bluuebunny/crossref_metadata_2025 huggingface dataset:
The Manuscript and Archaeological Traditions
Authors: Déroche François
Published: June 2020

The academic study of the early physical evidence of the Qur’an’s transmission has a long and convoluted history. Beginning in earnest with the provisional efforts of the Danish scholar Johann Christian Georg Adler, and followed by the contributions of distinguished individuals such as Michele Amari, Nabia Abbott, Adolf Grohmann, and others, over the years the field has witnessed an intricate array of approaches brought to bear on the study of the various materials. Within these contexts, preliminary advances in Arabic palaeography, epigraphy, codicology, numismatics, art history, and papyrology have played intricate roles in the analysis of the available sources. In this chapter key junctures in the attempts to investigate the early transmission of the Qur’an and its chronological provenance are reviewed with the aim of shedding light on developments within the field.
The Qur’an and Judaism
Authors: Firestone Reuven
Published: June 2020

This chapter consists of two parts. The first examines the historical-phenomenological relationship between the Qur’an and Judaism (the Qur’an and Judaism), while the second examines perspectives expressed by the Qur’an toward Judaism (the Qur’an on Judaism). The former includes perspectives offered by pre-modern and contemporary non-Muslim researchers regarding the Qur’an and its relationship to the religion and culture of Judaism; the latter considers how the Qur’an itself appears to evaluate Judaism. Both are considered within an explicit evaluative framework of assessment that reflects on the problematic of tension inherent in the relationship between established religion and emergent religion
Aesthetically Oriented Interpretations of the Qur’ān
Authors: Abu-Deeb Kamal
Published: June 2020

The tradition of Qurʾānic interpretation is one of the richest aspects of cultural production in Arabic. Its richness goes beyond the question of explaining the content of Qurʾānic verses from a doctrinal point of view to present some brilliant acts of exploration of purely artistic constituents of the text of the Qurʾān as a whole, interconnected, interlaced body of discourse in which the sublime nature of the divine message is embodied in equally powerful, artistically sublime linguistic formulations. A prime example of this holistic nature of the text is seen by many mufassirīn to reside in the various types of majāzī and/or metaphorical language and, in the case of some Sufi mufassirīn, of symbolic language. The chapter explores the three arguably finest tafāsir in which this aesthetically oriented current of thought reaches its zenith: al-Zamakhsharī’s al-Kashshāf, Ibn ʿArabī’s al-Futūḥāt al-Makkiyya, and Abū Ḥayyān’s al-Baḥr al-Muḥīṭ. While bringing out some of their finest achievements, this study also recognizes their limitations as well as the limitations of contemporary interpretations of the Qur’an and points to urgently needed fresh ways of writing about the Qurʾān from a predominantly aesthetic angle. It offers examples of aspects of this great text which can be understood in anew fashion if such fresh approaches are employed; in this light, the chapter looks at orality as a possible new source of knowledge that may help us understand some complex aspects of the Qur’an that have remained so far little understood or indeed explored.
Twelver Shīʿī Exegesis
Authors: Rizvi Sajjad
Published: June 2020

In this chapter normative approaches to exegesis from a Twelver Shīʿī perspective are combined with a diachronic historical approach. From the normative perspective, the function of exegesis is to reveal the walāya of the imams and the close complementarity of the Qur’an and the imam is the central concern for the exegete. That process begins with the classical tradition in which the Qur’an is glossed on the basis of the sayings of the imams alone, both through explicit citation and through claims articulated that draw on oral teaching. From a diachronic perspective, one finds that the development of exegesis in the Twelver Shīʿī context follows the wider scholarly engagement in different milieux over roughly three or four stages of development. Hence one finds comprehensive exegeses that examine all aspects of understanding from the language to the law, others that focus on philosophy and theology, and others still that engage in mystical speculation. The traditions of exegesis remain very much alive and flourishing in the present in manners of social engagement as well as a shift towards a more thematic approach to making sense of the Qurʾan in the contemporary world from a Shīʿī perspective.
Ibāḍī Tafsīr Literature
Authors: Hoffman Valerie J. , bin Ali bin Ameir Al-Shueili Sulaiman
Published: June 2020

Although Ibāḍīs wrote frequently on philology, rhetoric, theology, and the sciences of Qur’an interpretation, there has been little interest in the composition of complete Ibāḍī tafsīrs until the modern period. Ibāḍī teachers taught Qur’anic interpretation to their students using Sunni tafsīrs as their reference before the publication of Aṭfiyyash’s tafsīrs in the nineteenth century. Ibāḍī commentators have based their works on Sunni tafsīrs, inserting the distinct doctrinal perspectives of their school at relevant points. Ibāḍī tafsīrs share a perspective on the necessity of interpreting the Qur’an in a non-literal manner if the literal meaning of the text contradicts Ibāḍī doctrines on God, faith, and the afterlife.
Key considerations for designing capacity-building interventions to support evidence-based programming in underserved communities: a qualitative exploration
Authors: Ramanadhan Shoba , Galbraith-Gyan Kayoll , Revette Anna , Foti Alisa , Rackard James Charlotte , Martinez-Dominguez Vilma , Miller Elecia , Tappin Jamiah , Tracy Natalicia , Bruff Carmenza , Donaldson S Tiffany , Minsky Sara , Sempasa Doris , Siqueira Carlos , Viswanath Kasisomayajula
Published: June 2020

