bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical trials knowledge and attitudes of Vietnamese‐ and Anglo‐Australian cancer patients: A cross‐sectional study
Authors: Smith Allan B. , Niu Anita Y. , Descallar Joseph , Delaney Geoff P. , Wu Verena S. , Agar Meera R. , Girgis Afaf
Published: August 2020

Aim

Low participation in cancer clinical trials by culturally and linguistically diverse (CALD) patients limits access to cutting‐edge treatments and generalizability of results. This is the first study exploring trials knowledge/attitudes and their association with trial participation in Vietnamese‐ and Anglo‐Australian cancer patients.

Methods

Eligible patients diagnosed with cancer in the past 10 years were invited to complete a self‐report questionnaire comprising validated measures of: trials knowledge and attitudes, preferred information amount, preferred decision‐making involvement, health literacy, and past and future (i.e. hypothetical) trial participation. Multivariable linear regression evaluated correlates of trials knowledge/attitudes. Multinomial logistic regression estimated the relationship between trials knowledge/attitudes and possible future trial participation.

Results

Vietnamese‐Australian participants (n = 50) had more negative attitudes regarding trials than Anglo‐Australians (n = 100; B = −9.28; 95% confidence interval [CI], −17.60 to −0.97; P = 0.029), but similar knowledge (B = −0.91; 95% CI, −2.27 to 0.44; P = 0.18). Future trial participation was associated with positive attitudes (odds ratio [OR] = 1.08; 95% CI, 1.04–1.12; P < 0.001) and greater knowledge (OR = 1.30; 95% CI, 1.04–1.62; P = 0.02), but not Vietnamese background (OR = 0.95; 95% CI, 0.27–3.32; P = 0.93).

Conclusion

Despite poorer attitudes regarding trials in Vietnamese‐Australians, Vietnamese background was not associated with less likely future trial participation, suggesting low trial participation by CALD patients may be more due to opportunity barriers. Improving knowledge and attitudes may increase trial participation generally.
MR‐guided simulation is superior than FDG/PET‐guided simulation for local control in nasopharyngeal cancer patients treated with intensity‐modulated radiotherapy
Authors: Gundog Mete , Basaran Hatice , Dogan Serap , Abdulrezzak Ummuhan
Published: August 2020

Background

MRI and PET/CT scans are the main supportive methods for nasopharyngeal cancer (NPC) for staging and planning. The aim of this study is to compare MRI and PET/CT scanning in terms of survival in patients with NPC who had MRI or PET/CT‐simulated radiotherapy planning.

Methods

Pathological diagnosed nonkeratinized undifferentiated type and stage II‐IVA 91 NPC patients with treated intensity‐modulated radiotherapy plus chemotherapy were scanned. The patients were immobilized by a customized thermoplastic mask for fusion images both MRI scans and PET/CT scans. CTVs were created via MR‐guided simulation and PET/CT‐guided simulation.

Results

PET/CT‐guided simulation was performed with 44 patients (56.4%) and MR‐guided simulation was performed with 34 patients (43.6%). Local recurrence‐free survival (LRFS) of patients was 68.1 months. LRFS of patients with PET/CT‐guided simulation was 59.9, while LRFS of patients with MR‐guided was 66.9 months. There was a statistically significant difference between groups (P = .03). In the subgroup analyses, the patients were assessed by dividing into the three groups for the T1‐T2 stage, T‐3 stage, and T‐4 stage. In the patients with T1‐T2 stage, 5‐year LRFS rates were found %74.4 for PET/CT‐guided simulation and %83.3 for MR‐guided simulation. There was no statistically significant difference between groups (P = .33). In the patients with T‐3 stage, 5‐year LRFS rates were found %55.6 for PET/CT‐guided simulation and %83.3 for MR‐guided simulation. There was not a statistically significant difference between groups (P = .59). In the patients with T‐4 stage, 5‐year LRFS rates were found %42.2 for PET/CT‐guided simulation and %85.1 for MR‐guided simulation. The difference between groups was found to be statistically significant (P = .04).

Conclusion

In this study, we founded that MR‐guided simulation has better than PET/CT‐guided simulation for LRFS.
Lost in Space? The spatial and scalar dimensions of organised crime in the Pacific
Authors: Walton Grant W. , Dinnen Sinclair
Published: August 2020

Two theoretical frameworks frame the spatial dimensions of organised crime. The first, which has shaped international responses to the problem, stresses the scalar and territorial nature of the problem; the second (and recently emerging) has drawn on network theories to suggest that organised crime is ascalar and operates through fluid relationships between people, places and things. We suggest that these viewpoints tend to bifurcate scalar and flat ontologies and argue that understanding and responding to organised crime requires engaging with theories of scale and networks simultaneously. We bring this theoretical insight to bear on a case study: we examine the way state power has shaped organised crime and responses to it across the Pacific. The case study highlights that responses to organised crime are by and large driven by scalar and state‐based responses, which have been shaped by political power. In contrast, organised crime constitutes networked relations that are significantly shaped by administrative and political scales. The paper argues that the disjuncture between the nature of responses to organised crime helps perpetuate the problem. It also highlights the advantages of greater dialogue between scalar and networked theories of organised crime.
Effects of growth hormone receptor antagonism and somatostatin analog administration on quality of life in acromegaly
Authors: Dichtel Laura E. , Kimball Allison , Yuen Kevin C. J. , Woodmansee Whitney , Haines Melanie S. , Guan Qiu Xia , Swearingen Brooke , Nachtigall Lisa B. , Tritos Nicholas A. , Sharpless Julie L. , Kaiser Ursula B. , Gerweck Anu V. , Miller Karen K.
Published: August 2020

Objective

Acromegaly is associated with impaired quality of life (QoL). We investigated the effects of biochemical control of acromegaly by growth hormone receptor antagonism vs somatostatin analog therapy on QoL.

