non‐Roma across 12 European countries, we track the relationship between trust and support across both mainstream and marginalized populations. Our findings suggest that living in contexts with more trust has protective effects particularly for members of marginalized groups: the Roma are more likely to have distal support in contexts with higher trust. We conclude that contextual trust helps to broaden the circle of support beyond family and friends; thus, trust can indeed be a synthetic force that binds individuals together in broadened structures of support.
The Challenges for Labour Market Policy during the COVID‐19 Pandemic*
Authors: Costa Dias Monica , Joyce Robert , Postel‐Vinay Fabien , Xu Xiaowei
Published: June 2020

The COVID‐19 pandemic is having a dramatic economic impact in most countries. In the UK, it has led to sharp falls in labour demand in many sectors of the economy and to initial acute labour shortages in other sectors. Much more than in a typical downturn, the current crisis is not simply a general slowdown in economic activity but also a radical short‐term shift in the mix of economic activities – of which an unknown, but possibly significant, amount will be persistent. The initial policy response has focused on cushioning the blow to families’ finances and allowing the majority of workers and firms to resume their original activities once the crisis subsides. These are crucial priorities. But there should also be a focus on reallocating some workers, either temporarily if working in shut‐down sectors or permanently by facilitating transitions to sectors and jobs offering better prospects and facing labour shortages. The phasing‐out of the furlough subsidies, which is projected to happen in Autumn 2020, brings this into even sharper focus since the alternative for many workers will be unemployment. Active labour market policy will need to be front and centre.
Core components of a staff wellness strategy in emergency departments: A clinician‐informed nominal group study
Authors: Elder Elizabeth , Johnston Amy NB , Byrne Jacqueline H , Wallis Marianne , Crilly Julia
Published: June 2020

Objective

Busy, high‐stress EDs prompt many work‐based interventions to address staff wellness, with mixed success. The aim of the present study was to enable ED clinicians to systematically identify core components of a work‐based strategy to improve their working environment and/or coping.

Methods

Purposively sampled ED doctors and nurses from one health service were invited to participate in modified nominal group technique. Participants identified, from a pre‐defined list, a key ED stressor and then discussed and ratified proposed core components of a work‐based strategy to address or ameliorate this stressor.

Results

Two nominal group technique sessions were held with a total of 10 participants (n = 7 nurses and n = 3 doctors). Participants proposed several strategies aimed at both individual and organisational levels to address occupational stress and coping, and support staff well‐being in the workplace. These included mobile/web‐based applications, group counselling sessions, yoga, social activities, team building activities and debriefing. Participants described three key components to promote staff wellness and hence enhance their ability to buffer negative aspects of occupational stress: (i) increased individual and team support; (ii) development of professional resilience; and (iii) maximising opportunities for social connection.

Conclusions

Ensuring appropriate systems, services and support for ED staff should be a priority at local departmental, wider organisational and governmental levels. ED clinicians are ideally placed to identify such systems, services and supports. Managers and policy makers can use these findings to inform the implementation of interventions in EDs.
Blood pressure in Danish children during general anaesthesia: Hypotension in a paediatric population observational (HIPPO) study
Authors: Clausen Nicola G. , Filipovic Maja , de Pater Gerrit H. , Zickerman Caroline , Ydemann Mogens
Published: June 2020

Background

In Denmark, thousands of infants and children require general anaesthesia annually. Hypotension during general anaesthesia might reduce cerebral blood flow and oxygen delivery to the brain. Safe lower limits of blood pressure are ill defined. The Hypotension in Paediatric Populations Observational study objective was to assess blood pressure in Danish children during general anaesthesia.

Methods

This study is a prospective observational multicentre study. Primary outcomes were mean arterial blood pressures in children aged 0‐12 years. Lowest mean arterial blood pressure, intervention thresholds to increase blood pressure and type of intervention were secondary outcomes. Premature infants and children scheduled for cardio‐thoracic surgery were excluded. Blood pressures were measured by oscillometry or invasively.

Results

In total, 726 patients were included. In children < 1 year, median arterial pressure was 51 mm Hg, (interquartile range; 43‐58) and increased to 58 mm Hg (interquartile range; 52‐65) for 12‐year‐old children. In 32 patients, 49 actions were taken to modulate blood pressure. Pre‐induction blood pressures were recorded for 29%.

