bluuebunny/crossref_metadata_2025 huggingface dataset:
The numerical probability of carcinogenicity to humans of some pharmaceutical drugs: Alkylating agents, topoisomerase inhibitors or poisons, and DNA intercalators
Authors: Suarez‐Torres Jose D. , Orozco Camilo A. , Ciangherotti Carlos E.
Published: March 2021

The nonclinical branch of regulatory pharmacology has traditionally relied on the sensitivity and specificity of regulatorily recommended bioassays. Nonetheless, any predictive testing (eg, safety pharmacology) with less than 100% sensitivity or 100% specificity is prone to deliver false positive or negative results (namely, outcomes discordant to the clinical gold standard). It was recently suggested that the statistics‐based and regulatory pertinent “predictive values approach” (PVA) might help to reach a more predictive use of preclinical testing data. To resolve the associated probability of carcinogenicity to humans, the PVA was applied to 37 pharmaceuticals bearing inadequate epidemiological evidence of carcinogenicity, but identifiable as unequivocal mutagens. According to current knowledge, a 98.9% (or more) probability of carcinogenicity to humans was reckoned for those 37 genotoxic drugs. Accordingly, these pharmaceutical drugs might be either scientifically or regulatorily regarded as “carcinogenic to humans.” In the USA, European Union, or Canada as examples, the great majority of these 37 pharmaceuticals are authorized for medical use in humans. From the results of the present appraisal, the following is suggested (1) for the pharmaceuticals listed in this report, to include significant carcinogenicity warnings in their prescribing information; (2) to conduct pharmacoepidemiology studies or risk‐benefit analyses (if warranted), and (3) based on the respective risk‐benefit analyses, to re‐evaluate the authorization of hydralazine and phenoxybenzamine as antihypertensives, oxcarbazepine as an anticonvulsant, and phenazopyridine as a urinary tract antimicrobial or analgesic. For the four latter drugs (eg, phenoxybenzamine), a 99.5% probability of carcinogenicity to humans was estimated.
Results of a randomized phase III/IV trial comparing intermittent bolus versus continuous infusion of antihaemophilic factor (recombinant) in adults with severe or moderately severe haemophilia A undergoing major orthopaedic surgery
Authors: Pabinger Ingrid , Mamonov Vasily , Windyga Jerzy , Engl Werner , Doralt Jennifer , Tangada Srilatha , Spotts Gerald , Ewenstein Bruce
Published: March 2021

Introduction

In patients with haemophilia A undergoing surgery, factor VIII (FVIII) replacement therapy by continuous infusion (CI) may offer an alternative to bolus infusion (BI).

Aim

To compare the perioperative haemostatic efficacy and safety of antihaemophilic factor (recombinant) (ADVATE®; Baxalta US Inc., a Takeda company, Lexington, MA, USA) CI or BI administration.

Methods

In this multicentre, phase III/IV, controlled study (NCT00357656), 60 previously treated adult patients with severe or moderately severe disease undergoing elective unilateral major orthopaedic surgery (knee replacement, n = 48; hip surgery, n = 4; other, n = 8) requiring drain placement were randomized to receive antihaemophilic factor (recombinant) CI (n = 29) or BI (n = 31) through postoperative day 7. Primary outcome measure was cumulative packed red blood cell (PRBC)/blood volume in the drainage fluid within 24 h after surgery, used to establish non‐inferiority of CI to BI.

Results

CI:BI ratio of cumulative PRBC volume in the 24‐h drainage fluid was 0.92 (p‐value <.001 for non‐inferiority; 95% confidence interval, 0.82–1.05). Total antihaemophilic factor (recombinant) dose per kg body weight received in the combined trans‐ and postoperative periods was similar with CI and BI to maintain targeted FVIII levels during/after surgery. Treatment‐related adverse events (AEs) were reported in five patients treated by CI (eight events) and five treated by BI (six events), including two serious AEs in each arm.

Conclusion

CI administration of antihaemophilic factor (recombinant) is a viable alternative to BI in patients with haemophilia A undergoing major orthopaedic surgery, providing comparable efficacy and safety.
Clinical impact of the finger‐circle test in patients with liver diseases
Authors: Nishikawa Hiroki , Yoh Kazunori , Enomoto Hirayuki , Nishimura Takashi , Nishiguchi Shuhei , Iijima Hiroko
Published: March 2021

Aim

To elucidate the relationship between the finger‐circle test (Yubi‐wakka [in Japanese] test; three levels of bigger, just‐fits, and smaller) and sarcopenia‐related factors and anthropometric parameters in patients with chronic liver disease (n = 202, 99 men, mean age 61 years).

Methods

Patients with both grip strength decline (<26 kg for men and <18 kg for women) and skeletal muscle index (SMI) decline (<7.0 kg/m2 in men and <5.7 kg/m2 in female) were diagnosed as sarcopenia.

