bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics of hematological patients concomitant with COVID‐19
Authors: Zhou Xiaoxi , Wang Gaoxiang , Chen Liting , Meng Fankai , Huang Liang , Huang Lifang , Wang Na , Li Tongjuan , Cao Yang , Zhou Jianfeng
Published: July 2020

The rapid spread of coronavirus disease 2019 (COVID‐19) represented the most serious issue to public health globally. Hematological patients as immunocompromised hosts are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. There is little information available regarding the clinical features of hematological patients concomitant with COVID‐19. In this study, 9 concomitant patients were analyzed for their clinical manifestations, laboratory data, radiological findings, and immunologic features. The median age was 50 years (range, 17‐68 years) and 6 patients were male. Seven patients were infected through hospital‐associated transmission and other 2 through community‐associated transmission. Onset of COVID‐19 in all patients occurred during routine treatments for their hematological diseases. Eight patients were classified as moderate and 1 patient as critically ill COVID‐19. Four patients died, 1 from leukemia progression, 2 from life‐threatening secondary infection, and the other from respiratory failure caused by COVID‐19. Abruptly elevated levels of cytokines were often correlated with progressive hematological disease or concurrent bacterial infections. Two patients had atypical computed tomography (CT) imaging findings of COVID‐19. The median interval from the first CT scan imaging to improvement in survivors was 40 days (range, 14‐51 days). Four of 5 survivors had negative serological tests 1 month after symptom onset. Positive viral load in 4 survivors lasted longer than 45 days. Our results indicated concomitant patients formed a distinct subgroup characterized by atypical clinical features, defective viral clearance, and lower level of SARS‐CoV‐2‐specific Abs. Targeted therapies that impair host humoral immunity should be avoided. These findings will be helpful to tailor appropriate management for the concomitant patients.
Reconceptualizing Urban Violence from the Global South
Authors: Villarreal Ana
Published: July 2020

Although urban violence is most often theorized in relation to marginality, violence affects wealthy and poor in Latin America, albeit in different ways. Drawing on qualitative fieldwork and media coverage of a gruesome turf war in Monterrey, Mexico, this paper illustrates how an increase in violence have led the upper class to “disembed” the municipality of San Pedro from the Monterrey Metropolitan Area, revamp the police, and attempt to create not only a “defended neighborhood,” but an entire “defended city.” Contemporary San Pedro reveals that violence and related fear can prompt not only the fragmentation of urban space into numerous gated communities, but also the simultaneous concentration of urban wealth and public security at a city level. Latin American metropoles call for a reconceptualization of urban violence beyond the margins and a closer examination of the invisible walls enclosing the urban wealthy around the world.
Cycling environment investigation and optimization of urban central road in Qingdao
Authors: Xue Kai , Deng Yue , Zhang Hang , Pandiyan Sanjeevi , Manickam Adhiyaman
Published: July 2020

In the context of the current construction of smart cities, cycling activities have grown rapidly, and the optimization of road cycling environments has become increasingly important. In order to explore the role of the optimization of cycling environment in improving the health of cyclists and shaping the overall sustainable environment of the city, this article takes the coastal road of Qingdao as the research object to consult the relevant literature and current environment investigation. The IPA analysis method is used to analyze and evaluate the safety, continuity, convenience, interest, and comfort of the cycling environment, to plan and construct the bicycle lanes to ensure the personal safety of cyclists, and to improve the original road facilities. In order to make suggestions for the optimization of the cycling environment in Qingdao, five aspects of developing the characteristic cycling route of coastal tourism are put forward. That is to ensure smooth cycling activities, to add bicycles parking facilities to maintain a good appearance of the city, to increase bicycles related services facilities, to make rational use of the vertical slope of the road, and to make use of the advantages of natural landscape resources.
The Canadian Occupational Performance Measure (COPM): a valuable tool for children with cerebral paresis
Authors: Enemark Larsen Anette
Published: July 2020

This commentary is on the original article by Kang et al. on pages 1154–1160of this issue.
Mechanisms, screening modalities and treatment options for individuals with non‐alcoholic fatty liver disease and type 2 diabetes
Authors: Hydes T. J. , Summers N. , Brown E. , Alam U. , Thomaides‐Brears H. , Wilding J. P. H. , Cuthbertson D. J.
Published: July 2020

Non‐alcoholic fatty liver disease (NAFLD) exists as a spectrum of disease ranging from excessive accumulation of fat within the liver (simple steatosis), inflammation (non‐alcoholic steatohepatitis) through to fibrosis, cirrhosis and end‐stage liver disease. There is also an increased risk of hepatocellular carcinoma. The principal risk factor for NAFLD is overweight or obesity, along with type 2 diabetes, and NAFLD itself is also a risk factor for incident type 2 diabetes. Overweight/obesity is synergistic with alcohol consumption in causing progressive and insidious liver damage. Recent consensus advocates a change in nomenclature from NAFLD to ‘metabolic associated fatty liver disease’ (MAFLD), reflective of the associated metabolic abnormalities (insulin resistance/type 2 diabetes and metabolic syndrome components). Additional extra‐hepatic manifestations of NAFLD include cardiovascular disease, chronic kidney disease and certain cancers. Unlike other micro‐ and macrovascular complications of type 2 diabetes, systematic screening or surveillance protocols have not been widely adopted in routine diabetes care to assess for presence/severity of NAFLD. Various screening tools are available (non‐invasive tests and biochemical indices) combined with imaging techniques (e.g. transient elastography) to detect steatosis and more importantly advanced fibrosis/cirrhosis to facilitate appropriate surveillance. Liver biopsy may be sometimes necessary. Treatment options for type 2 diabetes, including lifestyle interventions (dietary change and physical activity), glucose‐lowering therapies and metabolic surgery, can modulate hepatic steatosis and to a lesser extent fibrosis. Awareness of the impact of liver disease on the choice of glucose‐lowering medications in individuals with type 2 diabetes is also critical.
Foraging behavior responses of Orius insidiosus to thrips cues
Authors: Traczyk Edward , Funderburk Joe , Martini Xavier
Published: July 2020

