bluuebunny/crossref_metadata_2025 huggingface dataset:
Age‐related changes in oral motor‐control strategies during unpredictable load demands in humans
Authors: Almotairy Nabeel , Kumar Abhishek , Welander Nadia , Grigoriadis Anastasios
Published: August 2020

To investigate age‐related changes in oral motor strategies in response to unpredictable load demands. Sixty‐five healthy children (aged 3–17 yr) were divided into five age‐groups based on their dental eruption stages and compared with a group of healthy adults (aged 18–35 yr). Each participant was asked to perform a standardized motor control task involving ‘pulling’ and ‘holding’ a force transducer with the anterior teeth. Different loads were attached to the force transducer in an unpredictable manner. The temporal force profile was divided into two time‐segments (an initial segment and a later segment). The peak force and peak force rate during the initial time‐segment, and the holding force and intra‐trial variability (coefficient of variation) during the later time‐segment, were measured. The results showed no differences in the peak force, peak force rate, holding force, and force variability in children compared with adults. However, the trends in the data evaluated using a segmented regression analysis showed that a breakpoint (abrupt change) consistently occurred in the late‐mixed dentition group (age 9–11 yr) for most of the outcome variables. The results indicate that while the motor control strategies in children appear to be similar to those in adults, there is a shift in the oral motor developmental trend during the late‐mixed dentition stage.
A Qualitative Study to Assess the Content Validity of the 24‐Hour Migraine Quality of Life Questionnaire in Patients with Migraine
Authors: Speck Rebecca M. , Collins Ethan M. , Lombard Louise , Ayer David W.
Published: August 2020

Objective

A concept elicitation, cognitive debriefing, and usability study was undertaken to: (1) explore migraine symptoms and day‐to‐day impacts; (2) determine the comprehensiveness and comprehensibility of the previously developed 24‐Hour Migraine Quality of Life Questionnaire electronic patient‐reported outcome (24‐Hr MQoLQ ePRO) items, and the appropriateness and understanding of the recall period, response options, and instructions; and (3) assess the usability on an electronic hand‐held device.

Methods

Eleven United States English‐speaking people with episodic migraine were recruited to participate in one‐on‐one interviews, which followed methods appropriate for concept elicitation, cognitive debriefing, and usability testing. Interviews were audio‐recorded, transcribed, and analyzed following the constant comparative method.

Results

Participants had a mean age of 42 years, and 8 were female. Through spontaneous mention or probing, all concepts of the 24‐Hr MQoLQ ePRO were endorsed by a majority of the participants. Cognitive interviewing confirmed the 24‐Hr MQoLQ ePRO instructions were clear, meaningful, and important to assess as symptoms and day‐to‐day impacts experienced as a result of migraine. Overall impressions of the ePRO device were overwhelmingly favorable, and the ePRO device was preferred to paper and pencil by all participants. Participant responses regarding the level of headache pain that would be acceptable in order to continue to go about daily activities ranged from 3 to 6, on a scale of 0 to 10, with 0 being “no headache” and 10 being “the worst headache.”

Conclusions

The 24‐Hr MQoLQ ePRO is content‐valid and appropriate for inclusion in future acute treatment for migraine studies designed to measure the symptoms and health‐related quality of life of migraine.
An understanding of spirituality and spiritual care among people from Chinese backgrounds: A grounded theory study
Authors: Niu Yanping , McSherry Wilfred , Partridge Martin
Published: August 2020

Aim

To investigate the meaning of spirituality and spiritual care among people from Chinese backgrounds living in England.

Design

Strauss and Corbin’s grounded theory design was used.

Method

Twenty‐five participants were recruited from Chinese community centres after which data saturation was reached in September 2016. In‐depth interviews in Chinese were carried out. Transcribed digital recordings were translated into English. Data analysis followed the techniques of open coding, axial coding, and selective coding, using NVivo11. Data collection and analysis were conducted simultaneously.

Results

Three themes emerged from the data which provide an understanding of spirituality and spiritual care in the study context: ‘essence and nature of life’, ‘driving forces’, ‘self‐support’.

Conclusion

This study provides an understanding of spirituality and spiritual care from a Chinese cultural perspective. From a Daoist tradition, spirituality is seen as essence and driving force in the human body. From a Confucian viewpoint, it appears that patients saw themselves or the ‘self’ as a supporting resource.

Impact

The knowledge gained from this study has potential to support nurses and healthcare practitioners to identify the spiritual needs of people from Chinese backgrounds and to remove some of the Chinese misconceptions Chinese people hold about spiritual care by explaining what these concepts could mean. It could also improve cultural awareness for student nurses around what constitutes spiritual care. Further research is recommended among the wider community of health and social care workers to explore spirituality and spiritual care among people from Chinese backgrounds living in England.
Associations between sarcopenia and white matter alterations in older adults with diabetes mellitus: A diffusion tensor imaging study
Authors: Tamura Yoshiaki , Shimoji Keigo , Ishikawa Joji , Tachibana Aya , Kodera Remi , Oba Kazuhito , Toyoshima Kenji , Chiba Yuko , Tokumaru Aya M , Araki Atsushi
Published: August 2020

Aims/Introduction

Older adults with diabetes mellitus are susceptible to sarcopenia. Diffusion tensor imaging studies have also shown that patients with diabetes have altered white matter integrity. However, the relationship between these structural changes in white matter and sarcopenia remains poorly understood.

