bluuebunny/crossref_metadata_2025 huggingface dataset:
Pest and disease management by red light
Authors: Gallé Ágnes , Czékus Zalán , Tóth Liliána , Galgóczy László , Poór Péter
Published: July 2021

Light is essential for plant life. It provides a source of energy through photosynthesis and regulates plant growth and development and other cellular processes, such as by controlling the endogenous circadian clock. Light intensity, quality, duration and timing are all important determinants of plant responses, especially to biotic stress. Red light can positively influence plant defence mechanisms against different pathogens, but the molecular mechanism behind this phenomenon is not fully understood. Therefore, we reviewed the impact of red light on plant biotic stress responses against viruses, bacteria, fungi and nematodes, with a focus on the physiological effects of red light treatment and hormonal crosstalk under biotic stress in plants. We found evidence suggesting that exposing plants to red light increases levels of salicylic acid (SA) and induces SA signalling mediating the production of reactive oxygen species, with substantial differences between species and plant organs. Such changes in SA levels could be vital for plants to survive infections. Therefore, the application of red light provides a multidimensional aspect to developing innovative and environmentally friendly approaches to plant and crop disease management.
Bank Risk Appetite Communication and Risk Taking: The Key Role of Integrated Reports
Authors: Mio Chiara , Agostini Marisa , Panfilo Silvia
Published: July 2021

This article investigates whether qualitative information provided by banks about risk appetite (RA) sheds substantive insight on their effective risk taking (RT) and whether this latter in turn affects RA disclosure, as well as the role played by specific types of banks’ reports (i.e., integrated report, annual report, Pillar 3 report) on such relations. Using a sample of 134 reports representing 52 banks, a generalized structural equation model is applied. The article hypothesizes and empirically finds a reciprocal relation between RA disclosure and banks’ RT. More specifically, in line with agency theory, the analysis displays a predominance of the inverse relation according to which banks showing higher RT provide greater disclosure. In addition, RT is found to play a mediator role between the adoption of a specific type of report—the integrated report—and RA disclosure, independently of the context in which the banks operate. Results also highlight that RT in banks adopting an integrated report is lower than the one of matched banks. Overall, this study extends risk science by complementing the literature stream on banks’ accounting discretion and risk disclosure, supporting the impact of market discipline in promoting new forms of corporate reporting. Results indeed emphasize the key role of integrated reporting on RT, suggesting that integrated logic should be strengthened by policy makers to curb banks’ excessive RT and leading them to provide substantive disclosure.
Combining Non-Probability and Probability Survey Samples Through Mass Imputation
Authors: Kim Jae Kwang , Park Seho , Chen Yilin , Wu Changbao
Published: July 2021

Analysis of non-probability survey samples requires auxiliary information at the population level. Such information may also be obtained from an existing probability survey sample from the same finite population. Mass imputation has been used in practice for combining non-probability and probability survey samples and making inferences on the parameters of interest using the information collected only in the non-probability sample for the study variables. Under the assumption that the conditional mean function from the non-probability sample can be transported to the probability sample, we establish the consistency of the mass imputation estimator and derive its asymptotic variance formula. Variance estimators are developed using either linearization or bootstrap. Finite sample performances of the mass imputation estimator are investigated through simulation studies. We also address important practical issues of the method through the analysis of a real-world non-probability survey sample collected by the Pew Research Centre.
Using Text Mining to Track Outbreak Trends in Global Surveillance of Emerging Diseases: ProMED-mail
Authors: You Jingxian , Expert Paul , Costelloe Céire
Published: July 2021

ProMED-mail (Program for Monitoring Emerging Disease) is an international disease outbreak monitoring and early warning system. Every year, users contribute thousands of reports that include reference to infectious diseases and toxins. However, due to the uneven distribution of the reports for each disease, traditional statistics-based text mining techniques, represented by term frequency-related algorithm, are not suitable. Thus, we conducted a study in three steps (i) report filtering, (ii) keyword extraction from reports and finally (iii) word co-occurrence network analysis to fill the gap between ProMED and its utilization. The keyword extraction was performed with the TextRank algorithm, keywords co-occurrence networks were then produced using the top keywords from each document and multiple network centrality measures were computed to analyse the co-occurrence networks. We used two major outbreaks in recent years, Ebola, 2014 and Zika 2015, as cases to illustrate and validate the process. We found that the extracted information structures are consistent with World Health Organisation description of the timeline and phases of the epidemics. Our research presents a pipeline that can extract and organize the information to characterize the evolution of epidemic outbreaks. It also highlights the potential for ProMED to be utilized in monitoring, evaluating and improving responses to outbreaks.
How to implement a PEWS in a resource‐limited setting: A quantitative analysis of the bedside‐PEWS implementation in a hospital in northeast Brazil
Authors: van der Fluit Karin S. , Boom Matthijs C. , Brandão Marlon B. , Lopes Gabriel D. , Barreto Paula G. , Leite Deborah C. F. , Gurgel Ricardo Q.
Published: July 2021

OBJECTIVES

Quantitative analysis of the implementation of the bedside paediatric early warning system (B‐PEWS) in a resource‐limited setting. The B‐PEWS serves to pre‐emptively identify hospitalised children who are at risk for cardiopulmonary arrest and subsequently to provide critical care in time.

METHODS

We performed a retrospective review through the medical data records of patients after discharge from the paediatric ward of a philanthropic hospital in Brazil. Nurses’ performance using the system was measured with various parameters.