The minute pirate bugs (Hemiptera: Anthocoridae) are effective biological control agents against destructive agricultural pests such as the western flower thrips, Frankliniella occidentalis Pergande (Thysanoptera: Thripidae) in agroecosystems around the world. One species, Orius insidiosus (Say), has proven effective in controlling thrips populations in fields and greenhouses, and serves as an integral component of many integrated pest management (IPM) programs. Three experiments were conducted using motion‐tracking software and dual‐choice Y‐tube bioassays to determine whether direct thrips contact and thrips cues contact induced arrestant and attractant behaviors. The experiments revealed that O. insidiosus adults exhibited behavioral changes indicative of switching from extensive to intensive foraging after direct exposure to thrips prey. Similar arresting behavior was induced by the presence of thrips tracks alone. In Y‐tube bioassays O. insidiosus showed preference towards arms containing tracks from western flower thrips larvae vs. clean arms, but only when direct contact with the tracks was made in the stem. Our data indicate that thrips deposit non‐volatile semiochemicals that are used by O. insidiosus during foraging. These compounds have the potential to aid in O. insidiosus behavior manipulation which may help in early control of thrips populations in fields and greenhouses. Further research is necessary to determine the chemical composition of these cues and how to effectively and pragmatically integrate the inducing stimuli into biocontrol programs as part of IPM strategies.
Oxalate‐fluoride anion exchange in alpine tundra soil: Impact on aluminium transport
Authors: Evans Andrew , Jacobs Michael B.
Published: July 2020

Anion exchange between ubiquitous low‐molecular‐weight organic acids (LMWOA), such as oxalate, and surface‐retained inorganic anions, such as F−, SO42− and OH−, can play a critical role in Al bioavailability and transport in acidic alpine tundra soil. A series of batch equilibration and composite soil column leaching studies were conducted to examine anion exchange reactions between F−, oxalate and OH−, and the impact of increased soil solution F− concentration on Al transport. The addition of either F− or oxalate to soil suspensions resulted in significantly higher solution pH, suggesting F− and oxalate exchange with surface –OH groups. Distinct stages of OH− release were observed for all soil horizons leached with 1.32 × 10−3 mol l−1 F−, with OH− release decreasing in the order O/A1 ~ A2> > Bw. A similar OH− release pattern was observed in the O/A1 horizon for the 7.81 × 10−4 mol l−1 oxalate treatment, suggesting that both F− and oxalate may be competing for common exchange sites in the O/A1 horizon. Fluoride displacement by oxalate, in batch equilibration experiments, was observed for both the 2.84 × 10−4 mol l−1 and 7.81 × 10−4 mol l−1 oxalate treatment. Individual soil horizons leached with 7.81 × 10−4 mol l−1 oxalate exhibited increased F− leaching in the order O/A1 > A2 ~ Bw, with pulsed F− movement being observed in the O/A1 horizon. Soil columns eluted with 1.32 × 10−3 mol l−1 F− exhibited increased Al solubilization and transport, with Al leaching increasing in the order Bw > A2 > O/A1. Sequential leaching of soil columns in the order D. I. H2O → 1.32 × 10−3 mol l−1 F− → D.I. H2O → 7.81 × 10−4 mol l−1 oxalate indicated that previously adsorbed F− was displaced by oxalate. Displacement of F− by oxalate increased in the order O/A1 > A2 > Bw. Hydroxyl displacement by both F− and oxalate may be an important source of acid neutralization in a soil wetting front, affecting Al speciation and transport.

Highlights

Oxalate and F− compete for similar OH− exchange sites, increasing soil pH.

Adsorbed F− can be displaced by oxalate anions.

Al solubilization increases with F− adsorption in alpine tundra soil.

Aluminium fluoride speciation changes rapidly within the soil wetting front.

Anion exchange reactions should be considered in assessing soil ANC.
Box and block test, hand grip strength and nine‐hole peg test: correlations between three upper limb objective measures in multiple sclerosis
Authors: Solaro C. , Di Giovanni R. , Grange E. , Mueller M. , Messmer Uccelli M. , Bertoni R. , Brichetto G. , Tacchino A. , Patti F. , Pappalardo A. , Prosperini L. , Castelli L. , Rosato R. , Cattaneo D. , Marengo D.
Published: July 2020

Background and purpose

Limited data are available in the literature for upper limb impairment in multiple sclerosis (MS). This study aimed to report the distribution of values of hand grip strength (HGS), of the box and block test (BBT) and of the nine‐hole peg test (9HPT) correlated with demographic and clinical data in subjects with MS.

