bluuebunny/crossref_metadata_2025 huggingface dataset:
QTL analysis of salt tolerance in Sorghum bicolor during whole‐plant growth stages
Authors: Wang Hailian , Wang Runfeng , Liu Bin , Yang Yanbing , Qin Ling , Chen Erying , Zhang Huawen , Guan Yanan
Published: January 2020

To study the salt tolerance genetics of sorghum, 181 recombinant inbred lines (RILs) were used to locate quantitative trait loci (QTLs) underlying salt stress adaptability. Six traits, namely, plant height (PH), stem diameter (SD), total biomass (TB), stem fresh weight (SFW), juice weight (JW) and Brix, were investigated under normal and salt stress conditions in two years. A total of 53 QTLs for the six traits under both conditions and their corresponding salt tolerance index (STI) were detected and phenotypic variation explained (PVE) ranged from 4.16% to 20.42%. Six of the QTLs, qTB6, qSFW9, qJW9, qBrix2, qBrix10 and qSTI‐Brix9, were the main effect QTLs controlling salt tolerance and had a PVE more than 10%. qSFW9 and qJW9 colocalized in the same marker interval as SB5069‐UGSM18 and had PVEs of 17.70% and 14.20%, respectively, with positive effects from L‐Tian. QTL clusters controlling PH, TB, STI‐TB, SFW and JW were consistently mapped in the marker interval of Xcup19‐SB4177 on chromosome 7. These locations might serve as target sites for marker‐assisted selection (MAS) in improving salt tolerance of sorghum.
A retrospective study: Impact of consensus treatment plans on systemic therapy of pediatric morphea
Authors: Do Ngan , Ringold Sarah , Sullivan Erin , Brandling‐Bennett Heather
Published: January 2020

Background

Morphea is an inflammatory and fibrosing condition that affects the skin and subcutaneous structures. Morphea is managed by dermatologists, rheumatologists, or both. Prior studies have suggested there is significant variability in approach to treatment. In 2012, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) published consensus treatment plans (CTPs) for pediatric morphea to develop more standardized treatment plans for patients requiring systemic therapy. We aimed to assess whether the publication of CTPs has impacted care of patients with morphea at our institution.

Methods

Data were collected via a retrospective review of medical records of 61 pediatric patients diagnosed with morphea at Seattle Children's Hospital (SCH) from January 1, 2005, to December 12,2017.

Results

Prior to the publication of CTPs, 2 out of 24 patients (8.3%) were treated with a regimen that matched a subsequent CTP. After publication of CTPs, 29 out of 37 patients (78.4%) were treated with a regimen that matched a CTP (P < 0.001). A subanalysis was performed to assess the number of patients who needed second‐ or third‐line therapies. Of those who followed a CTP therapy plan (n = 26), 3 patients (11.5%) needed a second‐line therapy compared with 11 patients (44%) in the no‐CTP followed group (n = 25), (P = 0.012).

Conclusions

The publication of CTPs led to a significant change in treatment approach for patients with morphea requiring systemic therapy at SCH. Patients treated with one of the treatment plans recommended by the CTPs were less likely to need second‐line systemic therapy.
Associations of acetaminophen use during pregnancy and the first year of life with neurodevelopment in early childhood
Authors: Bertoldi Andréa D. , Rifas‐Shiman Sheryl L. , Boing Alexandra Crispim , da Silva Dal Pizzol Tatiane , Miranda Vanessa Iribarrem Avena , Silveira Marysabel Pinto Telis , Freitas Silveira Mariângela , Domingues Marlos R. , Santos Ina S. , Bassani Diego G. , Tovo‐Rodrigues Luciana , Oken Emily
Published: January 2020

Background

Over‐the‐counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children.

Objective

Estimate associations of prenatal and early‐life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts.

Methods

The American Project Viva cohort (1217 mother‐child pairs enrolled 1999‐2002) assessed cognition at approximately 3 years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother‐child pairs) assessed cognition at 2 years using the INTERGROWTH‐21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre‐pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex.

Results

In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (β −1.51, 95% CI −2.92, −0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER‐NDA motor scores (β 0.02; 95% CI −0.05, 0.09) and was associated with higher INTER‐NDA total scores (β 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations.

Conclusions

Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.
Understanding the link between work engagement and job satisfaction: Do role stressors underlie this relationship?
Authors: Orgambídez Alejandro , Extremera Natalio
Published: January 2020

Drawing upon Job Demands‐Resources (JD‐R) theory, most research on hindrance demands has focused on the antecedent role of work engagement. However, no studies have analysed the potential effects of hindrance demands as moderators in the engagement‐job satisfaction link. The objective of this study was to examine the moderator effect of role stressors (conflict and ambiguity) as hindrance demands in the relationship between work engagement and job satisfaction in a Spanish working sample. The sample was composed of 634 Spanish workers from different Southern service organizations. Hierarchical multiple regression results showed that the association between work engagement and job satisfaction decreased when role stress (particularly ambiguity) increased. These results underline the need to clarify goals, specify norms about work and member roles in organizations and determine the deleterious effect of hindrance demands even in engaged workers.
Procedure for accurate calculation of the J‐integral from digital volume correlation displacement data
Authors: Becker T.H. , Molteno M.R. , Marrow T.J.
Published: January 2020