RESULTS

A total of 499 patients were included, and a total of 8024 scores were checked. During the 21‐week research period, the implementation rate increased significantly from 66.5% (SD 26.0) in Period 1 to 93.1% (SD 16.6) in Period 2. The number of scores that resulted in a correct total score went from 7.5% in Period 1 to 32.2% in Period 2, p < 0.001. There was an improvement in the correct choice of age group between the two periods (from 32.2% to 53.4%). There was no difference in the mean admission time of patients in the two periods: in the first period 4.8 days (SD 2.9) and in the second period 4.8 days (SD 4.1).

CONCLUSIONS

It is possible to implement a PEWS in resource‐limited settings while achieving high implementation rates. However, this is a time‐ and energy‐consuming process. Having an active and involved team that is responsible for implementation is key for a successful implementation. Factors that likely hindered implementation were a large change in workflow for the nursing staff, non‐native speakers as main investigators.
Chemical and microbiological stability of diluted ceftazidime in three different solutions under three storage temperatures over a 28 day period
Authors: Hoff Sarah E. , Berger Darren J. , Viall Austin K. , Schrunk Dwayne , Noxon James O.
Published: July 2021

Background

Ceftazidime (CAZ) solutions are being used based on anecdotal reports for otitis externa complicated by multidrug‐resistant Pseudomonas aeruginosa (MDR PA). The chemical and microbiological stability of these proposed compounded solutions have not been evaluated, and likely are affected by the diluent and storage duration or temperature.

Hypothesis/Objectives

Compounded CAZ solutions would show variable degradation dependent on diluent, time and temperature. The antimicrobial activity of the solutions would reflect changes in concentration and not alterations to the chemical compound.

Methods and materials

Ceftazidime was compounded with 100 mL 0.9% sodium chloride (NA+CAZ), 118 mL Triz‐EDTA Aqueous flush (TE+CAZ) and 125 mL Douxo Micellar Solution (MI+CAZ). Aliquots of the solutions were stored at 25°C, 4°C and –20°C for 28 days. High‐performance liquid chromatography was used to analyse CAZ recovery from compounded solutions at weekly intervals. A modified broth dilution technique was utilised to assess minimum inhibitory concentration (MIC) to monitor antimicrobial activity against a reference PA strain.

Results

Temperature, duration of storage and diluent each had independent effects on the chemical stability of CAZ. CAZ concentrations decreased over time as well as with increased temperature. NA+CAZ solutions exhibited the least degradation compared to the other solutions. The MIC for PA was most consistent for NA+CAZ solutions regardless of storage temperature and duration of storage.

Conclusions and clinical importance

Chemical and microbiological stability of compounded CAZ solutions varied by diluent, storage temperature and duration of storage. Dilution in NA resulted in the lowest variation in stability over 28 days when stored at refrigerated or frozen temperatures compared to other diluents.
Recombinant Rhodococcus erythropolis expressing HAO and AMO genes promotes nitrogen and organic matter removal efficiency in the treatment of landfill leachate
Authors: Bai Fuliang , Tian Hui
Published: July 2021

The purpose of this study was to investigate the treatment efficacy of recombinant Rhodococcus erythropolis (RH) expressing hydroxylamine oxidase (HAO) and ammonia monooxygenase (AMO) genes (rRH‐HA) in removing nitrogen and organic matter in landfill leachate. Results demonstrated that rRH‐HA efficiently expressed HAO and AMO during the treatment of landfill leachate in aerobic system. Enhanced rRH‐HA production increased pH control and the activity and stability of activated sludge (AS); decreased carbon source addition and decreased total organic carbon (TOC), chemical oxygen demand (COD), organic matter and heavy metal concentration compared with AS system. In conclusion, data indicate that enhanced rRH‐HA production promotes pollutants removal efficiency in the treatment of landfill leachate.
An Overview of Flow Instabilities Occurring in Centrifugal Compressors Operating at Low Flow Rates
Authors: Vacula Jiří , Novotný Pavel
Published: July 2021

Researchers from all over the world have been researching the aerodynamics of centrifugal compressors. They have explained many properties of the aerodynamic phenomena occurring in centrifugal compressors during their operation and have introduced various terms. This work presents the crucial knowledge that has been published on the flow instabilities occurring in centrifugal compressors operating at low flow rates. It also introduces the capabilities of the computational tools used for the simulation of these phenomena. The characteristic of the centrifugal compressor including highlighted areas of possible occurrence of typical flow instabilities is presented. This review is extended to include a frequency description of the vibroacoustic behavior related to these aerodynamic instabilities. The frequency description enables better identification of the given aerodynamic phenomena based on measurements or computations, and relevant sources of literature are provided. The researchers will receive a structured summary of key publications leading to the better understanding of the flow instabilities in centrifugal compressors.
A prototype of a handheld augmented reality application to get familiar with ultrasound equipment knobology
Authors: Kollmann Christian , Santner Lukas
Published: July 2021