Conclusion

This study presents pragmatic, multicentre, prospectively collected observations of blood pressure in children undergoing general anaesthesia in usual practice. In the youngest infants, variability in blood pressure appears to be large. Measurement of blood pressure is recommended during every general anaesthesia and in children of all ages. Safe ranges of blood pressure remain to be defined.
Ketamine Versus Etomidate and Peri‐intubation Hypotension: A National Emergency Airway Registry Study
Authors: April Michael D. , Arana Allyson , Schauer Steven G. , Davis William T. , Oliver Joshua J. , Fantegrossi Andrea , Summers Shane M. , Maddry Joseph K. , Walls Ron M. , Brown Calvin A. ,   the NEAR Investigators
Published: June 2020

Background

The hemodynamic impact of induction agents is a critically important consideration in emergency intubations. We assessed the relationship between peri‐intubation hypotension and the use of ketamine versus etomidate as an induction agent for emergency department (ED) intubation.

Methods

We analyzed ED intubation data for patients aged >14 years from the National Emergency Airway Registry performed in 25 EDs during 2016 through 2018. We excluded patients with preintubation hypotension (systolic blood pressure <100 mm Hg) or cardiac arrest prior to intubation. The primary outcome was peri‐intubation hypotension. Secondary outcomes included interventions for hypotension (e.g., intravenous fluids or vasopressors). We report adjusted odds ratios (aOR) from multivariable logistic regression models controlling for patient demographics, difficult airway characteristics, and intubation modality.

Results

There were 738 encounters with ketamine and 6,068 with etomidate. Patients receiving ketamine were more likely to have difficult airway characteristics (effect size difference = 8.8%, 95% confidence interval [CI] = 5.3% to 12.4%) and to undergo intubation with video laryngoscopy (8.1%, 95% CI = 4.4% to 12.0%). Peri‐intubation hypotension incidence was 18.3% among patients receiving ketamine and 12.4% among patients receiving etomidate (effect size difference = 5.9%, 95% CI = 2.9% to 8.8%). Patients receiving ketamine were more likely to receive treatment for peri‐intubation hypotension (effect size difference = 6.5%, 95% CI = 3.9% to 9.3%). In logistic regression analyses, patients receiving ketamine remained at higher risk for peri‐intubation hypotension (aOR = 1.4, 95% CI = 1.2 to 1.7) and treatment for hypotension (aOR = 1.8, 95% CI = 1.4 to 2.0). There was no difference in the aOR of hypotension between patients receiving ketamine at doses ≤1.0 mg/kg versus >1.0 mg/kg or patients receiving etomidate at doses ≤0.3 mg/kg versus >0.3 mg/kg.

Conclusions

Pending additional data, our results suggest that clinicians should not necessarily prioritize ketamine over etomidate based on concern for hemodynamic compromise among ED patients undergoing intubation.
Friends’ childhood adversity and long‐term implications for substance misuse: a prospective Swedish cohort study
Authors: Bishop Lauren , Almquist Ylva B
Published: June 2020

Background and aims

Although an individual's childhood adversity is predictive of later substance misuse, the effect of adversity within an individual's friendship network has not been established. The current study aims to estimate the strength of the association between exposure to childhood adversity among individuals’ friends at the onset of adolescence, relative to individuals’ own exposure to childhood adversity, and hospitalization for substance misuse between young adulthood and retirement.

Design

Prospective cohort study.

Setting

Stockholm, Sweden.

Participants

Individuals born in 1953, living in Stockholm in 1963, and who nominated three best friends in the 6th grade school class (n = 7180; females = 3709, males = 3471), followed to 2016.

Measurements

The outcome was hospitalization with a main or secondary diagnosis attributed to substance misuse, reflected in Swedish inpatient records (ages 19–63 years). Five indicators of childhood adversity (ages 0–12 years) were operationalized into composite measures for individuals and their friends, respectively. Friendships were identified using sociometric data collected in the school class setting (age 13 years).

Findings

Individuals’ own childhood adversity does not predict childhood adversity among friends (P > 0.05). Childhood adversity among friends is independently associated with an increased risk of an individual's later substance misuse [hazard ratio (HR) = 1.17, 95% confidence interval (CI) = 1.09–1.24], independently of an individual's own childhood adversity (HR = 1.47, 95% CI = 1.34–1.61). However, childhood adversity among friends does not moderate the association between individuals’ own childhood adversity and later substance misuse.