Results

Liver cirrhosis was found in 56 patients (27.7%). The proportions of bigger, just‐fits, and smaller in liver cirrhosis versus non‐liver cirrhosis patients were 51.8%, 21.4%, and 26.8% versus 77.4%, 11.4%, and 8.2% (p < 0.01). The proportions of grip strength decline in patients with bigger, just‐fits, and smaller were 12.0% (77/142), 21.2% (7/33), and 40.7% (11/27; overall p < 0.01). The proportions of SMI decline in patients with bigger, just‐fits, and smaller were 9.9% (14/142), 45.5% (15/33), and 77.8% (21/27; overall p < 0.01). The proportions of sarcopenia in patients with bigger, just‐fits, and smaller were 3.5% (5/142), 18.2% (6/33), and 33.3% (9/27; overall p < 0.01). In both sexes, arm circumference, triceps skinfold thickness, calf circumference, and waist circumference were significantly stratified according to the finger‐circle test. In the multivariate analysis, smaller was an independent predictor for SMI decline (p < 0.01, risk ratio 8.188, bigger as a reference), and body mass index was an independent predictor for both SMI decline and sarcopenia.

Conclusion

The finger‐circle test can be helpful for the screening of sarcopenia in chronic liver disease and is closely linked to body composition.
Melanocytic lesions with blue naevus‐like (dendritic) morphology: an update with an emphasis on histopathological, immunophenotypic, and molecular features
Authors: Cho Woo Cheal , Prieto Victor G , Aung Phyu P
Published: March 2021

An accurate diagnosis of melanocytic lesions requires a thorough histopathological evaluation accompanied by appropriate correlation with clinical examination findings. Although most melanocytic lesions can readily be classified as one of the defined diagnostic entities according to well‐established diagnostic criteria, a subset of melanocytic lesions, particularly those with blue naevus‐like (pigmented dendritic) morphology, have notoriously constituted an enduring challenge for pathologists. These lesions are rare and often show histological ambiguities, with features of both benignity and malignancy, thereby making accurate risk assessment and prediction of their biological behaviours difficult on histological grounds alone. Herein, we outline a practical and systematic approach for the diagnosis of melanocytic lesions with dendritic morphology, with a particular focus on histological and immunophenotypic features that help to distinguish one entity from another. In this review, we provide the most current knowledge on these melanocytic lesions in the literature and our experience with these rare entities, and we discuss the utility of molecular techniques as an ancillary tool, especially in histologically ambiguous and/or borderline lesions.
Surface modification of K2TiF6:Mn4+ phosphor with SrF2 coating to enhance water resistance
Authors: Fang Zhiyong , Lai Xiaohui , Zhang Jian , Zhang Rui
Published: March 2021

K2TiF6:Mn4+ is an attractive narrow‐band red‐emitting phosphor for warm white light‐emitting diodes (LEDs). Nevertheless, the hexafluoride phosphor is liable to deliquesce in moist environments, which leads to a sharp deterioration performance of luminescence. Surface modification of K2TiF6:Mn4+ phosphor with SrF2 coating has been introduced, with the aid of KHF2 transition layer to moderate the lattice mismatch. The reaction mechanism is discussed in detail, as so as the influence of SrF2 coating on the luminescence intensity. The SrF2 coating is able to prevent the hydrolysis of internal [MnF6]2− group; thereby, the luminescence intensity retains over 90% of initial value after being immersed in distilled water for 2 h. The LED devices fabricated with commercial Y3Al5O12:Ce3+ and as‐modified K2TiF6:Mn4+ phosphors exhibit bright white light with tunable chromaticity coordinate, correlated color temperature, and color rendering index. It enlightens a convenient method to enhance the moisture resistance of Mn4+ doped fluoride phosphors for commercial application in the field of white LEDs.
Preparation and strengthening mechanism of prestressed ceramic tile components
Authors: Sun Yi , Wu Tianye , Bao Yiwang , Li Yueming , Wan Detian , Li Kai , He Lingfeng
Published: March 2021

To improve the flexural strength of ceramic tiles, a surface strengthening method is presented in this work. By cofiring coating and substrate, residual compressive stress is introduced in the coating. The phase composition and morphological characteristics of coating materials and the influences of coefficient of thermal expansion (CTE) and coating thickness on the flexural strength have been investigated. The prestressed ceramic tile is prepared by pressureless sintering a green body coated with a low CTE coating at 1200°C. The CTE of green body and optimal coating is 7.85 × 10−6°C−1 and 5.69 × 10−6°C−1, respectively. The flexural strength of prestressed porcelain tiles (89 ± 3 MP) has been increased by 102% when the coating thickness is 67 µm compared to their uncoated counterpart (44 ± 3 MPa). This simple surface strengthening method of ceramic tiles is cost‐efficient and economical for large‐scale industrial applications.
Influence of polyacrylic acid (PAA)/Na2HPO4 mixture on biphasic calcium phosphate cement: Enhancing strength and cell viability
Authors: Thaitalay Paritat , Thongsri Oranich , Dangviriyakul Rawee , Srisuwan Sawitri , Talabnin Chutima , Suksaweang Sanong , Srakaew Nuan La‐ong , Rattanachan Sirirat Tubsungnoen
Published: March 2021

