bluuebunny/crossref_metadata_2025 huggingface dataset:
Green synthesis of calcium oxide nanoparticles at different calcination temperatures
Authors: Bano Sofiya , Pillai Sandhya
Published: May 2020

Purpose

The purpose of this paper is to prepare calcium oxide (CaO) nanoparticles by green synthesis technique and study its structural, morphological and optical properties. The prepared samples were calcined at, 200°C, 300°C and 500°C, and the variation in the properties at different temperatures were investigated.

Design/methodology/approach

Green approach has been used in the present work to synthesise the CaO nanoparticles using Murraya Koenigii leaf (curry leaves) extract as a capping agent. This technique involves the use of nontoxic reagents and natural products derived from various parts of plants.

Findings

Studies reveal that CaO nanoparticles with good optical properties can be synthesized successfully by green approach. The optical absorbance spectra show a broad absorption peak around 400–500 nm. FTIR studies confirm the presence of different functional groups that help in the stabilization of CaO nanoparticles. PL emission spectra show a high intensity emission peak at around 231 nm in addition to peaks at 375 nm and 400 nm. XRD studies show planes of CaO cubic phase. SEM images show a nonuniform distribution of spherical particles along with some clusters. EDX spectra confirm the presence of calcium and oxygen.

Practical implications

CaO nanoparticles have wide applications in optical devices as well as in phototherapy. It is thus interesting to devise new and eco-friendly techniques to synthesise these nanoparticles to suit these applications.

Originality/value

This work would provide a new insight into the preparation of different metal oxide nanoparticles by a very simple and cost-effective green technique without the use of toxic reagents.
Personalized Medicine, Disruptive Innovation, and “Trailblazer” Guidelines: Case Study and Theorization of an Unsuccessful Change Effort
Authors: RUSHFORTH ALEX , GREENHALGH TRISHA
Published: May 2020

Policy Points

For complex reasons, the promise of “precision medicine” based on molecular pathways remains unrealized for many conditions.

Clinical practice guidelines (theoretically, at least) can act as “trailblazers” to introduce tests and treatments that reflect precision medicine discoveries.

We describe a detailed case study from the United Kingdom in which such an attempt was (so far) unsuccessful and show how this case provides generalizable lessons.

Policymakers should be wary of using clinical practice guidelines as the sole, or even the primary, lever for introducing precision medicine.

Context

Precision medicine, which addresses underlying molecular mechanisms of disease, depends on new technologies that measure specific biomarkers, leading (it is anticipated) to more accurate diagnosis, patient stratification, and tailored treatment. These technologies can be disruptive—that is, they make possible, and often require, radical changes to clinical practice and service organization—thereby improving quality, safety, or efficiency of care. Clinical practice guidelines may act as “trailblazers,” introducing and legitimizing novel technologies and practices.

Methods

We describe a case study of an attempt by academic researchers to radically change asthma management in the United Kingdom using a precision medicine biomarker (fractional exhaled nitric oxide, FeNO), measured using a portable breath device. We collected a wide‐ranging data set that included more than 100 documents, 61 interviews, and 150 hours of ethnographic observation, and we analyzed it using technology‐enhanced strong structuration theory (TESST).

Findings

Our study describes a so‐far unsuccessful attempt by academic respiratory medicine researchers to pave the way for a precision medicine approach to asthma using a government‐endorsed national guideline. These researchers considered asthma management, especially in primary care, to be characterized by overdiagnosis and poor tailoring of treatment; engaged a national guideline development body in an effort to fix this problem; and ensured that the guideline required primary care clinicians to use FeNO technology for diagnosis and monitoring. However, clinicians working outside the tertiary referral centers did not accept, or agree to enact, the vision of precision medicine inscribed in the guideline—for multiple professional, operational, and economic reasons.

Conclusions

“Trailblazer” guidelines, in which new technologies are recommended, may succeed as catalysts of change only in a limited way for interested individuals and groups. In the absence of a wider program of professionally led and adequately resourced change efforts, such guidelines will lack meaning, legitimacy, and authority among intended users and may be strongly resisted.
Comparative aroma and taste profiles of oil furu (soybean curd) fermented with different mucor strains
Authors: Wei Guanmian , Regenstein Joe M , Liu Xiaoming , Zhou Peng
Published: May 2020

The effects of different mucor strains (Mucor racemosus, Actinomucor, and Mucor wutungkiao) on aroma and taste profiles based on proteolysis, lipolysis, and their catabolism in oil furu were studied. Gas chromatography‐mass spectrometry and relative odor activity were used to monitor the changes of key volatile compounds and the differences in the characteristic aroma contents of oil furu. Using principal component analysis, the different fermentation strains had an effect on aroma profiles. The volatile compounds from metabolism of protein and fatty acid contributed to the aroma of oil furu with different contribution from the different strains, presumably due to their different enzymes. The electronic tongue and free amino acid profiles also showed strain differences of taste. Based on these results, optimization of the amount of each of the different mucor strains during cofermentation might achieve better flavor.
Continental Scale Heterogeneous Channel Flow Routing Strategy for Operational Forecasting Models
Authors: Meselhe Ehab , Lamjiri Maryam A. , Flint Kelly , Matus Sean , White Eric D. , Mandli Kyle
Published: May 2020

