bluuebunny/crossref_metadata_2025 huggingface dataset:
The Building Blocks to a Highly Effective Trauma Program
Authors: Gosnell Jaclyn , Slivinski Andrea
Published: March 2021

Background:

Well-developed trauma programs take years of planning, dedication, and commitment to the trauma population to achieve the desired outcomes and, even more, resilience and persistence to maintain a high-quality standard of care. Despite widespread trauma care systems across the nation and their link to improved outcomes for the trauma patient, there is a paucity of literature outlining the foundational elements required to evolve and grow a successful trauma program.

Objective:

The purpose of this article is to outline the key elements for developing and maintaining a successful trauma program that yields high-quality patient outcomes.

Methods:

Developing a program requires intense focus and continued efforts. Multiple foundational building blocks can facilitate program success and foster program growth.

Results:

Foundational elements include leadership structure and support, building the right team, clinical expertise, trauma registry, program data, research, outreach and education, injury prevention, and ensuring adequate survey readiness. Building on these foundational elements, engagement of stakeholders at all levels throughout the program and organization can help drive program growth. Using these strategies, a program has been able to grow from 7.6 full-time equivalents to 24.4 in just a few short years while achieving, exceeding, and sustaining top metrics across state and national benchmarks.

Conclusion:

A program can achieve sustainable, high-quality outcomes for the trauma patient by following a structured team approach to program development. Using the outlined building blocks for program development and sustainability, a successful trauma program can lead to improved patient and program outcomes.
Virological and serological characterization of critically ill patients with COVID-19 in the UK: a special focus on variant detection
Authors: Ratcliff Jeremy , Nguyen Dung , Fish Matthew , Rhynne Jennifer , Jennings Aislinn , Williams Sarah , Al-Beidh Farah , Bonsall David , Evans Amy , Golubchik Tanya , Gordon Anthony C , Lamikanra Abigail , Tsang Pat , Ciccone Nick , Leuscher Ullrich , Slack Wendy , Laing Emma , Mouncey Paul R , Ziyenge Sheba , Olivera Marta , Ploeg Rutger , Rowan Kathryn M , Shankar-Hari Manu , Roberts David J. , Menon David K , Estcourt Lise , Simmonds Peter , Harvala Heli
Published: March 2021

Background

Treatment of COVID-19 patients with convalescent plasma containing neutralising antibody to SARS-CoV-2 is under investigation as a means of reducing viral loads, ameliorating disease outcomes, and reducing mortality. However, its efficacy might be reduced in those infected with the emerging B.1.1.7 SARS-CoV-2 variant. Here, we report the diverse virological characteristics of UK patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomised controlled trial.

Methods

SARS-CoV-2 viral RNA was detected and quantified by real-time PCR in nasopharyngeal swabs obtained from study subjects within 48 hours of admission to intensive care unit. Antibody status was determined by spike-protein ELISA. B.1.1.7 strain was differentiated from other SARS-CoV-2 strains by two novel typing methods detecting the B.1.1.7-associated D1118H mutation with allele-specific probes and by restriction site polymorphism (SfcI).

Findings

Of 1260 subjects, 90% were PCR-positive with viral loads in nasopharyngeal swabs ranging from 72 international units [IUs]/ml to 1.7×1011IU/ml. Median viral loads were 45-fold higher in those who were seronegative for IgG antibodies (n=314; 28%) compared to seropositives (n=804; 72%), reflecting in part the latter group’s possible later disease stage on enrolment. Frequencies of B.1.1.7 infection increased from early November (<1%) to December 2020 (>60%). Anti-SARS-CoV-2 seronegative individuals infected with wild-type SARS-CoV-2 had significantly higher viral loads than seropositives (medians of 1.2×106and 3.4 ×104IU/ml respectively; p=2×10−9). However, viral load distributions were elevated in both seropositive and seronegative subjects infected with B.1.1.7 (13.4×106and 7.6×106IU/ml; p=0.18).

Interpretation

High viral loads in seropositive B.1.1.7-infected subjects are consistent with increased replication capacity and/or less effective clearance by innate or adaptive immune response of B.1.1.7 strain than wild-type. As viral genotype was associated with diverse virological and immunological phenotypes, metrics of viral load, antibody status and infecting strain should be used to define subgroups for analysis of treatment efficacy.
SWIFT: A Deep Learning Approach to Prediction of Hypoxemic Events in Critically-Ill Patients Using SpO2 Waveform Prediction
Authors: Annapragada Akshaya V. , Greenstein Joseph L. , Bose Sanjukta N. , Winters Bradford D. , Sarma Sridevi V. , Winslow Raimond L.
Published: March 2021

