bluuebunny/crossref_metadata_2025 huggingface dataset:
Fever of unknown origin (FUO) on a land on cross‐roads between Asia and Europa; a multicentre study from Turkey
Authors: Yenilmez Ercan , Kakalicoglu Deniz , Bozkurt Fatma , Filiz Mine , Akkol Camurcu Aysegul , Damar Midik Elif Ozge , Berk Cam Hande , Arkali Eren , Bilgic Atli Seval , Sahin Ahmet , Yorulmaz Goktas Sibel , Erkan Halil , Ceylan Mehmet Resat , Kacar Eker Merve , Kaya Hava , Karacaer Zehra , Tural Ersin , Dokmetas İlyas , Gorenek Levent , Kose Sukran
Published: March 2021

Aims

The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey.

Methods

A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated.

Results

The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult‐onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71).

Conclusions

Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state‐of‐the‐art technology in healthcare services.
The role of social identity in the explanation of collective action: An intergroup perspective on the Yellow Vests movement
Authors: Adam‐Troian Jaïs , Mahfud Yara , Urbanska Karolina , Guimond Serge
Published: March 2021

Social psychologists have developed influential theoretical models to understand intergroup conflicts, radicalism, and collective action. November 2018 saw the emergence of a new powerful movement in France named the Yellow Vests. Born on social media, the movement has sustained an unprecedented period of intense protests and violent clashes with the police, challenging the French government. As such, this movement offers an ideal context to examine the real‐world relevance of current social‐psychological theorizing. Using a social identity and self‐categorization perspective, two correlational studies (three samples, N = 1,849) tested the role of self‐categorization as a group member, or social identity, in accounting for individual participation in normative and nonnormative collective action. Using different operationalizations of identification, both studies confirm a powerful role of identification as a Yellow Vest and provided evidence that the effect of social media use on collective action is fully mediated by self‐categorization as a Yellow Vest. An alternative model suggesting that social media use mediated the relation between social identity and collective action was not supported by the data.
Functional characterization of Copy Number Variations regions in Djallonké sheep
Authors: Goyache Félix , Fernández Iván , Tapsoba Arnaud Stephan R. , Traoré Amadou , Menéndez‐Arias Nuria A. , Álvarez Isabel
Published: March 2021

A total of 184 Djallonké (West African Dwarf) sheep of Burkina Faso were analysed for Copy Number Variations (CNV) using Ovine 50 K SNP BeadChip genotyping data and two different CNV calling platforms: PennCNV and QuantiSNP. Analyses allowed to identify a total of 63 candidate Copy Number Variations Regions (CNVR) on 11 different ovine chromosomes covering about 82.5 Mb of the sheep genome. Gene‐annotation enrichment analysis allowed to identify a total of 751 potential candidate ovine genes located in the candidate CNVR bounds. Functional annotation allowed to identify five statistically significant Functional Clusters (FC; enrichment factor > 1.3) involving 61 candidate genes. All genes forming significantly enriched FC were located on ovine chromosome (OAR) 21. FC1 (22 genes including PAG4 and PAG6) and FC5 (three genes: CTSC, CTSW and CTSF), coding proteases (peptidases and cathepsins, respectively), were involved in reproductive performance and modulation of gestation. Both FC3 and FC4 were involved in inflammatory and immunologic response through coding serum amyloid A and B‐box‐type zinc finger proteins, respectively. Finally, FC2 consisted of 27 genes (including OR10G6 and OR8B8) involved in olfactory receptor activity, key for animals adapting to new food resources. CNVR identified on at least 15% of individuals were considered CNVR hotspots and further overlapped with previously reported quantitative trait loci (QTL). CNVR hotspots spanning genes putatively involved with lipid metabolism (SKP1, TCF7, JADE2, UBE2B and SAR1B) and differential expression in mammary gland (SEC24A and CDKN2AIPNL) on OAR5 and dairy traits (CCDC198 and SLC35F4) on OAR7 overlapped with QTL associated with lipid metabolism, milk protein yield and milk fat percentage. Information obtained from local sheep populations naturally adapted to harsh environments contributes to increase our understanding of the genomic importance of CNV.
Delaying elaborated feedback within computer‐based learning environments: The role of summative and question‐based feedback
Authors: Candel Carmen , Máñez Ignacio , Cerdán Raquel , Vidal‐Abarca Eduardo
Published: March 2021

Elaborative feedback (EF) containing explanations on students' responses benefits learning. Computer‐based environments provide learners with EF in different ways, for example, on an immediate question‐by‐question basis or after answering a set of questions. Recent findings also suggest that delaying EF enhances learning. However, it is unclear to what extent different types of delayed‐EF favour students' performance. This study examines whether and how two types of delayed‐EF (question‐based vs. summative) influence students' question‐answering performance and final learning over immediate‐EF. One hundred thirty‐three secondary‐school students read a scientific text and answered 12 multiple‐choice questions in a computer‐based environment. A day later, students completed a final learning test with 20 open‐ended questions. Results showed that neither question‐based delayed EF nor summative delayed EF outperformed immediate EF. However, EF moderated the relationship between students' prior knowledge and their performance outcomes, suggesting that students with higher levels of prior knowledge receiving summative delayed EF benefited more.
The mechanisms of left septal and anterior wall reentrant atrial tachycardias analyzed with ultrahigh resolution mapping: The role of functional block in the circuit
Authors: Miyazaki Shinsuke , Hasegawa Kanae , Ishikawa Eri , Mukai Moe , Aoyama Daisetsu , Nodera Minoru , Yamaguchi Junya , Shiomi Yuichiro , Tama Naoto , Ikeda Hiroyuki , Fukuoka Yoshitomo , Ishida Kentaro , Uzui Hiroyasu , Tada Hiroshi
Published: March 2021

Background

Low voltage areas (LVAs) are most commonly observed on the left atrial (LA) septal/anterior wall.