Design

Cross‐sectional.

Patients

116 subjects: n = 55 receiving a somatostatin analog (SSA group); n = 29 receiving pegvisomant (PEG group); n = 32 active acromegaly on no medical therapy (ACTIVE group).

Measurements

Acromegaly QoL Questionnaire (AcroQoL), Rand 36‐Item Short Form Survey (SF‐36) and Gastrointestinal QoL Index (GIQLI); fasting glucose, insulin and IGF‐1 levels (LC/MS, Quest Diagnostics).

Results

There were no group differences in mean age, BMI or sex [(whole cohort mean ± SD) age 52 ± 14 years, BMI 30 ± 6 kg/m2, and male sex 38%]. Mean IGF‐1 Z‐scores were higher in ACTIVE (3.9 ± 1.0) vs SSA and PEG, which did not differ from one another (0.5 ± 0.7 and 0.5 ± 0.7, P < .0001 vs ACTIVE). Eighty‐three per cent of PEG previously received somatostatin analogs, which had been discontinued due to lack of efficacy (52%) or side effects (41%). There were no differences in the four QoL primary end‐points (AcroQoL Global Score, SF‐36 Physical Component Summary Score, SF‐36 Mental Health Summary Score and GIQLI Global Score) between SSA and PEG. Higher HbA1c, BMI and IGF‐1 Z‐scores were associated with poorer QoL in several domains.

Conclusion

Our data support a comparable QoL in patients receiving pegvisomant vs somatostatin analogs, despite the fact that the vast majority receiving pegvisomant did not respond to or were not able to tolerate somatostatin analogs.
PD‐1 and PD‐L1 expression in Kaposi sarcoma: A comparative study according to the pathological stage and clinical characteristics
Authors: Kim Young Jae , Jung Chang Jin , Won Chong Hyun , Chang Sung Eun , Lee Mi Woo , Choi Jee Ho , Lee Woo Jin
Published: August 2020

Background

Kaposi sarcoma (KS) is a mesenchymal tumor with distinct histopathological features according to stage of progression. Programmed death‐1 (PD‐1) and its ligand PD‐L1 play major roles in the immune escape strategy of tumors.

Objectives

This study evaluated expression of PD‐1 and PD‐L1 in various stages of KS and investigated associations between their expression and clinical characteristics.

Methods

Fifty cases with histopathologically diagnosed KS were classified as early or late stage. These specimens were stained with anti‐PD‐1 and anti‐PD‐L1 antibodies. The extent of expression in the intratumoral and peritumoral areas was judged by two dermatopathologists.

Results

PD‐1 and PD‐L1 were expressed in 72.2% (13/18) and 11.1% (2/18) of early‐stage cases, respectively, compared with 43.8% (14/32) and 28.1% (9/32) of late‐stage cases, respectively. At the late stage, PD‐1 expression was significantly higher in the peritumoral area than in the intratumoral area (P = 0.001). PD‐1 expression in the intratumoral area was significantly higher at the early stage than at the late stage (P = 0.013). PD‐L1 expression in the peritumoral area was significantly higher at the late stage than at the early stage (P = 0.038).

Conclusions

The pattern of PD‐1 and PD‐L1 expression differs according to the stage of KS, but is unaffected by clinical variables.
Recovery of HIV encephalopathy in perinatally infected children on antiretroviral therapy
Authors: Innes Steve , Laughton Barbara , van Toorn Ronald , Otwombe Kennedy , Liberty Afaaf , Dobbels Els , Violari Avy , Kruger Mariana , Cotton Mark F
Published: August 2020

Aim

To describe the trajectory of clinical signs in children who developed human immunodeficiency virus encephalopathy (HIVE) after starting early antiretroviral therapy (ART).

Method

This was a retrospective case‐cohort description of HIVE among Cape Town participants from the Children with HIV Early AntiRetroviral treatment (CHER) trial. Criteria for HIVE diagnosis were at least two of: (1) acquired central motor deficit, (2) impaired brain growth, and (3) failure to attain or loss of developmental milestones in the absence of an alternative aetiology.

Results

Of 133 surviving participants who initiated ART at a median age of 9 weeks and who were followed until a median age of 6 years, 20 (12%) developed HIVE at a median age 31 months (interquartile range 19–37). In these, the first neurological deterioration was noticed at a median age of 19 months, when 16 were on ART and nine had undetectable HIV viral load for a median of 12 months. Signs of upper motor neurons were present in 18, of whom 12 resolved and four had persistent spastic diplegia; 19 had motor delay, of whom 14 resolved; 12 had language delay, of whom 11 resolved; and 16 had impaired brain growth, of whom only five recovered. For the 16 participants already on ART at HIVE diagnosis, regimens were not altered in response to diagnosis.

Interpretation

HIVE may occur despite early ART initiation and virological suppression and then resolve on unchanged ART, most likely as intrathecal inflammation subsides.