Hypoxemia is a significant driver of mortality and poor clinical outcomes in conditions such as brain injury and cardiac arrest in critically ill patients, including COVID-19 patients. Given the host of negative clinical outcomes attributed to hypoxemia, identifying patients likely to experience hypoxemia would offer valuable opportunities for early and thus more effective intervention. We present SWIFT (SpO2Waveform ICU Forecasting Technique), a deep learning model that predicts blood oxygen saturation (SpO2) waveforms 5 and 30 minutes in the future using only prior SpO2 values as inputs. When tested on novel data, SWIFT predicts more than 80% and 60% of hypoxemic events in critically ill and COVID-19 patients, respectively. SWIFT also predicts SpO2 waveforms with average MSE below .0007. SWIFT provides information on both occurrence and magnitude of potential hypoxemic events 30 minutes in advance, allowing it to be used to inform clinical interventions, patient triaging, and optimal resource allocation. SWIFT may be used in clinical decision support systems to inform the management of critically ill patients during the COVID-19 pandemic and beyond.
Just 2% of SARS-CoV-2-positive individuals carry 90% of the virus circulating in communities
Authors: Yang Qing , Saldi Tassa K. , Lasda Erika , Decker Carolyn J. , Paige Camille L. , Muhlrad Denise , Gonzales Patrick K. , Fink Morgan R. , Tat Kimngan L. , Hager Cole R. , Davis Jack C. , Ozeroff Christopher D. , Meyerson Nicholas R. , Clark Stephen K. , Fattor Will T. , Gilchrist Alison R. , Barbachano-Guerrero Arturo , Worden-Sapper Emma R. , Wu Sharon S. , Brisson Gloria R. , McQueen Matthew B. , Dowell Robin D. , Leinwand Leslie , Parker Roy , Sawyer Sara L.
Published: March 2021

We analyze data from the Fall 2020 pandemic response efforts at the University of Colorado Boulder (USA), where more than 72,500 saliva samples were tested for SARS-CoV-2 using quantitative RT-PCR. All samples were collected from individuals who reported no symptoms associated with COVID-19 on the day of collection. From these, 1,405 positive cases were identified. The distribution of viral loads within these asymptomatic individuals was indistinguishable from what has been previously reported in symptomatic individuals. Regardless of symptomatic status, approximately 50% of individuals who test positive for SARS-CoV-2 seem to be in non-infectious phases of the disease, based on having low viral loads in a range from which live virus has rarely been isolated. We find that, at any given time, just 2% of individuals carry 90% of the virions circulating within communities, serving as viral “super-carriers” and possibly also super-spreaders.
Evaluation of accuracy, exclusivity, limit-of-detection and ease-of-use of LumiraDx™-Antigen-detecting point-of-care device for SARS-CoV-2
Authors: Krüger Lisa J. , Klein Julian A.F. , Tobian Frank , Gaeddert Mary , Lainati Federica , Klemm Sarah , Schnitzler Paul , Bartenschlager Ralf , Cerikan Berati , Neufeldt Christopher J. , Nikolai Olga , Lindner Andreas K. , Mockenhaupt Frank P. , Seybold Joachim , Jones Terry C. , Corman Victor M. , Pollock Nira R. , Knorr Britta , Welker Andreas , de Vos Margaretha , Sacks Jilian A. , Denkinger Claudia M. ,   for the study team
Published: March 2021

Background

Rapid antigen-detecting tests (Ag-RDTs) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can transform pandemic control. Thus far, sensitivity (≤85%) of lateral-flow assays has limited scale-up. Conceivably, microfluidic immunofluorescence Ag-RDTs could increase sensitivity for SARS-CoV-2 detection.

Materials and Methods

This multi-centre diagnostic accuracy study investigated performance of the microfluidic immunofluorescence LumiraDx™ assay, enrolling symptomatic and asymptomatic participants with suspected SARS-CoV-2 infection. Participants collected a supervised nasal mid-turbinate (NMT) self-swab for Ag-RDT testing, in addition to a professionally-collected nasopharyngeal (NP) swab for routine testing with reverse transcriptase polymerase chain reaction (RT-PCR). Results were compared to calculate sensitivity and specificity. Sub-analyses investigated the results by viral load, symptom presence and duration. An analytical study assessed exclusivity and limit-of-detection (LOD). In addition, we evaluated ease-of-use.

Results

Study conduct was between November 2nd 2020 and January 21st 2021. 761 participants were enrolled, with 486 participants reporting symptoms on testing day. 120 out of 146 RT-PCR positive cases were detected positive by LumiraDx™, resulting in a sensitivity of 82.2% (95% CI: 75.2%-87.5%). Specificity was 99.3% (CI: 98.3-99.7%). Sensitivity was increased in individuals with viral load ≥ 7 log10 SARS-CoV2 RNA copies/ml (93.8%; CI: 86.2%-97.3%). Testing against common respiratory commensals and pathogens showed no cross-reactivity and LOD was estimated to be 2-56 PFU/mL. The ease-of-use-assessment was favourable for lower throughput settings.

Conclusion

The LumiraDx™ assay showed excellent analytical sensitivity, exclusivity and clinical specificity with good clinical sensitivity using supervised NMT self-sampling.
Meta-analytic findings on reading in children with cochlear implants
Authors: Wang Yingying , Sibaii Fatima , Lee Kejin , Gill Makayla J. , Hatch Jonathan L.
Published: March 2021

