bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric ambulatory appointment scheduling: a qualitative study of stakeholders’ perceptions and experiences
Authors: Quintanilha Maira , Tink Lisa , Perez Arnaldo , G o’neill Marcus , Holt Nicholas L , Bruce Aisha , Childs Michelle , Poitras Sarah Kane , Kherani Tamizan , Ladha Tehseen , Majaesic Carina , Webber Melina , Ball Geoff DC
Published: November 2020

Objective

Scheduling ambulatory clinic appointments includes a complex set of factors and diverse stakeholders. Families, administrative staff and clinicians may have varied experiences with scheduling clinic appointments. The objective of our study was to understand stakeholders’ perceptions and experiences with scheduling pediatric ambulatory clinic appointments.

Design

Guided methodologically by qualitative description, focus groups were conducted separately with three stakeholder groups and analyzed using qualitative content analysis.

Setting

This qualitative study was completed at a children’s hospital in Alberta, Canada.

Participants

Parents, administrative professionals and clinicians who used the pediatric ambulatory scheduling system regularly to elicit perceptions and experiences about issues and areas where improvements could be made.

Results

Across 12 focus groups, parents (n = 11), administrative professionals (n = 23) and clinicians (n = 13) discussed areas for improvement related to the pediatric ambulatory scheduling system. The perceived areas for improvement were grouped into three categories regarding levels of influence: (i) ‘intrapersonal’: knowledge, skills and behaviors (e.g. insufficient training of administrative professionals); (ii) ‘interpersonal’: communication processes (e.g. parents not receiving confirmation letters); and (iii) ‘institutional’: structures and processes (e.g. varying practices and processes across clinics).

Conclusions

Stakeholders provided a rich description of the interrelated factors and processes that influenced the scheduling of pediatric ambulatory clinic appointments. Multilevel, experimental interventions are needed to test whether the findings described herein can enhance the structure and function of pediatric ambulatory appointment scheduling.
Repeated isolation of an antibiotic-dependent and temperature-sensitive mutant ofPseudomonas aeruginosafrom a cystic fibrosis patient
Authors: Wolter Daniel J , Scott Alison , Armbruster Catherine R , Whittington Dale , Edgar John S , Qin Xuan , Buccat Anne Marie , McNamara Sharon , Blackledge Marcella , Waalkes Adam , Salipante Stephen J , Ernst Robert K , Hoffman Lucas R
Published: November 2020

Background

Bacteria adapt to survive and grow in different environments. Genetic mutations that promote bacterial survival under harsh conditions can also restrict growth. The causes and consequences of these adaptations have important implications for diagnosis, pathogenesis, and therapy.

Objectives

We describe the isolation and characterization of an antibiotic-dependent, temperature-sensitive Pseudomonas aeruginosa mutant chronically infecting the respiratory tract of a cystic fibrosis (CF) patient, underscoring the clinical challenges bacterial adaptations can present.

Methods

Respiratory samples collected from a CF patient during routine care were cultured for standard pathogens. P. aeruginosa isolates recovered from samples were analysed for in vitro growth characteristics, antibiotic susceptibility, clonality, and membrane phospholipid and lipid A composition. Genetic mutations were identified by whole genome sequencing.

Results

P. aeruginosa isolates collected over 5 years from respiratory samples of a CF patient frequently harboured a mutation in phosphatidylserine decarboxylase (psd), encoding an enzyme responsible for phospholipid synthesis. This mutant could only grow at 37°C when in the presence of supplemented magnesium, glycerol, or, surprisingly, the antibiotic sulfamethoxazole, which the source patient had repeatedly received. Of concern, this mutant was not detectable on standard selective medium at 37°C. This growth defect correlated with alterations in membrane phospholipid and lipid A content.

Conclusions

A P. aeruginosa mutant chronically infecting a CF patient exhibited dependence on sulphonamides and would likely evade detection using standard clinical laboratory methods. The diagnostic and therapeutic challenges presented by this mutant highlight the complex interplay between bacterial adaptation, antibiotics, and laboratory practices, during chronic bacterial infections.
Emerging roles of extracellular vesicles in physiology and disease
Authors: Hanayama Rikinari
Published: November 2020

Extracellular vesicles (EVs), such as exosomes and microvesicles, are small membrane vesicles secreted by almost all cell types and are abundant in blood, body fluids, such as urine, spinal fluid, tears and saliva, and cell culture media. From an evolutionary perspective, they are biologically significant as a means for expelling unwanted cellular contents. Recently, EVs have received considerable attention as messengers of intercellular communication networks, allowing the exchange of proteins and lipids between the cells producing them and target cells that trigger various cellular responses. EVs also carry mRNAs and microRNAs inside them, transferring genetic information among cells. In addition, the expression pattern of these molecules is related to the cellular state and the progression of diseases, and the search for biomarkers within the EV is underway in many research fields. However, the physiological and pathophysiological roles of EVs remain largely elusive. Therefore, in this special issue, we have compiled reviews of the latest research findings on EV research.
Effects of Soybean Planting Date on Yield Loss From Defoliation
Authors: Thrash Benjamin C , Catchot Angus L , Gore Jeffrey , Cook Donald , Musser Fred R , Irby Trenton , Krutz Jason , Lorenz Gus M
Published: November 2020

