bluuebunny/crossref_metadata_2025 huggingface dataset:
Two new miniature silverside fishes of the genus Membras Bonaparte (Atheriniformes, Atherinopsidae) from the Tropical North Atlantic Ocean
Authors: CHERNOFF BARRY , MACHADO-ALLISON ANTONIO , ESCOBEDO JENNIFER , FREIBURGER MICHAEL , HENDERSON ELIJAH , HENNESSY ANDREW , KOHN GRACE , NERI NOLA , PARIKH AASHNI , SCOBELL SOPHIE , SILVERSTONE BENJAMIN , YOUNG EMILY
Published: September 2020

Two new species of miniature silverside fishes are described from coastal habitats in the tropical Atlantic: Membras pygmaea sp. nov., from Brus Lagoon, Honduras, and M. procera sp. nov., from the Gulf of Urabá, Colombia. These new species belong to the martinica species-group within the genus Membras Bonaparte. The monophyletic martinica species-group (see below) contains four additional species, all coastal, marine that extend from the east coast of North America to São Paolo State, Brazil. Within the martinica species-group, all but M. martinica are miniature species, ranging from 41–60 mm SL. The smallest species, M. pygmaea sp. nov., is mature at 24 mm SL. A geometric morphometric analysis shows: (i) each species of the martinica species-group occupies its own portion of shape space; and (ii) none of the miniature species possess the shapes of small immature M. martinica. While some of the literature suggests that miniaturization may involve paedomorphosis, our results show that the miniatures accelerate to adult body forms.
A second species of Syrraphesina Raffray found adjacent to Wallace's Line
(Coleoptera, Staphylinidae, Pselaphinae)
Authors: YIN ZI-WEI , HLAVÁČ PETER
Published: September 2020

The monospecific genus Syrraphesina Raffray, 1903 contains a single species distributed in eastern New Guinea. In this paper a second species from Lombok Island, S. agostii Yin & Hlaváč, sp. nov., is described, figured, and compared to S. pliciventris Raffray, 1903. A revised diagnosis of Syrraphesina is provided. The distribution of Clavigerini through the islands of the world is briefly discussed.
Two new species of the genus Zaitzevia Champion, 1923 from China (Coleoptera: Elmidae: Macronychini)
Authors: JIANG RI-XIN , WANG SHUO
Published: September 2020

Two new riffle beetles of the genus Zaitzevia Champion, 1923: Z. chenzhitengi sp. nov. from Sichuan Province and Z. xiongzichuni sp. nov. from Yunnan Province are described from China. Habitus and other diagnostic features of the new species are described and illustrated. Habitat information and collection data of the new species are also provided.
Character state variation among species of Thrips genus (Thysanoptera) in Malaysia, with one new species and two new records
Authors: NG Y. F. , MOUND L. A.
Published: September 2020

Thrips korbuensis sp.n. is described from a high elevated area in Peninsular Malaysia. It shares many character states with Thrips coloratus but has 8-segmented antennae and abdominal segment VIII–X uniformly dark. It also shares some features with Thrips florum, and variation in some character states used to distinguish species in the Thrips hawaiiensis group are discussed. Two species, Thrips brevistylus and Thrips subnudula, are recorded for the first time from Malaysia, and an updated checklist is provided of 27 species of the genus Thrips recorded from Malaysia.
Piecewise Potential Vorticity Inversion without Far-Field Response?
Authors: Egger Joseph , Hoinka Klaus P.
Published: September 2020

Given a flow domain D with subdomains D1 and D2, piecewise potential vorticity inversion (PPVI) inverts a potential vorticity (PV) anomaly in D2 and assumes vanishing PV in D1 where boundary conditions must be taken into account. It is a widely held view that the PV anomaly exerts a far-field influence on D1, which is revealed by PPVI. Tests of this assertion are conducted using a simple quasigeostrophic model where an upper layer D2 contains a PV anomaly and D1 is the layer underneath. This anomaly is inverted. Any downward physical impact of PV in D2 must also be represented in the results of a downward piecewise density inversion (PDI) based on the hydrostatic relation and the density in D2 as following from PPVI. There is no doubt about the impact of the mass in D2 on the flow in the lower layer D1. Thus results of PPVI and PDI have to agree closely. First, PPVI is applied to a locally confined PV anomaly in D2. There is no far-field “response” in D1 if stationarity is imposed. Modifications of boundary conditions lead to “induced” flows in D1 but the results of PPVI and PDI differ widely. This leads to a simple proof that there is no physical far-field influence of PV anomalies in D2. Wave patterns of the streamfunction restricted to D2 are prescribed in a second series of tests. The related PV anomalies are obtained by differentiation and are also confined to D2 in this case. This approach illustrates the basic procedure to derive PV fields from observations which excludes a far-field response.
Finding Storm Track Activity Metrics That Are Highly Correlated with Weather Impacts. Part I: Frameworks for Evaluation and Accumulated Track Activity
Authors: Man-Wai Yau Albert , Kar-Man Chang Edmund
Published: September 2020

