bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of phosphogypsum and water treatment residual application on key chemical and biological properties of clay soil and maize yield
Authors: Mahmoud Esawy , Ghoneim Adel , El Baroudy Ahmed , Abd El‐Kader Nasser , Aldhumri ‏Sami Ali , Othman Sanaa , El Khamisy Rasha
Published: February 2020

The reuse of phosphogypsum (PG) and water treatment residual (WTR) waste for agricultural purposes is a possible option to improve the soil properties and increase the crop yield. The present study was conducted during the 2014 growing season in order to determine the impacts ofPGandWTRapplied to the heavy clay soils (which contain more than 50% clay particles) at rates of 5 and 10 t ha−1with the recommended nitrogen fertilizer (NF) on the key soil properties and maize yield. A field experiment was conducted as a randomized complete block design with five treatments and three replications. The treatments were as follows: recommended nitrogen fertilizer (NF);NF+PGat 5.0 t ha−1(NF+PG5);NF+PGat 10.0 t ha−1(NF+PG10);NF+WTRat 5.0 t ha−1(NF+WTR5); andNF+WTRat 10.0 t ha−1(NF+WTR10). The results revealed that the soil microbial biomass carbon (MBC),CO2evolution and dehydrogenase activity (DHA) increased significantly with the addition ofPGorWTR. The application ofPGwithNFat the rate of 10 t ha−1recorded the highest microbial activity, soil available nutrients, grain yield and yield component of maize plants compared to the other treatments. Additions ofNF+PGat the rates of 10 and 5 t ha−1and F+WTRat 10 and 5 t ha−1increasedDHAby 1.70, 1.60, 1.40 and 1.20 times, respectively, compared to theNFtreatment. It can be concluded that application ofPGandWTRwith the recommended application rates would help in improving the properties of heavy clay soils.
Amplitude growth of intracochlear electrocochleography in cochlear implant users with residual hearing
Authors: Krüger Benjamin , Büchner Andreas , Lenarz Thomas , Nogueira Waldo
Published: February 2020

In cochlear implant (CI) users with residual hearing, the electrode-nerve interface can be investigated combining electric-acoustic stimulation (EAS) via electrocochleography (ECochG), a technique to record cochlear potentials evoked by acoustic stimulation. EAS interaction was shown in previous studies using psychoacoustic experiments. This work characterizes EAS interaction through psychophysical experiments and the amplitude growth of cochlear microphonics (CM) and auditory nerve neurophonics (ANN) derived from intracochlear ECochG recordings. Significant CM responses were recorded at psychoacoustic threshold levels. The mean difference between psychoacoustic and CM threshold was 17.5 dB. No significant ANN responses were recorded at the psychoacoustic threshold level. At the psychoacoustic most comfortable level, significant CM and ANN responses were recorded. In the presence of electrical stimulation, the psychoacoustic detection thresholds were elevated on average by 2.38 dB while the recorded CM amplitudes were attenuated on average by 1.15 dB. No significant differences in electrophysiological EAS interaction across acoustic stimulation levels were observed from CM recordings. The presence of psychophysical and electrophysiological EAS interaction demonstrates that some aspects of psychoacoustic EAS interaction can be measured via intracochlear ECochG.
Functional proteomics interrogation of the kinome identifies MRCKA as a therapeutic target in high-grade serous ovarian carcinoma
Authors: Kurimchak Alison M. , Herrera-Montávez Carlos , Brown Jennifer , Johnson Katherine J. , Sodi Valerie , Srivastava Nishi , Kumar Vikas , Deihimi Safoora , O’Brien Shane , Peri Suraj , Mantia-Smaldone Gina M. , Jain Angela , Winters Ryan M. , Cai Kathy Q. , Chernoff Jonathan , Connolly Denise C. , Duncan James S.
Published: February 2020

Kinome profiling of ovarian tumors reveals a way to treat patients and get a step ahead of drug resistance.
Fluoride exposure alters Ca
2+
signaling and mitochondrial function in enamel cells
Authors: Aulestia Francisco J. , Groeling Johnny , Bomfim Guilherme H. S. , Costiniti Veronica , Manikandan Vinu , Chaloemtoem Ariya , Concepcion Axel R. , Li Yi , Wagner Larry E. , Idaghdour Youssef , Yule David I. , Lacruz Rodrigo S.
Published: February 2020

The mechanisms by which excessive fluoride causes defects in tooth enamel mineralization are revealed.
Estimating the biomass of a mixed species complex using hydroacoustics and catch data from the Bay of Fundy and Scotian Shelf summer ecosystem survey
Authors: Debertin Allan J.
Published: February 2020

