bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population‐based cohort study
Authors: Rimvall Martin K. , Jeppesen Pia , Skovgaard Anne Mette , Verhulst Frank , Olsen Else Marie , Rask Charlotte Ulrikka
Published: June 2020

Background

Severe health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention.

Methods

HA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population‐based birth cohort. Register‐based data on costs related to nonhospital‐based primary and secondary somatic health services were obtained over the follow‐up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates.

Results

High HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26–3.31). The group with persistent HA was small (n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85–2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22–2.98) and female sex (RR: 3.33, 95% CI: 2.01–5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow‐up. The increased costs were not explained by chronic somatic illness.

Conclusions

A small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed.
Cutaneous manifestations of SARS‐CoV‐2 infection: a clinical update
Authors: Gisondi P. , PIaserico S. , Bordin C. , Alaibac M. , Girolomoni G. , Naldi L.
Published: June 2020

On 11 March 2020, the World Health Organization (WHO) has declared the novel coronavirus disease (COVID‐19) a global pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2 virus). A consistent number of case reports and clinical series have been already published describing a complex spectrum of skin manifestations associated with the SARS‐CoV‐2 infection. We carried out a review of the English‐language literature up to 20 May 2020, reporting original cases or case series of the cutaneous manifestations of SARS‐CoV‐2 virus infection. The following databases were consulted: PubMed, Embase, Google Scholar and ResearchGate. The search of papers was conducted by using the key term ‘COVID‐19’ or ‘SARS‐CoV‐2’ or ‘coronavirus’ combined with each of the following: ‘skin’, ‘cutaneous’, ‘dermatologic’ or ‘dermatology’, ‘manifestation’, ‘lesions’, or ‘rash’. The patterns of dermatological manifestations associated with SARS‐CoV‐2 infection could be classified into four categories: exanthema (varicella‐like, papulo‐vesicular and morbilliform rash), vascular (chilblain‐like, purpuric/petechial and livedoid lesions), urticarial and acro‐papular eruption. Lastly, other skin manifestations to be considered are the cutaneous adverse reactions to the drugs prescribed for the treatment of COVID‐19. Whether SARS‐CoV‐2 infection can directly cause a worsening of chronic inflammatory diseases such as psoriasis or atopic dermatitis remains to be determined. Dermatology's outlook in the COVID‐19 pandemic is multidimensional.
The true identity of Bryconops cyrtogaster (Norman), and description of a new species of BryconopsKner (Characiformes: Iguanodectidae) from the Rio Jari, lower Amazon basin
Authors: Silva‐Oliveira Cárlison , Moreira Cristiano R. , Lima Flávio C. T. , Py‐Daniel Lúcia Rapp
Published: June 2020

Bryconops cyrtogaster, a poorly known species endemic from the Oyapock River at the border between French Guyana and Brazil, is redescribed herein based on examination of available type material, as well as newly collected material. Additionally, a new rheophilic species from the rio Jari rapids, lower Amazon basin, Brazil, is described. The two species belong to the subgenus Creatochanes and are unique among the congeneres for possessing a posteriorly positioned humeral blotch at the level of the sixth and seventh lateral line scales. They differ from each other by meristic and morphometric characters. The list of endemic species in the rio Jari basin is revised.
Prediction of size and mass of pistachio kernels using random Forest machine learning
Authors: Vidyarthi Sriram K. , Tiwari Rakhee , Singh Samrendra K. , Xiao Hong‐Wei
Published: June 2020

The size and mass of the pistachio kernels are important parameters in pistachio industry worldwide, which are generally associated with pistachio classification and consumer's approval. In this study, we proposed a technique that accurately measures the size and mass of raw pistachio kernels simultaneously using image processing and machine‐learning ensemble. An image‐processing algorithm applying recursive method was used to detect a pistachio kernel from an image and estimate its size based on the pixels occupied. The number of pixels representing a pistachio kernel was used as its digital impression to estimate its size and mass. We employed Random Forest (RF) model to predict the mass of the individual pistachio kernels based on the patterns derived from the pistachio pixels in the image. The mean measured length (18.002 mm) of 100 pistachio kernels were close to the RF predicted length (18.608 mm). Similar close correlation for individual measured pistachio kernel mass and predicted mass was noticed having a bootstrapped residual of 0.036 ± 0.004 g with a class interval of 0.0358–0.0362 at 95% confidence level. Compared to the regression model, bootstrapping and uncertainty quantification showed a good prediction accuracy and robustness of the RF model.

Practical Applications

The size of pistachio kernels is a crucial factor in defining pistachio grades commercially. Current pistachio grading in industry is still performed manually, which is tedious, time consuming, labor intensive and subject to human error and inconsistency. The developed machine learning algorithm based on Random Forest combined with image processing in this study can be a very useful tool in pistachio industry for rapid classification of pistachio worldwide.
Reply to: Neurological, Cognitive and Behavioral Disorders During COVID‐19: The Nitric Oxide Track
Authors: Alkeridy Walid A. , Almaghlouth Ibrahim
Published: June 2020

This letter comments on the letter by Cedric Annweiler
Improving the reliability of chemical manufacturing life cycle inventory constructed using secondary data
Authors: Meyer David E. , Cashman Sarah , Gaglione Anthony
Published: June 2020