What this paper adds

Despite suppressive antiretroviral therapy, children can develop human immunodeficiency virus encephalopathy,

The most common manifestations are motor deficits and impaired brain growth.

Most experience improvement, with many resolving without additional intervention.
Caregiver perception of hand function in infants with cerebral palsy: psychometric properties of the Infant Motor Activity Log
Authors: Carey Helen , Hay Krystal , Nelin Mary Ann , Sowers Brianna , Lewandowski Dennis J , Moore‐Clingenpeel Melissa , Maitre Nathalie L
Published: August 2020

Aim

To evaluate the properties of the Infant Motor Activity Log (IMAL), a caregiver‐report for frequency and quality of use of more affected upper extremity in infants with neurological and functional impairments.

Method

This was a prospective cohort study of 66 children (34 females, 32 males) aged 6 to 24 months (mean age [SD] 13.7mo [5.3]) with neurological and functional impairments and a confirmed cerebral palsy diagnoses after 2 years, and 51 age‐matched typically developing children. The IMAL was administered at baseline and 4 weeks later. Typically developing infants were tested with randomly assigned ‘more affected’ upper extremity. Psychometric properties were evaluated using Spearman's correlation coefficient, Cronbach's alpha, and Jonckheere‐Terpstra tests.

Results

In the children with impairments, the IMAL showed internal consistency (alpha≥0.88) for the How Well Scale (HWS) and How Often Scale (HOS). Test–retest reliability was 0.64 (HOS) and 0.70 (HWS), demonstrating stability over time. Correlation with Bayley Scales of Infant and Toddler Development, Third Edition more affected arm raw scores were 0.70 (HOS) and 0.72 (HWS) (p<0.001) demonstrating construct validity. Both scale scores decreased with increasing Gross Motor Function Classification System and Mini‐Manual Ability Classification System (p<0.001) levels, supporting discriminative validity. Discrimination between typically developing infants and infants with impairments was high (HWS: area under the receiver operating characteristic curve [AUC] 0.96, 95% confidence interval [CI] 0.94–0.99 and HOS AUC=0.95, CI 0.92–0.99).

Interpretation

The IMAL is a valid and reliable discriminative caregiver measure of upper limb performance and may complement measures of capacity in infants with neurological and functional impairments.

What this paper adds

The Infant Motor Activity Log (IMAL) is a valid and reliable measure of caregiver perception of upper limb function.

The IMAL fills a measurement gap for infant motor performance in children with impairments.

The IMAL discriminates among motor function levels.
Geographic patterns and environmental correlates of phylogenetic relatedness and diversity for freshwater fish assemblages in North America
Authors: Qian Hong , Cao Yong , Li Daijiang , Chu Cindy , Sandel Brody , Wang Xianli
Published: August 2020

The tropical niche conservatism hypothesis suggests that most groups should be most phylogenetically clustered in cold, dry environments. This idea has been well‐tested in plants and some animal groups, but not for fishes. We assess the geographic patterns of freshwater fish phylogenetic structure and investigate the relationships between these patterns and environmental variables across North America and within two biogeographic realms. Phylogenetic relatedness and diversity of 360 freshwater fish assemblages across North America were quantified with three metrics based on a well‐dated phylogeny, and were related to 15 environmental variables using correlation and regression analyses. Geographically, the data were analyzed for North America as well as for separate biogeographic realms. We found that cold temperatures are the strongest determinant of phylogenetic clustering overall. However, in the arid west, clustering is most pronounced in the driest regions. In eastern North America, phylogenetic clustering increases at higher latitudes, while the reverse is true in western North America. The strongest phylogenetic clustering for freshwater fish assemblages on the continent is found in the most arid, rather than the coldest, climate in North America. Our results highlight that patterns of phylogenetic structure of freshwater fishes in North America are driven by both ecological and evolutionary processes that differ regionally.
Noise during mouthbrooding impairs maternal care behaviors and juvenile development and alters brain transcriptomes in the African cichlid fishAstatotilapia burtoni
Authors: Butler Julie M. , Maruska Karen P.
Published: August 2020

Anthropogenic noise has increased underwater ambient sound levels in the range in which most fishes detect and produce acoustic signals. Although the impacts of increased background noise on fish development have been studied in a variety of species, there is a paucity of information on how noise affects parental care. Mouthbrooding is an energetically costly form of parental care in which the brooding fish carries developing larvae in the buccal cavity for the duration of development. In the African cichlidAstatotilapia burtoni, females carry their brood for ~2 weeks during which time they do not eat. To test the hypothesis that increased background noise impacts maternal care behaviors and brood development, we exposed brooding females to a 3‐h period of excess noise (~140 dB) played through an underwater speaker. Over half of noise‐exposed brooding females cannibalized or pre‐maturely released their brood, but 90% of control females exhibited normal brooding behaviors. RNA‐seq analysis revealed that transcripts related to feeding and parental care were differentially expressed in the brains of noise‐exposed females. Juveniles that were exposed to noise during their brood period within the mother's mouth had lower body condition factors, higher mortality and altered head transcriptomes compared with control broods. Furthermore, onset of adult‐typical coloration and behaviors was delayed compared with control fish. Together, these data indicate that noise has severe impacts on reproductive fitness in mouthbrooding females. Our results, combined with past studies, indicate that parental care stages are extremely susceptible to noise‐induced perturbations with detrimental effects on species persistence.
Nurse educator academic incivility: a qualitative descriptive study
Authors: Thupayagale‐Tshweneagae G. , Dithole K.S. , Baratedi W.M. , Raditloko S.
Published: August 2020

Aim

The aim of this study was to explore nurse educator academic incivility from the perspectives of nurse educator leaders.

