bluuebunny/crossref_metadata_2025 huggingface dataset:
Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features
Authors: Conforti C. , Pizzichetta M.A. , Vichi S. , Toffolutti F. , Serraino D. , Di Meo N. , Giuffrida R. , Deinlein T. , Giacomel J. , Rosendahl C. , Gourhant J.Y. , Zalaudek I.
Published: May 2020

Background

Among the various types of basal cell carcinoma, the sclerodermiform variant has a high risk of recurrence and local invasiveness. A systematic description of the dermatoscopic features associated with specific body localization is lacking.

Objectives

To describe the clinical and dermoscopic features of sclerodermiform basal cell carcinoma (BCC) according to localization in the body confronting with superficial and nodular types.

Methods

Clinical and dermoscopic images of sclerodermiform, nodular and superficial BCCs were retrospectively evaluated to study the location in the various body districts, maximum diameter, clinical appearance of the lesion, features of edges and presence or absence of specific dermatoscopic criteria of BCCs.

Results

We examined 291 histopathologically proven BCCs showing that in nodular BCCs, classical arborizing vessels were more frequently found in the body macro‐area (trunk and limbs; n = 46, 97.9%) than in the head/neck area (n = 43, 82.7%); within sclerodermiform BCCs, short arborizing vessels were found more frequently in the head/neck district (n = 35, 49.3%) than in the body (n = 6, 23.1%; P‐value 0.02); within nodular BCCs, multiple blue‐grey dots and globules were more frequently found on the trunk (n = 23, 48.9%) than in the head/neck district (n = 12, 23.1%; P‐value 0.01). In sclerodermiform BCCs, ulceration was found more frequently in the head/neck district (n = 38, 53.5%) than in the body (n = 4, 15.4%; P‐value > 0.01), and in superficial BCCs, ulceration was found more frequently in the head/neck district (n = 5, 38.5%) than in the body (n = 8, 9.8%; P‐value 0.02).

Conclusion

Our study shows that superficial BCC are found frequently in the head/neck district dermoscopically characterized by ulceration and arborizing vessels; nodular BCCs are more frequently found in the body than in the head/neck district, and the dermoscopic pattern is characterized by the combination of three features: (i) classical arborizing vessels, (ii) multiple blue‐grey dots and (iii) globules. Instead, sclerodermiform BCC is preferentially located in areas at high–moderate risk of recurrence; if pink‐white areas and/or fine arborizing vessels are seen, clinicians should consider this diagnosis. Furthermore, location‐specific dermatoscopic criteria have been described.
Common dolphinfish, Coryphaena hippurus, spawn at their easternmost Atlantic range adjacent to the Mediterranean Sea
Authors: Medina Antonio , Abascal Francisco J. , Varela José L.
Published: May 2020

This study provides sound evidence of the spawning activity of common dolphinfish (Coryphaena hippurus) in the Gulf of Cadiz (southwest Spain) during summer months. Along with waters off Côte d'Ivoire, this area adjacent to the Mediterranean Sea is the easternmost Atlantic spawning ground documented for the species. All the fish analysed (5 males and 15 females) were at spawning stage, except the smallest female (61.5 cm in fork length), which might not have yet reached sexual maturation. The oceanographic conditions during the samplings were similar to those occurring during the peak spawning season in the Gulf of Mexico. The study results are consistent with recent genetic studies indicating differentiation between Mediterranean and Atlantic dolphinfish populations, with the Strait of Gibraltar representing a boundary between two distinct reproductive units. The present results may contribute to improve the understanding of the dynamics of dolphinfish population and the management of eastern Atlantic and Mediterranean stocks.
Inhibitory control in zebrafish, Danio rerio
Authors: Lucon‐Xiccato Tyrone , Bertolucci Cristiano
Published: May 2020

We assessed whether zebrafish, Danio rerio, display inhibitory control using a simple and rapid behavioural test. Zebrafish were exposed to a prey stimulus placed inside a transparent tube, which initially elicited attack behaviour. However, zebrafish showed a rapid reduction in the number of attacks towards the prey, which indicated the ability to inhibit their foraging behaviour. Zebrafish also exhibited mnemonic retention of foraging inhibition, as indicated by a reduced number of attacks in a subsequent exposure to the unreachable prey. The ability to inhibit the foraging behaviour varied across three genetically separated wild‐type strains and across different individuals within strains, suggesting that zebrafish show heritable within‐species differences in inhibitory control. Our behavioural test might be suitable for screening large zebrafish populations in mutational studies and assessing the effects of pharmacologically active substances on inhibitory control.
Sensory processing profiles and autistic symptoms as predictive factors in autism spectrum disorder and Williams syndrome
Authors: Glod M. , Riby D. M. , Rodgers J.
Published: May 2020

Background

Unusual sensory responses were included in the diagnostic criteria for autism spectrum disorder (ASD), yet they are also common among individuals with other neurodevelopmental disorders, including Williams syndrome (WS). Cross‐syndrome comparisons of sensory atypicalities and the evaluation of their syndrome specificity however have rarely been undertaken. We aimed to (1) examine and compare the sensory profiles in ASD and WS groups and (2) investigate whether autistic symptoms, including sensory processing scores, can predict a group membership.

Methods

Parents of 26 children with ASD and intellectual disability, 30 parents of children with ASD (no intellectual disability) and 26 with WS aged between 4 and 16 years were recruited. Parents completed the Sensory Profile to provide information about their children's sensory experiences and the Social Responsiveness Scale – Second Edition (SRS‐2) to assess the degree of social impairment in their children.