This study has investigated the effect of combination of new liquid phase mixture of disodium hydrogen phosphate (Na2HPO4) and polyacrylic acid (PAA) on the compressive strength, setting time, bioactivity, and cytotoxicity of biphasic calcium phosphate cement. The PAA was known as one of water‐soluble and biocompatible polymers to improve the mechanical performances of the bone cement, but it usually inhibits the phase conversion to hydroxyapatite after the cement has already set. The aim of this work was to evaluate the incorporation of the mixture of PAA and Na2HPO4 into biphasic cement. We have found the crucial concentration for adding PAA/Na2HPO4 at 30:70 v/v% to enhance the mechanical strength, cell viability, and maintain bioactivity. The phase composition and crosslinking reaction between PAA and alpha‐tricalcium phosphate (α‐TCP) powder were detected by XRD and FTIR techniques. The beta‐tricalcium phosphate (β‐TCP) was added in the formula to achieve the biphasic cement, which composed of β‐TCP and apatite/calcium deficient‐hydroxyapatite (CD‐HA) in the final product. The biphasic granule commercial product was used as comparison in the cell viability test. This work had been confirmed that the cement was a nontoxic material. Therefore, our results suggest that the PAA/Na2HPO4 could be beneficial for further clinical applications.
The impact of parent and child media use on early parent–infant attachment
Authors: Linder Lisa K. , McDaniel Brandon T. , Stockdale Laura , Coyne Sarah M.
Published: March 2021

With the rise in affordability of digital media and mobile devices, children under age 2 on average spend significantly more time with digital media than is recommended. Although concerns have been expressed about how parent and child media use might negatively impact parent–child attachment, there continues to be a scarcity of research on the topic. The current study assessed both the amount and the way in which children (11–26 months) and their parents engage with digital media and the impact on early attachment after controlling for temperament, parent income, parent age, marital status, and access to support. The study utilizes data from a diverse sample: 248 parents of infants completed an attachment q‐sort and surveys assessing the amount of media use, parental absorption in media, types of parental mediation, temperament, and demographics. Results showed that for both parent and child, time using digital media and co‐viewing was not predictive of attachment insecurity. Parental absorption in media was found to significantly predict attachment insecurity. Greater child TV media use was associated with poorer attachment security when there was limited to no parental active mediation. Active mediation served as a protective factor for attachment while parental absorption in media serves as a risk factor for attachment.
A mixed methods study of seasonal influenza vaccine hesitancy in adults with chronic respiratory conditions
Authors: Williams Lynn , Deakin Karen , Gallant Allyson , Rasmussen Susan , Young David , Cogan Nicola
Published: March 2021

Background

Seasonal influenza vaccination is recommended for patients with chronic respiratory conditions, but uptake is suboptimal. We undertook a comprehensive mixed methods study in order to examine the barriers and enablers to influenza vaccination in patients with chronic respiratory conditions.

Methods

Mixed methods including a survey (n = 429) which assessed sociodemographics and the psychological factors associated with vaccine uptake (ie confidence, complacency, constraints, calculation and collective responsibility) with binary logistic regression analysis. We also undertook focus groups and interviews (n = 59) to further explore barriers and enablers to uptake using thematic analysis.

Results

The survey analysis identified that older participants were more likely to accept the vaccine, as were those with higher perceptions of collective responsibility around vaccination, lower levels of complacency and lower levels of constraints. Thematic analysis showed that concerns over vaccine side effects, lack of tailored information and knowledge, and a lack of trust and rapport with healthcare professionals were key barriers. In contrast, the importance of feeling protected, acceptance of being part of an at‐risk group and feeling a reduced sense of vulnerability after vaccination were seen as key enablers.

Conclusions

Our findings showed that the decision to accept a vaccine against influenza is influenced by multiple sociodemographic and psychological factors. Future interventions should provide clear and transparent information about side effects and be tailored to patients with chronic respiratory conditions. Interactions between patients and their healthcare providers have a particularly important role to play in helping patients address their concerns and feel confident in vaccination.
A new silver dressing, StopBac, used in the prevention of surgical site infections
Authors: Oliverius Martin , Drozd Jan , Bratka Petr , Whitley Adam , Mohlenikova Duchonova Beatrice , Gürlich Robert
Published: March 2021

Ideal dressings of surgical wounds should provide moist, semi‐permeable, and antiseptic environments for optimal wound healing. To maximise patient comfort, surgical dressings must be hypoallergenic, not restrict movement, and allow patients to manage their personal hygiene. From the aspect of health care personnel, dressings should enable visual monitoring of the wound without the need for removing them, thus reducing the number of dressing changes. The active antimicrobial effect of silver cations has been demonstrated by many studies. StopBac is a unique surgical dressing based on the sol‐gel process. Silver cations are bound in a colloidal solution in an organic‐inorganic hybrid organosilicate oligomer. This gel is deposited on a pad using spray atomisation. The result is a polymer nanolayer matrix with prolonged and controlled release of silver ions. This pad forms part of a waterproof hypoallergenic transparent adhesive bandage. The goal of this study was to prospectively evaluate the ability of StopBac to prevent surgical site infections (SSIs) in patients after abdominal surgery. The secondary goal was to compare costs and determine the properties of this new material. A total of 32 patients were included in the study. The patients were followed up until their surgical wounds healed completely. An SSI occurred only in one patient.
Chemical products for crop protection against freezing stress: A review
Authors: Román‐Figueroa Celián , Bravo León , Paneque Manuel , Navia Rodrigo , Cea Mara
Published: March 2021