The benefits of operational forecasting models to the general public are numerous. They support water management decisions, provide the opportunity to mitigate the impacts of weather‐ and flood‐related disasters and potentially save lives and properties. Channel flow routing is a key component of these models and affects their ability to forecast flood depth, duration, and extent. Continental scale channel flow routing within the operational forecasting environments encounters a broad spectrum of hydraulic characteristics. Deploying computationally demanding approaches, such as the dynamic wave, should be limited in time and space to conditions where the inertia terms are significant (typically in low‐gradient environments and whenever backwater effects are prominent); otherwise, efficient and robust methods, e.g., Kinematic, Muskingum‐Cunge or diffusive waves should be the default. The heterogeneous routing approach presented here provides a framework to evaluate the balance between friction, inertia, and pressure and strategically triggers the appropriate wave approximation. The strategy recommended here is to activate the appropriate wave approximation based on the ambient hydraulic conditions, and smoothly transitions among these approximations. This strategy, if successfully implemented, would strike a balance among the performance metrics of operational forecasting models, namely, computational efficiency, accuracy, and minimization of computational instabilities.
Literacy and State–Society Interactions in Nineteenth‐Century France
Authors: Zhang Nan , Lee Melissa M.
Published: May 2020

Modern states are distinguished by the breadth and depth of public regulation over private affairs. This aspect of state capacity and state power is predicated on frequent and dense encounters between the state and the population it seeks to control. We argue that literacy in the language of state administration facilitates state–society interaction by lowering the transaction costs of those encounters. We support this claim with evidence drawing upon detailed historical data from nineteenth‐century France during a crucial period of state and nation building. Focusing on the specific domain of French marriage regulations, we find that increasing literacy predicts greater popular involvement with local authorities across French regions over time. These results demonstrate that literacy plays an important role in political development not solely by enhancing loyalty to the state, as the literature has recognized, but also by lowering linguistic and human capital barriers to state–society interaction.
Current status of organ donation after brain death in the UK
Authors: Manara A. R. , Thomas I.
Published: May 2020

Organ donation after brain death remains the deceased organ donation pathway of choice. In the UK, the current identification and referral rate for potential donation after brain death donors is 99%, the testing rate for determining death using neurological criteria is 86% and the approach to families for donation is 91%. Increasing donation after brain death donation will primarily require a large increase in the current consent rate of 72% to one matching the consent rate of 80–90% achieved in other European countries. Implementing the use of evidence‐based donor optimisation bundles may increase the number of organs available for transplantation. Alternatively, the UK will need to look at more challenging ways of increasing the pool of potential donors after brain death. The first would be to delay the withdrawal of life‐sustaining treatment in patients with devastating brain injury to allow progression to brain death after the family have given consent to organ donation and with their consent to this delay. Even more challenging would be the consideration of re‐introducing intensive care to facilitate organ donation programmes that have been so successful at increasing the number of organ donors elsewhere.
Evaluation showed that stakeholders valued the support provided by the Implementing Pediatric Advance Care Planning Toolkit
Authors: Fahner Jurrianne , Rietjens Judith , van der Heide Agnes , Milota Megan , van Delden Johannes , Kars Marijke
Published: May 2020

Aim

This study described the development, and pilot evaluation, of the Implementing Pediatric Advance Care Planning Toolkit (IMPACT).

Methods

Key elements of paediatric advance care planning (ACP) were defined using a systematic review, a survey of 168 paediatricians and qualitative studies of 13 children with life‐limiting conditions, 20 parents and 18 paediatricians. Participants were purposively recruited from six Dutch university hospitals during September 2016 and November 2018. Key elements were translated into intervention components guided by theory. The acceptability of the content was evaluated by a qualitative pilot study during February and September 2019. This focused on 27 children with life‐limiting conditions from hospitals, a hospice and home care, together with 41 parents, 11 physicians and seven nurses who cared for them.

Results

IMPACT provided a holistic, caring approach to ACP, gave children a voice and cared for their parents. It provided information on ACP for families and clinicians, manuals to structure ACP conversations and training for clinicians in communication skills and supportive attitudes. The 53 pilot study participants felt that IMPACT was appropriate for paediatric ACP.

Conclusion

IMPACT was an appropriate intervention that supported a holistic approach towards paediatric ACP, focused on the child's perspective and provided care for their parents.
Children are unlikely to be the main drivers of the COVID‐19 pandemic – A systematic review
Authors: Ludvigsson Jonas F.
Published: May 2020

Aim

Many countries have closed schools and kindergartens to minimise COVID‐19, but the role that children play in disease transmission is unclear.

Methods

A systematic literature review of the MEDLINE and EMBASE databases and medRxiv/bioRxiv preprint servers to 11 May 2020 identified published and unpublished papers on COVID‐19 transmission by children.