Increasing the use of evidence-based programs (EBPs) in community settings is critical for improving health and reducing disparities. Community-based organizations (CBOs) and faith-based organizations (FBOs) have tremendous reach and trust within underserved communities, but their impact is constrained by limited staff capacity to use EBPs. This exploratory study sought to identify design and delivery considerations that could increase the impact of capacity-building interventions for CBOs and FBOs working with underserved communities. Data come from a community-based participatory research project addressing cancer disparities in Black, Latino, and Brazilian communities from Greater Boston and Greater Lawrence, Massachusetts. We conducted four focus group discussions with program coordinators in CBOs and FBOs (n = 27) and key informant interviews with CBO and FBO leaders (n = 15). Three researchers analyzed the data using a multi-stage coding process that included both prefigured and emergent codes. Key design considerations included embedding customized capacity-building interventions into community networks with local experts, supporting ongoing engagement with the intervention via a range of resources and communication channels, and addressing resource constraints. Regarding the contextual factors that should influence capacity-building intervention content, participants highlighted resource constraints, environments in which EBP use is not the norm, and challenges linking available programs with the multi-level barriers to good health faced by community members. Overall, the study highlights the need for integrated, long-term capacity-building efforts developed in partnership with, and ultimately sustained by, local organizations.
Hope After TBI Begins with Rehabilitation
Authors: Armstrong Tiffany , Murtaugh Brooke M.
Published: June 2020

Traumatic brain injury (TBI) is one of the leading causes of long-term disability in the United States. Persons with TBI can experience numerous alterations in functional status, self-care ability, and cognitive, emotional, and social functioning. Understanding TBI features, treatment, and rehabilitation is imperative for nurses in every setting. Trauma, intensive and acute care, and rehabilitation nurses are an essential part of the interprofessional team that promotes optimum outcomes through specific interventions to foster hope for TBI patients and families.
Incidence and Risk Factors for Delirium in Older Patients Following Intensive Care Unit Admission: A Prospective Observational Study
Authors: LI Xiao , ZHANG Lina , GONG Fang , AI Yuhang
Published: June 2020

Background

Both high prevalence and incidence rates of delirium occur frequently among patients aged 65 years or older in intensive care units (ICUs) and are accompanied by adverse outcomes. Because of lack of nursing staff resources and imperfect humanistic care, delirium is easily overlooked by both physicians and nurses in the ICU in Mainland China.

Purpose

This study aimed to explore the incidence rate of delirium and to determine the risk factors among critically ill older patients.

Methods

A prospective observational study was conducted on patients aged 65 years and older who were admitted consecutively to two ICUs of a university-affiliated hospital in China. The Confusion Assessment Method for the Intensive Care Unit and the Richmond Agitation–Sedation Scale were used to assess delirium status twice daily. Patient demographic, laboratory, medical, therapeutic, and prognostic data were collected.

Results

One hundred fifteen patients were included as participants, with a median age of 70 years (range 65–93 years). Seventy-six (66.1%) patients presented with delirium. Half of the sample had a hypoactive subtype. Patients who developed delirium had a longer mean length of ICU stay, greater chance of physical restraints use, greater use of fentanyl, and poorer sleep quality. A logistic regression analysis revealed that poor sleep quality (OR = 10.74, 95% CI [1.59, 72.47]) and physical restraints (OR = 13.04, 95% CI [1.57, 107.94]) were significantly associated with delirium.

Conclusions/Implications for Practice

Delirium is a common aggravation in older patients following ICU admission. The factors found in this study to be independently associated with delirium include poor sleep quality and physical restraints. Both critical care physicians and nurses should pay greater attention to the quality of the ICU stay experienced by their older patients.
Low glutamate dehydrogenase levels are associated with colonization in Clostridium difficile PCR-only positive patients with inflammatory bowel disease
Authors: Desai Meeta , Knight Kristin , Gray James M. , Nguyen Vu , Boone James , Sorrentino Dario
Published: June 2020

Background/aims

Clostridioides difficile infection (CDI) remains a diagnostic challenge in patients with inflammatory bowel disease (IBD). We tested novel biomarkers to differentiate CDI from colonization in patients without (CDI-only) and with IBD (IBD-CDI).

Methods

Samples were enzyme immunoassay (EIA)-tested for glutamate dehydrogenase (GDH) and toxin, followed by reflex PCR. Quantitative GDH [(qGDH) – a novel indicator of Clostridium difficile load] and stool lactoferrin were tested at days 0, 3 and 10 during antibiotic treatment. Samples were also analyzed for toxin B cytotoxicity neutralization assay (CNA) and toxigenic culture, gold standards to detect free toxin and virulent bacteria, respectively.

Results

Forty-five symptomatic patients (28 CDI-only, 13 with Crohn’s disease, 4 with ulcerative colitis) were recruited with 3 sequential samples available for 36 (21 CDI-only, 15 IBD-CDI). Thirty-nine of 45 (87%) cases were toxigenic culture-positive. In the CDI-only group, 78.6% were positive for EIA-toxin, 21.4% were PCR-positive while 82.1% were CNA-positive. In the IBD-CDI group, only one patient (6%) was EIA-toxin positive and 17.6% CNA-positive. The median qGDH level at day 0 was higher in CNA-positive patients compared to CNA-negative patients (1111 vs. 146 ng/g, P = 0.004) and dropped together with lactoferrin from day 0 to 10. CDI eradication improved symptoms in 72.2% of patients with CDI-only. In 60% of patients with IBD-CDI, eradication was ineffective, with symptoms improving in 89% of them after IBD therapy intensification.