Objective

We explored the mechanisms of LA septal/anterior wall reentrant tachycardias (LASARTs) using ultrahigh resolution mapping.

Methods

This study included seven consecutive LASARTs in six patients (75 [62.2–82.8] years, 4 women) who underwent atrial tachycardia (AT) mapping and ablation using Rhythmia systems.

Results

The AT cycle length was 266 (239–321) ms. During ATs, 11.0 (9.0–12.9) cm2 of LVAs were identified in all, and 0.8 (0.7–1.7) cm2 of dense scar was identified in four patients. Five ATs rotated around dense scar, while two rotated around functional linear block, which was confirmed during atrial pacing after AT termination. The AT circuit length was 8.7 ± 2.1 cm with a conduction velocity of 30.4 ± 3.7 cm/s. A median of 3.0 (2.0–4.0) slow conduction areas per circuit were identified, and 17/23 (73.9%) areas were present in LVAs, while they were at the border of the LVA and normal voltage areas in the remaining 6/23 (26.1%). Global activation histograms facilitated the identification of the critical isthmus in all. Tailor‐made ablation at critical isthmuses successfully eliminated all ATs. However, one patient with AT related to functional linear block experienced recurrent AT related to dense scar, which progressed after the procedure. During a mean 14 ± 13 month follow‐up after the last procedure, no patients experienced recurrent ATs without any complications.

Conclusion

LASARTs consist of not only fixed conduction blocks but also functional conduction blocks. Ultrahigh resolution mapping is highly useful to decide the optimal tailor‐made ablation strategy based on the mechanisms.
LncRNA TP73‐AS1 enhances the malignant properties of pancreatic ductal adenocarcinoma by increasing MMP14 expression through miRNA ‐200a sponging
Authors: Miao Haiyan , Lu Jingjing , Guo Yibing , Qiu Hongquan , Zhang Yu , Yao Xihao , Li Xiaohong , Lu Yuhua
Published: March 2021

Pancreatic ductal adenocarcinoma (PDAC) is an invasive and aggressive cancer that remains a major threat to human health across the globe. Despite advances in cancer treatments and diagnosis, the prognosis of PDAC patients remains poor. New and more effective PDAC therapies are therefore urgently required. In this study, we identified a novel host factor, namely the LncRNA TP73‐AS1, as overexpressed in PDAC tissues compared to adjacent healthy tissue samples. The overexpression of TP‐73‐AS1 was found to correlate with both PDAC stage and lymph node metastasis. To reveal its role in PDCA, we targeted TP73‐AS1 using LnRNA inhibitors in a range of pancreatic cancer (PC) cell lines. We found that the inhibition of TP73‐AS1 led to a loss of MMP14 expression in PC cells and significantly inhibited their migratory and invasive capacity. No effects of TP73‐AS1 on cell survival or proliferation were observed. Mechanistically, we found that TP73‐AS1 suppressed the expression of the known oncogenic miR‐200a. Taken together, these data highlight the prognostic potential of TP73‐AS1 for PC patients and highlight it as a potential anti‐PDAC therapeutic target.
TGF‐β isoforms inhibit hepatitis C virus propagation in transforming growth factor beta/SMAD protein signalling pathway dependent and independent manners
Authors: Zou Li‐Li , Li Jian‐Rui , Li Hu , Tan Jia‐Li , Wang Mei‐Xi , Liu Nan‐Nan , Gao Rong‐Mei , Yan Hai‐Yan , Wang Xue‐Kai , Dong Biao , Li Yu‐Huan , Peng Zong‐Gen
Published: March 2021

Transforming growth factor beta (TGF‐β) plays an important role in the viral liver disease progression via controlling viral propagation and mediating inflammation‐associated responses. However, the antiviral activities and mechanisms of TGF‐β isoforms, including TGF‐β1, TGF‐β2 and TGF‐β3, remain unclear. Here, we demonstrated that all of the three TGF‐β isoforms were increased in Huh7.5 cells infected by hepatitis C virus (HCV), but in turn, the elevated TGF‐β isoforms could inhibit HCV propagation with different potency in infectious HCV cell culture system. TGF‐β isoforms suppressed HCV propagation through interrupting several different stages in the whole HCV life cycle, including virus entry and intracellular replication, in TGF‐β/SMAD signalling pathway–dependent and TGF‐β/SMAD signalling pathway–independent manners. TGF‐β isoforms showed additional anti‐HCV activities when combined with each other. However, the elevated TGF‐β1 and TGF‐β2, not TGF‐β3, could also induce liver fibrosis with a high expression of type I collagen alpha‐1 and α‐smooth muscle actin in LX‐2 cells. Our results showed a new insight into TGF‐β isoforms in the HCV‐related liver disease progression.
A study on nursing effect of integrated traditional Chinese and Western medicine management mode on COVID‐19
Authors: Chu Lanfang , Zhang Yongwen
Published: March 2021

Aim

This study aims to explore the effect of integrated traditional Chinese and Western medicine management mode on nursing care of patients with coronavirus disease 2019 (COVID‐19).

