bluuebunny/crossref_metadata_2025 huggingface dataset:
South African physician emigration and return migration, 1991–2017: a trend analysis
Authors: Nwadiuko Joseph , Switzer Galen E , Stern Jaime , Day Candy , Paina Ligia
Published: December 2020

Although critical for understanding health labour market trends in low- and middle-income countries (LMICs), longitudinal LMIC health worker emigration and return migration trends are not routinely documented. This article seeks to better understand SA’s trends in physician emigration and return migration and whether economic growth and related policies affect migration patterns. This study used physician registry data to analyse patterns of emigration and return migration only among SA-trained physicians registered to practice in top destination countries such as Australia, Canada, New Zealand, the USA or the UK between 1991 and 2017, which represent the top five emigration destinations for this group. A linear regression model analysed the relationship between migration trends (as dependent variables) and SA’s economic growth, health financing and HIV prevalence (as independent variables). There has been a 6-fold decline in emigration rates from SA between 1991 and 2017 (from 1.8% to 0.3%/year), with declines in emigration to all five destination countries. About one in three (31.8% or 5095) SA physicians returned from destination countries as of 2017. Annual physician emigration fell by 0.16% for every $100 rise in SA GDP per capita (2011 international dollars) (95% confidence interval −0.60% to −0.086%). As of 2017, 21.6% (11 224) of all SA physicians had active registration in destination nations, down from a peak of 33.5% (16 366) in 2005, a decline largely due to return migration. Changes to the UK’s licensing regulations likely affected migration patterns while the Global Code of Practice on International Recruitment contributed little to changes. A country’s economic growth might influence physician emigration, with significant contribution from health workforce policy interventions. Return migration monitoring should be incorporated into health workforce planning.
Paperspray Ionization Mass Spectrometry as a Tool for Predicting Real-Time Optimized Dosing of the Chemotherapeutic Drug Melphalan
Authors: Zhao Junfang , Sharat Chandra , Mehta Parinda A , Mizuno Kana , Vinks Alexander A , Setchell Kenneth D R
Published: December 2020

Background

Melphalan, an important component of hematopoietic stem cell transplantation (HSCT) preparative regimens, is associated with significant toxicity and large between patient variability in pharmacokinetics making it difficult to calculate the optimal dose for pediatric patients. Paperspray (PS) ionization generates gas phase analyte ions directly from a dried blood spot without the need for prior sample preparation or chromatography. With these advantages, a validated PS–MS/MS assay was developed and applied to the ‘real-time’ determination of melphalan pharmacokinetics (PK).

Methods

Melphalan was quantified by stable-labeled isotope dilution analysis in whole blood by PS–MS/MS. Blood samples were obtained at timed intervals from patients during HSCT after administration of a very low (test) dose of melphalan to avoid toxicity. Pharmacokinetics parameters were calculated using WinNonlin v.6.4. From these data, the optimal therapeutic dose was estimated and full dose PK repeated.

Results

PS–MS/MS method was linear over a large dynamic range (25–50 000 ng/mL), intra- and interassay reproducibility of quality control samples was <15% CV. With essentially no prior sample preparation, PS–MS/MS measurement of blood melphalan concentrations showed excellent correlation (R2 = 0.959, n = 62) with a validated electrospray–LC–MS/MS method. Trapezoidal area under the curves calculated for 5 patients administered low dose melphalan showed a high linear correlation (R2 = 0.981) between the PS–MS/MS and LC–MS/MS methods. The faster PS approach permitted real-time PK evaluation of individual patients.

Conclusions

A validated PS–MS/MS assay for melphalan in patients undergoing HSCT is described that facilitates pharmacokinetic-guided individualized precision dosing with immediate bedside dose adjustments to improve outcomes by balancing toxicity and efficacy of melphalan.
External validation of the albumin, C-reactive protein and lactate dehydrogenase model in patients with metastatic renal cell carcinoma receiving second-line axitinib therapy in a Japanese multi-center cohort
Authors: Tamura Keita , Osawa Takahiro , Takeuchi Ario , Minami Keita , Nakai Yasutomo , Ueda Kosuke , Ozawa Michinobu , Uemura Motohide , Sugimoto Mikio , Ohba Kojiro , Suzuki Toshihiro , Anai Satoshi , Shindo Tetsuya , Kusakabe Naohisa , Komiyama Motokiyo , Tanaka Ken , Yokomizo Akira , Kohei Naoki , Shinohara Nobuo , Miyake Hideaki ,   Japanese Urological Oncology Group
Published: December 2020

Purpose

To externally validate the utility of the albumin, C-reactive protein and lactate dehydrogenase model to predict the overall survival of previously treated metastatic renal cell carcinoma patients.

Patients and methods

The ability of the albumin, C-reactive protein and lactate dehydrogenase model to predict overall survival was validated and compared with those of other prognostication models using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib therapy at 36 hospitals belonging to the Japan Urologic Oncology Group.

