bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective cohort study of confirmed severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection during pregnancy evaluating SARS‐CoV‐2 antibodies in maternal and umbilical cord blood and SARS‐CoV‐2 in vaginal swabs
Authors: Milbak Julie , Holten Victoria M. F. , Axelsson Paul Bryde , Bendix Jane Marie , Aabakke Anna J. M. , Nielsen Lene , Friis Martin Barfred , Jensen Claus A. J. , Løkkegaard Ellen Christine Leth , Olsen Tina Elisabeth , Rode Line , Clausen Tine Dalsgaard
Published: November 2021

Introduction

Evidence about the consequences of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in pregnancy is rapidly increasing; however, data on antibody response and risk of transmission during pregnancy and delivery are still limited. The aim of this study was to evaluate if SARS‐CoV‐2 is detectable in vaginal swabs and whether antibodies against SARS‐CoV‐2 are present in maternal and umbilical cord blood of pregnant women with confirmed SARS‐CoV‐2.

Material and methods

A single‐unit prospective cohort study in Denmark including pregnant women with SARS‐CoV‐2 infection confirmed by a pharyngeal swab between August 20, 2020, and March 1, 2021, who gave birth during the same period. All patients admitted to the maternity ward and antepartum clinic were screened for SARS‐CoV‐2 infection. A maternal blood sample and vaginal swabs were collected at inclusion. If included antepartum, these samples were repeated intrapartum when an umbilical cord blood sample was also collected. Swabs were analyzed for SARS‐CoV‐2 and blood samples were analyzed for SARS‐CoV‐2 total antibodies. Placental and neonatal swabs as well as placental histopathological examinations were performed on clinical indications.

Results

We included 28 women, of whom four had serious maternal or fetal outcomes including one case of neonatal death. Within the first 8 days after confirmed SARS‐CoV‐2 infection, SARS‐CoV‐2 was detectable in two vaginal swabs (2/28) and SARS‐CoV‐2 antibodies were detected in 1 of 13 women. From 16 days after confirmed infection, antibodies were observed in 19 of 21 of women. Antibodies in cord blood were not detected during the first 16 days after confirmed infection (n = 7). However, from 26 days, antibodies were present in 16 of 17 cord blood samples of seropositive mothers. Placental examination in two cases of severe fetal outcomes preceded by reduced fetal movements revealed SARS‐CoV‐2 in swabs and severe histopathological abnormalities.

Conclusions

SARS‐CoV‐2 was detected in only 2 of 28 vaginal swabs within 8 days after confirmed infection in pregnant women. Our data suggest that maternal seroconversion occurs between days 8 and 16, whereas antibodies in cord blood of seropositive mothers were present in the majority from 26 days after confirmed infection. Additional data are needed regarding timing of seroconversion for the mother and appearance of antibodies in cord blood.
Understanding “Zoom fatigue”: A mixed‐method approach
Authors: Nesher Shoshan Hadar , Wehrt Wilken
Published: November 2021

Video conference meetings, which became frequent during the COVID‐19 pandemic, might result in exhaustion (so‐called “Zoom fatigue”). However, only little is known about “Zoom fatigue,” the objective characteristics shaping it, and the subjective experiences eliciting this phenomenon. Gaining this knowledge is critical for understanding work life during the pandemic. Study 1, a within‐person quantitative investigation, tested whether video conferences are exhausting and if objective characteristics (i.e. meeting size, meeting duration, and the presence of the supervisor) moderate “Zoom fatigue”. Employees from Germany and Israel (N = 81) participated in a 2‐week study, with meetings nested within persons (n = 988). Results showed that video conferences are exhausting—more than meetings held through other media. However, objective characteristics did not moderate this relationship. In Study 2, qualitative data from Germany and Israel (N = 53) revealed employees' subjective experiences in video conferences that may lead to “Zoom fatigue”. These include, for example, experiences of loss and comparison with the “good old times” before the pandemic. Employees suggested ways to mitigate “Zoom fatigue,” particularly, better management of meetings by leaders. Our results provide empirical support for “Zoom fatigue” and suggest which subjective experiences elicit this phenomenon, opening directions for research and practice.
The environmental impact of inhalers for asthma: A green challenge and a golden opportunity
Authors: Wilkinson Alex , Woodcock Ashley
Published: November 2021

The propellants in metered‐dose inhalers (MDIs) are powerful greenhouse gases, which account for approximately 13% of the NHS's carbon footprint related to the delivery of care. Most MDI use is in salbutamol relievers in patients with poorly controlled disease. The UK lags behind Europe in this regard, with greater reliance on salbutamol MDI and correspondingly greater greenhouse gas emissions, roughly treble that of our European neighbours. There has been a broad switch towards MDIs in asthma treatment in the UK over the last 20 years to reduce financial costs, such that the treatment for two‐thirds of asthma patients in the UK is dominated by salbutamol MDI. Strategies that replace overuse of reliever MDIs with regimes emphasising inhaled corticosteroids have the potential to improve asthma control alongside significant reductions in greenhouse gas emissions. Real‐world evidence shows that once‐daily long‐acting combination dry‐powder inhalers (DPIs) can improve compliance and asthma control, and reduce the carbon footprint of care. Similarly, maintenance and reliever therapy (MART), which uses combination reliever and inhaled steroids in one device (usually a DPI), can simplify therapy, improve asthma control and reduce greenhouse gas emissions. Both treatment strategies are popular with patients, most of whom would be willing to change treatment to reduce their carbon footprint.