Methods

The study included 142 COVID‐19 patients hospitalized in Huoshenshan Hospital from February to March 2020. Nursing measures in the treatment (n = 111) and control (n = 31) groups included integrated management care and usual care. The integrated management model had eight components: WeChat group management, early Traditional Chinese Medicine (TCM) treatment, emotional nursing, music therapy, observation of tongue coating and pulse, vital Qi strengthening, preventing recurrence after recovery, and an individualized follow‐up scheme. The endpoints included clinical outcome, recovery time of clinical symptoms and signs, days of hospital stay, and survival without intensive care unit (ICU) admission.

Results

Recovery time from clinical symptoms such as fever, cough, shortness of breath, muscle aches, and fatigue in the treatment group was shorter than that in the control group. Less time was required to show negative chest computed tomography findings in the treatment group than in the control group (13.0 ± 2.8 vs. 16.7 ± 3.9, p < .025). The lengths of hospital stay in the two groups were 16.4 ± 7.3 days (treatment group) and 24.4 ± 4.8 days (control group) (p < .001). Kaplan–Meier curves for survival without ICU transfer showed statistical difference between the two groups (χ2 = 5.427, p = .020).

Conclusions

Our study shows that the integrated management mode can relieve the symptoms of patients faster, shorten hospital stay and disease course, and reduce the rate of ICU transfers.
The Relationship between Stakeholder Theory and Corporate Social Responsibility: Differences, Similarities, and Implications for Social Issues in Management
Authors: Dmytriyev Sergiy D. , Freeman R. Edward , Hörisch Jacob
Published: March 2021

Although stakeholder theory and corporate social responsibility (CSR) have evolved into major theoretical frameworks for exploring social issues in management, there is a limited and often misleading understanding of the relationship between them that inhibits the management field from adopting a social orientation to a full extent. Our aim is to remove unnecessary barriers that preclude collaboration between scholars in the stakeholder theory and CSR camps; empower organizational scholars and practitioners with a more nuanced language for dealing with social issues in management; and enable the creation of a coherent and integrative theoretical foundation in the area of social issues in management that has previously been at a disadvantage to other areas in management. In our conceptual analysis, we argue that stakeholder theory and CSR provide distinct but complementary theoretical frameworks with some overlap. The actual decision to choose a particular framework depends on the problem one wants to solve and the settings of that problem.
Same Old Song with a Different Melody: The Paradox of Market Reach and Financial Performance on Digital Platforms
Authors: Hänninen Mikko , Smedlund Anssi
Published: March 2021

In the service sector, digital platforms now enable service providers to reach customers through an online marketplace and use the value‐adding complementary services offered. However, despite the widespread prevalence of digital platforms, there has been little research on the market reach and financial performance captured by service providers. We explored these service provider‐specific outcomes of digital platforms by studying a digital platform in the beauty industry. Our results show that digital platforms present a troubling paradox for service providers participating in a platform‐based online marketplace: despite increases in market reach, in terms of a higher rate of new customer acquisition, those service providers participating in the marketplace have lower sales than others. However, the ‘dark side’ of this paradox is compensated by higher sales for service providers using more of the complementary services offered by the platform. Hence, although digital platforms may open new markets and add value, service providers should be wary of their paradoxical consequences. With these findings, we contribute new theoretical and managerial insight about the service provider‐specific outcomes of digital platforms and add to the ongoing debate about firm strategies in the digital age concerning the platform economy.
Incidence of allergen‐specific and total immunoglobulin E positivity in children undergoing adenotonsillectomy
Authors: Lam Matthew E , Kitipornchai Leon , Ball Natelle , Sarkissian Lernik , Sands Terry , Grundy Liam , MacKay Stuart G
Published: March 2021

Aim

To conduct a prospective, consecutive cohort study to evaluate the incidence of allergen‐specific and total immunoglobulin E (IgE) in a paediatric population undergoing adenotonsillectomy for sleep‐disordered breathing.

Methods

A total of 64 consecutive patients presenting for adenotonsillectomy at a single centre were recruited over a period of 3 months. All patients underwent adenotonsillectomy and had allergen‐specific and total IgE serum testing at the time of anaesthesia induction. Pre‐operative history and examination were conducted to determine clinical allergy. Caregivers completed the Sleep‐Related Breathing Disorder scale of the Paediatric Sleep Questionnaire and the Mini Rhinoconjunctivitis Quality of Life Questionnaire at baseline and at 6 weeks post‐operatively.

Results

A total of 37 (57.8%) patients had either allergen‐specific or total IgE positivity. House dust mite was the most prevalent allergen‐specific IgE finding, being present in moderate to high levels in 14 (21.9%) patients. A total of 17 (26.6%) patients had a history of atopy, while 34 (53.1%) had examination findings suggestive of allergy. Neither serum IgE testing nor clinical history and examination were independently associated with residual symptoms post adenotonsillectomy. Patients with concomitant serum IgE positivity and clinical allergy had higher residual symptom scores compared to those who did not using both Sleep‐Related Breathing Disorder scale of the Paediatric Sleep Questionnaire (P = 0.035) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (P = 0.02) questionnaires.