This meta-analysis study aims to quantify the group differences in reading skills between children with cochlear implants and their hearing peers and between children with cochlear implants and children with hearing aids (aged between 3 to 18 years old). Of the 5,642 articles screened, 47 articles met predetermined inclusion criteria (published between 2002 and 2019). The robust variance estimation based meta-analysis models were used to synthesize all the effect sizes. Children with cochlear implants scored significantly lower than their hearing peers in phonological awareness (g = - 1.62, p < .001), vocabulary (g = -1.50, p < .001), decoding (g = -1.24, p < .001), and reading comprehension (g = -1.39, p < .001), but not for fluency (g = -.67, p = .054). Compared to children with hearing aids, children with cochlear implants scored significantly lower in phonological awareness (g = -.30, p = .028). The percentage of unilateral cochlear implant negatively impacts the group difference between children with cochlear implants and their hearing peers. Findings from this study confirm a positive shift in reading outcomes for profoundly deaf children due to cochlear implantation. Some children with cochlear implants may need additional supports in educational settings.
COVID-19 test positivity: predictive value of various symptoms in a large community-based testing program in California
Authors: Miller Dave P. , Morrow Scott , Califf Robert M. , Kaiser Cameron , Kapur Ritu , Starsiak Casimir , Mega Jessica , Marks William J.
Published: March 2021

Background

Much of the early data on COVID-19 symptomatology was captured in the hospital setting. In a community setting the symptoms most predictive of SARS-CoV-2 positivity may be different. Data from the California sites of a COVID-19 community testing program are presented here.

Methods

Prior to being tested, participants in the Baseline COVID-19 Testing Program completed an online screener, in which they self-reported basic demographics and the presence or absence of 10 symptoms. Both positive and negative COVID-19 RT-PCR tests were linked back to the screener data. A multivariable model of positivity was fit using generalized estimating equations, adjusting for month of testing as a fixed effect and accounting for clustering of data within each test site.

Results

Among 547,018 first-time tests in California in 2020, positivity rates were 3.4%, 9.9%, and 19.8% for participants with no symptoms, 1 symptom, or 2 or more symptoms at the time of screening, respectively. All ten symptoms were individually associated with higher positivity rates, but only six of ten symptoms were associated with higher positivity when adjusting for other symptoms. Major symptoms with highest predictive value were recent loss of taste or smell, fever, and coughing with ORs of 3.27, 1.97, and 1.95, respectively. Shortness of breath and vomiting or diarrhea were negatively associated with positivity adjusting for other symptoms and, absent other symptoms, participants with these symptoms did not have significantly higher positivity rates than asymptomatic participants.

Conclusions

Recent loss of taste and smell should be elevated to a major symptom along with fever and coughing in public health messaging and in our community approach to testing and surveillance, while mild to moderate shortness of breath should be de-emphasized as a sensitive early predictor of COVID-19 positivity.
Model-based estimation of transmissibility and reinfection of SARS-CoV-2 P.1 variant
Authors: Coutinho Renato Mendes , Marquitti Flavia Maria Darcie , Ferreira Leonardo Souto , Borges Marcelo Eduardo , Paixão da Silva Rafael Lopes , Canton Otavio , Portella Tatiana P. , Poloni Silas , Franco Caroline , Plucinski Mateusz M. , Lessa Fernanda C. , Moura da Silva Antônio Augusto , Kraenkel Roberto Andre , de Sousa Mascena Veras Maria Amélia , Inácio Prado Paulo
Published: March 2021

The variant of concern (VOC) P.1 emerged in the Amazonas state (Brazil) in November-2020. It contains a constellation of mutations, ten of them in the spike protein. Consequences of these specific mutations at the population level have been little studied so far, despite the detection of P.1 variant in 26 countries, with local transmission in at least four other countries in the Americas and Europe. Here, we estimate P.1’s transmissibility and reinfection using a model-based approach, by fitting data from the Brazilian national health surveillance of hospitalized individuals and frequency of the P.1 variant in Manaus from December 2020 to February 2021, when the city was devastated by four times more cases than in the previous peak (April 2020). The new variant was found to be about 2.6 times more transmissible (95% Confidence Interval (CI): 2.4–2.8) than previous circulating variant(s). The city already had a high prevalence of individuals previously affected by the SARS-CoV-2 virus (estimated as 78%, CI:73–83%), and the fitted model attributed 28% of the cases during the period to reinfections by the variant P.1. Our estimates rank P.1 as the most transmissible among the current identified SARS-CoV-2 VOCs, posing a serious threat and requiring urgent measures to control its global spread.
Combining explainable machine learning, demographic and multi-omic data to identify precision medicine strategies for inflammatory bowel disease
Authors: Gardiner Laura-Jayne , Carrieri Anna Paola , Bingham Karen , Macluskie Graeme , Bunton David , McNeil Marian , Pyzer-Knapp Edward O.
Published: March 2021

Inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn’s disease, affect several million individuals worldwide. These diseases are heterogeneous at the clinical, immunological and genetic levels and result from a complex interaction between the host and environmental factors. Investigating drug efficacy in cultured human fresh IBD tissues can improve our understanding of the reasons why certain medications are more or less effective for different patients.

We propose an explainable machine learning (ML) approach that combines bioinformatics and domain insight, to informatively integrate multi-modal data to predict inter-patient specific variation in drug response. Using explanation of our models, we interpret the models’ predictions inferring unique combinations of important features associated with human tissue pharmacological responses. The inferred multi-modal features originate from multi-omic data (genomic and transcriptomic), demographic, medicinal and pharmacological data and all are associated with drug efficacy generated by a preclinical human fresh IBD tissue assay.