Materials and Methods

The study included 284 older patients (aged ≥65 years) who visited the Tokyo Metropolitan Geriatric Hospital Frailty Clinic. We used diffusion tensor imaging to measure fractional anisotropy (FA) and mean diffusivity (MD) to evaluate changes in white matter integrity. We investigated the associations between sarcopenia, or its diagnostic components, and FA or MD in seven white matter tracts considered to be associated with sarcopenia according to the patients’ diabetes status.

Results

We found significantly low FA or high MD values in the bilateral anterior thalamic radiations (ATR) and right inferior fronto‐occipital fasciculus (IFOF) of patients with Asian Working Group for Sarcopenia 2019‐defined sarcopenia, in all patients and those with diabetes. Using binominal regression analyses, we associated low FA values in the left ATR and right IFOF with sarcopenia in all patients and those with diabetes, after adjusting for age, gender, HbA1c, blood pressure, cognitive function, physical activity, depression, nutritional status, and inflammation.

Conclusions

White matter alterations in left ATR and right IFOF are associated with the prevalence of sarcopenia in patients with diabetes. Specific changes to the left ATR and right IFOF tracts could play critical roles in the occurrence of sarcopenia in patients with diabetes.
Can insurance alter poverty dynamics and reduce the cost of social protection in developing countries?
Authors: Janzen Sarah A. , Carter Michael R. , Ikegami Munenobu
Published: August 2020

This paper develops a dynamic theoretical model to assess the impact of asset insurance on poverty and the cost of social protection in developing countries. We analyze the model under two technological assumptions: a standard, globally concave production technology, and a fixed cost technology that creates a non‐convex production set and admits the possibility of multiple equilibria and a poverty trap. Under both assumptions, the introduction of an asset insurance market reduces poverty and the costs of social protection. Under the non‐convex production set, there is a strong public finance case for insurance premium subsidies that target poor and vulnerable households and bring them into the insurance market. While the challenges of making microinsurance markets work are multiple, this analysis suggests the potential gains to solving these challenges are substantial.
Investigating prescribing errors in the emergency department of a large governmental hospital in Jordan
Authors: Abdel-Qader Derar H , Al Meslamani Ahmad Z , El-Shara' Asma' A , Ismael Najlaa Saadi , Albassam Abdullah , Lewis Penny J , Hamadi Salim , Abbas Hazim Saleem , Al Mazrouei Nadia , Mohamed Ibrahim Osama
Published: August 2020

Background

Although prescribing errors (PEs) are the most common type of medication errors and cause morbidity and mortality, they have been rarely studied.

Objective

The study aimed to investigate PEs incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.

Setting

This study was conducted in the emergency department of the largest governmental hospital in Jordan.

Method

This was a retrospective observational 4-week study. A validated definition of PEs was adopted, and errors were identified by direct observation of all prescriptions. Structured interviews with doctors to assess the causes of errors were conducted within three days of the prescription date; the severity of PEs was rated by a committee.

Main outcome measure

Prescribing errors incidence, types, severity, causes, predictors, pharmacists' interventions accepted by doctors and computer-related errors.

Results

For 1330 patients, 3470 medication orders were recorded. Almost one in five patients had PEs (n = 288, 21.65%), and the total number of medication orders for patients who had errors was 610. The PEs incidence was 12.5% (95% CI 11.4%–3.5% (n = 450/3597)). Analgesics were the most common medications associated with PEs (232/610, 38.03%). The top two types of PEs detected were wrong drug (165/450, 36.6%) and wrong dose (142/450, 31.5%) respectively. Most PEs were clinically significant errors (342/450, 76%). Doctors refused pharmacists' interventions on their orders in 132 (45.8%) prescriptions. The most common cause of errors was poor skills of doctors in electronic prescribing system (266/450, 59%). Predictors of PEs were the following: drug with multiple dosage forms (OR 2.998; 95% CI 1.41–6.34; P = 0.004) and a prescription with polypharmacy (OR 1.685; 95% CI 1.25%–2.26%; P = 0.001).

Conclusion

A national approach for observing, intervening on and correcting PEs is necessary to improve patient safety.
Effects of silymarin supplementation during transition and lactation on reproductive performance, milk composition and haematological parameters in sows
Authors: Jiang XiaoJun , Lin Sen , Lin Yan , Fang ZhengFeng , Xu ShengYu , Feng Bin , Zhuo Yong , Li Jian , Che LianQiang , Jiang XueMei , Wu De
Published: August 2020