Results

No significant differences were found in sensory processing scores between the three groups. Binary logistic regression analyses were undertaken with sensory quadrants and SRS‐2 total score as factors. Models significantly predicted group membership, with Low Registration, Sensory Sensitivity and SRS‐2 total score being significant predictors.

Conclusions

The findings suggest that high rates of sensory atypicalities are a common neurodevelopmental characteristic that do not reliably distinguish between WS and ASD groups. Low Registration and Sensory Sensitivity‐related behaviours might, however, be more specific to ASD. Further work is needed to explore what behaviours within sensory profiles can discriminate between neurodevelopmental disorders and should be included in diagnostic classifications.
Indigenous community members' views on silver diamine fluoride to manage early childhood caries
Authors: Kyoon‐Achan Grace , Schroth Robert J. , DeMaré Daniella , Sturym Melina , Edwards Jeannette , Lavoie Josée G. , Sanguins Julianne , Campbell Rhonda , Chartrand Frances , Bertone Mary F. , Singh Sarbjeet , Moffatt Michael E. K. ,   the Scaling‐up Healthy Smile Happy Child team
Published: May 2020

Objectives

Early childhood caries (ECC) continues to be the leading reason for pediatric dental surgery in Canada and is particularly prevalent among Indigenous children. Silver diamine fluoride (SDF) offers an alternative method to manage non‐restoratively caries. It is important to determine Indigenous communities' views on and receptivity toward SDF.

Aim

To understand Indigenous community members' views on pediatric dental surgery to treat ECC under general anesthesia (GA) and receptivity to SDF as an alternative to restorative surgery.

Methods

Focus groups and sharing circles congruent with an Indigenous ways of gathering information were conducted. Three interviewers engaged eight groups of First Nation and Metis communities in three rural Indigenous communities and ne metropolitan urban setting in Manitoba, Canada. Overall, 59 individuals participated. Open coding was guided by grounded theory and further analysis using Nvivo 12 software™.

Results

Participants mean age was 35.6 years, 88 percent (52 individuals) had a least one child, and 32 percent (19 individuals) were employed. Eight themes emerged, including respondents' fear of dental surgery under GA, fear of pain after dental surgery, parents' need for more information before accepting SDF treatment, and concern about the black staining of treated lesions.

Conclusions

Indigenous parents' acceptance of SDF as a treatment option is contingent on having more information and assurance that treatment under GA can be avoided. Understanding Indigenous parents' views may ensure better acceptance of SDF as a minimally invasive treatment option to manage ECC. A cautious and informative approach to SDF implementation in Indigenous communities is recommended.
Long‐term clinical outcomes following surgery for spontaneous pneumothorax caused by pulmonary blebs and bullae in dogs – a multicentre (AVSTS Research Cooperative) retrospective study
Authors: Howes C. L. , Sumner J. P. , Ahlstrand K. , Hardie R. J. , Anderson D. , Woods S. , Goh D. , de la Puerta B. , Brissot H. N. , Das S. , Nolff M. , Liehmann L. , Chanoit G.
Published: May 2020

Objectives

To report the clinical characteristics and recurrence rate of spontaneous pneumothorax secondary to pulmonary blebs and bullae following surgical management in a large cohort of dogs. To explore potential risk factors for recurrence and describe outcome.

Materials and Methods

Medical records were retrospectively reviewed for cases with spontaneous pneumothorax managed surgically between 2000 and 2017. Signalment, clinical presentation, diagnostic imaging, surgery, histopathology findings and patient outcomes were recorded. Follow‐up was performed via patient records and telephone contact.

Results

Records of 120 dogs with surgically treated pneumothorax were identified and reviewed, with 99 cases appropriate for exploratory statistical analysis. Median follow‐up was 850 days (range: 9–5105 days). Two‐ and 5‐year survival rates were 88.4% and 83.5%, respectively. There was recurrence in 14 of 99 dogs (14.1%) with adequate follow‐up, with a median time to recurrence of 25 days (1–1719 days). Univariable Cox regression analysis suggested increased risk for recurrence in giant breeds (hazard ratio = 11.05, 95% confidence interval: 2.82–43.35) and with increasing bodyweight (HR = 1.04, 95% confidence interval: 1.00–1.09). Of 14 dogs with recurrence, six were euthanased, two died of causes related to pneumothorax and six underwent further treatment, of which five were resolved.

Clinical Significance

Long‐term survival for dogs with surgically managed spontaneous pneumothorax was good and associated with a low risk of recurrence. Giant breed dogs and increased bodyweight were the only variables identified as possible risk factors for recurrence. The outcome for dogs with recurrence undergoing a second intervention was also favourable.
The applicability of using a protease extracted from cashew fruits (Anacardium occidentale), as possible meat tenderizer: An experimental design approach
Authors: Ahmad Mohammad Norazmi , Shuhaimen Muhammad Shahrain , Normaya Erna , Omar Muhammad Nor , Iqbal Anwar , Ku Bulat Ku Halim
Published: May 2020

