bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical Attractiveness, Halo Effects, and Social Joining
Authors: Palmer Carl L. , Peterson Rolfe Daus
Published: November 2020

Objective: Scholarship in psychology on halo effects demonstrates the powerful effects attractiveness has on social interactions. Here, we consider the influence of physical attractiveness on the development of social capital through social joining. With the unavoidable nature of attractiveness biases, we argue that more physically attractive individuals should be increasingly likely to join social organizations, which have been shown to be important parts of broader social engagement and the growth of social capital.

Methods: Utilizing the Wisconsin Longitudinal Study and an original survey experiment, we find that individuals who are rated as more attractive are consistently more likely to participate in organizations, particularly early in adult life. These effects persist when controlling for socioeconomic variables like income and education.

Results: Our experimental results bolster these findings, showing that more attractive individuals are more likely to be invited to join both organizations and informal gatherings.

Conclusions: These findings suggest a further mechanism through which the development of social capital differs between individuals in society.
Neonatal red blood cell transfusion
Authors: Villeneuve Andréanne , Arsenault Valérie , Lacroix Jacques , Tucci Marisa
Published: November 2020

Transfusions are more common in premature infants with approximately 40% of low birth weight infants and up to 90% of extremely low birth weight infants requiring red blood cell transfusion. Although red blood cell transfusion can be life‐saving in these preterm infants, it has been associated with higher rates of complications including necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity and possibly abnormal neurodevelopment. The main objective of this review is to assess current red blood cell transfusion practices in the neonatal intensive care unit, to summarize available neonatal transfusion guidelines published in different countries and to emphasize the wide variation in transfusion thresholds that exists for red blood cell transfusion. This review also addresses certain issues specific to red blood cell processing for the neonatal population including storage time, irradiation, cytomegalovirus (CMV) prevention strategies and patient blood management. Future research avenues are proposed to better define optimal transfusion practice in neonatal intensive care units.
Pathognomonic thoracic radiographic findings are lacking in cats with acute Cytauxzoonosis
Authors: Melco Ashley L. , Petrovitch Nicholas P. , Birkenheuer Adam J. , Yang Tzushan S. , Schreeg Megan E. , Savage Mason
Published: November 2020

Cytauxzoon felis is a tick‐borne haemoprotozoan parasite that often causes fatal disease in domestic cats. Histological studies have described substantial pulmonary pathology due to cytauxzoonosis. Published reports were not found describing the thoracic radiographic signs associated with acute cytauxzoonosis in cats. The purpose of this retrospective descriptive study was to describe thoracic radiographic findings in a group of felines with confirmed acute cytauxzoonosis. A total of 37 cats with confirmed cytauxzoonosis and with available thoracic radiographs were included. A subset of 7 cats in this sample also had histopathologic evaluation of their lung parenchyma. Thoracic radiographs were retrieved and reviewed. A bronchial pulmonary pattern was identified as the most common finding (n = 27/37; 73%). Other radiographic findings included cardiomegaly (n = 19/37; 51%), interstitial pattern (n = 17/37; 46%), pleural effusion (n = 12/37; 32%), arterial vascular distension (n = 10/37; 27%), arterial and venous distension (n = 10/37; 27%), and venous distension (n = 1/37; 3%). The primary histological features present in 7 cats with additional histopathologic evaluation, similar to previously published studies, were vascular occlusion. Our study suggests that, despite severe histologic evidence of disease, there are no pathognomonic thoracic radiographic findings in cats with acute cytauxzoonosis.
In vivo Perturb-Seq reveals neuronal and glial abnormalities associated with autism risk genes
Authors: Jin Xin , Simmons Sean K. , Guo Amy , Shetty Ashwin S. , Ko Michelle , Nguyen Lan , Jokhi Vahbiz , Robinson Elise , Oyler Paul , Curry Nathan , Deangeli Giulio , Lodato Simona , Levin Joshua Z. , Regev Aviv , Zhang Feng , Arlotta Paola
Published: November 2020

An in vivo analysis of autism risk genes

CRISPR targeting in vivo, especially in mammals, can be difficult and time consuming when attempting to determine the effects of a single gene. However, such studies may be required to identify pathological gene variants with effects in specific cells along a developmental trajectory. To study the function of genes implicated in autism spectrum disorders (ASDs), Jin
et al.
applied a gene-editing and single-cell–sequencing system, Perturb-Seq, to knock out 35 ASD candidate genes in multiple mice embryos (see the Perspective by Treutlein and Camp). This method identified networks of gene expression in neuronal and glial cells that suggest new functions in ASD-related genes.

