bluuebunny/crossref_metadata_2025 huggingface dataset:
Editorial
Authors: Plontke Stefan K.
Published: April 2021

Seltene Erkrankungen stellen betroffene Patienten, ihre Angehörigen,
Ärzte, Pflegkräfte und Therapeuten oft vor besondere
Herausforderungen. Ihre Seltenheit erschwert aus medizinischen und
ökonomischen Gründen häufig die Forschung und die
medizinische Versorgung der betroffenen Patientinnen und Patienten. Die
komplexen Probleme, die mit der Diagnostik, Erforschung und Therapie seltener
Erkrankungen verbunden sind, wurden 1992 auf sehr bewegende Weise dem
Kinopublikum im Hollywood-Film „Lorenzos Öl“ dargelegt.
Der Regisseur George Miller verfilmte hier das reale Schicksal eines kleinen
Jungen, Lorenzo Michael Murphy Odone, bei dem 1984 im Alter von sechs Jahren die
seltene Nervenkrankheit Adrenoleukodystrophie (ALD) diagnostiziert worden war.
Zahlreiche der vielfältigen Probleme mit seltenen Erkrankungen, die im
Film dargestellt werden, existieren noch heute. Insbesondere in den letzten
Jahren sind jedoch die seltenen Erkrankungen immer mehr in das Licht der
öffentlichen Aufmerksamkeit gerückt.
Stochastic modeling for subgrid-scale particle dispersion in large-eddy simulation of inhomogeneous turbulence
Authors: Knorps Maria , Pozorski Jacek
Published: April 2021

We consider Lagrangian modeling of heavy particle motion in inhomogeneous turbulence. The dynamics of point particles is one-way coupled to the large-eddy simulation (LES) of fluid flow. To account for the effect of non-resolved (subgrid) flow scales on particle motion, we propose a model for the fluid velocity along the particle trajectories. The model, based on a stochastic diffusion process, accounts for turbulence anisotropy and utilizes the statistical estimates of subgrid quantities: the velocity components (the r.m.s. and covariance) and the Lagrangian time scales. The turbulent channel flow case is taken for validation. First, we discuss the outcome of an a priori LES study. Then, the proposed subgrid dispersion model is tested in a true LES computation. The resulting velocity statistics, particle concentration profiles, and the deposition velocity are compared against available reference data from direct numerical simulations.
Optic nerve microcirculation: Fluid flow and electrodiffusion
Authors: Zhu Yi , Xu Shixin , Eisenberg Robert S. , Huang Huaxiong
Published: April 2021

Complex fluids flow in complex ways in complex structures. Transport of water and various organic and inorganic molecules in the central nervous system (CNS) are important in a wide range of biological and medical processes [C. Nicholson and S. Hrabětová, “Brain extracellular space: The final frontier of neuroscience,” Biophys. J. 113(10), 2133 (2017)]. However, the exact driving mechanisms are often not known. In this paper, we investigate flows induced by action potentials in an optic nerve as a prototype of the CNS. Different from traditional fluid dynamics problems, flows in biological tissues such as the CNS are coupled with ion transport. It is driven by osmosis created by the concentration gradient of ionic solutions, which in turn influence the transport of ions. Our mathematical model is based on the known structural and biophysical properties of the experimental system used by the Harvard group [R. K. Orkand, J. G. Nicholls, and S. W. Kuffler, “Effect of nerve impulses on the membrane potential of glial cells in the central nervous system of amphibia,” J. Neurophysiol. 29(4), 788 (1966)]. Asymptotic analysis and numerical computation show the significant role of water in convective ion transport. The full model (including water) and the electrodiffusion model (excluding water) are compared in detail to reveal an interesting interplay between water and ion transport. In the full model, convection due to water flow dominates inside the glial domain. This water flow in the glia contributes significantly to the spatial buffering of potassium in the extracellular space. Convection in the extracellular domain does not contribute significantly to spatial buffering. Electrodiffusion is the dominant mechanism for flows confined to the extracellular domain.
Taxonomic revision of five species groups of ebracteate-erect
Authors: Meudt Heidi M.
Published: April 2021

Macro-morphological data were analysed to assess the distinctiveness and revise the taxonomy of 14 species, varieties and tag-named taxa in five informal species groups of ebracteate-erect forget-me-nots endemic to New Zealand. The following nine species are recognised: Myosotis albosericea Hook.f., M. brockiei L.B.Moore & M.J.A.Simpson, M. capitata Hook.f., M. concinna Cheeseman, M. goyenii Petrie, M. laeta Cheeseman, M. monroi Cheeseman, M. rakiura L.B.Moore, and M. traversii Hook.f. Three species have two allopatric subspecies each in the South Island, distinguished by few, minor morphological characters, including Myosotis brockiei subsp. brockiei and M. brockiei subsp. dysis Courtney & Meudt subsp. nov., M. goyenii subsp. goyenii and M. goyenii subsp. infima Meudt & Heenan, and M. traversii subsp. cantabrica (L.B.Moore) Meudt comb. et stat. nov. and M. traversii subsp. traversii. Myosotis × cinerascens Petrie is hypothesised to be a rare natural hybrid involving M. traversii subsp. cantabrica and another species, possibly M. colensoi. Several vegetative and floral characteristics can distinguish the study taxa from one another and from other ebracteate-erect species. The nine species plus M. × cinerascens are included in the taxonomic treatment, and the key also includes other recently revised ebracteate-erect species.
Rules of formation of H–C–N–O compounds at high pressure and the fates of planetary ices
Authors: Conway Lewis J. , Pickard Chris J. , Hermann Andreas
Published: April 2021