Methods

This study involved five Italian neurological centres. The inclusion criteria were age ≥ 18, MS diagnosis, stable disease phase, right‐hand dominance. All subjects underwent HGS, BBT and 9‐HPT evaluation.

Results

In all, 202 subjects with MS were enrolled: 137 females; mean age 48.4 years; mean Expanded Disability Status Scale (EDSS) 4.17; mean disease duration 14.12 years; disease course 129 relapsing–remitting, 21 primary progressive and 52 secondary progressive MS subjects; mean right HGS 25.3 kg, left 23.2 kg; mean right BBT 45.7 blocks, left 44.9 blocks; mean right 9‐HPT 30.7 s, left 33.4 s. All results were statistically significantly different compared to healthy controls. HGS, BBT and 9‐HPT were associated with age, EDSS and disease duration, whilst disease course correlated with BBT and 9‐HPT. The BBT and 9‐HPT scores significantly differed according to level of disability (EDSS ≤3.0, 3.5–5.5, ≥6.0).

Conclusion

Hand grip strength and BBT value distribution in a large MS population is reported. Correlations between HGS, BBT and 9‐HPT were generally low.
Potential short‐term earthquake forecasting by farm animal monitoring
Authors: Wikelski Martin , Mueller Uschi , Scocco Paola , Catorci Andrea , Desinov Lev V. , Belyaev Mikhail Y. , Keim Daniel , Pohlmeier Winfried , Fechteler Gerhard , Martin Mai P.
Published: July 2020

Whether changes in animal behavior allow for short‐term earthquake predictions has been debated for a long time. Before, during and after the 2016/2017 earthquake sequence in Italy, we deployed bio‐logging tags to continuously observe the activity of farm animals (cows, dogs, and sheep) close to the epicenter of the devastating magnitude M6.6 Norcia earthquake (Oct–Nov 2016) and over a subsequent longer observation period (Jan–Apr 2017). Relating 5,304 (in 2016) and 12,948 (in 2017) earthquakes with a wide magnitude range (0.4 ≤ M ≤ 6.6) to continuously measured animal activity, we detected how the animals collectively reacted to earthquakes. We also found consistent anticipatory activity prior to earthquakes during times when the animals were in a building (stable), but not during their time on a pasture. We detected these anticipatory patterns not only in periods with high, but also in periods of low seismic activity. Earthquake anticipation times (1–20 hr) are negatively correlated with the distance between the farm and earthquake hypocenters. Our study suggests that continuous bio‐logging of animal collectives has the potential to provide statistically reliable patterns of pre‐seismic activity that could yield valuable insights for short‐term earthquake forecasting. Based on a priori model parameters, we provide empirical threshold values for pre‐seismic animal activities to be used in real‐time observation stations.
A minimally invasive clinical model to test sunscreen toxicity based on oxidative stress levels using microbiopsy and confocal microscopy – a proof of concept study
Authors: Yamada Miko , Lin Lynlee L. , Hang Lydia Y.T. , Belt Paul J. , Peter Soyer H. , Raphael Anthony P. , Prow Tarl W.
Published: July 2020

Objective

This proof‐of‐concept study demonstrated that using minimally invasive skin microsampling could enable significantly higher throughput of cosmetic testing in volunteers than conventional biopsy. Nanoparticle sunscreen was used as a model to test toxicity based on oxidative stress using microbiopsy and confocal imaging.

Methods

Six volunteers were recruited for this study (3 males and 3 females). Zinc oxide nanoparticle containing topical formulation was prepared at 10% w/v. Each volunteer had 3 areas of 4 cm2 each mapped on each inner forearm for a total of 6 treatment areas (intact/ tape‐stripped and with/without treatment). The topical zinc‐nanoparticle formulation was applied directly to volunteer skin (2mg/cm2) for 2 hrs. Microbiopsied tissue from each treatment group was stained for reactive oxygen and nitrogen species in addition to mitochondrial superoxide. The stained samples were then imaged using confocal microscopy prior to image analysis.

Results

Skin exposed to zinc oxide nanoparticles did not show any significant increases in oxidative stress. Zinc oxide nanoparticle tape‐stripped skin resulted in signal significantly lower (P < 0.001) oxidative stress levels than t‐butylated hydroxytoluene treated tape‐stripped skin for oxidative stress markers. Topically applied zinc oxide nanoparticles had no detectable effect on the oxidative status in volunteer skin. No adverse reactions or effects were observed after all treatments including microbiopsy.

Conclusion

The data support the hypothesis that microbiopsy is a viable approach to study cosmeceutical‐ skin interactions in volunteers with capacity for molecular assays and high throughput with very low risk to the volunteer.
A review of varietal change in roots, tubers and bananas: consumer preferences and other drivers of adoption and implications for breeding
Authors: Thiele Graham , Dufour Dominique , Vernier Philippe , Mwanga Robert O. M. , Parker Monica L. , Schulte Geldermann Elmar , Teeken Béla , Wossen Tesfamicheal , Gotor Elisabetta , Kikulwe Enoch , Tufan Hale , Sinelle Sophie , Kouakou Amani Michel , Friedmann Michael , Polar Vivian , Hershey Clair
Published: July 2020