Meat tenderness is one of the most important organoleptic properties in determining consumer acceptance in meat product marketability. Therefore, an effective meat tenderization method is sought after by exploring plant‐derived proteolytic enzymes as meat tenderizer. In this study, a novel protease from Cashew was identified as a new alternative halal meat tenderizer. The extraction of cashew protease was optimized using response surface methodology (R2 = 0.9803) by varying pH, CaCl2 concentration, mixing time, and mass. pH 6.34, 7.92 mM CaCl2 concentration, 5.51 min mixing time, and 19.24 g sample mass were the optimal extraction conditions. There was no significant difference (n = 3; p < 0.05) between the calculated (6.302 units/ml) and experimental (6.493 ± 0.229 units/ml) protease activity. The ascending order of the effects was pH < mixing time < CaCl2 < sample mass. In meat tenderizing application, the meat samples treated with 9% (v/w) crude protease extract obtained the lowest shear force (1.38 ± 0.25 N) to cause deformation on the meat. An electrophoretic analysis showed that protein bands above ~49.8 kDa were completely degraded into protein bands below ~22.4 kDa. Scanning electron microscopy shows the disruption of the muscle fibers after being treated by the Cashew protease. The results of this study show the Cashew (Anacardium occidentale) crude extract can be used as an alternative of the animal and microbial protease as meat tenderizer and subsequently overcome the shortcoming of the halal industrial protease.
Hypotheses that attribute false beliefs: A two‐part epistemology (Darwin + Akaike)
Authors: Roche William , Sober Elliott
Published: May 2020

Why expect organisms that have beliefs to have false beliefs? And if an organism occasionally occupies a neural state that encodes a perceptual belief, how do you evaluate hypotheses about the state's semantic content, where some of those hypotheses attribute beliefs that are sometimes false while others attribute beliefs that are always true? To address the first of these questions, we discuss evolution by natural selection. To address the second, we discuss a problem that is widely recognized in statistics, the problem of overfitting, and use the Akaike Information Criterion to solve epistemological versions of the disjunction and distality problems.
Southern right whales show no behavioral response to low noise levels from a nearby unmanned aerial vehicle
Authors: Christiansen Fredrik , Nielsen Mia L. K. , Charlton Claire , Bejder Lars , Madsen Peter T.
Published: May 2020

Unmanned aerial vehicles (UAVs) are increasingly used for wildlife research and monitoring, but little information exists on their potential effect on marine mammals. We assessed the effects of a UAV on the behavior of southern right whales (Eubalaena australis) in Australia. Focal follows of ten right whale mother‐calf pairs were conducted using a theodolite. Control data were recorded for 30 min, and then a DJI Inspire 1 Pro was flown above the whales for 10 min at 5 m altitude. Potential changes to horizontal behavior (swim speed and turning angle) and surfacing pattern (interbreath intervals) were investigated by comparing mother‐calf behavior before and during UAV approaches. Changes in respiration rate were used to quantify energetic effects. We also explored acoustic cue perceptibility of the UAV at 5, 10, and 30 m altitude, by measuring the received UAV underwater noise level on whales equipped with acoustic tags (DTAGs). The received noise levels were 86.0 ± 3.9 dB re 1 μPa, while the measured ambient noise was 80.7 ± 7.3 dB re 1 μPa in the same frequency band (100–1,500 Hz). No behavioral response to the UAV was observed. This provides support for UAVs as a noninvasive tool to study baleen whale behavior and ecophysiology.
Proximal reflux: biochemical mediators, markers, therapeutic targets, and clinical correlations
Authors: Klimara Miles J. , Randall Derrick R. , Allen Jacqueline , Figueredo Edgar , Johnston Nikki
Published: May 2020

Airway reflux is implicated in the pathophysiology of a wide range of adult and pediatric upper and lower airway diseases. However, the diagnosis of proximal reflux–associated disease remains challenging due to evolving clinical criteria and institutional and regional variances in diagnostic practices. Evidence suggests that nonacidic contents of reflux may serve as both pathologic mediators of and biomarkers for reflux in the upper airway. Furthermore, they offer potential pharmaceutical and surgical intervention targets and are the focus of novel clinical diagnostic tools currently under investigation.
Social norms and obesity prevalence: From cohort to system dynamics models
Authors: Crielaard Loes , Dutta Pritha , Quax Rick , Nicolaou Mary , Merabet Nadège , Stronks Karien , Sloot Peter M.A.
Published: May 2020

Group‐level obesity can be seen as an emergent property of a complex system, consisting of feedback loops between individual body weight perception, individual weight‐related behaviour and group‐level social norms (a product of group‐level ‘normal' body mass index (BMI) and sociocultural ‘ideal' BMI). As overweight becomes normal, the norm might be counteracting health awareness in shaping individual weight‐related behaviour. System dynamics modelling facilitates understanding and simulating this system's emergent behaviour. We constructed six system dynamics models (SDMs) based on an expert‐informed causal loop diagram and data from six sociocultural groups (Dutch, Moroccan and South‐Asian Surinamese men and women). The SDMs served to explore the effect of three scenarios on group‐level BMI: ‘what if' weight‐related behaviour were driven by (1) health awareness, (2) norms or (3) a combination of the two. Median BMI decreased approximately 50% and 30% less in scenarios 2 and 3, respectively, than in 1. In men, the drop in BMI was approximately two times larger in scenario 1 versus 3, whereas in women, the drop was approximately equal in these scenarios. This study indicates that the overweight norm in men holds group‐level BMI close to overweight despite health awareness. Since norms are counteracting health awareness less strongly in women, other drivers of obesity must be more relevant.
Prevention, diagnosis, and management of atrioesophageal fistula
Authors: Gianni Carola , Della Rocca Domenico G. , MacDonald Bryan C. , Mohanty Sanghamitra , Quintero Mayedo Angel , Sahore Salwan Anu , Trivedi Chintan , Natale Andrea
Published: May 2020

