bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacts of COVID‐19 and elective surgery cancellations on platelet supply and utilization in the Canadian Province of British Columbia
Authors: Shopsowitz Kevin E. , Lim Christina , Shih Andrew W. , Fishbane Nick , Berry Brian R. , Bigham Mark , Petraszko Tanya , Trudeau Jacqueline , Wyatt Maureen , Yan Matthew T. S. , Morrison Douglas
Published: July 2021

Background and Objectives

The coronavirus disease 2019 (COVID‐19) pandemic raised concerns about the vulnerability of platelet supply and the uncertain impact of the resumption of elective surgery on utilization. We report the impact of COVID‐19 on platelet supply and utilization across a large, integrated healthcare system in the Canadian province of British Columbia (BC).

Materials and Methods

Historical platelet use in BC by indication was compiled for fiscal year 2010/2011–2019/2020. Platelet collections, initial daily inventory and disposition data were assessed pre‐COVID‐19 (1 April 2018–15 March 2020) and for two COVID‐19 time periods in BC: a shutdown phase with elective surgeries halted (16 March–17 May, 2020) and a renewal phase when elective surgeries resumed (18 May–27 September 2020); comparisons were made provincially and for individual health authorities.

Results

Historically, elective surgeries accounted for 10% of platelets transfused in BC. Initial daily supplier inventory increased from baseline during both COVID‐19 periods (93/90 units vs. 75 units pre‐COVID‐19). During the shutdown phase, platelet utilization decreased 10.4% (41 units/week; p < 0.0001), and remained significantly decreased during the ensuing renewal period. Decreased platelet utilization was attributed to fewer transfusions during the shutdown phase followed by a decreased discard/expiry rate during the renewal phase compared to pre‐COVID‐19 (15.2% vs. 18.9% pre‐COVID‐19; p < 0.0001). Differences in COVID‐19 platelet utilization patterns were noted between health authorities.

Conclusion

Decreased platelet utilization was observed in BC compared to pre‐COVID‐19, likely due to a transient reduction in elective surgery as well as practice and policy changes triggered by pandemic concerns.
Effectiveness of technology-based interventions compared with other non-pharmacological interventions for relieving procedural pain in hospitalized neonates: a systematic review protocol
Authors: Palomaa Anna-Kaija , Tuomikoski Anna-Maria , Huhtala Saija , Pölkki Tarja
Published: July 2021

Objective:

The objective of this review is to evaluate the effectiveness of technology-based interventions in relieving procedural pain in hospitalized neonates compared with other non-pharmacological interventions.

Introduction:

Neonates requiring hospital care often experience acute pain during medical procedures. The current best practice for relieving pain in neonates is the use of non-pharmacological interventions, such as oral solutions or intervention-based human touch. Technological solutions (such as games, eHealth applications, and mechanical vibrators) have become more commonplace in pediatric pain management over recent years. However, there is a knowledge gap about how effective technology-based interventions are at relieving pain in neonates.

Inclusion criteria:

This review will consider experimental trials that include technology-based non-pharmacological interventions for relieving procedural pain in hospitalized neonates. Primary outcomes of interest include pain response to a procedure measured by a validated pain assessment scale for neonates, behavioral indicators, and/or changes in physiological indicators.

Methods:

MEDLINE (Ovid), CINAHL (EBSCO), Scopus (Elsevier), Cochrane Central Register of Controlled Trials, and the MEDIC databases will be searched for studies published in English, Finnish, and Swedish. Critical appraisal and data extraction will be conducted by two independent researchers following JBI methodology. Quantitative data will be pooled in statistical meta-analyses. If statistical analysis is not possible, the findings will be reported narratively.

Systematic review registration:

PROSPERO CRD42021254218
Development of Intertwined Infills to Improve Multi-Material Interfacial Bond Strength
Authors: Mustafa Irfan , Kwok Tsz-Ho
Published: July 2021

Recently, the availability of various materials and ongoing research in developing advanced systems for multi-material additive manufacturing (MMAM) have opened doors for innovation in functional products. One major concern of MMAM is the strength at the interface between materials. This article hypothesizes overlapping and interlacing materials to enhance the bonding strength. To test this hypothesis, we need a computer-aided manufacturing (CAM) tool that can process the overlapped material regions. However, existing computational tools lack key multi-material design processing features and have certain limitations in making full use of the material information, which restricts the testing of our hypothesis. Therefore, this research also develops a new MMAM slicing framework that efficiently identifies the boundaries for materials to develop different advanced features. By modifying a ray tracing technology, we develop layered-depth material images (LDMI) to process the material information from computer-aided design (CAD) models for slicing and process planning. Each sample point in the LDMI has associated material and geometric properties that are used to identify the multi-material regions. Based on the material information in each slice, interlocking joint (T-Joint) and interlacing infill are generated in the regions with multiple materials. Tensile tests have been performed to verify the enhancement of mechanical properties by the use of overlapping and interlacing materials.
Influence of Insulin Application Time and High-Intensity Intermittent Exercise on Hypoglycemic Risk in Adolescents With Type 1 Diabetes
Authors: de Lima Valderi de Abreu , Cordeiro Gabriel Ribeiro , Mascarenhas Luis Paulo Gomes , França Suzana Nesi , Decimo Juliana Pereira , de leão Andréia Araújo Porchat , Fritz Camila Kapp , Leite Neiva
Published: July 2021