In the midlatitudes, storm tracks give rise to much of the high-impact weather, including precipitation and strong winds. Numerous metrics have been used to quantify storm track activity, but there has not been any systematic evaluation of how well different metrics relate to weather impacts. In this study, two frameworks have been developed to provide such evaluations. The first framework quantifies the maximum one-point correlation between weather impacts at each grid point and the assessed storm track metric. The second makes use of canonical correlation analysis to find the best correlated patterns and uses these patterns to hindcast weather impacts based on storm track metric anomalies using a leave-N-out cross-validation approach. These two approaches have been applied to assess multiple Eulerian variances and Lagrangian tracking statistics for Europe, using monthly precipitation and a near-surface high-wind index as the assessment criteria. The results indicate that near-surface storm track metrics generally relate more closely to weather impacts than upper-tropospheric metrics. For Eulerian metrics, synoptic time scale eddy kinetic energy at 850 hPa relates strongly to both precipitation and wind impacts. For Lagrangian metrics, a novel metric, the accumulated track activity (ATA), which combines information from both cyclone track frequency and amplitude, is found to be best correlated with weather impacts when spatially filtered 850-hPa vorticity maxima are used to define cyclones. The leading patterns of variability for ATA are presented, demonstrating that this metric exhibits coherent large-scale month-to-month variations that are highly correlated with variations in the mean flow and weather impacts.
Cloud Assumption of Precipitation Retrieval Algorithms for the Dual-Frequency Precipitation Radar
Authors: Kubota Takuji , Seto Shinta , Satoh Masaki , Nasuno Tomoe , Iguchi Toshio , Masaki Takeshi , Kwiatkowski John M. , Oki Riko
Published: September 2020

An assumption related to clouds is one of uncertain factors in precipitation retrievals by the Dual-Frequency Precipitation Radar (DPR) on board the Global Precipitation Measurement (GPM) Core Observatory. While an attenuation due to cloud ice is negligibly small for Ku and Ka bands, attenuation by cloud liquid water is larger in the Ka band and estimating precipitation intensity with high accuracy from Ka-band observations can require developing a method to estimate the attenuation due to cloud liquid water content (CLWC). This paper describes a CLWC database used in the DPR level-2 algorithm for the GPM V06A product. In the algorithm, the CLWC value is assumed using the database with inputs of precipitation-related variables, temperature, and geolocation information. A calculation of the database was made using the 3.5-km-mesh global atmospheric simulation derived from the Nonhydrostatic Icosahedral Atmospheric Model (NICAM) global cloud-system-resolving model. Impacts of current CLWC assumptions for surface precipitation estimates were evaluated by comparisons of precipitation retrieval results between default values and 0 mg m−3 of the CLWC. The impacts were quantified by the normalized mean absolute difference (NMAD) and the NMAD values showed 2.3% for the Ku, 9.9% for the Ka, and 6.5% for the dual-frequency algorithms in global averages, while they were larger in the tropics than in high latitudes. Effects of the precipitation estimates from the CLWC assumption were examined further in terms of retrieval processes affected by the CLWC assumption. This study emphasizes the CLWC assumption provided more effects on the precipitation estimates through estimating path-integrated attenuation due to rain.
Demographic and Clinical Characteristics Associated With Adherence to Guideline‐Based Polysomnography in Children With Down Syndrome
Authors: Knollman Philip D. , Heubi Christine H. , Wiley Susan , Smith David F. , Shott Sally R. , Ishman Stacey L. , Meinzen‐Derr Jareen
Published: September 2020

Objectives

To compare the demographic and clinical characteristics of children with Down syndrome who did and did not receive polysomnography to evaluate for obstructive sleep apnea after publication of the American Academy of Pediatrics’ guidelines recommending universal screening by age 4 years.

Study Design

Retrospective cohort study.

Setting

Single tertiary pediatric hospital.

Methods

Review was conducted of children with Down syndrome born between 2007 and 2012. Children who obtained polysomnography were compared with children who did not, regarding demographic data, socioeconomic status, and comorbidities.

Results

We included 460 children with Down syndrome; 273 (59.3%) received at least 1 polysomnogram, with a median age of 3.6 years (range, 0.1‐8.9 years). There was no difference in the distribution of sex, insurance status, or socioeconomic status between children who received polysomnography and those who did not. There was a significant difference in race distribution (P =. 0004) and distance from home to the medical center (P <. 0001) between groups. Among multiple medical comorbidities, only children with a history of hypothyroidism (P =. 003) or pulmonary aspiration (P =. 01) were significantly more likely to have obtained polysomnography.

Conclusions

Overall, 60% of children with Down syndrome obtained a polysomnogram. There was no difference between groups by payer status or socioeconomic status. A significant difference in race distribution was noted. Proximity to the medical center and increased medical need appear to be associated with increased likelihood of obtaining a polysomnogram. This study illustrates the need for improvement initiatives to increase the proportion of patients receiving guideline‐based screening.
Unique Challenges for Otolaryngology Patients During the COVID‐19 Pandemic
Authors: Ghulam‐Smith Melissa , Choi Yeyoon , Edwards Heather , Levi Jessica R.
Published: September 2020

The coronavirus disease 2019 (COVID‐19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day‐to‐day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient‐centered care both during and in the aftermath of the COVID‐19 pandemic.
Auditory Brainstem Response in Preterm Infants in the Neonatal Intensive Care Unit
Authors: Raposo Diogo , Orfão João , Menezes Marco , Trindade‐Soares Mafalda , Guimarães Ana , Freire Filipe
Published: September 2020

Objective

To analyze auditory brainstem response (ABR) findings of preterm and term infants in the neonatal intensive care unit (NICU) with perinatal problems.