Significance

The planetary ices water, methane, and ammonia, deep inside icy planets, are subject to compression work that matches chemical bond energies. Icy mixtures are then free to form entirely new compounds, based on the energy landscape of the H–C–N–O elemental chemical space. Here, we present an exhaustive survey of this quaternary space aimed at exploring pressure-induced chemical changes, based on structure searches at 5 million atm. Led by the simplest possible compound, HCNO, we find that, at this pressure, stable compounds emerge from simple chemical rules of balanced redox reactions and filled electronic shells. They are mostly hydrogen-poor to form high-density materials. Planetary ice mixtures react to form host–guest compounds, long hydrocarbons, and other materials.
Verticillium dahliae (Verticillium wilt).
Authors: Subbarao Krishna
Published: April 2021

Introduction: V. dahliae affects many important crops worldwide and causes economically significant losses in many countries (Pegg and Brady, 2002; Inderbitzin and Subbarao, 2014). History shows that V. dahliae has the potential to evolve new strains that can overcome the resistance in commercial cultivars, particularly in cotton, lettuce, tomato and sunflower. It has also shown that the pathogen can be taken to new areas and cause serious losses (Nachmias and Krikun, 1985). Thus, for many vulnerable crops, selection for wilt resistance remains a major criterion of disease management.
SUMOylation stabilizes sister kinetochore biorientation to allow timely anaphase
Authors: Su Xue Bessie , Wang Menglu , Schaffner Claudia , Nerusheva Olga O. , Clift Dean , Spanos Christos , Kelly David A. , Tatham Michael , Wallek Andreas , Wu Yehui , Rappsilber Juri , Jeyaprakash A. Arockia , Storchova Zuzana , Hay Ronald T. , Marston Adèle L.
Published: April 2021

During mitosis, sister chromatids attach to microtubules from opposite poles, called biorientation. Sister chromatid cohesion resists microtubule forces, generating tension, which provides the signal that biorientation has occurred. How tension silences the surveillance pathways that prevent cell cycle progression and correct erroneous kinetochore–microtubule attachments remains unclear. Here we show that SUMOylation dampens error correction to allow stable sister kinetochore biorientation and timely anaphase onset. The Siz1/Siz2 SUMO ligases modify the pericentromere-localized shugoshin (Sgo1) protein before its tension-dependent release from chromatin. Sgo1 SUMOylation reduces its binding to protein phosphatase 2A (PP2A), and weakening of this interaction is important for stable biorientation. Unstable biorientation in SUMO-deficient cells is associated with persistence of the chromosome passenger complex (CPC) at centromeres, and SUMOylation of CPC subunit Bir1 also contributes to timely anaphase onset. We propose that SUMOylation acts in a combinatorial manner to facilitate dismantling of the error correction machinery within pericentromeres and thereby sharpen the metaphase–anaphase transition.
Vibrational CARS measurements in a near-atmospheric pressure plasma jet in nitrogen: II. Analysis
Authors: Kuhfeld J , Luggenhölscher D , Czarnetzki U
Published: April 2021

The understanding of the ro-vibrational dynamics in molecular (near)-atmospheric pressure plasmas is essential to investigate the influence of vibrational excited molecules on the discharge properties. In a companion paper Kuhfeld et al (2021 J.
Phys. D: Appl. Phys.

54

305204), results of ro-vibrational coherent anti-Stokes Raman scattering (CARS) measurements for a nanosecond pulsed plasma jet consisting of two conducting molybdenum electrodes with a gap of 1 mm in nitrogen at 200 mbar are presented. Here, those results are discussed and compared to theoretical predictions based on rate coefficients for the relevant processes found in the literature. It is found, that during the discharge the measured vibrational excitation agrees well with predictions obtained from the rates for resonant electron collisions calculated by Laporta et al (2014 Plasma Sources Sci. Technol.
23 065002). The predictions are based on the electric field during the discharge, measured by electric field induced second harmonic generation Kuhfeld et al (2021 J.
Phys. D: Appl. Phys.