Results

We identified 700 scientific papers and letters and 47 full texts were studied in detail. Children accounted for a small fraction of COVID‐19 cases and mostly had social contacts with peers or parents, rather than older people at risk of severe disease. Data on viral loads were scarce, but indicated that children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk. Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID‐19 seldom caused outbreaks. However, it is highly likely that children can transmit the SARS‐COV‐2 virus, which causes COVID‐19, and even asymptomatic children can have viral loads.

Conclusion

Children are unlikely to be the main drivers of the pandemic. Opening up schools and kindergartens is unlikely to impact COVID‐19 mortality rates in older people.
Letter: does vitamin D have a potential role against COVID‐19?
Authors: Kumar Deepak , Gupta Prakamya , Banerjee Dibyajyoti
Published: May 2020

LINKED CONTENT

This article is linked to Tian et al and Tian and Rong papers. To view these articles, visit https://doi.org/10.1111/apt.15731 and https://doi.org/10.1111/apt.15817.
Sedimentary biomarkers reaffirm human impacts on northern Beringian ecosystems during the Last Glacial period
Authors: Vachula Richard S. , Huang Yongsong , Russell James M. , Abbott Mark B. , Finkenbinder Matthew S. , O'Donnell Jonathan A.
Published: May 2020

Our understanding of the timing of human arrival to the Americas remains fragmented, despite decades of active research and debate. Genetic research has recently led to the ‘Beringian standstill hypothesis’ (BSH), which suggests an isolated group of humans lived somewhere in Beringia for millennia during the Last Glacial, before a subgroup migrated southward into the American continents about 14 ka. Recently published organic geochemical data suggest human presence around Lake E5 on the Alaskan North Slope during the Last Glacial; however, these biomarker proxies, namely faecal sterols and polycyclic aromatic hydrocarbons (PAHs), are relatively novel and require replication to bolster their support of the BSH. We present new analyses of these biomarkers in the sediment archive of Burial Lake (latitude 68°26′N, longitude 159°10′W m a.s.l.) in northwestern Alaska. Our analyses corroborate that humans were present in Beringia during the Last Glacial and that they likely promoted fire activity. Our data also suggest that humans coexisted with Ice Age megafauna for millennia prior to their eventual extinction at the end of the Last Glacial. Lastly, we identify fire as an overlooked ecological component of the mammoth steppe ecosystem.
Development and validation of a Web‐based malignancy risk‐stratification system of thyroid nodules
Authors: Zhang Bin , Pei Shufang , Chen Qiuying , Dong Yuhao , Zhang Lu , Mo Xiaokai , Cong Shuzhen , Zhang Shuixing
Published: May 2020

Objectives

Previous publications on risk‐stratification systems for malignant thyroid nodules were based on conventional ultrasound only. We aimed to develop a practical and simplified prediction model for categorizing the malignancy risk of thyroid nodules based on clinical data, biochemical data, conventional ultrasound and real‐time elastography.

Design

Retrospective cohort study.

Patients

A total of 2818 patients (1890 female, mean age, 45.5 ± 13.2 years) with 2850 thyroid nodules were retrospectively evaluated between April 2011 and October 2016. 26.8% nodules were malignant.

Measurements

We used a randomly divided sample of 80% of the nodules to perform a multivariate logistic regression analysis. Cut‐points were determined to create a risk‐stratification scoring system. Patients were classified as having low, moderate and high probability of malignancy according to their scores. We validated the models to the remaining 20% of the nodules. The area under the curve (AUC) was used to evaluate the discrimination ability of the systems.

Results

Ten variables were selected as predictors of malignancy. The point‐based scoring systems with and without elasticity score achieved similar AUCs of 0.916 (95% confidence interval [CI]: 0.885‐0.948) and 0.906 (95% CI: 0.872‐0.941) when validated. Malignancy risk was segmented from 0% to 100.0% and was positively associated with an increase in risk scores. We then developed a Web‐based risk‐stratification system of thyroid nodules (http: thynodscore.com).

Conclusion

A simple and reliable Web‐based risk‐stratification system could be practically used in stratifying the risk of malignancy in thyroid nodules.
Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations
Authors: Lewandowski Krzysztof C. , Garnysz Karolina , Horzelski Wojciech , Kawalec Joanna , Budzen Karolina , Grzesiak Mariusz , Lewinski Andrzej
Published: May 2020

Background

There is no universal consensus regarding cut‐off points for TSH in pregnancy, so concentrations of 2.5 or 4.0 mIU/L were suggested for first trimester (Endocrine Society [2012] and ATA [2017] guidelines, respectively). Yet, the impact of physiological variation in TSH secretion has not been assessed.

Subjects and Methods

We assessed baseline concentrations of free T4, free T3 and TSH at 30‐minute intervals (between 7.00 and 9.00 hours) in 110 healthy pregnant women, age 30.2 ± 6.0 years, 9.9 ± 2.4 weeks of gestation, and in 19 female controls, age 28.9 ± 10.7.