To pharmacologically assess patient variation in response to IBD treatment, we used the reduction in the release of the inflammatory cytokine TNFα from the fresh IBD tissues in the presence or absence of test drugs, as a measure of drug efficacy. The TNF pathway is a common target in current therapies for IBD; we initially explored the effects of a mitogen-activated protein kinase (MAPK) inhibitor on the production of TNFα; however, we later show the approach can be applied to other targets, test drugs or mechanisms of interest. Our best model was able to predict TNFα levels from a combination of integrated demographic, medicinal and genomic features with an error as low as 4.98% on unseen patients. We incorporated transcriptomic data to validate and expand insights from genomic features. Our results showed variations in drug effectiveness between patients that differed in gender, age or condition and linked new genetic polymorphisms in our cohort of IBD patients to variation in response to the anti-inflammatory treatment BIRB796 (Doramapimod).

Our approach models drug response in a relevant human tissue model of IBD while also identifying its most predictive features as part of a transparent ML-based precision medicine strategy.
Effect of Pre-harvest Calcium Chloride and Salicylic Acid Spray on Morphological and Biochemical Traits of Guava (Psidium guajava)
Authors: Kaushik Lochan , Kumar Rahul , Reddy Dilip Kumar , Kaushik Prashant
Published: March 2021

Guava is a small, tropical fruit tree grown in various tropical and subtropical regions. Salicylic acid (SA) is a phenolic compound that enhances disease resistance and delays the fruit ripening process. Calcium is an essential cell component that delays ripening, particularly softening of the fruit. The effect of foliar spray of CaCl2, and SA, on the physical and biochemical traits of guava was investigated in the present investigation. The application of CaCl22% + SA 2mM was more effective as compared with both when applied alone. The data were recorded on fruit set (%), fruit weight (g), fruit length (cm), fruit diameter (cm), fruit yield (kg), ripening period (days), TSS, acidity, total sugar, ascorbic acid, nitrogen, phosphorus, potassium. CaCl22% + SA 2mM was showed better performance in all cases, followed by SA 2mM and CaCl22%. Overall, this work determines the influence on guava's essential traits by pre-harvest calcium chloride and salicylic acid.
Conserved structures of neural activity in sensorimotor cortex of freely moving rats allow cross-subject decoding
Authors: Melbaum Svenja , Russo Eleonora , Eriksson David , Schneider Artur , Durstewitz Daniel , Brox Thomas , Diester Ilka
Published: March 2021

Our knowledge about neuronal activity in the sensorimotor cortex relies primarily on stereotyped movements that are strictly controlled in experimental settings. It remains unclear how results can be carried over to less constrained behavior like that of freely moving subjects. Toward this goal, we developed a self-paced behavioral paradigm that encouraged rats to engage in different movement types. We employed bilateral electrophysiological recordings across the entire sensorimotor cortex and simultaneous paw tracking. These techniques revealed behavioral coupling of neurons with lateralization and an anterior–posterior gradient from the premotor to the primary sensory cortex. The structure of population activity patterns was conserved across animals despite the severe under-sampling of the total number of neurons and variations in electrode positions across individuals. We demonstrated cross-subject and cross-session generalization in a decoding task through alignments of low-dimensional neural manifolds, providing evidence of a conserved neuronal code

One-sentence summary

Similarities in neural population structures across the sensorimotor cortex enable generalization across animals in the decoding of unconstrained behavior.

Graphical abstract

Conserved structures of neural activity in freely moving rats allow for cross-subject decoding.

(a) We conducted electrophysiological recordings across the bilateral sensorimotor cortex of six freely moving rats. Neural activities were projected into a low-dimensional space with LEMs (22). (b) In a decoding task, points in the aligned low-dimensional neural state space were used as input for a classifier that predicted behavioral labels. Importantly, training and testing data originated from different rats. (c) Our procedure led to successful cross-subject generalization for sessions with sufficient numbers of recorded units. The rat and brain drawings are adapted fromscalablebrainatlas.incf.organd SciDraw.
Generation and mutational analysis of a transgenic mouse model of human SRY
Authors: Thomson Ella , Zhao Liang , Chen Yen-Shan , Longmuss Enya , Ng Ee Ting , Sreenivasan Rajini , Croft Brittany , Song Xin , Sinclair Andrew , Weiss Michael , Pelosi Emanuele , Koopman Peter
Published: March 2021

SRY is the Y-chromosomal gene that determines male sex development in humans and most other mammals. After three decades of study, we still lack a detailed understanding of which domains of the SRY protein are required to engage pathway of gene activity leading to testis development. Some insight has been gained from the study of genetic variations underlying differences/disorders of sex determination (DSD), but the lack of a system of experimentally generating SRY mutations and studying their consequences in vivo has limited progress in the field. To address this issue, we generated a mouse model carrying a humanSRYtransgene able to drive male sex determination in XX mice. Using CRISPR-Cas9 gene editing, we generated novel genetic modifications in each ofSRY’s three domains (N-terminal, HMG box, and C-terminal) and performed detailed analysis of their molecular and cellular effects on embryonic testis development. Our results provide new functional insights unique to humanSRYand the causes of DSD, and present a versatile and powerful system in which to demonstrate causality ofSRYvariations in DSD, to functionally study theSRYvariation database, and to characterize new pathogenicSRYvariations found in DSD.
Identifying Dihydropyrimidine Dehydrogenase as a Novel Regulator of Hepatic Steatosis
Authors: Sullivan Kelly E. , Kumar Sheetal , Zhang Ye , de Koning Emily , Yuan Jing , Fan Fan
Published: March 2021