Study Design

Case series with chart review.

Setting

Secondary care hospital.

Methods

Analysis consisted of a consecutive series of 101 infants (69 preterm and 32 term) admitted in the NICU of Hospital Fernando Fonseca between 2016 and 2018 with perinatal problems who underwent an ABR evaluation.

Results

The major perinatal problems identified were hyperbilirubinemia, intravenous gentamicin >5 days, mechanical ventilation >5 days, congenital cytomegalovirus infection, meningitis, and periventricular hemorrhage. Gentamicin use significantly increased the absolute latency of wave I in preterm infants (95% CI, 0.01‐0.37; P =. 037). Mechanical ventilation significantly decreased the latency of wave V and intervals I‐V and III‐V in preterm infants (95% CI, −0.35 to −0.22; P =. 026; 95% CI, −0.33 to −0.00; P =. 001; 95% CI, −0.46 to 0.12; P =. 049). Congenital cytomegalovirus significantly decreased interval III‐V in preterm infants (95% CI, −0.36 to −0.01; P =. 042).

Multivariate analysis revealed that gentamicin use, lower gestational age, and lower birth weight predicted an increased ABR threshold in preterm infants (95% CI, 1.64‐15.31; P =. 016; 95% CI −1.72 to −0.09; P =. 030; 95% CI, −14.55 to −0.63; P =. 033). ABR measurements in term infants were not significantly altered, with the exception of an increased latency of wave III with a lower gestational age (95% CI, −0.49 to −0.01; P =. 038).

Conclusions

These findings suggest that perinatal problems in the NICU significantly impair the ABR threshold and the auditory pathway maturational process in preterm but not term infants.
Airborne Aerosolized Mouse Cytomegalovirus From Common Otolaryngology Procedures: Implications for COVID‐19 Infection
Authors: Sayahi Tofigh , Nielson Christopher , Yu Yuan , Neuberger Kaden , Seipp Michael , Firpo Matthew A. , Kelly Kerry , Park Albert H.
Published: September 2020

Objectives

To determine whether common otolaryngology procedures generate viable aerosolized virus through a murine cytomegalovirus (mCMV) model for infection.

Study Design

mCMV model of infection.

Setting

University of Utah laboratory.

Methods

Three‐day‐old BALB/c mice were inoculated with mCMV or saline. Five days later, each mouse underwent drilling, microdebrider, coblation, and electrocautery procedures. Particle size distribution and PM2.5 (particulate matter <2.5 µm) concentration were determined with a scanning mobility particle sizer and an aerosol particle sizer in the range of 15 nm to 32 µm. Aerosolized samples from these procedures were collected with an Aerosol Devices BioSpot sampler for viral titer based on polymerase chain reaction and for viable virus through viral culture.

Results

As compared with the background aerosol concentrations, coblation and electrocautery showed statistically significant increases in airborne aerosols (Tukey‐adjusted P value <.040), while microdebrider and drilling at 30,000 rpm did not (.870 < Tukey‐adjusted P value <. 930). We identified viral DNA in samples from coblation and drilling procedures, although we did not identify viable viruses in aerosol samples from any of the 4 procedures.

Conclusion

Coblation and electrocautery procedures generate >100‐fold increases in aerosol concentrations over background; only coblation and drilling produce aerosolized viral DNA. The high concentration of aerosols from coblation and electrocautery suggests the need for appropriate safeguards against particle exposure to health care workers. The presence of viral DNA from drilling and coblation procedures warrants the need for appropriate protection against droplet and aerosol exposure.
The preparation of novel sulfonated poly(aryl ether ketone sulfone)/TiO2 composite membranes with low methanol permeability for direct methanol fuel cells
Authors: Yuan Chengyun , Wang Yinghan
Published: September 2020

A sulfonated poly(aryl ether ketone sulfone) (SPAEKS) with locally dense sulfonic acid groups is synthesized and different amounts of TiO2 is doped into SPAEKS matrix to prepare composite membranes (SPAEKS/TiO2-x). SEM shows that TiO2 in the composite membranes has good dispersibility when TiO2 content is not higher than 3%. The composite membranes show good mechanical properties, dimensional stability and oxidative stability. The proton conductivity of composite membranes is near to that of Nafion 117 membrane and methanol permeability of composite membranes is much lower than that of Nafion 117 membrane. Therefore, the proton selectivity of composite membranes is higher than that of Nafion 117 membrane. In particular, proton selectivity of SPAEKS/TiO2-3% (12.8 × 104 S s cm−3) is four times higher than that of Nafion 117 membrane (3.2 × 104 S s cm−3).
A stiffness optimization method for a shaft-bearing-pedestal system based on the dynamics
Authors: Liu Jing
Published: September 2020

