bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconsidering the nursing role in antimicrobial stewardship: a multisite qualitative interview study
Authors: Kirby Emma , Broom Alex , Overton Kristen , Kenny Katherine , Post Jeffrey J , Broom Jennifer
Published: October 2020

Objectives

This study responds to calls for greater focus on nursing roles, and the need for nursing integration within the antimicrobial optimisation agenda. The objective of this study was to explore Australian hospital nurses’ views on antimicrobial resistance and antimicrobial stewardship (AMS) in a hospital setting, in order to better understand the opportunities for and challenges to integration of nursing staff in antimicrobial optimisation within hospital settings.

Design

Qualitative one-on-one, semistructured interviews. Interview transcripts were digitally audio-recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory.

Setting

Four hospitals (three public and one private), across metropolitan, regional and remote areas, in two Australian states.

Participants

86 nurses (77 females, 9 males), from a range of hospital departments, at a range of career stages.

Results

Findings were organised into three thematic domains: (1) the current peripheral role of nurses in AMS; (2) the importance of AMS as a collaborative effort, and current tensions around interprofessional roles and (3) how nurses can bolster antimicrobial optimisation within AMS and beyond.

Conclusion

Nursing staff are central to infection management within the hospital and are thus ideally located to enhance antibiotic optimisation and contribute to AMS governance. However, without increased interprofessional cooperation, education and integration in the AMS agenda, as well as addressing organisational/resource constraints in the hospital, the nursing role in stewardship will remain limited.
Perceived barriers and facilitators to accessing and utilising sexual and reproductive healthcare for people who experience homelessness: a systematic review
Authors: Paisi Martha , March-McDonald Jane , Burns Lorna , Snelgrove-Clarke Erna , Withers Lyndsey , Shawe Jill
Published: October 2020

Introduction

People who experience homelessness face disproportionately poor reproductive health and adverse pregnancy outcomes, including but not limited to unintended pregnancy, abortion, low birth weight and preterm birth, as well as a higher risk of sexually transmitted infections (STIs). Precarious living conditions are known to contribute to poor uptake and engagement with sexual and reproductive healthcare (SRH) for this population.

Aim

To identify and understand the perceived barriers and facilitators for accessing and utilising SRH for people who experience homelessness from their perspective, and the perspective of support staff/volunteers and healthcare professionals.

Methods

Electronic databases and online sources were searched. Two reviewers independently carried out the screening, data extraction, critical appraisal, data synthesis and thematic analysis of findings.

Results

Following deduplication and screening, 23 papers/reports were considered eligible for the review. Barriers for people experiencing homelessness to accessing and utilising SRH were identified within the themes of complexity, feelings and knowledge (ie, individual-level factors), as well as patient/provider interaction and healthcare system (ie, organisational factors). Facilitators were identified within all of the above themes except for complexity.

Conclusions

Both population characteristics and attributes of the healthcare system influence access and utilisation of SRH by people experiencing homelessness. Given the complexity of living conditions associated with homelessness, greater efforts to improve access should be placed on healthcare systems and aspects of care delivery. This systematic review highlights current gaps in the literature and provides recommendations for enhancing future research and practice to meet the needs of this vulnerable group more effectively.
‘It’s the ultimate observer role…you’re feeling and seeing what’s happening to you’: students’ experiences of peer simulation
Authors: Pritchard Shane A , Dalwood Narelle , Keating Jennifer L , Nestel Debra , Te Maxine , Blackstock Felicity
Published: October 2020

Introduction

Simulation-based education (SBE) benefits learners, but multiple barriers limit curriculum integration. Peer simulation, where students are formally educated to portray patient roles in simulated interactions with their peers, might maintain the educational benefits of SBE, be cost-effective, and enable additional learning. Our research question was: ‘What are the perspectives and experiences of physiotherapy students who participated in peer simulation?’.

Methods

Second-year physiotherapy students (n=16) participated in a blended peer simulation programme that included preparation for patient role portrayal and simulated clinical interactions with peers. Using an interpretivist approach, students’ experiences and perspectives were explored in two focus groups. Inductive thematic analysis was completed by two researchers.

Results

Three primary themes were identified that characterised the experiences and perspectives of physiotherapy students: peer simulation is a valuable learning experience, specific design features enable effective peer simulation, and portraying a patient provides unique insight. Peer simulation was unexpectedly realistic, revealed knowledge and skill deficits, and improved their clinical skills. Specific design features included consistent engagement, repetitive, individualised practice, multiple forms of feedback, and detailed role preparation. Being the patient in peer simulation gave students unique and valuable insight into patients’ experiences of and feelings about health issues and healthcare interactions.

Conclusion

Physiotherapy students acquire new insights during peer simulation that may enrich their capabilities for practice through understanding healthcare interactions from patients’ perspectives. Physiotherapy students’ learning in peer simulation appears to align with the powerful learning experiences of health professional students in other immersive simulation modalities.
Clinical and budget impacts of changes in oral anticoagulation prescribing for atrial fibrillation
Authors: Orlowski Andi , Gale Chris P , Ashton Rachel , Petrungaro Bruno , Slater Ruth , Nadarajah Ramesh , Cowan J Campbell , Buck Jackie , Smith Wayne , Wu Jianhua
Published: October 2020

Objective

To assess temporal clinical and budget impacts of changes in atrial fibrillation (AF)-related prescribing in England.