Atrioesophageal fistula (AEF) is a rare but deadly complication of radiofrequency ablation for atrial fibrillation. Given its rarity, the diagnosis of AEF is usually delayed with a wide variation in management strategies, which contribute to the high mortality associated with AEF. As such, the most important step of AEF management is prevention, whereas early diagnosis and treatment are crucial to reduce its associated high mortality.
Being a volunteer encountering older people’s loneliness and existential loneliness: alleviating loneliness for others and oneself
Authors: Sundström Malin , Blomqvist Kerstin , Edberg Anna‐Karin
Published: May 2020

Background

The increasing proportion of older people worldwide is challenging society and the healthcare sector to develop new solutions, such as involving volunteers, especially to combat loneliness among older people. Loneliness is a broad concept comprising, for example existential loneliness – a deep feeling of aloneness in the world. We know little about volunteers’ experience of encountering older people’s loneliness in general and existential loneliness in particular. Such knowledge is important in order to develop high‐quality volunteering.

Aim

This study aimed to describe volunteers’ experience of becoming and being a volunteer, and encountering older people’s loneliness in general and existential loneliness in particular.

Methods

This descriptive qualitative study is based on eight focus group interviews and twelve individual interviews with volunteers from different organisations, analysed using conventional content analysis.

Findings

Being a volunteer meant being a fellow human being, alleviating loneliness for others and oneself. Becoming a volunteer was a way of finding meaning, and volunteering made the volunteers feel rewarded and simultaneously emotionally challenged. Being a volunteer also meant acting on one’s values, challenging boundaries when necessary. Encountering loneliness, including existential loneliness, required sensitivity to others’ needs for both closeness and distance.

Conclusion

Being a volunteer benefitted not only the older persons the volunteers met, but also the volunteers’ own sense of meaning, by alleviating their own loneliness. Sharing existential thoughts and having meaningful conversations about life and death are challenging, but can contribute to the personal growth of the volunteers themselves. It is important to remember that not all volunteers are confident in having existential conversations, so it is important to pay attention to each volunteer’s prerequisites and needs. In addition, there is a need for support to volunteers’ engagement such as clarifying their role and clarifying the responsibility and expectations from health and social care.
Homeland‐Making among Cultural and Ethnic Kin: Ahıska Turks in Turkey
Authors: Dogan Hulya
Published: May 2020

Ahıska Turks are a dispersed community without a nation‐state and, similar to other ethnic minorities of the former Soviet Union, their political powerlessness rendered them subject to persecution under Stalinist rule. Most of the Ahıska Turks interviewed for this study identify themselves both ethnically and nationally with Turkey, but their cultural geographic focus lies in present‐day Georgia. By incorporating qualitative data collected through fieldwork in Turkey, this article investigates where home is for this group by asking whether Georgia still holds any meaning as homeland, or whether the location of the ‘homeland’ is shifting as the population resettles in Turkey.
When class is colorblind: A race‐conscious model for cultural capital research in education
Authors: Richards Bedelia Nicola
Published: May 2020

Sociologists of education frequently draw on the cultural capital framework to explore the ways in which educational institutions perpetuate inequality in schools and the larger society. However, these studies adhere to a white centered “class‐based master‐narrative,” to legitimize and perpetuate the assumption that racial differences are secondary manifestations of class‐based structures. The class‐based master‐narrative elevates a one‐dimensional view of inequality as rooted primarily in class‐based stratification and downplays the fact that the economic elites who inhabit these dominant social positions are predominantly white. In this essay, I propose a race‐conscious framework to challenge the colorblind assumptions and deficit perspectives inherent to the cultural capital framework. The race‐conscious model (a) focuses on how racial stratification impacts the cultivation, transmission, and activation of cultural capital on the individual and institutional levels and (b) highlights the harmful impact of the lack of racial literacy that is inherent to the white habitus.
A Unified Account: Pictorial, Photographic and Sculptural Seeing as Spectral Seeing
Authors: Kemp Gary
Published: May 2020

I extend my account involving the notion of “spectral seeing” from representation in painting (and drawing, etching, etc.) to representation in photography and sculpture. The account is psychological, but it steers clear of the psychological complexity often found in Wollheim‐derived accounts of pictorial representation; indeed no extra‐ordinary special sensory capacity is involved. That the account extends so naturally to these other non‐linguistic varieties of representation is a virtue of the account.
Visualization Research on Low-Temperature Ignition and Combustion Characteristics of Diesel/Gasoline Blends Under Cold-Start Conditions
Authors: Shi Zhicheng , Lee Chia-Fon , Wu Han , Li Haiying , Wu Yang , Zhang Lu , Liu Fushui
Published: May 2020

Although engines fueled with diesel/gasoline blends show excellent combustion and emission performance, its low-temperature flame development characteristics under cold-start conditions remain to be further verified. To clarify the details, experiments were conducted in an optical constant volume combustion chamber using Mie-scattering and direct photography methods at different ambient temperatures. Results show that the ignition delay of pure diesel during spray combustion shows a zero temperature coefficient (ZTC) region, and the addition of gasoline weakens the ZTC behavior until it disappears. The cool flame initiates the ignition, and the hot flame tends to far from the base of the cool flame as the gasoline content increases. In addition, the addition of gasoline to diesel increases the ratio of cool flames because the high evaporation reduces the temperature in the mixing zone, so only cool flame occurs in the G45 blends. Consequently, the total flame intensity presents an order of magnitude decrease. At lower ambient temperatures, the addition of gasoline significantly increases ignition instability. It is difficult to convert a cool flame into a hot flame due to the inhomogeneity of temperature and species field, which results in various unstable ignition phenomena, such as a short flash cool flame and intermittent cool and hot flame. Therefore, it is essential to directly target the cool flame and pay attention to the intrinsic mechanism of the evolution from the cool flame to the hot flame during the spray combustion process.
Combustion Instabilities With Different Degrees of Premixedness in a Separated Dual-Swirl Burner
Authors: Wang Xinyao , Han Xiao , Song Heng , Zhang Chi , Wang Jianchen , Hui Xin , Lin Yuzhen , Yang Dong , Sung Chih-Jen
Published: May 2020