Results

The following factors in this cohort were independently associated with poor overall survival in a multivariate analysis: a low Karnofsky performance status, <1 year from diagnosis to targeted therapy, a high neutrophil count, and low albumin, elevated C-reactive protein, and elevated lactate dehydrogenase, and the Japan Urologic Oncology Group model was newly developed based on the presence/absence of these independent factors. In this cohort, 151 (35.9%), 125 (27.7%) and 145 (34.4%) patients were classified into the favorable, intermediate and poor risk groups, respectively, according to the albumin, C-reactive protein and lactate dehydrogenase model; however, the proportions of patients in the intermediate risk group stratified by the Japan Urologic Oncology Group, Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models were >50%. The superiority of the albumin, C-reactive protein and lactate dehydrogenase model to the Memorial Sloan Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium models, but not the Japan Urologic Oncology Group model, was demonstrated by multiple statistical analyses.

Conclusions

The utility of the albumin, C-reactive protein and lactate dehydrogenase model as a simple and objective prognostication tool was successfully validated using data from 421 metastatic renal cell carcinoma patients receiving second-line axitinib.
Possibilities for and limits of upfront surgical strategy with lateral pelvic node dissection for low rectal cancer
Authors: Ouchi Akira , Komori Koji , Kinoshita Takashi , Oshiro Taihei , Kunitomo Aina , Ito Seiji , Abe Tetsuya , Shimizu Yasuhiro
Published: December 2020

Background

Metastatic lateral pelvic nodes represent an important cause of pelvic recurrence in low rectal cancer patients even after preoperative chemoradiotherapy. This study aimed to evaluate the prognostic benefit of an upfront lateral pelvic nodes dissection strategy.

Methods

A total of 175 consecutive patients with stage II/III low rectal adenocarcinoma who underwent mesorectal excision with lateral pelvic nodes dissection between 1998 and 2013 were identified. Regional lateral pelvic nodes were categorized as LD2 nodes (internal iliac, hypogastric and obturator) and LD3 nodes (external iliac, common iliac, lateral sacral, presacral and sacral promontory) according to the current Japanese Society for Cancer of the Colon and Rectum classification.

Results

Five-year cumulative risks of local recurrence and recurrence-free survival were 4.8% and 78.1% for stage II patients, and 11.8% and 61.7% for stage III patients, respectively. Among stage III patients, no differences were observed in cumulative risks of local recurrence (5 years: 9.3% vs 14.7%, P= 0.463) and recurrence-free survival (5 years: 65.1 vs 61.2%, P = 0.890) between lateral pelvic nodes (−) and LD2 (+) patients. In multivariate analyses, metastatic lateral pelvic nodes had no impact on cumulative risks of local recurrence (hazard ratioadj: 1.389; 95% confidence interval: 0.409–4.716) and recurrence-free survival (hazard ratioadj: 0.884; 95% confidence interval: 0.425–1.837).

Conclusions

Metastatic lateral pelvic nodes had no impact on cumulative risks of local recurrence and recurrence-free survival based on an upfront lateral pelvic nodes strategy. Lateral pelvic nodes can improve recurrence and survival outcomes in locally advanced low rectal cancer patients with metastatic lateral pelvic nodes.
A search for trends in spatially resolved debris discs at far-infrared wavelengths
Authors: Marshall J P , Wang L , Kennedy G M , Zeegers S T , Scicluna P
Published: December 2020

Debris discs around main-sequence stars are belts of planetesimals – asteroids and comets – formed in the protoplanetary discs around young stars. Planetesimals comprise both the building blocks of planets around young stars and the source of dusty debris around older stars. Imaging observations of dust continuum emission and scattered light reveal the location of these planetesimal belts around their host stars. Analysis of debris discs observed at millimetre wavelengths revealed a trend between the discs’ radii and the host star luminosities. This trend was tentatively linked to the preferential formation of dust-producing planetesimals near snow lines (specifically CO) in the protoplanetary discs around the host stars. Here, we perform a homogeneous analysis of 95 debris discs observed at far-infrared wavelengths by the Herschel Space Observatory and fit the obtained distribution of radii and widths as a function of stellar luminosity with a power-law relation. We identify a trend in disc radius as a function of stellar luminosity similar to that identified at millimetre wavelengths, but cannot convincingly recover it from the available data set due to the large uncertainties on disc radius and width inherent in the marginally spatially resolved data, and the bias of smaller discs around more distant stars (which are also the more luminous) being omitted from our analysis. We see a trend in disc temperature as a function of stellar luminosity, consistent with previous findings from similar analyses.
Simulations of radiation-driven winds from Keplerian discs
Authors: Raychaudhuri Sananda , Vyas Mukesh K , Chattopadhyay Indranil
Published: December 2020

We study the ejection of winds from thin accretion discs around stellar mass black holes and the time evolution of these winds in the presence of radiation field generated by the accretion disc. Winds are produced by radiation, thermal pressure, and the centrifugal force of the disc. The winds are found to be mildly relativistic, with speeds reaching up to terminal speeds of 0.1 for accretion rate of 4 in Eddington units. We show that the ejected matter gets its rotation by transporting angular momentum from the disc to the wind. We also show that the radiation drag affects the accretion disc winds in a very significant manner. Not only that the terminal speeds are reduced by an order of magnitude due to radiation drag, but we also show that the non-linear effect of radiation drag can mitigate the formation of the winds from the matter ejected by the accretion disc. As radiation drag reduces the velocity of the wind, the mass outflow rate is reduced in its presence as well.
Group-scale intrinsic galaxy alignments in the Illustris-TNG and MassiveBlack-II simulations
Authors: Tenneti Ananth , Kitching Thomas D , Joachimi Benjamin , Di Matteo Tiziana
Published: December 2020