Conclusion

In patients with IBD-CDI, PCR-only positivity might mainly reflect colonization rather than disease. C. difficile load by qGDH correlates with CNA-detected toxin and together with stool lactoferrin might differentiate CDI from colonization in patients with IBD.
Freeze-dried microspheres for selective intra-arterial radionuclide therapy: an affordable solution
Authors: Shukla Jaya , Kalra Naveen , Mittal Bhagwant Rai , Duseja Ajay , Kumar Rajender , Singh Harmandeep , Chaluvashetty Sreedhara Bettadahally , Parmar Madan , Krishnan Swathy , Kumar Ganesh , Vatsa Rakhee , Chhabra Anupriya , Bansal Kavita , Rathore Yogesh , Pandey Somit
Published: June 2020

Objective

Selective intra-arterial radionuclide therapy (SIRT) using radiolabelled microspheres is for the delivery of therapeutic radioisotope to liver cancers and thus, sparing healthy liver. Several radiolabelled microspheres are commercially available. The main issue associated with these microspheres is affordability. Re-188 is a generator produced radionuclide, emits high energy therapeutic beta particle and imageable gamma photons for pre- and post-therapy dosimetry.

Methods

Tc-99m/Re-188 labelled microspheres have been developed and quality control tests have been performed for suitable clinical use. The clinical studies with Re-188 microspheres for SIRT have been performed. Post-therapy images were acquired for dosimetry.

Results

The microspheres were found to possess spherical morphology of less than 20 µm size. The quality control revealed the suitability of microspheres for intravenous administration. The preliminary studies in thirty patients demonstrated good retention in tumor and high tumor to normal liver ratio. Re-188 microspheres were well tolerated by patients. Same microspheres labelled with either Tc-99m or Re-188 were used for pretherapy dosimetry and Re-188 labeled microspheres for therapy (SIRT) as a single-day procedure.

Conclusion

The freeze-dried microspheres may emerge as highly cost-effective candidates for both pre-therapy dosimetry and SIRT and may benefit a large population with inoperable liver cancer.
Estimating the Cost of Point-of-Care Early Infant Diagnosis in a Program Setting: A Case Study Using Abbott m-PIMA and Cepheid GeneXpert IV in Zimbabwe
Authors: Mukherjee Sushant , Cohn Jennifer , Ciaranello Andrea L. , Sacks Emma , Adetunji Oluwarantimi , Chadambuka Addmore , Mafaune Haurovi , Makayi McMillan , McCann Nicole , Turunga Esther
Published: June 2020

Background:

Point-of-care early infant diagnosis (POC EID) increases access to HIV test results and shortens time to result-return and antiretroviral therapy initiation, as compared to central laboratory-based EID. However, to scale-up POC EID, governments need more information about programmatic costs.

Methods:

We evaluated POC EID costs from a health systems perspective. Our primary analysis assessed the Abbott m-PIMA and 2 versions of the Cepheid GeneXpert IV platforms—with a solar battery or gel battery—used in Zimbabwe, with instrument purchase. We also included the following 2 scenarios with zero upfront equipment purchase: (1) m-PIMA using a reagent rental model, with an all-inclusive price when the buyer commits to an average testing volume, and (2) GeneXpert IV, reflecting contexts where GeneXpert is already in place for tuberculosis diagnosis or HIV viral load monitoring. We collected data from project expenditures, observations of health workers, and from government salary scales. We calculated cost per EID test based on number of EID tests performed on each machine per day.

Results:

The cost per successfully completed test was $44.55 for m-PIMA with platform purchase and $25.89 for m-PIMA reagent rental. Costs for GeneXpert IV with platform purchase were $25.70 using a solar battery, $25.29 using a gel battery, and $23.85 under a scenario assuming no equipment costs. In our primary analyses, materials costs comprised 73%–74% total costs, equipment 14%–20%, labor 5%–8%, training 1%, facility upgrades 1%, and monitoring 1%.

Conclusions:

As countries consider scaling up POC EID, these data are important for budgeting and planning.
Quiet FLAIR at 7T MRI
Authors: Rösch Julie , Mennecke Angelika , Knott Michael , Doerfler Arnd , Grodzki David M.
Published: June 2020

Objective

The aim of this study was to investigate acoustic noise reduction and image quality of cranial magnetic resonance imaging (MRI) at 7T MRI with and without sequence-based acoustic noise reduction.

Materials and Methods

Fifteen patients and 5 healthy volunteers underwent 7T MRI scanning. A fluid-attenuated inversion recovery (FLAIR) sequence was acquired with and without sequence-based acoustic noise reduction. The acoustic noise generated by each sequence was measured. Quantitative and qualitative assessments regarding signal-to-noise ratio, contrast-to-noise ratio, lesion conspicuity, level of artifacts, and overall image quality were performed. Furthermore, detection rates of white matter lesions were evaluated by 2 observers for both sequences.

Results

Acoustic noise was significantly reduced from initially 92.7 dB(A) to 78.9 dB(A), corresponding to an 80% reduction in sound pressure. The visual assessment revealed no significant difference in the level of artifacts. Although rated very high by both readers, lesion conspicuity and image quality averaged better for the regular FLAIR sequence. Signal-to-noise ratio and contrast-to-noise ratio slightly decreased when applying the sequence-based acoustic noise reduction. No significant difference was found between the detection rates of white matter lesions for both observers.