The shaft and pedestal deformations can produce large misalignments and displacements of shaft-bearing-pedestal systems (SBPSs). The phenomena have a great influence on the working performances of the SBPS. Thus, the shaft and pedestal stiffness should be properly optimized to minimize the system vibrations during the design process of the SBPSs. To overcome this issue, a new shaft and pedestal stiffness optimization strategy of a SBPS based on both the time- and frequency-domain vibrations is conducted in this work, which cannot be addressed by the previous methods considering single shaft or pedestal stiffness. Moreover, this method can be used to avoid the unexpected resonance frequencies of the rotor system during the design processing. A dynamic model of the SBPS considering both the flexible deformations of shaft and pedestal is presented. The effects of the shaft and pedestal stiffness on the vibration performances of the SBPS are discussed. The results give that the shaft and pedestal stiffness have a great effect on the time-domain waveform, magnitude, and peak frequencies of the vibrations of the SBPS. The relationships between the peak frequencies in the spectra of SBPS and two stiffness coefficients are nonlinear ones. However, they have no effect on the bearing passing frequency and its harmonics in the envelop spectra. It represents that the SBPS with the larger shaft and pedestal stiffness has a smaller vibration level. The obtained results can provide some guidance for the SBPS design with a low vibration level.
Estrogen suppresses SOX9 and activates markers of female development in a human testis-derived cell line
Authors: Stewart Melanie K. , Mattiske Deidre M. , Pask Andrew J.
Published: September 2020

Background

The increasing incidence of reproductive disorders in humans has been attributed to in utero exposure to estrogenic endocrine disruptors. In particular, exposure of the developing testis to exogenous estrogen can negatively impact male reproductive health. To determine how estrogens impact human gonad function, we treated the human testis-derived cell line NT2/D1 with estrogen and examined its impact on SOX9 and the expression of key markers of granulosa (ovarian) and Sertoli (testicular) cell development.

Results

Estrogen successfully activated its cognate receptor (estrogen receptor alpha;ESR1) in NT2/D1 cells. We observed a significant increase in cytoplasmic SOX9 following estrogen treatment. After 48 h of estrogen exposure, mRNA levels of the key Sertoli cell genesSOX9, SRY, AMH, FGF9andPTGDSwere significantly reduced. This was followed by a significant increase in mRNA levels for the key granulosa cell genesFOXL2andWNT4after 96 h of estrogen exposure.

Conclusions

These results are consistent with estrogen's effects on marsupial gonads and show that estrogen has a highly conserved impact on gonadal cell fate decisions that has existed in mammals for over 160 million years. This effect of estrogen presents as a potential mechanism contributing to the significant decrease in male fertility and reproductive health reported over recent decades. Given our widespread exposure to estrogenic endocrine disruptors, their effects on SOX9 and Sertoli cell determination could have considerable impact on the adult testis.
Further resolution of the house mouse (Mus musculus) phylogeny by integration over isolation-with-migration histories
Authors: Phifer-Rixey Megan , Harr Bettina , Hey Jody
Published: September 2020

Background

The three main subspecies of house mice, Mus musculus castaneus, Mus musculus domesticus, and Mus musculus musculus, are estimated to have diverged ~ 350-500KYA. Resolution of the details of their evolutionary history is complicated by their relatively recent divergence, ongoing gene flow among the subspecies, and complex demographic histories. Previous studies have been limited to some extent by the number of loci surveyed and/or by the scope of the method used. Here, we apply a method (IMa3) that provides an estimate of a population phylogeny while allowing for complex histories of gene exchange.

Results

Results strongly support a topology with M. m. domesticus as sister to M. m. castaneus and M. m. musculus. In addition, we find evidence of gene flow between all pairs of subspecies, but that gene flow is most restricted from M. m. musculus into M. m. domesticus. Estimates of other key parameters are dependent on assumptions regarding generation time and mutation rate in house mice. Nevertheless, our results support previous findings that the effective population size, Ne, of M. m. castaneus is larger than that of the other two subspecies, that the three subspecies began diverging ~ 130 - 420KYA, and that the time between divergence events was short.

Conclusions

Joint demographic and phylogenetic analyses of genomic data provide a clearer picture of the history of divergence in house mice.
Comparative transcriptome analysis of root, stem, and leaf tissues of Entada phaseoloides reveals potential genes involved in triterpenoid saponin biosynthesis
Authors: Liao Weifang , Mei Zhinan , Miao Lihong , Liu Pulin , Gao Ruijie
Published: September 2020

Background

Entada phaseoloides (L.) Merr. is an important traditional medicinal plant. The stem of Entada phaseoloides is popularly used as traditional medicine because of its significance in dispelling wind and dampness and remarkable anti-inflammatory activities. Triterpenoid saponins are the major bioactive compounds of Entada phaseoloides. However, genomic or transcriptomic technologies have not been used to study the triterpenoid saponin biosynthetic pathway in this plant.

Results

We performed comparative transcriptome analysis of the root, stem, and leaf tissues of Entada phaseoloides with three independent biological replicates and obtained a total of 53.26 Gb clean data and 116,910 unigenes, with an average N50 length of 1218 bp. Putative functions could be annotated to 42,191 unigenes (36.1%) based on BLASTx searches against the Non-redundant, Uniprot, KEGG, Pfam, GO, KEGG and COG databases. Most of the unigenes related to triterpenoid saponin backbone biosynthesis were specifically upregulated in the stem. A total of 26 cytochrome P450 and 17 uridine diphosphate glycosyltransferase candidate genes related to triterpenoid saponin biosynthesis were identified. The differential expressions of selected genes were further verified by qPT-PCR.