We study the alignments of satellite galaxies, and their anisotropic distribution, with respect to location and orientation of their host central galaxy in MassiveBlack-II (MB-II) and IllustrisTNG simulations. We find that: the shape of the satellite system in haloes of mass ($\gt 10^{13}\, h^{-1}\, \mathrm{M}_{\odot }$) is well aligned with the shape of the central galaxy at z = 0.06 with the mean alignment between the major axes being ∼Δθ = 12° when compared to a uniform random distribution; that satellite galaxies tend to be anisotropically distributed along the major axis of the central galaxy with a stronger alignment in haloes of higher mass or luminosity; and that the satellite distribution is more anisotropic for central galaxies with lower star formation rate, which are spheroidal, and for red central galaxies. Radially, we find that satellites tend to be distributed along the major axis of the shape of the stellar component of central galaxies at smaller scales and the dark matter component on larger scales. We find that the dependence of satellite anisotropy on central galaxy properties and the radial distance is similar in both the simulations with a larger amplitude in MB-II. The orientation of satellite galaxies tends to point toward the location of the central galaxy at small scales and this correlation decreases with increasing distance, and the amplitude of satellite alignment is higher in high-mass haloes. However, the projected ellipticities do not exhibit a scale-dependent radial alignment, as has been seen in some observational measurements.
Do we need non-ideal magnetohydrodynamic to model protostellar discs?
Authors: Wurster James
Published: December 2020

We investigate and discuss protostellar discs in terms of where the various non-ideal magnetohydrodynamics (MHD) processes are important. We find that the traditional picture of a magnetized disc (where Ohmic resistivity is dominant near the mid-plane, surrounded by a region dominated by the Hall effect, with the remainder of the disc dominated by ambipolar diffusion) is a great oversimplification. In simple parametrized discs, we find that the Hall effect is typically the dominant term throughout the majority of the disc. More importantly, we find that in much of our parametrized discs, at least two non-ideal processes have coefficients within a factor of 10 of one another, indicating that both are important and that naming a dominant term underplays the importance of the other terms. Discs that were self-consistently formed in our previous studies are also dominated by the Hall effect, and the ratio of ambipolar diffusion and Hall coefficients is typically less than 10, suggesting that both terms are equally important and listing a dominant term is misleading. These conclusions become more robust once the magnetic field geometry is taken into account. In agreement with the literature we review, we conclude that non-ideal MHD processes are important for the formation and evolution of protostellar discs. Ignoring any of the non-ideal processes, especially ambipolar diffusion and the Hall effect, yields an incorrect description of disc evolution.
Biophysical optimization of preimplantation embryo culture: what mechanics can offer ART
Authors: Hawkins Jamar , Miao Xiaosu , Cui Wei , Sun Yubing
Published: December 2020

Owing to the rise of ART and mounting reports of epigenetic modification associated with them, an understanding of optimal embryo culture conditions and reliable indicators of embryo quality are highly sought after. There is a growing body of evidence that mechanical biomarkers can rival embryo morphology as an early indicator of developmental potential and that biomimetic mechanical cues can promote healthy development in preimplantation embryos. This review will summarize studies that investigate the role of mechanics as both indicators and promoters of mammalian preimplantation embryo development and evaluate their potential for improving future embryo culture systems.
Comparison of loop extrusion and diffusion capture as mitotic chromosome formation pathways in fission yeast
Authors: Gerguri Tereza , Fu Xiao , Kakui Yasutaka , Khatri Bhavin S , Barrington Christopher , Bates Paul A , Uhlmann Frank
Published: December 2020

Underlying higher order chromatin organization are Structural Maintenance of Chromosomes (SMC) complexes, large protein rings that entrap DNA. The molecular mechanism by which SMC complexes organize chromatin is as yet incompletely understood. Two prominent models posit that SMC complexes actively extrude DNA loops (loop extrusion), or that they sequentially entrap two DNAs that come into proximity by Brownian motion (diffusion capture). To explore the implications of these two mechanisms, we perform biophysical simulations of a 3.76 Mb-long chromatin chain, the size of the long Schizosaccharomyces pombe chromosome I left arm. On it, the SMC complex condensin is modeled to perform loop extrusion or diffusion capture. We then compare computational to experimental observations of mitotic chromosome formation. Both loop extrusion and diffusion capture can result in native-like contact probability distributions. In addition, the diffusion capture model more readily recapitulates mitotic chromosome axis shortening and chromatin compaction. Diffusion capture can also explain why mitotic chromatin shows reduced, as well as more anisotropic, movements, features that lack support from loop extrusion. The condensin distribution within mitotic chromosomes, visualized by stochastic optical reconstruction microscopy (STORM), shows clustering predicted from diffusion capture. Our results inform the evaluation of current models of mitotic chromosome formation.
Unique Peripheral Antennas in the Photosystems of the Streptophyte Alga Mesostigma viride
Authors: Aso Michiki , Matsumae Renon , Tanaka Ayumi , Tanaka Ryouichi , Takabayashi Atsushi
Published: December 2020