Aims: A prototype application has been developed that is adapting modern augmented reality technology to support learning in ultrasound skills-labs or at home. The application enables students to get in real-time an orientation and information about the knobs on an equipment´s control panel that is available in the lab.Material and methods: The Augmented reality (AR) application for smartphones or tablets was created in Unity (San Francisco) with the software development kit Vuforia (Vuforia PTC Inc., Zurich) to support students with their own devices to learn the knobology of an ultrasound equipment. An interface was modelled, which is superimposed on the live camera image and provides information about the displayed knobs and sliders on the control panel.Results: The smartphone or tablet app is able to detect the specific ultrasound equipment in real in the skills-lab, as well as from a hardcopy photo or displayed by a monitor and to provide further detailed information. The application can be used therefore as preparation of a practical course or for orientation within the lab at the equipment.Conclusions: The flexibility of the app is optimal for students to become familiar with the equipment before they are having their skills-lab lecture and might help to reduce time for introduction to orientation at the equipment´s console.
Plastics in the Earth system
Authors: Stubbins Aron , Law Kara Lavender , Muñoz Samuel E. , Bianchi Thomas S. , Zhu Lixin
Published: July 2021

Plastic contamination of the environment is a global problem whose magnitude justifies the consideration of plastics as emergent geomaterials with chemistries not previously seen in Earth’s history. At the elemental level, plastics are predominantly carbon. The comparison of plastic stocks and fluxes to those of carbon reveals that the quantities of plastics present in some ecosystems rival the quantity of natural organic carbon and suggests that geochemists should now consider plastics in their analyses. Acknowledging plastics as geomaterials and adopting geochemical insights and methods can expedite our understanding of plastics in the Earth system. Plastics also can be used as global-scale tracers to advance Earth system science.
Embryo-scale, single-cell spatial transcriptomics
Authors: Srivatsan Sanjay R. , Regier Mary C. , Barkan Eliza , Franks Jennifer M. , Packer Jonathan S. , Grosjean Parker , Duran Madeleine , Saxton Sarah , Ladd Jon J , Spielmann Malte , Lois Carlos , Lampe Paul D. , Shendure Jay , Stevens Kelly R. , Trapnell Cole
Published: July 2021

Localizing gene expression

Single-cell RNA sequencing can provide information about cellular relationships based on shared transcriptomes, but most methods lose spatial information. Those methods that do retain spatial information can be limited to a specific set of genes and/or a small area. Srivatsan
et al.
introduce sci-Space, a spatial transcriptomic method that uses a grid of barcoded oligos on a slide that can be transferred to nuclei of an overlaid frozen tissue section to obtain both the spatial origin and the transcriptome of thousands of single cells per slide. The researchers used sci-Space to create a spatial atlas of mouse E14 sagittal sections, revealing spatially expressed genes across cell types. This application illustrates how sci-Space complements existing approaches in spatial genomics.

Science
, abb9536, this issue p.
111
The missing ocean plastic sink: Gone with the rivers
Authors: Weiss Lisa , Ludwig Wolfgang , Heussner Serge , Canals Miquel , Ghiglione Jean-François , Estournel Claude , Constant Mel , Kerhervé Philippe
Published: July 2021

No missing sink

Estimates of the flux of microplastics from rivers, in the context of the mass of plastic that has been observed in the ocean, have made it appear that a large, unidentified sink of plastics must exist there. Weiss
et al.
show that there may not be a missing sink after all. By reformulating how mass fluxes are calculated from observations of particle numbers, they demonstrate that those mass fluxes were overestimated by two to three orders of magnitude. This explains why the residence time of plastics in the ocean seemed so puzzlingly short and implies that ocean plastics may persist and degrade over longer periods than previously thought.

Science
, abe0290, this issue p.
107
Single-molecule laser nanospectroscopy with micro–electron volt energy resolution
Authors: Imada Hiroshi , Imai-Imada Miyabi , Miwa Kuniyuki , Yamane Hidemasa , Iwasa Takeshi , Tanaka Yusuke , Toriumi Naoyuki , Kimura Kensuke , Yokoshi Nobuhiko , Muranaka Atsuya , Uchiyama Masanobu , Taketsugu Tetsuya , Kato Yuichiro K. , Ishihara Hajime , Kim Yousoo
Published: July 2021

Single-molecule nanospectroscopy

Microscopic understanding and molecular-level control of individual electronic quantum states of a single molecule are a long-standing challenge in spectroscopy. Imada
et al.
found that a narrow-line tunable laser combined with a scanning tunneling microscope was able to generate photoluminescence spectra of the electronic and vibrational states of single molecules with micro–electron volt energy resolution and submolecular spatial resolution. The authors also discovered a way to tune the energy levels through a linear Stark effect and plasmon-exciton coupling in the tunneling junction. The proposed technique paves the way to efficient exploitation of energy conversion dynamics in electronic excited states, which constitutes the bedrock principle of such systems as LEDs, photovoltaics, and photosynthetic cells.

Science
, abg8790, this issue p.
95
Nurse cell­–derived small RNAs define paternal epigenetic inheritance in
Arabidopsis
Authors: Long Jincheng , Walker James , She Wenjing , Aldridge Billy , Gao Hongbo , Deans Samuel , Vickers Martin , Feng Xiaoqi
Published: July 2021

Germline defense against transposons

Genomes of germ cells present an existential vulnerability to organisms because germ cell mutations will propagate to future generations. Transposable elements are one source of such mutations. In the small flowering plant
Arabidopsis
, Long
et al.
found that genome methylation in the male germline is directed by small interfering RNAs (siRNAs) imperfectly transcribed from transposons (see the Perspective by Mosher). These germline siRNAs silence germline transposons and establish inherited methylation patterns in sperm, thus maintaining the integrity of the plant genome across generations.