Pyrimidine catabolism is implicated in hepatic steatosis. Dihydropyrimidine Dehydrogenase (DPYD) is an enzyme responsible for uracil and thymine catabolism, and DPYD human genetic variability affects clinically observed toxicity following 5-Fluorouracil (5-FU) administration. In anin vitromodel of diet-induced steatosis, the pharmacologic inhibition of DPYD resulted in protection from lipid accumulation. Additionally, a gain-of-function mutation of DPYD, created through clustered regularly interspaced short palindromic repeats associated protein 9 (CRISPR-Cas9) engineering, led to an increased lipid burden, which was associated with altered mitochondrial functionality in a hepatocarcionma cell line. The studies presented herein describe a novel role for DPYD in hepatocyte metabolic regulation as a modulator of hepatic steatosis.
Modulation of fatty acid elongation sustains sexually dimorphic hydrocarbons and female attractiveness inBlattella germanica(L.)
Authors: Pei Xiao-Jin , Fan Yong-Liang , Bai Yu , Bai Tian-Tian , Schal Coby , Zhang Zhan-Feng , Chen Nan , Li Sheng , Liu Tong-Xian
Published: March 2021

Insect cuticular hydrocarbons (CHCs) serve as important intersexual signaling chemicals and generally show variation between the sexes, but little is known about the generation of sexually dimorphic hydrocarbons (SDHCs) in insects. Here, we report the molecular mechanism and biological significance that underling the generation of SDHC in the German cockroach,Blattella germanica. Sexually mature females possess more C29 cuticular hydrocarbons (CHCs), especially the contact sex pheromone precursor 3,11-DimeC29. RNAi screen against fatty acid elongase gene family members and combined with heterologous expression revealed that bothBgElo12andBgElo24were involved in HC production, butBgElo24is of wide catalytic activities and is able to provides substrates forBgElo12, and only the female-enrichedBgElo12was responsible for sustaining female-specific HC profile. RepressingBgElo12masculinized the female CHC profile, decreased contact sex pheromone level and consequently reduced the sexual attractiveness of female cockroaches. Moreover, the asymmetric expression ofBgElo12between the sexes is modulated by sex differentiation cascade. Specifically, male-specificBgDsxrepresses the transcription ofBgElo12in males, whileBgTrais able to remove this effect in females. Our study reveals a novel molecular mechanism responsible for the formation of SDHCs, and also provide evidences on shaping of the SDHCs by sexual selection, as females use them to generate high levels of contact sex pheromone.
Orexigen: Valuing Contrave
Authors: Calkins Tim
Published: March 2021

In January 2013, small biotechnology firm Orexigen was in the final stages of testing Contrave, a promising new pharmaceutical product for the treatment of obesity. At the time, Orexigen had no products in the market, so all its hopes of financial success rested on this new treatment. Contrave had proven to be highly effective in clinical trials, and Orexigen executives were confident it would receive FDA approval.

At the same time, a much larger pharmaceutical company was considering acquiring Orexigen. Because the decision to acquire would ultimately be a financial one, the project team from the large company had to complete a valuation for Orexigen's only significant product in its pipeline, Contrave. What was the new product actually worth?
Knowledge-intensive business services in time of crisis: the coronavirus pandemic
Authors: Miles Ian Douglas , Belousova Veronika , Chichkanov Nikolay , Krayushkina Zhaklin
Published: March 2021

Purpose

Knowledge-intensive business services (KIBS) firms focus on applying their expert knowledge to help solve the business problems of their clients: these clients confronted major new problems due to the COVID-19 pandemic and policy measures such as social distancing and travel restrictions, designed to reduce the rapid spread of the illness. Many KIBS were reliant upon extensive contact with clients, and within teams working on projects; they found their practices disrupted. This study aims to examine how KIBS are evolving to cope with both the sets of changes: those in their own operations, and those involving the emerging business problems of clients.

Design/methodology/approach

The main data sources are material contained in websites of a sample of leading firms in a range of KIBS sectors, and in media reports and other documentation of efforts to confront the pandemic.

Findings

The results indicate considerable efforts in KIBS to address emerging client problems, as well as to adapt their own practices. Their substantial role in confronting the pandemic and associated business difficulties has implications for future crises. KIBS are likely to be important players in shaping responses not only to future pandemics but also to the looming climate crisis.

Originality/value

The study demonstrates the growing role of KIBS and their “second knowledge infrastructure” in modern economies, exemplified by their role in the context of an emerging crisis.
Prediction of bursting strength of the nylon parachute fabrics
Authors: Raj Vijay Kirubakar , Devi Renuka
Published: March 2021

Purpose

Parachutes are equipment that is repeatedly used as and when needed. Some of them are used for as many as 60 jumps. The property of the canopy fabric gets deteriorated with use. It is evaluated by destructive tensile and bursting strength. This study aims to focus on the nondestructive evaluation of the canopy fabric's fitness by testing air permeability and relating it with bursting strength. Predictor equations were developed to determine bursting strength from air permeability values.

Design/methodology/approach

ANOVA techniques and statistical regression equations were formed.

Findings

A series of samples containing five parachutes fabrics was used seven times, and their air permeability and bursting strength were determined to find the extent to the effect of reuse of parachute fabrics on their bursting strength and air permeability determination. It was found that there was a progressive drop in bursting strength and an increase in air permeability. An investigation of the extent of determination in terms of bursting strength and an increase in air permeability following the sense of five different types of parachute fabrics is reported.