This study proposes methods to improve data mining workflows for modeling chemical manufacturing life cycle inventory. Secondary data sources can provide valuable information about environmental releases during chemical manufacturing. However, the often facility‐level nature of the data challenges their utility for modeling specific processes and can impact the quality of the resulting inventory. First, a thorough data source analysis is performed to establish data quality scoring and create filtering rules to resolve data selection issues when source and species overlaps arise. A method is then introduced to develop context‐based filter rules that leverage process metadata within data sources to improve how facility air releases are attributed to specific processes and increase the technological correlation and completeness of the inventory. Finally, a sanitization method is demonstrated to improve data quality by minimizing the exclusion of confidential business information (CBI). The viability of the methods is explored using case studies of cumene and sodium hydroxide production in the United States. The attribution of air releases using process context enables more sophisticated filtering to remove unnecessary flows from the inventory. The ability to sanitize and incorporate CBI is promising because it increases the sample size, and therefore representativeness, when constructing geographically averaged inventories. Future work will focus on expanding the application of context‐based data filtering to other types and sources of environmental data.
Utility of platelet‐rich plasma for treatment of striae distensae: A current exploration
Authors: Heitmiller Kerry , Wang Jordan V. , Murgia Robert D. , Saedi Nazanin
Published: June 2020

Platelet‐rich plasma (PRP) has recently become a popular treatment for various skin conditions, including striae distensae, acne scars, traumatic scars, hair regrowth, and cutaneous rejuvenation. Although PRP has been utilized in orthopedics for many years, its recent entry into dermatology has been met with controversy. While the recent research has generally been limited and is often contradictory, this has differed from the persuasive marketing campaigns targeting patients and consumers. Aesthetic practitioners should be knowledgeable with the available evidence for PRP in the treatment of striae distensae. Here, we review the pertinent literature and offer additional insights.
Self‐contrast study of pinprick therapy combined with super pulse fractional CO2 laser for the treatment of atrophic acne scars
Authors: Yang Zhi , Jiang Song , Zhang Yiqiong , Chen Yuan , Tan Yaxin , Su Hong , Xiong Ying , Li Qiongyan , He Li
Published: June 2020

Aims

This study is to evaluate the clinical efficacy and safety of a “double‐layer” mode of super pulse fractional CO2 laser and a combined treatment of pinprick therapy with fractional CO2 laser for the treatment of atrophic acne scars.

Methods

A split‐face and self‐contrast method was applied. A total of 20 patients with atrophic acne scars randomly received the above mentioned therapy on the left or right side of the cheek for 3 times with an interval of 3 months. ECCA scores, IVA scores, patients’ satisfaction, VAS scores, and adverse reactions were evaluated.

Results

Atrophic acne scars on both sides of the cheek were improved obviously. The ECCA scores showed a significant decrease, while IVA scores significantly increased. Compared with the super pulse fractional CO2 laser group, the decrease of ECCA scores, the increase of IVA scores, and the patients’ satisfaction were significantly higher and improvement on V‐shaped and U‐shaped acne scars was significantly better in the combined treatment group. No patients had severe adverse reactions such as blister, infection, or hypertrophic scars.

Conclusions

Super pulse fractional CO2 laser and pinprick treatment combined with fractional CO2 laser are both safe and effective therapy for the treatment of atrophic acne scars.
Glycolic acid adjusted to pH 4 stimulates collagen production and epidermal renewal without affecting levels of proinflammatory TNF‐alpha in human skin explants
Authors: Narda Mridvika , Trullas Carles , Brown Anthony , Piquero‐Casals Jaime , Granger Corinne , Fabbrocini Gabriella
Published: June 2020

Background

Glycolic acid (GA) is an effective way of reversing the signs of age and photodamage. GA enhances desquamation of the stratum corneum and induces biological responses that can help restore skin's integrity. GA can, however, cause irritation, especially when its concentration is high, and its pH is low. Thus, most commercially available products for home use contain relatively low GA concentrations and are partially neutralized to a pH around 4.

Aims

The aim of this study was to determine the biological effects and relative efficacy of cosmetic formulations containing GA at concentrations ranging from 8% to 25% at pH 4 in human ex vivo skin explants.

Methods

Human skin explants were topically treated with gel formulations and oil‐in‐water creams containing 8%, 10%, 15%, or 25% GA, adjusted to pH 4, daily for 5 days. The degree of desquamation, their effect on cell proliferation, and their impact upon total collagen levels were determined 24 hours later. Levels of tumor necrosis factor‐alpha (TNF‐α) were measured after days 3 and 6.

Results

All formulations effectively induced desquamation in a concentration‐dependent manner. Total collagen levels were increased at all concentrations, with greatest effects at higher GA concentrations. No effect on TNF‐α expression was observed.

Conclusions

These data suggest that partially neutralized GA formulations retain skin rejuvenating properties without causing irritation and inflammation and that their use can be tailored to individual needs based on the concentration of GA in the formulation.
Stratification of Fabry mutations in clinical practice: a closer look at α‐galactosidase A‐3D structure
Authors: Rickert V. , Wagenhäuser L. , Nordbeck P. , Wanner C. , Sommer C. , Rost S. , Üçeyler N.
Published: June 2020

Background

Fabry disease (FD) is an X‐linked lysosomal storage and multi‐system disorder due to mutations in the α‐galactosidase A (α‐GalA) gene. We investigated the impact of individual amino acid exchanges in the α‐GalA 3D‐structure on the clinical phenotype of FD patients.