Conclusions

Reducing sound pressure by 80% in FLAIR imaging at 7T ultra-high-field MRI is feasible while maintaining high diagnostic image quality.
Microsurgical Replantation of Completely Avulsed Scalp Segment Recovered From Under Snow
Authors: Akyurek Mustafa , Lujan-Hernandez Jorge
Published: June 2020

Complete scalp avulsion is a devastating injury resulting in permanent disfigurement. Replantation is the procedure of choice whenever possible. This report describes a successful case of microsurgical reattachment of complete scalp avulsion of temporoparietal segment in a 72-year-old female patient after her hair was tangled in the hoof crack of a horse when the animal slipped on ice and fell on a cold New England night. The amputated segment could be recovered from under snow only after 4 hours following the incident. The procedure involved microvascular anastomoses of superficial temporal artery and vein. The recovery was uneventful, with complete survival of the replant, including the severely crushed segment. There was no need for any transfusion. Long term follow up revealed excellent aesthetic outcome with complete hair growth. This report presents a case experience of successful scalp replantation even after the amputated part was exposed to freezing conditions for 4 hours.
Outcomes and Health Care Utilization After Early Hospital Dismissal in Kidney Transplantation
Authors: Calderon Esteban , Chang Yu-Hui , Chang James M. , Velazco Cristine S. , Giorgakis Emmanouil , Srinivasan Ananth , Moss Adyr A. , Khamash Hasan , Heilman Raymond , Reddy Kunam S. , Mathur Amit K.
Published: June 2020

Objective:

To understand whether reduced lengths of stay after kidney transplantation were associated with excess health care utilization in the first 90 days or long-term graft and patient survival outcomes.

Background:

Reducing length of stay after kidney transplant has an unknown effect on post-transplant health care utilization. We studied this association in a cohort of 1001 consecutive kidney transplants.

Methods:

We retrospectively reviewed 2011–2015 data from a prospectively-maintained kidney transplant database from a single center.

Results:

A total of 1001 patients underwent kidney transplant, and were dismissed from the hospital in 3 groups: Early [≤2 days] (19.8%), Normal [3–7 days] (79.4%) and Late [>7 days] (3.8%). 34.8% of patients had living donor transplants (Early 51%, Normal 31.4%, Late 18.4%, P < 0.001). Early patients had lower delayed graft function rates (Early 19.2%, Normal 32%, Late73.7%, P = 0.001). By the hospital dismissal group, there were no differences in readmissions or emergency room visits at 30 or 90 days. Glomerular filtration rate at 12 months and rates of biopsy-proven acute rejection were also similar between groups. The timing of hospital dismissal was not associated with the risk-adjusted likelihood of readmission. Early and Normal patients had similar graft and patient survival. Late dismissal patients, who had higher rates of cardiovascular complications, had significantly higher late mortality versus Normal dismissal patients in unadjusted and risk-adjusted models.

Conclusion:

Dismissing patients from the hospital 2 days after kidney transplant is safe, feasible, and improves value. It is not associated with excess health care utilization or worse short or long-term transplant outcomes.
Radiologic predictors of in-hospital mortality after traumatic craniocervical dissociation
Authors: Schellenberg Morgan , Anderson Geoffrey A. , Owattanapanich Natthida , Cheng Vincent , Lam Lydia , Demetriades Demetrios , Inaba Kenji , Myers Lee
Published: June 2020

BACKGROUND

Traumatic craniocervical dissociation (CCD) is the forcible dislocation of the skull from the vertebral column. Because most CCD patients die on scene, prognostication for those who arrive alive to hospital is challenging. The study objective was to determine if greater dissociation, based on radiologic measurements of CCD, is predictive of in-hospital mortality among patients surviving to the emergency department.

METHODS

All trauma patients arriving to our Level 1 trauma center (January 2008 to April 2019) with CCD were retrospectively identified and included. Transfers and patients without computed tomography head/cervical spine were excluded. Study patients were dichotomized into groups based on in-hospital mortality. Radiologic measurements of degree of CCD were performed based on the index computed tomography scan by an attending radiologist with Emergency Radiology fellowship training. Measurements were compared between patients who died in-hospital versus those who survived.

RESULTS

After exclusions, 36 patients remained: 12 (33%) died and 24 (67%) survived. Median age was 55 years (30–67 years) versus 44 (20–61 years) (p = 0.199). Patients who died had higher Injury Severity Score (39 [31–71] vs. 27 [14–34], p = 0.019) and Abbreviated Injury Scale head/neck score (5 [5–5] vs. 4 [3–4], p = 0.001) than survivors. The only radiologic measurement that differed between groups was greater soft tissue edema at mid C1 among patients who died (12.37 [7.60–14.95] vs. 7.86 [5.25–11.61], p = 0.013). Receiver operating characteristic curve analysis of soft tissue edema at mid C1 and mortality revealed 10.86 mm or greater of soft tissue width predicted mortality with sensitivity and specificity of 0.75. All other radiologic parameters, including the basion-dens interval, were comparable between groups (p > 0.05).

CONCLUSION

Among patients who arrive alive to hospital after traumatic CCD, greater radiologic dissociation is not associated with increased mortality. However, increased soft tissue edema at the level of mid C1, particularly 10.86 mm or greater, is associated with in-hospital death. These findings improve our understanding of this highly lethal injury and impart the ability to better prognosticate for patients arriving alive to hospital with CCD.