Purpose: The study analyzed the influence of exercise on hypoglycemia episodes postexercise and in the subsequent 24 hours in children and adolescents with type 1 diabetes. Methods: Thirty young people performed the same protocol of physical exercises for 1 hour (Ex1h) and 2 hours (Ex2h) after the administration of insulin. They performed 30 minutes of exercise on a cycle ergometer with a load of 60% of maximal oxygen uptake, interspersed with maximum intensity sprints lasting 10 seconds every 5 minutes. Results: Regarding the occurrence of hypoglycemia, in the 8 hours following the exercises, there was no occurrence in Ex1h (χ2 = 0.001; P = .0001) and a greater proportion for Ex2h (n = 71 episodes, 53.8%), while Ex1h had a higher number of nocturnal hypoglycemic episodes (n = 60, 71.4%) compared with Ex2h (n = 31, 23.1%, χ2 = 49.521, P = .0001), Ex1h triggered a lower number of hypoglycemia (n = 84) than Ex2h (n = 134, χ2 = 11.504, P = .001). There was a greater reduction in the average amount of fast-acting insulin administered the day after Ex1h compared with Ex2h (P = .031). Conclusions: Intermittent exercise performed 1 hour after insulin administration shows a lower risk of hypoglycemia within 8 hours after exercise, as well as a reduction in insulin the following day.
RexAB Promotes the Survival of Staphylococcus aureus Exposed to Multiple Classes of Antibiotics
Authors: Clarke Rebecca S. , Ha Kam Pou , Edwards Andrew M.
Published: July 2021

Antibiotics inhibit essential bacterial processes, resulting in arrest of growth and, in some cases, cell death. Many antibiotics are also reported to trigger endogenous production of reactive oxygen species (ROS), which damage DNA, leading to induction of the mutagenic SOS response associated with the emergence of drug resistance. However, the type of DNA damage that arises and how this triggers the SOS response are largely unclear.
Monoclonal Antibody Therapy against
Acinetobacter baumannii
Authors: Nielsen Travis B. , Yan Jun , Slarve Matthew , Lu Peggy , Li Rachel , Ruiz Juan , Lee Bosul , Burk Elizabeth , Talyansky Yuli , Oelschlaeger Peter , Hurth Kyle , Win William , Luna Brian M. , Bonomo Robert A. , Spellberg Brad
Published: July 2021

Extremely drug-resistant (XDR)
Acinetobacter baumannii
is a notorious and frequently encountered pathogen demanding novel therapeutic interventions. An initial monoclonal antibody (MAb), C8, raised against
A. baumannii
capsule, proved a highly effective treatment against a minority of clinical isolates.
An
rfuABCD
-Like Operon and Its Relationship to Riboflavin Utilization and Mammalian Infectivity by Borrelia burgdorferi
Authors: Muramatsu Matthew K. , Zhou Jianli , Fitzgerald Bryna L. , Deka Ranjit K. , Belisle John T. , Norgard Michael V.
Published: July 2021

Riboflavin is an essential micronutrient, but its transport and utilization have remained largely understudied among pathogenic spirochetes. Here, we show that
Borrelia burgdorferi
, the zoonotic spirochete that causes Lyme disease, is able to import riboflavin via products of its
rfuABCD
-like operon as well as synthesize flavin mononucleotide and flavin adenine dinucleotide despite lacking canonical genes for their synthesis.
Small Proteins; Big Questions
Authors: Gray Todd , Storz Gisela , Papenfort Kai
Published: July 2021

In recent years, there has been increased appreciation that a whole category of proteins, small proteins of around 50 amino acids or fewer in length, has been missed by annotation as well as by genetic and biochemical assays. With the increased recognition that small proteins are stable within cells and have regulatory functions, there has been intensified study of these proteins.
High-resolution late Paleozoic cyclostratigraphy and tectonic evolution of the Keeler Basin, California, southwest Laurentia
Authors: Gannon Patrick J. , Smith M. Elliot , Umhoefer Paul J. , Leary Ryan J.
Published: July 2021