Conclusions

The dataset reported here will facilitate the research about the functional genomics of triterpenoid saponin biosynthesis and genetic engineering of Entada phaseoloides.
Transcriptome response comparison between vector and non-vector aphids after feeding on virus-infected wheat plants
Authors: Li Dandan , Zhang Chi , Tong Zeqian , Su Dan , Zhang Gaisheng , Zhang Shize , Zhao Huiyan , Hu Zuqing
Published: September 2020

Background

Plant viruses maintain intricate interactions with their vector and non-vector insects and can impact the fitness of insects. However, the details of their molecular and cellular mechanisms have not been studied well. We compared the transcriptome-level responses in vector and non-vector aphids (Schizaphis graminum and Rhopalosiphum padi, respectively) after feeding on wheat plants with viral infections (Barley Yellow Dwarf Virus (BYDV) and Wheat dwarf virus (WDV), respectively). We conducted differentially expressed gene (DEG) annotation analyses and observed DEGs related to immune pathway, growth, development, and reproduction. And we conducted cloning and bioinformatic analyses of the key DEG involved in immune.

Results

For all differentially expressed gene analyses, the numbers of DEGs related to immune, growth, development, reproduction and cuticle were higher in vector aphids than in non-vector aphids. STAT5B (signal transducer and activator of transcription 5B), which is involved in the JAK-STAT pathway, was upregulated in R. padi exposed to WDV. The cloning and bioinformatic results indicated that the RpSTAT5B sequence contains a 2082 bp ORF encoding 693 amino acids. The protein molecular weight is 79.1 kD and pI is 8.13. Analysis indicated that RpSTAT5B is a non-transmembrane protein and a non-secreted protein. Homology and evolutionary analysis indicated that RpSTAT5B was closely related to R. maidis.

Conclusions

Unigene expression analysis showed that the total number of differentially expressed genes (DEGs) in the vector aphids was higher than that in the non-vector aphids. Functional enrichment analysis showed that the DEGs related to immunity, growth and reproduction in vector aphids were higher than those in non-vector aphids, and the differentially expressed genes related to immune were up-regulated. This study provides a basis for the evaluation of the response mechanisms of vector/non-vector insects to plant viruses.
Cost-effectiveness analysis of systematic fast-track transition from oncological treatment to specialised palliative care at home for patients and their caregivers: the DOMUS trial
Authors: Halling Christine Marie Bækø , Wolf Rasmus Trap , Sjøgren Per , Von Der Maase Hans , Timm Helle , Johansen Christoffer , Kjellberg Jakob
Published: September 2020

Background

While hospitals remain the most common place of death in many western countries, specialised palliative care (SPC) at home is an alternative to improve the quality of life for patients with incurable cancer. We evaluated the cost-effectiveness of a systematic fast-track transition process from oncological treatment to SPC enriched with a psychological intervention at home for patients with incurable cancer and their caregivers.

Methods

A full economic evaluation with a time horizon of six months was performed from a societal perspective within a randomised controlled trial, the DOMUS trial (Clinicaltrials.gov: NCT01885637). The primary outcome of the health economic analysis was a incremental cost-effectiveness ratio (ICER), which is obtained by comparing costs required per gain in Quality-Adjusted Life Years (QALY). The costs included primary and secondary healthcare costs, cost of intervention and informal care from caregivers. Public transfers were analysed in seperate analysis. QALYs were measured using EORTC QLQ-C30 for patients and SF-36 for caregivers. Bootstrap simulations were performed to obtain the ICER estimate.

Results

In total, 321 patients (162 in intervention group, 159 in control group) and 235 caregivers (126 in intervention group, 109 in control group) completed the study. The intervention resulted in significantly higher QALYs for patients when compared to usual care (p-value = 0.026), while being more expensive as well. In the 6 months observation period, the average incremental cost of intervention compared to usual care was €2015 per patient (p value < 0.000). The mean incremental gain was 0.01678 QALY (p-value = 0.026). Thereby, the ICER was €118,292/QALY when adjusting for baseline costs and quality of life. For the caregivers, we found no significant differences in QALYs between the intervention and control group (p-value = 0.630). At a willingness to pay of €80,000 per QALY, the probability that the intervention is cost-effective lies at 15% in the base case scenario.

Conclusion

This model of fast-track SPC enriched with a psychological intervention yields better QALYs than usual care with a large increase in costs.

Trial registration

The trial was prospectively registered 25.6.2013. Clinicaltrials.gov Identifier: NCT01885637.
From twisting to settling down as a nurse in China: a qualitative study of the commitment to nursing as a career
Authors: Ye Jiao , Mao Aimei , Wang Jialin , Okoli Chizimuzo T. C. , Zhang Yuan , Shuai Huiqiong , Lin Min , Chen Bo , Zhuang Linli
Published: September 2020

Background

The nurse workforce shortage, partially caused by high work turnover, is an important factor influencing the quality of patient care. Because previous studies concerning Chinese nurse work turnover were predominantly quantitative, they lacked insight into the challenges faced by nurses as they transition from university to their career. A successful transition can result in new nurses’ commitment to the career. As such, this study sought to understand how new nurses commit to the career, and focused on identifying facilitators and barriers to such commitment.