Frost is an important abiotic stress for plants and crops because of the economic losses that are incurred. Plants have two mechanisms for freezing protection: freezing avoidance and freezing tolerance. The former prevents extrinsic and/or intrinsic ice nucleation, while the latter provides plants with tools to survive apoplastic ice formation, by several coordinated physiological and biochemical features such as the increase in cryoprotectants (metabolites and proteins) which in general maintain cell membrane and cells macromolecules stability, cause a freezing point depression or decrease the cell osmolarity preventing the severe cell dehydration caused by apoplastic freezing. Many products against freezing have been developed, and there are at least 20 products on the international market. Ten products mainly avoid ice formation by forming semi‐permeable or permeable membranes that inhibit extrinsic ice nucleation over leaves, three products work for favouring tolerating ice formation in plants, and two use both mechanisms of action. Some kind of lipids, such as phospholipids and α‐tocopherol, effectively maintain the stability and integrity of cell membranes, while some osmolytes (mainly polyols) decrease the freezing point of water, both inside and outside the cell, but also can interact with the polar moieties of phospholipids stabilizing membranes. Despite this, more information on products for crop protection against freezing is required in order to determine their effectiveness. New formulations that protect crops against freezing must include ingredients that employ both mechanisms. The use of lipids is likely to continue while new alternatives that reduce ice formation are evaluated, among which antifreeze and cryoprotective proteins may offer attractive alternatives.
Nanoindentation pop‐in in oxides at room temperature: Dislocation activation or crack formation?
Authors: Fang Xufei , Bishara Hanna , Ding Kuan , Tsybenko Hanna , Porz Lukas , Höfling Marion , Bruder Enrico , Li Yingwei , Dehm Gerhard , Durst Karsten
Published: March 2021

Most oxide ceramics are known to be brittle macroscopically at room temperature with little or no dislocation‐based plasticity prior to crack propagation. Here, we demonstrate the size‐dependent brittle to ductile transition in SrTiO3 at room temperature using nanoindentation pop‐in events visible as a sudden increase in displacement at nominally constant load. We identify that the indentation pop‐in event in SrTiO3 at room temperature, below a critical indenter tip radius, is dominated by dislocation‐mediated plasticity. When the tip radius increases to a critical size, concurrent dislocation activation and crack formation, with the latter being the dominating process, occur during the pop‐in event. Beyond the experimental examination and theoretical justification presented on SrTiO3 as a model system, further validation on α‐Al2O3, BaTiO3, and TiO2 are briefly presented and discussed. A new indentation size effect, mainly for brittle ceramics, is suggested by the competition between the dislocation‐based plasticity and crack formation at small scale. Our finding complements the deformation mechanism in the nano‐/microscale deformation regime involving plasticity and cracking in ceramics at room temperature to pave the road for dislocation‐based mechanics and functionalities study in these materials.
Eu2+‐doped oxyfluoride glass‐ceramic with nepheline as an efficient 400 nm UV‐LED color converter
Authors: Lee Hansol , Chung Woon Jin
Published: March 2021

SiO2‐Na2O‐Al2O3‐LaF3 glass‐ceramics doped with Eu2+ were synthesized as an efficient inorganic color converter for 400 nm UV‐LED. When Eu2+ formed within the glass matrix, the obtained glass showed cyan emission under 400 nm excitation, but its emission peak drastically shifted to greenish yellow upon heat treatment. With heat treatment the glass‐ceramic also showed highly increased emission intensity, and the color coordinate of the glass‐ceramic shifted to yellow. When it was mounted on top of a 400 nm UV‐LED, it demonstrated high color conversion efficiency and practical feasibility as an UV‐LED color converter. To vary the color coordination the heat‐treatment conditions and the thickness of the glass‐ceramic were adjusted. The resulting ceramic showed a high quantum yield of up to 78%, which is comparable to conventional ceramic phosphors. The spectral change in the glass‐ceramic is attributed to the formation of nepheline and LaF3 crystalline phases. X‐ray diffractometer (XRD), transmission electron microscope with energy dispervise spectroscopy (TEM‐EDS) and cathode luminescence (CL) were used to investigate the mechanism of Eu2+‐doped nepheline crystal formation, and its effect on the spectral change with heat treatment.
Significant photostrictive response in lead‐free Bi0.5Na0.5TiO3 ceramics under visible light illumination
Authors: Fang Hanliang , Chen Chen , Zhang Faqiang , Cao Minghe , Yi Zhiguo
Published: March 2021

Photostrictive effect that has been discovered for over half a century is getting renewed interest in recent years in view of the great potential for the wireless remote‐control technology. Compared with lead lanthanum zirconate titanate (PLZT) ferroelectrics that have been intensively studied, Bi0.5Na0.5TiO3 (BNT) ceramics have a more environment‐friendly prospect. In this study, we present a significant photostrictive response for Bi0.5Na0.5TiO3 ceramics under visible light illumination. The ultraviolet–visible diffuse reflectance spectrum indicates that the BNT ceramic is a direct bandgap semiconductor (Eg = 2.93 eV) with a long tail absorbance till wavelength ~560 nm. Transmission electron microscopy analysis reveals nanoscale domains and fluctuated local structure in BNT ceramics. A significant photostriction ΔL/L about 0.08% was observed for BNT when irradiated by 405‐nm laser at the power of 20 kW/m2. The nonuniform shifts of the X‐ray diffraction peaks under external laser illumination indicates that the photostriction is mainly attributed to the light‐induced distortion of crystalline lattice. Such a big deformation approaching that of piezoelectrics/ferroelectrics induced by electric field shows great promise for photo‐driven multifunctional applications.
Trauma experiences of people with an intellectual disability and their implications: A scoping review
Authors: McNally Paddy , Taggart Laurence , Shevlin Mark
Published: March 2021

Background

People with an intellectual disability are more vulnerable to psychological trauma compared with the general population. The aim of this scoping review was to identify the current status of the literature on trauma that is specific to the experiences of adults with an intellectual disability, living in community settings.