Methods

Data on AF prevalence, AF-related stroke incidence and prescribing for all National Health Service general practices, hospitals and registered patients with hospitalised AF-related stroke in England were obtained from national databases. Stroke care costs were based on published data. We compared changes in oral anticoagulation prescribing (warfarin or direct oral anticoagulants (DOACs)), incidence of hospitalised AF-related stroke, and associated overall and per-patient costs in the periods January 2011–June 2014 and July 2014–December 2017.

Results

Between 2011–2014 and 2014–2017, recipients of oral anticoagulation for AF increased by 86.5% from 1 381 170 to 2 575 669. The number of patients prescribed warfarin grew by 16.1% from 1 313 544 to 1 525 674 and those taking DOACs by 1452.7% from 67 626 to 1 049 995. Prescribed items increased by 5.9% for warfarin (95% CI 2.9% to 8.9%) but by 2004.8% for DOACs (95% CI 1848.8% to 2160.7%). Oral anticoagulation prescription cost rose overall by 781.2%, from £87 313 310 to £769 444 028, (£733,466,204 with warfarin monitoring) and per patient by 50.7%, from £293 to £442, giving an incremental cost of £149. Nevertheless, as AF-related stroke incidence fell by 11.3% (95% CI −11.5% to −11.1%) from 86 467 in 2011–2014 to 76 730 in 2014–2017 with adjustment for AF prevalence, the overall per-patient cost reduced from £1129 to £840, giving an incremental per-patient saving of £289.

Conclusions

Despite nearly one million additional DOAC prescriptions and substantial associated spending in the latter part of this study, the decline in AF-related stroke led to incremental savings at the national level.
Impact of opioid use disorders on outcomes and readmission following cardiac operations
Authors: Madrigal Josef , Sanaiha Yas , Hadaya Joseph , Dhawan Puneet , Benharash Peyman
Published: October 2020

Objective

While opioid use disorder (OUD) has been previously associated with increased morbidity and resource use in cardiac operations, its impact on readmissions is understudied.

Methods

Patients undergoing coronary artery bypass grafting and valve repair or replacement, excluding infective endocarditis, were identified in the 2010–16 Nationwide Readmissions Database. Using International Classification of Diseases 9/10, we tabulated OUD and other characteristics. Multivariable regression was used to adjust for differences.

Results

Of an estimated 1 978 276 patients who had cardiac surgery, 5707 (0.3%) had OUD. During the study period, the prevalence of OUD increased threefold (0.15% in 2010 vs 0.53% in 2016, parametric trend<0.001). Patients with OUD were more likely to be younger (54.0 vs 66.0 years, p<0.001), insured by Medicaid (28.2 vs 6.2%, p<0.001) and of the lowest income quartile (33.6 vs 27.1%, p<0.001). After multivariable adjustment, OUD was associated with decreased mortality (1.5 vs 2.7%, p=0.001). Although these patients had similar rates of overall complications (36.1 vs 35.1%, p=0.363), they had increased thromboembolic (1.3 vs 0.8%, p<0.001) and infectious (4.1 vs 2.8%, p<0.001) events, as well as readmission at 30 days (19.0 vs 13.2%, p<0.001). While patients with OUD had similar hospitalisation costs ($50 766 vs $50 759, p=0.994), they did have longer hospitalisations (11.4 vs 10.3 days, p<0.001).

Conclusion

The prevalence of OUD among cardiac surgical patients has steeply increased over the past decade. Although the presence of OUD was not associated with excess mortality at index hospitalisation, it was predictive of 30-day readmission. Increased attention to predischarge interventions and care coordination may improve outcomes in this population.
Human macrophages engineered to secrete a bispecific T cell engager support antigen-dependent T cell responses to glioblastoma
Authors: Gardell Jennifer L , Matsumoto Lisa R , Chinn Harrison , DeGolier Kole R , Kreuser Shannon A , Prieskorn Brooke , Balcaitis Stephanie , Davis Amira , Ellenbogen Richard G , Crane Courtney A
Published: October 2020

Background

Targeted and effective treatment options are needed for solid tumors, including glioblastoma (GBM), where survival rates with standard treatments are typically less than 2 years from diagnosis. Solid tumors pose many barriers to immunotherapies, including therapy half-life and persistence, tumor penetrance, and targeting. Therapeutics delivered systemically may not traffic to the tumor site. If cellular therapies or drugs are able to access the tumor site, or can be delivered directly within the tumor, treatments may not persist for the duration necessary to reduce or eliminate tumor burden. An approach that allows durable and titratable local therapeutic protein delivery could improve antitumor efficacy while minimizing toxicities or unwanted on-target, off-tissue effects.

Methods

In this study, human monocyte-derived macrophages were genetically engineered to secrete a bispecific T cell engager (BiTE) specific to the mutated epidermal growth factor variant III (EGFRvIII) expressed by some GBM tumors. We investigated the ability of lentivirally modified macrophages to secrete a functional BiTE that can bind target tumor antigen and activate T cells. Secreted BiTE protein was assayed in a range of T cell functional assays in vitro and in subcutaneous and intracranial GBM xenograft models. Finally, we tested genetically engineered macrophages (GEMs) secreting BiTE and the proinflammatory cytokine interleukin (IL)-12 to amplify T cell responses in vitro and in vivo.