Research limitations/implications

The work focuses on the prediction of bursting strength to textile materials only and may not apply to other materials like membranes and sheets. The process of determining air permeability is relatively simpler and faster.

Practical implications

The bursting strength can be predicted for used parachutes, which are otherwise subjected to destructive testing.

Social implications

The men using the parachutes can be assured of the superior flawless performance of the parachute as equipment and also contribute to the saving of resources due to nondestructive testing, 100% evaluation of all parachutes is possible.

Originality/value

This article describes the nature of the test procedure and discusses the means of introducing it to users of parachutes. It is accepted that the method must undergo field evaluation and possible modification before it can become a routine tool of parachute using organizations.
Multisensory modalities increase working memory for mating signals in a treefrog
Authors: Zhu Bicheng , Zhou Ya , Yang Yue , Deng Ke , Wang Tongliang , Wang Jichao , Tang Yezhong , Ryan Michael J. , Cui Jianguo
Published: March 2021

Animal choruses, such as those found in insects and frogs, are often intermittent. Thus, females sampling males in the chorus might have to remember the location of the potential mates' calls during periods of silence. Although a number of studies have shown that frogs use and prefer multimodal mating signals, usually acoustic plus visual, it is not clear why they do so. Here we tested the hypothesis that preference for multimodal signals over unimodal signals might be due to multimodal signals instantiating longer memories than unimodal signals, particularly during the inter‐chorus intervals.

We tested this hypothesis in serrate‐legged small treefrogs Kurixalus odontotarsus whose males produce advertisement calls accompanied by conspicuous vocal sac inflation. Females were tested with acoustic and acoustic + visual (video of inflating‐deflating vocal sac) mating calls.

We found that females prefer multimodal calls over unimodal, audio‐only calls. Furthermore, multimodal calls are still preferred after a silent period of up to 30 s, a time that spans the average silent period of the chorus. This was not true of unimodal calls.

Our results demonstrate that a multimodal signal can engage longer working memory than a unimodal signal, and thus female memory might favour the evolution of multimodal signals in males through sexual selection. Selection might also favour female preference for multimodal signals if longer memory facilitates mate searching and assessment. Our study does not allow us to elucidate the sequence of evolution of this trait and preference.
An in‐vitro study of subretinal perfluorocarbon liquid (PFCL) droplets and the physics of their retention and evacuation
Authors: Chan Yau Kei , Laybourne James P. , Ng Chiu On , Saha Chinmoy , Yap Hazel Pik Yen , Chandra Aman , Steel David H. , Sandinha Maria T. , Wong David
Published: March 2021

Purpose

To investigate the physics associated with the retention and removal of subretinal perfluorocarbon liquid (PFCL), as inspired by a series of anecdotal cases of spontaneous ‘disappearance’ of subretinal PFCL.

Methods

The profiles of subretinal PFCL in situ from published OCT images were studied and compared with that of PFCL droplets resting on a hydrophilic surface in vitro. A mathematical model based on Sampson’s and Poiseuille’s formula was developed to explain how evacuation of subretinal PFCL without aspiration could occur.

Results

The mathematical model suggested that in vivo subretinal PFCL can completely evacuate in less than a second via a 41‐guage retinal hole. Perfluorocarbon liquid (PFCL) droplets in situ subretinally substantially varied in their aspect ratios (from 0.28 to 2.71) and their contact angles with the retinal pigment epithelium (from 98° to 155°). Conversely, PFCL in vitro had aspect ratios and contact angles close to 1 and 150° respectively.

Conclusion

This study showed evidence that stretching of the retina to accommodate subretinal PFCL occurs, which might be responsible for the varied profile of the droplets and resultant forces that can cause retinal holes, and spontaneous evacuation of large PFCL droplets. By filling the vitreous cavity with PFCL, a small retinotomy alone might allow spontaneous evacuation without the need for aspiration.
The futures of cooperation in European governance: Brexit and the European knowledge policies
Authors: Veiga Amélia
Published: March 2021

This paper analyses the purposes of cooperation as they challenge the European governance of higher education. Using Brexit to analyse meanings of cooperation and conveying secondary data analysis of ten case studies undertaken in the framework of the exploratory research project titled Brexit and higher education in the UK and Europe: Towards a cross‐country investigation, this study identifies a plurality of meanings of cooperation. These meanings resonate within the scenarios of Europe 2025 traced by the European Commission. In the scenarios (1) nothing but the single market, (2) doing less more efficiently, (3) those who want more do more, the different meanings of cooperation put at risk the future of cooperation driven by academic values and beliefs at the core of the Europeanisation of knowledge policies. Ultimately, the paper underlines that cooperation as a driver of the internationalisation of higher education questions the role of national openness and/or closure in framing shared European interests and the value of international cooperation.
Stimulus value gates multisensory integration
Authors: Bean Naomi L. , Stein Barry E. , Rowland Benjamin A.
Published: March 2021