The application of digital image and volume correlation techniques to obtain displacement fields from images has become ubiquitous in experimental fracture mechanics. In this paper, a procedure to extract the J‐integral (J) from three‐dimensional displacement fields obtained using digital volume correlation is presented. The procedure has been specially adapted to allow for experimental noise and errors, such as poorly defined crack front displacements, smearing of the displacement field across the crack faces, and knowledge of the imprecise crack front location. The implementation is verified using analytical crack‐tip fields perturbed with synthetic image correlation errors to characterise the response of J. The method is then applied to experimental results using a Magnesium alloy WE43 loaded elastically in mixed mode. The steps outlined are intended as a guideline for the application of the volume integral from displacement fields to allow for accurate calculation of J along a crack front embedded within the volume.
Characterization of two new HLA alleles: HLA‐A*33:199 and HLA‐B*13:140
Authors: Swelsen Wendy T. N. , Tetar Gayatri C. , Varlack Samantha V. , Matar Abir , Lardy Neubury M.
Published: January 2020

Two new HLA alleles were identified during routine next generation sequencing.
A genetic link between leaf carbon isotope composition and whole‐plant water use efficiency in the C4 grass Setaria
Authors: Ellsworth Patrick Z. , Feldman Max J. , Baxter Ivan , Cousins Asaph B.
Published: January 2020

Genetic selection for whole‐plant water use efficiency (yield per transpiration; WUEplant) in any crop‐breeding programme requires high‐throughput phenotyping of component traits of WUEplant such as intrinsic water use efficiency (WUEi; CO2 assimilation rate per stomatal conductance). Measuring WUEi by gas exchange measurements is laborious and time consuming and may not reflect an integrated WUEi over the life of the leaf. Alternatively, leaf carbon stable isotope composition (δ13Cleaf) has been suggested as a potential time‐integrated proxy for WUEi that may provide a tool to screen for WUEplant. However, a genetic link between δ13Cleaf and WUEplant in a C4 species has not been well established. Therefore, to determine if there is a genetic relationship in a C4 plant between δ13Cleaf and WUEplant under well watered and water‐limited growth conditions, a high‐throughput phenotyping facility was used to measure WUEplant in a recombinant inbred line (RIL) population created between the C4 grasses Setaria viridis and S. italica. Three quantitative trait loci (QTL) for δ13Cleaf were found and co‐localized with transpiration, biomass accumulation, and WUEplant. Additionally, WUEplant for each of the δ13Cleaf QTL allele classes was negatively correlated with δ13Cleaf, as would be predicted when WUEi influences WUEplant. These results demonstrate that δ13Cleaf is genetically linked to WUEplant, likely to be through their relationship with WUEi, and can be used as a high‐throughput proxy to screen for WUEplant in these C4 species.
Synthesis and Characterization of the Paraffin/Expanded Perlite Loaded With Graphene Nanoparticles as a Thermal Energy Storage Material in Buildings
Authors: Rathore Pushpendra Kumar Singh , Shukla Shailendra Kumar , Gupta Naveen Kumar
Published: January 2020

Various properties of the paraffin have made them compatible to be incorporated in the building materials for improving the latent heat storage capacity of the building envelope. However, the poor thermal conductivity of the paraffin reduces their thermal performance and hence limits their direct application/incorporation in the buildings. In this study, composite mixtures of paraffin and expanded perlite (EP) with an equal weight percent of 49.5 and 47.5, loaded with 1% and 5% of graphene nano-platelets, respectively, were synthesized. The developed samples were characterized uncycled and after 2000 thermal cycles. The results indicate that phase change material (PCM)/expanded perlite/graphene nano-platelets composite shows a significant increment in the thermal conductivity, reduction in the latent heat storage capacity, and a small weight loss. The heat storage/release test depicts that the phase change material/expanded perlite/graphene nano-platelets-5 shows 1.66 and 2.5 times faster heat storage/release rate than phase change material/expanded perlite/graphene nano-platelets-1 and paraffin, respectively. There is no significant change noted after 2000 thermal cycles in phase change material/expanded perlite/graphene nano-platelets-5 and phase change material/expanded perlite/graphene nano-platelets-1 samples, suggesting long-term reliability of the composite PCM. Additionally, thermogravimetric analysis (TGA) and Fourier-transform infrared spectroscopy (FTIR) testing were also conducted and the results suggest high thermal reliability and good chemical compatibility. These analyses suggest that the phase change material/expanded perlite/graphene nano-platelets composite can become a potential candidate for thermal energy storage.
Comparative Study of New Airfoils for Small Horizontal Axis Wind Turbines
Authors: Canale Thiago , Ismail Kamal A. R. , Lino Fatima A. M. , Arabkoohsar Ahmad
Published: January 2020