Patients and methods

We enrolled 80 adult FD patients with α‐GalA missense mutations and stratified them into three groups based on the amino acid exchange location in the α‐GalA 3D‐structure: patients with active site mutations, buried mutations and other mutations. Patient subgroups were deep phenotyped for clinical and laboratory parameters and FD‐specific treatment.

Results

Patients with active site or buried mutations showed a severe phenotype with multi‐organ involvement and early disease manifestation. Patients with other mutations had a milder phenotype with less organ impairment and later disease onset. α‐GalA activity was lower in patients with active site or buried mutations than in those with other mutations (P < 0.01 in men; P < 0.05 in women) whilst lyso‐Gb3 levels were higher (P < 0.01 in men; <0.05 in women).

Conclusions

The type of amino acid exchange location in the α‐GalA 3D‐structure determines disease severity and temporal course of symptom onset. Patient stratification using this parameter may become a useful tool in the management of FD patients.
Being arealnurse: A secondary qualitative analysis of how public health nurses rework their work identities
Authors: Drevdahl Denise J. , Canales Mary K.
Published: June 2020

Many Western nations are emphasizing the importance of population health across health care delivery organizations and education systems. Despite significant momentum to integrate population health into nursing practice, a parallel effort to examine how these efforts impact practicing nurses' views of their professional role and work identity has not occurred. This secondary qualitative analysis, employing an abductive approach, explored processes public health nurses use in creating and maintaining their work identity through three organizing themes: narrative self‐identity, mandated identity, and identity as struggle. The analysis was based on interview data collected from 30 US public health nurses residing in 17 states. ‘Being a real nurse’ describes public health nurses' efforts to balance a contradictory work identity where at times they are expected to focus on populations and at other times, on individuals. The identity work revealed through this study should be further explicated and specific strategies developed for stabilizing a work identity for public health nurses, as well as for any nurse charged with a population health role.
Accumulation of the RNA polymerase subunit RpoB depends on RNA editing by OsPPR16 and affects chloroplast development during early leaf development in rice
Authors: Huang Weifeng , Zhang Yang , Shen Liqiang , Fang Qian , Liu Qun , Gong Chenbo , Zhang Chen , Zhou Yong , Mao Cui , Zhu Yongli , Zhang Jinghong , Chen Hongping , Zhang Yu , Lin Yongjun , Bock Ralph , Zhou Fei
Published: June 2020

Plastid‐encoded genes are coordinately transcribed by the nucleus‐encoded RNA polymerase (NEP) and the plastid‐encoded RNA polymerase (PEP). Resulting primary transcripts are frequently subject to RNA editing by cytidine‐to‐uridine conversions at specific sites. The physiological role of many editing events is largely unknown.

Here, we have used the CRISPR/Cas9 technique in rice to knock out a member of the PLS‐DYW subfamily of pentatricopeptide repeat (PPR) proteins.

We found that OsPPR16 is responsible for a single editing event at position 545 in the chloroplast rpoB messenger RNA (mRNA), resulting in an amino acid change from serine to leucine in the β‐subunit of the PEP. In striking contrast to loss‐of‐function mutations of the putative orthologue in Arabidopsis, which were reported to have no visible phenotype, knockout of OsPPR16 leads to impaired accumulation of RpoB, reduced expression of PEP‐dependent genes, and a pale phenotype during early plant development. Thus, by editing the rpoB mRNA, OsPPR16 is required for faithful plastid transcription, which in turn is required for Chl synthesis and efficient chloroplast development.

Our results provide new insights into the interconnection of the finely tuned regulatory mechanisms that operate at the transcriptional and post‐transcriptional levels of plastid gene expression.
Significant Association between the T2 Values of Vertebral Cartilage Endplates and Pfirrmann Grading
Authors: Cao Yi , Guo Qing‐wei , Wan Ye‐da
Published: June 2020

Objective

The T2 value of lumbar cartilage endplates was measured using the T2 mapping imaging technique, aiming to explore the correlation between the T2 value and Pfirrmann grading of intervertebral discs.

Methods

A total of 130 patients with lumbar spine MR examination due to persistent low back pain were enrolled, including 71 men and 59 women (age: 21–63 years). Lumbar Modic changes and Schmorl nodules were recognized by conventional T1WI and T2WI images in 49 patients, and these patients were excluded from the study. A total of 81 patients were enrolled in this study, including 45 men (45.16 ± 12.20 years) and 36 women (43.33 ± 11.27 years). Pfirrmann (Pm) grading of each lumbar disc was performed based on conventional T2WI median sagittal images and the position of cartilage endplates (CEP) was determined by IDEAL‐SPGR images. Meanwhile, the T2 mapping technique was used to obtain T2 values of cartilage endplates. The T2 values of CEP corresponding to different Pm grade discs were compared, and the correlation between the T2 value and the Pm grade of intervertebral discs was analyzed.