By focussing on patients who are currently using high amounts of salbutamol MDI and prioritising inhaled steroids via DPIs, there are golden opportunities to make asthma care in the UK more effective, safer and greener.
Transition stories: Voices of school leavers with intellectual disabilities
Authors: Scanlon Geraldine , Doyle Alison
Published: November 2021

Accessible summary

This paper focuses on the transition stories of young people with intellectual disabilities.

People with intellectual disabilities have the lowest participation rates in further education training and employment.

A model of supported transition places the young person at the centre of the process.

Young people with intellectual disabilities have the same dreams and aspirations for their lives as everybody else.

This paper found that the model of supported transition aligns with proposed national polices in the Republic of Ireland.

Background

The principal destinations for school leavers with intellectual disabilities from special schools in Ireland are further education (FE) through providers such as the National Learning Network or training and employment (TE) within adult day services and rehabilitation centres. In 2015, a number of inherent barriers to participation in FE/TE for young people with intellectual disabilities were identified. These were found to be linked to attitudes, stigma and low expectations of their capabilities. This resulted in the development of a supported transition model WALK PEER (Providing Equal Employment Routes).

Methods

This study explored the experiences of school leavers with intellectual disabilities who were engaging with the WALK PEER model. Data were collected from a purposive sample of 31 students with intellectual disabilities from two special schools: Group 1 (Pre‐transition) students in the penultimate year of formal education, Group 2 (Transitioning) students in the final year of formal education and Group 3 (Post‐transition) had left school two years previously.

Findings

Engaging in the supported transition programme provided young people with access to information, options, confidence and some of the hard and soft skills required for successful transition into education and employment contexts.

Conclusions

The findings demonstrate a strong correlation between support programmes, transition planning and positive transitions, which is critical if young people with intellectual disabilities are to realise their goals. The research proposes a new model of“Supported Transition”that has clear implications for the development of a national transition policy as directed by the Comprehensive Employment Strategy.
Multi‐source BERT stack ensemble for cross‐domain author profiling
Authors: Delmondes Neto José Pereira , Paraboni Ivandré
Published: November 2021

Author profiling is the computational task of inferring an author's demographics (e.g., gender, age etc.) based on text samples written by them. As in other text classification tasks, optimal results are usually obtained by using training data taken from the same text genre as the target application, in so‐called in‐domain settings. On the other hand, when training data in the required text genre is unavailable, a possible alternative is to perform cross‐domain author profiling, that is, building a model from a source domain (e.g., Facebook posts), and then using it to classify text in a different target domain (e.g., e‐mails.) Methods of this kind may however suffer from cross‐domain vocabulary discrepancies and other difficulties. As a means to ameliorate these, the present work discusses a particular strategy for cross‐domain author profiling in which multiple source domains are combined in a stack ensemble architecture of pre‐trained language models. Results from this approach are shown to compare favourably against standard single‐source cross‐domain author profiling, and are found to reduce overall accuracy loss in comparison with optimal in‐domain gender and age classification.
Compassionate practice in a hospital setting. Experiences of patients and health professionals: A narrative inquiry
Authors: Durkin Joanne , Jackson Debra , Usher Kim
Published: November 2021

Aim

To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting.

Background

Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients.

Design

Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ).

Methods

Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework.

Results

Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering.

Conclusion

Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting.

Impact

Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice.
Mental health risk among children during COVID‐19 lockdown
Authors: Asif Marium , Ullah Irfan , Kumari Usha , Munir Saqib , Tahir Muhammad Junaid , Asghar Muhammad Sohaib
Published: November 2021

The COVID‐19 pandemic has created a hugely detrimental impact on the psychological health of people around the world. Children are extremely vulnerable; therefore, it is of utmost importance to discuss the prevalence of the symptoms, their associated risk factors, and the strategies to identify and understand their deteriorating mental health (MH) before it leads to disastrous outcomes. Hence, parents and schools should come together in devising modes to create an environment in which children can easily tackle the lockdown periods which have become the new reality. Negative effects on MH have long‐term consequences, therefore necessary interventions must take place.
Management of intrauterine adhesions using human amniotic mesenchymal stromal cells to promote endometrial regeneration and repair through Notch signalling
Authors: Yu Jie , Zhang Wenwen , Huang Jiayue , Gou Yating , Sun Congcong , Zhang Yingfeng , Mao Yanhua , Wu Benyuan , Li Changjiang , Liu Nizhou , Wang Tingting , Huang Jiren , Wang Jia
Published: November 2021