Methods

A scoping review was conducted using the Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) framework. Forty‐one international papers were reviewed spanning 2000–2020, and their quality assessed using the MMAT.

Findings

(1) Aggressive behaviours can be symptoms of trauma, (2) there are appropriate assessment tools for the impact of trauma, (3) evidence‐based interventions for trauma may be effective, and (4) factors associated with disability can be experienced as traumatic.

Conclusion

There is a growing body of literature highlighting assessment needs and potential interventions for people with an intellectual disability who have experienced psychological trauma. Further research is needed to develop trauma‐informed pathways.
Navigating inferior vena cava filters in invasive cardiology procedures: A systematic review
Authors: Shah Kuldeep , Patel Sati , Hanson Ivan , Williamson Brian , Kutinsky Ilana , Dixon Simon , Haines David E. , Mehta Nishaki Kiran
Published: March 2021

Background

Transfemoral venous access (TFV) is the cornerstone of minimally invasive cardiac procedures. Although the presence of inferior vena cava filters (IVCFs) was considered a relative contraindication to TFV procedures, small experiences have suggested safety. We conducted a systematic review of the available literature on cardiac procedural success of TFV with IVCF in‐situ.

Methods

Two independent reviewers searched PubMed, EMBASE, SCOPUS, and Google Scholar from inception to October 2020 for studies that reported outcomes in patients with IVCFs undergoing TFV for invasive cardiac procedures. We investigated a primary outcome of acute procedural success and reviewed the pooled data for patient demographics, procedural complications, types of IVCF, IVCF dwell time, and procedural specifics.

Results

Out of the 120 studies initially screened, 8 studies were used in the final analysis with a total of 100 patients who underwent 110 procedures. The most common IVCF was the Greenfield Filter (36%), 60% of patients were males and the mean age was 67.8 years. The overall pooled incidence of acute procedural success was 95.45% (95% confidence interval = 89.54–98.1) with no heterogeneity (I2 = 0%, p = 1) and there were no reported filter‐related complications.

Conclusion

This systematic review is the largest study of its kind to demonstrate the safety and feasibility of TFV access in a variety of cardiac procedures in the presence of IVCF.
Direct oral anticoagulants to treat left ventricular thrombus—A systematic review and meta‐analysis: ELECTRAM investigators
Authors: Shah Siddharth , Shah Kuldeep , Turagam Mohit K. , Sharma Abhinav , Natale Andrea , Lakkireddy Dhanunjaya , Garg Jalaj
Published: March 2021

Introduction

Though current guidelines currently recommend using warfarin, there is also a growing interest in the utilization of direct oral anticoagulants (DOACs) to treat left ventricular (LV) thrombus.

Methods

We performed a systematic search using PubMed, SCOPUS, EMBASE, Google Scholar, and ClinicalTrials.gov from inception to September 30, 2020, for studies that had reported outcomes in patients with left ventricular thrombus treated with DOACs (PROSPERO registration number CRD42020219761).

Results

Twelve studies (n = 867 patients) were included in the analysis. The pooled incidence of the systemic embolic events (SEE) with DOACs was 2.7%, whereas the thrombus resolution rate was 86.6%. The pooled incidence of overall bleeding (composite of major and minor bleeding) and major bleeding with DOACs were 5.6% and 1.1%, respectively. No significant difference was observed in terms of SEE (OR 0.81, 95% confidence interval [CI] 0.44–1.52, p = .54), major bleeding (OR 0.29, 95% CI 0.07–1.26, p = .24), and failure of LV thrombus resolution (OR 0.86, 95% CI 0.28–2.58, p = .68); whereas overall bleeding was significantly low in patients with LV thrombus treated with DOACs compared to vitamin K antagonists (VKAs) (OR 0.33, 95% CI 0.14–0.81, p = .02).

Conclusion

Our study demonstrates no significant difference in SEE, major bleeding, or failure of LV thrombus resolution between the two groups, thus demonstrating that DOACs are an efficacious and safe alternative for the treatment of LV thrombus compared to VKAs. However, further well‐designed prospective trials are needed to answer important clinical questions—optimal dosing/duration of DOACs and its safety in the background of antiplatelet therapy.
Unmet family caregiver training needs associated with acute care utilization during home health care
Authors: Burgdorf Julia G. , Arbaje Alicia I. , Stuart Elizabeth A. , Wolff Jennifer L.
Published: March 2021

Background/Objectives

Medicare‐certified home health agencies are required to offer family caregiver training, but little is known regarding the potential impact of this training on outcomes during home health care. We estimate the proportion of family caregivers assisting Medicare home health patients who have unmet training needs and examine whether these unmet training needs are associated with older adults' risk of acute care utilization during home health care.

Design

Observational, nationally representative cohort study.

Setting

Linked National Health and Aging Trends Study, Outcome and Assessment Information Set (OASIS), Medicare Provider of Services file, and Medicare claims data from 2011 to 2016.

Participants

Thousand two hundred seventeen (weighted n = 5,870,905) community‐living Medicare beneficiaries who received home health care between 2011 and 2016.

Measurements

Family caregivers' unmet training needs measured from OASIS and Medicare claims; home health patients' acute care utilization (including emergency department use and hospitalization) measured from OASIS.