Results

The T2 values of cephalic and caudal CEP of L1–2 in Pm grades I–II, Pm grades III, and Pm grades IV–V were 61.96 ± 5.89 ms, 54.45 ± 3.29 ms, 42.47 ± 3.69 ms and 64.35 ± 5.93 ms, 55.28 ± 3.97 ms, 44.75 ± 2.12 ms, respectively. For cephalic and caudal CEP of L2–3, the T2 values in Pm grades I–II, Pm grades III, and Pm grades IV–V were 62.96 ± 6.93 ms, 55.19 ± 4.02 ms, 48.67 ± 4.56 ms and 65.51 ± 6.49 ms, 57.16 ± 5.55 ms, 52.05 ± 4.20 ms, respectively. The T2 values of cephalic and caudal CEP from L3–4 to L5–S1 in Pm grades I–II, Pm grades III, and Pm grades IV–V were (63.72 ± 5.76 ms, 53.96 ± 6.52 ms, 48.05 ± 5.00 ms), (65.46 ± 6.37 ms, 55.70 ± 7.50 ms, 48.10 ± 3.27 ms); (66.34 ± 7.68 ms, 56.76 ± 9.48 ms, 47.80 ± 4.33 ms), (64.44 ± 4.65 ms, 59.30 ± 8.80 ms, 47.30 ± 5.78 ms), (65.32 ± 5.11 ms, 55.33 ± 6.65 ms, 48.18 ± 5.37 ms), and (63.47 ± 4.92 ms, 50.32 ± 8.86 ms, 44.77 ± 4.69 ms), respectively. There were significant differences in T2 values of cartilage endplates between the Pm grades I–II, III, and IV–V of intervertebral discs (P = 0.000). T2 values corresponding to Pm I–II grades were higher than those in Pm III grade, while T2 values in Pm grades IV–V were lowest. The T2 value of the L4–5, L5–S1 segment endplates was highly correlated with the Pm grades (r = −0.711, −0.721, −0.796, −0.745; P = 0.000) and that of L1–2, L2–3 endplates were moderately correlated (r = −0.542, −0.562, −0.637, −0.612; P = 0.000).

Conclusion

The T2 values of cartilage endplates revealed varying degrees of degeneration of intervertebral discs, and more severe degeneration corresponded to lower T2 values. Measurement of changes in the T2 value through cartilage endplates can be useful for the diagnosis of early intervertebral disc degeneration and the prevention of disc degeneration.
DRD4 polymorphisms modulate reward positivity and P3a in a gambling task: Exploring a genetic basis for cultural learning
Authors: Glazer James , King Anthony , Yoon Carolyn , Liberzon Israel , Kitayama Shinobu
Published: June 2020

Prior work shows that people respond more plastically to environmental influences, including cultural influences, if they carry the 7 or 2‐repeat (7/2R) allelic variant of the dopamine D4 receptor gene (DRD4). The 7/2R carriers are thus more likely to endorse the norms and values of their culture. So far, however, mechanisms underlying this moderation of cultural acquisition by DRD4 are unclear. To address this gap in knowledge, we tested the hypothesis that DRD4 modulates the processing of reward cues existing in the environment. About 72 young adults, preselected for their DRD4 status, performed a gambling task, while the electroencephalogram was recorded. Principal components of event‐related potentials aligned to the Reward‐Positivity (associated with bottom‐up processing of reward prediction errors) and frontal‐P3 (associated with top‐down attention) were both significantly more positive following gains than following losses. As predicted, the gain‐loss differences were significantly larger for 7/2R carriers than for noncarriers. Also, as predicted, the cultural backgrounds of the participants (East Asian vs. European American) did not moderate the effects of DRD4. Our findings suggest that the 7/2R variant of DRD4 enhances (a) the detection of reward prediction errors and (b) controlled attention that updates the context for the reward, thereby suggesting one possible mechanism underlying the DRD4 × Culture interactions.
The impact of high‐intensity interval training on inflammatory markers in metabolic disorders: A meta‐analysis
Authors: Khalafi Mousa , Symonds Michael E.
Published: June 2020

Introduction

High‐intensity interval training (HIIT) is considered a time‐efficient strategy to improve metabolic health. We performed a systematic meta‐analysis to assess the effects of HIIT on inflammatory markers and adipo‐cytokines compared with control conditions (CON) or moderate‐intensity continuous training (MICT) in individuals with metabolic disorders.

Methods

Up to January 2020, electronic databases were searched for HIIT interventions based on populations with metabolic disorders including diabetes, metabolic syndrome, polycystic ovary syndrome, non‐alcoholic fatty liver disease or overweight/obesity, with outcome measurements that included IL‐6, TNF‐α, CRP, leptin or adiponectin and training ≥2 weeks. Random‐effects models were used to aggregate a mean effect size (ES), 95% confidence intervals (Cis), and potential moderators were explored.

Results

Twenty‐nine studies involving 841 participants were included in the meta‐analysis. HIIT improved circulating adiponectin (P = .02), leptin (P = .02), and TNF‐α (P = .003) when compared to CON. There were no differences between groups in IL‐6 and CRP. Intervention duration was a significant moderator for the effect of HIIT on IL‐6, and leptin (P < .05).