The high cost and poor performance of small wind turbines make them not widely used. In an attempt to meliorate this situation, the authors propose to investigate alternative airfoils with different chord and pitch angle distributions that permit low manufacturing, installation and maintenance costs, as well as high efficiency. To achieve these goals, two airfoil sections, Gottingen and Joukowski, together with different chord and pitch angle distributions were simulated by using a validated numerical code based on the blade element momentum (BEM) method. The chord geometry includes constant, linear, and elliptic distributions while the twist angle includes constant and linear distributions. The results reveal that the linear pitch distribution reduces the thrust in the intermediate region of the blade and the bending moment at the root and reduces the power coefficient for both rotors. Rotors with elliptic chord distribution show increased forces in the intermediate region. Joukowski based blades with elliptic chord distribution show lower thrust compared with those with linear chord distribution. The linear chord distribution increases the thrust in the intermediate region and reduces it at the tip and root regions. Blades with multiple airfoils show marginal improvement. The Gottingen and Joukowski based rotors have similar annual energy production (AEP). The Joukowski based rotor with linear pitch and linear chord distribution shows better performance at low velocities and easy to manufacture which makes it a good candidate for small power wind turbines.
6 BIBLIOGRAPHY
Authors: -- --
Published: January 2020

Anthroposophy (Steiner)
Recovery of quantum efficiency on Cs/O-activated GaN and GaAs photocathodes by thermal annealing in vacuum
Authors: Sato Daiki , Nishitani Tomohiro , Honda Yoshio , Amano Hiroshi
Published: January 2020

In this paper, the authors describe the effectiveness of thermal annealing in vacuum for quantum efficiency (QE) recovery from Cs/O-activated GaN and GaAs photocathodes. The QE of Cs/O-activated GaN photocathodes at 3.4 eV dropped from 1.0% to <0.001% upon exposure to nitrogen and then increased to 0.6% upon annealing. On the other hand, the QE of Cs/O-activated GaAs at 1.42 eV did not increase after annealing. In addition, after Cs/O activation, the sample was exposed to normal laboratory air and installed in an X-ray photoemission spectroscopy system. Upon annealing at 330 °C, three key results were confirmed as follows: (1) the work function decreased by 0.32 eV, (2) the chemical states of Cs 4d and Ga 3d were unchanged, and (3) the intensities of O 1s and C 1s on the high-binding-energy side decreased. In conclusion, the experimental results indicate that the annealing recovers the QE of Cs/O-activated GaN photocathode.
Atomic layer deposition of Nb-doped TiO2: Dopant incorporation and effect of annealing
Authors: Berghuis Wilhelmus J. H. (Willem-Jan) , Melskens Jimmy , Macco Bart , Basuvalingam Saravana Balaji , Verheijen Marcel A. , Kessels Wilhelmus M. M. (Erwin)
Published: January 2020

Transparent conductive oxides form an important group of materials that combine high conductivity with high transparency. In this context, the authors designed an atomic layer deposition process for Nb-doped TiO2. The presented process enables accurate control over both the position and concentration of the Nb dopants. The as-deposited films become crystalline (brookite) and low resistive (4.3 × 10−3 Ω cm) upon a postdeposition anneal with temperatures as low as 300 °C. Variations in annealing ambient and temperature yielded resistivity changes over four orders of magnitude and significant changes in the sub-bandgap absorption of light. Next to doping, annealing is therefore shown to be a powerful tool in controlling electrical and optical properties of TiO2:Nb.
Atomic layer deposition of aluminum oxyfluoride thin films with tunable stoichiometry
Authors: Mahuli Neha , Cavanagh Andrew S. , George Steven M.
Published: January 2020

Atomic layer deposition (ALD) of aluminum oxyfluoride (AlOxFy) thin films was demonstrated at 150 °C. Trimethyl aluminum, water, and HF were used as the aluminum, oxygen, and fluorine sources, respectively. In situ quartz crystal microbalance studies were utilized to monitor the AlOxFy deposition. Two deposition pathways were explored to grow the AlOxFy thin films based on the HF exchange method and the nanolaminate method. Linear AlOxFy growth was observed during both deposition methods. The HF exchange method is based on the thermodynamically favorable fluorination of Al2O3 by HF. Compositional control was achieved either by changing the HF pressure during the HF exposure or by varying the thickness of the underlying Al2O3 layer prior to the HF exposure. The nanolaminate method is based on the sequential deposition of Al2O3 ALD and AlF3 ALD layers. The ratio of the number of Al2O3 ALD cycles to the number of AlF3 ALD cycles is the main parameter used to control the O and F concentrations. Ex situ x-ray photoelectron spectroscopy (XPS) depth-profiling and Rutherford backscattering spectroscopy measurements were used to determine the composition of the AlOxFy thin films. The XPS depth-profile measurements confirmed the uniform distribution of Al, O, and F throughout the AlOxFy films using both deposition methods. Both techniques could obtain a wide range of compositional tunability between Al2O3 and AlF3. Physical sputtering rates were also observed to be dependent on the relative concentrations of O and F in the AlOxFy films. The physical sputtering rates at 3 keV varied from 0.03  to 0.28 Å/s for Al2O3 and AlF3, respectively.
Accommodation of gender-related phonetic differences by listeners with cochlear implants and in a variety of vocoder simulations
Authors: Winn Matthew B.
Published: January 2020