Intrauterine adhesions (IUAs) severely hamper women's reproductive functions. Human amniotic mesenchymal stromal cell (hAMSC) transplantation is effective in treating IUAs. Here, we examined the function of Notch signalling in IUA treatment with hAMSC transplantation. Forty‐five Sprague‐Dawley female rats were randomly divided into the sham operation, IUA, IUA + E2, IUA + hAMSCs and IUA + hAMSCs + E2 groups. After IUA induction in the rats, hAMSCs promoted endometrial regeneration and repair via differentiation into endometrial epithelial cells. In all groups, the expression of key proteins in Notch signalling was detected in the uterus by immunohistochemistry. The results indicated Notch signalling activation in the hAMSCs and hAMSCs + E2 groups. We could also induce hAMSC differentiation to generate endometrial epithelial cells in vitro. Furthermore, the inhibition of Notch signalling using the AdR‐dnNotch1 vector suppressed hAMSC differentiation (assessed by epithelial and mesenchymal marker levels), whereas its activation using the AdR‐Jagged1 vector increased differentiation. The above findings indicate Notch signalling mediates the differentiation of hAMSCs into endometrial epithelial cells, thus promoting endometrial regeneration and repair; Notch signalling could have an important function in IUA treatment.
Morphology and chemical characteristics of taste buds associated with P2X3‐immunoreactive afferent nerve endings in the rat incisive papilla
Authors: Ito Motoi , Yokoyama Takuya , Hirakawa Masato , Yamamoto Yoshio , Sakanoue Wakana , Sato Kenichi , Saino Tomoyuki
Published: November 2021

The present study investigated the cellular components and afferent innervations of taste buds in the rat incisive papilla by immunohistochemistry using confocal scanning laser microscopy. Taste buds containing guanine nucleotide‐binding protein G(t), subunit α3 (GNAT3)‐imunoreactive cells were densely distributed in the lateral wall of incisive papilla forming the opening of nasoincisor ducts. GNAT3‐immunoreactive cells in the taste buds were slender in shape and the tips of apical processes gathered at one point at the surface of the epithelium. The number of taste buds was 56.8 ± 4.5 in the incisive papilla. The incisive taste buds also contained ectonucleoside triphosphate diphosphohydrolase 2‐immunoreactive cells and synaptotagmin‐1‐immunoreactive cells in addition to GNAT3‐immunoreactive cells. Furthermore, GNAT3‐immunoreactive cells were immunoreactive to taste transduction molecules such as phospholipase C, β2‐subunit, and inositol 1,4,5‐trisphosphate receptor, type 3. P2X3‐immunoreactive subepithelial nerve fibers intruded into the taste buds and terminated with hederiform or calix‐like nerve endings attached to GNAT3‐immunoreactive cells and synaptosomal‐associated protein, 25 kDa‐immunoreactive cells. Some P2X3‐immunoreactive endings were also weakly immunoreactive for P2X2. Furthermore, a retrograde tracing method using fast blue dye indicated that most of the P2X3‐immunoreactive nerve endings originated from the geniculate ganglia (GG) of the facial nerve. These results suggest that incisive taste buds are morphologically and cellularly homologous to lingual taste buds and are innervated by P2X3‐immunoreactive nerve endings derived from the GG. The incisive papilla may be the palatal taste papilla that transmits chemosensory information in the oral cavity to the GG via P2X3‐immunoreactive afferent nerve endings.
Stability and change in levels of work–family conflict: A multi‐study, longitudinal investigation
Authors: Smith Claire E. , Wayne Julie Holliday , Matthews Russell A. , Lance Charles E. , Griggs Tracy L. , Pattie Marshall W.
Published: November 2021

There has been little theoretical and empirical attention to the role of time in studying levels of work–family conflict. Contrary to theoretical assumptions that work–family conflict is a highly dynamic construct, we borrow from established theories to describe a Stability and Change Model, which posits that work–family conflict levels are primarily stable with some meaningful change over time. The proposed model also outlines predictors of stability (and change) in work–family conflict levels: stability (or change) in‐person (i.e., neuroticism) and situational factors (i.e., role demands and, to a lesser extent, resources). Findings across two longitudinal studies with timeframes of 5 months (one‐month lags) and 3 years (one‐year lags) suggest that 75–80% of the observed variance in work–family conflict levels is stable over mid‐ to long‐term timeframes. In line with our Stability and Change Model, trait‐state‐occasion modelling results indicate that stability in work–family conflict is primarily due to stability in workload demands and to a lesser extent, personality factors (i.e., neuroticism), but, unexpectedly, not resources. There was some meaningful change in work–family conflict levels over time, primarily due to changes in demands and to a lesser extent, changes in person characteristics. Theoretical, methodological, and analytical considerations for future studies of work–family conflict levels are discussed.

Practitioner points

WFC levels may be very resistant to change.

Our findings highlight the importance for organizations to make a sustained commitment to addressing factors that might create WFC rather than short‐term efforts.

Organizations may design impactful interventions by aiming to significantly and durably reduce job demands, specifically:

High involvement work practices that foster empowerment, information sharing, rewards, and training have been shown to reduce job demands including role overload (Kilroy et al., 2016, Human Resource Management Journal, 26, 408).

Supervisors could reduce workload by eliminating unnecessary tasks or prioritizing most important tasks and/or developing employees’ time management skills so they can accomplish important job tasks in the time available.