Land plants evolved from a single group of streptophyte algae. One of the key factors needed for adaptation to a land environment is the modification in the peripheral antenna systems of photosystems (PSs). Here, the PSs of Mesostigma viride, one of the earliest-branching streptophyte algae, were analyzed to gain insight into their evolution. Isoform sequencing and phylogenetic analyses of light-harvesting complexes (LHCs) revealed that M. viride possesses three algae-specific LHCs, including algae-type LHCA2, LHCA9 and LHCP, while the streptophyte-specific LHCB6 was not identified. These data suggest that the acquisition of LHCB6 and the loss of algae-type LHCs occurred after the M. viride lineage branched off from other streptophytes. Clear-native (CN)-polyacrylamide gel electrophoresis (PAGE) resolved the photosynthetic complexes, including the PSI–PSII megacomplex, PSII–LHCII, two PSI–LHCI–LHCIIs, PSI–LHCI and the LHCII trimer. Results indicated that the higher-molecular weight PSI–LHCI–LHCII likely had more LHCII than the lower-molecular weight one, a unique feature of M. viride PSs. CN-PAGE coupled with mass spectrometry strongly suggested that the LHCP was bound to PSII–LHCII, while the algae-type LHCA2 and LHCA9 were bound to PSI–LHCI, both of which are different from those in land plants. Results of the present study strongly suggest that M. viride PSs possess unique features that were inherited from a common ancestor of streptophyte and chlorophyte algae.
Cognitive Processing Speed Impairment Does Not Influence the Construct Validity of Six-Spot Step Test Performance in People With Multiple Sclerosis
Authors: Sandroff Brian M , Silveira Stephanie L , Baird Jessica F , Huynh Trinh , Motl Robert W
Published: December 2020

Objective

There is evidence supporting the construct validity of Six-Spot Step Test (SSST) performance as a functional mobility measure in people with multiple sclerosis (MS); however, it is unknown if cognitive processing speed impairment confounds the construct validity of SSST performance in MS, as this test seemingly requires intact cognitive processing. The objective of this study was to examine the influence of cognitive processing speed impairment on the construct validity and precision of SSST performance as a functional mobility measure in MS.

Methods

Participants (N = 213) completed the SSST, timed 25-foot walk, 6-Minute Walk Test, Timed “Up and Go” Test, Multiple Sclerosis Walking Scale-12, device-measured steps per day, and Late-Life Function and Disability Inventory, Patient-Determined Disease Steps, and the Symbol-Digit Modalities Test as a cognitive processing speed measure. The overall sample was divided into subsamples with (n = 75) and without (n = 138) cognitive processing speed impairment based on normative Symbol-Digit Modalities Test data. Correlations between SSST performance with other mobility outcomes in the overall sample and cognitive processing speed impairment subsamples were examined and compared. SSST performance was compared relative to other mobility measures for differentiating MS walking function levels in people with and without cognitive processing speed impairment.

Results

SSST performance was significantly and strongly correlated with most mobility outcomes in the overall sample and cognitive processing speed impairment subsamples. The magnitudes of correlations between SSST performance with most mobility outcomes were not statistically different among subsamples. Cognitive processing speed impairment did not diminish the relative precision of SSST performance for differentiating walking function levels.

Conclusion

The presence of cognitive processing speed impairment is not a source of invalidity or imprecision when interpreting SSST performance as a functional mobility measure among people with MS.

Impact

The SSST is a high-quality endpoint for inclusion in interventions targeting mobility in MS, regardless of cognitive processing speed status. This information is critical for rehabilitation research and clinical practice given that mobility and cognitive impairment are highly prevalent, co-occurring, and disabling in MS.
How can we help? Medical students’ views on their role in the COVID-19 pandemic
Authors: Michno D A , Tan J , Adelekan A , Konczalik W , Woollard A C S
Published: December 2020

Background

The ongoing COVID-19 pandemic has resulted in a sharp rise in demand for healthcare workers worldwide. This has been coupled with reduced numbers of available medical professionals due to confirmed or suspected infections with SARS-CoV-2. To counteract these shortages, governments of several countries have considered the enrolment of medical students into the workforce in order to help to tackle the ongoing crisis.

Methods

Questionnaire-based study assessing the perceived role of medical students in assisting in the COVID-19 pandemic. The primary aim was to determine factors contributing to the willingness of medical students to actively assist in the pandemic. The secondary aim was to evaluate their perspectives regarding the associated changes in medical education.

Results

Out of 760 responses, 71.18% of medical students were willing to assist the medical workforce during the pandemic. Clinical year students were more likely to help in a medical capacity than pre-clinical students (OR = 0.384, 95%CI [0.167, 0.883, P < 0.05)]. Respondents concerned about their own well-being were less likely to engage in clinical work (OR = 0.680, 95%CI [0.491, 0.941], P < 0.020). Students who agreed that online lectures will negatively impact their education were inclined to think that the academic year should be extended (95%CI [0.065, 0.271], P = 0.001).