Conclusions

Our prospective, consecutive cohort of patients reflect a greater incidence of serum IgE positivity compared to historical figures. When utilised with clinical findings on history and examination, serum IgE is a useful adjunct that is associated with greater residual symptoms post‐adenotonsillectomy.
Significant compartment‐specific impact of different RNA extraction methods and PCR assays on the sensitivity of hepatitis E virus detection
Authors: Behrendt Patrick , Bremer Birgit , Todt Daniel , Steinmann Eike , Manns Michael Peter , Cornberg Markus , Wedemeyer Heiner , Maasoumy Benjamin
Published: March 2021

Background

RNA detection in plasma/stool is the gold‐standard for diagnosis of hepatitis E virus (HEV) infection. The impact of viral extraction methods on HEV RNA detection is poorly investigated.

Methods

We determined the limit of detection of the RealStar HEV RT‐PCR V2.0 Kit (altona Diagnostics, RS) utilizing 3 RNA extraction methods (COBAS® AmpliPrep Total Nucleic Acid Isolation Kit, TNAi Roche; MagNA Pure 96 DNA, Viral NA SV Kit, MgP; QIAamp Viral RNA mini Kit Qiagen; VRK) in plasma and stool. The most sensitive method was evaluated in a total of 307 longitudinal samples of patients with HEV infection (acute = 18/chronic = 36) and compared to results with the former diagnostic standard of our centre (TNAi/FastTrack Diagnostic; FTD).

Results

The plasma‐LOD was 49, 94 and 329 IU/mL for extraction with MgP, VRK and TNAi respectively. In stool, the LOD was 21 IU/mL, 528 IU/mL and indefinable for extraction with TNAi, VRK and MgP respectively. Utilizing longitudinal patient plasma samples, MgP/RS revealed 56 HEV RNA‐positive samples in 158 negative samples as determined by TNAi/FTD. In stool, from 37 HEV negative samples (TNAi/FTD), 15 were positive with TNAi/RS. At end of treatment, 8 out of 27 chronically infected patients were RNA positive with MgP/RS, while classified negative with TNAi/FTD. A relapse occurred in 3 of these patients.

Conclusion

Different methods for RNA extraction and quantification have a significant, compartment‐specific impact on the sensitivity of HEV detection. Knowledge about the favourable combinations of extraction and quantification has important implications for diagnosis and patients receiving antiviral therapy.
Quantification of the covariation of lake microbiomes and environmental variables using a machine learning‐based framework
Authors: Sperlea Theodor , Kreuder Nico , Beisser Daniela , Hattab Georges , Boenigk Jens , Heider Dominik
Published: March 2021

It is known that microorganisms are essential for the functioning of ecosystems, but the extent to which microorganisms respond to different environmental variables in their natural habitats is not clear. In the current study, we present a methodological framework to quantify the covariation of the microbial community of a habitat and environmental variables of this habitat. It is built on theoretical considerations of systems ecology, makes use of state‐of‐the‐art machine learning techniques and can be used to identify bioindicators. We apply the framework to a data set containing operational taxonomic units (OTUs) as well as more than twenty physicochemical and geographic variables measured in a large‐scale survey of European lakes. While a large part of variation (up to 61%) in many environmental variables can be explained by microbial community composition, some variables do not show significant covariation with the microbial lake community. Moreover, we have identified OTUs that act as “multitask” bioindicators, i.e., that are indicative for multiple environmental variables, and thus could be candidates for lake water monitoring schemes. Our results represent, for the first time, a quantification of the covariation of the lake microbiome and a wide array of environmental variables for lake ecosystems. Building on the results and methodology presented here, it will be possible to identify microbial taxa and processes that are essential for functioning and stability of lake ecosystems.
Plant sugar feeding patterns of wild‐caught Aedes aegypti from dengue endemic and non‐endemic areas of Kenya
Authors: Wanjiku C. , Tchouassi D. P , Sole C. L , Pirk C. , Torto B.
Published: March 2021

A fundamental understanding of plant sugar feeding behaviour in vector populations can lead to the development of ecologically effective vector monitoring and control strategies. Despite previous studies on mosquito–plant interactions, relatively few have been conducted on the dengue vector Aedes aegypti (Diptera: Culicidae). The authors studied Ae. aegypti–plant interactions at two sites of varying dengue endemicity in Kenya: Kilifi (endemic) and Isiolo (non‐endemic). Using chemical and molecular assays [DNA barcoding targeting the chloroplast ribulose‐1,5 bisphosphate carboxylase/oxygenase large chain (rbcL) gene], the authors show that at the two sites plant feeding in this mosquito species: (a) varies by sex and season; (b) results in the acquisition of diverse sugars, and (c) is associated with diverse host plants in the families Fabaceae, Malvaceae, Poaceae and Rosaceae. These results reveal insights into the plant sugar feeding patterns of wild‐caught Ae. aegypti and provide a baseline for future studies on the olfactory basis for host plant attraction for the development of vector monitoring and control tools.
Serum Aspergillus galactomannan lateral flow assay for the diagnosis of invasive aspergillosis: A single‐centre study
Authors: Serin Istemi , Dogu Mehmet Hilmi
Published: March 2021

Background

Aspergillus species meet the most important group of invasive fungal diseases (IFD) in immunosuppressed patients. Galactomannan is a polysaccharide antigen located in the wall structure of Aspergillus. The most commonly used method for antigen detection is enzyme‐linked immunoassay (ELISA). Aspergillus galactomannan lateral flow assay (LFA) constitutes one of the new methods in the diagnosis of invasive aspergillosis (IA). The goal of this study was to demonstrate efficacy of LFA in our patients and to compare it to synchronous ELISA results.