Reducing hindrance stressors such as role ambiguity and hassles tend not to be as relevant.

Organizations may also want to consider person variables (e.g., personality, affect) by training for individual characteristics that may help employees manage WFC such as mindfulness training.
Thirty years of illiberal democracy in Guanajuato
Authors: Sánchez‐Gutiérrez Arturo , Moreno López Margarita
Published: November 2021

Guanajuato was the second state in Mexico to have political alternation, in 1991. Additionally, it was one of the first states in which there was political alternation at the municipal level, in the 1980s. Since then, alternation at that level of government is frequent. Even though this situation might lead us to think of Guanajuato as a state that has been democratically consolidated over the last 30 years, we find illiberal structures and practices that have been repeated over time and that have come to damage the democratic exercise in the state. This article describes each of the illiberal practices and structures, using data and a case study.
Long‐term warming effects on the microbiome andnifHgene abundance of a common moss species in sub‐Arctic tundra
Authors: Klarenberg Ingeborg J. , Keuschnig Christoph , Russi Colmenares Ana J. , Warshan Denis , Jungblut Anne D. , Jónsdóttir Ingibjörg S. , Vilhelmsson Oddur
Published: November 2021

Bacterial communities form the basis of biogeochemical processes and determine plant growth and health. Mosses harbour diverse bacterial communities that are involved in nitrogen fixation and carbon cycling. Global climate change is causing changes in aboveground plant biomass and shifting species composition in the Arctic, but little is known about the response of moss microbiomes in these environments.

Here, we studied the total and potentially active bacterial communities associated withRacomitrium lanuginosumin response to a 20‐yrin situwarming in an Icelandic heathland. We evaluated the effect of warming and warming‐induced shrub expansion on the moss bacterial community composition and diversity, andnifHgene abundance.

Warming changed both the total and the potentially active bacterial community structure, while litter abundance only affected the total bacterial community structure. The abundance ofnifHgenes was negatively affected by litter abundance. We also found shifts in the potentially nitrogen‐fixing community, withNostocdecreasing and noncyanobacterial diazotrophs increasing in relative abundance.

Our data suggest that the moss microbial community and potentially nitrogen fixing taxa will be sensitive to future warming, partly via changes in litter and shrub abundance.
Photophysicochemical and Biological Properties of New Phthalocyanines Bearing 4‐(trifluoromethoxy)phenoxy and 2‐(4‐methylthiazol‐5‐yl)ethoxy Groups on Peripheral Positions
Authors: Farajzadeh Nazli , Özdemir Sadin , Gonca Serpil , Atmaca Göknur Yaşa , Erdoğmuş Ali , Bayır Zehra Altuntaş , Koçak Makbule Burkut
Published: November 2021

As thiazoles and fluorinated groups are well known as active species of hybrid pharmaceutical agents, this study aimed to evaluate the synergic effect of these groups on the biological features of phthalocyanines for the first time in the hope of discovering efficient pharmaceutical agents. Therefore, a new phthalonitrile derivative namely 4‐(2‐(4‐methylthiazol‐5‐yl)ethoxy)‐5‐(4‐(trifluoromethoxy)phenoxy)phthalonitrile (1) and its metal‐free (2)/metal phthalocyanines (3‐5) were prepared and characterized using various spectroscopic techniques. Solubility of new phthalocyanines (2‐5) was examined in a series of polar and nonpolar solvents. Additionally, sono/photochemical methods were applied to examine the photophysical and sono/photochemical properties of new zinc phthalocyanine to measure its potential as a probable material for sono/photodynamic therapies. The antioxidant activities of compounds (1‐5) were evaluated using the DPPH scavenging activity method and the highest radical scavenging activity was obtained 92.13% (200 mg L−1) for manganese phthalocyanine. All the phthalocyanines demonstrated high DNA nuclease activity, as well. The antimicrobial activities of compounds (1‐5) were investigated using disk diffusion and microdilution methods. The phthalocyanines exhibited effective microbial cell inhibition activity against Escherichia coli (E. coli). Antimicrobial photodynamic therapy activity was investigated against E. coli by LED irradiation. Compounds (2‐5) acted as photosynthesizers. Also, they displayed significant biofilm inhibition activity against Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa).
Ultrasonographic observation in combination with progesterone monitoring for detection of ovulation in Labrador Retrievers
Authors: Tsuchida Mei , Komura Nako , Yoshihara Tatsuya , Kawasaki Yuta , Sakurai Daichi , Suzuki Hiroshi
Published: November 2021

