bluuebunny/crossref_metadata_2025 huggingface dataset:
Buprenorphine exposures in adolescents and adults: a 10‐year experience of a French Poison Control Center
Authors: Boulamery Audrey , von Fabeck Katharina , Glaizal Mathieu , de Haro Luc , Simon Nicolas
Published: November 2020

Buprenorphine has been used in pain and opioid addiction management for nearly 25 years. Compared to methadone, buprenorphine is thought to exhibit less side effects and respiratory depression in case of accidental or suicidal overdose. The aim was to describe the characteristics of exposures reported to a French Poison Control Center (PCC). We conducted a retrospective study including all buprenorphine exposures for which advice of our PCC was required between 2009 and 2018. After data extraction from the electronic medical files and anonymous transfer to an Access base, a statistical descriptive analysis was performed focusing on adolescents over 10 years old and adults. One hundred and ninety‐nine cases were analyzed. The major circumstances of exposure were suicide attempts and overdoses in patients with previously identified substance abuse. Buprenorphine exposures have been reduced by 50% between 2009 and 2018. Coingestions, often with benzodiazepines or antidepressants, were almost systematic and 79% of all the series exhibited at least one symptom. Among the symptomatic cases, neurological effects were the most frequent (83%) and respiratory symptoms occurred in 13%. No deaths were registered. Severity did not exceed PSS1 in 80% of all the cases. Treatment was mainly symptomatic even though naloxone was required in at least 5% of the symptomatic cases. Within 24 h after exposure, 120 patients were discharged from the emergency department. Despite loss to follow‐up, our results suggest that buprenorphine is relatively safe.
Social participation and barriers to community activities among middle‐aged and older Canadians: Differences and similarities according to gender and age
Authors: Naud Daniel , Généreux Mélissa , Alauzet Aline , Bruneau Jean‐François , Cohen Alan , Levasseur Mélanie
Published: November 2020

Aim

This study described and compared participation with community activities and perceived barriers among middle‐aged and older Canadians by gender and age group (45–64, 65–74, 75–84, ≥85 years).

Method

Using the cross‐sectional 2008–2009 Canadian Community Health Survey – Healthy Aging, we considered the frequency of involvement in eight community activities and the presence of 10 perceived personal and environmental barriers.

Results

Although frequency was globally similar for women and men (15.2 vs. 14.5 activities per month; P < 0.01), adults aged 65–74 years had higher participation (16.0 activities per month) than adults aged 45–64, 75–84 and ≥85 years (P < 0.01). Barriers showed wider gender and age gaps than participation to community activities. Notably, health condition limitations were the most reported barrier aged ≥65 years, and environmental barriers were generally greater for women than men, particularly transportation problems (P < 0.01), except ≥85 years.

Conclusion

The results highlight that further study of social participation and barriers among older adults must consider gender and age differences. The differences are important to consider for designing population interventions aiming at improving social participation among aging Canadians. Geriatr Gerontol Int 2021; 21: 77–84.
Green tea extract rich in epigallocatechin gallate impairs alveolar bone loss in ovariectomized rats with experimental periodontal disease
Authors: Vargas‐Sanchez Paula Katherine , Pitol Dimitrius Leonardo , de Sousa Luiz Gustavo , Beloti Márcio Mateus , Rosa Adalberto Luiz , Rossi Ana Cláudia , Siéssere Selma , Bombonato‐Prado Karina Fittipaldi
Published: November 2020