Conclusions

Most students are willing to help in both a medical and non-medical capacity. Their primary concerns when working in a medical setting are the risk of infecting their relatives and patients, lack of protective equipment and necessary knowledge as well as legal uncertainty whilst working without a medical qualification.
Haploidentical α/β T-cell and B-cell depleted stem cell transplantation in severe mevalonate kinase deficiency
Authors: Faraci Maura , Giardino Stefano , Podestà Marina , Pierri Filomena , Dell’Orso Gianluca , Beccaria Andrea , Neves João Farela , Volpi Stefano , Gattorno Marco
Published: December 2020

Objective

Mevalonic aciduria represents the most severe form of mevalonate kinase deficiency (MKD). Patients with mevalonic aciduria have an incomplete response even to high doses of anti-cytokine drugs such as anakinra or canakinumab and stem cell transplantation (SCT) represents a possible therapy for this severe disease.

Methods

We report the first two children affected by severe MKD who received haploidentical α/β T-cell and B-cell depleted SCT. Both patients received a treosulfan-based conditioning regimen and one received a second haploidentical-SCT for secondary rejection of the first.

Results

Both patients obtained a stable full donor engraftment with a complete regression of clinical and biochemical inflammatory signs, without acute organ toxicity or acute and chronic GvHD. In both, the urinary excretion of mevalonic acid remained high post-transplant in the absence of any inflammatory signs.

Conclusion

Haploidentical α/β T-cell and B-cell depleted SCT represents a potential curative strategy in patients affected by MKD. The persistence of urinary excretion of mevalonic acid after SCT, probably related to the ubiquitous expression of MVK enzyme, suggests that these patients should be carefully monitored after SCT to exclude MKD clinical recurrence. Prophylaxis with anakinra in the acute phase after transplant could represent a safe and effective approach. Further biological studies are required to clarify the pathophysiology of inflammatory attacks in MKD in order to better define the therapeutic role of SCT.
Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis
Authors: Lane Jennifer C E , Craig Richard S , Rees Jonathan L , Gardiner Matthew D , Shaw Abigail V , Spiteri Michelle , Kuo Rachel , Dean Benjamin F , Green Jane , Prieto-Alhambra Daniel , Furniss Dominic
Published: December 2020

Objectives

Intra-articular steroid injection is commonly used to treat base of thumb osteoarthritis (BTOA), despite a lack of large-scale data on safety and effectiveness. We estimate the incidence of serious complications and further procedures following BTOA injection, including the risk of post-operative serious surgical site infection for subsequent operative intervention.

Methods

Hospital Episode Statistics data linked to mortality records from 1 April 1998 to 31 March 2017 were used to identify all BTOA injections undertaken in adults in the National Health Service secondary care in England. Patients were followed up longitudinally until death or 31 March 2017. A multivariable regression with a Fine and Gray model adjusting for the competing risk of mortality in addition to age, sex and socioeconomic deprivation was used to identify factors associated with progression to further procedure. Secondary outcomes included serious complications after injection and subsequent surgical site infection.

Results

A total of 19 120 primary injections were performed during the 19-year period in 18 356 patients. Of these 76.5% were female; mean age 62 years (s.d. 10.6); 50.48% underwent further procedure; 22.40% underwent surgery. Median time to further intervention was 412 days (IQR 110–1945). Female sex was associated with increased risk of proceeding to surgery. Serious complication rate following injection was 0.04% (0.01–0.08) within 90 days. Of those proceeding to surgery 0.16% (0.06–0.34) presented with a wound infection within 30 days and 90 days, compared with an overall post-operative wound infection rate of 0.03% (0.02–0.05).

Conclusions

Very low rates of serious complications were identified following BTOA injections performed in secondary care; only one in five patients proceeded to subsequent surgery.

Clinical trial registration

clinicaltrials.gov, https://www.clinicaltrials.gov, NCT03573765
Correlates and Trajectories of Preterm Infant Sucking Patterns and Sucking Organization at Term Age
Authors: McGrath Jacqueline M. , Bromiker Ruben , Hanlon Alex , McGlothen-Bell Kelly , Medoff-Cooper Barbara
Published: December 2020

Background:

Premature infants may experience increased difficulty with nutrition and growth. Successful oral feeding is an important factor associated with discharge readiness. Despite the importance of feeding as a growth-fostering process, little empiric evidence exists to guide recommendations for early interventions.

Purpose:

Evaluate whether specific elements of sucking, during preterm initiation of oral feeding, predict sucking organization at corrected term age.

Methods:

Sucking performance of 88 preterm infants born between 24 and 34 weeks of post–menstrual age was measured at baseline and term (33-35 and 40 ± 1.5 weeks). Participants were divided into 4 groups (quartiles) based on initial measures of performance including number of sucks, number of bursts, sucks per burst, and maximum pressure. Stability in sucking organization was assessed by comparing changes in infant's quartile location from baseline to term.

Results:

A correlation between quartile location was observed for mean maximum pressure (PMAX): infants with PMAX in the lowest quartile (poorest performance) were significantly more likely to remain in the lowest quartile at term (P < .000); infants in the highest quartile (best performance) at baseline were significantly more likely to be in the highest quartile at term (P < .000).

Implication for Practice:

Infants with the weakest sucking pressures at 34 weeks of post–menstrual age continue to be at risk for less than optimal feeding skills at 40 weeks of post–menstrual age. Early identification of at-risk infants may allow for effective interventions to potentially decrease long-term feeding problems.