Silymarin has been shown to be a multiple‐functional plant extract having antioxidant, hepatoprotective, hypolipidemic, antihypertensive, antidiabetic and anti‐obesity effects. In recent years, the galactagogue effects of silymarin in animals and humans have also been revealed. This research was conducted to test whether dietary inclusion of silymarin during transition and lactation could impact reproductive performance of sows and to explore the underlying mechanisms. From day 108 of gestation to weaning, sows were randomly assigned to receive dietary treatment of silymarin (40 g/day) or not and were designated as control group (CGP, n = 55) or treatment group (TGP, n = 55). The results showed that piglets’ average daily gain and average weaning weight were higher in TGP than CGP sows. In comparison with the CGP sows, the TGP sows had higher serum concentrations of catalase (CAT) on day 18 of lactation and glutathione peroxidase (GSH‐Px) on day 7 of lactation. The TGP sows had lower concentration of TNF‐α on day 7 of lactation and significantly lower concentration of IL‐1β on day 18 of lactation than CGP sows. There was significantly higher serum concentration of PRL on day 7 of lactation in sows consuming silymarin than sows from the CGP group. On day 18 of lactation, the protein and urea contents in milk were significantly increased while the serum urea concentration was significantly decreased in TGP sows. In summary, our results indicate that silymarin supplementation during transition and lactation can increase circulating concentrations of PRL transiently, reduce oxidative stress, increase feed intake and enhance protein metabolism, thereby significantly increasing milk yield of sows and subsequently improving growth performance of their offsprings.
Functional traits: Adaption of ferns in forest
Authors: Jin Dong‐Mei , Zhou Xi‐Le , Schneider Harald , Wei Hong‐Jin , Wei Hong‐Yu , Yan Yue‐Hong
Published: August 2020

Ferns that evolved from 400 million years ago show various functional traits and ecological strategies in extant species, over 80% of which belong to the youngest order Polypodiales. How the functional traits and strategies of ferns have changed during their evolutionary history remains unexplored. Here, we measured functional traits that are sensitive to environmental light and water availability in 345 fern species across fern phylogeny, and reconstructed their evolutionary histories. We found that ferns, mainly Polypodiales, have developed diversified functional traits in response to forest environments. Terrestrial species, especially Thelypteridaceae and Athyriaceae in eupolypods II, since the late Jurassic period, have shown decreased leaf mass per area (LMA) and area‐based leaf nitrogen (Narea), but increased mass‐based leaf nitrogen (Nmass) compared with early‐derived polypods. Epiphytic species, mainly those in Polypodiaceae, have shown reductions in Nmass and individual leaf area (Area) since the late Cretaceous period. The adaption of functional traits of Polypodiales to forest environment may have played a crucial role in fern radiation since the late Jurassic period. Integrative analysis of functional traits, especially numerical ones, may shed new light on plant evolution.
Metal grains in lunar rocks as indicators of igneous and impact processes
Authors: Day James M. D.
Published: August 2020

Anhedral metal grains of >micrometer size occur in many lunar rock types, including mare basalts, magnesian suite rocks (MGS), ferroan anorthosites (FAN), and impact melt rocks and breccias. Some metal grains are inherited from, or modified by, impactors striking the Moon into crustal materials. These grains have high Ni/Co resulting from the addition of chondritic or iron impactors. Metal grains in mare basalts, FAN, and MGS have Ni/Co ranging from >20 to <1, being generally distinct from impactor compositions. Nickel and Co behave as compatible elements in lunar melts, with parental melts having between ~40–50 ppm Co, ~40–60 ppm Ni, and Ni/Co ~1. These compositions suggest a bulk silicate Moon (BSM) with Ni some three times lower than in bulk silicate Earth. Modeling of Ni and Co during fractional crystallization of mafic mare basalt parental melts originating from a BSM source predicts high Ni/Co metals form during early olivine fractionation. The combined effects of pyroxene ± plagioclase crystallization and increasing but variable compatibility of Ni and Co during basaltic melt evolution can explain the generation of low Ni/Co metals in more differentiated mare basalts. High‐Ti mare basalts have metal with low Ni/Co, but the crystallization of ilmenite and armalcoite restricts the range of Ni and Co in metal. Collectively, these results are consistent with metal grains in mare basalts forming solely through endogenous processes. Measurement of metal grains represents a rapid way for determining endogenous (e.g., lunar interior melts) versus exogenous (e.g., impact contamination) processes acting on lunar samples. In turn, the presence of low Ni/Co metal grains in mare basalts supports their origin as uncontaminated partial melts originating from lunar mantle sources that may have experienced loss of Ni to a small lunar core.
Pb‐Pb ages and initial Pb isotopic composition of lunar meteorites: NWA 773 clan, NWA 4734, and Dhofar 287
Authors: Merle R. E. , Nemchin A. A. , Whitehouse M. J. , Snape J. F. , Kenny G. G. , Bellucci J. J. , Connelly J. N. , Bizzarro M.
Published: August 2020