Although it is well known that the ovulation occurs during a period of time after LH surge in dogs, there are few reports of observing the entire process of development, ovulation and luteinization of each follicle. This study aimed to detect the ovulation kinetics by ultrasonography in combination with progesterone monitoring and therefore identify the time‐range of the ovulation process in a dog. Daily transabdominal ultrasonography and progesterone monitoring were conducted for 24 natural oestrus cycles of Labrador Retrievers. Ovarian follicles were observed as anechoic structure with contours before ovulation. Ovulation (follicular collapse) was defined as when follicles became cloudy and contours obscure by transabdominal ultrasonography. Ultrasound imaging was capable of identifying the day of ovulation for 94.7% (178/188) of the follicles through the appearance of collapsed follicle or corpus luteum. Ovulation was observed between LH 0 (the day of LH surge) and LH 5, with 48.0%, 33.5% and 15.0% for LH 2, LH 3 and LH 1, respectively. The total number of ovulations on LH 2 and LH 3 accounted for 81.5% (141/173) of the total ovulation in 24 cycles examined. Ovulation occurred in 12 cycles for 2 d and for 3 d in 12 cycles. Seventeen cycles (70.8%) with multiple days of ovulation showed the largest number of ovulations on LH 2. The average follicle diameter 3 d before the LH surge was less than 5 mm, then exceeded 5 mm 2 d before the LH surge. The average follicle diameter at the time of ovulation (follicular collapse) was 6.1 ± 1.0 mm (n = 118). On the day before ovulation, the average diameters of the follicles ovulated on LH 1, LH 2 and LH 3 were 5.0 ± 0.7 mm, 5.8 ± 1.2 mm and 6.2 ± 1.3 mm, respectively. There was a significant difference in the follicle diameter between LH1 and LH2 (p < .001), LH2 and LH3 (p < .05), and LH1 and LH3 (p < .001). Suggesting that it is difficult to estimate the ovulation day based on follicle size. This study showed that combination of ultrasonography with progesterone monitoring could follow follicular development, ovulation and luteinization of the ovary in Labrador Retrievers. The direct visualization of the ovulation was achieved in a non‐invasive, labour‐friendly way. Furthermore, the time‐range of the ovulation process was clarified in a dog. These results may contribute to an accurate understanding of the optimum timing of mating and improved breeding efficiency, including artificial insemination and embryo transfer for Labrador Retrievers.
Aqueous angiography in pre‐glaucomatous and glaucomatous ADAMTS10‐mutant canine eyes: A pilot study
Authors: Burn Jessica B. , Huang Alex S. , Weber Arthur , Komáromy András M. , Pirie Christopher G.
Published: November 2021

Objective

To evaluate intravenous scleral and intracameral aqueous angiography in normotensive (n = 4) and hypertensive glaucomatous (n = 6) ADAMTS10‐mutant canine eyes.

Animals studied

Ten ADAMTS10‐mutant dogs were used in this study.

Procedures

Dogs were sedated and one eye from each dog underwent scleral angiography following intravenous injection of 0.25% indocyanine green (ICG). After a 24‐h recovery period, the same eye underwent aqueous angiography via intracameral administration of ICG. Imaging of identical scleral sectors from the same eye was performed using a Heidelberg Spectralis® Confocal Scanning Laser Ophthalmoscope. Intrascleral vessel depth and lumen diameters were measured using Heidelberg Spectralis® optical coherence tomography and computer software.

Results

Scleral angiography permitted visualization of vascular components associated with conventional aqueous humor outflow pathways with an average time from injection to fluorescence of 35.8 ± 10.6 s (mean ± SD). Two normotensive eyes (2/10;20%) demonstrated turbulent dye movement, while 4 hypertensive eyes (4/10;40%) exhibited laminar flow. Aqueous angiography demonstrated dye fluorescence within the post‐trabecular conventional aqueous humor outflow pathways in all 10 eyes at 34.3 ± 11.0 s post‐injection. Sectoral and dynamic outflow patterns were observed primarily within the superotemporal sector in nine eyes (9/10; 90%). Seven eyes (7/10; 70%) demonstrated pulsatile dye movement and five eyes (5/10; 50%) exhibited laminar flow. The degree of laminar movement of dye was greatest in hypertensive eyes. Vessel lumen diameters measured 133.85 ± 28.36 µm and 161.18 ± 6.02 µm in hypertensive and normotensive eyes, respectively.

Conclusions

Aqueous angiography allowed for visualization of fluorescent dye in the superotemporal sclera. Laminar flow and smaller lumen vessels were observed mainly in hypertensive eyes.
Adult patients’ experiences of patient-professional communication in patient portals: a qualitative systematic review protocol
Authors: Huhtakangas Moona , Tuomikoski Anna-Maria , Laukka Elina , Kääriäinen Maria , Kanste Outi
Published: November 2021

Objective:

The objective of the review is to identify, critically appraise, and synthesize the best available evidence on adult patients’ experiences of patient-professional communication in patient portals.

Introduction:

Alongside face-to-face communication, patient portals can improve care quality and patients’ self-management of chronic diseases. It is important to examine how patients experience patient-professional communication in patient portals because this digital environment inherently lacks non-verbal messages, which can lead to misunderstandings.

Inclusion criteria:

Qualitative studies that describe patients’ experiences of reciprocal patient-professional communication in patient portals will be included. Patients must be over the age of 18 years and have a need for long-term care delivered by a health care professional (eg, patients with chronic diseases, such as cancer or diabetes). The health care professionals considered for inclusion are the members of the patient's health care team who communicate with the patient using patient portals. A patient portal is defined as a personal health record, which is either an independent webpage or interconnected with an electronic health record.