54

305204), Lepikhin et al (2020 J. Phys. D: Appl. Phys.
54 055201) and the electron density, which is deduced from the field and mobility data calculated with Bolsig+ Hagelaar and Pitchford (2005 Plasma Sources Sci. Technol.
14 722–33). In the afterglow a simple kinetic simulation for the vibrational subsystem of nitrogen is performed and it is found, that the populations of vibrational excited states develop according to vibrational-vibrational transfer on timescales of a few microseconds, while the development on timescales of some hundred microseconds is determined by the losses at the walls. No significant influence of electronically excited states on the populations of the vibrational states visible in the CARS measurements (

v
≲
7

) was observed.
Direct observation of surface charge redistribution in active nanoscale conducting channels by Kelvin Probe Force Microscopy
Authors: Ye Sheng , Yan Xingzhao , Husain Muhammad Khaled , Saito Shinichi , de Groot C H (Kees) , Tsuchiya Yoshishige
Published: April 2021

Surface-exposed uniformly doped silicon-on-insulator channels are fabricated to evaluate the accuracy of Kelvin Probe Force Microscopy (KPFM) measured surface potential and reveals the role of surface charge on the exposed channel operated in the ambient environment. First, the quality of the potential profile probed in the vacuum environment is assessed by the consistency of converted resistivity from KPFM result to the resistivity extracted by the other three methods. Second, in contrast to the simulated and vacuum surface potential profile and image, the ambient surface potential is bent excessively at the terminals of the channel. The excessive bending can be explained by the movement of surface charge under the drive of geometry induced strong local electric field from the channel and results in non-uniform distribution. The dynamic movement of surface charges is proved by the observation of time-dependent potential drift in the ambient measurement. The result suggests the surface charge effect should be taken into account of the measurement of the surface potential in the ambient environment and the design of charge sensitive devices whose surfaces are exposed to air or in ambient conditions in their operation.
Production of light flavor hadrons in small systems measured by PHENIX at RHIC
Authors: Mitrankova M M , Berdnikov Ya A , Berdnikov A Ya , Kotov D O , Mitrankov Iu M
Published: April 2021

With the recent observations of collective behavior of produced particles in small collision systems, measurements of the modification of hadron production in small systems have become increasingly relevant. To study the properties of possible quark-gluon plasma and cold nuclear matter effects PHENIX has performed measurements of light flavor hadrons (π
±, π
0, K
*0, φ, and

p

¯

) in a broad set of projectile-target combinations including p+Al, p+Au, d+Au and 3He+Au collisions at

s

NN

= 200 GeV. The obtained invariant transverse momentum spectra and nuclear modification factors are presented and compared to theoretical model predictions where available. The observation of baryon enhancement in the new experimental data and the comparisons with different calculations confirm that quark-gluon plasma could be formed in small collision systems. However, the volume and the lifetime of the medium produced in small collision systems might be insufficient for observation of strangeness enhancement and jet quenching effects.
MeV Gamma-ray imaging spectroscopic observation for Galactic Centre and Cosmic Background MeV gammas by SMILE-2+ Balloon Experiment
Authors: Tanimori Toru
Published: April 2021

Recently, there appears lots of papers on the possibility of light Dark Matter (DM) in MeV and sub-GeV scale. Until now, only INTEGRAL and COMPTEL provided experimental data of 511keV of galactic center, and two spectra of Galactic Diffuse MeV gammas (GDMG) and COMPTEL provided the Cosmic Background MeV gammas (CBMG) for wide sky for indirect detection of light DMs. However except 511keV, those spectra for diffuse gammas included large statistical and systematic errors in spite of 10 years observation, since both two instruments suffered from severe background radiation in space. In 2018 April, we (SMILE-project in Comic-ray Group of Kyoto University) have observed MeV gamma rays for whole southern sky by Electron Tracking Compton Camera (ETCC) using JAXA balloon at Australia during one-day. (SMILE2+ Project) By measuring all parameters of Compton scattering in every gamma, ETCC has achieved for the first time to obtain the complete direction of MeV gammas as same as optical telescopes, and also to distinguish signal gammas from huge background gammas in space clearly. In this observation, ETCC with a large Field of View of 3sr observed MeV gammas from 3/5 of all sky including galactic centre, a half disk, crab, and most of CBMG By reconstructing the Compton process, we successfully obtained pure comic gammas by reducing background by more 2 orders, which is clearly certificated by the clear enhancement of detected gamma flux with ˜30% during galactic center passing through the Field of View, which is consistent with the ratio of CBMG and GDMG. Now 511keV gammas GDMG are preliminarily detected with ˜5 and >10σ respectively around Galactic Centre. Also we have obtained near 105events of CBMG in with quite low background of only a few 10% in total CBMG events. Thus we obtained good data for both with high statistics and very low systematics even one day observation.
Physics prospects of the JUNO experiment
Authors: Sisti Monica
Published: April 2021

JUNO is a 20 kton multi-purpose liquid scintillator detector currently being built in China in a dedicated underground laboratory and expected to complete the detector construction in 2021. JUNO primary physics goal is the determination of the neutrino mass ordering, with a significance of 3-4 sigma in six years of data taking, by measuring the oscillation pattern of electron antineutrinos coming from two nuclear power plants at a baseline of about 53 km. Besides this fundamental aim, its large target mass, unprecedented energy resolution of 3% at 1 MeV, and vertex reconstruction capability will provide vast opportunities in particle physics and astrophysics. JUNO will have a very rich physics program, which includes the precise measurement at a sub-percent level of the solar neutrino oscillation parameters, the detection of low-energy neutrinos coming from galactic core-collapse supernova, the measurement of the diffuse supernova neutrino background, the detection of neutrinos coming from the Sun and the Earth (geo-neutrinos). In this paper I will give an overview on the JUNO physics potential and discuss the performance of the JUNO detector for the various proposed measurements.
The Super Separator Spectrometer (S3) for the SPIRAL2 facility
Authors: Drouart A. , Nolen J.A. , Savajols H.
Published: April 2021