Methods

Galactomannan antigen was examined using both LFA and ELISA in serum samples taken from patients who were followed up in our haematology clinic. All patients are classified in subgroups as ‘proven’, ‘probable’ and ‘possible’ patients according to the last EORTC / MSG guideline. Patients who met the ‘proven’ IA criteria were included in the study as the gold standard.

Results

A total of 87 patients were included in the study. Majority of patients had acute myeloid leukaemia (AML) (56.3%). Eleven (12.6%) were in ‘proven’ IA group. LFA test showed a superior diagnostic performance compared with ELISA (LFAAUC = 0.934 vs ELISAAUC = 0.545; p < .001). The LFA had a sensitivity of 90.9% and a specificity of 90.8% for ‘0.5 ODI’ in predicting IA (PPV = 55.8%; NPV = 98.6%; p < .001).

Conclusion

The most important finding of this study is that the specificity of LFA was found to be higher for cut‐off value of 0.5. It is recommended to combine the methods in many studies to provide a better early diagnosis for IA.
Oncology nurses' perceptions of advance directives for patients with cancer
Authors: Hobden Breanne , Bryant Jamie , Waller Amy , Shepherd Jan , Sanson‐Fisher Rob
Published: March 2021

This study examined oncology nurses' perceptions of the impact of advance directives on oncology patients' end‐of‐life care. Nurses (n = 104), who were members of an oncology nursing society or worked in a large metropolitan cancer center, completed a cross‐sectional survey assessing perceptions of advance directives. There was high agreement that advance directives (i) make decisions easier for family (87%) and providers (82%); (ii) are doctors' responsibility to implement (80%); (iii) reduce unwanted aggressive treatment in the last weeks of life (80%); (iv) protect patient autonomy (77%); and (v) increase the likelihood of dying in a preferred location (76%). There was moderate or low agreement that advance directives (i) are accessible when needed (60%); (ii) are oncology nurses' responsibility to implement (46%); (iii) are always followed (41%); (iv) reduce the likelihood of pain in the last weeks of life (31%); (v) contain difficult to follow statements (30%); and (vi) have no impact on comfort in the last weeks of life (15%). Most nurses perceive benefits for advance directives, however, there remains uncertainty around accessibility and implementation. Guidelines and education about advance directive processes in oncology could improve person‐centered end‐of‐life care.
The performance and confidence of clinicians in training in the analysis of ophthalmic images within a work‐integrated teaching model
Authors: Zhang Sophia , Phu Jack , Xu Pauline , Wang Henrietta , Kalloniatis Michael , Zangerl Barbara
Published: March 2021

Purpose

A fundamental clinical skill is the recognition of artefacts within the outputs of advanced imaging modalities. However, current teaching programmes of healthcare practitioners are becoming increasingly challenged to provide practical exposure within an already crowded curriculum. This study evaluates the impact of a novel work‐integrated teaching model on the confidence and competence of clinicians in the use of optical coherence tomography (OCT) and the recognition of its artefacts. The outcomes were then used to develop a model to predict performance and guide teaching strategies.

Methods

We prospectively evaluated a 6‐week clinical placement for final year optometry students within a diagnostic eye clinic in 2018‐2020. Participants completed a quiz on the identification of common OCT artefacts and rated their confidence levels on key areas of OCT application using a five‐point Likert scale. Both were completed before (pre‐rotation) and after (post‐rotation) the placement. The cohort was divided into two groups; the first group was used to assess the impact of the placement and derive the prediction model for post‐placement performance, which was then validated against the second group.

Results

A significant improvement in detecting OCT imaging artefacts was seen upon completion of the placement, which was greater in participants with lower entry level performance. Across all OCT artefact subtypes, there was an improvement in detecting segmentation error, delineation error and media opacities. A model predicting post‐placement student performance was developed using entry level knowledge base as the key dependent variable. Self‐rated confidence improved across all domains of OCT application but was not found to be a direct predictor of actual performance.

Conclusions

These results highlight the benefit of a work‐integrated learning programme on both academic performance and confidence whilst identifying entry level knowledge base as the key variable predicting improvement. Tailored teaching incorporating entering knowledge is the best predictor of improvement during clinical placements. Integrating clinicians into a work‐integrated setting with tailored teaching and comprehensive practical exposure can be an effective method for training future or current healthcare professionals.
An overview of optometrists' diabetic retinopathy practice patterns – a cross‐sectional survey
Authors: Tang Vanessa , Symons Robert C Andrew , Guest Daryl , McKendrick Allison M
Published: March 2021

Purpose

Contemporary eye care increasingly recommends the use of advanced retinal imaging technology. Anecdotal evidence suggests that this equipment is widely available in primary eye care settings; however, knowledge regarding how optometrists use this equipment in the context of diabetic retinopathy (DR) is limited. This study aimed to obtain a current overview of optometrists' clinical practice behaviours in the detection, screening, diagnosis and management of patients with diabetes.