Speech perception requires accommodation of a wide range of acoustic variability across talkers. A classic example is the perception of “sh” and “s” fricative sounds, which are categorized according to spectral details of the consonant itself, and also by the context of the voice producing it. Because women's and men's voices occupy different frequency ranges, a listener is required to make a corresponding adjustment of acoustic-phonetic category space for these phonemes when hearing different talkers. This pattern is commonplace in everyday speech communication, and yet might not be captured in accuracy scores for whole words, especially when word lists are spoken by a single talker. Phonetic accommodation for fricatives “s” and “sh” was measured in 20 cochlear implant (CI) users and in a variety of vocoder simulations, including those with noise carriers with and without peak picking, simulated spread of excitation, and pulsatile carriers. CI listeners showed strong phonetic accommodation as a group. Each vocoder produced phonetic accommodation except the 8-channel noise vocoder, despite its historically good match with CI users in word intelligibility. Phonetic accommodation is largely independent of linguistic factors and thus might offer information complementary to speech intelligibility tests which are partially affected by language processing.
Noise acceptance of acoustic sequences for indoor soundscape in transport hubs
Authors: Wang Bin , Kang Jian , Zhao Wei
Published: January 2020

Noise acceptance is an aspect of indoor soundscape research. While staying or walking in a transport hub, sequential sounds form sequence sounds sessions, which are referred to as an acoustic sequence. The basic phenomenon and effects of acoustic sequences on acceptance evaluations have been explored. A total of 209 sections of 30 s acoustic units were extracted before performing acceptance evaluations. The acoustic units were divided into strong, medium, and weak levels, and compiled into 37 pieces of acoustic sequences, which were then subjected to four tests for acceptance evaluation: sound content, acceptance level, and effects of weak and strong acceptance units. One piece of an acoustic sequence consists of 20 acoustic units. The results show that all acoustic sequences exhibit “attenuation effects”—as for any acoustic unit that makes up the sequence, general acceptance decreases with time. The lower the acceptance, the faster the decay in score. High acceptance units have an “enhancement effect,” and the acceptance increases after a high acceptance unit. Low acceptance units have a “boost effect,” and the acceptance increases after a low-level acceptance. Both enhancement and boost effects could improve the acceptance evaluation of acoustic sequences and sound experiences in transport hubs.
Fast computation of time-domain scattering by an inhomogeneous stratified seafloor
Authors: Olson Derek R. , Holland Charles W.
Published: January 2020

Marine sediment properties exhibit fluctuations on a very wide range of scales in all three spatial dimensions. These fluctuations lead to scattering of acoustic waves. Seabed scattering models that treat such fluctuations are reasonably well developed under the plane-wave assumption. A recent model, called TDSS (time domain model for seafloor scattering), accurately treats the important point-source-point-receiver geometry for generally stratified fluid sediments—important because this is the geometry employed in many seabed scattering measurements. The computational cost associated with this model is very high and scales roughly with the product of mean source-receiver height above the basement to the fifth power and both bandwidth and wavenumber to the second power. Thus, modeling deep ocean scattering from a near sea surface source and receiver is prohibitive at frequencies above a few tens of hertz. A computational approach was developed based on Levin's method of oscillatory integration, which is orders of magnitude faster than standard numerical integration techniques and makes deep ocean seabed scattering computations practical up to many kilohertz. This approach was demonstrated to agree with the narrowband sonar equation in several simple environments in the limit of small bandwidths, but the TDSS model is expected to be valid for a much wider range of environments.
6′-β-Fluoro-Homoaristeromycin and 6′-Fluoro-Homoneplanocin A Are Potent Inhibitors of Chikungunya Virus Replication through Their Direct Effect on Viral Nonstructural Protein 1
Authors: Kovacikova Kristina , Morren Bas M. , Tas Ali , Albulescu Irina C. , van Rijswijk Robin , Jarhad Dnyandev B. , Shin Young Sup , Jang Min Hwan , Kim Gyudong , Lee Hyuk Woo , Jeong Lak Shin , Snijder Eric J. , van Hemert Martijn J.
Published: January 2020

Alphaviruses are arthropod-borne, positive-stranded RNA viruses capable of causing severe disease with high morbidity. Chikungunya virus (CHIKV) is an alphavirus that causes a febrile illness which can progress into chronic arthralgia. The current lack of vaccines and specific treatment for CHIKV infection underscores the need to develop new therapeutic interventions. To discover new antiviral agents, we performed a compound screen in cell culture-based infection models and identified two carbocyclic adenosine analogues, 6′-β-fluoro-homoaristeromycin (FHA) and 6′-fluoro-homoneplanocin A (FHNA), that displayed potent activity against CHIKV and Semliki Forest virus (SFV) with 50% effective concentrations in the nanomolar range at nontoxic concentrations.
Complete Genome Sequence of
Chryseobacterium
sp. Strain NBC 122, a Plant Growth-Promoting Bacterium Isolated from Freshwater
Authors: Kim Hyangmi , Yu Sang Mi
Published: January 2020

Chryseobacterium
sp. strain NBC 122, isolated from freshwater of the Nakdong River in the Republic of Korea, was previously characterized as a plant growth-promoting bacterium. Here, we report the genome sequence of
Chryseobacterium
sp. NBC 122.
Complete Genome Sequence and Annotation of Campylobacter jejuni YH003, Isolated from Retail Chicken
Authors: He Yiping , Reed Sue , Strobaugh Terence P.
Published: January 2020