Periodontal disease and osteoporosis are characterized by bone resorption, and researchers have shown an association between these two diseases through increasing loss of systemic bone mass and triggering alveolar bone loss. Green tea is a common and easily accessible beverage, and evidences show that flavonoid epigallocatechin gallate (EGCG) could decrease bone loss in pathologies such as osteoporosis and periodontal disease. In order to verify its possible effects and apply them in the treatment and prevention of these diseases, this investigation aimed to evaluate the influence of green tea extract (GTE) on bone metabolism of ovariectomized rats after experimental periodontal disease (EPD) by histological, morphological and microtomographic parameters. Wistar female rats were divided into Sham, Sham + EPD, Sham + EPD + GTE, OVX, OVX + EPD and OVX + EPD + GTE groups. Immediately after surgery, gavage administration of 50 mg/kg of green tea extract (GTE) was performed for 60 days, with subsequent induction of periodontal disease by ligature 15 days before euthanasia. Mandible and femur samples were collected for histological, morphometric and microtomographic analysis. The results were analysed by means of statistical software with significance set at 5%. Histological and morphometric analysis showed a significant decrease in alveolar and femoral trabecular bone loss in groups that received GTE. Microtomographic results showed that trabecular thickness and bone surface density values in alveolar bone interradicular septum of the OVX + EPD + GTE groups were similar to the Sham group. The results obtained suggest that green tea extract may improve bone metabolism in osteoporotic rats with periodontal disease.
The role of MKK4 in T‐cell development and immunity to viral infections
Authors: Preston Simon P , Doerflinger Marcel , Scott Hamish W , Allison Cody C , Horton Miles , Cooney James , Pellegrini Marc
Published: November 2020

The stress‐activated protein kinases (SAPKs)/c‐Jun‐N‐terminal‐kinases (JNK) are members of the mitogen‐activated protein kinase family. These kinases are responsible for transducing cellular signals through a phosphorylation‐dependent signaling cascade. JNK activation in immune cells can lead to a range of critical cellular responses that include proliferation, differentiation and apoptosis. MKK4 is a SAPK that can activate both JNK1 and JNK2; however, its role in T‐cell development and function has been controversial. Additionally, loss of either JNK1 or JNK2 has opposing effects in the generation of T‐cell immunity to viral infection and cancer. We used mice with a conditional loss of MKK4 in T cells to investigate the in vivo role of MKK4 in T‐cell development and function during lymphocytic choriomeningitis virus (LCMV) infection. We found no physiologically relevant differences in T‐cell responses or immunity to either acute or chronic LCMV in the absence of MKK4.
Traditional Chinese Medicine as a complementary therapy in combat with COVID‐19—A review of evidence‐based research and clinical practice
Authors: Wu Xi Vivien , Dong Yanhong , Chi Yuchen , Yu Mingming , Wang Wenru
Published: November 2020

Aim

To examine the literature on Traditional Chinese Medicine (TCM) used in the treatment, prevention and supportive care in patients with COVID‐19.

Design

A narrative review was performed.

Data Sources

A systematic and comprehensive search was conducted on both Chinese and English electronic databases: China National Knowledge Infrastructure, Wanfang Data, CINAHL, Embase, Cochrane, PubMed, PsycINFO. Articles published from 1 December 2019 ‐1 April 2020 were included in this review.

Review Methods

Studies reporting on the treatment and prevention of COVID‐19 using TCM regardless of study designs were included. In addition, grey literatures, including media reports on Chinese government websites or official media websites and treatment guidelines were searched for TCM treatment and prevention on COVID‐19.

Results

Limited research has been published on the use of TCM for COVID‐19. We qualitatively described and synthesized the published research and current clinical practice on the use of TCM for COVID‐19, and focused on the following areas: TCM treatment used in SARS, MERS, H1N1; TCM treatment plan for COVID‐19; TCM in Prevention and Treatment at Early Stage of COVID‐19; TCM emotional therapy; and personalized TCM treatment plan.

Conclusion

The combination of western medicine and TCM in treatment, and treatment based on the local condition, isolation, personal protective measures are of great significance for the prevention and treatment of COVID‐19. Relevant laboratory research and clinical evaluation should be continued to collect scientific evidences on the efficacy of TCM.