LEVEL OF EVIDENCE

Prognostic and Epidemiological, Level III.
Early treatment with exosomes following traumatic brain injury and hemorrhagic shock in a swine model promotes transcriptional changes associated with neuroprotection
Authors: Williams Aaron M. , Higgins Gerald A. , Bhatti Umar F. , Biesterveld Ben E. , Dekker Simone E. , Kathawate Ranganath G. , Tian Yuzi , Wu Zhenyu , Kemp Michael T. , Wakam Glenn K. , Liu Baoling , Li Yongqing , Buller Benjamin , Alam Hasan B.
Published: June 2020

BACKGROUND

We have shown that administration of mesenchymal stem cell–derived exosomes (single dose given within 1 hour) in models of traumatic brain injury (TBI) and hemorrhagic shock is neuroprotective. The precise mechanisms responsible for the neuroprotection are not fully understood. This study was designed to investigate the transcriptomic changes in the brain that are associated with this treatment strategy.

METHODS

Yorkshire swine (40–45 kg) were subjected to a severe TBI (12-mm cortical impact) and hemorrhagic shock (40% estimated total blood volume). One hour into shock, animals were randomized (n = 5/cohort) to receive either lactated Ringer's (LR; 5 mL) or exosomes suspended in LR (LR + EXO; 1 × 1013 exosome particles in 5 mL LR). Animals then underwent additional shock (1 hour) followed by normal saline resuscitation. After 6 hours of observation, brain swelling (% increase compared with the uninjured side) and lesion size (mm3) were assessed. Periinjured brain tissue was processed for RNA sequencing, analyzed with high through-put RNA sequencing data analysis, and results compared between control and experimental groups.

RESULTS

Exosome treatment significantly increased (p < 0.005) gene expression associated with neurogenesis, neuronal development, synaptogenesis, and neuroplasticity. It also significantly reduced (p < 0.005) genes associated with stroke, neuroinflammation, neuroepithelial cell proliferation, and nonneuronal cell proliferation contributing to reactive gliosis. Exosome treatment also significantly increased (p < 0.005) the genes that are associated with stability of blood-brain barrier.

CONCLUSIONS

Administration of a single dose of exosomes induces transcriptomic changes suggestive of neuroprotection. Their use as a treatment for TBI is promising and requires further investigation for human translation.
Dynamic effects of calcium on in vivo and ex vivo platelet behavior after trauma
Authors: Matthay Zachary A. , Fields Alexander T. , Nunez-Garcia Brenda , Patel Maya H. , Cohen Mitchell J. , Callcut Rachael A. , Kornblith Lucy Z.
Published: June 2020

BACKGROUND

Mobilization of intra and extracellular calcium is required for platelet activation, aggregation, and degranulation. However, the importance of alterations in the calcium-platelet axis after injury is unknown. We hypothesized that in injured patients, in vivo initial calcium concentrations (pretransfusion) predict ex vivo platelet activation and aggregation, viscoelastic clot strength, and transfusion of blood products. We additionally hypothesized that increasing calcium concentrations ex vivo increases the expression of platelet activation surface receptors and platelet aggregation responses to agonist stimulation in healthy donor blood.

METHODS

Blood samples were collected from 538 trauma patients on arrival to the emergency department. Standard assays (including calcium), platelet aggregometry (PA) and thromboelastometry (ROTEM) were performed. In PA, platelet activation (prestimulation impedance [Ω]) and aggregation responses to agonist stimulation (area under the aggregation curve [AUC]) with adenosine diphosphate (ADP), thrombin receptor-activating peptide, arachidonic acid (AA), and collagen (COL) were measured. Multivariable regression tested the associations of calcium with PA, ROTEM, and transfusions. To further examine the calcium-platelet axis, calcium was titrated in healthy blood. Platelet aggregometry and ROTEM were performed, and expression of platelet glycoprotein IIb/IIIa and P-selectin was measured by flow cytometry.

RESULTS

The patients were moderately injured with normal calcium and platelet counts. Higher calcium on arrival (pretransfusion) was independently associated with increased platelet activation (prestimulation, Ω; p < 0.001), aggregation (ADP-stimulated, AUC; p = 0.002; thrombin receptor-activating peptide–stimulated, AUC; p = 0.038), and clot strength (ROTEM max clot firmness; p < 0.001), and inversely associated with 24-hour transfusions of blood, plasma, and platelets (all p < 0.005). Up-titrating calcium in healthy blood increased platelet activation (prestimulation, Ω; p < 0.001), aggregation (ADP, AA, COL-stimulated AUCs; p < 0.050), and expression of P-selectin (p = 0.003).

CONCLUSION

Initial calcium concentrations (pretransfusion) are independently associated with platelet activation, aggregation, clot-strength, and transfusions after injury. These changes may be mediated by calcium driven expression of surface receptors necessary for platelet activation and aggregation. However, the therapeutic benefit of early, empiric calcium repletion in trauma patients remains undefined.

LEVEL OF EVIDENCE

Prognostic, level V.
A clinical pharmacist-led integrated approach for evaluation of medication errors among medical intensive care unit patients
Authors: Aghili Mina , Neelathahalli Kasturirangan Meera
Published: June 2020

Aim:

Medication errors jeopardize the safety of critically ill patients. Using only one method for the detection of medication errors may not reflect an existing picture of patient safety accurately. Therefore, we designed a clinical pharmacist-led integrated approach to evaluate incidence rate, type, and severity of medication errors and preventable adverse drug events (ADEs) and to assess the impact of the implementation of interventions recommended by the clinical pharmacist.