Science
, abh0556, this issue p.
eabh0556
; see also abj5020, p.
26
Laser soliton microcombs heterogeneously integrated on silicon
Authors: Xiang Chao , Liu Junqiu , Guo Joel , Chang Lin , Wang Rui Ning , Weng Wenle , Peters Jonathan , Xie Weiqiang , Zhang Zeyu , Riemensberger Johann , Selvidge Jennifer , Kippenberg Tobias J. , Bowers John E.
Published: July 2021

Chip-based frequency combs

The realization of optical frequency combs, light sources with precisely spaced frequencies across a broad spectrum of wavelengths, in dielectric microresonators has affected a range of applications from imaging and ranging to precision time keeping and metrology. Xiang
et al.
demonstrate that the entire system, the laser-pumping system and the comb-generating microresonators, can be combined into an integrated silicon-based platform. Compatibility with foundry fabrication methods will enable this innovation to have a major impact on coherent communications, optical interconnects, and low-noise microwave generation.

Science
, abh2076, this issue p.
99
Monolithic optical microlithography of high-density elastic circuits
Authors: Zheng Yu-Qing , Liu Yuxin , Zhong Donglai , Nikzad Shayla , Liu Shuhan , Yu Zhiao , Liu Deyu , Wu Hung-Chin , Zhu Chenxin , Li Jinxing , Tran Helen , Tok Jeffrey B.-H. , Bao Zhenan
Published: July 2021

Direct optical polymer patterning

As a platform for electronic devices, polymeric materials offer the advantages of intrinsic flexibility and stretchability relative to hard material devices. However, unlike materials such as silicon, there are few tools for large-scale patterning of monolithic devices. Zheng
et al.
developed an optical lithography technique for the high-throughput fabrication of transistor circuitry on stretchable substrates. In this method, ultraviolet light is used to control the local solubility of the polymer, which makes it possible to fabricate transistors on the micrometer scale. These devices can be made with high yield and excellent uniformity without compromising their electronic and mechanical characteristics.

Science
, abh3551, this issue p.
88
Finding genes that control body weight
Authors: Yeo Giles S. H. , O'Rahilly Stephen
Published: July 2021

DNA exome sequencing at scale reveals unknown human biology of adiposity
A binding global agreement to address the life cycle of plastics
Authors: Simon Nils , Raubenheimer Karen , Urho Niko , Unger Sebastian , Azoulay David , Farrelly Trisia , Sousa Joao , van Asselt Harro , Carlini Giulia , Sekomo Christian , Schulte Maro Luisa , Busch Per-Olof , Wienrich Nicole , Weiand Laura
Published: July 2021

To eliminate plastic pollution, a holistic approach is needed
Draft Genome Sequences of Multiple
Streptomyces
Isolates from Arizona
Authors: Baltrus David A. , White Aaron , Smith Caitlin , Clark Meara
Published: July 2021

Streptomyces
strains are bacteria that are well known for their distinctive physiology, behaviors, and ecology, as well as for being prodigious producers of diverse antibiotics. Here, we report draft genome sequences for eight
Streptomyces
strains that were isolated from multiple sky islands in Arizona and sequenced using an Oxford Nanopore Technologies Flongle adapter and MinION system.
Fracture of heterotopic mass in the lower limb: surgical case report and review of the literature
Authors: Thompson Joshua W , Plastow Ricci , Rogers Matthew , Haddad Fares S
Published: July 2021

Heterotopic ossification (HO) is a rare sequela of sports injuries with a predominance in young active males located within bulky muscle planes. In most cases it is self-limiting and spontaneous resolution can occur. Fractures of HO are sparsely reported within the literature. We present a rare case of a professional athlete with a recurrent fracture of mature HO within the deep fascial plane between the anterior and posterior thigh compartments. The heterotopic mass and associated fracture had restricted return to sport and thus necessitated surgical management. The athlete successfully returned to sport following surgical excision with postoperative medical therapy to inhibit recurrence.
Trigeminal neuralgia leading to a diagnosis of ovarian cancer: a timely coincidence or a case of paraneoplastic syndrome?
Authors: Gaughran Jonathan , Lyne Tom , Sayasneh Ahmad
Published: July 2021

A 51-year-old woman was referred to oral medicine with a 2-month history of progressive paraesthesia of the right lip, chin and oral mucosa. Examination revealed decreased sensation to the right dermatone of the inferior alveolar nerve and allodynia to light touch of the lower lip. An MRI of the head revealed bilateral cisternal trigeminal nerve pathological enhancement. While blood tests suggested a connective tissue disorder as the cause of the trigeminal neuralgia, a subsequent diagnosis of high-grade serous ovarian cancer gave a differential diagnosis of paraneoplastic syndrome.
Platypnea-orthodeoxia syndrome in patent foramen ovale and fenestrated atrial septal aneurysm with normal right atrial pressure: what is the culprit?
Authors: Pelayo Jerald , Shahzad Anum , Peterson Eric , Pressman Gregg
Published: July 2021

A 76-year-old Korean woman presented with intermittent episodes of exertional hypoxia at the rehabilitation facility after a recent admission for ischaemic stroke. Clinical and diagnostic investigation confirmed the presence of platypnea-orthodeoxia syndrome (POS). Transoesophageal echocardiogram revealed a patent foramen ovale and hyperdynamic interatrial septum with right-to-left intracardiac shunt. Further diagnostic workup did not reveal right atrial hypertension, cirrhosis, pulmonary hypertension or any other extracardiac causes of right-to-left shunt. Positional preferential blood flow from inferior vena cava to the left atrium due to counterclockwise displacement of interatrial septum with age and posture was postulated to explain the atrial right-to-left shunt and the resultant POS. Closure was performed using a cribriform amplatzer occluder which improved her symptoms.
Unusual metachronous presentation of bilateral frontoethmoid sinus mucoceles
Authors: Davies Kirsty , Wallace Jennifer , Abelardo Edgardo , Jaramillo Mario
Published: July 2021

A case report of a patient with bilateral frontoethmoid mucoceles with no obvious predisposing factors and each side presenting three years apart, with no ongoing nasal or paranasal signs of disease in the interim.