Results

Mean TSH concentrations in pregnant women were 1.62 ± 1.26 mIU/L and on average varied by 39.5% (dispersion between the highest and the lowest TSH), with no difference in TSH variation between pregnant women and controls. Taking into account the highest TSH out of five consecutive measurements, TSH >2.5 mIU/L and TSH above 4.0 mIU/L were found in 23 (20.9%) and 10 (9.1%) pregnant women, respectively. In contrast, when the lowest TSH value was considered, then concentrations of TSH >2.5 mIU/L and >4.0 mIU/L were found in 14 (12.7%) and 4 (3.6%) women, respectively. This discrepancy was even more pronounced in aTPO‐negative subjects (21 [21.2%] vs 8 [8.1%] women, for TSH >2.5 mIU/L, and six [6.06%] vs one [1.01%], for TSH >4.0 mIU/L). Furthermore, either six (5.4%) or 10 (9.1%) women had TSH concentrations below 0.1 mIU/L.

Conclusions

In a significant number of patients, diagnosis of subclinical thyroid dysfunction could be erroneously made not as a result of ‘disease’, but as a result of physiological variation in TSH concentrations.
Endoscopic management of pancreatic diseases in patients with surgically altered anatomy: clinical outcomes of combination of double‐balloon endoscopy‐ and endoscopic ultrasound‐guided interventions
Authors: Kogure Hirofumi , Sato Tatsuya , Nakai Yousuke , Ishigaki Kazunaga , Hakuta Ryunosuke , Saito Kei , Saito Tomotaka , Takahara Naminatsu , Hamada Tsuyoshi , Mizuno Suguru , Yamada Atsuo , Tada Minoru , Isayama Hiroyuki , Koike Kazuhiko
Published: May 2020

Objectives

In patients with surgically altered anatomy, endoscopic treatment of pancreatic diseases is technically challenging. We aimed to evaluate the feasibility, effectiveness, and safety of an interchangeable combination of double‐balloon endoscope‐assisted ERP (DB‐ERP) and endoscopic ultrasonography‐guided pancreatic duct drainage (EUS‐PD) in this clinical setting.

Methods

Consecutive patients with surgically altered anatomy undergoing endoscopic treatment (DB‐ERP, EUS‐PD, or both) for pancreatic diseases were studied. The primary outcome was technical success; secondary outcomes were clinical success and adverse events.

Results

Forty patients who underwent DB‐ERP (38) and EUS‐PD (2) as an initial intervention were retrospectively studied. Indications for intervention included 18 pancreaticojejunostomy anastomotic stricture (PJAS), four pancreatic duct stone (PDS), four pancreatic fistula (PF), 11 PJAS with PDS, and three PJAS with PF. Prior surgical reconstruction was 26 Billroth‐II, 13 Roux‐en‐Y, and one Imanaga reconstruction. Along with salvage procedures including three DB‐ERP and seven EUS‐PD, the overall technical success rates of DB‐ERP and EUS‐PD were 70.7% (29/41) and 100% (9/9), respectively. Clinical success was achieved in 85.0% (34/40) by combination of DB‐ERP and EUS‐PD; successful drainage for PJAS, complete removal of PDS, and resolution of PF were achieved in 90.6%, 80.0%, and 71.4%, respectively. Adverse event rates were 12.2% (5/41; one perforation, and four pancreatitis) in DB‐ERP and 55.6% (5/9; three pancreatic leakage, and two abdominal pain) in EUS‐PD.

Conclusions

A combination of DB‐ERP and EUS‐PD can achieve high technical and clinical success for pancreatic diseases in surgically altered anatomy patients. A prospective multicenter study to investigate an appropriate treatment algorithm is warranted.
Functional outcomes and patient satisfaction following inpatient treatment for childhood‐onset schizophrenia spectrum disorders vs non‐psychotic disorders in children in the United Kingdom
Authors: Galitzer Hayley , Anagnostopoulou Nefeli , Alba Anca , Gaete Jorge , Dima Danai , Kyriakopoulos Marinos
Published: May 2020

Aim

The aim of this study was to compare clinical characteristics and treatment outcomes between children with Childhood‐onset schizophrenia spectrum disorders (COSS) and children with other severe non‐psychotic psychiatric conditions (non‐COSS), all admitted to a national mental health inpatient children's unit.

Methods

We conducted a retrospective study of all children discharged from a national children's inpatient unit in the United Kingdom, between 2009 and 2018. We compared functional and treatment outcomes and satisfaction with treatment in COSS with non‐COSS in the whole sample and separately for male and female patients.

Results

A total of 211 children (55% boys) were included in the sample. The mean age on admission was 129.7 months (10.8 years; age range, 6‐12).Twenty cases were diagnosed with COSS (9.5%). In the whole sample, COSS patients had significantly lower Children's Global Assessment Scale (CGAS) scores on admission compared to non‐COSS (P = .006). There was a trend towards children with COSS as a group having a longer admission (M = 194.6 days, SD = 125.4) compared to non‐COSS (M = 135.8 days, SD = 86.2), (P = .053). Females with COSS seemed to have more significant differences compared to females with non‐COSS, in particular, longer admissions (P = .016) and worse CGAS scores at discharge (P = .04), whilst in males, these differences seemed to be attenuated.