Science
, this issue p.
eaaz6063
; see also p.
1038
Abl and Canoe/Afadin mediate mechanotransduction at tricellular junctions
Authors: Yu Huapeng H. , Zallen Jennifer A.
Published: November 2020

Tension where multiple cells meet

Cells exist in varying environments and must respond to specific stimuli. During development, epithelial cells need to rapidly reorganize under tension without compromising epithelial integrity. Yu
et al.
demonstrate that
Drosophila
epithelial cells achieve this by transiently stabilizing adhesion at tricellular junctions where three cells meet (see the Perspective by Raghavan and Vasioukhin). The conserved adhesion regulator Canoe/Afadin is recruited to tricellular junctions under tension within seconds and dissociates when tension is released through a mechanism that requires Abl-dependent tyrosine phosphorylation. These results identify an in vivo mechanotransduction pathway that dynamically couples tricellular adhesion with physiological forces, allowing cells to rapidly modulate their behavior in response to mechanical changes in their environment.

Science
, this issue p.
eaba5528
; see also p.
1036
Abrupt shift to hotter and drier climate over inner East Asia beyond the tipping point
Authors: Zhang Peng , Jeong Jee-Hoon , Yoon Jin-Ho , Kim Hyungjun , Wang S.-Y. Simon , Linderholm Hans W. , Fang Keyan , Wu Xiuchen , Chen Deliang
Published: November 2020

A dangerous trend

How anthropogenically driven climate change is affecting heat waves and drought is one of the most important environmental issues facing societies around the globe. Zhang
et al.
present a 260-year-long record of temperature and soil moisture over inner East Asia that reveals an abrupt shift to hotter and drier conditions (see the Perspective by Zhang and Fang). Extreme episodes of hotter and drier climate over the past 20 years, which are unprecedented in the earlier records, are caused by a positive feedback loop between soil moisture deficits and surface warming and potentially represent the start of an irreversible trend.

Science
, this issue p.
1095
; see also p.
1037
Critical instability at moving keyhole tip generates porosity in laser melting
Authors: Zhao Cang , Parab Niranjan D. , Li Xuxiao , Fezzaa Kamel , Tan Wenda , Rollett Anthony D. , Sun Tao
Published: November 2020

Driving the pores away

The formation of “keyholes” (vapor-filled depressions) during additive manufacturing leads to porosity, which degrades alloy performance, especially fracture properties, and remains a big challenge for the 3D printing of metals. Zhao
et al.
used high-speed x-ray imaging to take a detailed look at how keyhole formation connects to porosity in a titanium alloy. They found that instability at the keyhole tip drives pores away to get trapped in the solidification front. Understanding this process and the operating parameters under which it occurs provides a roadmap for avoiding porosity and building high-quality metal parts.

Science
, this issue p.
1080
Steps toward translocation-independent RNA polymerase inactivation by terminator ATPase ρ
Authors: Said Nelly , Hilal Tarek , Sunday Nicholas D. , Khatri Ajay , Bürger Jörg , Mielke Thorsten , Belogurov Georgiy A. , Loll Bernhard , Sen Ranjan , Artsimovitch Irina , Wahl Markus C.
Published: November 2020

How to stop RNA polymerase

Timely and tunable cessation of RNA synthesis is vital for cellular homeostasis. RNA helicases such as the archetypal termination factor r actively dismantle transcription complexes, but the transitory nature of termination makes the process hard to study structurally. Said
et al.
assembled ρ-bound transcription complexes and studied them using cryo–electron microscopy with an approach that captured a series of functional states en route to termination. They found an extensive and dynamic network of r interactions with RNA polymerase, nucleic acids, and accessory Nus factors. ρ mediates stepwise rearrangements of these contacts, transforming an actively transcribing complex into a moribund pretermination intermediate.

Science
, this issue p.
44
Febrile young infants with abnormal urine dipstick at low risk of invasive bacterial infection
Authors: Velasco Roberto , Lejarzegi Ainara , Gomez Borja , de la Torre Mercedes , Duran Isabel , Camara Amaia , de la Rosa Daniel , Manzano Sergio , Rodriguez Jose , González Andres , Lopes Anne-Aurelie , Rivas Aristides , Martinez Isabel , Angelats Carlos Miguel , Moya Sandra , Corral Sonia , Alonso Juan , del Rio Patricia , Sancho Elena , Ruiz del Olmo Ignacio , Nieto Inmaculada , Vega Beatriz , Mintegi Santiago
Published: November 2020

Objectives

To develop and validate a prediction rule to identify well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of invasive bacterial infections (IBIs, bacteraemia or bacterial meningitis).

Design

Ambispective, multicentre study.

Setting

The derivation set in a single paediatric emergency department (ED) between 2003 and 2017. The validation set in 21 European EDs between December 2017 and November 2019.

Patients

Two sets of well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick (either leucocyte esterase and/or nitrite positive test).

Main outcome

Prevalence of IBI in low-risk infants according to the RISeuP score.

Results

We included 662 infants in the derivation set (IBI rate:5.2%). After logistic regression, we developed a score (RISeuP score) including age (≤15 days old), serum procalcitonin (≥0.6 ng/mL) and C reactive protein (≥20 mg/L) as risk factors. The absence of any risk factor had a sensitivity of 96.0% (95% CI 80.5% to 99.3%), a negative predictive value of 99.4% (95% CI 96.4% to 99.9%) and a specificity of 32.9% (95% CI 28.8% to 37.3%) for ruling out an IBI. Applying it in the 449 infants of the validation set (IBI rate 4.9%), sensitivity, negative predictive value and specificity were 100% (95% CI 87.1% to 100%), 100% (95% CI 97.3% to 100%) and 29.7% (95% CI 25.8% to 33.8%), respectively.