Methods:

A prospective study was conducted from November 2017 to January 2019 in the medical ICU. The clinical pharmacist performed a combination of medication error detection methods, which included medication chart review, patient monitoring until discharge/death, and attending medical rounds. Detected medication errors were intervened with prescribers. Based on the prescribers’ decision on delivered interventions, patients were divided into two groups: A (clinical pharmacist's interventions were implemented), and B (clinical pharmacist's interventions were not implemented). We compared patients’ outcomes obtained from study groups to evaluate the impact of the implementation of interventions performed by the clinical pharmacist.

Results:

A total of 271 medication errors (122.62 per 1000 patient hospital-days) were detected among the study patients (n = 228). Drug–drug interactions (70, 25.8%), guideline nonconformity (51, 18.8%), and inadequate drug monitoring (29, 11%) were the most common types of detected medication errors. Eighty-six percentage of the clinical pharmacist's interventions were implemented by prescribers. Approximately half of medication errors were intercepted before reaching to patients who received the clinical pharmacist's interventions (group A). Overall, medication errors induced 33 preventable ADEs (14.93 per 1000 patient hospital-days), of which the number of preventable ADEs was significantly greater in group B (P < 0.0001). Significantly in group B, detected medication errors initiated chains of consecutive errors when the clinical pharmacist's interventions were not accepted. Also, this group had significantly increased length of stay (P < 0.0001), number of deaths (P = 0.0312), and more than a three-fold greater number of patients intratransferring to higher levels of care (P = 0.0235; odds ratio, 3.41; 95% confidence interval, 1.08–10.8).

Conclusion:

The clinical pharmacist-led integrated approach revealed that medication errors commonly occurred among critically ill patients, and the clinical pharmacist's interventions intercepted the majority of these medication errors. The number of preventable ADEs was significantly fewer in a group of patients who received these interventions. However, medication errors formed chains of errors that adversely affected patients’ investigated outcomes in the study group with no implementation of the clinical pharmacist interventions.
Arm waving in stylophoran echinoderms: three-dimensional mobility analysis illuminates cornute locomotion
Authors: Clark Elizabeth G. , Hutchinson John R. , Bishop Peter J. , Briggs Derek E. G.
Published: June 2020

The locomotion strategies of fossil invertebrates are typically interpreted on the basis of morphological descriptions. However, it has been shown that homologous structures with disparate morphologies in extant invertebrates do not necessarily correlate with differences in their locomotory capability. Here, we present a new methodology for analysing locomotion in fossil invertebrates with a rigid skeleton through an investigation of a cornute stylophoran, an extinct fossil echinoderm with enigmatic morphology that has made its mode of locomotion difficult to reconstruct. We determined the range of motion of a stylophoran arm based on digitized three-dimensional morphology of an early Ordovician form,Phyllocystis crassimarginata. Our analysis showed that efficient arm-forward epifaunal locomotion based on dorsoventral movements, as previously hypothesized for cornute stylophorans, was not possible for this taxon; locomotion driven primarily by lateral movement of the proximal aulacophore was more likely. Three-dimensional digital modelling provides an objective and rigorous methodology for illuminating the movement capabilities and locomotion strategies of fossil invertebrates.
Linearized Bayesian inference for Young’s modulus parameter field in an elastic model of slender structures
Authors: Fatehiboroujeni Soheil , Petra Noemi , Goyal Sachin
Published: June 2020

The deformations of several slender structures at nano-scale are conceivably sensitive to their non-homogenous elasticity. Owing to their small scale, it is not feasible to discern their elasticity parameter fields accurately using observations from physical experiments. Molecular dynamics simulations can provide an alternative or additional source of data. However, the challenges still lie in developing computationally efficient and robust methods to solve inverse problems to infer the elasticity parameter field from the deformations. In this paper, we formulate an inverse problem governed by a linear elastic model in a Bayesian inference framework. To make the problem tractable, we use a Gaussian approximation of the posterior probability distribution that results from the Bayesian solution of the inverse problem of inferring Young’s modulus parameter fields from available data. The performance of the computational framework is demonstrated using two representative loading scenarios, one involving cantilever bending and the other involving stretching of a helical rod (an intrinsically curved structure). The results show that smoothly varying parameter fields can be reconstructed satisfactorily from noisy data. We also quantify the uncertainty in the inferred parameters and discuss the effect of the quality of the data on the reconstructions.
Brachistochrone on a velodrome
Authors: Benham G. P. , Cohen C. , Brunet E. , Clanet C.
Published: June 2020