Results

Transduced human macrophages secreted a lentivirally encoded functional EGFRvIII-targeted BiTE protein capable of inducing T cell activation, proliferation, degranulation, and killing of antigen-specific tumor cells. Furthermore, BiTE secreting macrophages reduced early tumor burden in both subcutaneous and intracranial mouse models of GBM, a response which was enhanced using macrophages that were dual transduced to secrete both the BiTE protein and single chain IL-12, preventing tumor growth in an aggressive GBM model.

Conclusions

The ability of macrophages to infiltrate and persist in solid tumor tissue could overcome many of the obstacles associated with systemic delivery of immunotherapies. We have found that human GEMs can locally and constitutively express one or more therapeutic proteins, which may help recruit T cells and transform the immunosuppressive tumor microenvironment to better support antitumor immunity.
EBV-EBNA1 constructs an immunosuppressive microenvironment for nasopharyngeal carcinoma by promoting the chemoattraction of Treg cells
Authors: Huo Shaofen , Luo Yunfan , Deng Rui , Liu Xiong , Wang Jie , Wang Lu , Zhang Bao , Wang Fan , Lu Juan , Li Xiangping
Published: October 2020

Background

Nasopharyngeal carcinoma (NPC) is primarily caused by the Epstein-Barr virus (EBV) infection in NPC endemic areas. EBNA1 is an EBV-encoded nuclear antigen, which plays a critical role in the maintenance and replication of EBV genome. However, the mechanisms of EBNA1-promoted NPC immune escape are unknown. Regulatory T (Treg) cells are among the key regulators in restraining antitumor responses. However, the mechanisms of accumulation of Treg cells in NPC have not been defined. This study attempted to identify the detailed mechanisms of EBNA1 functions as a tumor accelerator to promote NPC immune escape by enhancing chemoattraction of Treg cells.

Methods

mRNA profiles were determined by next-generation sequencing in NPC cells. In vitro and in vivo assays were performed to analyze the role of EBNA1 in regulation of recruitment of Treg cells. Colocation and coimmunoprecipitation analyzes were used to identify the SMAD3/c-JUN complex. Chromatin immunoprecipitation assay and dual luciferase reporter assays were designed to demonstrate c-JUN binding to miR-200a promoter and miR-200a targeting to CXCL12 3’Untranslated Regions. The hepatocellular carcinoma models were designed to demonstrate universality of the CXCL12-CXCR4-Treg axis in promoting immune evasion of various tumors.

Result

A novel molecular mechanism was identified that involves EBV-EBNA1-stimulated chemotactic migration of Treg cells toward NPC microenvironment by upregulation of the transforming growth factor-β1 (TGFβ1)-SMAD3-PI3K-AKT-c-JUN-CXCL12-CXCR4 axis and downregulation of miR-200a. EBV-EBNA1 promotes the chemoattraction of Treg cells by governing the protein–protein interactions of the SMAD3/c-JUN complex in a TGFβ1-dependent manner in vitro and in vivo. TGFβ1 suppresses miR-200a by enhancing the SMAD3/c-JUN complex. miR-200a negatively regulates the CXCL12 chemokine by direct targeting of the CXCL12 3’UTR region. However, CXCL12 acts as the target gene of miR-200a and as an inhibitor of miR-200a transcription, and inhibition of miR-200a by CXCL12 is mediated by c-JUN, which directly binds to the miR-200a promoter and forms a c-JUN-miR-200a-CXCL12-c-JUN feedback loop. In addition, enhanced CXCL12 efficiently attracts CXCR4-positive Treg cells to remodel an immunosuppressive microenvironment.

Conclusions

EBV-EBNA1 promotes chemotactic migration of Treg cells via the TGFβ1-SMAD3-PI3K-AKT-c-JUN-miR-200a-CXCL12-CXCR4 axis in the NPC microenvironment. These results suggest that EBV-EBNA1 may serve as a potential therapeutic target to reshape the NPC microenvironment.
Incidence and predictors of ophthalmic artery occlusion in intra-arterial chemotherapy for retinoblastoma
Authors: Sweid Ahmad , El Naamani Kareem , Sajja Kalyan Chekravarthy , Hammoud Batoul , Knapp Michael D , Moylan Daniel D , Joffe Daniel , Morse Charles E , Habbal Daniel , Weinberg Joshua H , Tjoumakaris Stavropoula I , Shields Carol L , Lezama David A , Lim Li-Anne S , Dalvin Lauren A , Rosenwasser Robert , Jabbour Pascal
Published: October 2020

Background

Retinoblastoma is the most common primary intraocular malignancy in children.

Objective

To determine the incidence of ophthalmic artery (OA) occlusion in patients treated with selective ophthalmic artery catheterization (OAC) for chemotherapy infusion for retinoblastoma. Also, to evaluate technical, anatomical, tumorous, and patient-related factors that are predictors of OA occlusion.

Methods

A retrospective chart review was performed for patients diagnosed with intraocular retinoblastoma and managed with intra-arterial chemotherapy (IAC).

Results

The total study cohort included 208 retinoblastoma tumors of 208 eyes in 197 consecutive patients who underwent 688 attempted IAC infusions overall with a total of 624 successful OAC infusions. The total incidence of ophthalmic artery thrombosis was 11.1% (23/208). The numbers of successful OAC procedures before diagnosing OA occlusion were one OAC in six cases (27.3%), two in seven cases (31.8%), three in four cases (18.2%), four in one case (4.5%), five in two cases (9.1%), and six in one case (4.5%).