Conclusion

This prediction rule accurately identified well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of IBI. This score can be used to guide initial clinical decision-making in these patients, selecting infants suitable for an outpatient management.
Optic nerve head vessel density in different stages of pseudoexfoliation disease
Authors: Safizadeh Mona , Shaabani Amirreza , Kamalipour Alireza , Fard Masoud Aghsaei , Yeh Kaileen , Yaseri Mehdi , Hamzeh Nikoo , Khatibi Nassim , Rao Harsha Laxmana , Weinreb Robert , Moghimi Sasan
Published: November 2020

Purpose

To evaluate the superficial vascular density of the optic nerve head in different stages of pseudoexfoliation disease using optical coherence tomography angiography (OCTA).

Methods

In this cross-sectional study, 57 normal eyes, 41 eyes with pseudoexfoliation syndrome (PXS), 82 eyes with pseudoexfoliation glaucoma (PXG) and 27 non-glaucomatous fellow eyes of PXG (NL-PXG) that had OCTA were included. Circumpapillary RNFL (cpRNFL) thickness and circumpapillary capillary density (cpCD) were compared among the groups after adjusting for confounders using linear-mixed model.

Results

PXG eyes had thinner global RNFL and lower cpCD (74.2±14.3 µm and 36.7±10.0%) than control (103.3±8.6 µm and 52.5±2.3%), PXS (96.8±8.8 µm and 51.5±2.3%), and NL-PXG eyes (96.3±11.1 µm and 50.1±3.9%) (p<0.001). After adjustment for age, gender and signal strength index, global cpRNFL thickness was comparable among control, PXS and NL-PXG. NL-PXG had the lowest cpCD (p=0.045) and sectoral cpCD compared to PXS and control eyes. Although cpCD was comparable between control and PXS (p=0.425) eyes, sectoral differences (p=0.009 and 0.004, for inferonasal and temporal-inferior cpCD, respectively) were detectable between the two groups. AUROC for differentiating NL-PXG eyes from normal were better for cpCD (0.78) compared to cpRNLF (0.69).

Conclusions

OCTA can detect reduced capillary density before significant changes in cpRNFL in fellow eyes of PXG patients. This can enable earlier detection of glaucomatous loss in pseudoexfoliation disease and enhance management of the disease.
Real-world risk of hypoglycemia-related hospitalization in Japanese patients with type 2 diabetes using SGLT2 inhibitors: a nationwide cohort study
Authors: Horii Takeshi , Oikawa Yoichi , Kunisada Narumi , Shimada Akira , Atsuda Koichiro
Published: November 2020

Introduction

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are believed to lower glucose levels and inhibit cardiovascular events related to type 2 diabetes (T2D). To maximize their benefits, the risk of resultant hypoglycemia has to be minimized; however, the magnitude of this risk remains unclear. Here, we aimed to identify clinical factors linked to an increased risk of hypoglycemia among Japanese patients with T2D and treated with SGLT2 inhibitors.

Research design and methods

This was a real-world retrospective cohort study conducted using the Japanese Medical Data Vision database. We identified patients with T2D and treated with SGLT2 inhibitors who were enrolled in the database from April 2014 to October 2019. Cox multivariate regression analyses were performed to determine demographical and clinical factors linked to SGLT2 inhibitor-associated hypoglycemia-related hospitalization.

Results

Of 171 622 patients prescribed SGLT2 inhibitors, hypoglycemia-related hospitalization occurred in 216 (0.13%), with 0.60 incidences per 100 person-years. The risk of SGLT2 inhibitor-associated hypoglycemia was higher with each 10-year increase in age (HR 1.49; 95% CI 1.32 to 1.68) and high in patients with body mass index <25 kg/m2 (HR 1.98; 95% CI 1.50 to 2.61), insulin use (HR 3.26; 95% CI 2.43 to 4.38), and sulfonylurea use (HR 1.44; 95% CI 1.02 to 2.03). The risk was lower in women than in men (HR 0.73; 95% CI 0.54 to 0.98) and low in concomitant metformin users (HR 0.52; 95% CI 0.37 to 0.74).

Conclusions

These findings may help minimize the risk of hypoglycemia-related hospitalization due to T2D treatment with SGLT2 inhibitors. We revealed that the risk of hypoglycemia may be higher when combining SGLT2 inhibitors with sulfonylureas and/or insulin. Furthermore, we discovered a high risk of hypoglycemia in older and non-obese patients. These findings may assist in maximizing the benefits of SGLT2 inhibitors for the treatment of T2D.
Relationship between triglyceride glucose index and the incidence of non-alcoholic fatty liver disease in the elderly: a retrospective cohort study in China
Authors: Huanan Chen , Sangsang Li , Amoah Adwoa Nyantakyiwaa , Yacong Bo , Xuejiao Chen , Zhan Shi , Guodong Wan , Jian Huang , Songhe Shi , Quanjun Lyu
Published: November 2020

Objective

Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of liver-related diseases but relationship between triglyceride glucose (TyG) and NAFLD in the elderly is not reported yet. In this study, we investigated the role of TyG index for predicting the incidence of NAFLD in the elderly.