Conclusions

Within a birth cohort of individuals born in 1950s Stockholm, Sweden, childhood adversity among an individual's friends appears to predict the individual's substance misuse in later life independently of an individual's own exposure to childhood adversity.
Post‐fire development of faunal habitat depends on plant regeneration traits
Authors: Rainsford Frederick W. , Kelly Luke T. , Leonard Steve W.J. , Bennett Andrew F.
Published: June 2020

The concept that vegetation structure (and faunal habitat) develops predictably with time since fire has been central to understanding the relationship between fire and fauna. However, because plants regenerate after fire in different ways (e.g. resprouting from above‐ground stems vs. underground lignotubers), use of simple categories based on time since fire might not adequately represent post‐fire habitat development in all ecosystems. We tested the hypothesis that the post‐fire development of faunal habitat structure differs between ecosystems, depending on fire regeneration traits of the dominant canopy trees. We measured 12 habitat components at sites in foothill forests (n = 38), heathy woodlands (n = 38) and mallee woodlands (n = 98) in Victoria, Australia, and used generalised additive models to predict changes in each variable with time since fire. A greater percentage of faunal habitat variables responded significantly to time since fire in mallee woodlands, where fires typically are stand‐replacing, than in foothill forests and heathy woodlands, where canopy tree stems generally persist through fire. In the ecosystem with the highest proportion of epicormic resprouters (foothill forests), only ground cover and understorey vegetation responded significantly to time since fire, compared with all but one variable in the ecosystem dominated by basal resprouters (mallee woodlands). These differences between ecosystems in the post‐fire development of key habitat components suggest there may also be fundamental differences in the role of fire in shaping the distribution of fauna. If so, this challenges the way in which many fire‐prone ecosystems currently are categorised and managed, especially the level of dependence on time since fire and other temporal surrogates such as age‐classes and successional states. Where time since fire is a poor surrogate for habitat structural development, additional complexity (e.g. fire severity, topography and prior land‐use history) could better capture processes that determine faunal occurrence in fire‐prone ecosystems.
Soluble immune checkpoints CTLA‐4, HLA‐G, PD‐1, and PD‐L1 are associated with endometriosis‐related infertility
Authors: Santoso Budi , Sa'adi Ashon , Dwiningsih Sri Ratna , Tunjungseto Arif , Widyanugraha Muhammad Yohanes Ardianta , Mufid Alfin Firasy , Rahmawati Nanda Yuli , Ahsan Fadhil
Published: June 2020

Problem

Soluble immune checkpoint molecules constitute the emerging novel mediators in immune regulation. Their role in the pathogenesis of endometriosis has not been fully addressed. In this study, we aimed to investigate the relationship between the clinical manifestation of endometriosis‐associated infertility and the level of four soluble immune checkpoints: sCTLA4, sHLA‐G, sPD‐1, and sPD‐L1.

Method of study

The soluble immune checkpoint concentrations in serum and peritoneal fluid from 88 patients who underwent laparoscopy were evaluated by the enzyme‐linked immunosorbent assay (ELISA). Clinical and hematological parameters were documented and analyzed.

Results

Endometriosis cases were evident to have significantly higher levels of serum sPD‐L1 and all four molecules in peritoneal fluid compared to non‐endometriosis control. Contrary, no significant differences were found in the concentration of serum sCTLA‐4, sHLA‐G and, sPD‐1 between endometriosis and control group. There were significant positive correlations between serum and peritoneal fluid concentrations of sCTLA‐4, sPD‐L1, and sHLA‐G. Serum sPD‐L1 could discriminate endometriosis‐related infertility to other pathological control. At a cutoff of 14,61 pg/mL, serum sPD‐L1 had a sensitivity of 77% and specificity of 83%. Moreover, sPD‐L1 level showed positive correlations with pelvic adhesion score and myeloid cell count.