Impact

TCM has been used in the treatment and prevention of COVID‐19 in China, and the clinical evidences indicated that TCM regulates immunity and exerts anti‐viral effect simultaneously. This review provides practical recommendation for the policymakers in the selection process of the treatment and preventive measures for the global pandemic of COVID‐19.
Cranial irradiation alters neuroinflammation and neural proliferation in the pituitary gland and induces late‐onset hormone deficiency
Authors: Xu Yiran , Sun Yanyan , Zhou Kai , Xie Cuicui , Li Tao , Wang Yafeng , Zhang Yaodong , Rodriguez Juan , Zhang Xiaoan , Shao Ruijin , Wang Xiaoyang , Zhu Changlian
Published: November 2020

Cranial radiotherapy induces endocrine disorders and reproductive abnormalities, particularly in long‐term female cancer survivors, and this might in part be caused by injury to the pituitary gland, but the underlying mechanisms are unknown. The aim of this study was to investigate the influence of cranial irradiation on the pituitary gland and related endocrine function. Female Wistar rat pups on postnatal day 11 were subjected to a single dose of 6 Gy whole‐head irradiation, and hormone levels and organ structure in the reproductive system were examined at 20 weeks after irradiation. We found that brain irradiation reduced cell proliferation and induced persistent inflammation in the pituitary gland. The whole transcriptome analysis of the pituitary gland revealed that apoptosis and inflammation‐related pathways were up‐regulated after irradiation. In addition, irradiation led to significantly decreased levels of the pituitary hormones, growth hormone, adrenocorticotropic hormone, thyroid‐stimulating hormone and the reproductive hormones testosterone and progesterone. To conclude, brain radiation induces reduction of pituitary and reproduction‐related hormone secretion, this may due to reduced cell proliferation and increased pituitary inflammation after irradiation. Our results thus provide additional insight into the molecular mechanisms underlying complications after head irradiation and contribute to the discovery of preventive and therapeutic strategies related to brain injury following irradiation.
Long‐term management of avulsed “hopeless” teeth in the adult dentition
Authors: Mathews David P. , Spear Frank M.
Published: November 2020

Objective

This case will demonstrate a thoughtful approach to the management of avulsed/replanted teeth in the adult dentition and their long‐term maintenance. Often times these teeth are either not replanted, or extracted soon after replantation when resorptive lesions appear and the teeth are deemed “hopeless”. The term “hopeless tooth” (HT) has become more popular since the advent of implants. Implants allowed for a simple solution to the HT by extraction and immediate replacement with a fixture and a restoration. However, now that we are realizing that implants do not last forever and also have attendant problems, saving the HT takes on a new light.

Clinical considerations

Prolonging the life of the HT can preserve bone and give the patient a functional, esthetic tooth for many years. With each additional year, clinicians garner new skills, and technology improves our future treatment outcomes. This will allow clinicians to improve and extend the life of future replacements.

Conclusions

If there is minimal risk to adjacent structures, retaining the HT has many advantages for the patient and clinician. Clinicians should adopt a policy of thinking ahead and asking “What's Next”? when their prospective treatment fails or needs to be replaced. By prolonging the life of the HT, the “best ultimate treatment” has a greater chance to outlive the patient.

Clinical significance

With the advent of single tooth implants, the term “hopeless tooth” has become more popular. It is easier to justify extraction of a tooth when it is deemed “hopeless”. Many of these teeth could be saved. The advantages of this philosophy will be elucidated.
Clinical importance of muscle volume in lenvatinib treatment for hepatocellular carcinoma: Analysis adjusted with inverse probability weighting
Authors: Hiraoka Atsushi , Kumada Takashi , Kariyama Kazuya , Tada Toshifumi , Tani Joji , Fukunishi Shinya , Atsukawa Masanori , Hirooka Masashi , Tsuji Kunihiko , Ishikawa Toru , Takaguchi Koichi , Itobayashi Ei , Tajiri Kazuto , Shimada Noritomo , Shibata Hiroshi , Ochi Hironori , Kawata Kazuhito , Yasuda Satoshi , Toyoda Hidenori , Ohama Hideko , Nouso Kazuhiro , Tsutsui Akemi , Nagano Takuya , Itokawa Norio , Hayama Korenobu , Arai Taeang , Imai Michitaka , Koizumi Yohei , Nakamura Shinichiro , Joko Kouji , Michitaka Kojiro , Hiasa Yoichi , Kudo Masatoshi ,   Real‐life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Published: November 2020