This review of the literature on varietal change in sub‐Saharan Africa looks in detail at adoption of new varieties of bananas in Uganda, cassava in Nigeria, potato in Kenya, sweetpotato in Uganda and yams in Côte d’Ivoire. The review explored three hypotheses about drivers of varietal change. There was a strong confirmation for the hypothesis that insufficient priority given to consumer‐preferred traits by breeding programmes contributes to the limited uptake of modern varieties (MVs) and low varietal turnover. Lack of evidence meant the second hypothesis of insufficient attention to understanding and responding to gender differences in consumer preferences for quality and post‐harvest traits was unresolved. The evidence on the third hypothesis about the informal seed system contributing to slow uptake of MVs was mixed. In some cases, the informal system has contributed to rapid uptake of MVs, but often it appears to be a barrier with inconsistent varietal naming a major challenge.
Effects of carboxymethylation, hydroxypropylation and dual‐enzyme hydrolysis combination with heating on in vitro hypoglycaemic properties of coconut cake dietary fibres
Authors: Zheng Yajun , Shi Panqi , Li Yan , Yongliang Zhuang , Wang Xian , Liu Le
Published: July 2020

Effects of carboxymethylation, hydroxypropylation and dual‐enzyme hydrolysis combined with heating on in vitro hypoglycaemic properties of coconut cake dietary fibre (CCDF) were studied. Results showed that all the three modification methods could effectively improve (P < 0.05) the glucose‐adsorption ability (GAA), glucose dialysis retardation index (GDRI), α‐glucosidase and α‐amylase inhibition activity of CCDF. The highest GAA (4.45–4.93 mm g−1), GDRI (85.09–86.94% mm g−1) and α‐glucosidase inhibition activity (16.39–19.37%) were found on CCDFs modified by hydroxypropylation and carboxymethylation, attributed to the increased soluble dietary fibre content, viscosity and water retention and swelling capacity. Moreover, CCDF treated by enzymatic hydrolysis combined with heating demonstrated the highest α‐amylase inhibition activity (53.95%), attributed to the high specific surface area, more porous surface structure and formation of fibre–amylase complex proved by fluorescence spectroscopy. These results suggest that the modified CCDFs could be used as low‐calorie functional ingredients in food or other industries.
Reference charts for body composition parameters by dual‐energy X‐ray absorptiometry in European children and adolescents aged 6 to 18 years—Results from the Austrian LEAD (Lung, hEart, sociAl, boDy) cohort
Authors: Ofenheimer Alina , Breyer‐Kohansal Robab , Hartl Sylvia , Burghuber Otto C. , Krach Florian , Schrott Andrea , Franssen Frits M. E. , Wouters Emiel F. M. , Breyer Marie‐Kathrin
Published: July 2020

Background

DXA is a widely used technique to assess body composition. Reference values based on a large general population cohort of European children and adolescents were missing. The aim of this study was to provide age‐ and sex‐specific reference percentiles of body composition parameters for European children and adolescents and to compare them to the American NHANES cohort. Additionally, exponents accounting best for height biases were analysed.

Methods

DXA scans of 1573 participants, aged 6 to 18 years, recruited from 2011 to 2019 by the Austrian LEAD study, a representative population‐based cohort, have been used to create reference charts using the LMS model.

Results

Reference charts displaying percentile curves and the corresponding reference values are provided. Fat mass parameters were higher in females, while lean mass parameters were higher in males. Compared to the NHANES cohort medians of FMI and LMI were always lower. For FMI, BMI, LMI and ALMI the best fitting exponent were 2.5, 3, 3 and 3.5 respectively

Conclusions

The present study provides reference charts for children and adolescents aged 6 to 18 years, for body composition parameters assessed by DXA. The charts enable comparison to a European general‐population cohort and indicate that reference populations should be chosen with caution.
Time Together as an arena for mental health nursing – staff experiences of introducing and participating in a nursing intervention in psychiatric inpatient care
Authors: Molin Jenny , Hällgren Graneheim Ulla , Ringnér Anders , Lindgren Britt‐Marie
Published: July 2020

A lack of meaningful activities for people with mental ill health admitted to psychiatric inpatient care has been related to feelings of boredom and ‘doing nothing’ and is not in line with recovery‐oriented care. Staff in psychiatric inpatient care report having limited time, ambiguous responsibilities, and insufficient support that counteracts their ideals of good nursing care and puts them at risk for high levels of stress and stress of conscience. Research highlights a need for interactions between patients and staff, but few nursing interventions with such a focus are described in the literature. This qualitative study aimed to illuminate staff experiences of introducing and participating in the nursing intervention Time Together, via qualitative content analysis of 17 individual semi‐structured interviews with nursing staff in psychiatric inpatient care. The results show that these staff members experienced Time Together as an arena for mental health nursing. They prepared for the introduction of the intervention by laying a framework for success. Although the actual implementation led to them feeling burdened, they found that Time Together fostered relationships between patients and staff. For successful implementation, mental health nurses need to advocate the intervention. As Time Together constitutes an arena for mental health nursing, play and conversations based on reciprocity and equality can contribute to patients’ recovery.
Effect of home and over the contour bleaching on stainability of CAD/CAM esthetic restorative materials
Authors: Tinastepe Neslihan , Malkondu Ozlem , Iscan Ipek , Kazazoglu Ender
Published: July 2020

Objective

To determine the effect of home and over the counter bleaching on the stainability of CAD/CAM restorative materials, and to correlate the surface roughness with discoloration.