An acoustic-based index of biomass was developed due to concerns that the existing bottom-trawl index for western component pollock (Pollachius virens) was inaccurate and imprecise. Acoustic data were recorded during annual summer ecosystem surveys. Pollock and other common groundfish could not be readily identified from echo-traces within echograms. Survey catch data were analyzed concurrently with acoustic data to estimate biomass from echo-integrals contributed by the six most commonly caught fish species: pollock, Atlantic cod (Gadus morhua), haddock (Melanogrammus aeglefinus), redfish (Sebastes fasciatus), Atlantic herring (Clupea harengus), and spiny dogfish (Squalus acanthias). A cluster analyses that used a Bayesian conditional probability classified homogeneous regions based on species composition. Species composition, nautical area scatter coefficient, and backscattering cross-section of fishes for regions were used to calculate the biomass of fishes. Acoustic indices were considered as appropriate as bottom-trawl indices for fisheries management advice because the bias and variance were similar between the indices when analyzed using repeated K-fold cross-validation.
CenEEGs
Authors: Dai Chenglong , Pi Dechang , Becker Stefanie I. , Wu Jia , Cui Lin , Johnson Blake
Published: February 2020

This article explores valid brain electroencephalography (EEG) selection for EEG classification with different classifiers, which has been rarely addressed in previous studies and is mostly ignored by existing EEG processing methods and applications. Importantly, traditional selection methods are not able to select valid EEG signals for different classifiers. This article focuses on a source control-based valid EEG selection to reduce the impact of invalid EEG signals and aims to improve EEG-based classification performance for different classifiers. We propose a novel centroid-based EEG selection approach named CenEEGs, which uses a scale-and-shift-invariance similarity metric to measure similarities of EEG signals and then applies a globally optimal centroid strategy to select valid EEG signals with respect to a similarity threshold. A detailed comparison with several state-of-the-art time series selection methods by using standard criteria on 8 EEG datasets demonstrates the efficacy and superiority of CenEEGs for different classifiers.
Molecular Simulations of Gram-Negative Bacterial Membranes Come of Age
Authors: Im Wonpil , Khalid Syma
Published: February 2020

Gram-negative bacteria are protected by a multicompartmental molecular architecture known as the cell envelope that contains two membranes and a thin cell wall. As the cell envelope controls influx and efflux of molecular species, in recent years both experimental and computational studies of such architectures have seen a resurgence due to the implications for antibiotic development. In this article we review recent progress in molecular simulations of bacterial membranes. We show that enormous progress has been made in terms of the lipidic and protein compositions of bacterial systems. The simulations have moved away from the traditional setup of one protein surrounded by a large patch of the same lipid type toward a more bio-logically representative viewpoint. Simulations with multiple cell envelope components are also emerging. We review some of the key method developments that have facilitated recent progress, discuss some current limitations, and offer a perspective on future directions.
Cryptanalysis and Security Improvement of Two Authentication Schemes for Healthcare Systems Using Wireless Medical Sensor Networks
Authors: Mo Jiaqing , Hu Zhongwang , Lin Yuhua
Published: February 2020

Wireless medical sensor networks (WMSNs) play an important role in collecting healthcare data of the remote patient and transmitting them to the medical professional for proper diagnosis via wireless channel. To protect the patient's healthcare data which is private-related and sensitive, some authentication schemes for healthcare systems using WMSN have been proposed to ensure the secure communication between the medical sensors and the medical professional. Since cryptanalyzing the security defects of authenticated protocols is crucial to put forward solutions and propose truly robust protocols, we scrutinize two state-of-the-art authentication protocols using WMSN for healthcare systems. Firstly, we examine Ali et al.’s enhanced three-factor based authentication protocol and show that although it provides a formal proof and a security verification, it still fails to resist offline dictionary guessing attack, desynchronization attack, and privileged insider attack and contains a serious flaw in the password change phase. Secondly, we investigate Shuai et al.’s lightweight and three-factor based authentication protocol and point out that it cannot achieve high security level as they claimed; it is actually subject to offline dictionary guessing attack and privileged insider attack, and it also has a design flaw in the password change phase. In addition, we suggest several countermeasures to thwart these security weaknesses in these two schemes for WMSN and the similar kinds.
Phenotypic and Functional Changes in Peripheral Blood Natural Killer Cells in Crohn Disease Patients
Authors: Samarani Suzanne , Sagala Patrick , Jantchou Prevost , Grimard Guy , Faure Christophe , Deslandres Colette , Amre Devendra K. , Ahmad Ali
Published: February 2020