Implications for Research:

Future research should focus on the development of personalized interventions to address attributes of problematic feeding such as sucking efficiency.
Vaccination and Immune Checkpoint Inhibitors
Authors: Desage Anne-Laure , Bouleftour Wafa , Rivoirard Romain , Magne Nicolas , Collard Olivier , Fournel Pierre , Tissot Claire
Published: December 2020

Introduction:

Immune checkpoint inhibitors (ICIs) have become part of cancer treatments. Their main side effects are immune-related adverse events (irAEs). So far, there has been no recommendation regarding routine vaccinations during ICIs treatment. Clinicians are aware of the risk of irAEs increases in this specific situation. The aim of this review of literature is to summarize the main studies about vaccination and ICIs interactions.

Methods:

A systematic assessment of literature articles was performed by searching in PubMed (MEDLINE), and major oncology meeting following PRISMA guidelines.

Results:

This review highlights the lack of literature. Indeed, most of the studies published were about influenza vaccination. Vaccination for patients under ICIs causes a humoral response and seems to be associated with an increase rate of seroconversion. Interestingly vaccination may provoke irAEs in ICIs-treated patients. So far, inactivated vaccines have not been contraindicated during ICI treatment.

Conclusion:

Larger prospective studies are needed in order to define a consensus on the use of vaccines under immunotherapy.
Temporal Characterization of Tritium Smear Activities
Authors: Stavola Adam J. , Hartberger Adam G.
Published: December 2020

Tritium collection efficiency varies as a function of smear media. The use of porous smear materials leads to an increase in the measured tritium activity as a function of time when the measurement is performed with liquid scintillation counters. Operational inclusion of the efficiency differences and the time dependence of the tritium smear activity is necessary to preclude inadvertently releasing materials or areas. Thomas Jefferson National Laboratory Radiological Control Department identified a contaminated stainless steel containment vessel that previously housed a target containing more than 37 TBq of tritium. The item was systematically sectioned and surveyed to compare three smear types: water-wetted cotton swabs, water-wetted paper smears, and ethanol-wetted Styrofoam wipes (NUC-Wipes™). The total activity of each section was determined using repeated decontamination. The time dependence of the measured activity was also studied. The measured activity of both paper smears and cotton swabs showed significant time dependence. The cotton swabs also showed significantly reduced collection efficiency. Given the widespread use of both of these media in routine contamination surveys, site operational limits were derived using fitted curves for time dependence and average efficiency results. The use of these more restrictive limits allows for rapid measurement of tritium smears while ensuring regulatory compliance.
Recurrent NR3C1 Aberrations at First Diagnosis Relate to Steroid Resistance in Pediatric T-Cell Acute Lymphoblastic Leukemia Patients
Authors: van der Zwet Jordy C. G. , Smits Willem , Buijs-Gladdines Jessica G. C. A. M. , Pieters Rob , Meijerink Jules P. P.
Published: December 2020

The glucocorticoid receptor NR3C1 is essential for steroid-induced apoptosis, and deletions of this gene have been recurrently identified at disease relapse for acute lymphoblastic leukemia (ALL) patients. Here, we demonstrate that recurrent NR3C1 inactivating aberrations—including deletions, missense, and nonsense mutations—are identified in 7% of pediatric T-cell ALL patients at diagnosis. These aberrations are frequently present in early thymic progenitor-ALL patients and relate to steroid resistance. Functional modeling of NR3C1 aberrations in pre-B ALL and T-cell ALL cell lines demonstrate that aberrations decreasing NR3C1 expression are important contributors to steroid resistance at disease diagnosis. Relative NR3C1 messenger RNA expression in primary diagnostic patient samples, however, does not correlate with steroid response.
The putative phosphate transporter PitB (PP1373) is involved in tellurite uptake in Pseudomonas putida KT2440
Authors: Montenegro Rafael , Vieto Sofía , Wicki-Emmenegger Daniela , Vásquez-Castro Felipe , Coronado-Ruiz Carolina , Fuentes-Schweizer Paola , Calderón Paula , Pereira Reinaldo , Chavarría Max
Published: December 2020

Tellurium oxyanions are chemical species of great toxicity and their presence in the environment has increased because of mining industries and photovoltaic and electronic waste. Recovery strategies for this metalloid that are based on micro-organisms are of interest, but further studies of the transport systems and enzymes responsible for implementing tellurium transformations are required because many mechanisms remain unknown. Here, we investigated the involvement in tellurite uptake of the putative phosphate transporter PitB (PP1373) in soil bacterium

Pseudomonas putida

KT2440. For this purpose, through a method based on the CRISPR/Cas9 system, we generated a strain deficient in the pitB gene and characterized its phenotype on exposing it to varied concentrations of tellurite. Growth curves and transmission electronic microscopy experiments for the wild-type and ΔpitB strains showed that both were able to internalize tellurite into the cytoplasm and reduce the oxyanion to black nano-sized and rod-shaped tellurium particles, although the ΔpitB strain showed an increased resistance to the tellurite toxic effects. At a concentration of 100 μM tellurite, where the biomass formation of the wild-type strain decreased by half, we observed a greater ability of ΔpitB to reduce this oxyanion with respect to the wild-type strain (~38 vs ~16 %), which is related to the greater biomass production of ΔpitB and not to a greater consumption of tellurite per cell. The phenotype of the mutant was restored on over-expressing pitB in trans. In summary, our results indicate that PitB is one of several transporters responsible for tellurite uptake in