Constraining the duration of magmatic activity on the Moon is essential to understand how the lunar mantle evolved chemically through time. Determining age and initial isotopic compositions of mafic lunar meteorites is a critical step in defining the periods of magmatic activity that occurred during the history of the Moon and to constrain the chemical characteristics of mantle components involved in the sources of the magmas. We have used the in situ Pb‐Pb SIMS technique to investigate eight lunar gabbros and basalts, including six meteorites from the Northwest Africa (NWA) 773 clan (NWA 2727, NWA 2700, NWA 3333, NWA 2977, NWA 773, and NWA 3170), NWA 4734, and Dhofar 287A. These samples have been selected as there is no clear agreement on their age and they are all from the dominant low titanium chemical group. We have obtained ages of 2981 ± 12 Ma for NWA 4734 and 3208 ± 22 Ma for Dhofar 287. For the NWA 773 clan, four samples (the fine‐grained basalt NWA 2727 and the three gabbros NWA 773, NWA 2977, NWA 3170) out of six yielded isochron‐calculated ages that are identical within uncertainties and yielding an average age of 3086 ± 5 Ma. The age obtained for the fine‐grained basalt NWA 2700 is not precise enough for comparison with the other samples. The gabbroic sample NWA 3333 yielded an age of 3038 ± 20 Ma suggesting that two distinct magmatic events may be recorded in the meteorites of the NWA 773 clan. The present study aims to identify and assess all potential issues that are associated with different ways to date lunar rocks using U‐Pb–based methods. To achieve this, we have compared the new ages with the previously published data set. The entire age data set from lunar mafic meteorites was also screened to identify data showing analytical issues and evidence of resetting and terrestrial contamination. The data set combining the ages of mafic lunar meteorites and Apollo rocks suggests pulses of magmatic activity with two distinct phases between 3950 and 3575 Ma and between 3375 and 3075 Ma with the two phases separated by a gap of approximately 200 Ma. The evolution of the Pb initial ratios of the low‐Ti mare basalts between approximately 3400 and 3100 Ma suggests that these rocks were progressively contaminated by a KREEP‐like component.
Associations of coenzyme Q10 with endothelial function in hemodialysis patients
Authors: Gao Jian‐jun , Xu Yong‐xing , Jia Hua‐ping , Zhang Li , Cao Xue‐ying , Zuo Xiao‐wen , Cai Guang‐yan , Chen Xiang‐mei
Published: August 2020

Background

Endothelial dysfunction is common in patients undergoing hemodialysis (HD). However, little is known about the relationship between endothelial dysfunction and coenzyme Q10 (CoQ10) levels in HD patients.

Methods

Eligible HD patients were enrolled in this study according to prespecified inclusion and exclusion criteria. Endothelial function was assessed by brachial artery flow‐mediated dilation (FMD). Plasma CoQ10, serum malondialdehyde (MDA) and 8‐hydroxydeoxyguanosine (8‐OHdG) levels were measured. The potential confounders identified by univariate analyses (P < 0.15) were selected in a stepwise multiple regression model.

Results

In total, 111 HD patients were enrolled in this study. The mean CoQ10 level was 633.53 ± 168.66 ng/mL, and endothelial dysfunction was prevalent (91.0%) using a cut‐off value of 10% FMD. A significant correlation was observed between FMD and plasma CoQ10 level (r = 0.727, P < 0.001). After adjusting for potential parameters, a stepwise multivariate linear regression analysis revealed that CoQ10 level was an independent predictor of FMD (β = 0.018, P < 0.001). When CoQ10 was dichotomized using the median value (639.74 ng/mL), the conclusion remained unchanged (β = 0.584, P < 0.001). Pearson's correlation analyses revealed that plasma CoQ10 level was negatively correlated with MDA (r = −0.48, P < 0.001) and 8‐OHdG (r = −0.43, P < 0.001) levels.

Conclusion

Our data demonstrate that impaired brachial artery FMD was common in HD patients. CoQ10 level was independently associated with FMD, and oxidative stress may constitute a link between CoQ10 level and endothelial dysfunction in these patients.
Chondrodysplasia punctata and neonatal lupus in an infant with positive anti‐RNP and negative anti‐Ro/SSA and –La/SSB antibodies, a case report
Authors: Milliken Michael , Lee Jack , Cipriano Sarah D.
Published: August 2020

Rhizomelic chondrodysplasia punctata is a rare, often fatal disease that shares many clinical dysmorphologic features with the rare often non‐lethal chondrodysplasia punctata due to maternal autoimmune disease. Characteristic findings of both conditions include mid‐face hypoplasia, stippled epiphyses of the vertebrae and long bones, and growth failure. A growing association with anti‐ribonucleoprotein antibodies is emerging amongst patients with chondrodysplasia punctata due to maternal autoimmune disease and also neonatal lupus that have potential important screening implications. We present a unique case of chondrodysplasia punctata with neonatal lupus in the setting of positive anti‐RNP antibodies and negative anti‐Ro/SSA and –La/SSB antibodies born to a mother with mixed connective tissue disease and Raynaud's syndrome.
Between Realism and Relativism: Moral Certainty as a Third Option
Authors: Laves Samuel
Published: August 2020