Results

Rates of unmet need for training varied by activity, from 8.2% of family caregivers assisting with household chores to 16.0% assisting with self‐care tasks. After controlling for older adult and home health provider characteristics, older adults whose family caregivers had an unmet need for training with any caregiving activity were twice as likely to incur acute care utilization during their home health episode (adjusted odds ratio [aOR]: 2.01, 95% confidence interval [CI]: 1.20–3.38). This relationship held across specific caregiving activities including household chores (aOR: 1.98; 95% CI: 1.13–3.46), medication management (aOR: 2.50; 95% CI: 1.46–4.26), patient supervision (aOR: 2.92; 95% CI: 1.36–6.24), and self‐care tasks (aOR: 3.11; 95% CI: 1.62–6.00).

Conclusions and Relevance

Unmet training needs among family caregivers are associated with greater likelihood of acute care utilization among Medicare beneficiaries receiving home health care. Identifying and addressing family caregivers' training needs may reduce older adults' risk of acute care utilization during home health care.
Helium plasma dermal resurfacing: VISIA CR assessment of facial spots, pores, and wrinkles—Preliminary findings
Authors: Holcomb John David
Published: March 2021

Objectives

Effects of low energy, single‐pass helium plasma dermal resurfacing (PDR) treatment on brown spots, enlarged pores, and wrinkles—preliminary findings.

Methods

Twenty two subjects (64.6 ± 6.6 years) with Fitzpatrick Wrinkle and Elastosis Scale score (FWS) of ≤2 and seeking improvement of facial appearance were included in this subanalysis. All subjects received a single, one‐pass, full face, and low power helium PDR treatment. Standard digital images were collected using the VISIA‐CR (Canfield Scientific Inc.) at baseline and 3 months after treatment with images assessed for improvement in FWS and for improvements in brown spots, enlarged pores, and wrinkles by proprietary automated image processing algorithms.

Results

Nearly all subjects demonstrated ≥1‐point improvement in FWS and also reported improvement per modified Global Aesthetic Improvement Scale query. The numbers of brown spots and enlarged pores decreased by 45.1% and 28.3%, respectively. Stratification of brown spots data by presence or absence of post‐inflammatory hyperpigmentation revealed paradoxically conflicting data. The improvement detected in wrinkle area and mean wrinkle thickness was less pronounced with overall reductions of 13.4% and 4.8%, respectively. 37 Non‐serious adverse events (AEs) in 22 subjects were reported with most resolving within 14 days or less, and no serious AEs were observed.

Conclusions

While longer‐term follow‐up is needed, these early study results show that one single‐pass, low energy helium PDR treatment improves facial skin appearance both qualitatively and quantitatively. Studies evaluating higher energy levels and multiple treatment passes are ongoing.
Indonesian mothers' beliefs on caring practices at home for preterm babies after hospital discharge: A qualitative study
Authors: Hariati Suni , Sutomo Retno , McKenna Lisa , Reisenhofer Sonia , Lusmilasari Lely , Febriani Andi D. B.
Published: March 2021

Purpose

Premature birth may be associated with infant health problems and frequently requires in‐hospital and then at‐home specialized care. Studies investigating home‐caring experiences of mothers of preterm infants in developing countries are limited. This study was to explore preterm mothers' experiences of caring practices at home 1 month after their infant's discharge from a neonatal unit.

Design and Method

A descriptive qualitative study using in‐depth interviews with eight purposively sampled mothers who had been discharged home from neonatal unit in one city in Indonesia. All interviews were audio‐recorded, transcribed verbatim, and analyzed using thematic analysis.

Result

Three main themes emerged: (1) transition to independent motherhood, (2) focus on care of infant after discharge, and (3) barriers and enablers for care. The mothers managed their infant care at home by focusing on feeding and managing infant health problems. They faced on myth and culture as one of the barriers.

Conclusions

Comprehensive discharge education for mothers of preterm infants and their families is required to enhance mothers' caring abilities and overcome barriers is sufficient. Nurses/midwives need to improve care related to the well‐being of mothers and their infants in preparation for, and after, discharge from the neonatal unit.
Changes in tree size, not species diversity, underlie the low above‐ground biomass in natural forest edges
Authors: Silva Mateus Cardoso , Melo Felipe Pimentel Lopes , van den Berg Eduardo
Published: March 2021

Questions

Forest's above‐ground biomass is an important component of the global carbon cycle and, in forest fragments, it tends to decrease near the edges. This edge effect on biomass can be due to the number and identity of species residing at edges or due to the context of edges constraining plant functioning regardless of the species. Here, we took advantage of species‐rich natural forest edges to test the role of species richness, composition, and context dependency in explaining why forest edges stock less above‐ground biomass than interiors.

Location

Gallery forests in Brazilian savanna (latitude 21° S, longitude 44° W).

Methods

We tested the relationship between species richness and above‐ground biomass in 49 forest plots (10,142 trees). We used a novel adaptation of the Price equation to calculate the impact of species composition (losses and gains) and context dependency on the differences of above‐ground biomass between edges and interiors.

Results

Differences in species richness and composition did not explain the lower above‐ground biomass of forest edges when compared to interiors. Biomass responses were context‐dependent, in which the same species achieved smaller sizes when it grew in the edge than in the interior.