P. putida

KT2440.
Reenvisioning space, mobilities and public engagement with young adult literature
Authors: Hamilton-McKenna Caroline , Rogers Theresa
Published: December 2020

Purpose

In an era when engagement in public spaces and places is increasingly regulated and constrained, we argue for the use of literary analytic tools to enable younger generations to critically examine and reenvision everyday spatialities (Rogers, 2016; Rogerset al., 2015). The purpose of this paper is to consider how spatial analyses of contemporary young adult literature enrich interrogations of the spaces and places youth must navigate, and the consequences of participation for different bodies across those spheres.

Design/methodology/approach

In a graduate seminar of teachers and writers, we examined literary texts through a combined framework of feminist cultural geography, mobilities and critical mobilities studies. In this paper, we interweave our own spatial analyses of two selected works of young adult fiction with the reflections of our graduate student participants to explore our spatial framework and its potential to enhance critical approaches to literature instruction.

Findings

We argue that spatial literary analysis may equip teachers and students with tools to critically examine the spaces and places of everyday life and creatively reenvision what it means to be an engaged citizen in uncertain and troubling times.

Originality/value

While we have engaged in this work for several years, we found that in light of the global pandemic, coupled with the recent antiracist demonstrations, a spatial approach to literary study emerges as a potentially even more relevant and powerful component of literature instruction.
Forecasting smog in Beijing using a novel time-lag GM(1,N) model based on interval grey number sequences
Authors: Shi Jia , Xiong Pingping , Yang Yingjie , Quan Beichen
Published: December 2020

Purpose

Smog seriously affects the ecological environment and poses a threat to public health. Therefore, smog control has become a key task in China, which requires reliable prediction.

Design/methodology/approach

This paper establishes a novel time-lag GM(1,N) model based on interval grey number sequences. Firstly, calculating kernel and degree of greyness of the interval grey number sequence respectively. Then, establishing the time-lag GM(1,N) model of kernel and degree of greyness sequences respectively to obtain their values after determining the time-lag parameters of two models. Finally, the upper and lower bounds of interval grey number sequences are obtained by restoring the values of kernel and degree of greyness.

Findings

In order to verify the validity and practicability of the model, the monthly concentrations of PM2.5, SO2 and NO2 in Beijing during August 2017 to September 2018 are selected to establish the time-lag GM(1,3) model for kernel and degree of greyness sequences respectively. Compared with three existing models, the proposed model in this paper has better simulation accuracy. Therefore, the novel model is applied to forecast monthly PM2.5 concentration for October to December 2018 in Beijing and provides a reference basis for the government to formulate smog control policies.

Practical implications

The proposed model can simulate and forecast system characteristic data with the time-lag effect more accurately, which shows that the time-lag GM(1,N) model proposed in this paper is practical and effective.

Originality/value

Based on interval grey number sequences, the traditional GM(1,N) model neglects the time-lag effect of driving terms, hence this paper introduces the time-lag parameters into driving terms of the traditional GM(1,N) model and proposes a novel time-lag GM(1,N) model.
Multiple dimensions of e-healthcare ethics and its relationship to the ethical concerns of the consumer
Authors: Verma Prachi , Kumar Satinder , Sharma Sanjeev K.
Published: December 2020

Purpose

This study aims to explore the different dimensions of e-healthcare ethics and their relationships, influencing the ethical concerns of the consumer in making ethical e-healthcare choices.

Design/methodology/approach

A study was conducted at two identified major hospitals of Punjab (a private hospital) and Chandigarh (a public hospital), India providing e-healthcare services with the help of a self-administered questionnaire. The respondents were identified from the waiting areas of the selected hospitals, and only those respondents were selected for the study, who agreed to be aware of e-health services and were using them for some time. The statistical analysis was done using the structural equation modeling technique and included both exploratory and confirmatory factor analysis using SPSS 20 and AMOS 21.

Findings

Exploratory factor analysis extracted five dimensions of ethical concerns of the consumer, which include service promotion, content quality, candor, professionalism and confidentiality. The results signify that content quality plays a significant role in ethics, followed by candor, service promotion and confidentiality. However, the relationship with professionalism did not prove to be significant for the ethical concerns of the e-health consumer.

Practical implications

This research delivers a practical significance in identifying the critical dimensions of the ethical concerns of the consumer while selecting e-health services. It gives an insight into the various dimensions, which should be considered by the e-health providers while crafting e-health services to make it more ethically acceptable by the consumers.