The complete genome sequence of
Campylobacter jejuni
YH003, isolated from retail chicken, was determined using PacBio and Illumina technologies. The assembled genome is 1,743,985 bp (G+C content of 30.3%). Genome annotation revealed several genes encoding virulence and antibiotic resistance factors, including a type VI secretion system, cytolethal distending toxins, and a multidrug efflux system.
Draft Genome Sequence of Red-Heat-Causing Halomonas eurihalina MS1, a Moderately Halophilic Bacterium Isolated from Saline Soil in Alicante, Spain
Authors: Hussain Syed Ammar , Xu Aixia , Sommers Christopher H. , Sarker Majher I.
Published: January 2020

Here, we report the draft genome sequence of
Halomonas eurihalina
MS1, which was isolated from saline soil in Alicante, Spain, and causes the condition known as “red heat” in salt-packed cured hides, decreasing their commercial value for leather production.
Complete Genome Sequences of Dengue Virus Type 2 Epidemic Strains from Reunion Island and the Seychelles
Authors: Pascalis Hervé , Biscornet Leon , Toty Céline , Hafsia Sarah , Roche Marjolaine , Desprès Philippe , Atyame Nten Célestine , Bibi Jastin , Louange Meggy , Gedeon Jude , Mavingui Patrick
Published: January 2020

Dengue virus has recently reemerged in the southern Indian Ocean islands, causing outbreaks in Reunion Island and the Seychelles. In the present study, we determined the complete genome sequences of closely related clinical isolates of dengue virus type 2 circulating in the Seychelles in 2016 and Reunion Island in 2018.
Genome Sequences of Brevundimonas naejangsanensis Strain FS1091 and Bacillus amyloliquefaciens Strain FS1092, Isolated from a Fresh-Cut-Produce-Processing Plant
Authors: Gu Ganyu , Gonzalez-Escalona Narjol , Zheng Jie , Bolten Samantha , Luo Yaguang , Mafiz Abdullah I. , Leon Maria Sanchez , Nou Xiangwu
Published: January 2020

The complete genome sequences of
Brevundimonas naejangsanensis
strain FS1091 and
Bacillus amyloliquefaciens
strain FS1092, which were isolated from a commercial fresh-cut-produce-processing facility, were determined. Both FS1091 and FS1092 have one circular chromosome of approximately 3.15 and 4.24 Mb, respectively.
Neonatal early onset sepsis in Middle Eastern countries: a systematic review
Authors: Khalil Nadim , Blunt Heather B , Li Zhongze , Hartman Tyler
Published: January 2020

Background

Early onset neonatal sepsis (EOS) accounts for a significant portion of neonatal mortality, which accounts for 46% of global under five child mortality.

Objective

This systematic review studies the bacterial aetiology of EOS in the Middle East, susceptibility patterns to recommended empirical antibiotic therapy and whether this differs between high-income and middle-income countries in the region.

Methods

Articles were collected from Medline, Web of Science, the Cochrane Library and Index Medicus for the Eastern Mediterranean Region. The articles included in our systematic review met the following criteria: published after January 2000, data relevant to the Middle East, data specific for early onset sepsis, no language restriction. Data on aetiology and susceptibility were extracted from prospective and retrospective studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. This study focused on EOS but does include data regarding neonatal late-onset sepsis antibiotic susceptibility. The data regarding coagulase-negativeStaphylococcusspecies were excluded from final analysis, as possible contaminants. The protocol for this systematic review was registered on PROSPERO: CRD42017060662.

Results

33 articles from 10 countries were included in the analysis. There were 2215 cases of culture-positive EOS, excluding coagulase-negativeStaphylococcus. In middle-income countries,Klebsiellaspecies (26%),Staphylococcus aureus(17%) andEscherichia coli(16%) were the most common pathogens, in contrast to group BStreptococcus(26%),E. coli(24%) andKlebsiella(9%) in high-income countries. Overall susceptibility to ampicillin/gentamicin and third-generation cephalosporin were 40% and 37%, respectively, in middle-income countries versus 93% and 91%, respectively, in high-income countries.

Conclusions

EOS in middle-income countries was more likely to be due to Gram-negative pathogens and less likely to be susceptible to empirical antibiotic therapy. This has important public health implications regarding neonatal mortality in the Middle East region.
Impact of sociodemographic and clinical factors on offer and parental consent to postmortem following stillbirth or neonatal death: a UK population-based cohort study
Authors: Evans Margaret J , Draper Elizabeth S , Smith Lucy K
Published: January 2020

Objective

To identify factors associated with the offer of and consent to perinatal post-mortem.

Design

National population-based cohort study

Setting

The UK.

Population

26 578 perinatal deaths born between 1 January 2013 and 31 December 2017.

Main outcome measures

Postmortem offer by clinical staff; parental consent to post-mortem.

Results

Postmortem offer rates were high but varied significantly with time of death from 97.8% for antepartum deaths to 88.4% for neonatal deaths following neonatal admission. Offer rates did not significantly vary by gestation, year of birth, mother’s socioeconomic deprivation, ethnicity or age. Only 44.5% of parents consented to a postmortem. Mothers from the most deprived areas were less likely to consent than those from the least deprived areas (relative risk (RR)=0.76, 95% CI 0.71 to 0.80). Consent rates were similar for mothers of white, mixed, Asian Indian, black Caribbean and black African ethnicity (43%–47%), but significantly lower for mothers of Asian Pakistani (20%) and Asian Bangladeshi (18%) ethnicity. Consent increased with increasing gestation (p<0.001) and was lower for deaths following neonatal unit admission than for antepartum death (RR 0.71, 95% CI 0.67 to 0.75).