Conclusions

Our study shows that edge effects on biomass may operate independently of biodiversity as edges and interiors had a similar number of species but distinct above‐ground biomass. Indeed, in the studied natural forest patches, the edge context itself limits plant size and, thus, the above‐ground biomass stock. Beyond unveiling the underlying causes of edge effects on forest biomass, our results call for distinct policies to conserve both the carbon stocks in forest interiors but also the unique diversity of natural edges.
Colomera (Granada, Spain): More than a century of an IIE iron meteorite journey
Authors: Lozano R. P. , Sánchez J. A. , González‐Laguna R. , Martín‐Crespo T.
Published: March 2021

Colomera is the Spanish meteorite (IIE) that has aroused the greatest interest among the international scientific community. Until now, the story of the find was only partially known and certain data are incorrect. The amazing journey of this meteorite has been recounted in this work. It reveals unpublished information derived from local archives, and testimonies from the descendants of the family that found the meteorite in 1913, and from the inhabitants of Colomera (Granada, Spain). We also document the story after its discovery, which culminated in a 2015 court ruling demanding the return of the largest part the mass (120.34 kg) to the heirs of the Spanish family that discovered the meteorite. Some of the material initially extracted in Spain (305 g) is currently housed in the Natural History Museum (121.3 g; London, UK). Nine kilograms of fragments remains in the United States after returning the meteorite to Spain in 1969. Of these, we have only located slightly more than 4 kg in several American institutions. Recently, 235 g has been returned to Spain: two fragments in private collections and two fragments in the Museo Geominero, Spanish Geological and Mining Institute (Spanish acronym: IGME).
Untangling the structural and molecular mechanisms underlying colour and rapid colour change in a lizard, Agama atra
Authors: Nicolaï Michaël P. J. , D’Alba Liliana , Goldenberg Jonathan , Gansemans Yannick , Van Nieuwerburgh Filip , Clusella‐Trullas Susana , Shawkey Matthew D.
Published: March 2021

With functions as diverse as communication, protection and thermoregulation, coloration is one of the most important traits in lizards. The ability to change colour as a function of varying social and environmental conditions is thus an important innovation. While colour change is present in animals ranging from squids, to fish and reptiles, not much is known about the mechanisms behind it. Traditionally, colour change was attributed to migration of pigments, in particular melanin. More recent work has shown that the changes in nanostructural configuration inside iridophores are able to produce a wide palette of colours. However, the genetic mechanisms underlying colour, and colour change in particular, remain unstudied. Here we use a combination of transcriptomic and microscopic data to show that melanin, iridophores and pteridines are the main colour‐producing mechanisms in Agama atra, and provide molecular and structural data suggesting that rapid colour change is achieved via melanin dispersal in combination with iridophore organization. This work demonstrates the power of combining genotypic (gene expression) and phenotypic (microscopy) information for addressing physiological questions, providing a basis for future studies of colour change.
The problem of omnivory: A synthesis on omnivory and DNA metabarcoding
Authors: Tercel Maximillian P. T. G. , Symondson William O. C. , Cuff Jordan P.
Published: March 2021

Dietary analysis using DNA metabarcoding is a powerful tool that is increasingly being used to further our knowledge of trophic interactions in highly complex food webs but is not without limitations. Omnivores, the most generalist of consumers, pose unique challenges when using such methods. Here, we provide the rationale to understand the problems associated with analysing the complex diets of omnivores. By reviewing existing metabarcoding studies of omnivorous diet, and constructing hypothetical scenarios arising from each, we outline that great caution is required when interpreting sequencing data in such cases. In essence, the problems of accidental consumption and secondary ingestion are significant sources of error when investigating omnivorous diets. The integration of multiple high throughput sequencing markers increases the taxonomic breadth of taxa detected but we reveal how some detections may be misleading. Disentangling which taxa have been deliberately or accidentally consumed by the focal omnivore is challenging and can falsely emphasise those that were not intentionally consumed, obscuring biologically meaningful interactions. Although we suggest ways to disentangle these issues, we urge that the results of such analyses should be interpreted with caution and all possible scenarios for the presence of biota within omnivores given due consideration.
Parental age does not influence offspring telomeres during early life in common gulls (Larus canus)
Authors: Sepp Tuul , Meitern Richard , Heidinger Britt , Noreikiene Kristina , Rattiste Kalev , Hõrak Peeter , Saks Lauri , Kittilson Jeffrey , Urvik Janek , Giraudeau Mathieu
Published: March 2021

Parental age can affect offspring telomere length through heritable and epigenetic‐like effects, but at what stage during development these effects are established is not well known. To address this, we conducted a cross‐fostering experiment in common gulls (Larus canus) that enabled us distinguish between pre‐ and post‐natal parental age effects on offspring telomere length. Whole clutches were exchanged after clutch completion within and between parental age classes (young and old) and blood samples were collected from chicks at hatching and during the fastest growth phase (11 days later) to measure telomeres. Neither the ages of the natal nor the foster parents predicted the telomere length or the change in telomere lengths of their chicks. Telomere length (TL) was repeatable within chicks, but increased across development (repeatability = 0.55, intraclass correlation coefficient within sampling events 0.934). Telomere length and the change in telomere length were not predicted by post‐natal growth rate. Taken together, these findings suggest that in common gulls, telomere length during early life is not influenced by parental age or growth rate, which may indicate that protective mechanisms buffer telomeres from external conditions during development in this relatively long‐lived species.
Optimising the delivery of remediation programmes for doctors: A realist review
Authors: Price Tristan , Wong Geoff , Withers Lyndsey , Wanner Amanda , Cleland Jennifer , Gale Tom , Prescott‐Clements Linda , Archer Julian , Bryce Marie , Brennan Nicola
Published: March 2021

Context

Medical underperformance puts patient safety at risk. Remediation, the process that seeks to ‘remedy’ underperformance and return a doctor to safe practice, is therefore a crucially important area of medical education. However, although remediation is used in health care systems globally, there is limited evidence for the particular models or strategies employed. The purpose of this study was to conduct a realist review to ascertain why, how, in what contexts, for whom and to what extent remediation programmes for practising doctors work to restore patient safety.