Material and Methods

Specimens were fabricated from feldspathic ceramic, an hybrid ceramic, a resin nano‐ceramic, and lithium disilicate‐reinforced glass ceramic. After baseline surface roughness (Ra1) and color measurement, each material was randomly divided into three groups according to bleaching regimen as Opalescence PF and; Opalescence Go; control. Then, the second color and surface roughness (Ra2) measurements were made. Thereafter, all specimens were immersed in a coffee solution for 12 days and the third color measurement was made. Color and whiteness change (CIELAB— ΔEab, CIEDE2000—ΔE00, whiteness index—ΔWID) were calculated after bleaching (ΔE1;ΔE001;ΔWID1) and immersion in the coffee solution (ΔE2;ΔE002;ΔWID2).

Results

According to both CIELAB, CIEDE 2000 and WID formulas, the highest mean ΔE1, ΔE2, ΔWID1, ΔWID2 values were observed for LAVA Ultimate groups while the lowest values were measured for e.max CAD groups. The findings also showed that there was a positively significant relationship between Ra2, and ΔE2 and ΔWID2.

Conclusions

Type of restorative materials and bleaching agents had an impact on color change after bleaching and immersion in coffee.

Clinical Significance

Home and over‐the‐counter bleaching agents may cause an increase in susceptibility of restorative materials to staining.
“I don’t do it for myself, I do it for them”: A grounded theory study of South Asians’ experiences of making lifestyle change after myocardial infarction
Authors: Dilla Davis , Ian Jones , Martin Johnson , Michelle Howarth , Felicity Astin
Published: July 2020

Aims and objectives

To explore South Asians’ experience of choosing and prioritising lifestyle changes during their recovery from first myocardial infarction.

Background

Coronary heart disease continues to be a leading cause of premature death globally. South Asians’ suffer increased risk of coronary heart disease and have poorer outcomes following myocardial infarction compared to other ethnic groups. Lifestyle modification slows atherosclerosis, and models of behaviour change have been proposed to support such changes. However, little is known about the experiences of South Asians’ when attempting to modify their lifestyle.

Design

Constructivist grounded theory design, using longitudinal, face‐to‐face, semistructured in‐depth interviews. The consolidated criteria for reporting qualitative research checklist were used to report the study.

Method

A series of in‐depth interviews with a purposive sample of South Asian patients were conducted at 3 and 16 weeks following hospital discharge. Transcripts were analysed line by line with focused and theoretical coding using the constant comparative method and memo writing. Data collection and analysis occurred simultaneously.

Results

Three categories characterised the findings. First, patronage of the family, referring to the role that family played in supporting recovery. Conflict often existed between the needs of the family and the individual with the family needs taking priority resulting in lifestyle modifications being abandoned. Second, conforming to beliefs, which explain how religious and health beliefs influenced decisions. Third, affinity towards one's group which refers to the conflictual nature afforded by social norms. The need for “harmony” was identified as the substantive theory. Decisions about choosing and prioritising lifestyle changes were based on what helped participants to maintain harmony in their life rather than meeting individual health needs.

Conclusion

South Asians’ choose and prioritise lifestyle changes after first myocardial infarction against a backdrop of competing religious, cultural and family beliefs.

Relevance to Clinical Practice

This paper illustrates that South Asians attempt to balance their individual needs with their family goals, cultural priorities and their religious beliefs when attempting to adopt a healthy lifestyle post myocardial infarction. We propose a model of shared priority setting as a means of promoting behaviour change with South Asians.
Caring for the carers in a public health district: A well‐being initiative to support healthcare professionals
Authors: Almeida Shamika , Bowden Alera , Bloomfield Jason , Jose Besty , Wilson Valerie
Published: July 2020

Aims and Objectives

To assess the impact of the proactive organisational resource allocation in terms of a 6‐week well‐being initiative to support public healthcare professionals' workplace engagement, well‐being and job satisfaction.

Background

Burnout of healthcare professionals can be a major cost to the Australian economy and public healthcare sector. According to the social exchange theory, when healthcare professionals perceive that their organisation proactively allocates resources to caring for its employees, then they are more likely to reciprocate and become more engaged in their work roles.

Design

The study used a pre‐ and postsurvey of healthcare professionals who participated in the well‐being initiative.

Methods

Between February–June 2019, 172 healthcare professionals were surveyed before and after a well‐being initiative. The survey included questions on workplace engagement, workplace well‐being and job satisfaction. Paired t tests were used to determine whether the difference between before and after averages was significant. The TREND statement was used to ensure the quality reporting of this study.

Results

The well‐being initiative had a positive impact on the healthcare professionals involved in the initiative. Nursing staff benefitted the most from the well‐being initiative, while the full‐time staff members and highly experienced demonstrated an increase in engagement.

Conclusion

Well‐being initiatives can be a targeted strategy to help alleviate burnout amongst healthcare professionals and build a mutually beneficial relationship between management and employees.

Relevance to clinical practice

This study shows how implementing a staff well‐being initiative increases workplace engagement, which benefits both the individual and the organisation.
Pieris brassicae eggs trigger interplant systemic acquired resistance against a foliar pathogen in Arabidopsis
Authors: Orlovskis Zigmunds , Reymond Philippe
Published: July 2020

Recognition of plant pathogens or herbivores activate a broad‐spectrum plant defense priming in distal leaves against potential future attacks, leading to systemic acquired resistance (SAR). Additionally, attacked plants can release aerial or below‐ground signals that trigger defense responses, such as SAR, in neighboring plants lacking initial exposure to pathogen or pest elicitors. However, the molecular mechanisms involved in interplant defense signal generation in sender plants and decoding in neighboring plants are not fully understood.