Methods:

The following databases will be searched: MEDLINE (PubMed), CINAHL (EBSCO), ProQuest (Abi/Inform), Scopus, Medic, Google Scholar, Science Direct and Cochrane CENTRAL. Gray literature will be searched in MedNar. Studies published in English, Finnish, or Swedish will be considered, and there is no date limitation. Studies will be screened and critically appraised for methodological quality by two independent researchers. Data will be extracted using a standardized tool from JBI SUMARI. Data synthesis will be conducted according to the meta-aggregation approach. Confidence in the evidence will be assessed using the ConQual approach.

Systematic review registration number:

PROSPERO CRD42021286177
When persistence doesn't pay
Authors: Brosnan Sarah F.
Published: November 2021

Rats, mice, and humans all invest more time in a foraging task than is in their interest
Femtosecond structural photobiology
Authors: Moffat Keith
Published: November 2021

Time-resolved crystallography reveals how bacteriorhodopsin uses light to drive chemistry
A Combination of Amino Acid Mutations Leads to Resistance to Multiple Nucleoside Analogs in Reverse Transcriptases from HIV-1 Subtypes B and C
Authors: Boyer Paul L. , Rehm Catherine A. , Sneller Michael C. , Mican JoAnn , Caplan Margaret R. , Dewar Robin , Ferris Andrea L. , Clark Patrick , Johnson Adam , Maldarelli Frank , Hughes Stephen H.
Published: November 2021

Resistance to anti-HIV drugs has been a problem from the beginning of antiviral drug treatments. The recent expansion of combination antiretroviral therapy worldwide has led to an increase in resistance to antiretrovirals; understanding the mechanisms of resistance is increasingly important.
Highly Conserved
gsc1
Gene of Pneumocystis jirovecii in Patients with or without Prior Exposure to Echinocandins
Authors: Bonnet Pierre L. , Le Gal Solène , Hoffmann Claire V. , Morio Florent , Diabira Fouleymata , de Quélen Athéna , Curral Guillaume , Negri Steven , Cogulet Virginie , Huon Jean-François , Grégoire Matthieu , Papon Nicolas , Le Pape Patrice , Bouchara Jean-Philippe , Nevez Gilles
Published: November 2021

Echinocandins are noncompetitive inhibitors of the GSC1 subunit of the enzymatic complex involved in synthesis of 1,3-beta-
d
-glucan, a cell wall component of most fungi, including
Pneumocystis
spp. Echinocandins are widely used for treating systemic candidiasis and rarely used for treating
Pneumocystis
pneumonia.
Evaluation of Bacteriophage Cocktails Alone and in Combination with Daptomycin against Daptomycin-Nonsusceptible Enterococcus faecium
Authors: Morrisette Taylor , Lev Katherine L. , Canfield Gregory S. , Duerkop Breck A. , Kebriaei Razieh , Stamper Kyle C. , Holger Dana , Lehman Susan M. , Willcox Smaranda , Arias Cesar A. , Rybak Michael J.
Published: November 2021

Enterococcus faecium
is a significant multidrug-resistant pathogen. Bacteriophage cocktails are being proposed to complement antibiotic therapy.
Extreme metamorphism and metamorphic facies series at convergent plate boundaries: Implications for supercontinent dynamics
Authors: Zheng Yong-Fei , Chen Ren-Xu
Published: November 2021

Crustal metamorphism under extreme pressure-temperature conditions produces characteristic ultrahigh-pressure (UHP) and ultrahigh-temperature (UHT) mineral assemblages at convergent plate boundaries. The formation and evolution of these assemblages have important implications, not only for the generation and differentiation of continental crust through the operation of plate tectonics, but also for mountain building along both converging and converged plate boundaries. In principle, extreme metamorphic products can be linked to their lower-grade counterparts in the same metamorphic facies series. They range from UHP through high-pressure (HP) eclogite facies to blueschist facies at low thermal gradients and from UHT through high-temperature (HT) granulite facies to amphibolite facies at high thermal gradients. The former is produced by low-temperature/pressure (T/P) Alpine-type metamorphism during compressional heating in active subduction zones, whereas the latter is generated by high-T/P Buchan-type metamorphism during extensional heating in rifting zones. The thermal gradient of crustal metamorphism at convergent plate boundaries changes in both time and space, with low-T/P ratios in the compressional regime during subduction but high-T/P ratios in the extensional regime during rifting. In particular, bimodal metamorphism, one colder and the other hotter, would develop one after the other at convergent plate boundaries. The first is caused by lithospheric subduction at lower thermal gradients and thus proceeds in the compressional stage of convergent plate boundaries; the second is caused by lithospheric rifting at higher thermal gradients and thus proceeds in the extensional stage of convergent plate boundaries. In this regard, bimodal metamorphism is primarily dictated by changes in both the thermal state and the dynamic regime along plate boundaries. As a consequence, supercontinent assembly is associated with compressional metamorphism during continental collision, whereas supercontinent breakup is associated with extensional metamorphism during active rifting. Nevertheless, aborted rifts are common at convergent plate boundaries, indicating thinning of the previously thickened lithosphere during the attempted breakup of supercontinents in the history of Earth. Therefore, extreme metamorphism has great bearing not only on reworking of accretionary and collisional orogens for mountain building in continental interiors, but also on supercontinent dynamics in the Wilson cycle.
Identification of seasonal varves in the lower Pliocene Bouse Formation, lower Colorado River Valley, and implications for Colorado Plateau uplift
Authors: Spencer Jon E. , Constenius Kurt N. , Dettman David L. , Domanik Kenneth J.
Published: November 2021