This paper is an attempt to lay out a meta‐ethical position that is inspired by the framework of Wittgenstein's later philosophy. To achieve this goal, this paper is divided into two parts. First, I explore recent attempts to tie Wittgenstein's epistemology in On Certainty to moral epistemology. I argue that there can be a meaningful parallel drawn between the epistemic certainties discussed in On Certainty and what I consider to be moral certainties. These moral certainties are unjustified fundamental moral attitudes that underlie our moral practices. Then, I show how the debate over moral certainty has branched into two directions. One direction presents the concept of moral certainty as a naturalistic concept. On this reading, moral certainties transcend time and place since they are rooted in our natural tendencies to act or not act in certain ways. The other direction presents moral certainty as a distinctly relativistic concept. On this reading, we have our moral certainties because we belong to communities that agree on these certainties. In the second section, I argue that we have both natural, universal certainties and localized, relative certainties. I also argue that our localized certainties are constrained by non‐moral facts about ourselves and about the world. To make this argument, I rely on Wittgenstein's concept of “general facts of nature.” The result of the paper is a meta‐ethical position that can be located in between moral relativism and moral realism.
Cardiac defense reactivity and cognitive flexibility in high‐ and low‐resilience women
Authors: Otero Julia , Muñoz Miguel A. , Fernández‐Santaella María Carmen , Verdejo‐García Antonio , Sánchez‐Barrera María B.
Published: August 2020

Resilience is a protective health variable that contributes to successful adaptation to stressful experiences. However, in spite of its relevance, few studies have examined the psychophysiological and neuropsychological mechanisms involved in resilience. The present study analyzes, in a sample of 54 young women, the relationships between high‐ and low‐resilience, measured with the Spanish versions of Connor‐Davidson Resilience Scale questionnaire and the Resilience Scale, and two indices of psychophysiological and neuropsychological adaptability, the cardiac defense response (CDR) and cognitive flexibility. The CDR is a specific reaction to an unexpected intense noise characterized by two acceleration‐deceleration heart rate components. Cognitive flexibility, defined as the ability to adapt our behavior to changing environmental demands, is measured in this study with the CAMBIOS neuropsychological test. The results showed that the more resilient people, in addition to having better scores on mental health questionnaires, had a larger initial acceleration‐deceleration of the CDR‐indicative of greater vagal control, obtained better scores in cognitive flexibility, and evaluated the intense noise as less unpleasant than the less resilient people. No group differences were found in the second acceleration‐deceleration of the CDR‐indicative of sympathetic cardiac control, in the skin conductance response, or in subjective intensity of the noise. The present findings broaden the understanding of how resilient people change their adaptable responses to address environmental demands.
Efficacy of stent‐graft placement to salvage central vein stents with recalcitrant restenosis in patients with arteriovenous fistulas
Authors: Gong Maofeng , Zhou Yangyi , Zhao Boxiang , Kong Jie , He Xu
Published: August 2020

The purpose of this study was to determine the effectiveness and permanency of stent‐graft placement to salvage stents with recalcitrant restenosis due to central vein stenosis (CVS). Between May 2014 and February 2016, VIABAHN stent‐grafts were deployed in patients with functioning arteriovenous (AV) fistulas who underwent previous bare metal stent (BMS) placement and had recalcitrant stent restenosis that did not respond to percutaneous transluminal angioplasty (PTA). Surveillance was carried out at 3, 6, 12, 18, and 24 months with diagnostic fistulography. Fourteen patients initially underwent 15 BMS placements. In the follow‐up period (range, 118‐976 days), patients presented with symptomatic venous hypertension; subsequently, a total of 52 unsuccessful repeat PTAs for BMS restenosis were undertaken, and the median primary access survival of PTAs was 66 ± 43 days. For salvage, 14 stent‐grafts were placed in segments with recalcitrant restenosis of a CVS stent. Within 1.25 ± 0.72 days after stent‐graft placement, patients who initially presented with symptomatic venous hypertension reported complete resolution. The median primary access survival (mean, 1183 ± 312 days) was longer than PTAs alone (P < .01). No major or minor complications were associated with stent‐graft deployment or any of the subsequent interventions in the study period. The primary patency rate at 6, 12, and 18 months was 100%, and it was 85.7% at 24 months. The secondary access patency rate was 92.9% at 24 months. In conclusion, stent‐graft placement to salvage CVS stents with recalcitrant restenosis in patients with AV fistulas is safe and effective if PTAs fails to maintain luminal patency.
Parenting and children’s negative emotionality, self‐regulation, and academic skills: The moderating role of fathers’ residency
Authors: Han Seunghee , Palermo Francisco , Ispa Jean M. , Carlo Gustavo
Published: August 2020

We examined whether fathers’ residency modified the associations among mothers’ supportiveness, father involvement, children’s negative emotionality during toddlerhood and children’s academic skills in pre‐kindergarten via children’s self‐regulation. Participants were 2,291 mothers (Mage = 23.24 years) and children (Mage = 14.99 months at Wave 1; 50.7% girls) in the Early Head Start Research and Evaluation Project. Results revealed distinctive associations by fathers’ residency: self‐regulation mediated the association between mothers’ supportiveness and academic skills only in resident‐father‐families. Self‐regulation mediated the association between negative emotionality and academic skills only in nonresident‐father‐families. The findings highlight the family processes of mothers, fathers, and children in low‐income family contexts that contribute to children’s academic skills, and how those family processes may vary by fathers’ residency status.
Rapid establishment of a COVID‐19 convalescent plasma program in a regional health care delivery network
Authors: Blackall Douglas , Wulff Shephali , Roettger Timothy , Jacobs Lauren , Lacasse Alexandre , Patri Manokiran , Zinser Phillip , Pherez Francisco , Jamkhana Zafar , Frey Sharon E. , Smith Linda , Goel Ruchika , Katz Louis
Published: August 2020

Background

COVID‐19 convalescent plasma (CCP) represents an appealing approach to the treatment of patients with infections due to SARS‐CoV‐2. We endeavored to quickly establish a sustainable CCP transfusion program for a regional network of health care facilities.