Conclusions

Local factors relating to the chemotherapy and selective microcatheterization of the OA are essential factors in the development of OA thrombosis, as seen by the association of OA thrombosis with the frequency of IAC.
Do EXCEL and NOBLE translate into real world? A 5-year observational study of left main stem outcomes
Authors: Joy George , Eissa Hany
Published: October 2020

Aims

We aimed to uncover the 5-year real world outcomes of patients with significant left mainstem (LMS) disease managed with percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) or medical management.

Methods

We identified patients with LMS disease in 2012 and analysed baseline characteristics and outcomes in the following 5 years.

Results

119 patients were identified, 62% (74) received CABG and 12% (14) received PCI and 26% (31) were medically managed. In PCI versus CABG, there was no significant difference in age and Synergy between PCI with Taxus and Cardiac Surgery score but there were significantly higher rates of pretreatment heart failure (ejection fraction 42%±10 vs 52%±13p=0.01). Overall major adverse cardiovascular event (MACE) being a composite of stroke, myocardial infarction (MI), target vessel revascularisation and all-cause mortality were not statistically different but numerically higher in the PCI group (36% (5) vs 23% (17) p=0.12). Medically managed patients were significantly older than those that were revascularised (PCI or CABG n=88; 75±11 vs 69±9 years p=0.01). They also had higher MACE (74% (23) vs 25% (22) p=0.000002) driven by MI (19% (6) vs 2% (1) p=0.01) and all-cause mortality (52% (16) vs 19% (17) p=0.01) compared with those with revascularisation.

Conclusions

The bleak outcomes of medical management in LMS disease are reflective findings from studies performed from several decades ago. Our findings show that there is still a role for PCI in the management of LMS disease in selected patients.
Managing drug-induced QT prolongation in clinical practice
Authors: Khatib Rani , Sabir Fatima R N , Omari Caroline , Pepper Chris , Tayebjee Muzahir Hassan
Published: October 2020

Many drug therapies are associated with prolongation of the QT interval. This may increase the risk of Torsades de Pointes (TdP), a potentially life-threatening cardiac arrhythmia. As the QT interval varies with a change in heart rate, various formulae can adjust for this, producing a ‘corrected QT’ (QTc) value. Normal QTc intervals are typically <450 ms for men and <460 ms for women. For every 10 ms increase, there is a ~5% increase in the risk of arrhythmic events. When prescribing drugs associated with QT prolongation, three key factors should be considered: patient-related risk factors (eg, female sex, age >65 years, uncorrected electrolyte disturbances); the potential risk and degree of QT prolongation associated with the proposed drug; and co-prescribed medicines that could increase the risk of QT prolongation. To support clinicians, who are likely to prescribe such medicines in their daily practice, we developed a simple algorithm to help guide clinical management in patients who are at risk of QT prolongation/TdP, those exposed to QT-prolonging medication or have QT prolongation.
In-hospital complications affect short-term and long-term mortality in ICH: a prospective cohort study
Authors: Zhang Yaqing , Wang Yongjun , Ji Ruijun , Wang Anxin , Wang Yilong , Yang Zhonghua , Liu Liping , Wang Penglian , Zhao Xingquan
Published: October 2020

Background

Medical complications strongly affected the mortality of patients with stroke. However, only limited research has studied the effect of in-hospital medical complications on the mortality of patients with spontaneous intracerebral haemorrhage (ICH) globally. Using the China National Stroke Registry, the effect was prospectively and systematically investigated in patients with spontaneous ICH during their hospitalisation, at 3, 6 and 12 months after disease onset.

Methods

This study collected data on patients over 18 years old with spontaneous ICH from 132 Chinese clinical centres across 32 provinces and four municipalities (Hong Kong included), from September 2007 to August 2008. Data on patient complications, death and other information were acquired through paper-based registry forms. Using multivariable logistic regression, the association of medical complications with stroke outcomes was evaluated.

Results

Of 3255 patients with spontaneous ICH, 878 (26.97%) had in-hospital medical complications. In-hospital medical complications were independent risk factors for death during the hospitalisation (adjusted OR 4.41, 95% CI 3.18 to 6.12), at 3 months (adjusted OR 2.18, 95% CI 1.70 to 2.80), 6 months (adjusted OR 1.84, 95% CI 1.45 to 2.34) and 12 months (adjusted OR 1.59, 95% CI 1.26 to 2.01) after spontaneous ICH.

Conclusion

The results revealed that the short-term and long-term mortality of patients with spontaneous ICH in China was significantly associated with their in-hospital medical complications.
Cellular and molecular imaging for stem cell tracking in neurological diseases
Authors: Yang Xiaoxia , Tian De-Cai , He Wenyan , Lv Wei , Fan Junwan , Li Haowen , Jin Wei-Na , Meng Xia
Published: October 2020

Stem cells (SCs) are cells with strong proliferation ability, multilineage differentiation potential and self-renewal capacity. SC transplantation represents an important therapeutic advancement for the treatment strategy of neurological diseases, both in the preclinical experimental and clinical settings. Innovative and breakthrough SC labelling and tracking technologies are widely used to monitor the distribution and viability of transplanted cells non-invasively and longitudinally. Here we summarised the research progress of the main tracers, labelling methods and imaging technologies involved in current SC tracking technologies for various neurological diseases. Finally, the applications, challenges and unresolved problems of current SC tracing technologies were discussed.
Acute upper limb compartment syndrome in children: special focus on nerve recovery
Authors: Jerome Terrence Jose
Published: October 2020

Background

Many studies have discussed acute compartment syndrome in children associated with or without fractures and have given their visible perspectives. Little is known about the nerve involvement and the factors associated with recovery patterns in these patients. We intend to propose that ischemic nerve and muscles tend to regenerate after surgical decompression but in a different pattern and the given circumstances.