Method

We conducted a realist literature review consistent with RAMESES standards. We developed a programme theory of remediation by carrying out a systematic search of the literature and through regular engagement with a stakeholder group. We searched bibliographic databases (MEDLINE, EMBASE, PsycINFO, HMIC, CINAHL, ERIC, ASSIA and DARE) and conducted purposive supplementary searches. Relevant sections of text relating to the programme theory were extracted and synthesised using a realist logic of analysis to identify context–mechanism–outcome configurations (CMOcs).

Results

A 141 records were included. The majority of the studies were from North America (64%). 29 CMOcs were identified. Remediation programmes are effective when a doctor's insight and motivation are developed and behaviour change reinforced. Insight can be developed by providing safe spaces, using advocacy to promote trust and framing feedback sensitively. Motivation can be enhanced by involving the doctor in remediation planning, correcting causal attribution, goal setting and destigmatising remediation. Sustained change can be achieved by practising new behaviours and skills, and through guided reflection.

Conclusion

Remediation can work when it creates environments that trigger behaviour change mechanisms. Our evidence synthesis provides detailed recommendations on tailoring implementation and design strategies to improve remediation interventions for doctors.
3D active dynamic actuation model for offshore cranes
Authors: Fantuzzi Nicholas , Rustico Althea , Formenti Massimiliano , Ferreira Antonio J. M.
Published: March 2021

The handling of offshore payloads is a critical operation that presents numerous challenges, in particular related to the required precision in controlling their oscillations in a safe and accurate manner. The uncontrolled payload oscillations induced by the rolling movement of the vessel have been historically mitigated by the experience of on‐deck operators by means of taglines. The availability of experienced personnel is not always present, and a manual control operation still presents inconsistent performances and a high risk for the safety of men and machines. This study presents a novel approach to an antisway control conceived to mitigate such problems and possibly to automate some of the operations concerning the payload sway control that are currently done manually. In particular, a system consisting of a translating trolley actuated through a proportional–integral–derivative controller is taken into consideration to mitigate the oscillations induced by the vessel's rolling and pitching motion onto a three‐dimensional 8 degrees of freedom with double‐pendulum model representing the hanging payload. The study is completed through an analysis aimed to characterize the bandwidth and frequency response of the controlled closed‐loop system and highlight all the potential areas of interest for which further characterization is needed.
Marked host association and molecular evidence of limited transmission of ticks and fleas between sympatric wild foxes and rural dogs
Authors: Cevidanes A. , Ulloa‐Contreras C. , Di Cataldo S. , Latrofa M. S. , Gonzalez‐Acuña D. , Otranto D. , Millán J.
Published: March 2021

Wild and domestic carnivores share ectoparasites, although molecular evidence is lacking. The goals of this study were to describe tick and flea infestation in sympatric free‐ranging dogs Canis lupus familiaris (Linnaeus, 1758) (Carnivora: Canidae) and Andean foxes Lycalopex culpaeus (Molina, 1782) (Carnivora: Canidae) and to determine whether interspecific transmission occurs. Fleas and ticks retrieved from 79 foxes and 111 dogs in the human‐dominated landscapes of central Chile were identified and a subset of specimens characterized by PCR and amplicon sequencing. Each ectoparasite species was clearly associated with a host: abundance and occurrence of Rhipicephalus sanguineus (Latreille 1806) (Acari: Ixodidae) and Ctenocephalides spp. (Siphonaptera: Pulicidae) were significantly higher in dogs than in foxes, whereas the opposite was true for Amblyomma tigrinum (Koch, 1844) (Acari: Ixodidae) and Pulex irritans (Linnaeus, 1758) (Siphonaptera: Pulicidae). Genetic analyses of a subset of ectoparasites revealed that dogs and foxes shared a limited number of nucleotide sequence types, suggesting that the interspecific transmission of these ectoparasites happens infrequently. Data also indicated that the ecological association and biological cycles of ticks and fleas determine the ectoparasite fauna of sympatric carnivores. In conclusion, our study shows that cross‐species transmission should be assessed at a molecular level.
Recurrent cerebellar infarction due to vertebral artery dissection in an athetotic patient
Authors: Oono Miki , Nodera Hiroyuki , Sanada Mitsuru , Iizuka Hideaki , Kawahara Norio , Matsui Makoto
Published: March 2021

A 42‐year‐old man with longstanding athetotic‐type cerebral palsy and history of cervical spine fusion surgery was affected by multiple episodes of vertebral artery dissections, resulting in bilateral cerebellar infarction. Continuous involuntary movements noted in the upper limbs and neck, as well as a limited cervical range of motion due to the operation might have precipitated the dissecting events.