The Super Separator Spectrometer S3 is, with the NFS (Neutrons For Science) facility, a major experimental system developed for SPIRAL2. It is designed for very low cross section experiments at low (<15MeV/u) energy. It will receive the very high intensity (more than 1pμA) stable ion beams accelerated by the superconducting LINAG accelerator of SPIRAL2. S3 will be notably used for the study of rare nuclei produced by fusion evaporation reactions, such as superheavy elements and neutron-deficient isotopes. Such experiments require a high transmission of the products of interest but also a separation of these nuclei from unwanted species. Hence S3 must have a large acceptance but also a high selection power including physical mass resolution. These properties are reached with the use of seven large aperture superconducting quadrupole triplets which include sextupolar and octupolar corrections in a two - stage separator (momentum achromat followed by a mass spectrometer) that can be coupled to the SIRIUS implantation-decay spectroscopy station or to the REGLIS3 gas cell with laser ionization to provide very pure beams for low energy experiments. S3 is now in the construction phase. We will present the scientific objectives of S3 as well as the current status of the facility and its different elements.
Dynapenia, abdominal obesity or both: which accelerates the gait speed decline most?
Authors: de Oliveira Máximo Roberta , de Oliveira Dayane Capra , Ramírez Paula Camila , Luiz Mariane Marques , de Souza Aline Fernanda , Delinocente Maicon Luís Bicigo , Steptoe Andrew , de Oliveira Cesar , da Silva Alexandre Tiago
Published: April 2021

Objective

to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time.

Methods

a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength <26 kg for men and <16 kg for women. Abdominal obesity was determined as a waist circumference >102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period.

Results

over time, only the D/AO individuals had a greater gait speed decline (−0.013 m/s per year, 95% CI: −0.024 to −0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline.

Conclusion

dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults.
A New List for Choosing Wisely Canada From the “Hidden Profession” of Medical Laboratory Science
Authors: VanSpronsen Amanda D , Villatoro Valentin , Zychla Laura , Wang Yutian , Turley Elona , Ohinmaa Arto , Yuan Yan
Published: April 2021

Objectives

Choosing Wisely Canada (CWC) publishes practices that may contribute to medical overuse and patient harm. Many practices concern laboratory testing, but the recommendations are often written for the test-ordering professionals. Our objective was to develop a list for CWC reflecting the scope of practice of nonpathologist medical laboratory professionals (MLPs).

Methods

We used a national survey, a convention session, and a panel of MLPs from across Canada to generate content for the CWC list. We used a modified Delphi process to identify the most important items and scoping reviews to gather evidence supporting each item.

Results

We identified 95 potential CWC list items. After 2 Delphi rounds, there was little movement in the top items. Scoping reviews revealed varying degrees of evidentiary support, which influenced the composition of the final list of 7 CWC items submitted. Three of the final recommendations address ways MLPs preserve the status quo with respect to overutilization of laboratory tests by other health care professionals. The remaining recommendations prompt MLPs to exert clinical judgment in specific scenarios, particularly where they can impact blood collection volumes.

Conclusions

This work brings a more nuanced and comprehensive understanding of the relationships among MLPs, patient safety, and resource waste.
Association Between Medicaid Expansion and Suicide Mortality Among Nonelderly US Adults
Authors: Austin Anna E , Naumann Rebecca B , Short Nicole A
Published: April 2021

In 2014, the Affordable Care Act gave states the option to expand Medicaid coverage to nonelderly adults (persons aged 18–64 years) with incomes up to 138% of the federal poverty level. To our knowledge, the association of Medicaid expansion with suicide, a leading cause of death in the United States, has not been examined. We used 2005–2017 data from the National Violent Death Reporting System to analyze suicide mortality in 8 Medicaid expansion states and 7 nonexpansion states. Using a difference-in-differences approach, we examined the association between Medicaid expansion and the rate of suicide death (number of deaths per 100,000 population) among nonelderly adults. After adjustment for state-level confounders, Medicaid expansion states had 1.2 fewer suicide deaths (β = −1.2, 95% confidence interval: –2.5, 0.1) per 100,000 population per year during the postexpansion period than would have been expected if they had followed the same trend in suicide rates as nonexpansion states. Medicaid expansion was associated with reductions in suicide rates among women, men, persons aged 30–44 years, non-Hispanic White individuals, and persons without a college degree. Medicaid expansion was not associated with a change in suicide rates among persons aged 18–29 or 45–64 years or among non-White or Hispanic individuals. Overall, Medicaid expansion was associated with reductions in rates of suicide death among nonelderly adults. Further research on inequities in Medicaid expansion benefits is needed.
Building a Virtual Global Knowledge Network During the Coronavirus Disease 2019 Pandemic: The Infection Prevention and Control Global Webinar Series
Authors: Wilson Kathryn , Dennison Cori , Struminger Bruce , Armistad Amy , Osuka Hanako , Montoya Eva , Padoveze Maria Clara , Arora Sanjeev , Park Benjamin , Lessa Fernanda C
Published: April 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has been an unprecedented global health challenge. Traditional modes of knowledge dissemination have not been feasible. A rapid solution was needed to share guidance and implementation examples within the global infection prevention and control (IPC) community. We designed the IPC Global Webinar Series to bring together subject matter experts and IPC professionals in the fight against COVID-19.