Soybean, Glycine max (L.) Merr., is planted during 3.5–4 mo across the Mid-South United States. Currently, no information exists regarding the effects of planting date on soybean yield loss from early season defoliation. In 2015 and 2016, to evaluate the effects of planting date on yield loss from defoliation, soybean were planted in field plots 2 wk apart from early April to mid-June, for a total of six planting dates. Each planting date included a nondefoliated control and a 100% defoliation treatment where leaves were manually excised at the V4 growth stage. Mean yield loss from defoliation varied across planting dates, with mid-April plantings having the least amount yield reduction, 573 kg/ha, and early-June plantings having the greatest yield reduction, 904 kg/ha. Percent yield reduction from defoliation increased as planting was delayed, suggesting that defoliation thresholds might need adjustment based on planting date and yield potential. However, more research is needed at lower levels of defoliation to accurately delineate such thresholds.
The congestion relief benefit of public transit: evidence from Rome
Authors: Adler Martin W , Liberini Federica , Russo Antonio , Ommeren Jos N. van
Published: November 2020

We estimate the effect of public transport supply on travel times of motor-vehicle and bus users in Rome, Italy. We apply a quasi-experimental methodology exploiting hourly information on public transport service reductions during strikes. We find that a 10-percentage point reduction in public transit supply increases the travel time of motor-vehicles by about 1.6% in the morning peak. The effect on bus travel time is similar. The congestion-relief benefit of public transport is thus sizeable and bus travel time gains account for an important share of it.
Baseline diet of an urban carnivore on an expanding range front
Authors: Duncan N , Asher O , Weckel M , Nagy C , Henger C , Yau F , Gormanzano L
Published: November 2020

For the past 200 years, coyotes have steadily expanded their range eastward from the Midwestern USA. They have successfully colonized the contiguous landscape east of the Mississippi River and have been documented on Long Island, New York since 2009 with successful breeding confirmed in 2016. Occupying a diverse array of habitat types along the way, they are now commonplace in many urban and suburban landscapes as well. Using 149 scats and 13 stomachs collected from 2009 to 2017 and analyzed by traditional scat analysis methods, we described the diet of coyotes found in the New York City. The most common prey items, as a percentage of scats, were rodents (35.2%), birds (27.7%), followed by anthropogenic items (26.4%). These results were similar when compared to that of seven other urban centers in North America.
Wind-evoked anemotropism affects the morphology and mechanical properties of Arabidopsis
Authors: Zhdanov Oleksandr , Blatt Michael R , Zare-Behtash Hossein , Busse Angela
Published: November 2020

Plants are known to exhibit a thigmomorphogenetic response to mechanical stimuli by altering their morphology and mechanical properties. Wind is widely perceived as mechanical stress and in many experiments its influence is simulated by applying mechanical perturbations. However, it is known that wind-induced effects on plants can differ and at times occur even in the opposite direction compared with those induced by mechanical perturbations. In the present study, the long-term response of Arabidopsis thaliana to a constant unidirectional wind was investigated. We found that exposure to wind resulted in a positive anemotropic response and in significant alterations to Arabidopsis morphology, mechanical properties, and anatomical tissue organization that were associated with the plant’s strategy of acclimation to a windy environment. Overall, the observed response of Arabidopsis to wind differs significantly from previously reported responses of Arabidopsis to mechanical perturbations. The presented results suggest that the response of Arabidopsis is sensitive to the type of mechanical stimulus applied, and that it is not always straightforward to simulate one type of perturbation by another.
Abundance of metalloprotease FtsH12 modulates chloroplast development in Arabidopsis thaliana
Authors: Mielke Kati , Wagner Raik , Mishra Laxmi S , Demir Fatih , Perrar Andreas , Huesgen Pitter F , Funk Christiane
Published: November 2020

The ATP-dependent metalloprotease FtsH12 (filamentation temperature sensitive protein H 12) has been suggested to participate in a heteromeric motor complex, driving protein translocation into the chloroplast. FtsH12 was immuno-detected in proplastids, seedlings, leaves, and roots. Expression of Myc-tagged FtsH12 under its native promotor allowed identification of FtsHi1, 2, 4, and 5, and plastidic NAD-malate dehydrogenase, five of the six interaction partners in the suggested import motor complex. Arabidopsis thaliana mutant seedlings with reduced FTSH12 abundance exhibited pale cotyledons and small, deformed chloroplasts with altered thylakoid structure. Mature plants retained these chloroplast defects, resulting in slightly variegated leaves and lower chlorophyll content. Label-free proteomics revealed strong changes in the proteome composition of FTSH12 knock-down seedlings, reflecting impaired plastid development. The composition of the translocon on the inner chloroplast membrane (TIC) protein import complex was altered, with coordinated reduction of the FtsH12-FtsHi complex subunits and accumulation of the 1 MDa TIC complex subunits TIC56, TIC214 and TIC22-III. FTSH12 overexpressor lines showed no obvious phenotype, but still displayed distinct differences in their proteome. N-terminome analyses further demonstrated normal proteolytic maturation of plastid-imported proteins irrespective of FTSH12 abundance. Together, our data suggest that FtsH12 has highest impact during seedling development; its abundance alters the plastid import machinery and impairs chloroplast development.
Chromatin dynamics during DNA damage and repair in plants: new roles for old players
Authors: Casati Paula , Gomez Maria Sol
Published: November 2020