We previously reported that Pieris brassicae eggs induce intraplant SAR against the foliar pathogen Pseudomonas syringae in Arabidopsis thaliana. Here we extend this effect to neighboring plants by discovering an egg‐induced interplant SAR via mobile root‐derived signal(s).

The generation of an egg‐induced interplant SAR signal requires pipecolic acid (Pip) pathway genes ALD1 and FMO1 but occurs independently of salicylic acid (SA) accumulation in sender plants. Furthermore, reception of the signal leads to accumulation of SA in the recipient plants.

In response to insect eggs, plants may induce interplant SAR to prepare for potential pathogen invasion following feeding‐induced wounding or to keep neighboring plants healthy for hatching larvae. Our results highlight a previously uncharacterized below‐ground plant‐to‐plant signaling mechanism and reveals genetic components required for its generation.
Oral rehabilitation in a patient with Jeune syndrome presenting with multiple teeth agenesis
Authors: Mira Paôla Caroline da Silva , Arid Juliana , Paula‐Silva Francisco Wanderley Garcia , de Queiroz Alexandra Mussolino , de Carvalho Fabricio Kitazono , Pagnano Valéria Oliveira
Published: July 2020

Jeune syndrome (JS) is a rare disease, with systemic manifestations, such as renal and hepatic insufficiency, retinal pigmentation, and respiratory insufficiency. Etiological factors have not been completely elucidated, but the molecular biology has contributed to the diagnosis and understanding of JS with DNA sequencing, showing the association among polymorphisms in different genes DYNC2H1 (MIM 603297) and TCTEX1D2 (MIM617353), which are the main genes associated with JS. There are a few reports on buccal findings in these patients; here, we present dental anomalies and clinical oral findings in a patient with JS, focusing on a multidisciplinary approach for rehabilitation. A 15‐year‐old boy with JS was referred to our dental clinic. Clinical and radiographic examination revealed the presence of dental agenesis, taurodontism, and geographic tongue with lobulations. The treatment plan consisted of preventive, restorative, surgical, and oral rehabilitation. We observed that the treatment improved the patient's quality of life owing to improved functions, maintenance of oral health, and above all, self‐esteem. Clinical findings in this case may contribute to a better characterization of JS and other ciliopathies.
Integrating handover curricula in medical school
Authors: Sheng Jim , Manjunath Sonakshi , Michael Meghan , Gajera Prakash , Wang Eric , Sendelbach Dorothy , Greilich Philip , Ambardekar Aditee
Published: July 2020

Background

Transitions of care are a patient‐safety priority. Constructs such as SBAR (situation, background, assessment, recommendation) and I‐PASS (illness severity, patient summary, action list, situation awareness, synthesis by receiver) have been used to teach the benefit of structured handovers and have demonstrated an impact in simulated and clinical environments. Despite this, there is still a lack of literature describing handover training for medical students that allows early and sustained knowledge and skill acquisition.

Methods

We designed a curriculum to teach handovers to medical students that spanned 28 months of a 4‐year medical education curriculum at a large medical school. The curriculum included two separate workshops that book‐ended medical student core clerkships. The curriculum was evaluated via knowledge‐based surveys and open‐ended feedback from students.

Results

Two‐hundred and forty students participated in the first ‘Transition to clerkship’ (T2C) workshop. There was improvement in the mean scores on a knowledge‐based survey after the workshop (p < 0.001). The overall improvement in performance remained significant 1 year later (p < 0.001). Following the second, ‘Residency essentials’ (RE) workshop, students demonstrated marginal improvement in knowledge when compared with scores immediately post‐T2C and pre‐RE. There was overall improvement from pre‐T2C to post RE.

Discussion

We outline the design and facilitation of two workshops for a large medical school class, as book‐ended curricula before and after the clerkship phase of education. This project highlights the need for targeted learning and practice in handover delivery during clinical rotations to maintain and continually improve skills. We describe vertically integrated curricula that are logistically plausible, meaningful and beneficial.
Anti‐CD40 monoclonal antibody ameliorates experimental autoimmune uveoretinitis in mice
Authors: Xu Lei , Gao Jie , Pan Yongquan , Tian Na , He Mingzhong , Jin Lei , Chen Feilan
Published: July 2020

Objective

To investigate the effects of CD40 on ocular inflammation in experimental autoimmune uveoretinitis (EAU) in B10.RIII mice.

Animals studied

EAU‐susceptible B10.RIII mice were subcutaneously immunized with interphotoreceptor retinoid‐binding protein (IRBP) 161‐180 in complete Freund's adjuvant and evaluated clinically and pathologically on days 7, 14, 21, 28, and 35 postimmunization. Anti‐CD40 antibody was intraperitoneally injected into mice every other day from days 7 to 14 postimmunization. Phosphate‐buffered saline (PBS)‐injected EAU mice were used as the controls.

Procedures

The frequencies of CD11c+CD40+ dendritic cells (DCs), CD11c+MHC‐II+ DCs, and CD11c+CD40+MHC‐II+ DCs in splenocytes were evaluated by flow cytometry on days 0, 7, 14, and 21 after immunization. Tumor necrosis factor (TNF)‐α and interleukin (IL)‐6 production in CD11c+ DCs was assessed by ELISA. IRBP‐specific lymphocyte proliferation was assessed using a modified MTT cell proliferation assay.