Originality/value

By using e-health services, consumers play an active role in their health-care decisions. The consumers need to consider ethics while choosing health-care services as an ethical judgment will also be the correct judgment. This study helps in the identification of the significant dimensions for the ethical concerns of the consumers.
Optimal number of privatised products in a differentiated mixed oligopoly with free market entry
Authors: Kawasaki Akio
Published: December 2020

This study investigates how a privatisation policy affects long‐run market equilibrium when a public firm produces multiple products. It contributes to the literature by (a) examining the long‐run effect of a privatisation policy on a multi‐product public firm and (b) investigating whether the market is characterised by excess or insufficient entry when in long‐run equilibrium. This study assumes that there is a multi‐product public firm and potential private firm entrants that produce one product in the economy. The public firm can privatise some production sectors, the privatised firm produces only one product, and the potential entrant private firm can enter the market by incurring entry costs. The public firm decides how many sectors to privatise. The private firms enter the market if they earn non‐negative profits. The study's findings show that full nationalisation is socially preferable in the long run. In equilibrium, when the number of production sectors of the public firm is small, excess entry occurs easily; the converse is also true. The results may assist the government in determining its privatisation policy and the private sector in determining whether to enter markets that were previously monopolised by the government.
Radiology in the era of value‐based healthcare: A multi‐society expert statement from the ACR, CAR, ESR, IS3R, RANZCR and RSNA
Authors: Brady Adrian P , Bello Jaqueline A , Derchi Lorenzo E , Fuchsjäger Michael , Goergen Stacy , Krestin Gabriel P , Lee Emil JY , Levin David C , Pressacco Josephine , Rao Vijay M , Slavotinek John , Visser Jacob J , Walker Richard EA , Brink James A
Published: December 2020

Background

The value‐based healthcare (VBH) concept is designed to improve individual healthcare outcomes without increasing expenditure and is increasingly being used to determine resourcing of and reimbursement for medical services. Radiology is a major contributor to patient and societal healthcare at many levels. Despite this, some VBH models do not acknowledge radiology’s central role; this may have future negative consequences for resource allocation.

Methods, findings and interpretation

This multi‐society paper, representing the views of Radiology Societies in Europe, the USA, Canada, Australia and New Zealand, describes the place of radiology in VBH models and the healthcare value contributions of radiology. Potential steps to objectify and quantify the value contributed by radiology to healthcare are outlined.
Cannabis use and co‐use in tobacco smokers and non‐smokers: prevalence and associations with mental health in a cross‐sectional, nationally representative sample of adults in Great Britain, 2020
Authors: Hindocha Chandni , Brose Leonie S. , Walsh Hannah , Cheeseman Hazel
Published: December 2020

Background and aims

In Great Britain, cannabis and tobacco are commonly used substances, both independently and together. Use of either substance is associated with mental health problems, but prevalence of co‐use within these populations is unknown. We aimed to (1) estimate prevalence of cannabis use, frequency of use and routes of administration (ROA) among tobacco smokers and non‐smokers and (2) investigate mental health problems among non‐users, tobacco‐only, cannabis‐only and co‐users of both substances.

Design

Cross‐sectional national on‐line survey (Action on Smoking and Health) fielded in February–March 2020.

Setting

Great Britain.

Participants

Adults in Great Britain aged ≥ 18 years (n = 12 809)

Measurements

Tobacco use status [smoker (daily or non‐daily) or non‐smoker (never or ex‐smoker)], cannabis use frequency (never to daily), detailed ROAs of cannabis, self‐reported treatment for mental health disorders (depression, anxiety and any). Statistically weighted prevalence estimates were computed to ensure representativeness. Correlates were assessed using χ2 tests and logistic regression.

Findings

In Great Britain in 2020, 7.1% of the sample had used cannabis in the past year. Tobacco smokers had greater odds of using cannabis in the past year (21.9%) and using cannabis daily (8.7%) than non‐smokers [past‐year: 4.7%; adjusted odds ratio (aOR) = 10.07, 95% confidence interval (CI) = 8.4–12.0; daily: 0.7%; aOR = 24.6, 95% CI = 18.0–33.6)]. Co‐administration with tobacco was common (46.2% of non‐smokers, 80.8% of tobacco smokers). Co‐users reported the highest prevalence of any treatment for mental health problems (54.2%) in comparison to cannabis‐only (45.8%), tobacco‐only (33.2%) and non‐users (22.7%; all P ≤ 0.05).

Conclusion

Approximately one in 13 adults in Great Britain reports having used cannabis in the past year, approximately four times as many among cigarette smokers as non‐smokers. Co‐administration of cannabis and tobacco, via smoking, appears to be common, including among self‐identified non‐smokers. Mental health problems appear to be particularly common among dual users.
Beyond electrification for development: Solar home systems and social reproduction in rural Solomon Islands
Authors: Hobbis Stephanie Ketterer
Published: December 2020

Based on an in‐depth examination of the acquisition, use, maintenance and deterioration of solar home systems in a village in Malaita, Solomon Islands, this article challenges the analytical focus of current debates on electrification in Pacific Island countries – why Pacific Island countries have not yet sufficiently electrified to achieve their development goals. Alternatively it examines what is, how, in this case, rural Solomon Islanders have integrated already available electricity into their daily lives. This perspectival shift highlights how rural Solomon Islanders have developed an energy identity that corresponds to their needs, interests and values, rather than those of national and international actors. It re‐emphasises the struggles of national and international electrification initiatives in rural environments, linking them to a broader distrust in the motivations of external actors. At the same time, it reveals how, throughout their life cycle, rural solar home systems have become integrated into processes of social reproduction rather than development aspirations. Contrary to dominant debates, rural solar home systems matter most in the opportunities that they provide for reciprocal exchange than for what the electricity enables them to do.