Conclusion

High‐intensity interval training improves circulating TNF‐α, leptin and adiponectin, thereby indicating that it may be an effective and time‐efficient intervention for controlling low‐grade inflammation in individuals with metabolic disorders.
Detection of the HLA‐DRB4*01:44 allele in a Kuwaiti individual
Authors: Jahromi Mohamed , Rahma Zahra , Taha Nehad , Lin Py‐Yu , Yang Kuo‐Liang
Published: June 2020

One nucleotide substitution in codon 39 of HLA‐DRB4*01:01:01:01 results in a novel allele, HLA‐DRB4*01:44.
A case of successful treatment of severe COVID‐19 pneumonia with favipiravir and tocilizumab in post–kidney transplant recipient
Authors: Thammathiwat Theerachai , Tungsanga Somkanya , Tiankanon Kanitha , Torvorapanit Pattama , Chumpangern Worawat , Udomkarnjananun Suwasin , Avihingsanon Yingyos , Sriprasart Thitiwat , Srisawat Nattachai , Jutivorakool Kamonwan , Paitoonpong Leilani , Putcharoen Opass , Townamchai Natavudh
Published: June 2020

We report a case of COVID‐19 in kidney transplant patient in Thailand. A 58‐year‐old 2 years post–kidney transplant recipient, with maintenance immunosuppression of tacrolimus, mycophenolate mofetil (MMF), and prednisolone, presented with acute diarrhea which followed by fever on day 12. Symptoms of pneumonia together with lymphopenia from complete blood count were developed on day 7 after onset of fever with the x‐ray finding of bilateral multifocal patchy infiltration. COVID‐19 infection has been confirmed by reverse real‐time polymerase chain reaction (PCR) in nasal swab as well as found in stool. Darunavir together with ritonavir, hydroxychloroquine, azithromycin, and favipiravir was initiated on the first day of admission at primary hospital. Patient has been transferred to our hospital on day 2 of admission in which tacrolimus together with MMF was discontinued. High‐flow nasal cannula oxygen therapy was required on days 4‐5 of hospitalization. Tocilizumab was administered after rising of serum IL‐6 level. Symptoms of pneumonia were improved in which no oxygen treatment required from day 10 of hospitalization. Drug interaction between tacrolimus and anti‐viral treatment leads to severely high level of tacrolimus which caused reversible acute kidney injury (AKI) after supportive treatment.
How the COVID‐19 pandemic changed cellular therapy at Columbia University Irving Medical Center/NewYork‐Presbyterian Hospital
Authors: Tanhehco Yvette C. , Schwartz Joseph
Published: June 2020

New York is at the epicenter of the coronavirus disease 2019 (COVID‐19) pandemic caused by the SARS‐CoV‐2 virus. Columbia University Irving Medical Center/NewYork‐Presbyterian Hospital (CUIMC/NYPH) had to make changes to its cellular therapy operations to ensure patient, donor, and staff safety and well‐being. In this article, we discuss the process changes we instituted for cellular therapy clinical care, collection, processing, and cryopreservation to cope with the rapidly evolving pandemic.
Development and assessment of a formal learning module to educate veterinary students in an intensive care unit about transfusion reactions
Authors: Haines Jillian M. , Wardrop K. Jane , Lindberg Christopher J. , Carbonneau Kira J. , Ngwenyama Thandeka R. , Martin Linda G.
Published: June 2020

Objective

To develop and assess the instructional efficacy of an online learning module on transfusion reactions in small animals and to evaluate participants’ satisfaction of the module.

Design

Randomized controlled trial.

Setting

University teaching hospital.

Subjects

A total of 55, fourth‐year veterinary students, 27 in a treatment group that received the learning module plus standard rotation training and 28 in a control group (no module) who received only standard training

Interventions

Students received a pretest on transfusion reactions followed by administration of a transfusion reaction learning module covering recognition, treatment, prevention, case examples, and self‐assessment questions for 6 common transfusion reactions. Students also received a module satisfaction survey, a post‐test at 2 weeks post‐module, and a retention test at 6 weeks post‐module.

Measurements and main results

Previous transfusion medicine exposure did not affect pretest scores and there was no difference in pretest scores between groups. The module group scored higher on the post‐test (P < 0.001) and retention test (P = 0.002) than the control group. Mean post‐test scores were 74.4% and 57.7% and mean retention test scores were 80.6% and 56.5% for the module and control groups, respectively. The module group scored higher on posttest and retention questions involving reaction recognition (P < 0.001). Students were overall very satisfied with the module with an average score of 4.8 (1‐5).

Conclusions

A transfusion reaction instructional module can be delivered successfully to veterinary students on an ICU‐based clinical rotation. Students taking the module scored significantly better on post‐assessments up to 6 weeks after module administration as compared to students receiving only conventional clinical rotation training.
Mechanically Tunable Solid/Solid Phononic Crystals Through the Rearrangement of Hard Scatterers Controlled by the Deformation of Periodic Elastomeric Matrixes
Authors: Ning Shaowu , Luo Chengcheng , Yang Fengyuan , Liu Zhanli , Zhuang Zhuo
Published: June 2020