Methods

This was a qualitative study using a grounded theory design. Through purposive sampling, clinical nurses were recruited from hospitals in Western China to participate in semi-structured interviews. The data was analyzed through coding to develop categories and themes.

Results

Theoretical saturation was achieved after interviewing 25 participants. The data revealed the ‘zigzag journey’ of committing to the nursing career. The emerging core theme was “getting settled”, indicating that new nurses needed to acclimate to the work reality in the nursing career. By analyzing the data provided by the participants, the researchers concluded that the journey to getting settled in nursing compassed four stages:1) “sailing out with mixed feelings”, 2) “contemplating to leave”, 3) “struggling to stay”, and 4) “accepting the role”. For most participants, nursing was described as a way to earn a living for their family, not as a career about which they felt passionate.

Conclusions

Committing to the nursing career is a complicated long-term process. There seems to be a lack of passion for nursing among the Chinese clinical nurses participating in this study. Thus, the nurses may need continued support at different career stages to enhance their ability to remain a nurse for more than economic reasons.
Reflecting on “Marketing communications in health and medicine: perspectives from Willis-Knighton Health System”: understanding the big picture
Authors: Elrod James K. , Fortenberry John L.
Published: September 2020

Background

Willis-Knighton Health System’s special supplement in BMC Health Services Research, “Marketing communications in health and medicine: perspectives from Willis-Knighton Health System,” focuses on advertising, public relations, sales promotion, and related communicative avenues, associated theory, and more. Across the supplement’s articles, insights from the institution’s experiences are presented, addressing the components of the marketing communications mix, foundational elements of communication, the patronage process, and the necessity for integrating marketing communications.

Discussion

As an understanding of the big picture is crucial in marketing communications, especially given that many of its components must be effected simultaneously, this particular article takes the insights provided in the supplement and presents them in an operational framework, demonstrating the marketing communications process. This framework concisely summarizes the facets profiled in the associated articles, permitting readers to see how these pieces work in concert with one another in health and medical settings, providing a basic communications structure which healthcare establishments can use to advance their patient engagement initiatives.

Conclusions

Health and medical providers must ensure that they possess a detailed understanding of core marketing communications facets, but as they acquire associated knowledge, they also must direct attention toward understanding the interrelationships between and among these facets, permitting a global perspective of communicative operations. This particular article summarizes insights from Willis-Knighton Health System’s special supplement in BMC Health Services Research, providing a pathway toward realizing big picture marketing communications perspectives.
Impact of the Programa Mais médicos (more doctors Programme) on primary care doctor supply and amenable mortality: quasi-experimental study of 5565 Brazilian municipalities
Authors: Hone Thomas , Powell-Jackson Timothy , Santos Leonor Maria Pacheco , de Sousa Soares Ricardo , de Oliveira Felipe Proenço , Sanchez Mauro Niskier , Harris Matthew , de Oliveira de Souza Santos Felipe , Millett Christopher
Published: September 2020

Background

Investing in human resources for health (HRH) is vital for achieving universal health care and the Sustainable Development Goals. The Programa Mais Médicos (PMM) (More Doctors Programme) provided 17,000 doctors, predominantly from Cuba, to work in Brazilian primary care. This study assesses whether PMM doctor allocation to municipalities was consistent with programme criteria and associated impacts on amenable mortality.

Methods

Difference-in-differences regression analysis, exploiting variation in PMM introduction across 5565 municipalities over the period 2008–2017, was employed to examine programme impacts on doctor density and mortality amenable to healthcare. Heterogeneity in effects was explored with respect to doctor allocation criteria and municipal doctor density prior to PMM introduction.

Results

After starting in 2013, PMM was associated with an increase in PMM-contracted primary care doctors of 15.1 per 100,000 population. However, largescale substitution of existing primary care doctors resulting in a net increase of only 5.7 per 100,000. Increases in both PMM and total primary care doctors were lower in priority municipalities due to lower allocation of PMM doctors and greater substitution effects. The PMM led to amenable mortality reductions of − 1.06 per 100,000 (95%CI: − 1.78 to − 0.34) annually – with greater benefits in municipalities prioritised for doctor allocation and where doctor density was low before programme implementation.

Conclusions

PMM potential health benefits were undermined due to widespread allocation of doctors to non-priority areas and local substitution effects. Policies seeking to strengthen HRH should develop and implement needs-based criteria for resource allocation.
Correction to: Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations
Authors: Ostuzzi Giovanni , Papola Davide , Gastaldon Chiara , Schoretsanitis Georgios , Bertolini Federico , Amaddeo Francesco , Cuomo Alessandro , Emsley Robin , Fagiolini Andrea , Imperadore Giuseppe , Kishimoto Taishiro , Michencigh Giulia , Nosé Michela , Purgato Marianna , Dursun Serdar , Stubbs Brendon , Taylor David , Thornicroft Graham , Ward Philip B. , Hiemke Christoph , Correll Christoph U. , Barbui Corrado
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
AuthentiCT: a model of ancient DNA damage to estimate the proportion of present-day DNA contamination
Authors: Peyrégne Stéphane , Peter Benjamin M.
Published: September 2020