The Brachistochrone problem, which describes the curve that carries a particle under gravity in a vertical plane from one height to another in the shortest time, is one of the most famous studies in classical physics. There is a similar problem in track cycling, where a cyclist aims to find the trajectory on the curved sloping surface of a velodrome that results in the minimum lap time. In this paper, we extend the classical Brachistochrone problem to find the optimum cycling trajectory in a velodrome, treating the cyclist as an active particle. Starting with two canonical cases of cycling on a sloping plane and a cone, where analytical solutions are found, we then solve the problem numerically on the reconstructed surface of the velodrome in Montigny le Bretonneux, France. Finally, we discuss the parameters of the problem and the effects of fatigue.
Coronavirus testing indicates transmission risk increases along wildlife supply chains for human consumption in Viet Nam, 2013-2014
Authors: Huong Nguyen Quynh , Thanh Nga Nguyen Thi , Van Long Nguyen , Luu Bach Duc , Latinne Alice , Pruvot Mathieu , Phuong Nguyen Thanh , Vinh Quang Le Tin , Van Hung Vo , Lan Nguyen Thi , Hoa Nguyen Thi , Minh Phan Quang , Diep Nguyen Thi , Tung Nguyen , Ky Van Dang , Roberton Scott I. , Thuy Hoang Bich , Van Long Nguyen , Gilbert Martin , Wicker Leanne , Mazet Jonna A. K. , Johnson Christine Kreuder , Goldstein Tracey , Tremeau-Bravard Alex , Ontiveros Victoria , Joly Damien O. , Walzer Chris , Fine Amanda E. , Olson Sarah H.
Published: June 2020

Outbreaks of emerging coronaviruses in the past two decades and the current pandemic of a novel coronavirus (SARS-CoV-2) that emerged in China highlight the importance of this viral family as a zoonotic public health threat. To gain a better understanding of coronavirus presence and diversity in wildlife at wildlife-human interfaces in three southern provinces in Viet Nam 2013-2014, we used consensus Polymerase Chain Reactions to detect coronavirus sequences. In comparison to previous studies, we observed high proportions of positive samples among field rats (34.0%, 239/702) destined for human consumption and insectivorous bats in guano farms (74.8%, 234/313) adjacent to human dwellings. Most notably among field rats, the odds of coronavirus RNA detection significantly increased along the supply chain from field rats sold by traders (reference group; 20.7% positivity, 39/188) by a factor of 2.2 for field rats sold in large markets (32.0%, 116/363) and 10.0 for field rats sold and served in restaurants (55.6%, 84/151). Coronaviruses were detected in the majority of wildlife farms (60.7%, 17/28) and in the Malayan porcupines (6.0%, 20/331) and bamboo rats (6.3%, 6/96) that are farmed. We identified six known coronaviruses in bats and rodents, clustered in threeCoronaviridaegenera, including theAlpha-,Beta-, andGammacoronaviruses. Our analysis also suggested either mixing of animal excreta in the environment or interspecies transmission of coronaviruses, as both bat and avian coronaviruses were detected in rodent feces in the trade. The mixing of multiple coronaviruses, and their apparent amplification along the wildlife supply chain into restaurants, suggests maximal risk for end consumers and likely underpins the mechanisms of zoonotic spillover to people.
The Role of the Medial Prefrontal Cortex in Spatial Margin of Safety Calculations
Authors: Qi Song , Cross Logan , Wise Toby , Sui Xin , O’Doherty John , Mobbs Dean
Published: June 2020

Humans, like many other animals, pre-empt danger by moving to locations that maximize their success at escaping future threats. We test the idea that spatial margin of safety (MOS) decisions, a form of pre-emptive avoidance, results in participants placing themselves closer to safer locations when facing more unpredictable threats. Using multivariate pattern analysis on fMRI data collected while subjects engaged in MOS decisions with varying attack location predictability, we show that while the hippocampus encodes MOS decisions across all types of threat, a vmPFC anterior-posterior gradient tracked threat predictability. The posterior vmPFC encoded for more unpredictable threat and showed functional coupling with the amygdala and hippocampus. Conversely, the anterior vmPFC was more active for the more predictable attacks and showed coupling with the striatum. Our findings suggest that when pre-empting danger, the anterior vmPFC may provide a safety signal, possibly via predictable positive outcomes, while the posterior vmPFC drives prospective danger signals.
Localization of hyphal growth associated with mycotoxin production during the malting of Fusarium head blight infected grains
Authors: Jin Zhao , Solanki Shyam , Ameen Gazala , Gross Thomas , Poudel Roshan Sharma , Borowicz Pawel , Brueggeman Robert S. , Schwarz Paul
Published: June 2020

Fusarium head blight (FHB) and the occurrence of mycotoxins is the largest food safety threat to malting and brewing grains. Objectives of the current study were to localize the growth ofFusariumwithin FHB infected kernels and to associate it with the production of DON that occurred during malting. FHB infected barley, wheat, rye, and triticale grains that exhibited large increases inFusarium Tri5DNA and trichothecene mycotoxins following malting, were screened for hyphal localization. The growth of hyphae, both on the surface of kernels and within tissues of grain and malt was, imagined by scanning electron microscopy and confocal laser scanning microscopy assisted with WGA-Alexa Fluor 488 pre-staining, respectively. In barley, hyphae were primarily present on or within husk, vascular bundle, and pericarp cavities. Following malting, large amounts of hyphal growth were observed in not only these regions, but also in the aleurone layer, endosperm, and embryo. Extensive fungal growth was also observed following malting of wheat, rye, and triticale. Interestingly, these grains already had an extensive internal presence of hyphae in unmalted grain, occurring in the pericarp, testa, vascular bundle, nucellar projection, aleurone layer, endosperm, pericarp and endosperm cavities, and embryo. Shotgun sequencing followed by metagenomics analysis verified thatFusariumspp. accounted for above 90% of the fungal hyphae growing in the interior of grains during malting, which coincided with the significant production of mycotoxins.
Suspension of a Point-Mass-Loaded Filament in Non-Uniform Flows: Passive Dynamics of a Ballooning Spider
Authors: Cho Moonsung , Cruz Bournazou Mariano Nicolas , Neubauer Peter , Rechenberg Ingo
Published: June 2020