Bilateral paranasal sinus mucoceles have rarely been described in the literature; this case is unique, as it is the first description of a metachronous presentation. Additionally, the absence of any predisposing factors such as trauma, surgery or chronic sinusitis in either presentation is unusual.
Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology?
Authors: Williams Rachel , Aldakhil Reham , Blandford Ann , Jani Yogini
Published: July 2021

Background

In order to reduce safety risks associated with medication administrations, technologies such as barcode medication administration (BCMA) are increasingly used. Examining how human factors influence adoption and usability of this technology can potentially highlight areas for improvement in design and implementation.

Objective

To describe how human factors related determinants for BCMA have been researched and reported by healthcare and human–computer interaction disciplines.

Data sources

The Cumulative Index of Nursing, and Allied Health Literature, PubMed, OVID MEDLINE and Google Scholar.

Study eligibility criteria

Primary research published from April 2000 to April 2020, search terms developed to identity different disciplinary research perspectives that examined BCMA use, used a human factors lens and were published in English.

Synthesis methods

Computerised systematic searches were conducted in four databases. Eligible papers were systematically analysed for themes. Themes were discussed with a second reviewer and supervisors to ensure they were representative of content.

Results

Of 3707 papers screened, 11 were included. Studies did not fit neatly into a clinical or human-computer interaction perspective but instead uncovered a range of overlapping narratives, demonstrating consensus on the key themes despite differing research approaches. Prevalent themes were misaligned design and workflow, adaptation and workarounds, mediating factors, safety, users’ perceptions and design and usability. Inadequate design frequently led to workarounds, which jeopardised safety. Reported mediating factors included clarity of user needs, pre/post implementation evaluations, analysis of existing workarounds and appropriate technology, infrastructure and staffing.

Limitations

Most studies were relatively small and qualitative, making it difficult to generalise findings.

Conclusion

Evaluating interdisciplinary perspectives including human factors approaches identified similar and complementary enablers and barriers to successful technology use. Often, mediating factors were developed to compensate for unsuitable design; a collaborative approach between system designer and end users is necessary for BCMA to achieve its true safety potential.
Using a pragmatically adapted, low-cost contingency management intervention to promote heroin abstinence in individuals undergoing treatment for heroin use disorder in UK drug services (PRAISE): a cluster randomised trial
Authors: Metrebian Nicola , Weaver Tim , Goldsmith Kimberley , Pilling Stephen , Hellier Jennifer , Pickles Andrew , Shearer James , Byford Sarah , Mitcheson Luke , Bijral Prun , Bogdan Nadine , Bowden-Jones Owen , Day Edward , Dunn John , Glasper Anthony , Finch Emily , Forshall Sam , Akhtar Shabana , Bajaria Jalpa , Bennett Carmel , Bishop Elizabeth , Charles Vikki , Davey Clare , Desai Roopal , Goodfellow Claire , Haque Farjana , Little Nicholas , McKechnie Hortencia , Mosler Franziska , Morris Jo , Mutz Julian , Pauli Ruth , Poovendran Dilkushi , Phillips Elizabeth , Strang John
Published: July 2021

Introduction

Most individuals treated for heroin use disorder receive opioid agonist treatment (OAT)(methadone or buprenorphine). However, OAT is associated with high attrition and persistent, occasional heroin use. There is some evidence for the effectiveness of contingency management (CM), a behavioural intervention involving modest financial incentives, in encouraging drug abstinence when applied adjunctively with OAT. UK drug services have a minimal track record of applying CM and limited resources to implement it. We assessed a CM intervention pragmatically adapted for ease of implementation in UK drug services to promote heroin abstinence among individuals receiving OAT.

Design

Cluster randomised controlled trial.

Setting and participants

552 adults with heroin use disorder (target 660) enrolled from 34 clusters (drug treatment clinics) in England between November 2012 and October 2015.

Interventions

Clusters were randomly allocated 1:1:1 to OAT plus 12× weekly appointments with: (1) CM targeted at opiate abstinence at appointments (CM Abstinence); (2) CM targeted at on-time attendance at appointments (CM Attendance); or (3) no CM (treatment as usual; TAU). Modifications included monitoring behaviour weekly and fixed incentives schedule.

Measurements

Primary outcome: heroin abstinence measured by heroin-free urines (weeks 9–12). Secondary outcomes: heroin abstinence 12 weeks after discontinuation of CM (weeks 21–24); attendance; self-reported drug use, physical and mental health.

Results

CM Attendance was superior to TAU in encouraging heroin abstinence. Odds of a heroin-negative urine in weeks 9–12 was statistically significantly greater in CM Attendance compared with TAU (OR=2.1; 95% CI 1.1 to 3.9; p=0.030). CM Abstinence was not superior to TAU (OR=1.6; 95% CI 0.9 to 3.0; p=0.146) or CM Attendance (OR=1.3; 95% CI 0.7 to 2.4; p=0.438) (not statistically significant differences). Reductions in heroin use were not sustained at 21–24 weeks. No differences between groups in self-reported heroin use.