Conclusion

The elevated level of sPD‐L1 in serum and immune checkpoint molecules in the peritoneal fluid could represent the hallmark of immune regulation in endometriosis. Serum sPD‐L1 could serve as a potential noninvasive endometriosis biomarker. Also, the immune compartment related to the local immune checkpoint molecules may be implicated in biological mechanisms underlying endometriosis‐related infertility.
The effects of climate change on respiratory allergy and asthma induced by pollen and mold allergens
Authors: D’Amato Gennaro , Chong‐Neto Herberto Jose , Monge Ortega Olga Patricia , Vitale Carolina , Ansotegui Ignacio , Rosario Nelson , Haahtela Tari , Galan Carmen , Pawankar Ruby , Murrieta‐Aguttes Margarita , Cecchi Lorenzo , Bergmann Christian , Ridolo Erminia , Ramon German , Gonzalez Diaz Sandra , D’Amato Maria , Annesi‐Maesano Isabella
Published: June 2020

The impact of climate change on the environment, biosphere, and biodiversity has become more evident in the recent years. Human activities have increased atmospheric concentrations of carbon dioxide (CO2) and other greenhouse gases. Change in climate and the correlated global warming affects the quantity, intensity, and frequency of precipitation type as well as the frequency of extreme events such as heat waves, droughts, thunderstorms, floods, and hurricanes. Respiratory health can be particularly affected by climate change, which contributes to the development of allergic respiratory diseases and asthma. Pollen and mold allergens are able to trigger the release of pro‐inflammatory and immunomodulatory mediators that accelerate the onset the IgE‐mediated sensitization and of allergy. Allergy to pollen and pollen season at its beginning, in duration and intensity are altered by climate change. Studies showed that plants exhibit enhanced photosynthesis and reproductive effects and produce more pollen as a response to high atmospheric levels of carbon dioxide (CO2). Mold proliferation is increased by floods and rainy storms are responsible for severe asthma. Pollen and mold allergy is generally used to evaluate the interrelation between air pollution and allergic respiratory diseases, such as rhinitis and asthma. Thunderstorms during pollen seasons can cause exacerbation of respiratory allergy and asthma in patients with hay fever. A similar phenomenon is observed for molds. Measures to reduce greenhouse gas emissions can have positive health benefits.
New Directions in Maritime and Fisheries Anthropology
Authors: Aswani Shankar
Published: June 2020

Maritime and fisheries anthropology is a mixture of different themes couched under various theoretical frameworks that straddle the humanities and the sciences. In this subject survey, I explore different thematic and theoretical strands of maritime and fisheries anthropology and illustrate broader changes in this subdiscipline since around the mid‐1990s. I also review developing and future thematic and theoretical research frontiers, and discuss their potential contribution to a public and actionable anthropology/scholarship that can better inform fisheries management and conservation. This is important because in the twenty‐first century, coastal peoples are facing socioeconomic and environmental challenges that are increasingly becoming hazardous. To create a more actionable discipline, anthropology needs to be more accessible, inform innovation, and recapture a more pluralistic scholarship that champions interdisciplinary work. This will require the consilience between the humanities and natural sciences for studying human–marine interactions more broadly and for protecting the marine environment. [maritime and fisheries anthropology, new directions, actionable scholarship, oceans]
Critical evaluation of different available guidelines for late‐onset hypogonadism
Authors: Giagulli Vito Angelo , Castellana Marco , Lisco Giuseppe , Triggiani Vincenzo
Published: June 2020

Background

Late‐onset hypogonadism (LOH) is a syndrome characterized by clinical and biochemical evidence of low testosterone levels with advancing age. In recent years, several guidelines, position statements and other recommendations have become available. It is unclear whether similar indications are reported in these documents.

Objective

To review similarities and differences among available documents on the management of hypogonadism, with a special focus on LOH.

Materials and methods

PubMed, Google and international societies websites were searched on March 2020 for documents published in the last 10 years on the management of hypogonadism and LOH.

Results

Nine documents were found, each developed by: (a) the American Urological Association; (b) the British Society for Sexual Medicine; (c) the Canadian Medical Association; (d) the Endocrine Society; (e) the Endocrine Society of Australia; (f) the European Academy of Andrology; (g) the European Association of Urology; (h) the International Consultation for Sexual Medicine; and (i) the International Society for the Study of Aging Male.

Discussion

Despite similar principles, differences were found both for the diagnostic workup and follow‐up. Particularly, discrepancies were reported both for total and free testosterone levels for diagnosis and for total testosterone for monitoring.

Conclusion

Available documents differ in terms of specific recommendations for the management of hypogonadism and LOH. Given the relevant clinical implications of adequate management of these disorders, future guidelines should report more consistent measures to be adopted in clinical practice.