The cause of Cenozoic uplift of the Colorado Plateau is one of the largest remaining problems of Cordilleran tectonics. Difficulty in discriminating between two major classes of uplift mechanisms, one related to lithosphere modification by low-angle subduction and the other related to active mantle processes following termination of subduction, is hampered by lack of evidence for the timing of uplift. The carbonate member of the Pliocene Bouse Formation in the lower Colorado River Valley southwest of the Colorado Plateau has been interpreted as estuarine, in which case its modern elevation of up to 330 m above sea level would be important evidence for late Cenozoic uplift. The carbonate member includes laminated marl and claystone interpreted previously in at least one locality as tidal, which is therefore of marine origin. We analyzed lamination mineralogy, oxygen and carbon isotopes, and thickness variations to discriminate between a tidal versus seasonal origin. Oxygen and carbon isotopic analysis of two laminated carbonate samples shows an alternating pattern of lower δ18O and δ13C associated with micrite and slightly higher δ18O and δ13C associated with siltstone, which is consistent with seasonal variation. Covariation of alternating δ18O and δ13C also indicates that post-depositional chemical alteration did not affect these samples. Furthermore, we did not identify any periodic thickness variations suggestive of tidal influence. We conclude that lamination characteristics indicate seasonal genesis in a lake rather than tidal genesis in an estuary and that the laminated Bouse Formation strata provide no constraints on the timing of Colorado Plateau uplift.
Paradoxical refractory hypotension following adrenaline administration in a patient taking clozapine
Authors: Alagappan Anand , Baruah Rosaleen , Cockburn Alastair , Sandilands Euan A
Published: November 2021

Clozapine is a potent antipsychotic commonly used for refractory schizophrenia. Adverse effects are well recognised including constipation, intestinal obstruction, agranulocytosis and cardiomyopathy. We present a case of paradoxical refractory hypotension following epinephrine administration in a patient taking clozapine. A psychiatric inpatient who had been taking clozapine for many years developed paralytic ileus and obstruction requiring surgical intervention. Following initiation of epinephrine administration intraoperatively he developed refractory hypotension which improved only when epinephrine was weaned off. This effect is likely due to uninterrupted β2-agonist activity in the presence of clozapine-induced α-blockade. Clinicians need to have greater awareness of this serious interaction and avoid the use of epinephrine in patients taking clozapine.
Substernal goitre presenting with upper and lower extremity oedema
Authors: Daggett Rebekah LeAnn Bennett , Farishta Daniel , Cuellar Hugo , Nathan Cherie-Ann O
Published: November 2021

Substernal goitre is characterised by compressive symptoms of the airway and oesophagus. Chronic, progressive symptoms usually result in surgical removal. We report a rare presentation of substernal goitre in a male in his early 70s who suffered from severe bilateral lower extremity (LE) lymphoedema, resulting in immobility and nursing home placement, and left upper extremity lymphoedema. Our initial assessment led to a filariasis work-up, which was negative, due to the patient’s prior 2-year residence in India and service overseas. Chest CT scan revealed an incidental substernal goitre extending posterior to the left innominate vein and aortic arch to the level of the left mainstem bronchus. The patient underwent a left hemithyroidectomy via cervical excision and sternotomy and had an uneventful recovery with resolution of lymphoedema and mobility. Despite extensive literature regarding clinical presentations of substernal goitre, severe lymphoedema of the LE is not a well-established association.
Home based rehabilitation after a knee replacement is as effective as physiotherapy
Authors: Saul Helen , Gursul Deniz
Published: November 2021

The study

Barker KL, Room J, Knight R, et al. Outpatient physiotherapy versus home-based rehabilitation for patients at risk of poor outcomes after knee arthroplasty: CORKA RCT.Health Technol Assess2020;24:1-116.

To read the full NIHR Alert, go to:https://evidence.nihr.ac.uk/alert/knee-replacements-home-based-rehabilitation-as-effective-physiotherapy/
Phase II, single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer
Authors: Lin Zhenyu , Cai Ming , Zhang Peng , Li Gang , Liu Tao , Li Xin , Cai Kailin , Nie Xiu , Wang Jing , Liu Junli , Liu Hongli , Zhang Weikang , Gao Jingbo , Wu Chuanqing , Wang Linfang , Fan Jun , Zhang Lan , Wang Zheng , Hou Zhiguo , Ma Chi , Yang Kunyu , Wu Gang , Tao Kaixiong , Zhang Tao
Published: November 2021

Background

In locally advanced rectal cancer (LARC), preoperative short-course radiotherapy (SCRT) with delayed surgery has been shown to be as effective as long-course chemoradiotherapy, with only modest benefits. This study aimed to evaluate the efficacy and safety of preoperative SCRT combined with subsequent CAPOX (capecitabine and oxaliplatin) and the anti-PD-1 antibody camrelizumab in patients with LARC.