The effects of premixedness degrees on combustion instabilities of separated dual-swirl flames have been investigated experimentally in the Beihang Axial Swirler Independently Stratified (BASIS) burner. The degree of premixedness is modulated by the fuel split between two injection positions in the outer stream. In the spectra of pressure oscillations, both the frequency and amplitude are positively correlated with fuel split ratios under partially premixed conditions, and the mode transition between perfectly and partially premixed conditions has been observed. The location of perfectly premixed flames shows no obvious variation at different phase angles, only with a slightly wrinkling of the flame surface along the shear layer. Under partially premixed conditions, however, the flame is found to feature a large-scale periodic convective motion, accompanied by the obvious variation of heat releases due to the equivalence ratio oscillations. The local Rayleigh index map compares the thermoacoustic driving factors under perfectly and partially premixed conditions. The development of above convective motions under partially premixed conditions is explained by combining the variations of pressure oscillations and heat releases. An analysis of the thermoacoustic network and convective path is applied to explain the cause of the mode transition. The results show that the appearance of equivalence ratio oscillations and the elongated convective path under partially premixed conditions brings a longer delay time of the flame response, which could be the reason for the mode transition.
Effect of casing on sound absorption characteristics of fine spherical granular material
Authors: Tsuruha Takumasa , Yamada Yoshinari , Otani Makoto , Takano Yasushi
Published: May 2020

To determine sound absorption coefficients of fine granular materials, the materials must be cased to suppress their flowability. In this study, effects of casing on the sound absorption coefficients of fine granular materials were investigated. The normal incidence sound absorption coefficients of cased hollow glass beads were measured using cylindrical impedance tubes. The measurement results demonstrated that the hollow glass beads present a sound absorption peak, which was attributed to the vibration of a particle frame, in the frequency range of 180 to 700 Hz for sample thickness in the range of 20 to 550 mm. With an increase in the material thickness or diameter of the casing, the first peak of the sound absorption coefficients shifted to a lower frequency. The sound absorption coefficients were calculated using an elastic frame model for porous materials. The effects of friction between the lateral wall of the case and the particle frame were incorporated in the bulk modulus and bulk density of the particle frame in the model. The model predicts correctly the frequency at which the first sound absorption peak occurs with an uncertainty of 10%.
The Immediate Effects of Instrumented-Assisted Soft Tissue Mobilization on Range of Motion, Strength, and Power in the Lower Extremity: A Critically Appraised Topic
Authors: Syeda Moni , Bartholomew Jason , Santiago Shayane , Peterson Jeff , Baker Russell T. , Cheatham Scott W.
Published: May 2020

Focused Clinical Question: What are the immediate effects of instrumented-assisted soft tissue mobilization (IASTM) application on measures of lower extremity range of motion, muscular power, and strength in physically active adults not currently suffering from a musculoskeletal injury? Clinical Bottom Line: Grade 1 evidence supports immediate improvements in lower extremity range of motion in physically active adults after IASTM application. However, the evidence is lacking to support IASTM to improve muscular power and strength. Therefore, additional research is warranted to determine the acute effects of IASTM use on muscular power and strength in healthy, physically active adults.
A noncompeting pair of human neutralizing antibodies block COVID-19 virus binding to its receptor ACE2
Authors: Wu Yan , Wang Feiran , Shen Chenguang , Peng Weiyu , Li Delin , Zhao Cheng , Li Zhaohui , Li Shihua , Bi Yuhai , Yang Yang , Gong Yuhuan , Xiao Haixia , Fan Zheng , Tan Shuguang , Wu Guizhen , Tan Wenjie , Lu Xuancheng , Fan Changfa , Wang Qihui , Liu Yingxia , Zhang Chen , Qi Jianxun , Gao George Fu , Gao Feng , Liu Lei
Published: May 2020

An antibody defense against COVID-19

One of the responses of the immune system to invading viruses is the production of antibodies. Some of these are neutralizing, meaning that they prevent the virus from being infectious, and can thus be used to treat viral diseases. Wu
et al.
isolated four neutralizing antibodies from a convalescent coronavirus disease 2019 (COVID-19) patient. Two of the antibodies, B38 and H4, blocked the receptor binding domain (RBD) of the viral spike protein from binding to the cellular receptor, angiotensin-converting enzyme 2 (ACE2). The structure of the RBD bound to B38 shows that the B38-binding site overlaps with the binding site for ACE2. Although H4 also blocks RBD binding to ACE2, it binds at a different site, and thus the two antibodies can bind simultaneously. This pair of antibodies could potentially be used together in clinical applications.