We investigated activation status, cytotoxic potential, and gut homing ability of the peripheral blood Natural Killer (NK) cells in Crohn disease (CD) patients. For this purpose, we compared the expression of different activating and inhibitory receptors (KIR and non-KIR) and integrins on NK cells as well as their recent degranulation history between the patients and age-matched healthy controls. The study was conducted using freshly obtained peripheral blood samples from the study participants. Multiple color flow cytometry was used for these determinations. Our results show that NK cells from treatment-naïve CD patients expressed higher levels of activating KIR as well as other non-KIR activating receptors vis-à-vis healthy controls. They also showed increased frequencies of the cells expressing these receptors. The expression of several KIR and non-KIR inhibitory receptors tended to decrease compared with the cells from healthy donors. NK cells from the patients also expressed increased levels of different gut-homing integrin molecules and showed a history of increased recent degranulation events both constitutively and in response to their in vitro stimulation. Furthermore, treatment of the patients tended to reverse these NK cell changes. Our results demonstrate unequivocally, for the first time, that peripheral blood NK cells in treatment-naïve CD patients are more activated and are more poised to migrate to the gut compared to their counterpart cells from healthy individuals. Moreover, they show that treatment of the patients tends to normalize their NK cells. The results suggest that NK cells are very likely to play a role in the immunopathogenesis of Crohn disease.
Two Pathogenic Gene Mutations Identified Associating with Congenital Cataract and Iris Coloboma Respectively in a Chinese Family
Authors: Li Bin , Lu Bin , Guo Xuewen , Hu Shenghui , Zhao Guihu , Huang Weihong , Hu Jianzhong , Song Kun
Published: February 2020

Purpose. To screen out pathogenic genes in a Chinese family with congenital cataract and iris coloboma. Material and Methods. A three-generation family with congenital cataract and iris coloboma from a Han ethnicity was recruited. DNA was extracted from peripheral blood samples collected from all individuals in the family. Whole exon sequencing was employed for screening the disease-causing gene mutations in the proband, and Sanger sequencing was used for other members of the family and a control group of 500 healthy individuals. Bioinformatics analysis and three-dimensional structure predictions were used to predict the impact of amino acid changes on protein structure and function. Results. The candidate genes of cataract and iris coloboma were successfully screened out. A heterozygote mutation, CRYGD c.70C>A (p.P24T), was identified as cosegregating with congenital cataracts, while another heterozygous mutation, WFS1 c.1514G>C (p.C505S), which had not been reported previously, cosegregated with congenital iris coloboma. Bioinformatic analyses and three-dimensional structure prediction proved that the three-dimensional structures of WFS1 p.C505S and CRYGD p.P24T changed markedly and may contribute significantly to iris coloboma and congenital cataract, respectively. Conclusions. We report a novel mutation, WFS1 p.C505S, and a known mutation, CRYGD p.P24T, that cosegregate with iris coloboma and congenital cataract, respectively, in a Chinese family. This is the first time the association of WFS1 p.C505S with iris coloboma has been demonstrated, although CRYGD p.P24T has been widely reported as being associated with congenital cataract, especially in the Eastern Asian population. These findings may have future therapeutic benefit for the diagnosis of iris coloboma and congenital cataract. The results may also be relevant in further studies aiming to investigate the molecular pathogenesis of iris coloboma and congenital cataract.
Gender Differences between Multimorbidity and All-Cause Mortality among Older Adults
Authors: Roman Lay Alejandra Andrea , Ferreira do Nascimento Carla , Caba Burgos Fresia , Larraín Huerta Angélica del Carmen , Rivera Zeballos René Eduardo , Pantoja Silva Verónica , Duarte Yeda Aparecida de Oliveira
Published: February 2020

Objectives. This study seeks to determine the prevalence of chronic diseases and analyze the association between multimorbidity and all-cause mortality by sex. Methods. This is a 16-year longitudinal study of follow-up. We used sample data of the SABE (Health, Well-Being and Aging) study cohort and mortality data obtained through the Mortality Information Improvement Program of the City of São Paulo (PRO-AIM) from the 2000–2016 period. Survival analysis was performed using Cox proportional hazard models. Results. Hypertension (HT) was the most prevalent disease in older adults (52.93%), followed by musculoskeletal disorders (MSDs) (27.09%), cardiovascular diseases (CD) (17.79%), diabetes mellitus (DM) (16.95%), mental disorders (MD) (15.43%), and respiratory diseases (RD) (9.72%). The highest mortality rate in women was observed in the combination of HT/MSDs/DM/MD (HR = 6.15, 95% CI = 2.32, 16.32), while in men was in the combination of HT/CD/MSDs/DM (HR = 5.72, 95% CI = 1.72, 19.06). Conclusion. Similar to previous studies carried out in developed countries, we found that all-cause mortality increased as diseases are added to an individual. Women and men presented different mortality patterns according to multimorbidity. Therefore, we suggest that additional longitudinal studies should be performed in order to analyze mortality by sex.
Management Outcome of Burn Injury and Associated Factors among Hospitalized Children at Ayder Referral Hospital, Tigray, Ethiopia
Authors: Alemayehu Sielu , Afera Bhafta , Kidanu Kalayou , Belete Tilahun
Published: February 2020