Cyclic strata exposed in the Inyo Mountains of eastern California contain a continuous 6 m.y. record of deep marine deposition that spans the Pennsylvanian–Permian boundary. To better understand the geologic evolution of southwest Laurentia and the role of glacially driven eustasy in upper Paleozoic stratigraphy, we measured two detailed ∼600 m composite stratigraphic sections of the Keeler Canyon Formation and collected a handheld spectral gamma ray log. Post-depositional deformation complicates field relationships, but 1:5000 scale mapping of faults and folds permits assembly of two continuous sections. Measured strata alternate at the 5–20 m scale between intervals of fine-grained laminated marlstone and intervals of mixed carbonate and siliciclastic turbidites and debrites. Based on facies characteristics and a prominent marker horizon, we reassign the Pennsylvanian-Permian age upper Salt Tram unit of the upper Keeler Canyon Formation to a new Estelle Member. We estimate sediment accumulation rates within the Keeler Canyon Formation using published conodont biostratigraphy and correlative U-Pb geochronology from Eastern Europe combined with spectral analysis and timescale optimization using the Astrochron R package. Evolutive harmonic analysis of gamma ray-derived element concentrations reveals prominent bundled periodicities that are consistent with both long and short eccentricity cycles. Average sediment accumulation rates calculated using the time scale optimization function of Astrochron suggest a gradual increase from 40–60 m/m.y. to ∼120 m/m.y. during the late Pennsylvanian and then a minima of ∼50 m/m.y. near the Pennsylvanian–Permian boundary, which is followed by an increase to ∼175 m/m.y. into the Early Permian. This trend in sediment accumulation rates and subsequent Permian contractile deformation are compatible with flexural subsidence in a SW-migrating foreland basin related to the southern part of the late Antler orogenic system.
Palliative care for children with complex cardiac conditions: survey results
Authors: Vemuri Sidharth , Butler Ashleigh E , Brown Katherine , Wray Jo , Bluebond-Langner Myra
Published: July 2021

Objective

To explore perspectives of paediatric cardiac and palliative care professionals on providing palliative care to children with complex cardiac conditions.

Design

A national survey including closed-ended and open-ended questions as well as clinical scenarios designed to capture referral practices, attitudes towards palliative care, confidence delivering key components of palliative care and perspectives on for whom to provide palliative care. Responses to closed-ended questions and scenarios were analysed using descriptive statistics. Open-ended responses were analysed thematically.

Participants

Paediatric cardiac and palliative care professionals caring for children with complex cardiac conditions in the UK.

Results

177 professionals (91 cardiac care and 86 palliative care) responded. Aspects of advance care planning were the most common reasons for referral to palliative care. Palliative care professionals reported greater confidence than cardiac colleagues with such discussions. Clinicians agreed that children with no further surgical management options, comorbid genetic disorders, antenatal diagnosis of a single ventricle, ventricular device in situ, symptomatic heart failure and those awaiting heart transplantation would benefit from palliative care involvement.

Conclusions

Components of palliative care, such as advance care planning, can be provided by cardiac care professionals alongside the disease-directed care of children with complex cardiac conditions. Further research and training are needed to address confidence levels in cardiac care professionals in delivering components of palliative care as well as clarification of professional roles and parent preferences in delivery of family-centred care for children with complex cardiac conditions.
Chondroid syringoma: an unusual presentation in a 7-year-old boy
Authors: Purkayastha Pujon , Thomson Richard , Wilson Jones Nicholas , Ng Selwyn
Published: July 2021

Coined in 1961 by Hirsch and Helwig, the term chondroid syringoma refers to a rare mixed tumour of subcutaneous tissue. Histologically, these tumours are almost identical to pleomorphic adenomas, arising from salivary glands. With the obvious difference being the presence of sweat gland tissue (syringoma) within a matrix of cartilage (chondroid). These mixed tumours remain scarce throughout the world, with an incidence of less than 0.098%. The vast majority of cases are reported in middle-aged and older adults, where they typically present as painless swellings in the head and neck, which gradually grow in size.
Acute encephalitis, myoclonus and Sweet syndrome after mRNA-1273 vaccine
Authors: Torrealba-Acosta Gabriel , Martin Jennifer C , Huttenbach Yve , Garcia Catherine R , Sohail Muhammad R , Agarwal Sandeep Krishna , Wasko Carina , Bershad Eric M , Hirzallah Mohammad I
Published: July 2021

A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis with lymphocyte predominance and hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques with scattered non-follicular pustules. Skin biopsy was consistent with a neutrophilic dermatosis. The patient fulfilled the criteria for Sweet syndrome. A thorough evaluation ruled out alternative infectious, autoimmune or malignant aetiologies, and all manifestations resolved with glucocorticoids. While we cannot prove causality, there was a temporal correlation between the vaccination and the clinical findings.
Management of type 2 diabetes in chronic kidney disease
Authors: Triozzi Jefferson L , Parker Gregg L , Virani Salim S , Navaneethan Sankar D
Published: July 2021