Study design and methods

A regional collaborative group was activated to address the issues necessary to implementing a CCP transfusion program and making the program sustainable. A wide range of health care providers including physicians (critical care, infectious disease, transfusion medicine), nurses, pharmacists, laboratorians, and information technology (IT) specialists were required to make the program a success.

Results

The CCP implementation team initially consisted of four members but quickly grew to a group of nearly 20 participants based on different issues related to program implementation. Overall, six major implementation “themes” were addressed: (a) registration of individual hospitals and principal investigators with a national investigational new drug research protocol; (b) collaboration with a regional blood donor center; (c) targeted recruitment of convalesced donors; (d) IT issues related to all aspects of CCP ordering, distribution, and transfusion; (e) prioritization of patients to receive CCP; and (f) evaluation of CCP products including antibody characteristics and patient response to therapy.

Conclusion

Within 4 weeks of initiation, CCP was successfully transfused at multiple hospitals in our regional health care delivery system. A program infrastructure was established that will make this program sustainable into the future. This approach has broader implications for the success of multi‐institutional programs requiring rapid implementation.
Self-healing ceramic coatings that operate in extreme environments: A review
Authors: Aouadi Samir M. , Gu Jingjing , Berman Diana
Published: August 2020

This paper provides an overview of the latest research developments in the design and exploration of ceramic coatings with high temperature adaptive behavior. The adaptive behavior, triggered by thermal or thermomechanical stimulus, may be used to create smart surfaces that are able to change their chemistry and structure to achieve the desired functionality. The initial focus of the paper will be to provide an overview on the basics of self-repairing materials. This will be followed by a brief outline of the work that has been reported on self-healing/adaptive mechanisms in bulk ceramics. We will then focus on providing a thorough review on self-healing ceramics with a focus on adaptation/healing in tribology as well as thermal barrier, anticorrosion, and oxidation resistant coatings. Advantages and disadvantages of using hybrid polymer-ceramic coatings will also be discussed toward the end of the article. This overview will provide a fundamental understanding of the changes in the structural and chemical properties of these materials and how that correlates to their performance. This review also includes a discussion on anticipated future developments in this important and upcoming area of research.
Physical synthesis of six-string guitar plucks using the Udwadia-Kalaba modal formulation
Authors: Debut V. , Antunes J.
Published: August 2020

Extending the previous work done by the authors, this paper develops a time domain synthesis method for the classical guitar based on substructuring concepts and using the Udwadia-Kalaba modeling strategy. Adopting a modal description of the dynamics of the separate flexible subsystems in terms of their unconstrained modes and enforcing coupling constraint conditions for the assembly, the result is an explicit dynamical modal formulation for the coupled system that directly lends itself to time-stepping methods for simulation. The guitar model couples six strings through an experimentally based body model of an actual instrument, includes two string polarizations, and the string geometrical nonlinear effects, as well as the string/fret interaction as the instrument is played. Details are given for putting all the vibrating components together in a satisfying manner, and a specific strategy is explored to allow for a nonrigid fret using flexible-dissipative-inertial constraints. The reliability of the approach is demonstrated with simulation examples that confirm the features one would expect regarding the dynamical behavior of classical guitars. Finally, a pragmatic approach is made to calculate the radiated sound by convolution, combining the computed bridge force with a measured vibro-acoustic impulse response of the instrument, which proved to give satisfactory sounding results.
Latency-dependent filtering and compact representation of the complete auditory pathway response
Authors: de la Torre Angel , Valderrama Joaquin T. , Segura Jose C. , Alvarez Isaac M.
Published: August 2020

Auditory evoked potentials (AEPs) include the auditory brainstem response (ABR), middle latency response (MLR), and cortical auditory evoked potentials (CAEPs), each one covering a specific latency range and frequency band. For this reason, ABR, MLR, and CAEP are usually recorded separately using different protocols. This article proposes a procedure providing a latency-dependent filtering and down-sampling of the AEP responses. This way, each AEP component is appropriately filtered, according to its latency, and the complete auditory pathway response is conveniently represented (with the minimum number of samples, i.e., without unnecessary redundancies). The compact representation of the complete response facilitates a comprehensive analysis of the evoked potentials (keeping the natural continuity related to the neural activity transmission along the auditory pathway), which provides a new perspective in the design and analysis of AEP experiments. Additionally, the proposed compact representation reduces the storage or transmission requirements when large databases are manipulated for clinical or research purposes. The analysis of the AEP responses shows that a compact representation with 40 samples/decade (around 120 samples) is enough for accurately representing the response of the complete auditory pathway and provides appropriate latency-dependent filtering. MatLab/Octave code implementing the proposed procedure is included in the supplementary materials.
Interaction of prosody and syntax-semantics in Mandarin wh-indeterminates
Authors: Hsu Yu-Yin , Xu Anqi
Published: August 2020