Conclusions

A pragmatically adapted CM intervention for routine use in UK drug services was moderately effective in encouraging heroin abstinence compared with no CM only when targeted at attendance. CM targeted at abstinence was not effective.

Trial registration number

ISRCTN 01591254.
Determining cost-effectiveness of lung cancer screening in urban Chinese populations using a state-transition Markov model
Authors: Sun Chengyao , Zhang Xin , Guo Sirou , Liu Yang , Zhou Liangru , Shi Jufang , Wu Ning , Zhai Zhao , Liu Guoxiang
Published: July 2021

Objectives

This study analyses the cost-effectiveness of annual low-dose CT (LDCT) screening of high-risk cancer populations in Chinese urban areas.

Design

We used a Markov model to evaluate LDCT screening from a sociological perspective.

Setting

The data from two large lung cancer screening programmes in China were used.

Participants

The sample consisted of 100 000 smokers who underwent annual LDCT screening until age 76.

Intervention

The study comprises five screening strategies, with the initial screening ages in both the screening strategies and their corresponding non-screening strategies being 40, 45, 50, 55 and 60 years, respectively.

Primary and secondary outcome measures

The incremental cost-effectiveness ratio (ICER) between screening and non-screening strategies at the same initial age was evaluated.

Results

In the baseline scenario, compared with those who were not screened, the specific mortality from lung cancer decreased by 18.52%–23.13% among those who underwent screening. The ICER of LDCT screening ranges from US$13 056.82 to US$15 736.06 per quality-adjusted life year, which is greater than one but less than three times the gross domestic product per capita in China. An initial screening age of 55 years is the most cost-effective strategy.

Conclusions

Baseline analysis shows that annual LDCT screening of heavy smokers in Chinese urban areas is likely to be cost-effective. The sensitivity analysis reveals that sensitivity, specificity and the overdiagnosis rate influence the cost-effectiveness of LDCT screening. All scenarios tested demonstrate cost-effectiveness, except for the combination of worst values of sensitivity, specificity and overdiagnosis. Therefore, the cost-effectiveness of a screening strategy depends on the performance of LDCT screenings.
Factors influencing the willingness of primary care physicians to provide care during the coronavirus disease pandemic: a nationwide survey in Taiwan
Authors: Huang Hsien-Liang , Jan Chyi-Feng Jeff , Bih-Jeng Chang Brian , Chiu Tai-Yuan
Published: July 2021

Objectives

The COVID-19 pandemic continues to advance worldwide with tremendous impact on public health, economy and society. Primary healthcare is crucial in every country during the pandemic for an integrated and coordinated healthcare delivery system; hence, it is of paramount importance to maintain a sufficient frontline workforce. This study aimed to identify factors influencing the willingness of primary care physicians to provide care during the COVID-19 pandemic.

Design

Cross sectional study.

Setting

Nationwide survey

Participants

Primary care physicians working in the community in Taiwan were selected using a cluster sampling method based on practice region from May to June 2020.

Outcome measures

The willingness of primary care physicians to provide care during the COVID-19 pandemic.

Results

This study surveyed 1000 primary care physicians nationwide, and 625 valid questionnaires were received and included in the final analysis, with an effective response rate of 62.5%. Factors significantly associated with physicians willingness to provide care during COVID-19 were ‘joining the Community Healthcare Group (CHCG)’ (p<0.001), ‘perceived more overall benefits for providing care’ (p<0.001) ‘perceived less overall barriers to providing care’ (p<0.001), ‘higher knowledge scores about COVID-19’ (p=0.049) and ‘physician’s major specialties’ (p=0.009) in the multivariate logistic regression model.

Conclusions

Building a comprehensive primary care system such as Taiwan’s CHCG, training of more family physicians or general practitioners, and protecting and supporting primary care physicians were important in response to infectious disease pandemics. The findings of this study inform the development of guidelines to support and maintain the primary healthcare workforces during the COVID-19 pandemic and for future events.
Reopening Italy’s schools in September 2020: a Bayesian estimation of the change in the growth rate of new SARS-CoV-2 cases
Authors: Casini Luca , Roccetti Marco
Published: July 2021

Objectives

COVID-19’s second wave started a debate on the potential role of schools as a primary factor in the contagion resurgence. Two opposite positions appeared: those convinced that schools played a major role in spreading SARS-CoV-2 infections and those who were not. We studied the growth rate of the total number of SARS-CoV-2 infections in all the Italian regions, before and after the school reopening (September–October 2020), investigating the hypothesis of an association between schools and the resurgence of the virus.

Methods

Using a Bayesian piecewise linear regression to scrutinise the number of daily SARS-CoV-2 infections in each region, we looked for an estimate of a changepoint in the growth rate of those confirmed cases. We compared the changepoints with the school opening dates, for each Italian region. The regression allows to discuss the change in steepness of the infection curve, before and after the changepoint.

Results

In 15 out of 21 Italian regions (71%), an estimated change in the rate of growth of the total number of daily SARS-CoV-2 infection cases occurred after an average of 16.66 days (95% CI 14.47 to 18.73) since the school reopening. The number of days required for the SARS-CoV-2 daily cases to double went from an average of 47.50 days (95% CI 37.18 to 57.61) before the changepoint to an average of 7.72 days (95% CI 7.00 to 8.48) after it.