The management of patients with type 2 diabetes and chronic kidney disease (CKD) encompasses lifestyle modifications, glycemic control with individualized HbA1c targets, and cardiovascular disease risk reduction. Metformin and sodium-glucose cotransporter-2 inhibitors are first-line agents. Glucagon-like peptide-1 receptor agonists are second-line agents. The use of other antidiabetic agents should consider patient preferences, comorbidities, drug costs, and the risk of hypoglycemia. Renin–angiotensin–aldosterone system inhibitors are strongly recommended for patients with diabetes, hypertension, and albuminuria. Non-steroidal mineralocorticoid receptor antagonists, which pose less risk of hyperkalemia than steroidal agents, are undergoing further evaluation among patients with diabetic kidney disease. Here, we discuss important advancements in the management of patients with type 2 diabetes and CKD.
Why do strategies to strengthen primary health care succeed in some places and fail in others? Exploring local variation in the effectiveness of a community health worker managed digital health intervention in rural India
Authors: Schierhout Gill , Praveen Devarsetty , Patel Bindu , Li Qiang , Mogulluru Kishor , Ameer Mohammed Abdul , Patel Anushka , Clifford Gari D , Joshi Rohina , Heritier Stephane , Maulik Pallab , Peiris David
Published: July 2021

Introduction

Digital health interventions (DHIs) have huge potential as support modalities to identify and manage cardiovascular disease (CVD) risk in resource-constrained settings, but studies assessing them show modest effects. This study aims to identify variation in outcomes and implementation of SMARTHealth India, a cluster randomised trial of an ASHA-managed digitally enabled primary healthcare (PHC) service strengthening strategy for CVD risk management, and to explain how and in what contexts the intervention was effective.

Methods

We analysed trial outcome and implementation data for 18 PHC centres and collected qualitative data via focus groups with ASHAs (n=14) and interviews with ASHAs, PHC facility doctors and fieldteam mangers (n=12) Drawing on principles of realist evaluation and an explanatory mixed-methods design we developed mechanism-based explanations for observed outcomes.

Results

There was substantial between-cluster variation in the primary outcome (overall: I2=62.4%, p<=0.001). The observed heterogeneity in trial outcomes was not attributable to any single factor. Key mechanisms for intervention effectiveness were community trust and acceptability of doctors’ and ASHAs’ new roles, and risk awareness. Enabling local contexts were seen to evolve over time and in response to the intervention. These included obtaining legitimacy for ASHAs’ new roles from trusted providers of curative care; ASHAs’ connections to community and to qualified providers; their responsiveness to community needs; and the accessibility, quality and appropriateness of care provided by higher level medical providers, including those outside of the implementing (public) subsystem.

Conclusion

Local contextual factors were significant influences on the effectiveness of this DHI-enabled PHC service strategy intervention. Local adaptions need to be planned for, monitored and responded to over time. By identifying plausible explanations for variation in outcomes between clusters, we identify potential strategies to strengthen such interventions.
Parenteral medications at Role 1: do doctors in the British Army require improved training and experience?
Authors: Turner Luke John , Martin-Bates A J
Published: July 2021

Role 1 doctors in the British Army work predominantly in primary healthcare, but also provide prehospital emergency care and administer potent parenteral medications in the field. Role 1 doctors have theoretical training in the use of these medications on short courses but then have little refresher training and use them infrequently in their routine practice, introducing the risk of skill fade. This may lead to higher rates of medication errors in an environment where the consequences may be significant. This article explores the current training of Role 1 doctors, the threat of skill fade and how the safety of drug administration can be improved. This includes recommendations for the development of training competencies, bespoke courses and clinical placements, e-learning and the use of new technology. Application of these recommendations has the potential to improve patient safety and the confidence of doctors in the use of parenteral analgesia.
Impact of the COVID-19 pandemic on the mental health and learning of college and university students: a protocol of systematic review and meta-analysis
Authors: Mao Jing , Gao Xin , Yan Peireng , Ren Xiaocao , Guan Yong , Yan Yi
Published: July 2021

Introduction

COVID-19 has a serious impact on people’s physical health and mental health. The COVID-19 pandemic forced college and university students to take online classes, which may have bad impacts on students’ learning. In addition, the students lost many job opportunities during the pandemic. Faced with employment and study pressure and worried about the epidemic, college and university students were prone to increased overall negative emotion, anxiety and depression. Therefore, this systematic review and meta-analysis will be conducted to explore the impact of the COVID-19 pandemic on the mental health and learning of college and university students.

Methods and analysis

We will conduct electronic literature search of the PubMed, Embase, Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure databases. Two researchers will independently screen the studies, extract data and assess the quality of the included studies. Any disagreement will be resolved by the third investigator. The Newcastle–Ottawa Scale and other tools will be used to assess the risk of bias, according to the study design of included studies. OR, risk ratio, mean difference and 95% CI will be considered as the effect size. Heterogeneity between studies will be assessed by subgroup and sensitivity analysis, and publication bias will be detected by funnel plots, Begg’s test and Egger’s test.

Ethics and dissemination

This systematic review and meta-analysis involves no patient contact and no interaction with healthcare providers or systems. We will disseminate the findings of this study through the presentation at scientific conferences and publication in a peer-reviewed journal.