Background and Aim

This study aimed to elucidate the clinical importance of muscle volume loss (pre‐sarcopenia) in patients receiving lenvatinib as treatment for unresectable hepatocellular carcinoma (u‐HCC).

Methods

Of 437 u‐HCC patients treated with lenvatinib at specific institutions in Japan between March 2018 and May 2020, 151 with available computed tomography imaging data from the time of lenvatinib introduction were enrolled. Pre‐sarcopenia was diagnosed based on a previously reported cut‐off value calculation formula [psoas muscle area at level of middle of third lumbar vertebra (cm2)/height (m)2]. Clinical features and prognostic factors for overall survival (OS) with inverse probability weighting were investigated retrospectively for their relationship with pre‐sarcopenia.

Results

Cox hazard multivariate analysis showed alpha‐fetoprotein (≥400 ng/mL) (hazard ratio [HR] 2.271, P < 0.001), Barcelona Clinic Liver Cancer stage (C and D) (HR 1.625, P = 0.018), and positive for pre‐sarcopenia (HR 1.652, P = 0.042) to be significant prognostic factors. OS rates for the pre‐sarcopenia group (n = 41) were worse than those for the non‐pre‐sarcopenia group (n = 110) (0.5‐, 1‐, and 1.5‐year OS: 72.5%, 27.9%, and 7.0% vs 80.7%, 56.7%, and 46.1%, respectively; P < 0.001), as was progression‐free survival (P = 0.025). Time to stopping lenvatinib or disease progression was better in the non‐pre‐sarcopenia group (0.5‐, 1‐, and 1.5‐year OS: 48.0%, 24.5%, and 8.4% vs 20.0%, 10.3%, and 4.2%, respectively; P < 0.001). Also, the frequency of the adverse event appetite loss (any grade) was greater in the pre‐sarcopenia group (43.9% vs 18.2%, P = 0.003).

Conclusion

Pre‐sarcopenia was shown to be a significant prognostic factor in patients treated with lenvatinib for u‐HCC.
Causes of nursing staff burnout: Exploring the effects of emotional exhaustion, work–family conflict, and supervisor support
Authors: Yeh Te‐Feng , Chang Yu‐Chia , Hsu Ya‐Hui , Huang Li‐Ling , Yang Cheng‐Chia
Published: November 2020

Aim

Nursing staff burnout threatens not only nurses' health but also the safety and health of their patients. Organizations should be aware of how work‐related conflict can affect this burnout. This study examined the effect of supervisor support and work–family conflict on resource loss and burnout.

Methods

A cross‐sectional method and quantitative approach were adopted. A total of 300 questionnaires were distributed to clinical nursing staff in two regional teaching hospitals, and 239 valid questionnaires were returned.

Results

Work–family conflict had a mediating effect on the relationship between supervisor support and emotional exhaustion. Emotional exhaustion fully mediated the relationships between depersonalization, work–family conflict, and reduced professional efficacy.