Contamination from present-day DNA is a fundamental issue when studying ancient DNA from historical or archaeological material, and quantifying the amount of contamination is essential for downstream analyses. We present AuthentiCT, a command-line tool to estimate the proportion of present-day DNA contamination in ancient DNA datasets generated from single-stranded DNA libraries. The prediction is based solely on the patterns of post-mortem damage observed on ancient DNA sequences. The method has the power to quantify contamination from as few as 10,000 mapped sequences, making it particularly useful for analysing specimens that are poorly preserved or for which little data is available.
Single oral fixed-dose praziquantel-miltefosine nanocombination for effective control of experimental schistosomiasis mansoni
Authors: Eissa Maha M. , El-Azzouni Mervat Z. , El-Khordagui Labiba K. , Abdel Bary Amany , El-Moslemany Riham M. , Abdel Salam Sara A.
Published: September 2020

Background

The control of schistosomiasis has been centered to date on a single drug, praziquantel, with shortcomings including treatment failure, reinfection, and emergence of drug resistance. Drug repurposing, combination therapy or nanotechnology were explored to improve antischistosomal treatment. The aim of the present study was to utilize a novel combination of the three strategies to improve the therapeutic profile of praziquantel. This was based on a fixed-dose nanocombination of praziquantel and miltefosine, an antischistosomal repurposing candidate, co-loaded at reduced doses into lipid nanocapsules, for single dose oral therapy.

Methods

Two nanocombinations were prepared to provide 250 mg praziquantel-20 mg miltefosine/kg (higher fixed-dose) or 125 mg praziquantel-10 mg miltefosine/kg (lower fixed-dose), respectively. Their antischistosomal efficacy in comparison with a non-treated control and their praziquantel or miltefosine singly loaded counterparts was assessed in murine schistosomiasis mansoni. A single oral dose of either formulation was administered on the initial day of infection, and on days 21 and 42 post-infection. Scanning electron microscopic, parasitological, and histopathological studies were used for assessment. Preclinical data were subjected to analysis of variance and Tukeyʼs post-hoc test for pairwise comparisons.

Results

Lipid nanocapsules (~ 58 nm) showed high entrapment efficiency of both drugs (> 97%). Compared to singly loaded praziquantel-lipid nanocapsules, the higher nanocombination dose showed a significant increase in antischistosomal efficacy in terms of statistically significant decrease in mean worm burden, particularly against invasive and juvenile worms, and amelioration of hepatic granulomas (P ≤ 0.05). In addition, scanning electron microscopy examination showed extensive dorsal tegumental damage with noticeable deposition of nanostructures.

Conclusions

The therapeutic profile of praziquantel could be improved by a novel multiple approach integrating drug repurposing, combination therapy and nanotechnology. Multistage activity and amelioration of liver pathology could be achieved by a new praziquantel-miltefosine fixed-dose nanocombination providing 250 mg praziquantel-20 mg miltefosine/kg. To the best of our knowledge, this is the first report of a fixed-dose nano-based combinatorial therapy for schistosomiasis mansoni. Further studies are needed to document the nanocombination safety and explore its prophylactic activity and potential to hinder the onset of resistance to the drug components.
Interaction of Tau with the chemokine receptor, CX3CR1 and its effect on microglial activation, migration and proliferation
Authors: Chidambaram Hariharakrishnan , Das Rashmi , Chinnathambi Subashchandrabose
Published: September 2020

Alzheimer’s disease (AD) is a neurodegenerative disease that leads to progressive loss of memory and dementia. The pathological hallmarks of AD include extracellular accumulation of amyloid-β peptides forming senile plaques and intracellular accumulation of Tau oligomers and filamentous species. Tau is a microtubule-binding protein that stabilizes tubulin to form microtubules under physiological condition. In AD/ pathological condition, Tau detaches from microtubules and aggregates to form oligomers of different sizes and filamentous species such as paired helical filaments. Microglia are the resident brain macrophages that are involved in the phagocytosis of microbes, cellular debris, misfolded and aggregated proteins. Chemokine receptor, CX3CR1 is mostly expressed on microglia and is involved in maintaining the microglia in a quiescent state by binding to its ligand, fractalkine (CX3CL1), which is expressed in neurons as both soluble or membrane-bound state. Hence, under physiological conditions, the CX3CR1/CX3CL1 axis plays a significant role in maintaining the central nervous system (CNS) homeostasis. Further, CX3CR1/CX3CL1 signalling is involved in the synthesis of anti-inflammatory cytokines and also has a significant role in cytoskeletal rearrangement, migration, apoptosis and proliferation. In AD brain, the expression level of fractalkine is reduced, and hence Tau competes to interact with its receptor, CX3CR1. In microglia, phagocytosis and internalization of extracellular Tau species occurs in the presence of a chemokine receptor, CX3CR1 which binds directly to Tau and promotes its internalization. In this review, the pathophysiological roles of CX3CR1/fractalkine signalling in microglia and neurons at different stages of Alzheimer’s disease and the possible role of CX3CR1/Tau signalling has been widely discussed.
Pharmacokinetic parameters and radiomics model based on dynamic contrast enhanced MRI for the preoperative prediction of sentinel lymph node metastasis in breast cancer
Authors: Liu Meijie , Mao Ning , Ma Heng , Dong Jianjun , Zhang Kun , Che Kaili , Duan Shaofeng , Zhang Xuexi , Shi Yinghong , Xie Haizhu
Published: September 2020

Background

To establish pharmacokinetic parameters and a radiomics model based on dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) for predicting sentinel lymph node (SLN) metastasis in patients with breast cancer.