The fixed band gap characteristic of passive phononic crystals (PCs) is possible to limit their applications in engineering. To overcome this shortcoming, inspired by the tunable mechanism of the spider silks, a new class of tunable PCs comprising periodic scatterers and periodic elastomeric matrix are proposed to effectively tune the band gaps and directionality of propagating waves. The orientation and arrangement of hard scatterers are controlled by the deformation of the periodic elastomeric matrix to enhance the tunability of their dynamic responses. According to this idea, PCs with differently shaped and arranged cylindroid scatterers are designed. Through introducing the multiple scatterers into the periodic elastomeric matrix, the scattering coupling effect between them is enhanced. The simulation results indicate that the orientation and arrangement of the scatterers could be altered continuously during deformation. During deformation, the number, position, and width of band gaps can be effectively tuned due to the geometric nonlinearity of the matrix and the rearrangement of multiple scatterers. The transmissibility of finite-sized structures without damping decreases significantly in the frequency ranges of band gaps. However, introducing the damping into the matrix material significantly enhances the ability to suppress elastic wave propagation but makes it difficult to identify the band gaps from the transmittance spectrum. The directionality of wave propagation can be also effectively tuned. In the low-frequency range, such as the first two phase constant surfaces, the phase and group velocity profiles and the anisotropy indexes are calculated and the results indicate that the deformation makes the wave propagation more isotropic. The schemes presented in this paper provide an effective approach to tune the band gaps of the solid/solid PCs and open avenues for the design of tunable PCs.
A New Method for Ultra-Low Permeability Reservoir Characterization After Water Flooding Development
Authors: Zhenyu Pang , Qi Hao , Yueshun He , Yiguo Zhang , Yulong Kang , Pu Bai , Pitong Shi
Published: June 2020

In order to reveal the pattern of oil–water movement during water flooding development in ultra-low permeability reservoir, flow units division and multiple methods such as rate-controlled mercury injection, nuclear magnetic resonance, water flooding in real sandstone model, permeability test are used to perform quantitative characterization of ultra-low permeability reservoir from two aspects, geological property and coupling micro-mechanism. Radius size and number-percentage of mainstream throats and moveable fluid saturation for different clusters of flow units have been characterized. Displacement types for different clusters of flow units and remaining oil distribution types have been specified. This provides a geological evidence to develop and adjust the water injection development plan. In this paper, the number-percentage of mainstream throats has been first proposed, which is a critical parameter to evaluate the difficulty of the predominant channel development process during water injection development. The quantitative characterization of the dominant seepage channel is realized.
Metalens-array–based high-dimensional and multiphoton quantum source
Authors: Li Lin , Liu Zexuan , Ren Xifeng , Wang Shuming , Su Vin-Cent , Chen Mu-Ku , Chu Cheng Hung , Kuo Hsin Yu , Liu Biheng , Zang Wenbo , Guo Guangcan , Zhang Lijian , Wang Zhenlin , Zhu Shining , Tsai Din Ping
Published: June 2020

Metalens-array–based quantum source

Spontaneous down-conversion is an exotic optical process in a nonlinear crystal in which a high-energy photon splits into two lower-energy photons that are quantum mechanically entangled. These entangled pairs are valuable commodities for quantum information processing and quantum communications. Because the experimental setup is usually performed with bulk optical components, there is a need to decrease the size scale for application. Li
et al.
combined an array of specialized metalenses with a nonlinear crystal and show that the scale of the process can be shrunk substantially. The approach should prove useful for developing miniaturized integrated quantum optical technologies.

Science
, this issue p.
1487
Mass-resolved electronic circular dichroism ion spectroscopy
Authors: Daly Steven , Rosu Frédéric , Gabelica Valérie
Published: June 2020

DNA circular dichroism in gas phase

Circular dichroism spectroscopy is widely used to distinguish between nonidentical mirror-image molecules. The technique relies on differential absorption of left versus right circularly polarized light and therefore tends to require solution-phase samples for adequate sensitivity. Daly
et al.
now report gas-phase circular dichroism spectra of DNA oligonucleotides based on detection of photodetached electrons rather than transmitted light (see the Perspective by Barran). The salient spectral features matched those in solution. Pairing the technique with mass spectrometry enables prior mass selection of particular molecules for analysis.

Science
, this issue p.
1465
; see also p.
1426
Microplastic in terrestrial ecosystems
Authors: Rillig Matthias C. , Lehmann Anika
Published: June 2020

Research shifts from ecotoxicology to ecosystem effects and Earth system feedbacks
Rational synthesis of atomically precise graphene nanoribbons directly on metal oxide surfaces
Authors: Kolmer Marek , Steiner Ann-Kristin , Izydorczyk Irena , Ko Wonhee , Engelund Mads , Szymonski Marek , Li An-Ping , Amsharov Konstantin
Published: June 2020

Graphene nanoribbons made on oxides

Atomically precise nanographenes and nanoribbons have been synthesized on metal surfaces that catalyze cyclode-hydrogenation of precursors. However, for use in devices, these structures usually must be transferred to insulating or semiconducting surfaces. Kolmer
et al.
synthesized precise graphene nanoribbons on the surface of rutile titanium dioxide (TiO
2
) that assisted the cyclode-hydrofluorination of specifically designed precursor molecules through a series of thermally triggered transformations. Scanning tunneling microscopy and spectroscopy confirmed the formation of well-defined zigzag ends of the nanoribbons as well as their weak interaction with the substrate.