Spiders utilize their fine silk fibres for their aerial dispersal, known as ballooning. With this method, spiders can disperse hundreds of kilometres, reaching as high as 4.5 km. However, the passive dynamics of a ballooning model (a highly flexible filament and a spider body at the end of it) are not well understood. The previous study (Rouse model: without taking into account anisotropic drag of a fibre) suggested that the flexible and extendible fibres reduce the settling speed of the ballooning model in homogeneous turbulence. However, the exact cause of the reduction of the settling speed is not explained and the assumed isotropic drag of a fibre is not realistic in the low Reynolds number flow. Here we introduce a bead-spring model that takes into account the anisotropic drag of a fibre to investigate the passive behaviour of the ballooning model in the various non-uniform flows (a shear flow, a periodic vortex flow field and a homogeneous turbulent flow). For the analysis of the wide range of parameters, we defined a dimensionless parameter, which is called ‘a ballooning number.’ The ballooning number means the ratio of Stokes’ fluid-dynamic force on a fibre by the non-uniform flow field to the gravitational force of a body at the end of the fibre. Our simulation shows that the settling speed of the present model in the homogeneous turbulent flows shows the biased characters of slow settling as the influence of the turbulent flow increases. The causes of this slow settling are investigated by simulating it in a wide range of shear flows. We revealed that the cause of this is the drag anisotropy of the filament structure (spider silk). In more detail, the cause of reduced settling speed lies not only in the deformed geometrical shape of the ballooning silk but also in its generation of fluid-dynamic force in a non-uniform flow (shear flow). Additionally, we found that the ballooning structure could become trapped in a vortex flow. This seemed to be the second reason why the ballooning structure settles slowly in the homogeneous turbulent flow. These results can help deepen our understanding of the passive dynamics of spiders ballooning in the atmospheric boundary layer.
Default and Control networks connectivity dynamics track the stream of affect at multiple timescales
Authors: Lettieri Giada , Handjaras Giacomo , Setti Francesca , Cappello Elisa Morgana , Bruno Valentina , Diano Matteo , Leo Andrea , Ricciardi Emiliano , Pietrini Pietro , Cecchetti Luca
Published: June 2020

In everyday life the stream of affect results from the interaction between past experiences, expectations, and the unfolding of events. How the brain represents the relationship between time and affect has been hardly explored, as it requires modeling the complexity of everyday life in the laboratory setting. Movies condense into hours a multitude of emotional responses, synchronized across subjects and characterized by temporal dynamics alike real-world experiences.

Here, we use time-varying intersubject brain synchronization and real-time behavioral reports to test whether connectivity dynamics track changes in affect during movie watching. Results show that polarity and intensity of experiences relate to connectivity of the default mode and control networks and converge in the right temporo-parietal cortex. We validate these results in two experiments including four independent samples, two movies, and alternative analysis workflows. Lastly, we reveal chronotopic connectivity maps within temporo-parietal and prefrontal cortex, where adjacent areas preferentially encode affect at specific timescales.
The neural basis of intelligence in fine-grained cortical topographies
Authors: Feilong Ma , Guntupalli J. Swaroop , Haxby James V.
Published: June 2020

Intelligent thought is the product of efficient neural information processing, which is embedded in fine-grained, topographically-organized population responses and supported by fine-grained patterns of connectivity among cortical fields. Previous work on the neural basis of intelligence, however, has focused on coarse-grained features of brain anatomy and function, because cortical topographies are highly idiosyncratic at a finer scale, obscuring individual differences in fine-grained connectivity patterns. We used a computational algorithm, hyperalignment, to resolve these topographic idiosyncrasies, and found that predictions of general intelligence based on fine-grained (vertex-by-vertex) connectivity patterns were markedly stronger than predictions based on coarse-grained (region-by-region) patterns. Intelligence was best predicted by fine-grained connectivity in the default and frontoparietal cortical systems, both of which are associated with self-generated thought. Previous work overlooked fine-grained architecture because existing methods couldn’t resolve idiosyncratic topographies, preventing investigation where the keys to the neural basis of intelligence are more likely to be found.
Protection after Quarantine: Insights from a Q-SEIR Model with Nonlinear Incidence Rates Applied to COVID-19
Authors: Antonio Minoza Jose Marie , Sevilleja Jesus Emmanuel , de Castro Romulo , Caoili Salvador E. , Bongolan Vena Pearl
Published: June 2020

Community quarantine has been resorted to by various governments to address the current COVID-19 pandemic; however, this is not the only non-therapeutic method of effectively controlling the spread of the infection. We study an SEIR model with nonlinear incidence rates, and introduce two parameters,αandε, which mimics the effect of quarantine (Q). We compare this with the Q-SEIR model, recently developed, and demonstrate the control of COVID-19 without the stringent conditions of community quarantine. We analyzed the sensitivity and elasticity indices of the parameters with respect to the reproduction number. Results suggest that a control strategy that involves maximizingαandεis likely to be successful, although quarantine is still more effective in limiting the spread of the virus. Release from quarantine depends on continuance and strict adherence to recommended social and health promoting behaviors. Furthermore, maximizingαandεis equivalent to a50%successful quarantine in disease-free equilibrium (DFE). This model reduced the infectious in Quezon City by3.45%and Iloilo Province by3.88%; however, earlier peaking by nine and 17 days, respectively, when compared with the results of Q-SEIR.