Conclusion

The mediating effect of emotional exhaustion in work–family conflict results from depersonalization and reduced professional efficacy, whereas work–family conflict mediated the effect of supervisor support on emotional exhaustion. The findings indicate that the medical industry should implement supervisor support strategies to reduce nursing staff work–family conflict and improve interventions for emotional exhaustion.
Laser‐assisted delivery of tranexamic acid for melasma: Pilot study using a novel 1927 nm fractional thulium fiber laser
Authors: Wang Jordan V. , Christman Mitalee P. , Feng Hao , Ferzli Georgina , Jeon Hana , Geronemus Roy G.
Published: November 2020

Background

Melasma can be associated with immense psychosocial stress, which can impact quality of life. One theory suggests that ultraviolet light can increase plasmin activity in keratinocytes, which has led to the investigation of tranexamic acid for treating melasma, since it possesses anti‐plasmin properties. The use of laser‐assisted drug delivery can also increase the uptake of topical medications.

Aims

A prospective pilot study was performed to assess the utility of combination treatment with low‐energy, low‐density 1927 nm fractional thulium fiber laser and topical tranexamic acid for melasma.

Patients/Methods

A total of 10 subjects were enrolled. Each received 5 treatments to the full face with a low‐energy, low‐density 1927 nm fractional thulium fiber laser. Immediately following treatment, topical tranexamic acid was applied, and subjects were instructed to apply it twice daily for 7 days. Clinical measures, quality of life, and patient satisfaction were assessed.

Results

Mean improvements in Melasma Area and Severity Index (MASI) scores were 1.1 (P = .0899), 3.5 (P = .0395), and 2.5 (P = .2429) at 30‐, 90‐, and 180‐day follow‐up, respectively. Maximum improvement occurred at 90‐day follow‐up. The mean improvement of Melasma Quality of Life Scale (MELASQOL) score was 9.6 (P = .0024) at 30‐day follow‐up. In addition to changes in pigmentation, subjects also believed their skin felt better, looked more radiant, and had improvements in skin texture and tone.

Conclusion

Combination of low‐energy, low‐density 1927 nm fractional thulium fiber laser and topical tranexamic acid improved clinical outcomes and quality of life associated with melasma. This combination treatment was safe, well‐tolerated, and well‐liked by subjects.
Hair loss treatment information on Facebook: Content analysis and comparison with other online sources
Authors: Gupta Aditya K. , Ivanova Iordanka A.
Published: November 2020

Background

Facebook is the biggest online social networking platform, and it is being utilized by patients for peer support as well as to explore treatment options. Hair loss patients can experience negative psychological effects and are likely to turn to social networking platforms for support and treatment information.

Aims

To evaluate the type and quality of Facebook hair loss treatment information that can be accessed by hair loss patients.

Methods

In August 2020, we searched Google for publicly accessible Facebook hair loss treatment content using the terms hair loss, alopecia, hair loss treatment, hair restoration, and hair transplant. We retrieved 133 Facebook pages and ranked them based on the number of visitors who received regular content updates. Content posted on the Top 5 most popular pages was analyzed based on type (advertising vs informational) and information quality (unsupported or supported by medical evidence).

Results

Most Facebook hair loss pages advertised products or hair restoration clinics, or were aimed at fundraising for alopecia organizations. There was high interest in natural hair loss treatments and follicular unit excision (FUE) procedures, consistent with global online search trends. Some products advertised as “natural” contained minoxidil. “Before & after” images of FUE procedures were popular with users. Only 3%‐13% of hair loss treatment posts were supported by medical evidence and user engagement with this content was low.

Conclusion

There is high user interest in hair loss treatment content on Facebook. Hair restoration specialists should discuss online sources of treatment information with potential patients.
Investigation of partially myristoylated carboxymethyl chitosan, an amphoteric‐amphiphilic chitosan derivative, as a new material for cosmetic and dermal application
Authors: Seino Haruyoshi , Kawaguchi Naoko , Arai Yukari , Ozawa Noriyasu , Hamada Kazuhiko , Nagao Norio
Published: November 2020

Background

Cationic amphiphilic chitosan derivatives can form polymeric micelles, which are useful cosmetic materials, but they form polyion complexes with anionic polymers, which can cause formulation difficulties.