PROSPERO registration number

CRD42020201132.
House dust mite (HDM) and storage mite (SM) molecular sensitisation profiles and association with clinical outcomes in allergic asthma and rhinitis: protocol for a systematic review
Authors: Matos-Semedo Filipa , Cruz Cíntia , Inácio Filipe , Gama Jorge M R , Nwaru Bright I , Taborda-Barata Luís
Published: July 2021

Introduction

Identification and characterisation of single allergens at molecular level is important. Component-resolved diagnosis offers the possibility of higher diagnostic precision, thereby allowing better patient management. House dust mites (HDM) have a worldwide distribution. Studies from different countries have shown that IgE-mediated allergy to storage mites (SM) is important in rural and urban populations. With the availability of HDM and SM molecular allergen components, studies have investigated whether different molecular sensitisation profiles are associated with clinical disease outcomes. However, no previous systematic review has synthesised the underlying evidence.

Methods and analysis

We will search Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science (Science and Social Science Index) from inception to March 2020. Unpublished and ongoing work, as well as research in progress will be searched inwww.ClinicalTrials.gov;www.controlledtrials.comandwwwanzctrorgau. We will contact an international panel of experts in this field. No language restrictions will apply; translations will be undertaken where necessary. The Critical Appraisal Skills Programme quality assessment tool will be used to appraise the methodological quality of included studies. A descriptive summary with data tables will be constructed, and if adequate, meta-analysis using random effects will be performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed for reporting.

Ethics and dissemination

Since this systematic review will be only based on published and retrievable literature, no ethics approval is required. We will publish the systematic review in an international peer-reviewed journal.

Trial registration number

reviewregistry959.
Sexual and reproductive health services provided by community pharmacists: a scoping review
Authors: Navarrete Javiera , Yuksel Nese , Schindel Theresa J , Hughes Christine A
Published: July 2021

Objectives

Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas.

Design

Scoping review

Data sources

Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007–July 2020).

Study selection

Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists.

Data extraction

Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes.

Results

Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists’ delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking.

Conclusion

This scoping review highlights the expansion of pharmacists’ roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users’ acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.
Prevalence of mental health symptoms among male and female Australian professional footballers
Authors: Kilic Özgür , Carmody Sean , Upmeijer Judith , Kerkhoffs Gino M M J , Purcell Rosemary , Rice Simon , Gouttebarge Vincent
Published: July 2021

Objective

Determining the prevalence of mental health symptoms (MHS) among Australian professional footballers compared with former players. A secondary aim was to assess whether MHS were associated with recent injury and psychological resilience.

Methods

This cross-sectional study included 149 male (mean age: 24 years) and 132 female (mean age: 23 years) Australian A-League and W-League professional footballers (study group) and 81 former male footballers (control group, mean age: 39 years) for analysis. MHS and psychological resilience were assessed through validated questionnaires. Severe injuries were assessed through a single question. The adjusted Wald method was used to assess the primary aim. Logistic regression analyses was used to assess the secondary aim.

Results

The most prevalent MHS among active footballers and former footballers was sport-related psychological distress (63%) and alcohol misuse (69%), respectively. Global psychological distress, sleep disturbance, alcohol misuse and substance misuse were significantly lower among active male footballers than among former players. Increased psychological resilience among active male footballers was associated with a decrease in symptoms of sport-related and global psychological distress, anxiety and depression of 9%, 14%, 23% and 20%, respectively. Increased psychological resilience among female players was associated with 10% decrease in symptoms of depression. Problem gambling and sleep disturbance was associated with injury in the previous 6 months among active male and female footballers, respectively.

Conclusions

MHS are prevalent among active and former professional footballers. Higher level of psychological resilience is associated with decreased reporting of MHS. Severe injury is associated with problem gambling and sleep disturbance.
Healthcare interpreters and difficult conversations: a survey
Authors: James Helen , Crawford Gregory Brian
Published: July 2021

Objectives

The aims of this survey of healthcare interpreters were to assess the impacts of difficult conversations such as discussions involving explanation of a serious diagnosis, goals-of-care or death or dying and to discover interpreters’ opinions on ways to improve these conversations.

Methods

A purpose derived survey incorporating the Professional Quality of Life measure 5 was distributed to all healthcare interpreters in an Australian state. Outcome measures were to quantify levels of compassion satisfaction (CS), burn-out and secondary traumatic stress (STS), as well as to determine how well interpreters believed difficult conversations were being conducted and suggestions for improvement.

Results

There were 94 respondents all scoring moderate (34.1%) or high (65.9%) on the CS score. No respondents scored high on burn-out or STS scales. Significant subgroup analysis was those aged 18–30 with higher burn-out scores. The two most common concerns raised were (1) not knowing the content prior to a discussion and (2) feeling guilty about delivering bad news. The two most frequent suggestions for improvement were (1) prebriefing with medical teams prior and (2) allowing opportunity to explain cultural concerns.