Methods

Twenty-four children with acute compartment syndrome in the upper limb were analyzed between 2009 and 2015. Data included demographic features of these patients, the time interval between the injury and surgery, and the attempt to correlate with motor and sensory recovery.

Results

The average follow-up was 67.3 months (range 59–80). Of the 24, 14 patients (58%) had immediate recovery of motor and sensory functions. The remaining 10 patients had variable recovery patterns with a mean time for the radial nerve, median nerve and ulnar nerve motor recovery of 6.0, 7.5 and 8.5 months, respectively, and sensory recovery at 12, 12 and 13 months, respectively. The overall study had a mean sensory recovery as per the Medical Research Council (MRC) of S3 in 3 (12%) and S4 in 21 (88%). The mean 2-point discrimination (2PD) was 6.9 mm (range 5–10). Twenty-one patients (88%) had a full range of movements at their final follow-up with a mean Visual Analog Scale score of 0.6; a quick Disabilities of the Arm, Shoulder and Hand score of 5.9 (range 2.3–25.0) and a Mayo wrist score of 79.

Conclusions

There was a definite motor and sensory recovery in patients who underwent surgical decompression in acute compartment syndrome of the upper limb irrespective of age, gender, delay in presentation and various etiologies. The motor and nerve fibers can regenerate after ischemic sequela of compartment syndrome.
Differences in growth and condition of juvenileOncorhynchus mykissrelated to sex and a migration-associated genomic region
Authors: Rundio David E. , Garza John Carlos , Lindley Steven T. , Williams Thomas H. , Pearse Devon E.
Published: October 2020

The expression of anadromy in partially migratory salmonid populations is influenced by sex-specific interactions among an individual’s genotype, condition, and environment, but genotype–phenotype relationships prior to the expression of migratory type are poorly understood. We examined whether juvenile growth and condition differed with respect to sex and a migration-associated genomic region (Omy05) in a coastal California population of steelhead and rainbow trout (Oncorhynchus mykiss). Sex and Omy05 genotype had additive effects on annual growth from age 0+ to age 1+ (∼6–18 months old), with higher growth in males and individuals with copies of the rearranged–resident haplotype. Condition at age 1+ increased with the number of copies of the rearranged–resident haplotype, with similar support for additive or interactive effects with sex; additive effects suggested that genotype differences occurred in both sexes and also that condition was slightly higher in males, while interactive effects suggested that the genotype differences occurred only in males. Our results indicate that phenotypic differences related to sex and Omy05 genotype occur well in advance of anadromous migration or freshwater maturation in this southern O. mykiss population.
Distribution of integrons and phylogenetic groups among Escherichia coli causing community-acquired urinary tract infection in Upper Egypt
Authors: Farahat Eman M. , Hassuna Noha A. , Hammad Adel M. , Fattah Medhat Abdel , Khairalla Ahmed S.
Published: October 2020

Escherichia coli is a major cause of community‐acquired urinary tract infections (CA‐UTIs). In this study, we investigated the antimicrobial resistance patterns, the distribution of phylogenetic groups, and the prevalence and characteristics of integron-bearing E. coli isolates from outpatients with CA‐UTIs in El-Minia governorate, in Upper Egypt. Out of the 583 urine samples collected, 134 were positive for E. coli, from which the most resistant isolates (n = 80) were selected for further analysis. The majority of these isolates (62.5%, 50/80) showed multidrug resistance profiles. Group B2 was the most predominant phylogenetic group (52.5%), followed by group F (21.25%), Clades I or II (12.5%), and finally isolates of unknown phylogroup (13.75%). Of the 80 isolates, 7 (8.75%) carried class 1 integrons, which contained 3 different types of integrated gene cassettes, including those conferring resistance to streptomycin/spectinomycin, trimethoprim, and some open reading frames of unknown function (gcuF). In conclusion, the types and combinations of the gene cassettes in our study may reflect the specific selective pressures to which the isolates were subjected within the study region, therefore, providing valuable data for future intervention strategies that are precisely tailored to prevent the dissemination of the uropathogenic E. coli strains circulating within Upper Egypt.
Molecular characterization and diversity analysis of selected maize inbred lines using single-nucleotide polymorphism markers
Authors: Zawadi Mwaikonyole , Sibiya Julia , Mashingaidze Kingstone , Amelework Assefa B. , Kondwakwenda Aleck , Musvosvi Cousin
Published: October 2020