Aims

This study aimed to evaluate the usefulness of partially myristoylated carboxymethyl chitosan, an amphoteric‐amphiphilic chitosan derivative, as a new material for cosmetics in the absence of a surfactant comprising an anionic polymer.

Methods

An anionic polymer and 1,2‐decanediol (an antimicrobial agent)‐containing partially myristoylated carboxymethyl chitosan nanoemulsified lotion and glabridin (an antimelanogenic agent)‐containing partially myristoylated carboxymethyl chitosan polymeric micelle were prepared using a pressure homogenization method. The release of interleukin‐1α, cell viability, and melanogenesis inhibition was evaluated on a human skin model. Antimicrobial activity was evaluated using agar dilution method.

Results

A mixture of partially myristoylated carboxymethyl chitosan and carboxyvinyl polymer did not form a polyion complex, but it formed a hydrophilic gel. The anionic polymer‐containing partially myristoylated carboxymethyl chitosan nanoemulsified formulation was stable, with no decrease in cell viability and horny layer exfoliation, which are typically observed with Tween 60. Compared with the formulation with methyl paraben (0.2%), the formulation to which 1,2‐decanediol (0.05%) was added improved the antibacterial activity against methicillin‐resistant Staphylococcus aureus and Propionibacterium acnes; however, no interleukin‐1α upregulation was observed. The glabridin‐containing partially myristoylated carboxymethyl chitosan polymeric micelles enhanced melanogenesis inhibition and percutaneous glabridin delivery to the epidermis compared with conventional emulsified micelles.

Conclusions

These results suggest that partially myristoylated carboxymethyl chitosan‐forming polymeric micelles, in combination with 1,2‐decanediol and glabridin, may be useful for surfactant‐free cosmetic emulsions.
Notes on Monetary Institutions in State and Class Formation Processes
Authors: Feinig Jakob
Published: November 2020

Charles Tilly emphasizes that state formation is a contingent and violent process: states develop as they extract resources, including currency, from a population. Neochartalist approaches to money challenge what I call the extractivist view of state formation because they see currencies as public institutions established by governments, not a resource to be seized from a population. At the same time, neochartalists rarely address how state institutions capable of establishing monetary institutions emerge. In this article, I propose a framework to analyze the entangled development of the institutions of money and state. I then showcase its usefulness by revisiting a series of crowd actions and militarized responses in eighteenth‐century Massachusetts and Pennsylvania today known as Shays’ Rebellion and the Whiskey Rebellion, focusing on the initially ad hoc and then routinized funding mechanism that enabled emerging state actors to deploy armed groups. In closing, I argue that despite the violence involved in the emergence of the institutions of state and money, citizens and inhabitants can begin to imagine democratic ways of institutionalizing money today.
Tied to the Desk: The Somatic Experience of office Work, 1870–1920
Authors: Carlino PJ
Published: November 2020

Between 1870 and 1920, American manufacturers designed furniture that re–shaped the sensorial experience of office work. To help businesses inculcate efficient practice, furniture re–shaped the posture of employees, programmed their actions, and determined sight lines, soundscapes, and circulation patterns. In the catalogs, textbooks, and trade journals they published, manufacturers gendered and racialized furniture and occupations. By 1920, White–owned businesses adopted methods built upon standard mass–produced furniture that affixed White male clerks to their desks and transferred the responsibility for moving information through the office to middle–class White women. Understanding the historical use of furniture to shape demographics in the twentieth century office opens possibilities and opportunities for new paradigms in workspaces.
A Hand‐Held Ultrasound Device for the Assessment of Peripheral Nerves in Leprosy
Authors: Wheat Stephen W. , Stryjewska Barbara , Cartwright Michael S.
Published: November 2020

BACKGROUND AND PURPOSE

Mycobacterium leprae complex affects peripheral nerves, causing nerve enlargement. This proof‐of‐concept pilot study was conducted to determine if a small hand‐held ultrasound device can accurately identify nerve involvement in individuals with leprosy.