Science
, this issue p.
1274
TMPRSS2 and TMPRSS4 promote SARS-CoV-2 infection of human small intestinal enterocytes
Authors: Zang Ruochen , Castro Maria Florencia Gomez , McCune Broc T. , Zeng Qiru , Rothlauf Paul W. , Sonnek Naomi M. , Liu Zhuoming , Brulois Kevin F. , Wang Xin , Greenberg Harry B. , Diamond Michael S. , Ciorba Matthew A. , Whelan Sean P. J. , Ding Siyuan
Published: May 2020

The SARS-CoV-2 virus infects cultured ACE2-expressing human enterocytes aided by the TMPRSS2 and TMPRSS4 serine proteases.
Bioinspired underwater legged robot for seabed exploration with low environmental disturbance
Authors: Picardi G. , Chellapurath M. , Iacoponi S. , Stefanni S. , Laschi C. , Calisti M.
Published: May 2020

An underwater legged robot, inspired by benthic animals, opens new perspectives for seabed exploration.
Material remodeling and unconventional gaits facilitate locomotion of a robophysical rover over granular terrain
Authors: Shrivastava Siddharth , Karsai Andras , Aydin Yasemin Ozkan , Pettinger Ross , Bluethmann William , Ambrose Robert O. , Goldman Daniel I.
Published: May 2020

A laboratory model of the NASA Resource Prospector climbs loose sandy slopes via dynamic terrain remodeling.
PET ligands [
18
F]LSN3316612 and [
11
C]LSN3316612 quantify
O
-linked-β-
N
-acetyl-glucosamine hydrolase in the brain
Authors: Lu Shuiyu , Haskali Mohammad B. , Ruley Kevin M. , Dreyfus Nicolas J.-F. , DuBois Susan L. , Paul Soumen , Liow Jeih-San , Morse Cheryl L. , Kowalski Aneta , Gladding Robert L. , Gilmore Jeremy , Mogg Adrian J. , Morin S. Michelle , Lindsay-Scott Peter J. , Ruble J. Craig , Kant Nancy A. , Shcherbinin Sergey , Barth Vanessa N. , Johnson Michael P. , Cuadrado Maria , Jambrina Enrique , Mannes Andrew J. , Nuthall Hugh N. , Zoghbi Sami S. , Jesudason Cynthia D. , Innis Robert B. , Pike Victor W.
Published: May 2020

Two radioligands, [
18
F]LSN3316612 and [
11
C]LSN3316612, image and quantify brain
O
-linked-β-
N
-acetyl-glucosamine hydrolase in vivo.
CRISPR-engineered immune cells reach the bedside
Authors: György Bence
Published: May 2020

In a clinical trial, CRISPR editing of T cells to fight lung cancer was feasible and safe.
A Propensity Score Matched Study of the Positive Impact of Infectious Diseases Consultation on Antimicrobial Appropriateness in Hospitalized Patients with Antimicrobial Stewardship Oversight
Authors: Bork Jacqueline T. , Claeys Kimberly C. , Heil Emily L. , Banoub Mary , Leekha Surbhi , Sorkin John D. , Kleinberg Michael
Published: May 2020

Hospital-based antibiotic stewardship (AS) programs provide oversight and guidance for appropriate antimicrobial use in acute care settings. Infectious disease expertise is beneficial in the care of hospitalized patients with infections. The impact of infectious diseases consultation (IDC) on antimicrobial appropriateness in a large tertiary hospital with an established AS program was investigated. This was a cross-sectional study from October 2017 to March 2019 at a large academic hospital with an AS-directed prospective audit and feedback process and multiple IDC services.
Extended-Spectrum-β-Lactamase- and Plasmid AmpC-Producing Escherichia coli Causing Community-Onset Bloodstream Infection: Association of Bacterial Clones and Virulence Genes with Septic Shock, Source of Infection, and Recurrence
Authors: Fröding Inga , Hasan Badrul , Sylvin Isak , Coorens Maarten , Nauclér Pontus , Giske Christian G.
Published: May 2020

Invasive infections due to extended-spectrum-β-lactamase- and pAmpC-producing
Escherichia coli
(ESBL/pAmpC-EC) are an important cause of morbidity, often caused by the high-risk clone sequence type (ST131) and isolates classified as extraintestinal pathogenic
E. coli
(ExPEC). The relative influence of host immunocompetence versus microbiological virulence factors in the acquisition and outcome of bloodstream infections (BSI) is poorly understood. Herein, we used whole-genome sequencing on 278 blood culture isolates of ESBL/pAmpC-EC from 260 patients with community-onset BSI collected from 2012 to 2015 in Stockholm to study the association of virulence genes, sequence types, and antimicrobial resistance with severity of disease, infection source, ESBL/pAmpC-EC BSI low-risk patients, and patients with repeated episodes.
Context-Dependent Action of Scc4 Reinforces Control of the Type III Secretion System
Authors: Gao Leiqiong , Cong Yanguang , Plano Gregory V. , Rao Xiancai , Gisclair Lyndsey N. , Schesser Bartra Sara , Macnaughtan Megan A. , Shen Li
Published: May 2020

The T3SS is a key virulence factor required for
C. trachomatis
infection. The control of the T3SS has not been well studied in this obligate intracellular pathogen. Here, we show that Scc4 plays a major role for precise control of the pathogenic T3SS at the levels of gene expression and effector secretion through genetically separable protein networks, allowing a fast adaptive mode of
C. trachomatis
development during infection in human epithelial cells.
Draft Genome Sequence of Clostridium perfringens
netB
-Positive Strain 2016TE7641_69, Isolated from the Intestine of a Diseased Turkey in Italy
Authors: Profeta Francesca , Di Giannatale Elisabetta , Orsini Massimiliano , Ancora Massimo , Smoglica Camilla , Cammà Cesare , Di Francesco Cristina E.
Published: May 2020