Design and setting

This is a prospective cohort study in Henan, China, from 2011 to 2018.

Participants and methods

In total, 46 693 elderly who participated in a routine physical examination programme from 2011 to 2018 were included in this study. TyG index was calculated as ln (fasting triglyceride (mg/dL)×fasting plasma glucose (mg/dL)/2), while NAFLD was defined as hepatic steatosis after excluding other causes based on the results of abdominal ultrasonography; Cox regression model was performed to explore the relationship between TyG index and NAFLD. Also, mediation effect was used to analyse the role of the TyG index in WHtR (waist-to-height ratio) and NAFLD.

Results

During the 149 041 person-years follow-up, a total of 5660 NAFLD events occurred (3.80/100 person-years). After adjusting for potential confounding factors, quartiles 4 of TyG index significantly increased the incidence of NAFLD compared with quartile 1, the HRs and 95% CI were 1.314 (1.234 to 1.457). In addition, TyG index played a partial mediating role in the relationship between WHtR and NAFLD and indirect effect was 1.009 (1.006 to 1.011).

Conclusion

Higher TyG index was associated with higher risk of NAFLD in the aged, and therefore, TyG index may be a novel predictor for incidence of NAFLD. Further, regular examination and evaluation of the TyG index might be useful for controlling the occurrence of NAFLD.
Bleeding and thrombotic complications during treatment with direct oral anticoagulants or vitamin K antagonists in venous thromboembolic patients included in the prospective, observational START2-register
Authors: Palareti Gualtiero , Antonucci Emilia , Legnani Cristina , Mastroiacovo Daniela , Poli Daniela , Prandoni Paolo , Tosetto Alberto , Pengo Vittorio , Testa Sophie , Ageno Walter
Published: November 2020

Objective

The proportion and characteristics of Italian patients affected by venous thromboembolism (VTE) treated with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs), and complications occurring during follow-up.

Design

A prospective cohort of 2728 VTE patients included in the Survey on anticoagulaTed pAtients RegisTer (START2-Register) from January 2014 to June 2018 was investigated. Characteristics of patients, type of treatment and complications occurring during 2962 years of follow-up were analysed.

Setting

About 60 Italian anticoagulation and thrombosis centres participated in the observational START2-Register

Participants

2728 adult patients with VTE of a lower limb and/or pulmonary embolism (PE), with a follow-up after the initial phase treatment.

Interventions

Patients could receive DOACs or VKAs; both prescribed by the National and Regional Health Systems for patients with VTE.

Outcomes measures

Efficacy: rate of VTE recurrence (all thrombotic complications were also recorded). Safety: the rate of major and clinically relevant non-major bleeding events.

Results

Almost 80% of patients were treated with DOACs. The prevalence of symptomatic PE and impaired renal function was higher in patients receiving VKAs. Duration of anticoagulation was >180 days in approximately 70% of patients. Bleeding events were similar in both treatment groups. The overall eventuality of recurrence was significantly higher in DOAC cohorts versus VKA cohorts (HR 2.15 (1.14–4.06), p=0.018); the difference was almost completely due to recurrences occurring during extended treatment (2.73% DOAC vs 0.49% VKA, p<0.0001). All-cause mortality was higher in VKA-treated (5.9%) than in DOAC-treated patients (2.6%, p<0.001).

Conclusion

Italian centres treat most patients with VTE with DOACs and prefer VKA for those with more serious clinical conditions. Recurrences were significantly more frequent in DOAC-treated patients due to increased incidence after 180 days of treatment, probably due to reduced adherence to treatment. These results underline the importance of structured surveillance of DOAC-treated patients with VTE to strengthen treatment adherence during extended therapy.
Retrospective cohort study of clinical characteristics of 2199 hospitalised patients with COVID-19 in New York City
Authors: Paranjpe Ishan , Russak Adam J , De Freitas Jessica K , Lala Anuradha , Miotto Riccardo , Vaid Akhil , Johnson Kipp W , Danieletto Matteo , Golden Eddye , Meyer Dara , Singh Manbir , Somani Sulaiman , Kapoor Arjun , O'Hagan Ross , Manna Sayan , Nangia Udit , Jaladanki Suraj K , O’Reilly Paul , Huckins Laura M , Glowe Patricia , Kia Arash , Timsina Prem , Freeman Robert M , Levin Matthew A , Jhang Jeffrey , Firpo Adolfo , Kovatch Patricia , Finkelstein Joseph , Aberg Judith A , Bagiella Emilia , Horowitz Carol R , Murphy Barbara , Fayad Zahi A , Narula Jagat , Nestler Eric J , Fuster V , Cordon-Cardo Carlos , Charney Dennis , Reich David L , Just Allan , Bottinger Erwin P , Charney Alexander W , Glicksberg Benjamin S , Nadkarni Girish N
Published: November 2020

Objective

The COVID-19 pandemic is a global public health crisis, with over 33 million cases and 999 000 deaths worldwide. Data are needed regarding the clinical course of hospitalised patients, particularly in the USA. We aimed to compare clinical characteristic of patients with COVID-19 who had in-hospital mortality with those who were discharged alive.