The brain enhances its perceptual and behavioral decisions by integrating information from its multiple senses in what are believed to be optimal ways. This phenomenon of “multisensory integration” appears to be pre‐conscious, effortless, and highly efficient. The present experiments examined whether experience could modify this seemingly automatic process. Cats were trained in a localization task in which congruent pairs of auditory‐visual stimuli are normally integrated to enhance detection and orientation/approach performance. Consistent with the results of previous studies, animals more reliably detected and approached cross‐modal pairs than their modality‐specific component stimuli, regardless of whether the pairings were novel or familiar. However, when provided evidence that one of the modality‐specific component stimuli had no value (it was not rewarded) animals ceased integrating it with other cues, and it lost its previous ability to enhance approach behaviors. Cross‐modal pairings involving that stimulus failed to elicit enhanced responses even when the paired stimuli were congruent and mutually informative. However, the stimulus regained its ability to enhance responses when it was associated with reward. This suggests that experience can selectively block access of stimuli (i.e., filter inputs) to the multisensory computation. Because this filtering process results in the loss of useful information, its operation and behavioral consequences are not optimal. Nevertheless, the process can be of substantial value in natural environments, rich in dynamic stimuli, by using experience to minimize the impact of stimuli unlikely to be of biological significance, and reducing the complexity of the problem of matching signals across the senses.
The impact of agency failure on executive approval: Evidence from the Bush and Obama presidencies
Authors: Svensen Eric Paul
Published: March 2021

Over the past few decades, scholars have developed a rich research record on the causes and consequences of low presidential approval ratings. While this literature has provided valuable insight on presidential approval, little attention is paid to how agency failures also impact approval. In this article, I argue this understudied topic can provide additional leverage to help understand when public trust in the president is eroded. Using Markov Regime switching models of weekly approval ratings for the Bush and Obama presidencies, I demonstrate approval falls when agency failures make national headlines. In addition, findings also show that the impact of these events hinge on the number of failures and not the magnitude of any one breakdown in particular.
2021 European guideline on HIV testing in genito‐urinary medicine settings
Authors: Gökengin D. , Wilson‐Davies E. , Nazlı Zeka A. , Palfreeman A. , Begovac J. , Dedes N. , Tarashenko O. , Stevanovic M. , Patel R.
Published: March 2021

Testing for HIV is critical for early diagnosis of HIV infection, providing long‐term good health for the individual and prevention of onward transmission if antiretroviral treatment is initiated early. The main purpose of the 2021 European Guideline on HIV Testing in Genito‐Urinary Settings is to provide advice on testing for HIV infection in individuals aged 16 years and older who present to sexually transmitted infection, genito‐urinary or dermato‐venereology clinics across Europe. The guideline presents the details of best practice and offers practical guidance to clinicians and laboratories to identify and offer HIV testing to appropriate patient groups.
Experiments on creativity and work design
Authors: Rodet Cortney S.
Published: March 2021

Creative jobs make up an increasingly large part of the economy. While contextual factors of work design have been shown to affect job performance in various settings, their impact on creative tasks is understudied. This study uses a controlled laboratory experiment to understand the impact of time constraints and goal setting on creativity. I find that reducing task constraints by making time constraints ambiguous increases the creativity of ideas without undermining their quantity, relative to the baseline. I also find that a nonbinding quantity‐oriented goal increases the quantity of ideas without reducing creative quality. Likewise, a nonbinding creativity‐oriented goal increases the creativity of ideas without decreasing the number of ideas. Results indicate that work design is an important factor when developing strategies for cultivating creativity, and managers have several tools at their disposal.
Rectum sizes: Assessment by ultrasonography in children with functional constipation
Authors: Pop Daniela , Tătar Simona , Fufezan Otilia , Farcău Dorin
Published: March 2021

Aim

This study aimed to compare the transverse diameter and thickness of the anterior wall of the rectum in children with normal bowel movement and children with functional constipation in different age groups. Another objective was to find correlations of rectum sizes with faecal incontinence and constipation duration.

Methods

In the study, we included children with normal bowel movement and functional constipation diagnosed based on the Rome III and Rome IV criteria. We collected clinical data from the parents. We measured the rectum transverse diameter and the thickness of the anterior wall by abdominal ultrasound.

Results

The study included 65 children, 31 with normal bowel movement and 34 with functional constipation. The rectum transverse diameter and the thickness of the anterior wall had statistically significant higher values in patients with constipation (P < 0.05). There was a moderate and significant correlation between the duration of the disease (mean ± standard deviation = 31.7 ± 33.1 months) and rectum transverse diameter (r = 0.54; P = 0.0009). The rectum transverse diameter correlated moderately with the presence of faecal incontinence (r = 0.62; P = 0.003), but the thickness of the anterior wall did not correlate with this symptom (r = 0.02; P = 0.39).

Conclusions

We found statistically significant differences between the transverse rectal diameter and thickness of the rectum anterior wall, measured by abdominal ultrasound, in children with functional constipation compared with normal defaecation patterns. Faecal incontinence and long‐term constipation were correlated with the increased rectum diameter.
Disentangling by additive partitioning the effects of invasive species on the functional structure of communities
Authors: Guido Anaclara , Blanco Carolina C. , Pillar Valério D.
Published: March 2021

Questions

Eragrostis plana is the most invasive species in grasslands of southern Brazil. We ask how it affects the functional structure of communities considering leaf traits related to forage palatability for grazers. As consensus is lacking about whether to include or omit the invasive species in the analysis, we propose a method for partitioning functional diversity (FD) and community‐weighted means (CWMs) of invaded communities into invasive and resident species as additive components.