The genome of plants is organized into chromatin. The chromatin structure regulates the rates of DNA metabolic processes such as replication, transcription, DNA recombination, and repair. Different aspects of plant growth and development are regulated by changes in chromatin status by the action of chromatin-remodeling activities. Recent data have also shown that many of these chromatin-associated proteins participate in different aspects of the DNA damage response, regulating DNA damage and repair, cell cycle progression, programmed cell death, and entry into the endocycle. In this review, we present different examples of proteins and chromatin-modifying enzymes with roles during DNA damage responses, demonstrating that rapid changes in chromatin structure are essential to maintain genome stability.
Predestination in Dante’s Commedia in Light of Augustine
Authors: Graff Thomas
Published: November 2020

If Virgil’s damnation motivates Dante in the heaven of Jupiter to interrogate the inner workings of divine justice, the ultimate theological point in contention is the nature of predestination. This article offers Augustine as an unconsidered textual anchor and hermeneutic lens for illuminating predestination in the Commedia: a doctrine concerning not so much humanity’s attempt at impossible comprehension of God’s salvific will, as an invitation to creative participation in it, realized in and through ongoing, historical practices of caritas conforming the self to the body of Christ.
Birthing a Graphic Archive of Memory: Re-Viewing the Refugee Experience in Thi Bui’sThe Best We Could Do
Authors: Oh Stella
Published: November 2020

The Vietnam War is the topic of books, comics, documentaries, films, and television shows. Contrary to popular filmic and literary representations of the Vietnam War, which feature violence and militant hypermasculinity, Thi Bui's The Best We Could Do: An Illustrated Memoir (2017) weaves a tapestry of stories about the Vietnam War through memories of her family members. Rather than reiterating a shibboleth of masculine struggle and American exceptionalism during the war, Bui's narrative centers on women, specifically their experiences with birthing and motherhood. Her graphic novel offers us an alternative lens to view the Vietnam War and the experiences of those whose stories were often excluded. The Best We Can Do illustrates memories of women and families commonly disregarded as unimportant and affirms their importance in understanding history and identities shaped by such exclusions. In mapping bodies and their various connections and separations to the nation and to each other, Bui invokes a new archive of memory in which the female body becomes a site for reframing the discourse of the Vietnam War.
Radio/X-ray correlations and variability in the X-ray binary LS I +61°303
Authors: Sharma R , Massi M , Chernyakova M , Malyshev D , Perrott Y C , Kraus A , Dzib S A , Jaron F , Cantwell T M
Published: November 2020

The high-mass X-ray binary LS I +61°303 exhibits variability in its radio and X-ray emissions, ranging from minute to hour time-scales. At such short time-scales, not much is known about the possible correlations between these two emissions from this source, which might offer hints to their origin. Here, we study the relationship between these emissions using simultaneous X-ray and radio monitoring. We present new radio observations using the Arcminute Microkelvin Imager Large Array telescope at two frequency bands, 13–15.5 and 15.5–18 GHz. We also describe new X-ray observations performed using the XMM–Newton telescope. These X-ray and radio observations overlapped for five hours. We find for the first time that the radio and X-ray emission are correlated up to 81${{\ \rm per\ cent}}$ with their few per cent variability correlated up to 40 ${{\ \rm per\ cent}}$. We discuss possible physical scenarios that produces the observed correlations and variability in the radio and X-ray emission of LS I +61°303.
The dual nature of blazar fast variability: Space and ground observations of S5 0716+714
Authors: Raiteri C M , Villata M , Carosati D , Benítez E , Kurtanidze S O , Gupta A C , Mirzaqulov D O , D’Ammando F , Larionov V M , Pursimo T , Acosta-Pulido J A , Baida G V , Balmaverde B , Bonnoli G , Borman G A , Carnerero M I , Chen W-P , Dhiman V , Di Maggio A , Ehgamberdiev S A , Hiriart D , Kimeridze G N , Kurtanidze O M , Lin C S , Lopez J M , Marchini A , Matsumoto K , Mujica R , Nakamura M , Nikiforova A A , Nikolashvili M G , Okhmat D N , Otero-Santos J , Rizzi N , Sakamoto T , Semkov E , Sigua L A , Stiaccini L , Troitsky I S , Tsai A L , Vasilyev A A , Zhovtan A V
Published: November 2020

Blazar S5 0716+714 is well-known for its short-term variability, down to intraday time-scales. We here present the 2-min cadence optical light curve obtained by the TESS space telescope in 2019 December–2020 January and analyse the object fast variability with unprecedented sampling. Supporting observations by the Whole Earth Blazar Telescope Collaboration in B, V, R, and I bands allow us to investigate the spectral variability during the TESS pointing. The spectral analysis is further extended in frequency to the UV and X-ray bands with data from the Neil Gehrels Swift Observatory. We develop a new method to unveil the shortest optical variability time-scales. This is based on progressive de-trending of the TESS light curve by means of cubic spline interpolations through the binned fluxes, with decreasing time bins. The de-trended light curves are then analysed with classical tools for time-series analysis (periodogram, autocorrelation, and structure functions). The results show that below 3 d there are significant characteristic variability time-scales of about 1.7, 0.5, and 0.2 d. Variability on time-scales $\lesssim 0.2$ d is strongly chromatic and must be ascribed to intrinsic energetic processes involving emitting regions, likely jet substructures, with dimension less than about 10−3 pc. In contrast, flux changes on time-scales $\gtrsim 0.5$ d are quasi-achromatic and are probably due to Doppler factor changes of geometric origin.
Sparse Bayesian mass-mapping with uncertainties: Full sky observations on the celestial sphere
Authors: Price M A , McEwen J D , Pratley L , Kitching T D
Published: November 2020