Design

Demographic, clinical and outcomes data for patients admitted to five Mount Sinai Health System hospitals with confirmed COVID-19 between 27 February and 2 April 2020 were identified through institutional electronic health records. We performed a retrospective comparative analysis of patients who had in-hospital mortality or were discharged alive.

Setting

All patients were admitted to the Mount Sinai Health System, a large quaternary care urban hospital system.

Participants

Participants over the age of 18 years were included.

Primary outcomes

We investigated in-hospital mortality during the study period.

Results

A total of 2199 patients with COVID-19 were hospitalised during the study period. As of 2 April, 1121 (51%) patients remained hospitalised, and 1078 (49%) completed their hospital course. Of the latter, the overall mortality was 29%, and 36% required intensive care. The median age was 65 years overall and 75 years in those who died. Pre-existing conditions were present in 65% of those who died and 46% of those discharged. In those who died, the admission median lymphocyte percentage was 11.7%, D-dimer was 2.4 μg/mL, C reactive protein was 162 mg/L and procalcitonin was 0.44 ng/mL. In those discharged, the admission median lymphocyte percentage was 16.6%, D-dimer was 0.93 μg/mL, C reactive protein was 79 mg/L and procalcitonin was 0.09 ng/mL.

Conclusions

In our cohort of hospitalised patients, requirement of intensive care and mortality were high. Patients who died typically had more pre-existing conditions and greater perturbations in inflammatory markers as compared with those who were discharged.
Lung volume reduction eligibility in patients with COPD completing pulmonary rehabilitation: results from the UK National Asthma and COPD Audit Programme
Authors: Buttery Sara C , Lewis Adam , Kemp Samuel V , Banya Winston , Quint Jennifer K , Steiner Michael C , Hopkinson Nicholas S
Published: November 2020

Objectives

To establish what proportion of patients completing a UK pulmonary rehabilitation (PR) programme meet the 2018 National Institute for Health and Care Excellence (NICE) chronic obstructive pulmonary disease (COPD) guideline (NG115) criteria to have a respiratory review to establish whether referral to a lung volume reduction multidisciplinary team would be appropriate. This respiratory review would include evaluation of the presence of hyperinflation and the presence of emphysema on CT scan. The NICE criteria include measures of breathlessness and exercise capacity but these parameters are not completely defined.

Design

Observational study.

Setting

PR programmes across the UK in 2015 (210 centres) and 2017 (184 centres) entering data into the Royal College of Physicians’ National Asthma and COPD Audit Programme.

Participants

8295 (55.7%) of 14 889 patients in programmes using incremental shuttle walk test (ISWT) or 6-minute walk test (6MWT) as an outcome measure completed PR, and 4856 (32.6%) had complete data recorded (6MWT/ISWT, baseline spirometry, Medical Research Council (MRC) dyspnoea score).

Results

Depending on the walking test safety threshold adopted for the ISWT (≥140 m or ≥ 80 m) and the MRC dyspnoea score threshold used (MRC score ≥3 or ≥4 at the end of PR), between 4.9% and 18.1% of PR completers met the NICE criteria for a lung volume reduction-focused respiratory review.

Conclusions

Lung volume reduction therapies are beneficial in appropriately selected patients with COPD, but few procedures are performed, and treatment pathways are unclear. These data help to inform the feasibility of the approach recommended by NICE and highlight the need for future systematic pathways to reduce inequalities in patients being considered for effective treatments.
Women’s experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis
Authors: Tarzia Laura , Bohren Meghan A , Cameron Jacqui , Garcia-Moreno Claudia , O'Doherty Lorna , Fiolet Renee , Hooker Leesa , Wellington Molly , Parker Rhian , Koziol-McLain Jane , Feder Gene , Hegarty Kelsey
Published: November 2020

Objective

To identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP).

Methods

The databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women’s experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of individual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis.

Results

Thirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women’s experiences and expectations of HCPs: (1) connection through kindness and care; (2) see the evil, hear the evil, speak the evil; (3) do more than just listen; and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women.

Conclusions

Our findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their individual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.
Development and evaluation of a brief educational cartoon on trainee clinicians’ awareness of risks of ionising-radiation exposure: a feasibility pre-post intervention study of a novel educational tool to promote patient safety
Authors: Thurley Pete , Bowker Richard , Bhatti Imran , Skelly Rob , Law Russ , Salaman Rachel , Young Ben , Fogarty Andrew
Published: November 2020

Background

Over recent decades, CT scans have become routinely available and are used in both acute medical and outpatient environments. However, there is a small increase in the risk of adverse consequences, including an increase in the risk of both malignancy and cataracts. Clinicians are often unaware of these facts, and this represents a challenge for medical educators in England, where almost 5 million CT scans are done annually. New whiteboard methodologies permit development of innovative educational tools that are efficient and scalable in communicating simple educational messages that promote patient safety.