Background. Burn injuries are a global public health problem, accounting for an estimated 265,000 deaths. Globally, over half of the disability-adjusted life years lost from fire-related burns which occurred between the ages of 0 and 14 years. The rate of child deaths from burns is currently over 7 times higher in low- and middle-income countries than in high-income countries. In Ethiopia, burn was the second leading cause of death among children from the unintentional injuries. So far, no research had been conducted in terms of assessing the outcome of burn injury in children in Ethiopia and particularly in Tigray region. The aim of this study was to assess the outcome of burn injury and associated factors among hospitalized children of under 18 years at Ayder Referral Hospital in Mekelle, Ethiopia. Method. A retrospective document review was used to assess the outcome of burn injury and associated factors in Ayder Referral Hospital. A total of 382 hospitalized children’s chart from 2011 to 2015 were reviewed using a structured check list. To select the patients’ chart, a simple random sampling technique was used and a sampling frame was prepared based on a registration book. Data was entered, cleaned, and analyzed using SPSS version 20. Result. Almost 70% of the burns were caused by scald, and 45.3% of the burns were confined to the upper extremities. Eighty-two percent of the patients were discharged without complication. Lack of fluid resuscitation within 24 hours (AOR=2.767; 95% CI (1.276-5.999)) and a burn patient with malnutrition (AOR=0.252; 95% CI (0.069-0.923)) were statically significant with the outcome of burn injury. Conclusion. Majority of the pediatric burn patients were discharged without complication. The most causative agent of these accidents was scald; upper extremities also were the most affected area. The factors associated with the outcome of burn injury according to this study were lack of fluid resuscitation and malnourishment of burn patients.
Dissociation between Temporal and Spatial Anticipation in the Neural Dynamics of Goal-directed Movement Preparation
Authors: Canaveral Cesar Augusto , Savoie Félix-Antoine , Danion Frédéric R. , Bernier Pierre-Michel
Published: February 2020

It is well documented that providing advanced information regarding the spatial location of a target stimulus (i.e., spatial anticipation) or its timing of occurrence (i.e., temporal anticipation) influences reach preparation, reducing RTs. Yet, it remains unknown whether the RT gains attributable to temporal and spatial anticipation are subtended by similar preparatory dynamics. Here, this issue is addressed in humans by investigating EEG beta-band activity during reach preparation. Participants performed a reach RT task in which they initiated a movement as fast as possible toward visual targets following their appearance. Temporal anticipation was manipulated by having the target appear after a constant or variable delay period, whereas spatial anticipation was manipulated by precueing participants about the upcoming target location in advance or not. Results revealed that temporal and spatial anticipation both reduced reach RTs, with no interaction. Interestingly, temporal and spatial anticipation were associated with fundamentally different patterns of beta-band modulations. Temporal anticipation was associated with beta-band desynchronization over contralateral sensorimotor regions specifically around the expected moment of target onset, the magnitude of which was correlated with RT modulations across participants. In contrast, spatial anticipation did not influence sensorimotor activity but rather led to increased beta-band power over bilateral parieto-occipital regions during the entire delay period. These results argue for distinct states of preparation incurred by temporal and spatial anticipation. In particular, sensorimotor beta-band desynchronization may reflect the timely disinhibition of movement-related neuronal ensembles at the expected time of movement initiation, without reflecting its spatial parameters per se.
Explaining Extreme Events of 2018 from a Climate Perspective
Authors: Herring Stephanie C. , Christidis Nikolaos , Hoell Andrew , Hoerling Martin P. , Stott Peter A.
Published: February 2020

Editors note: For easy download the posted pdf of the Explaining Extreme Events of 2018 is a very low-resolution file. A high-resolution copy of the report is available by clicking here. Please be patient as it may take a few minutes for the high-resolution file to download.
Automatically steering cardiac catheters in vivo with respiratory motion compensation
Authors: Loschak Paul M , Degirmenci Alperen , Tschabrunn Cory M , Anter Elad , Howe Robert D
Published: February 2020

A robotic system for automatically navigating ultrasound (US) imaging catheters can provide real-time intra-cardiac imaging for diagnosis and treatment while reducing the need for clinicians to perform manual catheter steering. Clinical deployment of such a system requires accurate navigation despite the presence of disturbances including cyclical physiological motions (e.g., respiration). In this work, we report results from in vivo trials of automatic target tracking using our system, which is the first to navigate cardiac catheters with respiratory motion compensation. The effects of respiratory disturbances on the US catheter are modeled and then applied to four-degree-of-freedom steering kinematics with predictive filtering. This enables the system to accurately steer the US catheter and aim the US imager at a target despite respiratory motion disturbance. In vivo animal respiratory motion compensation results demonstrate automatic US catheter steering to image a target ablation catheter with 1.05 mm and 1.33° mean absolute error. Robotic US catheter steering with motion compensation can improve cardiac catheterization techniques while reducing clinician effort and X-ray exposure.
Development of a measure to assess acceptance of headache: The Headache Acceptance Questionnaire (HAQ)
Authors: Hamer Joshua D , Sackey Enoch T , Maack Danielle J , Smitherman Todd A
Published: February 2020

Background

Disability resulting from headache disorders is attributable in part to avoidant coping. Acceptance of pain connotes a willingness to experience pain in the service of life values, such that meaningful activities and goals are pursued despite pain. Acceptance facilitates positive health outcomes but has rarely been investigated in headache. Because headache disorders manifest differently than other forms of chronic pain, the present study sought to develop and validate a measure of acceptance of headache.