Results

The number of CD11c+CD40+ DCs, CD11c+MHC‐II+ DCs, and CD11c+CD40+MHC‐II+ DCs increased at the onset of EAU, peaked at the height of disease severity, and was sustained at a high level until day 21. Treatment with anti‐CD40 antibody significantly alleviated clinical and pathological activities related to EAU. Compared with the control mice, antibody‐treated EAU mice showed few CD11c+CD40+ DC and CD11c+CD40+MHC‐II+ DC frequencies in splenocytes. The anti‐CD40 antibody significantly suppressed IRBP‐specific lymphocyte proliferation and TNF‐α and IL‐6 production by DCs in EAU mice.

Conclusions

The increased expression of CD40 and major histocompatibility complex (MHC) class II molecules in the splenocytes of EAU mice were correlated with inflammatory activity. Anti‐CD40 treatment can significantly attenuate EAU activity by inhibiting systemic IRBP‐specific immune responses.
Health Status Analysis and Optimization of Load Dispatch for Power Plant Boiler
Authors: Huang Shuang , Yang Yujiu , Huang Biqing
Published: July 2020

Boiler is the main equipment of thermal power station. We established a health status evaluation model for the boiler’s superheater through a fuzzy comprehensive hierarchy analysis. Then, we explored the load-damage characteristic curve for ten boilers’ superheaters. Based on this, we aim to minimize the total damage of boilers in the thermal power station through load dispatch. Considering the start-stop state of all the boilers in one plant station, a heuristic Binary Particle Swarm Optimization algorithm for the Unit Commitment load dispatch model is put forward. The algorithm is proved valid to search the feasible particle both in efficiency and effectiveness in the ten-boilers system in 24 h period.
Suprachoroidal gene transfer with nonviral nanoparticles
Authors: Shen Jikui , Kim Jayoung , Tzeng Stephany Y. , Ding Kun , Hafiz Zibran , Long Da , Wang Jiangxia , Green Jordan J. , Campochiaro Peter A.
Published: July 2020

Suprachoroidal gene transfer with nonviral nanoparticles provides noninvasive transgene expression in photoreceptors and RPE.
Controllable freezing of the nuclear spin bath in a single-atom spin qubit
Authors: Mądzik Mateusz T. , Ladd Thaddeus D. , Hudson Fay E. , Itoh Kohei M. , Jakob Alexander M. , Johnson Brett C. , McCallum Jeffrey C. , Jamieson David N. , Dzurak Andrew S. , Laucht Arne , Morello Andrea
Published: July 2020

The presence or absence of an electron controls the freezing of the nuclear spin bath coupled to a single-atom qubit in silicon.
Synaptic zinc inhibition of NMDA receptors depends on the association of GluN2A with the zinc transporter ZnT1
Authors: Krall Rebecca F. , Moutal Aubin , Phillips Matthew B. , Asraf Hila , Johnson Jon W. , Khanna Rajesh , Hershfinkel Michal , Aizenman Elias , Tzounopoulos Thanos
Published: July 2020

Presynaptic zinc release and a postsynaptic transporter organize zinc into spatial and functional microdomains.
Temperature-resilient solid-state organic artificial synapses for neuromorphic computing
Authors: Melianas A. , Quill T. J. , LeCroy G. , Tuchman Y. , Loo H. v. , Keene S. T. , Giovannitti A. , Lee H. R. , Maria I. P. , McCulloch I. , Salleo A.
Published: July 2020

Ion gels enable temperature-stable and high-performance organic memories for integration into hardware artificial neural networks.
Finding Camel-ot: A Holy Grail against pandemic SARS-CoV-2?
Authors: Soong Deborah , Leeman Rachel , Pillai Asha
Published: July 2020

Engineered camelid antibody multimers can potently block SARS-CoV-2 viral entry.
Let’s talk about sex
Authors: Patti James C. , Griffin Gabriel K.
Published: July 2020

Complement gene variation drives sex biases in autoimmune disease.
The utility of ketones at triage: a prospective cohort study
Authors: Durnin Sheena , Jones Jennifer , Ryan Emer , Howard Ruth , Walsh Sean , Dawkins Ian , Blackburn Carol , O'Donnell Sinead M , Barrett Michael J
Published: July 2020

Objective

To establish the relationship between serum point-of-care (POC) ketones at triage and moderate-to-severe dehydration based on the validated Gorelick Scales.

Design, setting and patients

Prospective unblinded study from April 2016 to February 2017 in a paediatric emergency department. Patients aged 1 month to 5 years, with vomiting and/or diarrhoea and/or decreased intake with signs of moderate or severe dehydration or clinical concern for hypoglycaemia were eligible.

Main outcome measures

The primary outcome was to describe the relationship between triage POC ketones to the two Gorelick Scales. Secondary outcomes were to examine the response of ketone levels to fluid/glucose administration and patient disposition.