To date weak gravitational lensing surveys have typically been restricted to small fields of view, such that the flat-sky approximation has been sufficiently satisfied. However, with Stage IV surveys (e.g. LSST and Euclid) imminent, extending mass-mapping techniques to the sphere is a fundamental necessity. As such, we extend the sparse hierarchical Bayesian mass-mapping formalism presented in previous work to the spherical sky. For the first time, this allows us to construct maximum a posteriori spherical weak lensing dark-matter mass-maps, with principled Bayesian uncertainties, without imposing or assuming Gaussianty. We solve the spherical mass-mapping inverse problem in the analysis setting adopting a sparsity promoting Laplace-type wavelet prior, though this theoretical framework supports all log-concave posteriors. Our spherical mass-mapping formalism facilitates principled statistical interpretation of reconstructions. We apply our framework to convergence reconstruction on high resolution N-body simulations with pseudo-Euclid masking, polluted with a variety of realistic noise levels, and show a significant increase in reconstruction fidelity compared to standard approaches. Furthermore, we perform the largest joint reconstruction to date of the majority of publicly available shear observational data sets (combining DESY1, KiDS450, and CFHTLens) and find that our formalism recovers a convergence map with significantly enhanced small-scale detail. Within our Bayesian framework we validate, in a statistically rigorous manner, the community’s intuition regarding the need to smooth spherical Kaiser-Squires estimates to provide physically meaningful convergence maps. Such approaches cannot reveal the small-scale physical structures that we recover within our framework.
dbCNS: A New Database for Conserved Noncoding Sequences
Authors: Inoue Jun , Saitou Naruya
Published: November 2020

We developed dbCNS (http://yamasati.nig.ac.jp/dbcns), a new database for conserved noncoding sequences (CNSs). CNSs exist in many eukaryotes and are assumed to be involved in protein expression control. Version 1 of dbCNS, introduced here, includes a powerful and precise CNS identification pipeline for multiple vertebrate genomes. Mutations in CNSs may induce morphological changes and cause genetic diseases. For this reason, many vertebrate CNSs have been identified, with special reference to primate genomes. We integrated ∼6.9 million CNSs from many vertebrate genomes into dbCNS, which allows users to extract CNSs near genes of interest using keyword searches. In addition to CNSs, dbCNS contains published genome sequences of 161 species. With purposeful taxonomic sampling of genomes, users can employ CNSs as queries to reconstruct CNS alignments and phylogenetic trees, to evaluate CNS modifications, acquisitions, and losses, and to roughly identify species with CNSs having accelerated substitution rates. dbCNS also produces links to dbSNP for searching pathogenic single-nucleotide polymorphisms in human CNSs. Thus, dbCNS connects morphological changes with genetic diseases. A test analysis using 38 gnathostome genomes was accomplished within 30 s. dbCNS results can evaluate CNSs identified by other stand-alone programs using genome-scale data.
UniPath: a uniform approach for pathway and gene-set based analysis of heterogeneity in single-cell epigenome and transcriptome profiles
Authors: Chawla Smriti , Samydurai Sudhagar , Kong Say Li , Wu Zhengwei , Wang Zhenxun , TAM Wai Leong , Sengupta Debarka , Kumar Vibhor
Published: November 2020

Recent advances in single-cell open-chromatin and transcriptome profiling have created a challenge of exploring novel applications with a meaningful transformation of read-counts, which often have high variability in noise and drop-out among cells. Here, we introduce UniPath, for representing single-cells using pathway and gene-set enrichment scores by a transformation of their open-chromatin or gene-expression profiles. The robust statistical approach of UniPath provides high accuracy, consistency and scalability in estimating gene-set enrichment scores for every cell. Its framework provides an easy solution for handling variability in drop-out rate, which can sometimes create artefact due to systematic patterns. UniPath provides an alternative approach of dimension reduction of single-cell open-chromatin profiles. UniPath's approach of predicting temporal-order of single-cells using their pathway enrichment scores enables suppression of covariates to achieve correct order of cells. Analysis of mouse cell atlas using our approach yielded surprising, albeit biologically-meaningful co-clustering of cell-types from distant organs. By enabling an unconventional method of exploiting pathway co-occurrence to compare two groups of cells, our approach also proves to be useful in inferring context-specific regulations in cancer cells. Available at https://reggenlab.github.io/UniPathWeb/.
High Prevalence of SARS-CoV-2 Genetic Variation and D614G Mutation in Pediatric Patients With COVID-19
Authors: Pandey Utsav , Yee Rebecca , Shen Lishuang , Judkins Alexander R , Bootwalla Moiz , Ryutov Alex , Maglinte Dennis T , Ostrow Dejerianne , Precit Mimi , Biegel Jaclyn A , Bender Jeffrey M , Gai Xiaowu , Dien Bard Jennifer
Published: November 2020

Background

The full spectrum of the disease phenotype and viral genotype of coronavirus disease 2019 (COVID-19) have yet to be thoroughly explored in children. Here, we analyze the relationships between viral genetic variants and clinical characteristics in children.

Methods

Whole-genome sequencing was performed on respiratory specimens collected for all SARS-CoV-2-positive children (n = 141) between March 13 and June 16, 2020. Viral genetic variations across the SARS-CoV-2 genome were identified and investigated to evaluate genomic correlates of disease severity.