Science
, this issue p.
571
Guide cells help navigate axon regeneration
Authors: Roberts-Galbraith Rachel
Published: June 2020

Rebuilding the flatworm visual system after injury requires guidepost-like muscle cells
Pharmacist-Driven Implementation of Fast Identification and Antimicrobial Susceptibility Testing Improves Outcomes for Patients with Gram-Negative Bacteremia and Candidemia
Authors: Sheth Sahil , Miller Michael , Prouse Angela Beth , Baker Scott
Published: June 2020

Bloodstream infections (BSI) are associated with increased morbidity and mortality, especially when caused by Gram-negative or fungal pathogens. The objective of this study was to assess the impact of fast identification-antimicrobial susceptibility testing (ID/AST) with the Accelerate Pheno system (AXDX) from May 2018 to December 2018 on antibiotic therapy and patient outcomes. A pre-post quasiexperimental study of 200 patients (100 pre-AXDX implementation and 100 post-AXDX implementation) was conducted.
A Roadblock-and-Kill Mechanism of Action Model for the DNA-Targeting Antibiotic Ciprofloxacin
Authors: Ojkic Nikola , Lilja Elin , Direito Susana , Dawson Angela , Allen Rosalind J. , Waclaw Bartlomiej
Published: June 2020

Fluoroquinolones, antibiotics that cause DNA damage by inhibiting DNA topoisomerases, are clinically important, but their mechanism of action is not yet fully understood. In particular, the dynamical response of bacterial cells to fluoroquinolone exposure has hardly been investigated, although the SOS response, triggered by DNA damage, is often thought to play a key role. Here, we investigated the growth inhibition of the bacterium
Escherichia coli
by the fluoroquinolone ciprofloxacin at low concentrations.
The Large pBS32/pLS32 Plasmid of Ancestral Bacillus subtilis
Authors: Burton Aisha T. , Kearns Daniel B.
Published: June 2020

The ancestral strain of
Bacillus subtilis
NCIB3610 (3610) bears a large, low-copy-number plasmid, called pBS32, that was lost during the domestication of laboratory strain derivatives. Selection against pBS32 may have been because it encodes a potent inhibitor of natural genetic competence (ComI), as laboratory strains were selected for high-frequency transformation. Previous studies have shown that pBS32 and its sibling, pLS32 in
Bacillus subtilis
subsp.
natto
, encode a replication initiation protein (RepN), a plasmid partitioning system (AlfAB), a biofilm inhibitor (RapP), and an alternative sigma factor (SigN) that can induce plasmid-mediated cell death in response to DNA damage.
No evidence for carbon enrichment in the mantle source of carbonatites in eastern Africa
Authors: Casola Valentin , France Lydéric , Galy Albert , Bouden Nordine , Villeneuve Johan
Published: June 2020

Carbonatites are unusual, carbon-rich magmas thought to form either by the melting of a carbon-rich mantle source or by low-degree partial melting of a carbon-poor (<80 ppm C) mantle followed by protracted differentiation and/or immiscibility. Carbonate-bearing mantle xenoliths from Oldoinyo Lengai (East African Rift), the only active volcano erupting carbonatites, have provided key support for a C-rich mantle source. Here, we report unique microscale O and C isotopic analyses of those carbonates, which are present as interstitial grains in the silicate host lava, veins in the xenoliths, and pseudo-inclusions in olivine xenoliths. The δ18O values vary little, from 19‰ to 29‰, whereas δ13C values are more variable, ranging from –23‰ to +0.5‰. We show that such carbonate δ18O values result from the low-temperature precipitation of carbonate in equilibrium with meteoric water, rather than under mantle conditions. In this framework, the observed δ13C values can be reproduced by Rayleigh distillation driven by carbonate precipitation and associated degassing. Together with petrological evidence of a physical connection between the three types of carbonates, our isotopic data support the pedogenic formation of carbonates in the studied xenoliths by soil-water percolation and protracted crystallization along xenolith cracks. Our results refute a mechanism of C enrichment in the form of mantle carbonates in the mantle beneath the Natron Lake magmatic province and instead support carbonatite formation by low-degree partial melting of a C-poor mantle and subsequent protracted differentiation of alkaline magmas.
Stop, think SCORTCH: rethinking the traditional ‘TORCH’ screen in an era of re-emerging syphilis
Authors: Penner Justin , Hernstadt Hayley , Burns James Edward , Randell Paul , Lyall Hermione
Published: June 2020

Background

The epidemiology of congenital infections is ever changing, with a recent resurgence in syphilis infection rates seen in the UK. Identification of congenital infection is often delayed; early recognition and management of congenital infections is important. Testing modalities and investigations are often limited, leading to missed diagnostic opportunities.

Methods

The SCORTCH (syphilis, cytomegalovirus (CMV), ‘other’, rubella, toxoplasmosis, chickenpox, herpes simplex virus (HSV) and blood-borne viruses) acronym increases the awareness of clinicians to the increased risk of congenital syphilis, while considering other infectious aetiologies including: zika, malaria, chagas disease, parvovirus, enterovirus, HIV, hepatitis B and C, and human T-lymphotropic virus 1, in addition to the classic congenital infections recognised in the ‘TORCH screen’ (toxoplasmosis, ‘other’, rubella, CMV, HSV). The SCORTCH diagnostic approach describes common signs present in infants with congenital infection, details serological testing for mother and infant and important direct diagnostics of the infant. Direct diagnostic investigations include: radiology, ophthalmology, audiology, microbiological and PCR testing for both the infant and placental tissue, the latter also warrants histopathology.