The level of genetic diversity among the available breeding materials determines the potential success of a breeding program. In this study, 92 maize inbred lines were genotyped with 3047 single-nucleotide polymorphism (SNP) markers using a Kompetitive allele-specific polymerase chain reaction (KASP™) genotyping protocol. The objectives were to determine the level and pattern of genetic diversity and define potential heterotic groups of maize inbred lines developed by the Agricultural Research Council maize program of South Africa. More than 91% of the SNPs used were polymorphic with a mean polymorphic information content of 0.36. Gene diversity ranged from 0.35 to 0.37, with a mean of 0.36. Cluster analysis revealed the presence of three distinct subpopulations. Analysis of molecular variance revealed low but highly significant (P < 0.0001) variations among populations and high within and among individual variations. Variation among individuals contributed 83% of the total variation, whereas variation within individuals and among populations contributed 14% and 3%, respectively. Low mean population differentiation observed in this study suggested that the inbred lines might be developed from parental genotypes with similar genetic backgrounds. The mean percentage of genetic purity among the inbred lines was 4.8, with more than 79% of the inbred lines exhibiting less than 5% heterozygosity, indicating the inbred lines are fixed. Genotypes in different clusters may be earmarked as belonging to distinct heterotic groups, and their crosses may result in better heterosis. Thus, the findings of this study set the basis for earmarking heterotic groups and parental selection.
The biomedical lab after COVID-19: cascading effects of the lockdown on lab-based research programs and graduate students in Canada
Authors: Maranda Vincent , Yakubovich Edward
Published: October 2020

In the early months of 2020, the spread of the new coronavirus SARS-CoV-2 shook the world, which responded with various measures of quarantine, social distancing, and mass shutdowns. These measures have affected Canadian graduate students, especially those in lab-based science research programs who have been unable to access their workplaces. As a period of reopening may be approaching, and universities and research centers discuss ways to allow for work to resume cautiously, a discussion on the long-term impact of the pandemic on graduate students is necessary. Many students expressed significant concern regarding motivation with the shift to online courses; financial stress in terms of personal debt, bills, and tuition fees; as well as disrupted education and career plans. Uncertainty over the current economic situation and potential research material shortages lead to worry related to the quality and quantity of results and the impact these may have on funding. Luckily, universities, hospitals, governmental agencies, and employers have implemented a variety of programs and financial aid to help students in these trying times. Assuring the continuation of such measures is critical, and graduate students’ drive to succeed will manifest in novel ways to tackle the challenges that the COVID-19 lockdown has imposed.
From dipole spinors to a new class of mass dimension one fermions
Authors: Rogerio R. J. Bueno
Published: October 2020

In this paper, we investigate a quite recent new class of spin one-half fermions, namely Ahluwalia class-7 spinors, endowed with mass dimensionality 1 rather than 3/2, being candidates to describe dark matter. Such spinors, under the Dirac adjoint structure, belongs to the Lounesto’s class-6, namely, dipole spinors. Up to our knowledge, dipole spinor fields have Weyl spinor fields as their most known representative, nonetheless, here we explore the dark counterpart of the dipole spinors, which represents eigenspinors of the chirality operator.
Effective quantum tunneling from a semiclassical momentous approach
Authors: Aragón-Muñoz L. , Chacón-Acosta G. , Hernandez-Hernandez H.
Published: October 2020

In this work, we study the quantum tunnel effect through a potential barrier within a semiclassical formulation of quantum mechanics based on expectation values of configuration variables and quantum dispersions as dynamical variables. The evolution of the system is given in terms of a dynamical system for which we are able to determine numerical effective trajectories for individual particles, similar to the Bohmian description of quantum mechanics. We obtain a complete description of the possible trajectories of the system, finding semiclassical reflected, tunneled and confined paths due to the appearance of an effective time-dependent potential.
Critical Factors Related to Student Success Technology
Authors: VanDerSchaaf Hans , Daim Tugrul
Published: October 2020

This study examines university students’ perspectives on student success technology. Efforts to improve graduation and retention rates for undergraduates (i.e. “student success”) and initiatives to enhance the overall student experience are critical for higher education administrators, faculty and staff. These actors are significantly dependent on technology and technology-mediated services. To help understand student perspectives on online services related to student success, this study uses data from a 2016 survey of ABC University students about the importance and satisfaction that students placed on accomplishing key tasks online ([Formula: see text] respondents). The main questions in this inquiry are: (1) What, if any, factors, or latent variables, are in the data set? (2) If there are latent variables, what might they tell us about students’ perspectives on accomplishing critical online tasks? The study’s main findings are that five factors — navigation, tactical, funding, personalization and planning - are present in the data and statistically significant. The findings also suggest that a sixth factor, funding, is not significant. This study contributes to the literature by supporting the notion that there is harmony between the technology that universities utilize to support students and the value that students derive from such tools.
The Avocado Hand – the UK Experience of the Management of Avocado Hand Injuries
Authors: Sajid Soha , Gill James , Chojnowski Adrian , Singh Rohit
Published: October 2020

Background: Avocados are increasingly being consumed due to the nutritional benefits they provide. Avocado related hand injuries reflect their increasing popularity. Most injuries occur in attempting to de-stone the fruit. This is a prospective cohort study reviewing hand injuries sustained from preparing the fruit.

Methods: Data was prospectively collected from three centres across United Kingdom (UK) over a 4-year period. The data was analysed for patient demographics, nature and zone of injury and management required.