Methods

The Extension for Community Healthcare Outcomes (ECHO) model was adapted to create an interactive global knowledge network. Speakers and panelists provided presentations and answers to questions. Webinars were simultaneously interpreted into 5 languages and recorded for later access.

Results

Thirteen webinar sessions were completed from 14 May through 6 August 2020. On average, 634 participants attended each session (range, 393-1181). Each session was represented by participants from, on average, more than 100 countries.

Conclusions

Through the IPC Global Webinar Series, critical information was shared and peer-to-peer learning was promoted during the COVID-19 pandemic response. The webinar sessions reached a broader audience than many in-person events. The webinar series was rapidly scaled and can be rapidly reactivated as needed. Our lessons learned in designing and implementing the series can inform the design of other global health virtual knowledge networks. The continued and expanded use of adapted virtual communities of practice and other learning networks for the IPC community can serve as a valuable tool for addressing COVID-19 and other infectious disease threats.

The infection prevention and control (IPC) Global Webinar Series convened subject matter experts and IPC professionals from more than 100 countries to establish a global learning community for COVID-19. We advocate for expanded use of virtual knowledge networks.
Local multigrid solvers for adaptive isogeometric analysis in hierarchical spline spaces
Authors: Hofreither Clemens , Mitter Ludwig , Speleers Hendrik
Published: April 2021

We propose local multigrid solvers for adaptively refined isogeometric discretizations using (truncated) hierarchical B-splines ((T)HB-splines). Smoothing is only performed in or near the refinement areas on each level, leading to a computationally efficient solving strategy. We prove robust convergence of the proposed solvers with respect to the number of levels and the mesh sizes of the hierarchical discretization space under the assumption that the hierarchical mesh satisfies an admissibility condition, i.e., the number of interacting mesh levels is uniformly bounded. We also provide several numerical experiments. The main analytical tools are quasi-interpolators for THB-splines and the abstract convergence theory of subspace correction methods.
Nasopharyngeal Pneumococcal Colonization Density Is Associated With Severe Pneumonia in Young Children in the Lao People’s Democratic Republic
Authors: Carr Olivia J J , Vilivong Keoudomphone , Bounvilay Laddaphone , Dunne Eileen M , Lai Jana Y R , Chan Jocelyn , Vongsakid Malisa , Changthongthip Anisone , Siladeth C , Ortika Belinda , Nguyen Cattram , Mayxay Mayfong , Newton Paul N , Mulholland Kim , Do Lien A H , Dubot-Pérès Audrey , Satzke Catherine , Dance David A B , Russell Fiona M
Published: April 2021

Background

No studies have explored the association between pneumococcal nasopharyngeal density and severe pneumonia using the World Health Organization (WHO) 2013 definition. In Lao People’s Democratic Republic (Lao PDR), we determine the association between nasopharyngeal pneumococcal density and severe pneumonia in children.

Methods

A prospective observational study was undertaken at Mahosot Hospital, Vientiane, from 2014 to mid-2018. Children <5 years admitted with acute respiratory infections (ARIs) were included. Clinical and demographic data were collected alongside nasopharyngeal swabs for pneumococcal quantification by lytA real-time quantitative polymerase chain reaction. Severe pneumonia was defined using the 2013 WHO definition. For pneumococcal carriers, a logistic regression model examined the association between pneumococcal density and severe pneumonia, after adjusting for potential confounders including demographic and household factors, 13-valent pneumococcal conjugate vaccine status, respiratory syncytial virus co-detection, and preadmission antibiotics.

Results

Of 1268 participants with ARI, 32.3% (n = 410) had severe pneumonia and 36.9% (n = 468) had pneumococcal carriage. For pneumococcal carriers, pneumococcal density was positively associated with severe pneumonia (adjusted odds ratio, 1.4 [95% confidence interval, 1.1–1.8]; P = .020).

Conclusions

Among children with ARIs and pneumococcal carriage, pneumococcal carriage density was positively associated with severe pneumonia in Lao PDR. Further studies may determine if pneumococcal density is a useful marker for pneumococcal conjugate vaccine impact on childhood pneumonia.
Effects of Intertidal Position on Metabolism and Behavior in the Acorn Barnacle,Balanus glandula
Authors: Horn Kali M , Fournet Michelle E H , Liautaud Kaitlin A , Morton Lynsey N , Cyr Allie M , Handley Alyse L , Dotterweich Megan M , Anderson Kyra N , Zippay Mackenzie L , Hardy Kristin M
Published: April 2021