Methods

A cross‐sectional survey was designed to evaluate optometrists' self‐reported clinical practice patterns and perceptions, as well as the availability and impact of retinal imaging equipment specific to DR and diabetic macular oedema (DMO) on optometrists' clinical practice. The survey invited participation from all optometrists practising in Australia.

Results

One hundred and sixty‐seven optometrists participated. Optometrists' self‐reported confidence in assessing DR and DMO was high. Optometrists' referral patterns considered the severity of DR and DMO before initiating referral to secondary ophthalmology care. Nearly all optometrists (98.8%) indicated that they had some form of retinal imaging equipment available to them in clinical practice. An optical coherence tomography (OCT) device was available to 75.5% of optometrists. A significant association between having an OCT device in the practice and higher self‐reported confidence levels in the assessment of DMO was found.

Conclusions

Many optometrists are well equipped with sophisticated retinal imaging technology for the provision of high‐quality eye care. Enhancing optometric training and education programmes can maximise the community benefit of access to this equipment and improve delivery of eye care in the community.
Role of D‐dimer and Fibrinogen in the Diagnosis of Periprosthetic Joint Infection: A Systematic Review and Meta‐Analysis
Authors: Xu Hong , Xie Jin‐wei , Yang Jing‐li , Huang Ze‐yu , Pei Fu‐xing
Published: March 2021

The diagnostic potential of D‐dimer and fibrinogen to detect periprosthetic joint infection (PJI) of the hip and knee is not well‐understood. The aim of this study was to determine whether D‐Dimer and fibrinogen can be used as effective biomarkers to screen PJI. A systematic review of the literature indexed in Web of Science, PubMed, Cochrane Library, Embase, and Google Scholar databases was performed. All studies using D‐dimer levels in serum or plasma, or fibrinogen levels in plasma, for the diagnosis of PJI were included. Meta‐analysis estimates, including sensitivity, specificity, diagnostic odds ratios (DOR), and the area under the summary receiver operating characteristic curve (AUSROC), were calculated using a random‐effects model, and used to assess the diagnostic accuracy of these biomarkers. A total of nine studies were analyzed, and their quality was considered to be acceptable. D‐dimer gave a limited diagnostic value if serum and plasma combined: sensitivity (0.77, 95% confidence interval [CI] [0.63 to 0.87]), specificity (0.67, 95% CI [0.54 to 0.78]), DOR (6.81, 95% CI [2.67 to 17.37]), and AUSROC (0.78, 95% CI [0.74 to 0.82]). Plasma D‐dimer levels were associated with less satisfactory sensitivity (0.65, 95% CI 0.57 to 0.71), specificity (0.58, 95% CI 0.50 to 0.66), DOR (2.52, 95% CI 1.64 to 3.90), and AUSROC (0.65, 95% CI 0.61 to 0.69). Serum D‐dimer levels showed higher corresponding values of 0.89 (95% CI 0.79 to 0.94), 0.76 (95% CI 0.55 to 0.89), 24.24 (95% CI 10.07 to 58.32), and 0.91 (95% CI 0.88 to 0.93). Plasma fibrinogen showed acceptable corresponding values of 0.79 (95% CI 0.70 to 0.85), 0.73 (95% CI 0.57 to 0.85), 10.14 (95% CI 6.16 to 16.70), and 0.83 (95% CI 0.79 to 0.86). Serum D‐dimer may be an effective marker for the diagnosis of PJI in hip and knee arthroplasty patients, and it may show higher diagnostic potential than plasma fibrinogen. Plasma D‐dimer may have limited diagnostic potential.
The Moral Luck of Rules
Authors: Beran Ondřej
Published: March 2021

The text reflects on the view of morality, according to which its central elements are rules that make a society efficient, bringing the greatest benefit. I show that rules represent a part of our “circumstantial luck,” and that their particularity often makes life more difficult. As we tend to internalise rules and interpret spontaneously the situations of our lives in their terms, we may be, in the cases of unfeasible rules, prone to view ourselves as failure. Generally, rule‐like statements (including moral rules) more naturally serve as tools for reflection on our past (failures) than as guidelines for the future. The presence of rules in our lives thus calls for compassion towards those who have failed in terms of the rules that they acknowledge.
Albert Camus’ Philosophy of Love
Authors: Neiman Paul G.
Published: March 2021

Albert Camus does not provide a direct or sustained exploration of romantic love. Instead, love is addressed only indirectly in The Myth of Sisyphus, and sporadically in other writings. This article analyses the experience of absurdity in love. Absurdity clears away the social, cultural, and philosophical ideals of love to focus on the actual experience of love. With this in mind, a positive account of Camus’ philosophy of love is developed from several different works. This shows that Camus’ philosophy of love centres on the biological feelings of love, which are temporary, non‐exclusive, and do not imply commitment.
Changes in attitudes toward diabetes in nursing students at diabetes camp
Authors: Moran Vicki , Blanchette Julia , Whitley Heather , Pillion Dennis , Albritton Anna , Israel Heidi
Published: March 2021

Aim

The research purpose was to determine whether exposure to residential diabetes camps affects attitudes toward diabetes care and management in nursing students.

Background

Summer camp for children with type 1 diabetes mellitus (T1D) provides a unique and engaging clinical environment for nursing students to learn about evolving diabetes care and to help children develop diabetes management skills.