Conclusion

Studying the rate of growth of daily SARS-CoV-2 cases in all the regions provides some evidence in favour of a link between school reopening and the resurgence of the virus. The number of factors that could have played a role is too many to give a definitive answer. Still, the temporal correspondence warrants further systematic experiments to investigate on potential confounders that could clarify how much reopening schools mattered.
Clinical efficacy of T-cell therapy after short-term BRAF-inhibitor priming in patients with checkpoint inhibitor-resistant metastatic melanoma
Authors: Borch Troels Holz , Harbst Katja , Rana Aynal Haque , Andersen Rikke , Martinenaite Evelina , Kongsted Per , Pedersen Magnus , Nielsen Morten , Kjeldsen Julie Westerlin , Kverneland Anders Handrup , Lauss Martin , Hölmich Lisbet Rosenkrantz , Hendel Helle , Met Özcan , Jönsson Göran , Donia Marco , Marie Svane Inge
Published: July 2021

Purpose

Despite impressive response rates following adoptive transfer of autologous tumor-infiltrating lymphocytes (TILs) in patients with metastatic melanoma, improvement is needed to increase the efficacy and broaden the applicability of this treatment. We evaluated the use of vemurafenib, a small-molecule BRAF inhibitor with immunomodulatory properties, as priming before TIL harvest and adoptive T cell therapy in a phase I/II clinical trial.

Methods

12 patients were treated with vemurafenib for 7 days before tumor excision and during the following weeks until TIL infusion. TILs were grown from tumor fragments, expanded in vitro and reinfused to the patient preceded by a lymphodepleting chemotherapy regimen and followed by interleukin-2 infusion. Extensive immune monitoring, tumor profiling and T cell receptor sequencing were performed.

Results

No unexpected toxicity was observed, and treatment was well tolerated. Of 12 patients, 1 achieved a complete response, 8 achieved partial response and 3 achieved stable disease. A PR and the CR are ongoing for 23 and 43 months, respectively. In vitro anti-tumor reactivity was found in TILs from 10 patients, including all patients achieving objective response. Serum and tumor biomarker analyses indicate that baseline cytokine levels and the number of T cell clones may predict response to TIL therapy. Further, TCR sequencing suggested skewing of TCR repertoire during in vitro expansion, promoting certain low frequency clonotypes.

Conclusions

Priming with vemurafenib before infusion of TILs was safe and feasible, and induced objective clinical responses in this cohort of patients with checkpoint inhibitor-resistant metastatic melanoma. In this trial, vemurafenib treatment seemed to decrease attrition and could be considered to bridge the waiting time while TILs are prepared.
The value of long-term angiographic follow-up following Pipeline embolization of intracranial aneurysms
Authors: Lauzier David C , Cler Samuel J , Chatterjee Arindam R , Osbun Joshua W , Moran Christopher J , Kansagra Akash P
Published: July 2021

Background

Flow diversion of intracranial aneurysms with the Pipeline Embolization Device (PED) is commonly performed, but the value of long-term angiographic follow-up has not been rigorously evaluated. Here we examine the prevalence of actionable findings of aneurysm recurrence and development of in-stent stenosis in a cohort of patients that underwent long-term angiographic follow-up at multiple time points.

Methods

Angiographic data from eligible patients were retrospectively assessed for aneurysm occlusion, in-stent stenosis, and aneurysm regrowth or recurrence. Patients were included in this study if they underwent angiographic imaging at 6 months post-treatment and at least one later time point.

Results

100% (132/132) of aneurysms occluded at 6 months remained occluded at final follow-up. 85.7% (6/7), 56.3% (27/48), and 25% (6/24) of aneurysms with entry remnant, subtotal filling, and total filling, respectively, at 6 months were completely occluded at final follow-up. 98.7% (147/149) of PED constructs that demonstrated no stenosis at 6 months demonstrated no stenosis at final angiography, while 44.4% (8/18) of PED constructs demonstrating in-stent stenosis at 6 months had resolution of stenosis on final angiography.

Conclusions

Among patients who undergo treatment of intracranial aneurysms with PED, the value of long-term angiography in patients demonstrating complete aneurysm occlusion and no in-stent stenosis on 6 month post-treatment angiography is low.
My oldest stroke patient
Authors: Daneasa Alexandra I , Heckmann Josef G
Published: July 2021

We report the benign clinical course of a ‘hand knob’ stroke syndrome in a 106-year-old man and discuss some issues that arise when caring for the very oldest of the old.
The clinical indications for testing women for Mycoplasma genitalium
Authors: Latimer Rosie L , Vodstrcil Lenka A , Plummer Erica L , Doyle Michelle , Murray Gerald L , Fairley Christopher K , Bodiyabadu Kaveesha , Read Tim R H , Kaiser Marti , Mokany Elisa , Guy Rebecca , Chow Eric P F , Bradshaw Catriona
Published: July 2021

Background

While the contribution of Mycoplasma genitalium (MG) to symptoms in men is well described, less is known about its association with common genital symptoms in women. We aimed to determine the prevalence of MG and macrolide resistance, and its association with common genital symptoms in women attending a sexual health service, to inform indications for testing and clinical practice.