Results

Higher viral load was detected in symptomatic patients (P = .0007) and in children <5 years old (P = .0004). Genomic analysis revealed a mean pairwise difference of 10.8 single nucleotide variants (SNVs), and the majority (55.4%) of SNVs led to an amino acid change in the viral proteins. The D614G mutation in the spike protein was present in 99.3% of the isolates. The calculated viral mutational rate of 22.2 substitutions/year contrasts the 13.5 substitutions/year observed in California isolates without the D614G mutation. Phylogenetic clade 20C was associated with severe cases of COVID-19 (odds ratio, 6.95; P = .0467). Epidemiological investigation revealed major representation of 3 of 5 major Nextstrain clades (20A, 20B, and 20C) consistent with multiple introductions of SARS-CoV-2 in Southern California.

Conclusions

Genomic evaluation demonstrated greater than expected genetic diversity, presence of the D614G mutation, increased mutation rate, and evidence of multiple introductions of SARS-CoV-2 into Southern California. Our findings suggest a possible association of phylogenetic clade 20C with severe disease, but small sample size precludes a definitive conclusion. Our study warrants larger and multi-institutional genomic evaluation and has implications for infection control practices.
The Gender Earnings Gap in the Gig Economy: Evidence from over a Million Rideshare Drivers
Authors: Cook Cody , Diamond Rebecca , Hall Jonathan V , List John A , Oyer Paul
Published: November 2020

The growth of the “gig” economy generates worker flexibility that, some have speculated, will favour women. We explore this by examining labour supply choices and earnings among more than a million rideshare drivers on Uber in the U.S. We document a roughly 7% gender earnings gap amongst drivers. We show that this gap can be entirely attributed to three factors: experience on the platform (learning-by-doing), preferences and constraints over where to work (driven largely by where drivers live and, to a lesser extent, safety), and preferences for driving speed. We do not find that men and women are differentially affected by a taste for specific hours, a return to within-week work intensity, or customer discrimination. Our results suggest that, in a “gig” economy setting with no gender discrimination and highly flexible labour markets, women’s relatively high opportunity cost of non-paid-work time and gender-based differences in preferences and constraints can sustain a gender pay gap.
Significance of PR3-ANCA positivity in eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
Authors: Papo Matthias , Sinico Renato A. , Teixeira Vítor , Venhoff Nils , Urban Maria-Letizia , Iudici Michele , Mahrhold Juliane , Locatelli Francesco , Cassone Giulia , Schiavon Franco , Seeliger Benjamin , Neumann Thomas , Kroegel Claus , Groh Matthieu , Marvisi Chiara , Samson Maxime , Barba Thomas , Jayne David , Troilo Arianna , Thiel Jens , Hellmich Bernhard , Monti Sara , Montecucco Carlomaurizio , Salvarani Carlo , Kahn Jean-Emmanuel , Bonnotte Bernard , Durel Cécile-Audrey , Puéchal Xavier , Mouthon Luc , Guillevin Loïc , Emmi Giacomo , Vaglio Augusto , Terrier Benjamin ,   the French Vasculitis Study Group and the EGPA European Study Group
Published: November 2020

Objectives

Only a third of patients with eosinophilic granulomatosis with polyangiitis (EGPA) are ANCA-positive, mainly directed against MPO. ANCA directed against PR3 are rarely found in EGPA. We aimed to examine the significance of PR3-ANCA in EGPA.

Methods

We set up a retrospective European multicentre cohort including 845 patients. Baseline characteristics and outcomes were analysed and compared according to ANCA status.

Results

ANCA status was available for 734 patients: 508 (69.2%) ANCA-negative, 210 (28.6%) MPO-ANCA and 16 (2.2%) PR3-ANCA. At baseline, PR3-ANCA patients, compared with those with MPO-ANCA and ANCA-negative, less frequently had active asthma (69% vs 91% and 93%, P = 0.003, respectively) and peripheral neuropathy (31% vs 71% and 47%, P < 0.0001), more frequently had cutaneous manifestations (63% vs 38% and 34%, P = 0.03) and pulmonary nodules (25% vs 10% and 8%, P = 0.046), and lower median eosinophil count (1450 vs 5400 and 3224/mm3, P < 0.0001). Vasculitis relapse-free survival was shorter for PR3-ANCA (hazard ratio 6.05, P = 0.005) and MPO-ANCA patients (hazard ratio 1.88, P = 0.0002) compared with ANCA-negative patients.

Conclusion

PR3-ANCA EGPA patients differ from those with MPO-ANCA and negative ANCA, and share clinical features with granulomatosis with polyangiitis. This suggests that PR3-ANCA EGPA could be a particular form of PR3-ANCA-associated vasculitis.
Corporate Transfers for Dual-Career Couples: From GenderedTenkinto Gender-Equal Negotiations?
Authors: FUJITA Noriko
Published: November 2020

This qualitative-research-based article discusses corporate transfers of dual-career couples in large Japanese firms. In Japan’s internal labour market, inter-regional transfers, or tenkin, are de rigueur in many companies for purposes of training and promotion of long-term employees. Their implementation is often taken for granted because of the gendered assumption that only men are subject to tenkin. Women, who take responsibility in domestic roles, are not able to accept tenkin. Rather, they are either exempted from tenkin regardless of their wishes or forced to remain in secondary positions that require no tenkin. This gendered division of labour in tenkin has hampered women’s promotion in Japanese workplaces and hindered dual-career couples from achieving dual careers through tenkin. Using Acker’s (1990) theory of gendered organisations and Nemoto’s (2016) study of gendered practices in Japanese firms, this article elucidates the processes by which these cultural, gendered corporate transfers (a) reproduce gendered organisations, (b) are changing from dictates to negotiations in some companies where female workers are given more opportunities alongside intensification of the firms’ global competition, but (c) nevertheless continue to be in tension with dual-career families in contemporary Japan. To make a dual-career-couple model mainstream, the labour market structure that views corporate transfers as an absolute necessity needs radical change.
Dermatology Assessment
Authors: Maghfour Jalal , Jacob Sharon E.
Published: November 2020