Methods

This prospective, pretest/posttest study assessed student nurses' attitudes about diabetes, who attended one of four residential summer camps in the United States, using the Diabetes Attitude Survey 3 (DAS3). The survey was administered before and after clinical experience designed to fulfill experiential curricula requirements from various nursing programs.

Results

After attending diabetes camp, nursing students (N = 73) had a positive change in their attitudes regarding the need for special training and the psychosocial impact of diabetes.

Discussion

The diabetes camp clinical experience impacted nursing students' attitudes. Diabetes camps are a unique clinical setting that uses learned clinical knowledge and judgment to promote health and prevent disease and disability, supporting the integration of primary care and public health nursing.
Ombrohydrochory in Thismia panamensis (Standley) Jonk: a mycoheterotrophic species in Brazilian Cerrado forests
Authors: Coelho C. P. , Sousa I. P. , Silva G. E. , Rocha D. I. , Azevedo M. O. , Guilherme F. A. G.
Published: March 2021

Species of the genus Thismia Griff. are small herbs, considered mycoheterotrophic due to an intimate relationship with fungi. They are achlorophyllous, with complex floral structure but little information on reproductive strategies. This study evaluated structural and ecological aspects associated with the dispersal of seeds of Thismia panamensis (Standley) Jonk.

The study was carried out in a forest fragment in the Brazilian Cerrado. During the reproductive period, 36 individuals were monitored for spatial distribution of the population and their fruits were collected. Samples were subjected to light microscopy and microtomography techniques, in addition to an experiment to evaluate seed dispersal by water droplets.

Thismia panamensis is up to 8‐cm tall, with a tuberous root and stem, without leaves. Its fruit is dehiscent, cup‐shaped, 5 ± 1 mm in diameter, containing 219.33 ± 106.70 seeds, with an average length of 0.55 ± 0.07 mm. The seeds are exposed, and their coat has a thin and lignified wall. Accumulation of secretions was observed inside the fruits. The innermost cell layer of the ovary showed typical characteristics of aquiferous parenchyma. Water splash experiments showed that the seeds reached an average distance of 44.04 ± 26.58 cm. Each splash contained, on average, 1.50 ± 1.23 seeds, with 75% of the splashes containing a single seed. A total of 239 seeds were counted in the 163 splashes evaluated.

The data show potential seed dispersal by ombrohydrochory in T. panamensis, favouring its maintenance in the study area and reflecting its clumped spatial distribution.
Halothermal and hydrothermal time models describe germination responses of canola seeds to ageing
Authors: Bakhshandeh E. , Jamali M.
Published: March 2021

Hydrothermal time (HTT) and halothermal time (HaloTT) models were used to quantitatively characterize the combined effects of temperature (T), water potential (ψ) and NaCl concentration on seed germination of canola after different accelerated ageing periods (AAP) at 42 °C and 100% humidity.

Seed germination time courses were observed and electrical conductivities of seed leachates were measured in all experiments.

The cardinal temperatures estimated by both models were 4.6, 28 and 35 °C for the base (Tb), optimum (To) and ceiling (Tc) temperatures in water (0 MPa), respectively, when the seeds were not aged. The Tb increased with AAP, while the Tc decreased and the To remained constant at all AAP. Below To, the median base water potentials (ψb(50)) were −1.07, −0.73, −0.48 and −0.39 MPa for the AAP levels of 0, 24, 36 and 48 h, respectively. These values were more negative when germination occurred in salt solutions (the base NaCl concentrations converted to ψ were −1.25, −0.81, −0.51 and −0.41 MPa, respectively), due to uptake of salt ions. Thresholds became more positive above To and reached zero at Tc in all AAP.

Seed osmotic adjustment capacity declined linearly with increasing AAP while the conductivity of seed leachates increased in association with the loss of seed vigour. Significant correlations between conductivity results and the parameters of HTT and HaloTT models suggest that they could be considered as effective descriptors of canola seed vigour.
The impact of unpredictability of dyspnea offset on dyspnea perception, fear, and respiratory neural gating
Authors: von Leupoldt Andreas , Ashoori Minoo , Jelinčić Valentina , Herzog Michaela , Van Diest Ilse
Published: March 2021

Dyspnea is a debilitating and threatening symptom in various diseases. Affected patients often report the unpredictability of dyspnea episodes being particularly anxiety‐provoking and amplifying the perception of dyspnea. Experimental studies testing dyspnea unpredictability together with related neural processes, physiological fear responses, and dyspnea‐related personality traits are sparse. Therefore, we investigated the impact of unpredictability of dyspnea offset on dyspnea perception and fear ratings, respiratory neural gating and physiological fear indices, as well as the influence of interindividual differences in fear of suffocation (FoS). Forty healthy participants underwent a task manipulating the offset predictability of resistive load‐induced dyspnea including one unloaded safety condition. Respiratory variables, self‐reports of dyspnea intensity, dyspnea unpleasantness, and fear were recorded. Moreover, respiratory neural gating was measured in a paired inspiratory occlusion paradigm using electroencephalography, while electrodermal activity, startle eyeblink, and startle probe N100 were assessed as physiological fear indices. Participants reported higher dyspnea unpleasantness and fear when dyspnea offset was unpredictable compared to being predictable. Individuals with high levels of FoS showed the greatest increase in fear and overall higher levels of fear and physiological arousal across all conditions. Respiratory neural gating, startle eyeblink, and startle probe N100 showed general reductions during dyspnea conditions but no difference between unpredictable and predictable dyspnea conditions. Together, the current results suggest that the unpredictable offset of dyspnea amplifies dyspnea perception and fear, especially in individuals with high levels of FoS. These effects were unrelated to respiratory neural gating or physiological fear responses, requiring future studies on underlying mechanisms.
Land‐use change alters the stocks of carbon, nitrogen, and phosphorus in a Haplic Cambisol in the Brazilian semi‐arid region
Authors: Gava Carlos Alberto Tuão , Giongo Vanderlise , Signor Diana , Fernandes‐Júnior Paulo Ivan
Published: March 2021