Background

The academic environment should be safe and conducive to both teaching and learning. Both the students and faculty should have a sense of belonging and of being valued.

Introduction

Faculty‐to‐faculty incivility has been reported as being disruptive to the teaching and learning environment, and is associated with poor work outputs.

Method

A qualitative descriptive design, as explained by Sandelowski, was used to explore academic incivility as perceived by nurse educator leaders. Twenty semi‐structured interviews were conducted with nurse educator leaders, representing three levels of management in Botswana. The approach of Elo and Kyngas was used to analyse qualitative data. Their main aim was to compare categories at different periods, as was the case with different categories of nurse leaders in this study.

Findings

Three main themes emerged from the data analysis: lack of policy implementation, inadequate leadership skills and role modelling. Two subthemes emerged from the theme, lack of policy implementation, namely: poor record‐keeping and hierarchical issues. On further analysis of the theme, inadequate leadership skills, poor hierarchical coordination among nurse educator leaders; and favouritism emerged as subthemes. The last theme, role modelling, needed no further development and described the modelling of incivility as the behaviour that has birthed a generation of incivility among nurse educators.

Conclusion

Incivility exists in nursing colleges in Botswana, and it includes unruly behaviour towards one another; late coming; disrespect; and disregard of authority.

Implications for nursing education policy

There must be collaboration between nurse educators and health policymakers to strengthen cordial relationships as well as foster disciplinary procedures on incivility. Clear policy on disciplinary procedures focusing on mitigating various forms of uncivil behaviours is imperative. Nurse educator leaders’ training on management skill should also be strengthened and made mandatory before nurse educators are appointed to leadership positions.
Nursing diagnoses: what about NANDA‐I syndromes?
Authors: Romeiro J. , Caldeira S. , Herdman T.H. , Lopes C.T. , Vieira M.
Published: August 2020

Aim

The aim of this paper is to propose a label structure for nursing diagnosis syndromes from NANDA‐I.

Background

Worldwide changes and human needs seem to get more complex, offering challenging opportunities for nursing care and to nursing knowledge. Nursing classifications represent nursing knowledge and are critical in guiding clinical practice and patient‐centred care.

Sources of evidence

This discussion paper is based on the analysis of NANDA‐I Taxonomy II and related literature.

Discussion/Conclusion

A total of 13 diagnoses comprise the term ‘syndrome’; however, the labels are not consistent with the multiaxial system within the NANDA‐I model of a nursing diagnosis. Syndromes require a more specific approach and definition when compared to other type of nursing diagnoses. A new format for describing the label is provided and would be useful in improving current syndromes and in reflecting a more individualized and patient‐centred nursing care.

Implications for nursing policy and practice

The proposal provided in this paper could raise the quality of nurses’ assessment, increase accuracy of NANDA‐I nursing diagnoses, promote nurses’ clinical reasoning and the adequacy of care. Ultimately, changes should be not only perceived in nurses´ practice but also in nursing education as curricula should promote a critical thinking. Nurse leaders and policymakers could additionally use this in the development of advanced programmes and protocols that could manage and monitorize implementation of advanced care.
The great imitator with no diagnostic test: pyoderma gangrenosum
Authors: Alonso‐León Teresa , Hernández‐Ramírez Heidi H. , Fonte‐Avalos Veronica , Toussaint‐Caire Sonia , E. Vega‐Memije María , Lozano‐Platonoff Adriana
Published: August 2020

Pyoderma gangrenosum is a rare, neutrophil‐mediated, auto‐inflammatory dermatosis that wound care specialists must be prepared to recognise. This condition has clinical features analogous to infectious processes. There is no specific diagnostic test and the diagnosis is usually obtained from exclusion. Its early recognition and proper management with prompt initiation of immunosuppressive therapy are essential to improve the quality of life and the prognosis of patients.
An examination of maternal prenatal BMI and human fetal brain development
Authors: Norr Megan E. , Hect Jasmine L. , Lenniger Carly J. , Van den Heuvel Martijn , Thomason Moriah E.
Published: August 2020

Background

Prenatal development is a time when the brain is acutely vulnerable to insult and alteration by environmental factors (e.g., toxins, maternal health). One important risk factor is maternal obesity (Body Mass Index > 30). Recent research indicates that high maternal BMI during pregnancy is associated with increased risk for numerous physical health, cognitive, and mental health problems in offspring across the lifespan. It is possible that heightened maternal prenatal BMI influences the developing brain even before birth.

Methods

The present study examines this possibility at the level of macrocircuitry in the human fetal brain. Using a data‐driven strategy for parcellating the brain into subnetworks, we test whether MRI functional connectivity within or between fetal neural subnetworks varies with maternal prenatal BMI in 109 fetuses between the ages of 26 and 39weeks.

Results

We discovered that strength of connectivity between two subnetworks, left anterior insula/inferior frontal gyrus (aIN/IFG) and bilateral prefrontal cortex (PFC), varied with maternal BMI. At the level of individual aIN/IFG‐PFC connections, we observed both increased and decreased between‐network connectivity with a tendency for increased within‐hemisphere connectivity and reduced cross‐hemisphere connectivity in higher BMI pregnancies. Maternal BMI was not associated with global differences in network topography based on network‐based statistical analyses.