Conclusions

The current profile of cause of perinatal deaths in the UK is likely to be biased with less postmortem information available for babies dying in the neonatal period and those born to mothers from deprived areas and of Asian Pakistani or Asian Bangladeshi ethnicity. Such bias severely limits the design of effective strategies for reducing mortality in these high-risk groups. These findings have implications for high-income countries seeking to explore and improve the understanding of perinatal deaths.
Poor balance, bilateral upper limb phocomelia, no previous exercise: a challenging combination for fall prevention in a middle-aged thalidomide survivor
Authors: Morrison Dee
Published: January 2020

Poor balance and falls pose substantial risks to health and well-being. Thalidomide survivors with arm defects have an additional risk being unable to protect themselves in a fall. Generic exercise information to improve strength and balance is increasingly available to the elderly. However, disability can carry a lifetime risk. Identifying and correcting underlying musculoskeletal issues, correction of gait abnormalities together with establishing an appropriate exercise routine that is affordable, convenient and fun should improve outcomes at any stage of adult life. This can be challenging, not least in those who have never previously exercised and who are now middle aged or older. The Thalidomide Trust piloted focused support for a middle-aged thalidomide survivor with bilateral radial club hands and increasing balance issues who had never previously exercised. This met with great success improving his strength, balance, gait and posture together with ensuring an established exercise routine to maintain the improvement.
Postoperative Horner’s syndrome following excision of incidental cervical ganglioneuroma during hemithyroidectomy and parathyroid gland exploration
Authors: McCrory David , Kelly Andrew , Korda Marian
Published: January 2020

This 49-year-old woman was referred to ear, nose and throat (ENT) with primary hyperparathyroidism. Imaging studies failed to localise the adenoma so she required four-gland parathyroid exploration. She also required diagnostic left hemithyroidectomy as she had a U3 nodule with multiple insufficient fine needle aspirations (FNAs). Intraoperatively, the left thyroidectomy proceeded uneventfully. No convincing left inferior parathyroid gland was identified however palpation revealed a 1 cm mass just medial to carotid artery. This was excised as probable ectopic parathyroid gland. She was discharged two days later. Thirteen days postoperatively she attended Eye Casualty with a left-sided Horner’s syndrome. A CT angio of aortic arch was normal. She was reviewed at ENT outpatients. Histopathology report of the expected ectopic parathyroid gland returned as benign ganglioneuroma, likely arising from her left sympathetic chain. Horner’s syndrome is a common side effect from excision of ganglioneuromas, but an incredibly rare side effect from thyroid or parathyroid surgery.
Occipital encephalocele in a neonate: a case successfully managed by excision and formation of a reverse visor scalp flap
Authors: Tan Elizabeth , Makaranka Stanislau , Mohamed Nusrat , Cavale Naveen
Published: January 2020

Encephaloceles are one form of neural tube defect and are associated with partial absence of skull bone fusion, with an incidence of 1–4 cases for every 10 000 live births. We report the case of a neonate born at term, with an antenatal diagnosis of occipital encephalocele, which was successfully managed with excision and formation of a reverse visor scalp flap on day 2 of life.

Surgery was performed in a single stage, involving a multidisciplinary approach between neurosurgery and plastic surgery teams, with wider management involving neonatal intensive care, paediatric, obstetric and anaesthetic teams.

The patient had no early postoperative complications, and we use this case report to demonstrate that a reverse visor scalp flap is a good option to cover full-thickness defects in patients with encephaloceles.

Furthermore, we advocate early repair and a multidisciplinary approach to minimise the morbidity associated with occipital encephaloceles.
Binasal hemianopia in two sisters
Authors: Scotcher Sam , Morphis George , Good Peter
Published: January 2020

Binasal hemianopia is a rare visual field defect. A teenage girl presented with blurred vision and persistent headaches following a minor head injury. The ocular examination was normal except for a binasal hemianopia, and subsequent neuroimaging was also unremarkable. Her older sister was found to have the same visual field defect, also with normal neuroimaging. This represents the first reported case of binasal hemianopia found in siblings. Given that no neurological or ocular cause was identified in either sister, this supports the theory of an unknown congenital aetiology.
Isolated unilateral proximal focal femoral deficiency presenting in a young woman
Authors: Özdemir Meltem , Kavak Rasime Pelin , Ceylan Arda Halil , Cevval Zeycan Kübra
Published: January 2020

Proximal focal femoral deficiency (PFFD) is a rare congenital skeletal abnormality characterised by the partial absence of the proximal femoral segment with shortening of the entire lower extremity. It typically presents as a shortened thigh, which is flexed, externally rotated and abducted. Some other skeletal anomalies, especially fibular hemimelia, usually accompany the disorder. The diagnosis of PFFD is made in early childhood and based mainly on conventional radiography. However, the radiographic appearance of the disease evolves as the child grows. In addition, treatment procedures applied to the child affect the radiographic presentation of the disease in adulthood. Almost all cases of PFFD reported to date are in young children and in the current literature, there is a paucity of radiographic images of PFFD in mature skeleton. The aim of this case report is to present the radiographic appearance of PFFD in an adult patient and to increase awareness among radiologists about this disease.
A severe case of methaemoglobinaemia in a Brazilian hairdresser
Authors: de Vere Felicity , Moores Rachel , Dhadwal Kulwant , Karra Efthimia
Published: January 2020