Conclusions

Interpreters surveyed were not experiencing burn-out or STS and had moderate or high CS scores. Recommendations are: further training and evidence-based guidelines for medical staff and healthcare interpreters in the facilitation of difficult conversations; prebriefing and debriefing for interpreters; further research to delineate the characteristics that predispose to compassion fatigue.
Greater occipital nerve block modulates nociceptive signals within the trigeminocervical complex
Authors: Hoffmann Jan , Mehnert Jan , Koo Elena M , May Arne
Published: July 2021

Introduction

The pharmacological block of the greater occipital nerve has been proven effective in numerous headache and facial pain syndromes. This clinical effect supports the hypothesis of a strong functional interaction between the occipital and trigeminal nerves which has been proposed in neurophysiological in vivo experiments in rodents. Although it is likely that the interaction has to occur in the central nervous system, the exact site and the mechanisms of the interaction remain largely unknown.

Methods

Focusing on these questions we investigated in a double-blind, placebo-controlled, randomised study the influence of an occipital nerve block with lidocaine 1% on neuronal activation in the trigeminocervical complex using high-resolution functional magnetic resonance on a 3T scanner. In order to investigate potential clinical effects on the trigeminal nerve, we further performed quantitative sensory testing and analysed a potential shift in thermal detection and pain thresholds.

Results

The pharmacological block of the greater occipital nerve induced an occipital anaesthesia ipsilateral to the block. Functional imaging revealed that the occipital injection of lidocaine but not placebo significantly reduced nociceptive trigeminal activation.

Conclusions

These data suggest that the functional inhibition of the occipital nerve block on trigeminal nociceptive activity is likely to occur at the C2 level where the occipital nerve enters the trigeminocervical complex and converges on the same central nuclei before the signal crosses the midline at that level and is then transmitted to higher processing centres.
Postoperative mortality in hip fracture patients stratified by the Revised Cardiac Risk Index: a Swedish nationwide retrospective cohort study
Authors: Forssten Maximilian Peter , Mohammad Ismail Ahmad , Borg Tomas , Ahl Rebecka , Wretenberg Per , Cao Yang , Peden Carol J , Mohseni Shahin
Published: July 2021

Objectives

The Revised Cardiac Risk Index (RCRI) is a tool that can be used to evaluate the 30-day risk of postoperative myocardial infarction, cardiac arrest and mortality. This study aims to confirm its association with postoperative mortality in patients who underwent hip fracture surgery.

Methods

All adults who underwent primary emergency hip fracture surgery in Sweden between January 1, 2008 and December 31, 2017 were included in this study. The database was retrieved by cross-referencing the Swedish National Quality Register for hip fractures with the Swedish National Board of Health and Welfare registers. The outcomes of interest were the association between the RCRI score and mortality at 30 days, 90 days and 1 year postoperatively.

Results

134 915 cases were included in the current study. There was a statistically significant linear trend in postoperative mortality with increasing RCRI scores at 30 days, 90 days and 1 year. An RCRI score ≥4 was associated with a 3.1 times greater risk of 30-day postoperative mortality (adjusted incidence rate ratio (IRR) 3.13, p<0.001), a 2.5 times greater risk of 90-day postoperative mortality (adjusted IRR 2.54, p<0.001) and a 2.8 times greater risk of 1-year postoperative mortality (adjusted HR 2.81, p<0.001) compared with that observed with an RCRI score of 0.

Conclusion

An increasing RCRI score is strongly associated with an elevated risk 30-day, 90-day and 1-year postoperative mortality after primary hip fracture surgery. The objective and easily retrievable nature of the variables included in the RCRI calculation makes it an appealing choice for risk stratification in the clinical setting.

Levels of evidence

Level III.
Assessing the contribution of traditional foods to food security for the Wapekeka First Nation of Canada
Authors: Robidoux Michael A. , Winnepetonga Derek , Santosa Sylvia , Haman François
Published: July 2021

The food security crisis and disproportionately high burden of dietary related disease amongst northern Indigenous populations in Canada continues to be a troubling reality with little sign of improvement. The Government of Canada is responding by developing programs to support local food initiatives for northern isolated communities. While such investments appear commendable, the impact of local food harvesting to improve food security has yet to be determined. While there are clear nutritional and cultural benefits to traditional food sources, communities face considerable barriers acquiring it in sufficient amounts because of historically imposed lifestyle changes that have increased food insecurity rates. This study responds by providing a novel multidisciplinary approach that draws from firsthand experiences working with First Nations community members in a remote subarctic region in northwestern, Ontario, to estimate their community’s total food requirement and the amount of wild animal food sources needed to sustain yearly food intake. This transferrable energy demand approach will be critical for policy makers to put into perspective the amount of wild food needed to have an impact on food security rates and ultimately improve dietary related diseases.