Here, we report the complete genome sequence of
Clostridium perfringens
2016TE7641_69, isolated from the intestine of a turkey reared in a conventional poultry flock located in central Italy, where animals were showing enteric disorders suggesting subclinical necrotic enteritis.
Draft Genome Sequences of Acinetobacter sp. Strain EKM10A, Enterobacter hormaechei EKM10E, and Enterobacter hormaechei EKM11E (Phylum
Proteobacteria
) Colonizing the Seed Surface Biogel of Echinocystis lobata (Wild Cucumber)
Authors: Khalaf Eman M. , Raizada Manish N.
Published: May 2020

Here, we report the draft genome sequences of
Acinetobacter
sp. strain EKM10A,
Enterobacter hormaechei
EKM10E, and
Enterobacter hormaechei
EKM11E, containing 3,978,352, 4,760,222, and 4,758,163 bp, respectively. These seed biogel-associated endophytes were previously isolated from the seed wash of
Echinocystis lobata
(wild cucumber) and tested
in vitro
for antagonism against soilborne fungal/oomycete pathogens.
Draft Genome Sequence of Lactobacillus jensenii UMB0847, Isolated from the Female Urinary Tract
Authors: West-Pelak Ella , Miller-Ensminger Taylor , Voukadinova Adelina , Wolfe Alan J. , Putonti Catherine
Published: May 2020

Lactobacillus jensenii
is a protective bacterium native to the female urinary tract. Here, we present the 1.6-Mbp draft genome for
Lactobacillus jensenii
UMB0847, isolated from a catheterized urine sample obtained from a pregnant female.
Draft Genome Sequence of Klebsiella pneumoniae UMB7779, Isolated from the Female Urinary Tract
Authors: Bhimalli Pavan , Miller-Ensminger Taylor , Voukadinova Adelina , Wolfe Alan J. , Putonti Catherine
Published: May 2020

Klebsiella pneumoniae
is a pathogenic bacterium commonly responsible for urinary tract infections (UTIs). Here, we report the draft genome sequence of
K. pneumoniae
strain UMB7779, isolated from catheterized urine of a woman with a recurrent UTI.
Serum amoxicillin levels in young infants (0–59 days) with sepsis treated with oral amoxicillin
Authors: Mir Fatima , Pearce Robin E , Baig-Ansari Naila , Qazi Shamim , Barrett Jeffrey S , Abdel-Rahman Susan , Kearns Greg , Zaidi Anita KM
Published: May 2020

Background

WHO recommends simplified antibiotics for young infants with sepsis in countries where hospitalisation is not feasible. Amoxicillin provides safe, Gram-positive coverage. This study was done to determine pharmacokinetics, drug disposition and interpopulation variability of oral amoxicillin in this demographic.

Methods

Young infants with signs of sepsis enrolled in an oral amoxicillin/intramuscular gentamicin treatment arm of a sepsis trial in Karachi, Pakistan, were studied. Limited pharmacokinetic (PK) sampling was performed at 0, 2–3 and 6–8 hours following an index dose of oral amoxicillin. Plasma concentrations were determined by high-performance liquid chromatography/mass spectrometry. Values of ≥2 mg/L were considered as the effect threshold, given the regional minimal inhibitory concentration (MIC) of resistant Streptococcus pneumoniae.

Results

Amoxicillin concentrations were determined in 129 samples from 60 young infants. Six of 44 infants had positive blood cultures with predominant Gram-positive organisms. Forty-four infants contributing blood at ≥2 of 3 specified timepoints were included in the analysis. Mean amoxicillin levels at 2–3 hours (11.6±9.5 mg/L, n=44) and 6–8 hours (16.4±9.3 mg/L, n=20) following the index dose exceeded the MIC for amoxicillin (2.0 mg/L) against resistant S. pneumoniae strains. Of 20 infants with three serum levels, 7 showed a classic dose–exposure profile and 13 showed increasing concentrations with time, implying delayed absorption or excretion.

Conclusion

Amoxicillin concentrations in sera of young infants following oral administration at 75–100 mg/kg/day daily divided doses exceeds the susceptibility breakpoint for >50% of a 12-hour dosing interval.

Oral amoxicillin may hold potential as a safe replacement of parenteral ampicillin in newborn sepsis regimens, including aminoglycosides, where hospitalisation is not feasible.

Trial registration number

NCT01027429.
Population child health: understanding and addressing complex health needs
Authors: Aitchison Katelyn , McGeown Helen , Holden Ben , Watson Mando , Klaber Robert Edward , Hargreaves Dougal
Published: May 2020

Advances in paediatric care mean that more children with complex medical problems (heart disease, neurodevelopmental problems and so on) are surviving their early years. This has important implications for the design and delivery of healthcare given their extensive multidisciplinary requirements and susceptibility to poor outcomes when not optimally managed. Importantly, their medical needs must also be understood and addressed within the context of the child and family’s life circumstances. There is growing recognition that many other factors contribute to a child’s complex health needs (CHNs), for example, family problems, fragmentation of health and care provision, psychological difficulties or social issues.