Land‐use change (LUC) can impact soil quality. In semi‐arid areas of Brazil, impacts of LUC need to be understood for better soil management. This study evaluated the impact of LUC on soil organic carbon (SOC), nitrogen (N), and phosphorus (P) distributions through the soil profile and stocks of a Haplic‐Cambisol in the Brazilian Semi‐arid region. Three land‐use systems (LUS) were investigated: agricultural management (30 years), regeneration under controlled grazing (25 years) after 5 years arable management, and native dry forest. Soil contents of P, total C, total N, and N fractions were used to calculate stocks and their stoichiometric ratios for layers 0–5, 5–10, 10–20, and 20–40 cm. Data from these LUS were compared using Kruskal–Wallis non‐parametric tests. Changes to soil microbial biomass reflected the substantially reduced SOC concentration and stock in managed soils compared with that of the natural dry forest area. Total N stock was not affected by LUC, although increases in nitrate and ammonium offset a significantly reduced organic N fraction in the agricultural area. The largest P stock was found in agricultural land, followed by the grazed fallow regeneration site. LUC significantly influenced the stoichiometric ratio of C, N, and P, with the change from Caatinga to agriculture affecting the equilibrium between organic residues’ input and mineralization. LUC resulted in significant changes to C, N, and P stocks, which did not recover to the original values, even after 25 years of regeneration under controlled grazing.
The impact of ABO blood groups on clinical outcomes and susceptibility to COVID‐19: A retrospective study in an unselected population
Authors: Al‐Youha Sarah A. , Alduaij Waleed , Al‐Serri Ahmad , Almazeedi Sulaiman M. , Al‐Haddad Mohannad , Jamal Mohammad H. , Shih Andrew W. , Al‐Sabah Salman K.
Published: March 2021

Background

ABO blood groups have been linked to susceptibility to infection with certain microorganisms, including coronaviruses. We examined the relationship between blood group and clinical outcomes in individuals infected with severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) and compared their blood group distribution with the general population.

Methods

At the inception of the pandemic, all individuals testing positive for SARS‐CoV‐2 in Kuwait were admitted to one designated coronavirus disease 2019 (COVID‐19) hospital and enrolled in a prospective registry. Patients admitted from February 24 to May 27, 2020, were stratified according to blood group. As a control, blood groups of 3,730,027 anonymized individuals representing almost Kuwait's entire population were obtained from a national database.

Results

Of 3305 SARS‐CoV‐2–positive patients, 37.1%, 25.5%, 28.9%, and 8.5% were groups O, A, B, and AB, respectively. Univariate analysis revealed no significant differences in severe clinical outcomes or death among the blood groups. However, multivariable analysis demonstrated that group A individuals had higher odds of developing pneumonia compared with non–group A (adjusted odds ratio 1.32, 95% confidence interval 1.02–1.72, p < .036). Compared with the general population, the COVID‐19 cohort had a lower frequency of group O, equivalent frequency of A, and higher frequency of B and AB. No significant difference in the RhD group was found.

Conclusion

This study supports potential involvement of the ABO blood group system in predisposing to infection with SARS‐CoV‐2 in an unselected population. Examination of the mechanistic link between blood group and COVID‐19 and its implications on controlling the current pandemic is warranted.
Shrink-Fit Stresses and Deformations
Authors: Rankin A. W.
Published: March 2021

In this paper are derived the expressions for the stresses in a solid cylinder of infinite length caused by the action of an applied radial stress distributed uniformly over a single circumferential ring of finite length on the surface of the cylinder. An example of stresses of this type would be a long solid shaft with a uniform pressure applied on the surface for a short axial length. The practical worth of the results presented in this paper lie in their approximate applications to shrink fits. Test measurements of shaft deformations due to shrink pressures are included to illustrate the application of the theoretical results.
Strengthening of Circular Holes in Plates Under Edge Loads
Authors: Beskin Leon
Published: March 2021

In this paper, stress distributions are determined around strengthened circular holes in plates submitted to edge loads at infinity. Various proportions of circular strengthenings are considered, and three conditions of applied edge loads are investigated; uniform hydrostatic stress, uniform shearing stress, uniform axial stress. Stress distributions are found by methods of theory of elasticity, and the results are given in the form of stress-concentration factors. In order to reduce the results to a common basis, the stress-concentration factors have been defined by the ratio of the critical stress, computed by the distortion-energy theory, to the critical stress at infinity, which is the critical stress in the plate without hole.
Application of the Fourier Method to the Solution of Certain Boundary Problems in the Theory of Elasticity
Authors: Pickett Gerald
Published: March 2021

The paper shows how the Fourier method may be used to obtain exact solutions for stresses in rectangular prisms or circular cylinders for any boundary condition.