Conclusions

Overall effects were localized in regions that will later support behavioral regulation and integrative processes, regions commonly associated with obesity‐related deficits. By establishing onset in neural differences prior to birth, this study supports a model in which maternal BMI‐related risk is associated with fetal connectome‐level brain organization with implications for offspring long‐term cognitive development and mental health.
A randomized, split‐face, double‐blind, comparative study of the safety and efficacy of small‐ and large‐particle hyaluronic acid fillers for the treatment of nasolabial folds
Authors: Nikolis Andreas , Enright Kaitlyn M. , Öhrlund Åke , Winlöf Per , Cotofana Sebastian
Published: August 2020

Background

Injections of hyaluronic acid (HA) for tissue augmentation are one of the most common aesthetic treatments performed worldwide. However, few studies have compared the safety and efficacy of small‐ and large‐particle HA (SP‐HA; LP‐HA).

Aim

To assess and compare the safety and efficacy of SP‐HA and LP‐HA for the correction of nasolabial folds (NLFs).

Methods

A prospective, split‐face, triple‐blind study design was used. Ten female subjects were recruited. Patients underwent treatment at baseline, an optional touch up at Week 2, and a follow‐up visit at Week 4. At weeks 2 and 4, a blinded reviewer assessed the patients using the Global Aesthetic Improvement Scale (GAIS) and Wrinkle Severity Rating Scale (WSRS); and subjects completed the Patient Satisfaction Questionnaire (PSQ). At all visits, 3‐dimensional imagery and ultrasonography of patients’ NLFs were captured. Adverse events (AEs) were evaluated by the Investigator and recorded by subjects in diaries.

Results

The GAIS response rate, defined as ≥ “improved” from baseline, was between 90 (2 weeks) and 100% (1 month) for SP‐HA and was 100% for LP‐HA, at both visits. Paired‐samples t tests revealed significant differences in the change in WSRS scores between groups, at both visits (P < .01). Differences in the clinical effect and lifting capacity of both products were observed in 3‐dimensional imagery and ultrasonography. Treatment volumes varied, with 61.32% more SP‐HA being required than LP‐HA for achieving a ≥ one‐grade WSRS improvement. There were no severe AEs throughout the trial, nor AEs related to the investigational device.

Conclusions

LP‐HA demonstrates better efficacy for correcting bony resorption in the nasal pyriform region.
Ovarian cryopreservation for children aged 3 years or younger: A report of three cases
Authors: Kasei Ryo , Morimune Aina , Kimura Fuminori , Kitazawa Jun , Hanada Tetsuro , Murakami Takashi
Published: August 2020

Ovarian tissue cryopreservation has recently been performed as an option for fertility preservation in prepubertal girls with cancer. In this study, ovarian tissue was cryopreserved from 3 girls of 3 years of age or younger during a 3‐year period at our institution. Case 1 was a 1‐year‐old girl, who was diagnosed with a yolk sac tumor in the sacral region. Case 2 was a 2‐year‐old girl, who was diagnosed with retroperitoneal neuroblastoma. Case 3 was a 3‐year‐old girl, who was diagnosed with cerebellar medulloblastoma. All patients had planned to undergo chemotherapy that would affect the ovarian reserve. Because these patients were toddlers, consideration of ethics, the surgical procedure and postoperative management, and optimal method for freezing ovarian tissue was necessary, although gynecologists rarely experience these challenges in daily clinical practice. We herein present the clinical course of these three cases and discuss the peculiarities and countermeasures of ovarian cryopreservation in children.
A 10‐year retrospective survey of acute childhood osteomyelitis in Stockholm, Sweden
Authors: von Heideken Johan , Bennet Rutger , Eriksson Margareta , Hertting Olof
Published: August 2020

Aim

Children with osteomyelitis present with a range of signs and symptoms and with varying degree of severity. The purpose of this study was to provide data on a population‐based 10‐year material of children with acute osteomyelitis.

Methods

All children, 0–14 years in Stockholm Region with acute osteomyelitis hospitalised in July 2005–June 2015, were retrospectively studied. Time to hospital presentation, disease localization, inflammation markers, imaging procedures, microbiology, severity classified by the presence of complications, surgical procedures, hospital length of stay and seasonal variation were recorded.

Results

There were 430 children with acute osteomyelitis; 61% were boys. The incidence per 100 000 person‐years was 11.6; 9.3 in girls and 13.1 in boys. Median age at admission was 2.9 years with no peak later in childhood. Median time from first symptom to diagnosis was 4 days (range 1–21) and 48% of the cases were localised to femur or tibia. Mean C‐reactive protein was 59 mg/L (range 1–376). Blood (n = 82) or tissue cultures (n = 54) were positive in 118 (28%) children. The most common pathogen was Staphylococcus aureus (n = 88) followed by Streptococcus pyogenes (n = 12). Surgery was performed in 71 children (17%). There was no mortality. Severe complications were seen in 14 (3.3%) children, five of whom were admitted to intensive care. Median hospital length of stay was 4 days (range 1–60).