Methods

Forty-five candidate items were developed and, with input from an expert panel, reduced to 24 items. Five items were eliminated following administration to a development sample and exploratory factory analysis. Nineteen items were administered to a validation sample for confirmatory factory analysis and assessment of psychometric properties.

Results

Factor analysis produced a unidimensional six-item measure, the Headache Acceptance Questionnaire (HAQ). The HAQ evidenced good internal consistency, convergent validity with headache disability and related psychological constructs, and divergent validity with social desirability. The measure also distinguished between headache diagnostic groups.

Conclusions

Pending further validation in clinical settings, the HAQ may have utility in assessing psychological responses to headache symptoms, identifying targets of treatment for interventions that focus on reducing avoidance, and studying mechanisms of change.
Does Better Media Literacy Protect Against the Desire for Tanned Skin and Propensity for Making Appearance Comparisons?
Authors: Mingoia John , Hutchinson Amanda D. , Gleaves David H. , Wilson Carlene
Published: February 2020

Media literacy interventions provide education about the way media influence attitudes to tanned skin and promote risky health-related behaviors (e.g., sun exposure). This study tested whether higher levels of media literacy can protect against the internalization of a tanned ideal and participation in appearance comparisons online. A total of 151 young Australians aged 18 to 29 years (61 males, 90 females) completed a measure of media literacy before being randomly assigned to view photos of models with either tanned ( n = 77) or pale skin ( n = 74) on social media. Participants completed measures of internalization of a tanned ideal and tendency to make appearance comparisons following exposure to the photos. There were significant negative relationships between level of media literacy skills and both internalization of a tanned ideal and appearance comparisons. Moreover, exposure to tanned models resulted in a higher tendency to make appearance comparisons than exposure to pale models. Results indicate that media literacy skills protect against skin cancer risk factors associated with media exposure. Future interventions to reduce skin cancer risk should address the role of social networking sites in proclaiming tanned skin as ideal and increase skepticism about photos of tanned models online.
Prevalence and Burden of Health Problems in Male Elite Ice Hockey Players: A Prospective Study in the Norwegian Professional League
Authors: Nordstrøm Anine , Bahr Roald , Talsnes Ove , Clarsen Ben
Published: February 2020

Background:

As previous epidemiological studies in elite ice hockey have focused on acute time-loss injuries, little is known about the burden of overuse injuries and illnesses in ice hockey.

Purpose:

To report the prevalence and burden of all health problems in male professional ice hockey players in Norway during a single competitive season.

Study Design:

Descriptive epidemiological study.

Methods:

A total of 225 male ice hockey players in the GET League (the premier professional league) in Norway reported all health problems (acute injuries, overuse injuries, and illnesses) during the 2017-2018 competitive season. Players reported all injuries and illnesses for 31 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.

Results:

At any given time, 40% (95% CI, 37%-43%) of players reported symptoms from an injury or illness, and 20% (95% CI, 19%-22%) experienced health problems with a substantial negative impact on training and performance. Acute injuries represented the greatest incidence, prevalence, and burden (defined as the cross-product of severity and incidence). The most burdensome acute injuries were to the head/face, shoulder/clavicle, knee, and ankle. The most burdensome overuse injuries were to the knee, lumbar spine, and hip/groin.

Conclusion:

This registration captured a greater burden from overuse injuries than traditional injury registration, but acute injuries did represent a major problem. These data provide guidance in the development of prevention programs for both acute and overuse injuries, which should focus on the lumbar spine, hip/groin, and knee.
The relationship between metabolic syndrome and the incidence of colorectal cancer
Authors: Lee JungHyun , Lee Kun Sei , Kim Hyeongsu , Jeong Hyoseon , Choi Min-Jung , Yoo Hai-Won , Han Tae-Hwa , Lee Hyunjung
Published: February 2020

Objectives

This study evaluated the incidence of colorectal cancer (CRC) according to the number of metabolic syndrome (MetS) components.

Methods

Using health checkup and insurance claims data of 6,365,409 subjects, the occurrence of CRC according to stage of MetS by sex was determined from the date of the health checkup in 2009 until December 31, 2018.

Results

Cumulative incidence rates (CIR) of CRC in men and women was 3.9 and 2.8 per 1000 (p < 0.001), respectively. CIR of CRC for the normal, pre-MetS, and MetS groups in men was 2.6, 3.9, and 5.5 per 1000 (p < 0.001) and CIR in women was 2.1, 2.9, and 4.5 per 1000 (p < 0.001), respectively. Compared with the normal group, the hazard ratio (HR) of CRC for the pre-MetS group was 1.25 (95% CI 1.17–1.33) in men and 1.09 (95% CI 1.02–1.17) in women, and the HR of CRC for the MetS group was 1.54 (95% CI 1.43–1.65) in men and 1.39 (95% CI 1.26–1.53) in women after adjustment.