Conclusions

Children with COSS have lower functioning at the point of inpatient admission and possibly longer admissions, but similar satisfaction with treatment at discharge from hospital compared with non‐COSS. Females with COSS may have worse functional outcomes compared to non‐COSS at discharge.
The education of academically gifted students in South Korea: Innovative approaches in shadow education
Authors: Kim Young Chun , Jo Jaeseong , Jung Jung‐Hoon
Published: May 2020

Shadow education contributes to the learning and academic careers of Korean students. It benefits, in particular, gifted students who are strongly motivated and who outperform their peers academically. In this study, we explored the innovative characteristics of shadow education curricula for gifted students in terms of curricular programmes, methods, and teaching‐learning materials. Also, we explored how shadow education practices meet the academic abilities and needs of students. Informed by a literature review and qualitative research methods, the results reveal how common shadow education is; effects of shadow education; and innovative elements used in shadow education for gifted students in Korea. Overall, we found that shadow education plays a crucial role in gifted education; it is a necessary component for understanding academic excellence among students in Korea. The findings are helpful for teachers, curriculum developers, and policymakers as they explore how public schooling can help to support strongly motivated and academically advanced students.
Psychosocial profiles and their predictors in epilepsy using patient‐reported outcomes and machine learning
Authors: Josephson Colin B. , Engbers Jordan D. T. , Wang Meng , Perera Kevin , Roach Pamela , Sajobi Tolulope T. , Wiebe Samuel ,   Calgary Comprehensive Epilepsy Program collaborators
Published: May 2020

Objective

To apply unsupervised machine learning to patient‐reported outcomes to identify clusters of epilepsy patients exhibiting unique psychosocial characteristics.

Methods

Consecutive outpatients seen at the Calgary Comprehensive Epilepsy Program outpatient clinics with complete patient‐reported outcome measures on quality of life, health state valuation, depression, and epilepsy severity and disability were studied. Data were acquired at each patient's first clinic visit. We used k‐means++ to segregate the population into three unique clusters. We then used multinomial regression to determine factors that were statistically associated with patient assignment to each cluster.

Results

We identified 462 consecutive patients with complete patient‐reported outcome measure (PROM) data. Post hoc analysis of each cluster revealed one reporting elevated measures of psychosocial health on all five PROMs ("high psychosocial health" cluster), one with intermediate measures ("intermediate" cluster), and one with poor overall measures of psychosocial health ("poor psychosocial health" cluster). Failing to achieve at least 1 year of seizure freedom (relative risk [RR] = 4.34, 95% confidence interval [CI] = 2.13‐9.09) predicted placement in the "intermediate" cluster relative to the "high" cluster. In addition, failing to achieve seizure freedom, social determinants of health, including the need for partially or completely subsidized income support (RR = 6.10, 95% CI = 2.79‐13.31, P < .001) and inability to drive (RR = 4.03, 95% CI = 1.6‐10.00, P = .003), and a history of a psychiatric disorder (RR = 3.16, 95% CI = 1.46‐6.85, P = .003) were associated with the "poor" cluster relative to the "high" cluster.

Significance

Seizure‐related factors appear to drive placement in the "intermediate" cluster, with social determinants driving placement in the "poor" cluster, suggesting a threshold effect. Precision intervention based on cluster assignment, with an initial emphasis on improving social support and careful titration of medications for those reporting the worst psychosocial health, could help optimize health for patients with epilepsy.
The Role of Constructiveness in Interparental Conflict for Mothers' Perception of Children's Health
Authors: Zemp Martina , Jockers Marlene , Mata Jutta
Published: May 2020

Objective

To examine how constructiveness in interparental conflict affects mothers' perception of children's psychological and physical health and whether coparenting and positive parenting mediate these effects.

Background

Children exposed to high levels of interparental conflict are at elevated risk of developing health problems. However, previous research suggests that constructive and destructive interparental conflict may affect children's health differently.

Method

Mothers (n = 289) with at least one child aged 3.5 to 8 years completed an online survey about parenting, coparenting, interparental conflict, and different aspects of child health.

Results

Results suggest that higher constructiveness in interparental conflict is related to fewer emotional problems, less pain, and fewer infectious diseases in children, independent of gender. The effects were fully mediated by coparenting.

Conclusion

Constructive interparental conflict promotes children's physical and psychological health and coparenting emerged as an important mechanism for this
link.

Implications

Enhancement of constructive interparental conflict and coparenting are promising avenues to foster children's healthy development.
Use of p53 immunohistochemistry in conjunction with routine histology improves risk stratification of patients with Barrett’s oesophagus during routine clinical care
Authors: Tokuyama Minami , Geisler Daniel , Deitrick Christopher , Fasanella Kenneth E , Chennat Jennifer S , McGrath Kevin M , Pai Reetesh K , Davison Jon M
Published: May 2020

Aims

Abnormal p53 protein expression detected by immunohistochemistry (IHC) in Barrett’s oesophagus (BO) is reported to be a prognostic biomarker for progression to high‐grade dysplasia (HGD) or oesophageal adenocarcinoma (OAC). We evaluated our use of p53 IHC for patients with BO under surveillance from 2010 to 2016 in a single academic institution.