The intertidal zone is characterized by persistent, tidally-driven fluctuations in both abiotic (e.g., temperature, oxygen, and salinity) and biotic (e.g., food availability and predation) factors, which make this a physiologically challenging habitat for resident organisms. The relative magnitude and degree of variability of environmental stress differ between intertidal zones, with the most extreme physiological stress often being experienced by organisms in the high intertidal. Given that so many of the constantly shifting parameters in this habitat are primary drivers of metabolic rate (e.g., temperature, [O2], and food availability), we hypothesized that sessile conspecifics residing in different tidal zones would exhibit distinct “metabolic phenotypes,” a term we use to collectively describe the organisms’ baseline metabolic performance and capacity. To investigate this hypothesis, we collected acorn barnacles (Balanus glandula) from low, mid, and high intertidal positions in San Luis Obispo Bay, CA, and measured a suite of biochemical (whole-animal citrate synthase (CS) and lactate dehydrogenase (LDH) activity, and aerial [D-lactate]), physiological (O2 consumption rates), morphological (body size), and behavioral (e.g., cirri beat frequency and percentage of time operculum open) indices of metabolism. We found tidal zone-dependent differences in B. glandula metabolism that primarily related to anaerobic capacity, cirral activity patterns, and body size. Barnacles from the low intertidal tended to have a greater capacity for anaerobic metabolism (i.e., increased LDH activity and increased baseline [D-lactate]), have reduced cirral beating activity—and presumably reduced feeding—when submerged, and be smaller in size compared to conspecifics in the high intertidal. We did not, however, see any D-lactate accumulation in barnacles from any tidal height throughout 96 h of air exposure. This trend indicates that the enhanced capacity of low intertidal barnacles for anaerobic metabolism may have evolved to support metabolism during more prolonged episodes of emersion or during events other than emersion (e.g., coastal hypoxia and predation). There were also no significant differences in CS activity or baseline O2 consumption rates (in air or seawater at 14°C) across tidal heights, which imply that aerobic metabolic capacity may not be as sensitive to tidal position as anaerobic processes. Understanding how individuals occupying different shore heights differ in their metabolic capacity becomes increasingly interesting in the context of global climate change, given that the intertidal zone is predicted to experience even greater extremes in abiotic stress.
How Resource Scarcity Influences the Preference for Counterhedonic Consumption
Authors: Yang Haiyang , Zhang Kuangjie
Published: April 2021

Eight studies show that resource scarcity can influence consumers’ preference for counterhedonic consumption and that the sense of control is an underlying driver of this effect. Using a large-scale field dataset covering 82 countries over a 10-year period, study 1 showed that individuals from countries with greater resources consumed horror movies to a greater extent, but this pattern was not found for other movie genres such as romance or documentary. The remaining studies used diverse experimental approaches and counterhedonic consumption contexts (e.g., movie, novel, haunted house attraction, game) to provide causal and process evidence. Specifically, inducing perceived resource scarcity lowered participants’ preference for counterhedonic consumption (studies 2A–2C). Consistent with the sense-of-control-based mechanism, experimentally lowering participants’ sense of control or boosting it moderated the effect of perceived resource scarcity on their preference for counterhedonic consumption (studies 3A and 3B). The degradation of the sense of control due to perceived resource scarcity mediated the effect (studies 4 and 5). These results add to the literature on conterhedonic consumption as well as resource scarcity and have important managerial implications.
Development of a rapid multiplex PCR assay for the detection of common pathogens associated with community-acquired pneumonia
Authors: Koo Seok Hwee , Jiang Boran , Lim Pei Qi , La My-Van , Tan Thean Yen
Published: April 2021

Background

Community-acquired pneumonia (CAP) is one of the most common infectious diseases and is a significant cause of mortality and morbidity globally. A microbial cause was not determined in a sizable percentage of patients with CAP; there are increasing data to suggest regional differences in bacterial aetiology. We devised a multiplex real-time PCR assay for detecting four microorganisms (Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae and Burkholderia pseudomallei) of relevance to CAP infections in Asia.

Methods

Analytical validation was accomplished using bacterial isolates (n=10–33 of each target organism for analytical sensitivity and n=117 for analytical sensitivity) and clinical validation using 58 culture-positive respiratory tract specimens.

Results

The qPCR assay exhibited 100% analytical sensitivity and analytical specificity, and 100% clinical sensitivity and 94–100% clinical specificity. The limit of detection and efficiency for the multiplex PCR assay were 3–33 CFU/mL and 93–110%, respectively. The results showed that the PCR-based method had higher sensitivity than traditional culture-based methods. The assay also demonstrated an ability to semiquantify bacterial loads.

Conclusion

We have devised a reliable laboratory-developed multiplex qPCR assay, with a turnaround time of within one working day, for detection of four clinically important CAP-associated microorganisms in Asia. The availability of a test with improved diagnostic capabilities potentially leads to an informed choice of antibiotic usage and appropriate management of the patient to achieve a better treatment outcome and financial savings.
Coronavirus disease 2019 and pediatric anesthesia
Authors: Tan Jonathan M. , Disma Nicola , Matava Clyde T.
Published: April 2021

Purpose of review

The purpose of this review is to provide the latest evidence for delivering safe and effective anesthesia care for pediatric patients with coronavirus disease 2019 (COVID-19) and to highlight continuing gaps in the literature.