Dermatology Assessment represents a novel readership-based tutorial module. Each question links to the Journal of the Dermatology Nurses' Association articles (for members) and Journal of the American Academy of Dermatology article citations associated with the topic.
Interventions Post Catheter Removal (iPCaRe) in the Acute Care Setting
Authors: Gray Mikel , Beeson Terrie , Kent Dea , Mackey Dianne , McNichol Laurie , Thompson Donna L. , Engberg Sandra
Published: November 2020

Despite advances in the prevention of catheter-acquired urinary tract infections achieved by programs that include removal of the indwelling urinary catheter at the earliest possible time, evidence guiding bladder and incontinence management strategies following discontinuation of a catheter is sparse. To address this gap and guide best practice, the WOCN Society appointed a Task Force to develop an evidence- and consensus-based algorithm guiding clinical decision-making for effective bladder and incontinence management strategies after indwelling urinary catheter removal. This article describes the design and development of the algorithm, consensus-based statements used to guide best practice in this area, and its content validation.
Chryseoglobus indicus sp. nov., isolated from deep sea water
Authors: Pei Shengxiang , Xie Fuquan , Wang Wenjing , Zhang Shuang , Zhang Gaiyun
Published: November 2020

A novel Gram-stain-positive, motile, aerobic, non-spore-forming and slender rod-shaped actinobacterium, designated strain CTD02-10-2T, was isolated from deep sea water of the Indian Ocean. Phylogenetic analysis based on the 16S rRNA gene sequence indicated that strain CTD02-10-2T was grouped into a separated branch with

Chryseoglobus frigidaquae

JCM 14730T (98.4 % nucleotide sequence identity). The respiratory quinones were menaquinones with 11, 12, 13 and 14 isoprene units and anteiso-C15 : 0, iso-C16 : 0, anteiso-C15 : 1 A and anteiso-C17 : 0 were the major fatty acids. The major polar lipids were phosphatidylglycerol, diphosphatidylglycerol and three unknown glycolipids. The genome of strain CTD02-10-2T was 2.59 Mb, with a DNA G+C content of 69.6 mol% and contained genes involved in the biosynthesis of alkylresorcinol, ansamycin, and carotenoids. In silico DNA–DNA hybridization and average nucleotide identity values for whole-genome sequence comparisons between strain CTD02-10-2T and

C. frigidaquae

JCM 14730T were clearly below the thresholds used for the delineation of a new species. Based on its morphological and chemotaxonomic characteristics, as well as genotypic data, strain CTD02-10-2T was classified as a novel species of the genus

Chryseoglobus

, for which the name Chryseoglobus indicus sp. nov. is proposed. The type strain is CTD02-10-2T (=JCM 33842T=MCCC 1A16619T).
Automatic COVID-19 Detection from chest radiographic images using Convolutional Neural Network
Authors: Asif Sohaib , Amjad Kamran
Published: November 2020

The global pandemic of the novel coronavirus that started in Wuhan, China has affected more than 50 million people worldwide and caused more than 1263,787 tragic deaths. To date, the COVID-19 virus is still spreading and affecting thousands of people. The main problem with testing for COVID-19 is that there are very few test kits available for a large number of affected or suspicious individuals. This leads to the need for automatic detection systems that use artificial intelligence. Deep learning is one of the most powerful AI tools available, so we recommend creating a convolutional neural network to detect COVID-19 positive patients from chest radiographs. According to previous studies, lung X-rays of COVID-19-positive patients show obvious characteristics, so this is a reliable method for testing patients, because X-ray examination of suspicious patients is easier than rt-PCR. Our model has been trained with 820 chest radiographic images (excluding data augmentation) collected from 3 databases, with a classification accuracy of 99.45% (training accuracy of 99.70%), sensitivity of 99.30% and specificity of 99.40 %, proved that our model has become a reliable COVID-19 detector.
Multifaceted Brain Age Measures Reveal Premature Brain Aging and Associations with Clinical Manifestations in Schizophrenia
Authors: Chen Chang-Le , Hwang Tzung-Jeng , Tung Yu-Hung , Yang Li-Ying , Hsu Yung-Chin , Liu Chih-Min , Hwu Hai-Gwo , Lin Yi-Tin , Hsieh Ming-Hsien , Liu Chen-Chung , Chien Yi-Ling , Isaac Tseng Wen-Yih
Published: November 2020