Methods and results

We identified 78 patients under surveillance for BO who had biopsies evaluated for abnormal p53 expression in conjunction with routine histology and 892 patients who had histological evaluation alone. All available p53 IHC slides were rescored as wild‐type or abnormal. We evaluated the risk of subsequent diagnosis with HGD and OAC. p53‐tested patients were significantly more likely to be diagnosed with indefinite dysplasia (IND) or low‐grade dysplasia (LGD), compared to patients who were not tested (79.5 versus 10.8%, P = 7.4 × 10−40). Almost half (46.9%) of patients with abnormal p53 expression were diagnosed with HGD or OAC within 5 years, compared to 5.9% with wild‐type p53, and 7.6% of patients not tested (P = 2.6 × 10−18). However, this difference was heavily influenced by other risk factors, including dysplasia grade, in multivariate analyses. In the subgroup of patients diagnosed with IND (n = 109), abnormal p53 expression was associated with a fourfold increase (1.2–13.3, P = 0.023) in risk of HGD/OAC relative to untested patients diagnosed with IND, independent of other risk factors.

Conclusion

In patients under surveillance for BO in a single academic institution, we found evidence that selective use of p53 IHC in conjunction with routine histology modestly improved risk stratification by identifying patients with IND at higher risk of a subsequent diagnosis of HGD or OAC.
Dysfunctional breathing treated with continuous positive airway pressure in newly diagnosed obstructive sleep apnoea: a prospective cohort study
Authors: Barnett Adrian , Sriram Krishna B. , Hay Karen E. , Simpson Graham
Published: May 2020

A prospective cohort study investigating patients with obstructive sleep apnoea (OSA) was conducted to determine the prevalence of dysfunctional breathing and if continuous positive airway pressure (CPAP) therapy improves associated symptoms. Almost half of newly diagnosed patients with OSA had dysfunctional breathing and CPAP was not an effective treatment. Dysfunctional breathing is common in patients with OSA.
Multicomponent bulk metal nitride (Nb1/3Ta1/3Ti1/3)N1−δ synthesis via reaction flash sintering and characterizations
Authors: Mondal Santanu , Durygin Andriy , Drozd Vadym , Belisario Jose , Cheng Zhe
Published: May 2020

In this research, near fully dense single phase bulk multicomponent transition metal nitride (Nb1/3Ta1/3Ti1/3)N1−δ has been successfully synthesized from mixed commercial powders of NbN, TaN and TiN via reaction flash sintering technique. This was performed with an applied pressure of ~ 35 MPa at 25°C under a constant DC electric field (~24‐32 V/cm). The flash event, which is the abrupt increase in current (up to ~ 25.2 A/mm2) and temperature, occurred without preheating. The threshold power dissipation on the sample right before the flash is ~ 0.7 W/mm3. The formation of single phase (Nb1/3Ta1/3Ti1/3)N1−δ random solid solution and its compositional uniformity were confirmed by XRD and EDS, respectively. The effects of ball milling duration and limiting current density on phase formation were studied. Simulation based on Joule heating provides an estimate of the ultimate sample temperature of ~ 1850°C. Vickers hardness of the obtained (Nb1/3Ta1/3Ti1/3)N1−δ is 17.6 ± 0.6 GPa, which is comparable to similarly flash sintered ingredient binary nitrides of TaN and NbN. TGA in air shows that the oxidation resistance of (Nb1/3Ta1/3Ti1/3)N1−δ is better than that of TaN and NbN but inferior to TiN. The study demonstrates that reaction flash sintering can be a highly efficient technique for synthesizing bulk multicomponent ceramics for both material fundamental investigations and application development.
The pre‐Medical Emergency Team response: Nurses' decision‐making escalating deterioration to treating teams using urgent review criteria
Authors: Bingham Gordon , Fossum Mariann , Hughes Leanne , Digby Robin , Bucknall Tracey
Published: May 2020

Aim

To describe nurses' decision‐making, experiences and perceptions of escalating deteriorating patients to the treating medical team using urgent clinical review criteria.

Design

A qualitative design comprising individual in‐depth interviews with nurses from a major Australian metropolitan tertiary teaching hospital.

Method

A purposive sample of 30 Registered Nurses from nine surgical and medical wards were interviewed in April 2018 using semi‐structured interviews. An inductive thematic analysis was conducted.

Results

Identified themes included: detecting the deterioration; countering the problem; getting a response; and challenges faced in the process of escalation. Nurses reported an important awareness, sense of responsibility, and critical thinking to ensure the safe management and escalation of deteriorating patients. However, barriers to escalation necessitated individual workarounds and organizational structures to mitigate patient risk.

Conclusion

This study supports the importance of communication between clinical teams and recognizes that it is crucial to enable a fail‐safe experience for patients and families. Recognition of disciplinary contributions to patients' goals of care is required to better understand and address the prevalence of deteriorating patients. Our study is among the first to explore the actual experience of nurses who articulate balancing uncertainty and managing complex team dynamics on wards for patients experiencing deteriorating health status. The information may assist in determining team training strategies and structures to facilitate patient management during deterioration.