Conclusions

We found that MetS is a risk factor for CRC in this study. Therefore, the prevention and active management of MetS would contribute to the prevention of CRC.
Emergence of human avian influenza A(H7N9) virus infections in Wenshan City in Southwest China, 2017
Authors: Jiang Li , Zhao Xiaonan , Xu Wen , Zhou Xuehua , Luo Chunrui , Zhou Jiunan , Fu Xiaoqing , Chen Yaoyao , Li Duo
Published: February 2020

Background

The emergence of human infection with avian influenza A(H7N9) virus was reported in Wenshan City, southwestern China in 2017. The study describes the epidemiological and virological features of the outbreak and discusses the origin of the infection.

Methods

Poultry exposure and timelines of key events for each patient were collected. Samples derived from the patients, their close contacts, and environments were tested for influenza A(H7N9) virus by real-time reverse transcription polymerase chain reaction. Genetic sequencing and phylogenetic analysis were also conducted.

Results

Five patients were reported in the outbreak. An epidemiological investigation showed that all patients had been exposed at live poultry markets. The A(H7N9) isolates from these patients had low pathogenicity in avian species. Both epidemiological investigations of chicken sources and phylogenetic analysis of viral gene sequences indicated that the source of infection was from Guangxi Province, which lies 100 km to the east of Wenshan City.

Conclusions

In the study, a sudden emergence of human cases of H7N9 was documented in urban area of Wenshan City. Chickens were an important carrier in the H7N9 virus spreading from Guangxi to Wenshan. Hygienic management of live poultry markets and virological screening of chickens transported across regions should be reinforced to limit the spread of H7N9 virus.
Supporting quality care for ESRD patients: the social worker can help address barriers to advance care planning
Authors: Senteio Charles R. , Callahan Mary Beth
Published: February 2020

Background

Advance Care Planning (ACP) is essential for preparation for end-of-life. It is a means through which patients clarify their treatment wishes. ACP is a patient-centered, dynamic process involving patients, their families, and caregivers. It is designed to 1) clarify goals of care, 2) increase patient agency over their care and treatments, and 3) help prepare for death. ACP is an active process; the end-stage renal disease (ESRD) illness trajectory creates health circumstances that necessitate that caregivers assess and nurture patient readiness for ACP discussions. Effective ACP enhances patient engagement and quality of life resulting in better quality of care.

Main body

Despite these benefits, ACP is not consistently completed. Clinical, technical, and social barriers result in key challenges to quality care. First, ACP requires caregivers to have end-of-life conversations that they lack the training to perform and often find difficult. Second, electronic health record (EHR) tools do not enable the efficient exchange of requisite psychosocial information such as treatment burden, patient preferences, health beliefs, priorities, and understanding of prognosis. This results in a lack of information available to enable patients and their families to understand the impact of illness and treatment options. Third, culture plays a vital role in end-of-life conversations. Social barriers include circumstances when a patient’s cultural beliefs or value system conflicts with the caregiver’s beliefs. Caregivers describe this disconnect as a key barrier to ACP. Consistent ACP is integral to quality patient-centered care and social workers’ training and clinical roles uniquely position them to support ACP.

Conclusion

In this debate, we detail the known barriers to completing ACP for ESRD patients, and we describe its benefits. We detail how social workers, in particular, can support health outcomes by promoting the health information exchange that occurs during these sensitive conversations with patients, their family, and care team members. We aim to inform clinical social workers of this opportunity to enhance quality care by engaging in ACP. We describe research to help further elucidate barriers, and how researchers and caregivers can design and deliver interventions that support ACP to address this persistent challenge to quality end-of-life care.
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial
Authors: McCarthy Danielle M. , Powell Rhea E. , Cameron Kenzie A. , Salzman David H. , Papanagnou Dimitrios , Doty Amanda MB. , Leiby Benjamin E. , Piserchia Katherine , Klein Matthew R. , Zhang Xiao C. , McGaghie William C. , Rising Kristin L.
Published: February 2020

Background

Diagnostic uncertainty occurs frequently in emergency medical care, with more than one-third of patients leaving the emergency department (ED) without a clear diagnosis. Despite this frequency, ED providers are not adequately trained on how to discuss diagnostic uncertainty with these patients, who often leave the ED confused and concerned. To address this training need, we developed the Uncertainty Communication Education Module (UCEM) to teach physicians how to discuss diagnostic uncertainty. The purpose of the study is to evaluate the effectiveness of the UCEM in improving physician communications.