Novelty: Provide government policy makers information about current harvest yields in a remote northern First Nation to understand the potential contribution of traditional food to improve local food security. Provide Indigenous communities a means to assess local food resources to measure the caloric contributions of traditional foods toward household food security.
The S1PR1 agonist SEW2871 promotes the survival of skin flap
Authors: Zhang Dongdong , Qi Dongxu , Xu Yi , Hu Chunhe , Zhang Xiao , Yang Qingjian , Shang Zikun , Zhang Guisheng
Published: July 2021

Skin flap transfer is an important method to repair and reconstruct various tissue defects; however, avascular necrosis largely affects the success of flap transfer. The sphingosine 1-phosphate receptor 1 (S1PR1) agonist SEW2871 has been proven to ameliorate ischemic injury; however, its effect on flap survival has not been reported. In this study, an experimental skin flap model was established in rats to investigate the roles of SEW2871. The results indicated that SEW2871 greatly increased the survival of the skin flap, alleviated pathological injury, promoted the angiogenesis, and inhibited cells apoptosis in skin flap tissues. SEW2871 activated S1PR1 downstream signaling pathways, including heat shock protein 27 (HSP27), extracellular regulated protein kinases (ERK), and protein kinase B (Akt). In addition, SEW2871 promoted the expression of S1PR1. These findings may provide novel insights for skin flap transfer.
Long non-coding RNA H19 acts as a microRNA-194 sponge to inhibit the apoptosis and promote the proliferation of hypertrophic scar fibroblasts
Authors: Liu Bo , Lin Lijuan , Yu Shengjin , Xia Rongjun , Zheng Linlin
Published: July 2021

The effects of long non-coding RNAs (lncRNAs) on the proliferation of hypertrophic scars have been described, however, the underlying mechanisms are not well characterized. The present study aimed to investigate the mechanisms of lncRNA H19 in hypertrophic scars. The effects of the lncRNA H19 on the proliferation and apoptosis of hypertrophic scar fibroblasts (HSFs) were analyzed using 5′-ethynyl-2′-deoxyuridine staining, flow cytometry, and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT). The results revealed H19 promoted the proliferation and inhibited the apoptosis in HSF. In addition, the binding associations between H19 and microRNA-194 (miR-194), and miR-194 and insulin-like growth factor I receptor (IGF1R) were identified using bioinformatics screening and verified using dual-luciferase assays. Furthermore, the effects of the IGF1R knockdown on H19-induced HSF phenotypes and regulation over the p38 MAPK pathway were determined. Mechanistically, miR-194 was identified as the downstream effector of the H19-mediated phenotypes of HSFs through its ability to directly target IGF1R, thus modulating the p38 MAPK signaling pathway. In conclusion, the findings suggested that H19 may inhibit the apoptosis and promote the proliferation of HSFs through the miR-194/IGF1R/p38 MAPK signaling axis, thereby contributing to the progression of hypertrophic scars. These findings may provide novel targets for the treatment of hypertrophic scars.
Quantifying Turing: a systems approach to quantitatively assessing the degree of autonomy of any system
Authors: Meakin Mike
Published: July 2021

This paper describes a method by which the degree of autonomy of a system can be quantified in a manner that allows comparison between systems. The methodology revisits, refines, and extends the contextual autonomous capability (CAC) model proposed by the National Institute of Science and Technology (NIST) by defining three orthogonal system metrics against which the performance of a system may be assessed. During the development of this model, it was recognized that there existed two different but coupled domains of autonomy — the Executive Autonomy describing the degree of independence of a system during the execution of the mission; and the Developmental Autonomy describing the degree of independence of the system during preparation for the mission. The resulting methodology is explicitly developed to be system agnostic such that it could be applied to humans as well as computerized systems. As such, it provides a means of quantifiably comparing the performance of any two systems — including human and computer — that are performing comparable sets of missions. The proposed model is called the system-agnostic quantification of autonomy levels (SQuAL) model.
Strongly Gorenstein categories
Authors: Wu Wan , Gao Zenghui
Published: July 2021

We introduce and study strongly Gorenstein subcategory [Formula: see text], relative to an additive full subcategory [Formula: see text] of an abelian category [Formula: see text]. When [Formula: see text] is self-orthogonal, we give some sufficient conditions under which the property of an object in [Formula: see text] can be inherited by its subobjects and quotient objects. Then, we introduce the notions of one-sided (strongly) Gorenstein subcategories. Under the assumption that [Formula: see text] is closed under countable direct sums (respectively, direct products), we prove that an object is in right (respectively, left) Gorenstein category [Formula: see text] (respectively, [Formula: see text]) if and only if it is a direct summand of an object in right (respectively, left) strongly Gorenstein subcategory [Formula: see text] (respectively, [Formula: see text]). As applications, some known results are obtained as corollaries.
Upholding ACM's principles
Authors: Wolf Marty J. , Gotterbarn Don , Kirkpatrick Michael
Published: July 2021

Repeated ethical violations ends with membership revocation and ban.
Oxides with Mixed Protonic and Electronic Conductivity
Authors: Merkle Rotraut , Hoedl Maximilian F. , Raimondi Giulia , Zohourian Reihaneh , Maier Joachim
Published: July 2021