Impact

This is among the first study to investigate barriers influencing decision‐making of RNs prior to escalation using qualitative methods. This study provides a foundation to inform and develop policies and strategies aimed at ensuring escalation occurs for deteriorating patients.
Exploring the ability of individuals with an intellectual disability to generate and use a compassionate image
Authors: Brougham Laura , Pert Carol , Jahoda Andrew
Published: May 2020

Background

There is a growing interest in adapting third‐wave therapies such as mindfulness for people who have intellectual disabilities. This study explored their ability to generate and use a compassionate image.

Method

Nineteen people with an intellectual disability and twenty people without were recruited from further education colleges. A compassion‐focused therapy technique was adapted to help participants generate their own compassionate image, and examine whether they could use their images in potentially distressing situations.

Results

With appropriate support, participants with intellectual disabilities were just as able as those without disabilities to generate their own compassionate image. They were also able to generate self‐soothing statements.

Conclusions

The participants’ success in generating compassionate images suggests this approach may have clinical utility with people who have intellectual disabilities. The next question is whether this client group can use this technique to deal with personally salient stressors.
Students' self‐report and observed learning orientations in blended university course design: How are they related to each other and to academic performance?
Authors: Han Feifei , Pardo Abelardo , Ellis Robert A.
Published: May 2020

This study examines the extent to which the learning orientations identified by student self‐reports and the observation of their online learning events were related to each other and to their academic performance. The participants were 322 first‐year engineering undergraduates, who were enrolled in a blended course. Using students' self‐report on a questionnaire about their approaches to learning and perceptions of the blended learning environment, ‘understanding’ and ‘reproducing’ learning orientations were identified. Using observations of student activity online, a Hidden Markov Model (HMM) and agglomerative sequence clustering detected four qualitatively different patterns of online learning orientations. Cross‐tabulations showed significant and logical associations amongst the learning orientations derived by the self‐report and observational methods. Significant differences were also consistently found in the students' academic performance across the mid‐term and final assessments based on their learning orientations detected by both self‐report and observational methods, results which have important implications for learning research.
SARS‐CoV‐2 lgM/lgG antibody detection confirms the infection after three negative nucleic acid detection
Authors: Li Hua , Pan Jue , Su Yi , Wang Beili , Ge Junbo
Published: May 2020

An ongoing outbreak of viral pneumonia was caused by a novel coronavirus in China in 2019. By March 19, over 200 thousand confirmed cases of SARS‐CoV‐2 infection and over 9000 deaths have been reported throughout the world. For this infectious disease, nucleic acid detection is still the gold standard for pathogenic detection. However, nucleic acid detection takes a long time and has relatively high "false negative"; therefore, we need urgently a convenient and accurate detection method to make up for this deficiency. In this article, we will show such technical characteristics of lgM/lgG serum antibody detection, compared with nucleic acid detection.
Editorial: Some roads less travelled—different routes to understanding the causes of child psychopathology
Authors: Lervåg Arne
Published: May 2020

The most critical issue in our field is to understand the causes of the disorders we study. What genetic and environmental risk factors result in some children developing autism, and others depression? I discussed the issue of causation in an earlier editorial (Lervåg, 2019) and anticipated that ‘we will see many more studies in the Journal of Child Psychology and Psychiatry (JCPP) testing causal relationships’. My prediction is nicely borne out by studies in the current issue of the journal.
Identification of eggshell crack for hen egg and duck egg using correlation analysis based on acoustic resonance method
Authors: Sun Li , Feng Siyu , Chen Cheng , Liu Xianlin , Cai Jianrong
Published: May 2020

This work presents a novel method for eggshell crack timely detection of hen and duck eggs based on the acoustic resonance analysis. The developed experimental device consisting of an excitation device, an acquisition module of acoustic signals, and a personal computer was designed to generate and acquire the response signals by impaction on eggshell. The parameter of Pearson's correlation coefficients (PCCs) was calculated to compare the similarity between intact and crack eggs signals with various sampling points. The 200 sampling points of the response signal were selected as an effective response signal, which observed the values of higher than 0.85 and lower than 0.8 for intact eggs and crack eggs, respectively. Thereafter, multivariate analysis of variance (MANOVA) was conducted to find that the egg individual and the impact location were two remarkable influencing factors to the response signal from intact egg. The cross‐comparison of signals from the same direction of each egg sample was proposed to get the PCCs and served as feature parameters. A universal linear discriminant function was built to distinguish intact and crack egg. In the conducted experiments, a crack detection level of 95.5% and a false rejection level of 5% were achieved using the mixed samples of 100 hen eggs and 100 duck eggs. From the findings, it can be concluded that the proposed method will assist in simplifying the classification algorithm and in advancing the applicability for multiple categories of egg for an online detection system.