Methaemoglobinaemia is an extremely rare condition with multiple causes, both genetic and acquired. We present a severe case of methaemoglobinaemia occurring in a Brazilian hairdresser working in the UK. She presented after several days of preparing popular ‘Brazilian blowdry’ treatments for customers at a hair salon. She had been exposed to multiple volatile chemicals, including formaldehyde, without any respiratory protection, and we postulate that this may have caused her illness. If so, this would be the first published case of methaemoglobinaemia caused by exposure to the volatile components of beauty products.
Severe proximal muscle weakness with normal CK as a presenting feature of ANCA-associated vasculitis
Authors: Nagiah Sureshkumar , Saranapala Daunda Mudiyanselage Manodhi
Published: January 2020

Antineutrophil cytoplasmic antibodies associated vasculitis (AAV) presenting with muscle weakness is rarely reported. We report a case of myeloperoxidase positive vasculitis presenting with severe proximal muscle weakness with normal creatine kinase and no positron-emission tomography uptake. There was a significant delay in the diagnosis of AAV due to atypical presentation. We propose AAV be considered in the differential diagnosis of proximal muscle weakness after excluding the common causes.
Rickets with hypophosphatemia, hypokalemia and normal anion gap metabolic acidosis: not always an easy diagnosis
Authors: Agrawal Saurav Shishir , Mishra Chandan Kumar , Agrawal Chhavi , Chakraborty Partha Pratim
Published: January 2020

Rickets other than those associated with advanced kidney disease, isolated distal renal tubular acidosis (dRTA) and hypophosphatasia (defective tissue non-specific alkaline phosphatase) are associated with hypophosphatemia due to abnormal proximal tubular reabsorption of phosphate. dRTA, however, at times is associated with completely reversible proximal tubular dysfunction. On the other hand, severe hypophosphatemia of different aetiologies may also interfere with both distal tubular acid excretion and proximal tubular functions giving rise to transient secondary renal tubular acidosis (distal and/or proximal). Hypophosphatemia and non-anion gap metabolic acidosis thus pose a diagnostic challenge occasionally. A definitive diagnosis and an appropriate management of the primary defect results in complete reversal of the secondary abnormality. A child with vitamin D resistant rickets was thoroughly evaluated and found to have primary dRTA with secondary proximal tubular dysfunction in the form of phosphaturia and low molecular weight proteinuria. The child was treated only with oral potassium citrate. A complete clinical, biochemical and radiological improvement was noticed in follow-up.
How large should a cause of death be in order to be included in mortality trend analysis? Deriving a cut-off point from retrospective trend analyses in 21 European countries
Authors: Mitratza Marianna , Kardaun Jan W P F , Kunst Anton E
Published: January 2020

Objectives

The International Classification of Diseases (ICD-10) distinguishes a large number of causes of death (CODs) that could each be studied individually when monitoring time-trends. We aimed to develop recommendations for using the size of CODs as a criterion for their inclusion in long-term trend analysis.

Design

Retrospective trend analysis.

Setting

21 European countries of the WHO Mortality Database.

Participants

Deaths from CODs (3-position ICD-10 codes) with ≥5 average annual deaths in a 15-year period between 2000 and 2016.

Primary and secondary outcome measures

Fitting polynomial regression models, we examined for each COD in each country whether or not changes over time were statistically significant (with α=0.05) and we assessed correlates of this outcome. Applying receiver operating characteristicROC curve diagnostics, we derived COD size thresholds for selecting CODs for trends analysis.

Results

Across all countries, 64.0% of CODs had significant long-term trends. The odds of having a significant trend increased by 18% for every 10% increase of COD size. The independent effect of country was negligible. As compared to circulatory system diseases, the probability of a significant trend was lower for neoplasms and digestive system diseases, and higher for infectious diseases, mental diseases and signs-and-symptoms. We derived a general threshold of around 30 (range: 28–33) annual deaths for inclusion of a COD in trend analysis. The relevant threshold for neoplasms was around 65 (range: 61–70) and for infectious diseases was 20 (range: 19–20).

Conclusions

The likelihood that long-term trends are detected with statistical significance is strongly related to COD size and varies between ICD-10 chapters, but has no independent relation to country. We recommend a general size criterion of 30 annual deaths to select CODs for long-term mortality-trends analysis in European countries.
Availability and quality of publicly available health workforce data sources in Australia: a scoping review protocol
Authors: Gillam Marianne , Leach Matthew , Muller Jessica , Gonzalez-Chica David , Jones Martin , Muyambi Kuda , Walsh Sandra , May Esther
Published: January 2020

Introduction

The health workforce is an integral component of the healthcare system. Comprehensive, high-quality data on the health workforce are essential to identifying gaps in health service provision, as well as informing future health workforce and health services planning, and health policy. While many data sources are used in Australia for these purposes, the quality of the data sources with respect to relevance, accessibility and accuracy is not clear.