This paper reports on two speech-production experiments focused on Putonghua and Taiwan Mandarin sentence-final particles and wh-phrases that have interrogative or indefinite readings in three contexts: yes/no questions, wh-questions, and statements. Sentence-final particles were found to influence focus-prosody through right-edge shortening and lowering of F0 and intensity of wh-phrases, thus distinguishing wh-interrogatives from indefinites and questions from statements. Speakers adopt multidimensional acoustic strategies to shape intonation: while maintaining the lexical tones, prosody interacts with the organization imposed by syntax, semantics, and focus. The two varieties of Mandarin differ in the extent to which their prosodic differences represent such syntactic-semantic information.
Differential orthogonal frequency division multiplexing communication in water pipeline channels
Authors: Jing Liwen , Wang Mengdan , Lu Yu , Stojanovic Milica , Murch Ross
Published: August 2020

The problem of information transmission through water pipelines is addressed and a class of methods based on differentially encoded orthogonal frequency division multiplexing (OFDM) is proposed. Specifically, two methods are investigated; one based on conventional differential encoding with an estimation of the average time of arrival and another based on double encoding. Results show that the first approach improves performance in the low signal to noise ratio (SNR) region, while the second is better suited at high SNR. Adopting these techniques closes the performance gap between differential OFDM systems and coherent OFDM systems while retaining the benefits of computational simplicity.
Teaching-learning-based optimization of a composite metastructure in the 0–10 kHz broadband sound absorption range
Authors: Gao Nansha , Luo Dongdong , Cheng Baozhu , Hou Hong
Published: August 2020

This paper proposes a strategy to broaden the sound absorption region of porous materials by embedding ribs. The theoretical solution and the numerical simulations of the optimization model show that the composite metastructure exhibits ultra-wide high absorption characteristics and an average sound absorption coefficient of 0.937 in the 0–10 kHz range upon its teaching-learning-based optimization. High sound pressures are present only among the embedded ribs. A significant slowing down of the sound takes place inside the metastructure. The impedance tube test confirms the design of the broadband sound absorption region in agreement with the teaching-learning-based optimization method.
Investigation of a directional warning sound system for electric vehicles based on structural vibration
Authors: Kournoutos Nikolaos , Cheer Jordan
Published: August 2020

Warning sound systems for electric vehicles with advanced beamforming capabilities have been investigated in the past. Despite showing promising performance, such technologies have yet to be adopted by the industry, as implementation costs are generally too high and the components too fragile for implementation. A lower cost solution with higher durability could be achieved by using an array of inertial actuators instead of loudspeakers. These actuators can be attached directly to the body of the vehicle and thus require minimal design modifications. A directional sound field can then be radiated by controlling the vibration of the panel via adjustments to the relative magnitude and phase of the signals driving the array. This paper presents an experimental investigation of an inertial actuator-based warning sound system. A vehicle placed in a semi-anechoic environment is used to investigate different array configurations in terms of the resulting sound field directivity and the leakage of sound into the cabin. Results indicate that the most efficient configuration investigated has the actuators attached to the front bumper of the vehicle. Using this arrangement, real-time measurements for different beamformer settings are performed to obtain a thorough picture of the performance of the system across frequency and steering angle.
The collagen receptor glycoprotein VI promotes platelet-mediated aggregation of β-amyloid
Authors: Donner Lili , Toska Laura Mara , Krüger Irena , Gröniger Sandra , Barroso Ruben , Burleigh Alice , Mezzano Diego , Pfeiler Susanne , Kelm Malte , Gerdes Norbert , Watson Steve P. , Sun Yi , Elvers Margitta
Published: August 2020

Multiple receptors on platelets drive Alzheimer’s disease–associated amyloid deposits in brain vessels.
Afabicin, a First-in-Class Antistaphylococcal Antibiotic, in the Treatment of Acute Bacterial Skin and Skin Structure Infections: Clinical Noninferiority to Vancomycin/Linezolid
Authors: Wittke Frederick , Vincent Catherine , Chen James , Heller Barry , Kabler Heidi , Overcash J. Scott , Leylavergne François , Dieppois Guennaëlle
Published: August 2020

Afabicin (formerly Debio 1450, AFN-1720) is a prodrug of afabicin desphosphono, an enoyl-acyl carrier protein reductase (FabI) inhibitor, and is a first-in-class antibiotic with a novel mode of action to specifically target fatty acid synthesis in
Staphylococcus
spp. The efficacy, safety, and tolerability of afabicin were compared with those of vancomycin/linezolid in the treatment of acute bacterial skin and skin structure infections (ABSSSI) due to staphylococci in this multicenter, parallel-group, double-blind, and double-dummy phase 2 study.
A Calcium Sensor Discovered in Bluetongue Virus Nonstructural Protein 2 Is Critical for Virus Replication
Authors: Rahman Shah Kamranur , Kerviel Adeline , Mohl Bjorn-Patrick , He Yao , Zhou Z. Hong , Roy Polly
Published: August 2020