Methods

A short educational whiteboard cartoon was developed to explore the prior observation that adolescents under the care of paediatricians had a much lower risk of receiving a CT scan than those under the care of clinicians who care for adults. This explored the risks after receiving a CT scan and strategies that can be used to avoid them. The educational cartoon was piloted on new doctors who were attending induction training at a busy teaching hospital.

Results

The main output was the educational whiteboard cartoon itself. Before the new medical trainees’ induction, 56% (25/45) had received no formal training in radiation awareness, and this decreased to 26% (6/23) after the exposure to the educational cartoon (p=0.02). At baseline, 60% (27/45) of respondents considered that young females were at highest risk from exposure to ionising radiation, and this increased to 87% (20/23) after exposure to the educational cartoon (p=0.06).

Conclusions

This proof-of-concept feasibility study demonstrates that whiteboard cartoons provide a novel and feasible approach to efficiently promote patient safety issues, where a short succinct message is often appropriate.
Barriers and enablers to the implementation of multidisciplinary team meetings: a qualitative study using the theoretical domains framework
Authors: Maharaj Ashika D , Evans Sue M , Zalcberg John R , Ioannou Liane J , Graco Marnie , Croagh Daniel , Pilgrim Charles H C , Dodson Theresa , Goldstein David , Philip Jennifer , Kench James G , Merrett Neil D , Neale Rachel E , White Kate , Evans Peter , Leong Trevor , Green Sally E
Published: November 2020

Background

Evidence-based clinical practice guidelines recommend discussion by a multidisciplinary team (MDT) to review and plan the management of patients for a variety of cancers. However, not all patients diagnosed with cancer are presented at an MDT.

Objectives

(1) To identify the factors (barriers and enablers) influencing presentation of all patients to, and the perceived value of, MDT meetings in the management of patients with pancreatic cancer and; (2) to identify potential interventions that could overcome modifiable barriers and enhance enablers using the theoretical domains framework (TDF).

Methods

Semistructured interviews were conducted with radiologists, surgeons, medical and radiation oncologists, gastroenterologists, palliative care specialists and nurse specialists based in New South Wales and Victoria, Australia. Interviews were conducted either in person or via videoconferencing. All interviews were recorded, transcribed verbatim, deidentified and data were thematically coded according to the 12 domains explored within the TDF. Common belief statements were generated to compare the variation between participant responses.

Results

In total, 29 specialists were interviewed over a 4-month period. Twenty-two themes and 40 belief statements relevant to all the TDF domains were generated. Key enablers influencing MDT practices included a strong organisational focus (social/professional role and identity), beliefs about the benefits of an MDT discussion (beliefs about consequences), the use of technology, for example, videoconferencing (environmental context and resources), the motivation to provide good quality care (motivation and goals) and collegiality (social influences). Barriers included: absence of palliative care representation (skills), the number of MDT meetings (environmental context and resources), the cumulative cost of staff time (beliefs about consequences), the lack of capacity to discuss all patients within the allotted time (beliefs about capabilities) and reduced confidence to participate in discussions (social influences).

Conclusions

The internal and external organisational structures surrounding MDT meetings ideally need to be strengthened with the development of agreed evidence-based protocols and referral pathways, a focus on resource allocation and capabilities, and a culture that fosters widespread collaboration for all stages of pancreatic cancer.
Physical appearance and well-being in adults with incurable cancer: a thematic analysis
Authors: Tollow Philippa , Ogden Jane , McCabe Candida S , Harcourt Diana
Published: November 2020

Objectives

Existing research has established the importance of appearance concerns for individuals with cancer and identified appearance as an important factor in dying with dignity. No research, however, has explored in depth the role of appearance in the experiences of individuals who have incurable cancer. This research aims to explore patients’ experiences and perspectives in relation to the role of appearance issues in adults with incurable cancer.

Methods

Semi-structured interviews were conducted with 24 adults with incurable cancer (20 women, 4 men; mean age 54.5, SD 11.32).

Results

Thematic analysis generated three themes: ‘Identity: Embodying Cancer’, ‘Communication: Wearing your illness’ and ‘Support: Holistic Care’. Appearance was felt to be an important element of identity, which was often dominated by cancer, leading to feelings of separation from the participant’s previous self. Appearance changes also influenced the way in which individuals communicated with their external world, forcing discussion of their diagnosis, and increasing focus on their cancer, with participants having to manage the emotional impact of this on loved ones, as well as the impact on their legacy. Finally, participants highlighted the positive impact of appearance-related support in their well-being and identified peer connections and refocusing on the self as key elements of such support.