Conclusions

Osteomyelitis in children is a diagnostic challenge with a low yield of positive bacterial cultures. Few children with uncomplicated disease need surgery, but the risk of severe complications is not negligible.
Function and application of the Eutrema salsugineum PHT1;1 gene in phosphate deficiency stress
Authors: Yang S. , Zhao Y. , Wang J.
Published: August 2020

Low availability of inorganic phosphate (Pi) in soil is often a limiting factor for plant growth and productivity. The Pi transporter plays an important role in the absorption and utilization of phosphorus in plants. Eutrema salsugineum shows strong tolerance under Pi stress conditions, but the function of the E. salsugineum PHT1 genes has not yet been systematically studied.

This study isolated a phosphate transporter gene (EsPHT1;1) from the halophyte E. salsugineum and functionally characterized it in the herbaceous model plant, Arabidopsis thaliana, and in an important oil crop species, soybean (Glycine max (L.) Merr.).

Under Pi deficient conditions, transgenic Arabidopsis and transgenic soybean grew better and exhibited significant improvement in root growth, biomass accumulation and seed yield compared with wild‐type (WT) plants. These phenotypic enhancements were more apparent under inadequate Pi conditions than under sufficient or no Pi conditions, which is in agreement with the observation that the transgenic plants accumulated higher amounts of Pi and total P in shoots and roots than WT plants only when inadequate Pi was supplied.

The results of the present study indicate that overexpression of EsPHT1;1 can efficiently enhance the growth and reproductive performance of both Arabidopsis and soybean plants challenged by low P stress, which results confirm the important role of PHT1;1 in dealing with Pi deficiency.
Characterization of the novel HLA‐C*15:203 allele by next‐generation sequencing
Authors: Genebrier Steve , Elsermans Vincent , Nivet Carl , Chérel Mathilde , Renac Virginie
Published: August 2020

C*15:203 differs from C*15:02:01:01 by one nucleotide substitution at position 142 in exon 2.
Characterization of the novel HLA‐A*29:141 allele by next‐generation sequencing
Authors: Genebrier Steve , Elsermans Vincent , Nivet Carl , Chérel Mathilde , Renac Virginie
Published: August 2020

A*29:141 differs from A*29:02:01:01 by one nucleotide substitution at position 275 in exon 2.
Characterization of the novel HLA‐DRB1*15:175 allele by next‐generation sequencing
Authors: Genebrier Steve , Elsermans Vincent , Nivet Carl , Chérel Mathilde , Renac Virginie
Published: August 2020

DRB1*15:175 differs from DRB1*15:01:01:02 by one nucleotide substitution at position 233 in exon 2.
El desarrollo de nuevos productos a la luz y a la sombra de las capacidades dinámicas
Authors: Ortega Álvarez Ana María , García Merino Teresa , Santos Álvarez María Valle
Published: August 2020

El objetivo de esta investigación es analizar el proceso de desarrollo de nuevos productos ( y las concepciones en las cuales este proceso contribuye a la renovación como mecanismo de renovación organizativa. Para ello se revisa la literatura sobre DNP desde la óptica de las capacidades dinámicas, que cubre el análisis del entorno y la redefinición del dominio de actividad, pasando por la reconfiguración de las capacidades operativas. De la revisión de la literatura se constata que los procesos de DNP se pueden reinterpretar como capacidades dinámicas y, por ello, pueden servir como mecanismos de renovación organizativa. Sin embargo, a partir de reconocer las limitaciones de esta concepción y la necesidad de recuperar el concepto de capacidad organizativa, se considera que la dinamización de estas capacidades representa un proceso de renovación más abierto e inspirado en los retos del entorno.
How One Feels During Resistance Exercises: A Repetition-by-Repetition Analysis Across Exercises and Loads
Authors: Emanuel Aviv , Rozen Smukas Isaac , Halperin Israel
Published: August 2020

Context: The Feeling Scale (FS) is a unique and underexplored scale in sport sciences that measures affective valence. The FS has the potential to be used in athletic environments as a monitoring and prescription tool. Purpose: To examine whether FS ratings, as measured on a repetition-by-repetition basis, can predict proximity to task failure and bar velocity across different exercises and loads. Methods: On the first day, 20 trained participants (10 females) completed 1-repetition-maximum (1-RM) tests in the barbell bench and squat exercises and were introduced to the FS. In the following 3 sessions, participants completed 3 sets to task failure with either (1) 70% 1-RM bench press, (2) 70% 1-RM squat (squat-70%), or (3) 80% 1-RM squat (squat-80%). Sessions were completed in a randomized, counterbalanced order. After every completed repetition, participants verbally reported their FS ratings. Bar velocity was measured via a linear position transducer. Results: FS ratings predicted failure proximity and bar velocity in all 3 conditions (P < .001, R2 .66–.85). Based on the analysis, which included over 2400 repetitions, a reduction of 1 unit in the FS corresponded to approaching task failure by 14%, 11%, and 11%, and to a reduction in bar velocity of 10%, 4%, and 3%, in the bench, squat-70%, and squat-80%, respectively. Conclusion: This is the first study to investigate whether the FS can be used in resistance-training environments among resistance-trained participants on a repetition-by-repetition basis. The results indicate that the FS can be used to monitor and prescribe resistance training and that its benefits should be further explored.
A Combined Sleep Hygiene and Mindfulness Intervention to Improve Sleep and Well-Being During High-Performance Youth Tennis Tournaments
Authors: Lever Jonathon R. , Murphy Alistair P. , Duffield Rob , Fullagar Hugh H.K.
Published: August 2020