To facilitate proactive care for these patients, we must develop accurate ways to identify them. Whole Systems Integrated Care—an online platform that integrates routinely collected data from primary and secondary care—offers an example of how to do this. An algorithm applied to this data identifies children with CHNs from the entire patient population. When tested in a large inner-city GP practice, this analysis shows good concordance with clinical opinion and identifies complex children in the population to a much higher proportion than expected. Ongoing refinement of these data-driven processes will allow accurate quantification and identification of need in local populations, thus aiding the development of tailored services.
Fifteen-minute consultation: Recognising and addressing rude, undermining and bullying behaviour
Authors: Jacob Hannah , Baverstock Anna , Kingdon Camilla C
Published: May 2020

We set ourselves very high standards at work and when there is a sense that somehow we have failed, we are left feeling disappointed and frustrated. We all set very high standards for ourselves. When those feelings are exacerbated by the embarrassment of a public dressing down, especially if there isn’t an opportunity to explain just how difficult the situation had been, we are left feeling angry and let down. Most of us learn how a bully behaves in the playground or at nursery school—and yet, when it happens as an adult at work we often fail to realise what is happening. Harassment or undermining behaviour can be more challenging to identify because it isn’t always obvious and can happen without colleagues being aware. Sometimes, it isn’t even apparent to those who experience it, until an event means the problem becomes overwhelming. In fact, many people who experience undermining at work perceive the problem as their own and this can have a far more insidious impact on well-being, professional performance and mental health.
Bilateral adrenal histoplasmosis presenting as adrenal insufficiency in an immunocompetent host in the Philippines
Authors: Roxas Ma Carrissa Abigail , Sandoval Mark Anthony Santiago , Salamat Maria Sonia , Matias Patrick Joseph , Cabal Nikko Paolo , Bartolo Samantha S
Published: May 2020

Disseminated histoplasmosis, with the adrenal glands as being the only site of demonstrable disease in an immunocompetent adult, is a rare infection leading to adrenal insufficiency. This disease carries high mortality when unrecognised. We describe the first reported case of adrenal histoplasmosis in the Philippines in a 72-year-old immunocompetent, Filipino man who presented with a 3-month history of intermittent flank pain, weight loss and generalised weakness. His imaging demonstrated bilateral adrenal masses on ultrasonography and contrast-enhanced CT scan. The initial impression was adrenal cancer, however, fine-needle aspiration cytology revealed the presence of yeast cells and blood culture grewHistoplasma capsulatum. The diagnosis of the case represents a diagnostic challenge in immunocompetent individuals because they manifest with non-specific symptoms. A heightened suspicion is therefore needed to prevent significant morbidity and mortality.
Rate of visual field decay in glaucomatous eyes with acquired pits of the optic nerve
Authors: Mahmoudinezhad Golnoush , Lin Mark , Rabiolo Alessandro , Morales Esteban , Hirunpatravong Pradtana , Sharifipour Farideh , Caprioli Joseph
Published: May 2020

Background

To evaluate the relationship between the presence of an acquired pit of the optic nerve (APON) and the rate of visual field (VF) decay in primary open-angle glaucoma (POAG).

Methods

Consecutive patients with POAG were screened for APON by three glaucoma specialists. A control group of POAG eyes without APON were matched with the APON group for factors such as age, gender, baseline intraocular pressure and baseline mean deviation (MD). The pointwise rate of change (PRC) was used for pointwise comparisons between the two groups. MD rate, Visual Field Index (VFI) rate and Glaucoma Rate Index (GRI) were used for global rate comparisons. We compared the proportions of eyes progressing in the groups with event-based guided progression analysis (GPA), MD, VFI and GRI criteria.

Results

Mean (SD) PRC was faster in the APON group −1.00 (±2.57) %/year compared with the control group −0.25 (±2.19) %/year; p<0.001. MD rate (−0.22 (±0.27) dB/year vs 0.03 (±0.41) dB/year; p=0.009), VFI rate (−0.81 (±0.86) %/year vs −0.05 (±1.0) %/year; p=0.04) and GRI (−12.27 (±16.27) vs -3.75 (±10.6); p=0.052) were all faster in the APON group compared with controls. The proportion of progressing eyes with GPA, MD, VFI and GRI was not significantly different between the two groups (p>0.1).

Conclusions

The presence of APON in patients with POAG is associated with focal, fast rates of VF decay. Identification of patients with APON should alert clinicians to the possibility of a fast rate of functional progression and to consider appropriately aggressive treatment of their glaucoma.
Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research
Authors: Long Linda , Moore Darren , Robinson Sophie , Sansom Anna , Aylward Alex , Fletcher Emily , Welsman Jo , Dean Sarah Gerard , Campbell John L , Anderson Rob
Published: May 2020

Background

UK general practitioners (GPs) are leaving direct patient care in significant numbers. We undertook a systematic review of qualitative research to identify factors affecting GPs’ leaving behaviour in the workforce as part of a wider mixed methods study (ReGROUP).

Objective

To identify factors that affect GPs’ decisions to leave direct patient care.

Methods

Qualitative interview-based studies were identified and their quality was assessed. A thematic analysis was performed and an explanatory model was constructed providing an overview of factors affecting UK GPs. Non-UK studies were considered separately.

Results

Six UK interview-based studies and one Australian interview-based study were identified. Three central dynamics that are key to understanding UK GP leaving behaviour were identified: factors associated with low job satisfaction, high job satisfaction and those linked to the doctor–patient relationship. The importance of contextual influence on job satisfaction emerged. GPs with high job satisfaction described feeling supported by good practice relationships, while GPs with poor job satisfaction described feeling overworked and unsupported with negatively impacted doctor–patient relationships.

Conclusions

Many GPs report that job satisfaction directly relates to the quality of the doctor–patient relationship. Combined with changing relationships with patients and interfaces with secondary care, and the gradual sense of loss of autonomy within the workplace, many GPs report a reduction in job satisfaction. Once job satisfaction has become negatively impacted, the combined pressure of increased patient demand and workload, together with other stress factors, has left many feeling unsupported and vulnerable to burn-out and ill health, and ultimately to the decision to leave general practice.