Conclusions

Appearance changes play an important role in the experiences of individuals with incurable cancer with regards to both identity and communication and challenged participants’ ability to maintain normalcy. Further psychosocial support relating to appearance concerns was considered necessary to promote dignity and provide truly holistic patient care.
Need for patient-developed concepts of empowerment to rectify epistemic injustice and advance person-centred care
Authors: Bogaert Brenda
Published: November 2020

The dominant discourse in chronic disease management centres on the ideal of person-centred healthcare, with an empowered patient taking an active role in decision-making with their healthcare provider. Despite these encouraging developments toward healthcare democracy, many person-centred conceptions of healthcare and programming continue to focus on the healthcare institution’s perspective and priorities. In these debates, the patient’s voice has largely been absent. This article takes the example of patient empowerment to show how the concept has been influenced by a variety of competing and shifting influences that have led to conceptualisations and programming designed for the patient, but developed without the patient. The framework of epistemic injustice is proposed to unravel the complexity of these omissions. The concept can be defined as a wrong done to someone specifically in their capacity as a knower. It occurs when a person is ignored or not believed due to a prejudice of some kind. It has been applied to healthcare in order to better understand barriers for patient participation and will be used to better understand the problems with current empowerment definitions and implementation strategies. The article will end by proposing some methodologies to facilitate patient-developed concepts of empowerment.
Reconsidering scarce drug rationing: implications for clinical research
Authors: Nakamura Zev M , MacKay Douglas P , Davis Arlene M , Brassfield Elizabeth R , Joyner Jr. Benny L , Rosenstein Donald L
Published: November 2020

Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: (1) clinical use may not have stronger evidence than research use; (2) a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; (3) treatment within the context of a clinical trial may be the standard of care; and (4) research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation.
Crown structure of European beech (Fagus sylvatica): a noncausal proxy for mechanical–physical wood properties
Authors: Rais Andreas , Jacobs Martin , van de Kuilen Jan-Willem G. , Pretzsch Hans
Published: November 2020

The current tendency towards the silvicultural promotion of mixed tree species has increased the variability in the crown structure within stands. This study shows how neighbouring trees can influence both the external crown features and internal wood properties of trees. Using terrestrial laser scanning, the crown features of 100 European beech trees (Fagus sylvatica L.) from pure beech stands and mixed stands of beech with Douglas fir (Pseudotsuga menziesii (Mirb.) Franco), Norway spruce (Picea abies (L.) Karst.), sessile oak (Quercus petraea (Matt.) Liebl.), and Scots pine (Pinus sylvestris L.) were recorded. After felling and sawing, the dynamic modulus of elasticity was determined on 1623 boards from the two lowest 4.1 m logs. Significant differences were found between beech trees from pure stands and those from beech–pine mixed stands in terms of crown volume (415 vs 766 m3), crown ratio (50.0% vs 71.5%), crown projection ratio (0.182 vs 0.253 m·cm−1), and branch angle (30.7° vs 54.1°). Multiple regression mixed models revealed significant relationships between timber stiffness and crown volume (–1.7 N·mm−2·m−3), crown ratio (–28.4 N·mm−2·%−1), and crown projection ratio (–9835 N·mm−2·m−1·cm). Thus, the crown morphology of broad-leaved species reflects the tree’s long-term competitive status and suggests indicators for the assessment of mechanical–physical wood properties.
Dynamics of a Predator–Prey Model with Hunting Cooperation and Allee Effects in Predators
Authors: Zhang Jun , Zhang Weinian
Published: November 2020

With both hunting cooperation and Allee effects in predators, a predator–prey system was modeled as a planar cubic differential system with three parameters. The known work numerically plots the horizontal isocline and the vertical one with appropriately chosen parameter values to show the cases of two, one and no coexisting equilibria. Transitions among those cases with the rise of limit cycle and homoclinic loop were exhibited by numerical simulations. Although it is hard to obtain the explicit expression of coordinates, in this paper, we give the distribution of equilibria qualitatively, discuss all cases of coexisting equilibria, and obtain the Bogdanov–Takens bifurcation diagram to show analytical parameter conditions for those transitions. Our results give analytical conditions for not only the observed saddle-node bifurcation, Hopf bifurcation and homoclinic bifurcation but also the transcritical and pitchfork bifurcations at the predator-extinction equilibrium, which were not considered in the known work. Our analytic conditions provide a quantitative instruction to reduce the risk of predator extinction and promote the ecosystem diversity.
Spatiotemporal Dynamics Induced by Michaelis–Menten Type Prey Harvesting in a Diffusive Leslie–Gower Predator–Prey Model
Authors: Zuo Wei-Qin , Ma Zhan-Ping , Cheng Zhi-Bo
Published: November 2020