Schizophrenia is a mental disorder with extensive alterations of cerebral gray matter (GM) and white matter (WM) and is known to have advanced brain aging. However, how the structural alterations contribute to brain aging and how brain aging is related to clinical manifestations remain unclear. Here, we estimated the bias-free multifaceted brain age measures in patients with schizophrenia (N=147) using structural and diffusion magnetic resonance imaging data. We calculated feature importance to estimate regional contributions to advanced brain aging in schizophrenia. Furthermore, regression analyses were conducted to test the associations of brain age with illness duration, onset age, symptom severity, and intelligence quotient. The patients with schizophrenia manifested significantly old-appearing brain age (P<.001) in both GM and WM compared with the healthy norm. The GM and WM structures contributing to the advanced brain aging were mostly located in the frontal and temporal lobes. Among the features, the GM volume and mean diffusivity of WM were most sensitive to the neuropathological changes in schizophrenia. The WM brain age index was associated with a negative symptom score (P=.006), and the WM and multimodal brain age indices demonstrated negative associations with the intelligence quotient (P=.037; P=.040, respectively). Moreover, brain age exhibited associations with the onset age (P=.006) but no associations with the illness duration, which may support the early-hit non-progression hypothesis. In conclusion, our study reveals the structural underpinnings of premature brain aging in schizophrenia and its clinical significance. The brain age measures might be a potentially informative biomarker for stratification and prognostication of patients with schizophrenia.
Predictors of adverse outcome in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study
Authors: Francis Nick A , Stuart Beth , Knight Matthew , Vancheeswaran Rama , Oliver Charles , Willcox Merlin , Barlow Andrew , Moore Michael
Published: November 2020

Objective

Identify predictors of adverse outcome in a Virtual Hospital (VH) setting for COVID 19.

Design

Real-world prospective observational study.

Setting

Virtual hospital remote assessment service in West Hertfordshire NHS Trust, UK.

Participants

Patients with suspected COVID-19 illness enrolled directly from the community (post-accident and emergency (A&E) or medical intake assessment) or post-inpatient admission.

Main outcome measure

Death or (re-)admission to inpatient hospital care over 28 days.

Results

900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 post-inpatient) were included in the analysis. 76 (8.4%) of these experienced an adverse outcome (15 deaths in admitted patients, 3 deaths in patients not admitted, and 58 additional inpatient admissions). Predictors of adverse outcome were increase in age (OR 1.04 [95%CI: 1.02, 1.06] per year of age), history of cancer (OR 2.87 [95%CI: 1.41, 5.82]), history of mental health problems (OR 1.76 [95%CI: 1.02, 3.04]), severely impaired renal function (OR for eGFR <30 = 9.09 [95%CI: 2.01, 41.09]) and having a positive SARS-CoV-2 PCR result (OR 2.0 [95% CI: 1.11, 3.60]).

Conclusions

These predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to identify the reasons for increased risk of adverse outcome associated with cancer and mental health problems.

ARTICLE SUMMARY

Strengths and limitations of this study

The study uses anonymised data from all patients registered for the virtual hospital between 17/03/20 and 17/05/20, and therefore selection bias is not an issue.

At the time of this study, this was the only service providing remote follow-up for patients with suspected COVID-19 in the area, and therefore our findings are likely to be relevant to primary care patients receiving remote follow-up.

We were able to collect reliable data on a wide range of clinical and demographic features, and reliably follow all patients for the primary outcome for at least two weeks following their discharge from the VH.

We were not able to extract detailed symptom or clinical examination data, and there were significant amounts of missing data for some variables.

Our study is likely underpowered to detect all predictors, especially in the analysis of our two sub-groups
Changes in sexual behavior, PrEP adherence, and access to sexual health services due to the COVID-19 pandemic among a cohort of PrEP-using MSM in the South
Authors: Pampati Sanjana , Emrick Kayla , Siegler Aaron J. , Jones Jeb
Published: November 2020

Background

The COVID-19 pandemic has had unforeseen consequences on the delivery of HIV and STD prevention services. However, little is known about how the pandemic has impacted PrEP-using men who have sex with men (MSM).

Methods

Data come from an online cohort of PrEP-using MSM in the Southern United States from October 2019 to July 2020. Participants were administered ten surveys in total, including one ad hoc survey specifically on COVID-19. We conducted a cross-sectional analysis of this ad hoc survey (n=56) and present changes in sexual behaviors and utilization of and access to sexual health services. Using linear mixed-effects regression models, we also analyzed data from the larger cohort (n=78) and document how sexual behaviors and PrEP use varied longitudinally focusing on three months: February (pre-pandemic), April (early pandemic), and June (later in the pandemic).

Results

A fifth of participants discontinued or changed how often they take PrEP because of COVID-19. A quarter of the cohort documented challenges when attempting to access PrEP, HIV testing, or STD testing. For all sexual behaviors examined longitudinally—number of male sexual partners, anal sex acts, condomless anal sex, oral sex (all measured in the past 2 weeks)—there was a significant decrease from February to April followed by a significant increase from April to June.

Discussion

Our findings suggest reduced access to and utilization of STD and HIV services coupled with a continuation of behaviors which confer STD/HIV risk. Ensuring appropriate delivery of STD/HIV prevention services during this pandemic is imperative.
Enhanced NF-κB signaling in type-2 dendritic cells at baseline predicts non-response to adalimumab in psoriasis
Authors: Andres-Ejarque Rosa , Ale Hira Bahadur , Grys Katarzyna , Tosi Isabella , Solanky Shane , Ainali Chrysanthi , Catak Zeynep , Sreeneebus Hemawtee , Saklatvala Jake , Dand Nick , de Rinaldis Emanuele , Chapman Anna , Nestle Frank O. , Barnes Michael R. , Warren Richard B. , Reynolds Nick J. , Griffiths Christopher E.M. , Barker Jonathan N. , Smith Catherine H. , Di Meglio Paola
Published: November 2020