After entering the host cells, viruses use cellular host factors to ensure a successful virus replication process. For replication in infected cells, members of theReoviridaefamily form inclusion body-like structures known as viral inclusion bodies (VIB) or viral factories. Bluetongue virus (BTV) forms VIBs in infected cells through nonstructural protein 2 (NS2), a phosphoprotein. An important regulatory factor critical for VIB formation is phosphorylation of NS2. In our study, we discovered a characteristic calcium-binding EF-hand-like motif in NS2 and found that the calcium binding preferentially affects phosphorylation level of the NS2 and has a role in regulating VIB assembly.
F Plasmids Are the Major Carriers of Antibiotic Resistance Genes in Human-Associated Commensal Escherichia coli
Authors: Stephens Craig , Arismendi Tyler , Wright Megan , Hartman Austin , Gonzalez Andres , Gill Matthew , Pandori Mark , Hess David
Published: August 2020

Rising antibiotic resistance in human-associated bacterial pathogens is a serious threat to our ability to treat many infectious diseases. It is critical to understand how acquired resistance genes move in and through bacteria associated with humans, particularly for species such as
Escherichia coli
that are very common in the human gut but can also be dangerous pathogens. This work combined two distinct DNA sequencing approaches to allow us to explore the genomes of
E. coli
from college students to show that the antibiotic resistance genes these bacteria have acquired are usually carried on a specific type of plasmid that is naturally transferrable to other
E. coli
, and likely to other related bacteria.
COVID-19 associated with extensive pulmonary arterial, intracardiac and peripheral arterial thrombosis
Authors: Ferguson Katie , Quail Nathaniel , Kewin Peter , Blyth Kevin G
Published: August 2020

We describe a patient with COVID-19 who developed simultaneous pulmonary, intracardiac and peripheral arterial thrombosis. A 58-year-old man, without major comorbidity, was admitted with a 14-day history of breathlessness. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was confirmed by laboratory testing. Initial imaging revealed COVID-19 pneumonia but no pulmonary thromboembolism (PTE) on CT pulmonary angiography (CTPA). The patient subsequently developed respiratory failure and left foot ischaemia associated with a rising D-dimer. Repeat CTPA and lower limb CT angiography revealed simultaneous bilateral PTE, biventricular cardiac thrombi and bilateral lower limb arterial occlusions. This case highlights a broad range of vascular sequalae associated with COVID-19 and the fact that these can occur despite a combination of prophylactic and treatment dose anticoagulation.
Hit or miss: the new cholesterol targets
Authors: DuBroff Robert , Malhotra Aseem , de Lorgeril Michel
Published: August 2020

Drug treatment to reduce cholesterol to new target levels is now recommended in four moderate- to high-risk patient populations: patients who have already sustained a cardiovascular event, adult diabetic patients, individuals with low density lipoprotein cholesterol levels ≥190 mg/dL and individuals with an estimated 10-year cardiovascular risk ≥7.5%. Achieving these cholesterol target levels did not confer any additional benefit in a review of 35 randomised controlled trials. Recommending cholesterol lowering treatment based on estimated cardiovascular risk fails to identify many high-risk patients and may lead to unnecessary treatment of low-risk individuals. The negative results of numerous cholesterol lowering randomised controlled trials call into question the validity of using low density lipoprotein cholesterol as a surrogate target for the prevention of cardiovascular disease.
Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study
Authors: Raffel Katie E , Kantor Molly A , Barish Peter , Esmaili Armond , Lim Hana , Xue Feifei , Ranji Sumant R
Published: August 2020

Background

The prevalence and aetiology of diagnostic error among hospitalised adults is unknown, though likely contributes to patient morbidity and mortality. We aim to identify and characterise the prevalence and types of diagnostic error among patients readmitted within 7 days of hospital discharge.

Methods

Retrospective cohort study at a single urban academic hospital examining adult patients discharged from the medical service and readmitted to the same hospital within 7 days between January and December 2018. The primary outcome was diagnostic error presence, identified through two-physician adjudication using validated tools. Secondary outcomes included severity of error impact and characterisation of diagnostic process failures contributing to error.

Results

There were 391 cases of unplanned 7-day readmission (5.2% of 7507 discharges), of which 376 (96.2%) were reviewed. Twenty-one (5.6%) admissions were found to contain at least one diagnostic error during the index admission. The most common problem areas in the diagnostic process included failure to order needed test(s) (n=11, 52.4%), erroneous clinician interpretation of test(s) (n=10, 47.6%) and failure to consider the correct diagnosis (n=8, 38.1%). Nineteen (90.5%) of the diagnostic errors resulted in moderate clinical impact, primarily due to short-term morbidity or contribution to the readmission.

Conclusion

The prevalence of diagnostic error among 7-day medical readmissions was 5.6%. The most common drivers of diagnostic error were related to clinician diagnostic reasoning. Efforts to reduce diagnostic error should include strategies to augment diagnostic reasoning and improve clinician decision-making around diagnostic studies.