Purpose: To investigate the effects of combined sleep hygiene recommendations and mindfulness on actigraphy-based sleep parameters, perceptual well-being, anxiety, and match outcomes during high-performance junior tennis tournaments. Methods: In a randomized crossover design, 17 high-performance junior tennis players completed the baseline, control, and intervention (INT) conditions across 3 separate weeks. The baseline consisted of unassisted, habitual sleep during a regular training week, and the control was unassisted sleep during a tournament week. The players attended a sleep education workshop and completed a nightly sleep hygiene protocol during a tournament week for the INT. Analysis was performed on the weekly means and on the night prior to the first match of the tournament (T-1). Results: Significant differences were observed for increased time in bed, total sleep time, and an earlier bedtime (P < .05) across the INT week. These parameters also significantly improved on T-1 of the INT. A moderate effect size (P > .05, d > 1.00) was evident for decreased worry on T-1 of the INT. Small effect sizes were also evident for improved mood, cognitive anxiety, and sleep rating across the INT week. The match performance outcomes remained unchanged (P > .05). Conclusions: Sleep hygiene INTs increase the sleep duration of high-performance junior tennis players in tournament settings, including the night prior to the tournament’s first match. The effects on perceptual well-being and anxiety are unclear, although small trends suggest improved mood, despite no effect on generic match performance outcomes.
Promotion of Healthy Aging Within a Community Center Through Behavior Change: Health and Fitness Findings From the AgeWell Pilot Randomized Controlled Trial
Authors: Thom Jeanette M. , Nelis Sharon M. , Cooney Jennifer K. , Hindle John V. , Jones Ian R. , Clare Linda
Published: August 2020

The purpose of this randomized controlled trial was to determine if behavior change through individual goal setting (GS) could promote healthy aging, including health and fitness benefits in older adults who attended a community “AgeWell” Center for 12 months. Seventy-five older adults were randomly allocated to either a control or a GS group. Health outcomes were measured at baseline and after 12 months of the participants’ having access to the exception of Agewell Center facilities. The findings demonstrate that participation in the Center in itself was beneficial, with improved body composition and reduced cardiovascular risk in both groups (p < .05), and that this kind of community-based resource offers valuable potential for promoting protective behaviors and reducing health risk. However, a specific focus on identifying individual behavior change goals was required in order to achieve increased activity engagement (p < .05) and to bring about more substantial improvements in a range of health, diet, and physical function measures (p < .05).
Systems biological assessment of immunity to mild versus severe COVID-19 infection in humans
Authors: Arunachalam Prabhu S. , Wimmers Florian , Mok Chris Ka Pun , Perera Ranawaka A. P. M. , Scott Madeleine , Hagan Thomas , Sigal Natalia , Feng Yupeng , Bristow Laurel , Tak-Yin Tsang Owen , Wagh Dhananjay , Coller John , Pellegrini Kathryn L. , Kazmin Dmitri , Alaaeddine Ghina , Leung Wai Shing , Chan Jacky Man Chun , Chik Thomas Shiu Hong , Choi Chris Yau Chung , Huerta Christopher , Paine McCullough Michele , Lv Huibin , Anderson Evan , Edupuganti Srilatha , Upadhyay Amit A. , Bosinger Steve E. , Maecker Holden Terry , Khatri Purvesh , Rouphael Nadine , Peiris Malik , Pulendran Bali
Published: August 2020

Immune profiling of COVID-19 patients

Coronavirus disease 2019 (COVID-19) has affected millions of people globally, yet how the human immune system responds to and influences COVID-19 severity remains unclear. Mathewet al.present a comprehensive atlas of immune modulation associated with COVID-19. They performed high-dimensional flow cytometry of hospitalized COVID-19 patients and found three prominent and distinct immunotypes that are related to disease severity and clinical parameters. Arunachalamet al.report a systems biology approach to assess the immune system of COVID-19 patients with mild-to-severe disease. These studies provide a compendium of immune cell information and roadmaps for potential therapeutic interventions.

Science, this issue p.eabc8511, p.1210
Supplemental Material: Transition from the lithospheric to asthenospheric mantle-derived magmatism in the Early Jurassic along eastern Bangong–Nujiang Suture, Tibet: Evidence for continental arc extension induced by slab rollback
Authors: Xu Wangchun , al. et
Published: August 2020

Table S1: Zircon LA-ICP-MS U-Pb data of the early Jurassic mafic rocks from the Kaqiong microblock; Table S2: Zircon LA-ICP-MS REE (ppm) data of the early Jurassic mafic rocks from the Kaqiong microblock; Table S3: Whole-rock major (%) and trace (ppm) element data of the early Jurassic mafic rocks from the Kaqiong microblock; Table S4: Zircon LA-MC-ICP-MS Lu-Hf data of the early Jurassic mafic rocks from the Kaqiong microblock; Table S5: Whole-rock Sr-Nd isotopic data of the early Jurassic mafic rocks from the Kaqiong microblock.
Danish premature birth rates during the COVID-19 lockdown
Authors: Hedermann Gitte , Hedley Paula Louise , Bækvad-Hansen Marie , Hjalgrim Henrik , Rostgaard Klaus , Poorisrisak Porntiva , Breindahl Morten , Melbye Mads , Hougaard David M , Christiansen Michael , Lausten-Thomsen Ulrik
Published: August 2020

To explore the impact of COVID-19 lockdown on premature birth rates in Denmark, a nationwide register-based prevalence proportion study was conducted on all 31 180 live singleton infants born in Denmark between 12 March and 14 April during 2015–2020.