Results

One-hundred and ninety-eight patients were included; median age 1.8 years. The median triage ketones were 4.6 (IQR 2.8–5.6) mmol/L. A weak correlation was identified between triage ketones and the 10-point Gorelick Scale (Spearman’s ρ=0.217, p=0.002), however no correlation between triage ketones and the 4-point Gorelick Scale was identified. Those admitted had median triage ketones of 5.2 (IQR 4–6) mmol/L and repeat ketones of 4.6 (IQR 3.3–5.7) mmol/L compared with 4.2 (IQR 2.4–5.3) mmol/L and 2.9 (IQR 1.6–4.2) mmol/L in those discharged home.

Conclusion

No correlation between triage POC ketones and the 4-point Gorelick Scale was established. POC ketones at triage have poor accuracy for predicting hospital admission. The elevated profile of POC ketones in non-diabetic children with acute illness suggests a potential target of tailored treatments for further research.
Atezolizumab-induced type 1 diabetes mellitus in a patient with metastatic renal cell carcinoma
Authors: Rahman Wedad , Conley Anna , Silver Kristi D
Published: July 2020

Checkpoint inhibitor immunotherapy has revolutionised cancer treatment since its inception. During an inflammatory response, activated cytotoxic T cells expressing programmed cell death protein 1 (PD-1) interact with programmed cell death-ligand 1 (PD-L1) on peripheral tissues to thwart an autoimmune reaction. Cancer cells upregulate PD-L1 expression to evade the immune system and are vulnerable to attack in the presence of PD-1 or PD-L1 checkpoint inhibitors. However, blockade of this pathway also contributes to the unintended side effect of autoimmune endocrinopathies. Atezolizumab, a checkpoint inhibitor against PD-L1, is associated with the rare complication of type 1 diabetes. We present a case of glutamic acid decarboxylase antibody-positive type 1 diabetes developing in a patient with a long-standing history of well-controlled type 2 diabetes following treatment with atezolizumab for metastatic renal cell carcinoma.
Classification of pachychoroid disease on ultrawide-field indocyanine green angiography using auto-machine learning platform
Authors: Kim In Ki , Lee Kook , Park Jae Hyun , Baek Jiwon , Lee Won Ki
Published: July 2020

Aims

Automatic identification of pachychoroid maybe used as an adjunctive method to confirm the condition and be of help in treatment for macular diseases. This study investigated the feasibility of classifying pachychoroid disease on ultra-widefield indocyanine green angiography (UWF ICGA) images using an automated machine-learning platform.

Methods

Two models were trained with a set including 783 UWF ICGA images of patients with pachychoroid (n=376) and non-pachychoroid (n=349) diseases using the AutoML Vision (Google). Pachychoroid was confirmed using quantitative and qualitative choroidal morphology on multimodal imaging by two retina specialists. Model 1 used the original and Model 2 used images of the left eye horizontally flipped to the orientation of the right eye to increase accuracy by equalising the mirror image of the right eye and left eye. The performances were compared with those of human experts.

Results

In total, 284, 279 and 220 images of central serous chorioretinopathy, polypoidal choroidal vasculopathy and neovascular age-related maculopathy were included. The precision and recall were 87.84% and 87.84% for Model 1 and 89.19% and 89.19% for Model 2, which were comparable to the results of the retinal specialists (90.91% and 95.24%) and superior to those of ophthalmic residents (68.18% and 92.50%).

Conclusions

Auto machine-learning platform can be used in the classification of pachychoroid on UWF ICGA images after careful consideration for pachychoroid definition and limitation of the platform including unstable performance on the medical image.
Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review protocol
Authors: Bhate Ketaki , Lin Liang-Yu , Barbieri John , Leyrat Clémence , Hopkins Susan , Stabler Richard , Shallcross Laura , Smeeth Liam , Francis Nick A , Mathur Rohini , Langan Sinéad M , Sinnott Sarah-Jo
Published: July 2020

Introduction

Antimicrobial resistance (AMR) is a global health emergency. Acne vulgaris is a highly prevalent condition and the dominant role antibiotics play in its treatment is a major concern. Antibiotics are widely used in the treatment of acne predominantly for their anti-inflammatory effect, hence their use in acne may not be optimal. Tetracyclines and macrolides are the two most common oral antibiotic classes prescribed, and their average use can extend from a few months to several years of intermittent or continuous use. The overall aim of this systematic review is to elucidate what is known about oral antibiotics for acne contributing to antibiotic treatment failure and AMR.

Methods and analysis

A systematic review will be conducted to address the question: What is the existing evidence that long-term oral antibiotics used to treat acne in those over 8 years of age contribute towards antibiotic treatment failure or other outcomes suggestive of the impact of AMR? We will search the following databases: Embase, MEDLINE, the Cochrane Library and Web of Science. Search terms will be developed in collaboration with a librarian by identifying keywords from relevant articles and by undertaking pilot searches. Randomised controlled trials, cohort and case-controlled studies conducted in any healthcare setting and published in any language will be included. The searches will be re-run prior to final analyses to capture the recent literature. The Cochrane tool for bias assessment in randomised trials and ROBINS-I for the assessment of bias in non-randomised studies will be used to assess the risk of bias of included studies. GRADE will be used to make an overall assessment of the quality of evidence. A meta-analysis will be undertaken of the outcome measures if the individual studies are sufficiently homogeneous. If a meta-analysis is not possible, a qualitative assessment will be presented as a narrative review.

Ethics and dissemination

Ethical approval is not required for this systematic-review. The results will be published in a peer-reviewed journal and any deviations from the protocol will be clearly documented in the published manuscript of the full systematic-review.

PROSPERO registration number

CRD42019121738.