Practical Applications

Eggshell crack produced during packing and transportation may lead to significant economic loss and food security problem. This article presents a novel method of eggshell crack detection based on the acoustic resonance analysis for different categories egg. The effective response signals selection method and remarkable influencing factors analysis method of response signal was conducted to weaken the random interference of noise and reduce the computation consumption. As a result, a universal linear discriminant function was built to distinguish the intact and cracked eggs, which can satisfy the requirement in sorting industry. The overall results sufficiently indicated that the proposed methods in this study have significant potential for online detection of eggshell crack with high throughput.
Impact of thermosonication and pasteurization on total phenolic contents, total flavonoid contents, antioxidant activity, and vitamin C levels of elephant apple (Dillenia indica) juice
Authors: Nayak Prakash Kumar , Basumatary Birhang , Chandrasekar Chandra Mohan , Seth Dibyakanta , Kesavan Radha Krishnan
Published: May 2020

The present work evaluated the influence of different thermosonication conditions on the quality improvement of elephant apple (Dillenia indica) juice. The juice was processed under thermosonication at different temperatures (30–50°C) for different time periods (15–60 min). The results of sonication treatments were compared with fresh and thermally treated juices. The objectives of the research work were to determine the effect of thermosonication on the quality attributes such as pH, titratable acidity (TA), total soluble solids (TSS), total phenolic contents (TPC), total flavonoid contents (TFC), antioxidant activity (AA), ascorbic acid levels, microbiological, and sensory properties. pH, TA, and TSS of thermosonicated and pasteurized juice samples did not produce any significant (p < .05) differences. From the experimental results, it was also seen that thermosonication has improved the quality of elephant apple juice by increasing the levels of TPC, TFC, and AA significantly (p < .05) and ensuring the microbial safety of juices. Furthermore, the findings of the present study indicated that the thermosonication can be employed for processing of elephant apple juice as a replacement method for thermal processing with enhanced quality.

Practical applications

Ultrasound processing is one of the new method which has been applied widely to improve the shelf life of fruit juices without altering the quality attributes of juices. Commonly, thermal processing technologies are applied to improve the keeping quality of fruit juices, but it has some detrimental effects on the final quality of fruit products. So, ultrasound processing can be utilized as an alternative method to thermal processing. In the present work, ultrasound processing was applied to enhance the quality of elephant apple juices.
Subjective–objective sleep discrepancy in patients with insomnia during and after cognitive behavioural therapy: An actigraphy study
Authors: Janků Karolina , Šmotek Michal , Fárková Eva , Kopřivová Jana
Published: May 2020

Although patients with insomnia often show a discrepancy between self‐reported and objective sleep parameters, the role of and change in this phenomenon during treatment remain unclear. The present study aimed to assess the effect of cognitive behavioural therapy for insomnia on subjective and objective sleep discrepancy of total sleep time, sleep‐onset latency and wake after sleep onset. The total sleep time discrepancy was also assessed across the entire therapy. The second aim was to examine the treatment outcome of two insomnia groups differing in sleep perception. Thirty‐six adults with insomnia (mean age = 46.7 years,SD = 13.9; 22 females) were enrolled in the final analyses. Patients underwent a 6‐week group cognitive behavioural therapy for insomnia programme. Sleep diary and actigraphy measurements were obtained during the therapy. Patients who underestimated total sleep time (n = 16; underestimating group) were compared with patients who accurately perceived or overestimated total sleep time (n = 20; accurate/overestimating group). After cognitive behavioural therapy for insomnia, a significant decrease of total sleep time and sleep‐onset latency discrepancy was observed without a change in wake after sleep onset discrepancy in the total sample. Only the underestimating group reported decreased sleep‐onset latency discrepancy after the treatment, whereas total sleep time discrepancy significantly changed in both groups. The underestimating group showed a significant decrease of total sleep time discrepancy from Week 1 to Week 2 when the sleep restriction was implemented, whereas the accurate/overestimating group showed the first significant change at Week 4. In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different therapeutic components could play important roles in each group. components could play important roles in each group.
Policy Change in Brazil: New Challenges for Policy Analysis in Latin America
Authors: Brasil Felipe , Capella Ana Claudia Niedhardt , Fagan E.J.
Published: May 2020

From the emergence of punctuated equilibrium theory in the United States in the mid‐1990s to the creation of the Comparative Agendas Project, scholars have predicted that punctuated equilibrium theory and related agenda‐setting theories can be applied across all systems. Yet most of the literature to date has focused on Western countries. The Brazilian Agendas Project has now made data available on a wide range of policy inputs and outputs, the first such data available in Latin America. The objective of this article is introduce the data from the Brazilian project, justify the choices made in collecting and coding it, and present descriptive analyses on the dynamics of governmental attention toward different policy issues over time.
United States and European Union Online Media Diplomacy in Colombia: Mixed Messages in the Promotion of a Fragile Peace
Authors: Montoya Londoño Catalina
Published: May 2020

The signing of the revised Peace Agreement by the Colombian government and the Revolutionary Armed Forces of Colombia, and its ratification by the Colombian Congress in November 2016, marked not only a promising stage in the resolution of the armed conflict but also a challenging stage in the sustainability of multilateral peacebuilding efforts. Drawing on qualitative framing analysis, this article explores whether differing frames projected by the United States and the European Union shaped cooperative or competitive efforts for peace between the signing of the revised Peace Agreement and the forming of President Ivan Duque's new Colombian government by December 2018. The results highlight competitive U.S. and European Union priorities regarding the agreement; while the United States made it a function of the war on drugs, the European Union maintained fundamentally a commitment to its implementation.