Results: A total of 35 patients and 42 injuries were included in the study. The median age of patients presenting with these injuries was 33 years, with majority of injuries occurring in the 21–30 age group. Most (88%, n = 31) of patients were male. Majority (85%, n = 36) of injuries happened during the de-stoning of the fruit. All injuries occurred in the non-dominant hand, with 70%, (n = 30) of wounds being sustained in zone 3. All injuries required surgical management and needed between 1 to 6 follow up outpatient visits. Vital structures such as tendons, digital nerves, pulleys and joint capsule were frequently implicated and required exploration or repair.

Conclusions: Avocado related hand wounds are serious injuries with an associated morbidity. They frequently sustained by young patients. They usually require surgical management and may need numerous outpatient attendances. Caution and public education should be advocated on the preparation of avocados. This is the largest study to date that has reviewed the surgical management of avocado hand injuries.
Clinical Outcomes in Distal Radius Fractures Accompanied by Volar Lunate Facet Fragments: A Comparison between Dorsal and Volar Displaced Fractures
Authors: Obata Hiroyuki , Naito Kiyohito , Kaneko Ayaka , Goto Keniji , Sugiyama Yoichi , Nagura Nana , Kawakita So , Iwase Yoshiyuki , Kaneko Kazuo
Published: October 2020

Background: The treatment strategy for distal radius fractures accompanied by volar lunate facet fragment is controversial. In most cases, only the bone fragment size was discussed and a plate for distal placement is selected due to the accompanying volar lunate facet fragment regardless of the direction of bone fragment displacement. In this study, we divided distal radius fractures accompanied by volar lunate facet fragment into dorsal and volar displaced fractures, and treated these surgically based on different treatment strategies.

Methods: The subjects were 25 patients with distal radius fractures accompanied by volar lunate facet fragment treated by reduction and fixation using a volar locking plate (VLP) (male: 14, female: 11, mean age: 57.8 years old). A proximal VLP (PVLP) was selected for 13 dorsal displaced fractures and a distal VLP (DVLP) was selected for 12 volar displaced fractures. The range of motion, VAS, Q-DASH, and Mayo score were evaluated at 12 months after surgery, and compared.

Results: No significant difference due to the difference in the direction of displacement was noted in the range of motion, VAS, Q-DASH, or Mayo score at 12 months after surgery and there were no perioperative complications. In addition, no re-displacement of volar lunate facet fragment was noted after surgery in any patient and bone fusion was observed.

Conclusions: Reduction and fixation with a PVLP are possible even for dorsal displaced distal radius fractures accompanied by volar lunate facet fragment. For the volar displaced distal radius fractures, a favorable postoperative outcome is possible by applying a DVLP to the distal ulnar.
Treatment of Chronic Severe Flexion Contractures of Fingers with Bilateral Side-Finger Flaps (Wing Flaps) and Full-Thickness Skin Graft
Authors: Pataradool Kawee
Published: October 2020

Background: Severe flexion contractures of proximal interphalangeal joint of fingers can significantly impair hand function, typically after burn injury recovery. Extensive surgical release exposes deep vital structures, which subsequently requires significant skin coverage. The author presents the results of using bilateral side-finger flaps (wing flaps) and full-thickness skin graft for coverage of the defects.

Methods: Seven patients (8 fingers) with chronic severe flexion contractures of fingers resulting from burn injury were included.

Results: Mean flexion contracture and full flexion angles of the joints were improved from 84.4°/93.7° to 4.7°/92.5° at the last follow-up visit. No major complications were observed during the postoperative follow-up period (range, 6–16 months).

Conclusions: This alternative surgical technique can be successfully applied for the treatment of chronic severe flexion contractures of fingers. The advantages of this approach are the use of local flaps from injured digit, and that it can be performed as a one-session procedure.
Improved Quantum Circuits via Intermediate Qutrits
Authors: Baker Jonathan M. , Duckering Casey , Gokhale Pranav , Brown Natalie C. , Brown Kenneth R. , Chong Frederic T.
Published: October 2020

Quantum computation is traditionally expressed in terms of quantum bits, or qubits. In this work, we instead consider three-level qu
trits
. Past work with qutrits has demonstrated only constant factor improvements, owing to the log
2
(3) binary-to-ternary compression factor. We present a novel technique, intermediate qutrits, to achieve sublinear depth decompositions of the Generalized Toffoli and other arithmetic circuits using no additional ancilla—a significant improvement over linear depth for the best qubit-only equivalents. For example, our Generalized Toffoli construction features a 70× improvement in two-qudit gate count over a qubit-only decomposition. This results in circuit cost reductions for important algorithms like quantum neurons, Grover search, and even Shor’s algorithm. Using a previously developed simulator with near-term noise models, we demonstrate for these models over 90% mean reliability (fidelity) for the Toffoli construction, versus under 30% for the qubit-only baseline. For our other constructions, such as the Incrementer, the A + B adder and the +K adder, we demonstrate the power of intermediate qutrits in producing asymptotic depth improvements with no additional ancilla. Together, these results suggest qutrits offer a promising path toward scaling quantum computation.
DeepApp
Authors: Xia Tong , Li Yong , Feng Jie , Jin Depeng , Zhang Qing , Luo Hengliang , Liao Qingmin
Published: October 2020