Methods

This was a prospective, single-arm, phase II trial. Treatment-naïve patients with histologically confirmed T3-4N0M0 or T1-4N+M0 rectal adenocarcinoma received 5×5 Gy SCRT with two subsequent 21-day cycles of CAPOX plus camrelizumab after 1 week, followed by radical surgery after 1 week. The primary endpoint was pathological complete response (pCR) rate. Biomarker analysis was performed to identify a potential predictor of pCR to treatment.

Results

From November 7, 2019 to September 14, 2020, 30 patients were enrolled, and 27 patients received at least one dose of CAPOX plus camrelizumab. Surgery was performed in 27 (100%) patients. The pCR (ypT0N0) rate was 48.1% (13/27), including 46.2% (12/26) for proficient mismatch repair (MMR) tumors and 100% (1/1) for deficient MMR tumors. Immune-related adverse events were all grade 1–2, with the most common being reactive cutaneous capillary endothelial proliferation (81.5%). No grade 4/5 adverse events occurred. Biomarker analysis showed patients without FGFR1–3 deletions had a better tendency for pCR.

Conclusions

SCRT combined with subsequent CAPOX plus camrelizumab followed by delayed surgery showed a favorable pCR rate with good tolerance in patients with LARC, especially in the proficient MMR setting. A randomized controlled trial is ongoing to confirm these results.

Trial registration number

ClinicalTrials.gov identifier:NCT04231552.
Desiccation Keratitis
Authors: Ayoub J. E. M
Published: November 2021

(1) Temporary damage has been caused to the eyes of soldiers serving in the North African desert. The site is the corneal epithelium and the condition is transient.

(2) Discomfort, photophobia and impairment of vision are the outstanding symptoms.

(3) It is probable that the cause is drying of the corneal epithelium by a hot, dry wind which causes excessive evaporation of the lachrymal secretion over the exposed area of the cornea.

(4) The suggestion is put forward that corneal damage ascribed to snow-blindness is really caused, certainly in part, by desiccation and perhaps also freezing of the corneal epithelium and not by excessive ultra-violet light reflections.

(5) The condition could be prevented by the wearing of goggles.

(6) The name Desiccation Keratitis is suggested for the condition.
An Lp spaces-based mixed virtual element method for the two-dimensional Navier–Stokes equations
Authors: Gatica Gabriel N. , Sequeira Filánder A.
Published: November 2021

In this paper we extend the utilization of the Banach spaces-based formulations, usually employed for solving diverse nonlinear problems in continuum mechanics via primal and mixed finite element methods, to the virtual element method (VEM) framework and its respective applications. More precisely, we propose and analyze an [Formula: see text] spaces-based mixed virtual element method for a pseudostress-velocity formulation of the two-dimensional Navier–Stokes equations with Dirichlet boundary conditions. To this end, a dual-mixed approach determined by the introduction of a nonlinear tensor linking the usual pseudostress for the Stokes equations with the convective term is employed. As a consequence, this new tensor, say [Formula: see text], and the velocity [Formula: see text] of the fluid constitute the unknowns of the formulation, whereas the pressure is computed via a post-processing formula. The simplicity of the resulting VEM scheme is reflected by the absence of augmented terms, on the contrary to previous works on this and related models, and by the incorporation in it of only the projector onto the piecewise polynomial tensors and the usual stabilizer depending on the degrees of freedom of the virtual element subspace approximating [Formula: see text]. In turn, the non-virtual but explicit subspace given by the piecewise polynomial vectors of degree [Formula: see text] is employed to approximate [Formula: see text]. The corresponding solvability analysis is carried out by using appropriate fixed-point arguments, along with the discrete versions of the Babuška–Brezzi theory and the Banach–Nečas–Babuška theorem, both in subspaces of Banach spaces. A Strang-type lemma is applied to derive the a priori error estimates for the virtual element solution as well as for the fully computable approximation of [Formula: see text], the post-processed pressure, and a second post-processed approximation of [Formula: see text]. Finally, several numerical results illustrating the performance of the mixed-VEM scheme and confirming the rates of convergence predicted by the theory are reported.
Hybridization of the virtual element method for linear elasticity problems
Authors: Dassi Franco , Lovadina Carlo , Visinoni Michele
Published: November 2021

In this paper, we extend the hybridization procedure proposed in [D. N. Arnold and F. Brezzi, Mixed and nonconforming finite element methods: Implementation, postprocessing and error estimates, ESAIM Math. Model. Numer. Anal. 19 (1985) 7–32] to the Virtual Element Method for linear elasticity problems based on the Hellinger–Reissner principle. To illustrate such a technique, we focus on a specific 2D scheme, but other methods and 3D problems can be considered as well. We also show how to design a better approximation of the displacement field using a straightforward post-processing procedure. The numerical experiments confirm the theory for both two and three-dimensional problems.