Methods

A total of 164 breast cancer patients confirmed by pathology were prospectively enrolled from December 2017 to May 2018, and underwent DCE-MRI before surgery. Pharmacokinetic parameters and radiomics features were derived from DCE-MRI data. Least absolute shrinkage and selection operator (LASSO) regression method was used to select features, which were then utilized to construct three classification models, namely, the pharmacokinetic parameters model, the radiomics model, and the combined model. These models were built through the logistic regression method by using 10-fold cross validation strategy and were evaluated on the basis of the receiver operating characteristics (ROC) curve. An independent validation dataset was used to confirm the discriminatory power of the models.

Results

Seven radiomics features were selected by LASSO logistic regression. The radiomics model, the pharmacokinetic parameters model, and the combined model yielded area under the curve (AUC) values of 0.81 (95% confidence interval [CI]: 0.72 to 0.89), 0.77 (95% CI: 0.68 to 0.86), and 0.80 (95% CI: 0.72 to 0.89), respectively, for the training cohort and 0.74 (95% CI: 0.59 to 0.89), 0.74 (95% CI: 0.59 to 0.90), and 0.76 (95% CI: 0.61 to 0.91), respectively, for the validation cohort. The combined model showed the best performance for the preoperative evaluation of SLN metastasis in breast cancer.

Conclusions

The model incorporating radiomics features and pharmacokinetic parameters can be conveniently used for the individualized preoperative prediction of SLN metastasis in patients with breast cancer.
Development of risk prediction models to predict urine culture growth for adults with suspected urinary tract infection in the emergency department: protocol for an electronic health record study from a single UK university hospital
Authors: Rockenschaub Patrick , Gill Martin J. , McNulty David , Carroll Orlagh , Freemantle Nick , Shallcross Laura
Published: September 2020

Background

Urinary tract infection (UTI) is a leading cause of hospital admissions and is diagnosed based on urinary symptoms and microbiological cultures. Due to lags in the availability of culture results of up to 72 h, and the limitations of routine diagnostics, many patients with suspected UTI are started on antibiotic treatment unnecessarily. Predictive models based on routinely collected clinical information may help clinicians to rule out a diagnosis of bacterial UTI in low-risk patients shortly after hospital admission, providing additional evidence to guide antibiotic treatment decisions.

Methods

Using electronic hospital records from Queen Elizabeth Hospital Birmingham (QEHB) collected between 2011 and 2017, we aim to develop a series of models that estimate the probability of bacterial UTI at presentation in the emergency department (ED) among individuals with suspected UTI syndromes. Predictions will be made during ED attendance and at different time points after hospital admission to assess whether predictive performance may be improved over time as more information becomes available about patient status. All models will be externally validated for expected future performance using QEHB data from 2018/2019.

Discussion

Risk prediction models using electronic health records offer a new approach to improve antibiotic prescribing decisions, integrating clinical and demographic data with test results to stratify patients according to their probability of bacterial infection. Used in conjunction with expert opinion, they may help clinicians to identify patients that benefit the most from early antibiotic cessation.
Pembrolizumab on pre-existing inclusion body myositis: a case report
Authors: Uchio Naohiro , Unuma Atsushi , Kakumoto Toshiyuki , Osaki Masao , Zenke Yoshitaka , Sakuta Kenichi , Kubota Akatsuki , Uesaka Yoshikazu , Toda Tatsushi , Shimizu Jun
Published: September 2020

Background

Cases of exacerbation of pre-existing neuromuscular diseases induced by immune checkpoint inhibitors (ICIs) have rarely been reported because patients with autoimmune diseases have generally been excluded from ICI therapy due to the increased risk of exacerbation. We describe the first case of an elderly patient who experienced exacerbation of a previously undiagnosed sporadic inclusion body myositis (sIBM), the most common myopathy in the geriatric population, which was triggered by anti-programmed cell death-1 therapy.

Case presentation

A 75-year-old man who was receiving pembrolizumab presented with limb weakness. Three years prior, he had noticed slowly progressive limb weakness, but he received no diagnosis. After the first infusion of pembrolizumab, his creatine kinase (CK) levels had increased. The neurological examination and muscle biopsy findings confirmed the diagnosis of sIBM and suggested exacerbation of sIBM induced by pembrolizumab. After the patient’s CK levels decreased, pembrolizumab was restarted. The tumor progressed after its treatment with pembrolizumab. The patient died after 15 months of follow-up.

Conclusions

In patients with slowly progressive limb weakness, sIBM should be explored before ICI therapy. In addition, if patients show high CK levels after ICI introduction, it is necessary to confirm whether they have sIBM in order to avoid unnecessary immunosuppressive therapies and assess whether they can tolerate ICI reintroduction.