Methods

The trial is a multicenter, two-arm randomized controlled trial designed to teach communication skills using simulation-based mastery learning (SBML). Resident emergency physicians from two training programs will be randomly assigned to immediate or delayed receipt of the two-part UCEM intervention after completing a baseline standardized patient encounter. The two UCEM components are: 1) a web-based interactive module, and 2) a smart-phone-based game. Both formats teach and reinforce communication skills for patient cases involving diagnostic uncertainty. Following baseline testing, participants in the immediate intervention arm will complete a remote deliberate practice session via a video platform and subsequently return for a second study visit to assess if they have achieved mastery. Participants in the delayed intervention arm will receive access to UCEM and remote deliberate practice after the second study visit. The primary outcome of interest is the proportion of residents in the immediate intervention arm who achieve mastery at the second study visit.

Discussion

Patients’ understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. Although use of SBML is a resource intensive educational approach, this trial has been deliberately designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.

Trial registration

The trial was registered at clinicaltrials.gov (NCT04021771). Registration date: July 16, 2019.
Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students
Authors: Blanié Antonia , Amorim Michel-Ange , Benhamou Dan
Published: February 2020

Background

Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration.

Methods

In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups:

Simulation by gaming “SG”: the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;

Traditional Teaching “TT”: the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor.

CR skill was measured by script concordance tests (80 SCTs, score 0–100) immediately after the session (primary outcome) and on month later. Other outcomes included students’ satisfaction, motivation and professional impact.

Results

One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups.

Conclusions

In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG.

Trial registration

ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.
Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach
Authors: Timotijevic L. , Hodgkins C. E. , Banks A. , Rusconi P. , Egan B. , Peacock M. , Seiss E. , Touray M. M. L. , Gage H. , Pellicano C. , Spalletta G. , Assogna F. , Giglio M. , Marcante A. , Gentile G. , Cikajlo I. , Gatsios D. , Konitsiotis S. , Fotiadis D.
Published: February 2020

Background

Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty.

Methods

A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians’ (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both.

Results

Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices.

Conclusions

Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.
Physician code creep after the initiation of outpatient volume control program and implications for appropriate ICD-10-CM coding
Authors: Liang Fu-Wen , Wang Liang-Yi , Liu Lin-Yi , Li Chung Yi , Lu Tsung-Hsueh
Published: February 2020

Background

Most studies on the physician code creep (i.e., changes in case mix record-keeping practices to improve reimbursement) have focused on episodes (inpatient hospitalizations or outpatient procedures). Little is known regarding changes in diagnostic coding practices for better reimbursement among a fixed cohort of patients with chronic diseases.

Methods

To examine whether physicians in tertiary medical centers changed their coding practices after the initiation of the Outpatient Volume Control Program (OVCP) in Taiwan, we conducted a retrospective observational study of four patient cohorts (two interventions and two controls) from January 2016 to September 2017 in Taiwan. The main outcomes were the number of outpatient visits with four coding practices: 1) OVCP monitoring code recorded as primary diagnosis; 2) OVCP monitoring code recorded as secondary diagnosis; 3) non-OVCP monitoring code recorded as primary diagnosis; 4) non-OVCP monitoring code recorded as secondary diagnosis.

Results

The percentage change of the number of visits with coding practice 1 between 2016Q1 and 2017Q3 was − 74% for patients with hypertension and − 73% with diabetes in tertiary medical centers and − 23% and − 17% in clinics, respectively. By contrast, the percentage changes of coding practice 3 were + 73% for patients with hypertension and + 46% for patients with diabetes in tertiary medical centers and − 19% and − 2% in clinics, respectively.

Conclusions

Physician code creep occurred after the initiation of the OVCP. Education regarding appropriate outpatient coding for physicians will be relatively effective when proper coding is related to reimbursement.
Extensive genetic diversity of Plasmodium vivax dbp-II in Rio de Janeiro Atlantic Forest and Brazilian Amazon Basin: evidence of positive selection
Authors: Almeida-de-Oliveira Natália Ketrin , Lima-Cury Lidiane , de Abreu-Fernandes Rebecca , de Rosa Lavigne Aline , de Pina-Costa Anielle , de Souza Perce-da-Silva Daiana , Catanho Marcos , Brasil Patrícia , Daniel-Ribeiro Cláudio Tadeu , Ferreira-da-Cruz Maria de Fátima
Published: February 2020

Background

Plasmodium vivaxis the most widespread human malaria parasite outside Africa and is the predominant parasite in the Americas. Increasing reports ofP. vivaxdisease severity, together with the emergence of drug-resistant strains, underscore the urgency of the development of vaccines againstP. vivax. Polymorphisms on DBP-II-gene could act as an immune evasion mechanism and, consequently, limited the vaccine efficacy. This study aimed to investigate thepvdbp-II genetic diversity in two Brazilian regions with different epidemiological patterns: the unstable transmission area in the Atlantic Forest (AF) of Rio de Janeiro and; the fixed malaria-endemic area in Brazilian Amazon (BA).