Smartphone mobile application (App) usage prediction, i.e., which Apps will be used next, is beneficial for user experience improvement. Through an in-depth analysis on a real-world dataset, we find that App usage is highly spatio-temporally correlated and personalized. Given the ability to model complex spatio-temporal contexts, we aim to apply deep learning to achieve high prediction accuracy. However, the personalization yields a problem: training one network for each individual suffers from data scarcity, yet training one deep neural network for all users often fails to uncover user preference. In this article, we propose a novel App usage prediction framework, named
DeepApp
, to achieve context-aware prediction via multi-task learning. To tackle the challenge of data scarcity, we train one general network for multiple users to share common patterns. To better utilize the spatio-temporal contexts, we supplement a location prediction task in the multi-task learning framework to learn spatio-temporal relations. As for the personalization, we add a user identification task to capture user preference. We evaluate DeepApp on the large-scale dataset by extensive experiments. Results demonstrate that DeepApp outperforms the start-of-the-art baseline by 6.44%.
Effect of Impurity Elements on Localized Corrosion of Zirconium in Chloride Containing Environment
Authors: Tsutsumi Yusuke , Muto Izumi , Nakano Shigeyuki , Tsukada Junichi , Manaka Tomoyo , Chen Peng , Ashida Maki , Sugawara Yu , Shimojo Masayuki , Hara Nobuyoshi , Katayama Hideki , Hanawa Takao
Published: October 2020

To clarify the mechanism of localized corrosion on zirconium in chloride environments, corrosion tests of zirconium and its alloys were performed using conventional and micron-scale measurement systems with surface areas of 0.35 cm2 and less than 0.04 cm2, respectively. The pitting potential significantly dropped by more than 1 V when zirconium was alloyed with over 10 mol% of tin. Zr4Sn and Zr5Sn3 intermetallics hindered the formation of passive films on the substrate. Additionally, tin was found on the surface of a commercially pure zirconium. From the micron-scale measurement results, the inclusion with the highest concentration of tin (at least 0.44 mol%) in the tested area was selected as the preferential initiation site for pitting corrosion. Thus, tin played an important role in determining the corrosion resistance of zirconium in chloride environments.
The Design of Low Pt Loading Electrodes for Use in Fuel Cell-Based Breath Alcohol Sensors
Authors: Easton E. Bradley , Rahman Mohammad R. , Allan Jesse T. S. , Geoffrey Heather L.
Published: October 2020

Modern breath alcohol sensors (BrAS) employ an electrochemical sensor based upon fuel cell technology. These devices closely mimic power generating fuel cell technology from 30 years ago, with each electrode containing massive amounts of Pt black catalyst (∼10−20 mg cm−2). Here we report low-loading gas diffusion electrodes (GDE) fabricated using 40% Pt/C and studied the impact of Pt loading on sensor performance. The optimal loading was determined to be ca. 1 mgPt cm−2, which gives the optimal balance between Pt utilization and ethanol sensitivity. The ethanol sensitivity performance achieved with the GDE paired with a Nafion membrane was similar to that achieved with a commercial MEA that employs a Pt loading of 13.7 mg cm−2 and a PVC membrane. When paired with porous-PVC membranes our GDEs showed even greater sensitivity, readily exceed that of the commercial MEA despite the fact it employs 92% less Pt. The highest sensitivity was achieved when the GDE was paired to a gold-coated PVC membrane (Au-PVC), where the thin layer of gold is believed to enhance the membrane∣electrode interface. Thus, this sensor composition is proposed as a viable lower-cost alternative to the high-loading Pt black electrodes currently used in commercial BrAS technology.
Formation of Nanoporous Anodized Tin Oxide Films in Electrolyte Containing F− and S2−
Authors: Cao Jinwei , Wang Chen , Gao Zhaoqing , Shang Shengyan , Gu Qidi , Gao Nan , Wang Yunpeng , Ma Haitao
Published: October 2020

Nanoporous anodized tin oxide films have many potential applications in the fields of photocatalysis, sensors and electrode materials. In this paper, we found that potential played a dominant role in the morphological evolution of anodized tin oxide films in electrolyte containing F− and S2−. The critical potential for the formation of nanoporous structure was determined. Porous anodized tin oxide films with different nanostructure can be prepared by the application of low anodization potential and high anodization potential. The I–V curve analysis showed that the change of the nanoporous of tin oxide films at different potentials could be attributed to the oxygen which generated by the electronic current. The valence regulation of Sn element in anodized tin oxide film can be achieved by controlling the potential.
Finite-Time Asynchronous Stabilization for Nonlinear Hidden Markov Jump Systems with Parameter Varying in Continuous-Time Case
Authors: Xiao Lianjun , Wang Xiaofeng , Gao Lingling
Published: October 2020

The finite-time asynchronous stabilization problem has received great attention because of the wide application of actual engineering. In this paper, we consider the problem of finite-time asynchronous stabilization for nonlinear hidden Markov jump systems (HMJSs) with linear parameter varying. Compared with the existing research results on Markov jump systems, this paper considers the HMJSs which contain both the hidden state and the observed state in continuous-time case. Moreover, we consider the parameters of the systems are time varying. The aim of the paper is to design a proper observation-mode-based asynchronous controller such that the closed-loop HMJSs with linear parameter varying be stochastically finite-time bounded with

H

∞

performance (SFTB-

H

∞

). Then, we give some sufficient conditions to solve the SFTB-

H

∞

asynchronous controller by considering the stochastic Lyapunov–Krasovskii functional (SLKF) methods. Finally, a numerical example is used to show the validity of the main results.