Location

Southern Brazil.

Methods

Permanent plots were located on a natural grassland that was partially invaded by E. plana. Invader removal was performed by four different treatments (n = 10): (a) no removal, (b) clipping, (c) herbicide, and (d) hand‐pulling. Additionally, we located plots (n = 10) (e) in an adjacent non‐invaded patch. With data from annual vegetation surveys and leaf traits (mass per area, LMA; dry matter content, LDMC; and force to tear [toughness], Ft), we assessed temporal changes (2012–2016) in FD and CWMs, partitioned into resident and invasive components. Partitioning was based on 0 or 1 weights attributed to invasive and resident species. Temporal trajectories of communities by fuzzy‐weighted species composition were also evaluated.

Results

Invasion modified the resident community in terms of CWMs of LDMC and Ft and fuzzy‐weighted composition, but FD was not affected. Resident species of invaded plots contributed less to CWM values of LDMC and Ft than non‐invaded communities. However, E. plana´s higher values of Ft increased the total community toughness. Removals of the invasive were not enough to make the functional structure of resident communities similar to that of non‐invaded ones.

Conclusions

Species loss associated to invasion is not random, as E. plana displaces species with higher contribution to CWM of LDMC and Ft. The contribution of invasives to the total community increases toughness, decreasing the forage palatability of invaded grasslands. Our partition method helps to disentangle the additive components of such effects on resident and invasive species.
Paced or sensed conduction time to determine programming with cardiac resynchronization therapy: The PASED‐CRT Trial
Authors: Corbisiero Raffaele , Schmidt JoEllen , Muller David , Sookhu Sanjay , Shah Meet , Ochman Alexander , Kazemain Pedram
Published: March 2021

Background

Cardiac resynchronization therapy (CRT) is a well‐established treatment for patients with drug refractory heart failure.

Objectives

This study sought to compare the longest RVsense to LVsense activation time (sLAT) versus the longest RVpace to LVsense activation time (pLAT) as the programmed site for left ventricular (LV) pacing in CRT patients with quadripolar LV leads at 3 months.

Methods

This single site, double‐blinded, prospective trial, randomized patients 1:1 into the sLAT or pLAT group to determine response. LV pacing was programmed at implant and maintained through 3 months of follow‐up. The 6‐minute hall walk (6MHW) test, NYHA, Minnesota living with heart failure, and clinical composite score (CCS) at the 3 months was compared.

Results

N = 92 patients (73M:19F age 66 ± 11.3 years) were randomized implanted and programmed per protocol. Baseline characteristics were comparable. N = 39 sLAT and N = 34 pLAT completed the 3‐month visit for final analysis. Significant improvement from baseline to 3 months was seen in the sLAT group from 253.9 (+/−11.5) to 323.1 (+/−11.9) P = .001. Similarly, the pLAT group improved from 274.9 (+/−16.15) to 343.9 (+/−15.9) P = .003. The difference between these groups, however, did not reach significance (P = .86). The pLAT group demonstrated a higher responder rate of (71%) versus the sLAT group (64%) based on the CCS although not reaching significance (P = .56).

Conclusions

Use of both the pLAT and sLAT method of programming demonstrated significant improvement in 6MHW distance at 3 months with pLAT demonstrating a slightly higher responder rate based on CCS (P = .56). pLAT should be considered at minimum as equivalent in patients with no intrinsic conduction.
Adverse psychosocial factors in pregnancy and preterm delivery
Authors: Haviland Miriam J. , Nillni Yael I. , Cabral Howard J. , Fox Matthew P. , Wise Lauren A. , Burris Heather H. , Hacker Michele R.
Published: March 2021

Background

Mental health symptoms, stress, and low psychosocial resources are associated with preterm delivery. It is unknown if there are groups of women who experience similar patterns of these adverse psychosocial factors during pregnancy and if the risk of preterm delivery differs among these groups.

Objective

To identify groups of women with similar patterns of adverse psychosocial factors during pregnancy and determine whether the risk of preterm delivery differs among these groups.

Methods

Spontaneous Prematurity and Epigenetics of the Cervix (SPEC) is a prospective cohort study of pregnant women, aged 18 and older. In this analysis, we included women who enrolled after 24 August 2014 and delivered by 20 January 2019. As women could enrol more than once, our cohort included 774 women with 787 pregnancies. We conducted a latent class analysis to identify groups of women with similar patterns of adverse psychosocial factors during pregnancy based on their responses to measures assessing depression, perceived stress, anxiety (pregnancy‐related and generalised), stressful life events, resilience, and social support (partner and friend/family). After identifying the latent classes, we used log‐binomial regression to compare the incidence of preterm delivery among the classes.

Results

The median age among participants was 33.2 years (interquartile range 30.3‐36.3), and the majority were non‐Hispanic white (56.9%). We identified three classes of adverse psychosocial factors (few, some, and many factors). In total, 63 (8.0%) pregnancies resulted in a preterm delivery. Compared to participants with few factors, the risk of preterm delivery was no different among participants with some (RR 1.23, 95% CI 0.68, 2.25) and many adverse factors (RR 1.62, 95% CI 0.73, 3.62).

Conclusions

We identified three groups of pregnant women with similar patterns of adverse psychosocial factors. We did not observe a difference in the risk of preterm delivery among the classes.