Methods

216 BrazilianP. vivaxinfected blood samples, diagnosed by microscopic examination and PCR, were investigated. The region flankingpvdbp-II was amplified by PCR and sequenced. Genetic polymorphisms ofpvdbp-II were estimated based on the number of segregating sites and nucleotide and haplotype diversities; the degree of differentiation between-regions was evaluated applying Wright’s statistics. Natural selection was calculated using the rate of nonsynonymous per synonymous substitutions with the Z-test, and the evolutionary distance was estimated based on the reconstructed tree.

Results

79 samples from AF and 137 from BA were successfully sequenced. The analyses showed 28 polymorphic sites distributed in 21 codons, with only 5% of the samples Salvador 1 type. The highest rates of polymorphic sites were found in B- and T cell epitopes. Unexpectedly, the nucleotide diversity inpvdbp-II was higher in AF (0.01) than in BA (0.008). Among the 28 SNPs detected, 18 are shared betweenP. vivaxisolates from AF and BA regions, but 8 SNPs were exclusively detected in AF—I322S, K371N, E385Q, E385T, K386T, K411N, I419Land I419R—and 2 (N375Dand I419M) arose exclusively in BA. These findings could suggest the potential of these geographical clusters as population-specific-signatures that may be useful to track the origin of infections. The sample size should be increased in order to confirm this possibility.

Conclusions

The results highlight that thepvdbp-IIpolymorphisms are positively selected by host’s immune pressure. The characterization ofpvdbp-II polymorphisms might be useful for designing effective DBP-II-based vaccines.
ROCK1 activation-mediated mitochondrial translocation of Drp1 and cofilin are required for arnidiol-induced mitochondrial fission and apoptosis
Authors: Hu Jinjiao , Zhang Hongwei , Li Jie , Jiang Xiuxing , Zhang Yanhao , Wu Qin , Shen liwen , Shi Jingshan , Gao Ning
Published: February 2020

Background

Arnidiol is a pentacyclic triterpene diol that has multiple pharmacological activities. However, the apoptotic activities of arnidiol in human cancer cells have not yet been explored, nor has the mechanism by which arnidiol induces apoptosis been examined in depth.

Methods

MDA-MB-231 cells and xenografted mice were treated with arnidiol. Mitochondrial fission and apoptosis were determined by immunofluorescence, flow cytometry and related molecular biological techniques. The interaction and colocalization of cofilin and Drp1 was determined by immunoprecipitation and immunofluorescence assays.

Results

Arnidiol induces mitochondrial fission and apoptosis through mitochondrial translocation of Drp1 and cofilin. Importantly, the interaction of Drp1 and cofilin in mitochondria is involved in arnidiol-induced mitochondrial fission and apoptosis. Knockdown of either Drp1 or cofilin abrogated arnidiol-induced mitochondrial translocation, interaction of Drp1 and cofilin, mitochondrial fission and apoptosis. Only dephosphorylated Drp1 (Ser637) and cofilin (Ser3) were translocated to the mitochondria. Mutants of Drp1 S637A and cofilin S3A, which mimic the dephosphorylated forms, enhanced mitochondrial fission and apoptosis induced by arnidiol, whereas mutants of Drp1 S637D and cofilin S3E, which mimic the phosphorylated forms, suppressed mitochondrial fission and apoptosis induced by arnidiol. A mechanistic study revealed that ROCK1 activation plays an important role in the arnidiol-mediated Drp1 and cofilin dephosphorylation and mitochondrial translocation, mitochondrial fission, and apoptosis.

Conclusions

Our data reveal a novel role of both Drp1 and cofilin in the regulation of mitochondrial fission and apoptosis and suggest that arnidiol could be developed as a potential agent for the treatment of human cancer.
Autogeny in Culiseta longiareolata (Culicidae: Diptera) mosquitoes in laboratory conditions in Iran
Authors: Khaligh Fereshteh Ghahvechi , Naghian Abdollah , Soltanbeiglou Shadiyeh , Gholizadeh Saber
Published: February 2020

Objectives

Culiseta longiareolata is a cosmopolitan species and has implicated in the transmission of avian malaria, tularemia, and arboviruses. Despite the wide distribution of Cs. longiareolata in Iran, little is known about its biology and physiology. The current research was conducted to study the autogeny behavior in this potential vector. During 2018, larvae and pupae were collected from Nazloo region in Urmia City using standard methods. Mosquitoes were reared in cages and fed by 5% sugar in laboratory conditions and were then dissected in phosphate-buffered saline (PBS) under a stereo microscope.

Results

In total, 230 adult female Cs. longiareolata mosquitoes were dissected. Egg rafts were observed in the ovary of only 10.86% unfed female mosquitoes. Autogeny behavior is a significant factor in the growth of population without a blood feeding. Therefore, it is necessary to study how autogenous reproduction affects mosquito-borne diseases.