Oxides with mixed protonic and p-type electronic conductivity (and typically containing also mobile oxygen vacancies) are important functional materials, e.g., for oxygen electrodes in protonic ceramic electrochemical cells or for permeation membranes. Owing to the presence of three carriers, their defect chemical behavior is complex. Deviations from ideal behavior (defect interactions) have to be taken into account, which are related to the partially covalent character of the transition metal–oxygen bonds. Compared to acceptor-doped Ba(Zr,Ce)O3− z electrolytes, perovskites with redox-active transition-metal cations typically show smaller degrees of hydration. Trends in the proton uptake of (Ba,Sr,La)(Fe,Co,Y,Zn)O3−δ perovskites are analyzed and correlated to structural features (local lattice distortions) and electronic properties (the position of oxygen states on an absolute energy scale). The proton mobility in such mixed-conducting perovskites is estimated. Specific aspects of the application of protonic and electronic mixed-conducting oxides in protonic ceramic electrochemical cells are discussed, and an overview of recent materials and device developments is given.
Communication—The Role of Ascorbic Acid Oxidation During Neural Stimulation
Authors: Olczak Kaitlynn P. , Otto Kevin J.
Published: July 2021

During neural stimulation it is important to ensure charge transfer does not cause tissue damage. The safe range for stimulation is often defined by the oxidation/reduction of water. However, many biological molecules, such as ascorbic acid (AA), have lower oxidation potentials than water. Due to its low oxidation potential and high concentrations in the brain, we examined the role of AA oxidation during neural stimulation. By measuring the voltage transients during current-controlled stimulation we show significant AA oxidation occurs at stimulation levels typically deemed safe. These results highlight the importance of considering the effect of electrical stimulation on biological molecules.
Graphic Representation of a Dimensional Expansion of Triangular Fuzzy Number
Authors: Yun Yong Sik
Published: July 2021

We calculate Zadeh’s max-min composition operators for two 3-dimensional triangular fuzzy numbers. We prove that if the 3-dimensional result is limited to 2 dimensions, it is the same as the 2-dimensional result, which is shown as a graph. Since a 3-dimensional graph cannot be drawn, the value of the membership function is expressed with color density. We cut a 3-dimensional triangular fuzzy number by a perpendicular plane passing a vertex, and consider the cut plane as a domain. The value of the membership function for each point on the cut plane is also expressed with color density. The graph expressing the value of the membership function, defined in the plane as a 3-dimensional graph using the

z

-axis value instead of expressing with color density, is consistent with the results in the 2-dimensional case.
A Review on Expression, Pathological Roles, and Inhibition of TMPRSS2, the Serine Protease Responsible for SARS-CoV-2 Spike Protein Activation
Authors: Sarker Jyotirmoy , Das Pritha , Sarker Sabarni , Roy Apurba Kumar , Momen A. Z. M. Ruhul
Published: July 2021

SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, uses the host cell membrane receptor angiotensin-converting enzyme 2 (ACE2) for anchoring its spike protein, and the subsequent membrane fusion process is facilitated by host membrane proteases. Recent studies have shown that transmembrane serine protease 2 (TMPRSS2), a protease known for similar role in previous coronavirus infections, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS), is responsible for the proteolytic cleavage of the SARS-CoV-2 spike protein, enabling host cell fusion of the virus. TMPRSS2 is known to be expressed in the epithelial cells of different sites including gastrointestinal, respiratory, and genitourinary system. The infection site of the SARS-CoV-2 correlates with the coexpression sites of ACE2 and TMPRSS2. Besides, age-, sex-, and comorbidity-associated variation in infection rate correlates with the expression rate of TMPRSS2 in those groups. These findings provide valid reasons for the assumption that inhibiting TMPRSS2 can have a beneficial effect in reducing the cellular entry of the virus, ultimately affecting the infection rate and case severity. Several drug development studies are going on to develop potential inhibitors of the protease, using both conventional and computational approaches. Complete understanding of the biological roles of TMPRSS2 is necessary before such therapies are applied.
Identification of Secondary Metabolites in Flammulina velutipes by UPLC-Q-Exactive-Orbitrap MS
Authors: Ding Ying , Chen Sitan , Wang Honglin , Li Shanlei , Ma Changyang , Wang Jinmei , Cui Lili
Published: July 2021

Flammulina velutipes is the fourth largest edible fungus in China with high nutritional value. In this paper, ultrahigh-performance liquid chromatography tandem hybrid quadrupole-Orbitrap mass spectrometry (UPLC-Q-Exactive-Orbitrap MS) was used to identify the secondary metabolites of F. velutipes. The metabolites were identified by comparing the retention time, accurate molecular weight, and MS2 data with standard databases of mzVault and mzCloud (compound: 17,000+) and BGI high-resolution accurate mass plant metabolome database (plant metabolite: 2500+). Finally, 26 secondary metabolites were preliminarily identified, including flavonoids, phenylpropanoids, organic acids, and steroids.