Recent findings

Safe and efficient care of pediatric patients with COVID-19 can be delivered with the proper planning, coordination, supplies, and staff preparation. From the start of the pandemic, pediatric anesthesiologists from around the world contributed important insights and shared experience as to how best to adapt anesthesia care for children with COVID-19 requiring general anesthesia and sedation. Although initial efforts focused on creating safe airway management processes, the role of anesthesiologists as perioperative leaders quickly extended to ensuring well-coordinated management of COVID-19 patients throughout the hospital for procedures, including preprocedure testing, patient transport, operating room setup, and ensuring the safety of staff. Several important areas remain not well studied including, the timing of rescheduling elective procedures following COVID-19 infection, the perioperative implications of re-infection, and future considerations of managing vaccinated children.

Pediatric anesthesia care can be safely delivered to children with COVID-19 and after COVID-19 infection. More attention needs to be focused on the perioperative management of COVID-19 children in recovery requiring anesthesia.
Surgical Technique: Lower Trapezius Transfer in Paediatric Paralytic Shoulder
Authors: Valenti Philippe , Puig Dubois Julieta , Werthel Jean-David , Kazum Efi
Published: April 2021

The therapeutic management of the paralytic shoulder after an obstetric brachial plexus injury is complex. When nerve repair or neurotization fail, or if the biological times for nerve reconstruction is over, tendon transfer to restore active external rotation of the shoulder becomes the main surgical alternative. The purpose of this manuscript is to describe the surgical technique of the lower trapezius muscle transfer to the infraspinatus muscle, to restore active shoulder external rotation in the child with paralytic shoulder, step by step with details and pearls.
Design of Clinical Trials Evaluating Sedation in Critically Ill Adults Undergoing Mechanical Ventilation: Recommendations From Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) Recommendation III
Authors: Ward Denham S. , Absalom Anthony R. , Aitken Leanne M. , Balas Michele C. , Brown David L. , Burry Lisa , Colantuoni Elizabeth , Coursin Douglas , Devlin John W. , Dexter Franklin , Dworkin Robert H. , Egan Talmage D. , Elliott Doug , Egerod Ingrid , Flood Pamela , Fraser Gilles L. , Girard Timothy D. , Gozal David , Hopkins Ramona O. , Kress John , Maze Mervyn , Needham Dale M. , Pandharipande Pratik , Riker Richard , Sessler Daniel I. , Shafer Steven L. , Shehabi Yahya , Spies Claudia , Sun Lena S. , Tung Avery , Urman Richard D.
Published: April 2021

OBJECTIVES:

Clinical trials evaluating the safety and effectiveness of sedative medication use in critically ill adults undergoing mechanical ventilation differ considerably in their methodological approach. This heterogeneity impedes the ability to compare results across studies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research Recommendations convened a meeting of multidisciplinary experts to develop recommendations for key methodologic elements of sedation trials in the ICU to help guide academic and industry clinical investigators.

DESIGN:

A 2-day in-person meeting was held in Washington, DC, on March 28–29, 2019, followed by a three-round, online modified Delphi consensus process.

PARTICIPANTS:

Thirty-six participants from academia, industry, and the Food and Drug Administration with expertise in relevant content areas, including two former ICU patients attended the in-person meeting, and the majority completed an online follow-up survey and participated in the modified Delphi process.

MEASUREMENTS AND MAIN RESULTS:

The final recommendations were iteratively refined based on the survey results, participants’ reactions to those results, summaries written by panel moderators, and a review of the meeting transcripts made from audio recordings. Fifteen recommendations were developed for study design and conduct, subject enrollment, outcomes, and measurement instruments. Consensus recommendations included obtaining input from ICU survivors and/or their families, ensuring adequate training for personnel using validated instruments for assessments of sedation, pain, and delirium in the ICU environment, and the need for methodological standardization.

CONCLUSIONS:

These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who require mechanical ventilation. These recommendations should be viewed as a starting point to improve clinical trials and help reduce methodological heterogeneity in future clinical trials.
Improving Team Skills of Health Care Practitioners: Effects of an Interprofessional Education Program
Authors: Cohen Elaine V. , Luce Virge , González Manny J. , Hagestuen Ruth , González-Ramos Gladys , Cohen Hillel W.
Published: April 2021

Introduction:

Health care practitioners in Parkinson's care need to learn effective interprofessional team skills. This study examines posttraining effects on team skills of health practitioners attending an interprofessional education (IPE) program for team-based Parkinson's care.

Methods:

Using a quasi-experimental pre–post design, practitioners (n = 236) in nine professions (physician, nurse and nurse practitioner, physician assistant, occupational, physical and music therapy, speech-language pathology, and social work) completed the validated, self-report Team Skills Scale, before and after the training. Associations of Team Skills Scale change with intention to change practice, measured at end of each training day, and with improved attitudes toward team, knowledge, confidence, and amount of new information were examined.

Results:

All professions, except physician assistant, significantly improved perceived team skills, as did those showing greatest intention to change practice, with no meaningful differences in magnitude of change across profession groups. Team skills change was significantly associated with improved attitudes toward health care teams, increased knowledge about team and the role of other professions, and new knowledge gained. Confidence in Parkinson's care showed modest, statistically significant association with team skills improvement.