This paper is devoted to study the spatiotemporal dynamics of a diffusive Leslie–Gower predator–prey model with Michaelis-Menten type harvesting in the prey population. The existence and stability of possible non-negative constant equilibria are investigated. By regarding [Formula: see text] as a bifurcation parameter, the Hopf bifurcation from the positive constant equilibrium solution is investigated. The necessary and sufficient conditions of Turing instability are explicitly obtained. We show that at the critical value of the bifurcation parameter [Formula: see text] a Turing bifurcation occurs (i.e. a pattern arises). The conditions for the stability of the pattern are also derived in detail. Moreover, the global steady state bifurcation from the positive constant equilibrium solution is investigated. In particular, the local steady state bifurcation from double zero eigenvalues is also obtained by the techniques of space decomposition and the implicit function theorem. Our results show that Michaelis–Menten type harvesting in our model plays a crucial role in the formation of spatiotemporal dynamics, which is a strong contrast to the case without harvesting.
EFFECTS OF VOLATILITY AMONG COMMODITIES IN THE LONG TERM: ANALYSIS OF A COMPLEX NETWORK
Authors: DE OLIVEIRA PASSOS MARCELO , TESSMANN MATHIAS SCHNEID , ELY RÉGIS AUGUSTO , UHR DANIEL , TAVEIRA MÁRCIO TACELI
Published: November 2020

The large inflow of investment capital in critical periods sparked a debate about the extent to which these speculative bubbles affect asset volatility and how (and what extent) these volatilities are transmitted between them. In periods of greater uncertainty, commodity futures markets may receive and/or send two types of volatility spillovers: intergroup of assets and/or intragroup of assets. We tested for the period from March 3, 2000 to May 4, 2017, which of the two effects prevailed and in which group of assets was more intense. We concluded that the most relevant volatility transmission effects (measured by Diebold–Yilmaz indices) occurred intragroup of assets — corn, wheat, soy, oats and rice. These assets make up the main cluster of a commodities complex network. Thus, we detected and measured using network approach that the most significant effects was over the years of the Great Recession (2007–2009) and the peak of the European Sovereign Debt Crisis (2010–2012).
Layered neural rendering for retiming people in video
Authors: Lu Erika , Cole Forrester , Dekel Tali , Xie Weidi , Zisserman Andrew , Salesin David , Freeman William T. , Rubinstein Michael
Published: November 2020

We present a method for retiming people in an ordinary, natural video --- manipulating and editing the time in which different motions of individuals in the video occur. We can temporally align different motions, change the speed of certain actions (speeding up/slowing down, or entirely "freezing" people), or "erase" selected people from the video altogether. We achieve these effects computationally via a dedicated learning-based layered video representation, where each frame in the video is decomposed into separate RGBA layers, representing the appearance of different people in the video. A key property of our model is that it not only disentangles the direct motions of each person in the input video, but also correlates each person
automatically
with the scene changes they generate---e.g., shadows, reflections, and motion of loose clothing. The layers can be individually retimed and recombined into a new video, allowing us to achieve realistic, high-quality renderings of retiming effects for real-world videos depicting complex actions and involving multiple individuals, including dancing, trampoline jumping, or group running.
A harmonic balance approach for designing compliant mechanical systems with nonlinear periodic motions
Authors: Tang Pengbin , Zehnder Jonas , Coros Stelian , Thomaszewski Bernhard
Published: November 2020

We present a computational method for designing compliant mechanical systems that exhibit large-amplitude oscillations. The technical core of our approach is an optimization-driven design tool that combines sensitivity analysis for optimization with the Harmonic Balance Method for simulation. By establishing dynamic force equilibrium in the frequency domain, our formulation avoids the major limitations of existing alternatives: it handles nonlinear forces, side-steps any transient process, and automatically produces periodic solutions. We introduce design objectives for amplitude optimization and trajectory matching that enable intuitive high-level authoring of large-amplitude motions. Our method can be applied to many types of mechanical systems, which we demonstrate through a set of examples involving compliant mechanisms, flexible rod networks, elastic thin shell models, and multi-material solids. We further validate our approach by manufacturing and evaluating several physical prototypes.
Deferred neural lighting
Authors: Gao Duan , Chen Guojun , Dong Yue , Peers Pieter , Xu Kun , Tong Xin
Published: November 2020

We present deferred neural lighting, a novel method for free-viewpoint relighting from unstructured photographs of a scene captured with handheld devices. Our method leverages a scene-dependent neural rendering network for relighting a rough geometric proxy with learnable neural textures. Key to making the rendering network lighting aware are radiance cues: global illumination renderings of a rough proxy geometry of the scene for a small set of basis materials and lit by the target lighting. As such, the light transport through the scene is never explicitely modeled, but resolved at rendering time by a neural rendering network. We demonstrate that the neural textures and neural renderer can be trained end-to-end from unstructured photographs captured with a double hand-held camera setup that concurrently captures the scene while being lit by only one of the cameras' flash lights. In addition, we propose a novel augmentation refinement strategy that exploits the linearity of light transport to extend the relighting capabilities of the neural rendering network to support other lighting types (e.g., environment lighting) beyond the lighting used during acquisition (i.e., flash lighting). We demonstrate our deferred neural lighting solution on a variety of real-world and synthetic scenes exhibiting a wide range of material properties, light transport effects, and geometrical complexity.