Biological therapies have transformed the management of psoriasis but clinical outcome is variable leaving an unmet clinical need for predictive biomarkers of response. To identify the immune determinants of response to the anti-TNF drug adalimumab and evaluate their predictive value, we performed in-depth immunomonitoring of blood immune cells of 67 psoriasis patients, before and during therapy. We assessed proximal TNF signaling events, by measuring NF-κB nuclear translocation and phosphorylation, and downstream effects, such as cell phenotype and function. Enhanced NF-κBp65 phosphorylation, induced by TNF and LPS in type-2 dendritic cells (DC) before therapy, significantly correlated with lack of clinical response after 12 weeks’ treatment. The heightened NF-κB activation was mechanistically linked to increased DC maturation in vitro and frequency of IL-17+T cells in the blood of non-responders before therapy. Moreover, lesional skin of non-responders contained more activated dermal DC and increased numbers of IL-17+T cells. sFinally, we identified and clinically validated LPS-induced NF-κBp65 phosphorylation before therapy as a predictive biomarker of non-response to adalimumab, with 100% sensitivity and 90.1% specificity in an independent cohort. Our study uncovers key molecular and cellular players underpinning adalimumab mechanisms of action in psoriasis and proposes a blood biomarker for predicting clinical outcome.
Economic impact of the first wave of the COVID-19 pandemic on acute care hospitals in Japan
Authors: Shin Jung-ho , Takada Daisuke , Morishita Tetsuji , Lin Hueiru , Bun Seiko , Teraoka Emi , Okuno Takuya , Itoshima Hisashi , Nagano Hiroyuki , Kishimoto Kenji , Segawa Hiromi , Asami Yuka , Higuchi Takuya , Minato Kenta , Kunisawa Susumu , Imanaka Yuichi
Published: November 2020

Background

In response to the coronavirus diseases 2019 (COVID-19) pandemic, the Japanese government declared a state of emergency on April 7, 2020. Six days earlier, the Japan Surgical Society had recommended postponing elective surgical procedures. Along with the growing public fear of COVID-19, hospital visits in Japan decreased.

Methods

Using claims data from the Quality Indicator/Improvement Project (QIP) database, this study aimed to clarify the impact of the first wave of the pandemic, considered to be from March to May 2020, on case volume and claimed hospital charges in acute care hospitals during this period. To make year-over-year comparisons, we considered cases from July 2018 to June 2020.

Results

A total of 2,739,878 inpatient and 53,479,658 outpatient cases from 195 hospitals were included. In the year-over-year comparisons, total claimed hospital charges decreased in April, May, June 2020 by 7%, 14%, and 5%, respectively, compared to the same months in 2019. Our results also showed that per-case hospital charges increased during this period, possibly to compensate for the reduced case volumes. Regression results indicated that the hospital charges in April and May 2020 decreased by 6.3% for hospitals without COVID-19 patients. For hospitals with COVID-19 patients, there was an additional decrease in proportion with the length of hospital stay of COVID-19 patients including suspected cases. The mean additional decrease per COVID-19 patients was estimated to 5.5 million JPY.

Conclusion

It is suggested that the hospitals treating COVID-19 patients were negatively incentivized.
Effectiveness of technological interventions to improve upper limb motor function in people with stroke in low- and middle-income countries: Protocol for a systematic review and meta-analysis
Authors: Carbajal-Galarza Meiling Milagros , Chinchihualpa-Paredes Nathaly Olga , Abanto-Perez Sergio Alejandro , Lazo-Porras María
Published: November 2020

Introduction

Stroke is one of the main causes of disability in low- and middle-income countries (LMIC), frequently presenting with upper extremity paresis and causing major functional dependence. It requires high dose and intense rehabilitation which implies high economic costs, consequently limiting this therapy in LMIC. There are multiple technological interventions that facilitate rehabilitation either in intensity, adherence and motor evaluation; or enable access to rehabilitation such as robots, games or virtual reality, sensors, electronic devices and tele-rehabilitation. Their efficacy has been mainly evaluated in high-income countries, hence the importance of conducting a systematic review in LMIC settings.

Objectives

To measure the efficacy of technological interventions vs. classical physical rehabilitation in the upper extremity motor function in people who had suffered a first or recurrent episode of stroke in LMIC.

Methods and analysis

This protocol is consistent with the methodology recommended by the PRISMA-P and the Cochrane handbook for systematic reviews of interventions. We propose to do a systematic review and meta-analysis. In order to do so, we will perform an electronic search in PubMed, Global Index Medicus and Physiotherapy Evidence Database. No date range parameters will be used. Randomized controlled trials (RCT) published in English, Spanish, French and Portuguese, with the primary outcome focusing on upper limb motor function, will be included. Two reviewers will screen all retrieved titles, abstracts and full texts, perform the evaluation of the risk of bias and extract all data independently. The risk of bias of the included RCT will be evaluated by the Cochrane Collaboration’s tool. A qualitative synthesis will be provided in text and tables, to summarize the main results of the selected publications.The heterogeneity between studies will be assessed through the I2statistic. If there is sufficient homogeneity across outcomes, a meta-analysis will be considered. The outcomes to be evaluated will be motor functionality of the upper extremity, performance for activities of daily living and quality of life, through measurement scales.

Conclusions

This systematic review will provide evidence regarding the efficacy of multiple technological interventions to improve motor function of upper extremity in individuals with stroke in LMIC. Based on this analysis, we will be able to assess whether these interventions are also effective and feasible in the recovery of functionality after stroke in low- and middle-income countries, and thus offer recommendations in these areas.