The distribution of gestational ages (GAs) was significantly different (p=0.004) during the lockdown period compared with the previous 5 years and was driven by a significantly lower rate of extremely premature children during the lockdown compared with the corresponding mean rate for the same dates in the previous years (OR 0.09, 95% CI 0.01 to 0.40, p<0.001). No significant difference between the lockdown and previous years was found for other GA categories.

The reasons for this decrease are unclear. However, the lockdown has provided a unique opportunity to examine possible factors related to prematurity. Identification of possible causal mechanisms might stimulate changes in clinical practice.
Rapid assessment of avoidable blindness-based healthcare costs of diabetic retinopathy in Hungary and its projection for the year 2045
Authors: Tóth Gábor , Limburg Hans , Szabó Dorottya , Sándor Gábor L , Nagy Zoltán Z , Németh János
Published: August 2020

Background/aims

The purpose of this study was to estimate the total healthcare cost associated with diabetic retinopathy (DR) in the population aged 18 years and older in Hungary, and its projection for the year 2045.

Methods

A cost model was developed based on the standardised rapid assessment of avoidable blindness with the diabetic retinopathy module (RAAB+DRM) methodology and recently reported prevalent-based cost of illness model. Projection for 2045 was made based on the estimation for increasing diabetes mellitus (DM) prevalence of the International Diabetes Federation. Costs were analysed from the perspective of the healthcare system and the patients. Our DR cost model was constructed according to the Scottish DR grading scale and based on the DR severity stadium.

Results

The total DR-associated healthcare cost was US$145.8 million in 2016 and will increase to US$169.0 million by 2045. The two major cost drivers were intravitreal antivascular endothelial growth factor injections and vitrectomies in this study (US$126.4 million in 2016 and US$146.5 million in 2045); they amounted to 86.7% of the total treatment cost of DR. The DR-related cost per patient was US$180.5 in Hungary.

Conclusions

The cost per patient for treating DR was lower in Hungary than in other countries. Due to the increasing socioeconomic burden of proliferative DR and diabetes-related blindness, it would be important to invest in DR screening, prevention and early treatment. Our new RAAB-based cost of DR model may facilitate comparisons of DR treatment costs across countries.
Components of diabetes prevalence in Denmark 1996–2016 and future trends until 2030
Authors: Carstensen Bendix , Rønn Pernille Falberg , Jørgensen Marit Eika
Published: August 2020

Introduction

Incidence rates of diabetes have been increasing and mortality rates have been decreasing. Our aim is the quantification of the effects of these on the prevalence and prediction of the future burden of diabetes.

Research design and methods

From population-based registers of Denmark, we derived diabetes incidence and mortality rates and mortality rates for persons without diabetes for the period 1996–2016. Rates were modeled by smooth parametric terms using Poisson regression. Estimated rates were used to assess the relative contribution of incidence and mortality to changes in prevalence over the study period as well as for prediction of future rates and prevalence 2017–2040.

Results

The major contributors to prevalence was increasing incidence (22%) and epidemiological imbalance between incidence and mortality (27%). The decrease in mortality rates over the period 1996–2016 contributes only 9% of the prevalent cases at 2016. We estimated that 467 000 persons in Denmark would be living with diabetes in 2030. The age distribution of patients in the period 2017–2030 is predicted to change toward older ages. The total number of persons needing diabetes care will increase by 67% over the next 13 years, an average annual increase of 4.0%.

Conclusions

Lowering mortality among patients with diabetes even further is not likely to influence the prevalence substantially. Since the size and the increase in incidence of diabetes are major drivers of the increasing prevalence, the prevention of new cases of diabetes is required.
Predictors of 30-day unplanned hospital readmission among adult patients with diabetes mellitus: a systematic review with meta-analysis
Authors: Soh Jade Gek Sang , Wong Wai Pong , Mukhopadhyay Amartya , Quek Swee Chye , Tai Bee Choo
Published: August 2020

Adult patients with diabetes mellitus (DM) represent one-fifth of all 30-day unplanned hospital readmissions but some may be preventable through continuity of care with better DM self-management. We aim to synthesize evidence concerning the association between 30-day unplanned hospital readmission and patient-related factors, insurance status, treatment and comorbidities in adult patients with DM. We searched full-text English language articles in three electronic databases (MEDLINE, Embase and CINAHL) without confining to a particular publication period or geographical area. Prospective and retrospective cohort and case–control studies which identified significant risk factors of 30-day unplanned hospital readmission were included, while interventional studies were excluded. The study participants were aged ≥18 years with either type 1 or 2 DM. The random effects model was used to quantify the overall effect of each factor. Twenty-three studies published between 1998 and 2018 met the selection criteria and 18 provided information for the meta-analysis. The data were collected within a period ranging from 1 to 15 years. Although patient-related factors such as age, gender and race were identified, comorbidities such as heart failure (OR=1.81, 95% CI 1.67 to 1.96) and renal disease (OR=1.69, 95% CI 1.34 to 2.12), as well as insulin therapy (OR=1.45, 95% CI 1.24 to 1.71) and insurance status (OR=1.41, 95% CI 1.22 to 1.63) were stronger predictors of 30-day unplanned hospital readmission. The findings may be used to target DM self-management education at vulnerable groups based on comorbidities, insurance type, and insulin therapy.