Conclusion

The traditional ‘TORCH screen’ focuses on serology-specific investigations, often omits important direct diagnostic testing of the infant, and fails to consider emerging and re-emerging congenital infections. In recognition of syphilis as a re-emerging pathogen and the overlapping clinical presentations of various infectious aetiologies, we advocate for a broader outlook using the SCORTCH diagnostic approach.
Management of ventriculo-gallbladder shunt in the presence of gallstones
Authors: Alraee Sondus , Alshowmer Sahar , Alnamshan Mohammad , Azzubi Moutasem
Published: June 2020

Hydrocephalus is a prevalent health problem that is frequently encountered by paediatric neurosurgeons during infancy and childhood. We report a case of an 11-year-old boy with high cerebrospinal fluid protein hydrocephalus secondary to optic glioma that required a ventriculoperitoneal (VP) shunt. The patient had multiple failures of VP shunt and developed massive ascites. Alternatively, the hydrocephalus was treated by ventriculo-gallbladder (VG) shunt in the presence of sludge which was removed from the gallbladder before placement of the shunt. After VG shunt insertion, the patient expressed signs of infection with elevated liver profile, which emphasised the presence of gallstones. While the shunt was kept in its place without any complications, the gallstones were successfully removed by an endoscopic retrograde cholangiopancreatography. In conclusion, the presence of sludge is not a contraindication for VG shunt placement, and, if the VG shunt was complicated with gallstones, it could be treated without the need for cholecystectomy.
APEX: a phase II randomised clinical trial evaluating the safety and preliminary efficacy of oral X-82 to treat exudative age-related macular degeneration
Authors: Cohen Michael N. , O’Shaughnessy Denis , Fisher Kate , Cerami Jennifer , Awh Carl C , Salazar Daniel E , Rosenfeld Philip , Heier Jeffrey S
Published: June 2020

Purpose

The safety and efficacy of X-82, an orally administered inhibitor of vascular endothelial growth factor (VEGF) and platelet-derived growth factor, was investigated for treatment of wet age-related macular degeneration (AMD) in a phase II clinical trial.

Methods

This phase II, randomised, double-masked, placebo-controlled trial enrolled subjects with a prior diagnosis of exudative AMD having received at least two intravitreal injections of anti-VEGF therapy. Subjects were randomised equally into four groups that received either daily 50mg, 100mg or 200mg dosages of X-82 or a placebo tablet. At each 4-week interval visit for 52 weeks, subjects were to be assessed to determine if rescue treatment was needed with anti-VEGF therapy.

Results

157 patients were enrolled. Due to gastrointestinal and hepatobiliary adverse events and the fulfilment of the primary endpoint, the trial was stopped prematurely after a second interim analysis. The primary endpoint of non-inferiority of visual acuity compared with placebo was demonstrated in all groups receiving X-82 (p<0.001). There was a dose-dependent trend in the number of injections over a 52-week period, with the 50 mg (n=40), 100 mg (n=39), 200 mg (n=39) and placebo (n=39) group requiring 6.7, 6.0, 4.7 and 8.1 injections, respectively.

Conclusions

X-82 oral therapy in combination withpro re nataanti-VEGF injections showed non-inferiority in visual acuity outcomes while achieving a dose-dependent decrease in the number of anti-VEGF injections compared with placebo. Given the limited tolerability and safety issues observed, X-82 does not have a sufficient benefit to risk profile in treatment of patients with AMD.
Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic
Authors: Agrawal Rupesh , Testi Ilaria , Lee Cecilia S , Tsui Edmund , Blazes Marian , Thorne Jennifer E , Okada Annabelle A , Smith Justine R , McCluskey Peter J , Kempen John H , Tappeiner Christoph , Agarwal Manisha , Bodaghi Bahram , Nguyen Quan Dong , Gupta Vishali , De Smet Marc D , Zierhut Manfred , Pavesio Carlos
Published: June 2020

Background

Immunomodulatory therapy (IMT) is often considered for systemic treatment of non-infectious uveitis (NIU). During the evolving coronavirus disease-2019 (COVID-19) pandemic, given the concerns related to IMT and the increased risk of infections, an urgent need for guidance on the management of IMT in patients with uveitis has emerged.

Methods

A cross-sectional survey of international uveitis experts was conducted. An expert steering committee identified clinical questions on the use of IMT in patients with NIU during the COVID-19 pandemic. Using an interactive online questionnaire, guided by background experience and knowledge, 139 global uveitis experts generated consensus statements for IMT. In total, 216 statements were developed around when to initiate, continue, decrease and stop systemic and local corticosteroids, conventional immunosuppressive agents and biologics in patients with NIU. Thirty-one additional questions were added, related to general recommendations, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hydroxychloroquine.

Results

Highest consensus was achieved for not initiating IMT in patients who have suspected or confirmed COVID-19, and for using local over systemic corticosteroid therapy in patients who are at high-risk and very high-risk for severe or fatal COVID-19. While there was a consensus in starting or initiating NSAIDs for the treatment of scleritis in healthy patients, there was no consensus in starting hydroxychloroquine in any risk groups.

Conclusion

Consensus guidelines were proposed based on global expert opinion and practical experience to bridge the gap between clinical needs and the absence of medical evidence, to guide the treatment of patients with NIU during the COVID-19 pandemic.