Methods

We undertook a cross-sectional study of symptomatic and asymptomatic women attending Melbourne Sexual Health Centre (MSHC), between April 2017 and April 2019. Women were tested for MG and macrolide resistance, Chlamydia trachomatis (CT), Neisseria gonorrhoeae, Trichomonas vaginalis, bacterial vaginosis and vulvovaginal candidiasis. Women completed a questionnaire on symptoms, and symptomatic women underwent examination. The prevalence of MG (and macrolide resistance) and other genital infections was calculated with 95% CIs, and associations between these outcomes and specific genital symptoms were examined using logistic regression.

Results

Of 1318 women, 83 (6%, 95% CI: 5% to 8%) had MG, of which 39 (48%, 95% CI: 36% to 59%) had macrolide-resistant MG; 103 (8%, 95% CI: 6% to 9%) women had CT. MG prevalence was similar in asymptomatic (10 of 195; 5%) and symptomatic (73 of 1108; 7%) women, p=0.506. MG was associated with mucopurulent cervicitis on examination (adjusted OR=4.38, 95% CI: 1.69 to 11.33, p=0.002), but was not associated with other specific genital symptoms or signs.

Conclusions

MG was as common as CT among women attending MSHC. MG was not associated with genital symptoms, but like CT, was significantly associated with cervicitis. These data provide evidence that routine testing for MG in women with common genital symptoms is not indicated. The presence of macrolide resistance in 48% of women supports use of resistance-guided therapy.
The effect of total dissolved gas supersaturation on gas bubble trauma in juvenile rainbow trout (Oncorhynchus mykiss), juvenile kokanee (Oncorhynchus nerka), and two age classes of white sturgeon (Acipenser transmontanus)
Authors: Kovac Anthony , Pleizier Naomi K. , Brauner Colin J.
Published: July 2021

Hydroelectric dams are an important source of electricity globally, but they can also cause total dissolved gas (TDG) supersaturation in rivers. TDG supersaturation can harm fish through a condition called gas bubble trauma (GBT), which has been studied primarily in salmonids, such as rainbow trout and steelhead salmon (Oncorhynchus mykiss), but seldomly in non-salmonids like white sturgeon (Acipenser transmontanus). We assessed the vulnerability of juvenile rainbow trout (<1 year old), juvenile kokanee (Oncorhynchus nerka) (<1 year old), and two ages of white sturgeon (<1 year old and 3+ years old) to GBT. Bubble formation and the time to 50% loss of equilibrium (LOE) was quantified during exposure to nominal levels of 100%, 115%, 120%, and 130% TDG. We predicted that all three species would show similar times to 50% LOE at a given TDG level. However, time to LOE was longer, the proportion of fish with external symptoms of GBT was lower, and the proportion of fish with bubbles in the gills was higher or lower (dependant on age) in white sturgeon relative to rainbow trout and kokanee at a given TDG. The physiological basis for the difference is not known. However, it is important to consider species-specific differences in TDG sensitivity in the conservation of vulnerable species.
Reconstruction of the three-dimensional beat pattern underlying swimming behaviors of sperm
Authors: Gong A. , Rode S. , Gompper G. , Kaupp U. B. , Elgeti J. , Friedrich B. M. , Alvarez L.
Published: July 2021

The eukaryotic flagellum propels sperm cells and simultaneously detects physical and chemical cues that modulate the waveform of the flagellar beat. Most previous studies have characterized the flagellar beat and swimming trajectories in two space dimensions (2D) at a water/glass interface. Here, using refined holographic imaging methods, we report high-quality recordings of three-dimensional (3D) flagellar bending waves. As predicted by theory, we observed that an asymmetric and planar flagellar beat results in a circular swimming path, whereas a symmetric and non-planar flagellar beat results in a twisted-ribbon swimming path. During swimming in 3D, human sperm flagella exhibit torsion waves characterized by maxima at the low curvature regions of the flagellar wave. We suggest that these torsion waves are common in nature and that they are an intrinsic property of beating axonemes. We discuss how 3D beat patterns result in twisted-ribbon swimming paths. This study provides new insight into the axoneme dynamics, the 3D flagellar beat, and the resulting swimming behavior.

Graphic abstract
Automated pill quality inspection using deep learning
Authors: Mac Thi Thoa , Hung Nguyen Thanh
Published: July 2021

The pill manufacturing process accrues substantial financial costs due to quality. Pill quality inspection is laborious, time-consuming and subjective, resulting in poor statistical representation and inconsistent results. In this study, we developed an approach that integrates deep learning algorithms and computer-vision-based processing with an optimization algorithm to fully automate the image analysis of internal crack/contamination detection. This approach exploits the features learned by convolutional neural network using various sub-processing techniques and Adam optimization. It achieves robust quantification of internal pill defects with an average accuracy of 95%.
Using deep learning for digitally controlled STIRAP
Authors: Moro Lorenzo , Paparelle Iris , Prati Enrico
Published: July 2021

Stimulated Raman Adiabatic Passage (STIRAP) is a technique for preparing atoms and molecules in an arbitrary preselected coherent superposition of quantum states, ordinarily controlled by Gaussian laser pulses. We search novel pulse sequences by exploiting deep reinforcement learning algorithms in order to achieve fast and flexible solutions for integer and fractional STIRAP. By using the robustness of the PPO algorithm, we impose the agent to exploit only digital pulses corresponding to on/off states of the control radiation instead of continuous amplitudes. Such method allows to adapt to detuning of the energy levels and disturbances such as dephasing.