Discussion:

The Allied Team Training for Parkinson-IPE program significantly improved perceived team skills of health care practitioners, effectively teaching about skills for collaborative teamwork. Future IPE research should explore whether similar programs in other settings achieve the enhanced team skills competencies with postlicensure practitioners observed here and validate our findings from self-developed measures using larger samples, additional professions, and follow-up of transfer of learning effects through direct observation of skills of actual teams.
The Ontological Choreography of Continuing Professional Development: A Mixed-Methods Study of Continuing Professional Development Leaders and Program Directors
Authors: Paton Morag , Rowland Paula , Tavares Walter , Schneeweiss Suzan , Ginsburg Shiphra
Published: April 2021

Introduction:

Reports have forecast significant changes ahead for Continuing Professional Development (CPD). With new models on the horizon, CPD developers will require additional knowledge and training. Our objective was to learn how CPD leaders and developers came into their roles, if they are engaged in scholarship and the challenges and opportunities in pursuing scholarship.

Methods:

We conducted a mixed grounded theory study, inviting CPD leaders within our institution for interviews focused on career paths, CPD and scholarly activities, networks, and supports and challenges. We invited 405 program/conference directors from our institution to participate in a survey focused on similar themes. We used the framework of ontological choreography in our final analysis.

Results:

We conducted 13 interviews and had a survey response rate of 28.6% (n = 116). We identified three themes: (1) the pathway to becoming an expert in CPD planning and delivery is often unplanned, unclear, and uncredentialed; (2) CPD is undervalued as a field, with inadequate time and funding allocated; and (3) engagement with scholarship is variable while identifying resources to support scholarship is difficult.

Discussion:

Beyond the usual calls for CPD to be more appropriately recognized and valued, this article offers another way to explore why past visions of the future have not been fully realized; CPD means different things to different people; it is ontologically different even across a single network in a single faculty.
Evaluation of a High Stakes Physician Competency Assessment: Lessons for Assessor Training, Program Accountability, and Continuous Improvement
Authors: Wenghofer Elizabeth F. , Steele Robert S. , Christiansen Richard G. , Carter Misti H.
Published: April 2021

Introduction:

There is a dearth of evidence evaluating postlicensure high-stakes physician competency assessment programs. Our purpose was to contribute to this evidence by evaluating a high-stakes assessment for assessor inter-rater reliability and the relationship between performance on individual assessment components and overall performance. We did so to determine if the assessment tools identify specific competency needs of the assessed physicians and contribute to our understanding of physician dyscompetence more broadly.

Method:

Four assessors independently reviewed 102 video-recorded assessments and scored physicians on seven assessment components and overall performance. Inter-rater reliability was measured using intraclass correlation coefficients using a multiple rater, consistency, two-way random effect model. Analysis of variance with least-significant difference post-hoc analyses examined if the mean component scores differed significantly by quartile ranges of overall performance. Linear regression analysis determined the extent to which each component score was associated with overall performance.

Results:

Intraclass correlation coefficients ranged between 0.756 and 0.876 for all components scored and was highest for overall performance. Regression indicated that individual component scores were positively associated with overall performance. Levels of variation in component scores were significantly different across quartile ranges with higher variability in poorer performers.

Discussion:

High-stake assessments can be conducted reliably and identify performance gaps of potentially dyscompetent physicians. Physicians who performed well tended to do so in all aspects evaluated, whereas those who performed poorly demonstrated areas of strength and weakness. Understanding that dyscompetence rarely means a complete or catastrophic lapse competence is vital to understanding how educational needs change through a physician's career.
Knowledge of Infant Development and Parent Well-Being: Cross-Sectional Analysis of Toddlers
Authors: Sullivan Jacqueline A. , Zvara Bharathi J. , Keim Sarah A. , Andridge Rebecca , Anderson Sarah E.
Published: April 2021

Objective:

Knowledge about child development is associated with parenting and children's outcomes. Parents with less accurate knowledge about developmental milestones may have unrealistic expectations for their child's behavior, which may affect parent well-being. Limited research has examined this topic relative to depression, but other aspects of parent well-being (e.g., parenting stress) are unexplored.

Methods:

Cross-sectional analysis of an ongoing prospective cohort study of 300 families in central Ohio enrolled when children were a mean (SD) calendar age of 18.2 (0.7) months. Children of all gestational ages at birth are included, and 37% were born preterm (<37 weeks' gestation.) Primary caregivers (93% mothers) completed the 20-item Knowledge of Infant Development Index (KIDI) and questionnaires for child temperament and 3 aspects of parent well-being (depressive and anxious symptoms, parenting stress, and general health). Covariate-adjusted regression models assessed relationships between the KIDI score and each well-being outcome. We hypothesized that parents with less knowledge would have more symptoms of depression and anxiety, greater parenting stress, and poorer health. Whether associations were stronger for parents of children born preterm or who had high negative affect was explored.

Results:

Knowledge of Infant Development Index scores were associated with sociodemographic characteristics, child temperament, and gestational age (more knowledge: higher socioeconomic position, less child negative affect, and full-term birth). KIDI scores did not predict any aspect of parent well-being, and there was no evidence that child temperament or preterm birth altered these findings.

Conclusion:

In this sample of parents of toddlers assessed in 2018/19, greater knowledge of infant development was not associated with parent well-being.