Methods and analysis

This scoping review aims to identify and appraise publicly available data sources describing the Australian health workforce. The review will include any data source (eg, registry, administrative database and survey) or document reporting a data source (eg, journal article, report) on the Australian health workforce, which is publicly available and describes the characteristics of the workforce. The search will be conducted in 10 bibliographic databases and the grey literature using an iterative process. Screening of titles and abstracts will be undertaken by two investigators, independently, using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Documents/data sources identified as potentially eligible will be retrieved in full text and reviewed following the same process. Data will be extracted using a customised data extraction tool. A customised appraisal tool will be used to assess the relevance, accessibility and accuracy of included data sources.

Ethics and dissemination

The scoping review is a secondary analysis of existing, publicly available data sources and does not require ethics approval. The findings of this scoping review will further our understanding of the quality and availability of data sources used for health workforce and health services planning in Australia. The results will be submitted for publication in peer-reviewed journals and presented at conferences targeted at health workforce and public health topics.
1 Hyperglycaemia in T1DM and pancreatitis related diabetes
Authors: Amin Omar , Cartwright Douglas , Azharuddin Mohammed
Published: January 2020

Introduction

With the introduction of blood ketone testing, it is now possible to quantify the level of ketosis prior to the patient developing life threatening diabetic keto-acidosis (DKA). Administering correction doses of short acting insulin based on ketone level, similar to that for diabetic sick day rules, may avoid critical care admissions, use of variable rate insulin infusions and reduce hospital admissions.

Testing is not without its challenges in particular cost, risk of inappropriate testing in type 2 diabetics (T2DM) and misdiagnosis alternative causes of ketosis. We describe here the experience of introducing ketone testing to A+E and acute wards at a district general hospital.

Methods

Blood ketone testing was introduced to A+E, 2 medical wards and 2 surgical wards together with training for ward staff and a written guideline. Ketone testing was triggered if a type 1 diabetic (T1DM) or pancreatitis related diabetic had a BM >14 mmol/L. Based on the ketone level the guideline prompted either no action, correction dose of short acting insulin followed by repeat testing or arterial blood gas analysis. A retrospective analysis was performed after 8 months to investigate compliance with the protocol and effect of the protocol on the incidence of inpatient DKA. Patients were identified through search of the laboratory information management system followed by a review of electronically scanned medical records.

Results

910 ketone tests were carried out representing 116 patients. 395 tests had no patient identifier and were therefore untraceable. Over half of patients (51%) had type 2 diabetes. Of the patients with T1DM/pancreatitis related diabetes 9 patients presented with DKA on admission. Nearly three quarters (73%) resolved with additional subcutaneous insulin as per protocol and 23% were started on a Variable Rate Insulin Infusion. 1 patient developed DKA during an inpatient admission and the protocol had not been followed in this case. The main reasons for deviation from the protocol was lack of documentation and repeat BM testing.

Conclusions

The protocol itself is very effective when used correctly. It clearly helps to identify patients at risk of deteriorating, and clearly outlines what steps should be taken. While the guideline is intended for patients with T1DM and Pancreatic Related Diabetes, there were many occasions where the ketone testing was used inappropriately on patients with T2DM. In response to this the protocol was updated to include additional guidance on management of hyperglycaemia in T2DM. Documentation and lack of patient identification information was another key issue.
Erector spinae plane versus paravertebral nerve blocks for postoperative analgesia after breast surgery: a randomized clinical trial
Authors: Swisher Matthew W , Wallace Anne M , Sztain Jacklynn F , Said Engy T , Khatibi Bahareh , Abanobi Maryann , Finneran IV John J , Gabriel Rodney A , Abramson Wendy , Blair Sarah L , Hosseini Ava , Dobke Marek K , Donohue Michael C , Ilfeld Brian M
Published: January 2020

Background

Paravertebral nerve blocks (PVBs) are frequently used to treat pain during and following breast surgery, but have various undesirable risks such as pneumothorax. The erector spinae plane block (ESPB) also provides perioperative breast analgesia, but is purported to be easier to administer with a favorable safety profile. However, it remains unknown if the new ESPB provides comparable analgesia as the decades-old PVB technique.

Methods

Subjects undergoing unilateral or bilateral non-mastectomy breast surgery were randomized to a single-injection ESPB or PVB in a subject-blinded fashion (ropivacaine 0.5% with epinephrine; 20 mL unilateral or 16 mL/side for bilateral). We hypothesized that (1) analgesia would be non-inferior in the recovery room as measured on a Numeric Rating Scale (NRS) with ESPB, and (2) opioid consumption would be non-inferior in the operating and recovery rooms with ESPB.

Results

Both pain scores and opioid consumption were higher in subjects with ESPBs (n=50) than PVBs (n=50; median NRS 3.0 vs 0; 95% CI −3.0 to 0; p=0.0011; and median morphine equivalents 2.0 vs 1.5 mg; 95% CI −1.2 to −0.1; p=0.0043). No block-related adverse events occurred in either group.

Conclusions

PVBs provided superior analgesia and reduced opioid requirements following non-mastectomy breast surgery. To compare the relatively rare complications between the techniques will require a sample size 1–2 orders of magnitude greater than the current investigation; however, without a dramatic improvement in safety profile for ESPBs, it appears that PVBs are superior to ESPBs for postoperative analgesia after non-mastectomy breast surgery.

Trial registration number

NCT03549234.