METHODS

Peripheral nerve ultrasound was conducted of the bilateral median (wrist, forearm, elbow, and mid‐humerus), ulnar (wrist, forearm, elbow, 4 cm proximal to the elbow, and mid‐humerus), C5 root, and greater auricular nerves with a standard ultrasound device (15 Mhz) and a hand‐held ultrasound device (5 MHz). Nerve cross‐sectional areas were compared using the two devices.

RESULTS

Eight individuals with leprosy were examined. Strong correlation was found between the standard and hand‐held ultrasound devices (r = .76, P < .001). A certain amount of variability between ultrasound devices may occur for multiple reasons.

CONCLUSION

A hand‐held ultrasound device can readily identify nerve enlargement in individuals with leprosy. This type of device may assist in the diagnosis of leprosy in areas with limited healthcare resources because of the portability and low‐cost nature of such devices.
Two New and Nontoxigenic Pseudo‐nitzschia species (Bacillariophyceae) from Chinese Southeast Coastal Waters
Authors: Chen Xiu Mei , Pang Jin Xiu , Huang Chun Xiu , Lundholm Nina , Teng Sing Tung , Li Aifeng , Li Yang
Published: November 2020

To explore the species diversity and toxin profile of Pseudo‐nitzschia, monoclonal strains were established from Chinese southeast coastal waters. The morphology was examined under light and transmission electron microscopy. The internal transcribed spacer region of ribosomal DNA was sequenced for phylogenetic analyses, and the secondary structure of ITS2 was predicted and compared among allied taxa. A combination of morphological and molecular data showed the presence of two new species, Pseudo‐nitzschia hainanensis sp. nov. and Pseudo‐nitzschia taiwanensis sp. nov. Pseudo‐nitzschia hainanensis was characterized by a dumpy‐lanceolate valve with slightly blunt apices and a central nodule, as well as striae comprising two rows of poroids. Pseudo‐nitzschia taiwanensis was characterized by a slender‐lanceolate valve, and striae comprising one row of split poroids. The poroid structure mainly comprised two sectors. Both taxa constituted their own monophyletic lineage in the phylogenetic analyses inferred from ITS2 rDNA and were well differentiated from other Pseudo‐nitzschia species. Morphologically, P. hainanensis and P. taiwanensis could be assigned to the Pseudo‐nitzschia delicatissima and the Pseudo‐nitzschia pseudodelicatissima complex, respectively. Particulate domoic acid was measured using liquid chromatography coupled with tandem mass spectrometry (LC‐MS/MS), but no detectable pDA was found. With the description of the two new species, the species diversity of genus Pseudo‐nitzschia reaches 58 worldwide, among which 31 have been recorded from Chinese coastal waters.
SGT1 is not required for plant LRR‐RLK‐mediated immunity
Authors: Yu Gang , Xian Liu , Zhuang Haiyan , Macho Alberto P.
Published: November 2020

Plant immune signalling activated by the perception of pathogen‐associated molecular patterns (PAMPs) or effector proteins is mediated by pattern‐recognition receptors (PRRs) and nucleotide‐binding and leucine‐rich repeat domain‐containing receptors (NLRs), which often share cellular components and downstream responses. Many PRRs are leucine‐rich repeat receptor‐like kinases (LRR‐RLKs), which mostly perceive proteinaceous PAMPs. The suppressor of the G2 allele of skp1 (SGT1) is a core immune regulator required for the activation of NLR‐mediated immunity. In this work, we examined the requirement of SGT1 for immune responses mediated by several LRR‐RLKs in both Nicotiana benthamiana and Arabidopsis. Using complementary genetic approaches, we found that SGT1 is not limiting for early PRR‐dependent responses or antibacterial immunity. We therefore conclude that SGT1 does not play a significant role in bacterial PAMP‐triggered immunity.
Workplace well‐being in pediatric anesthesia: How to design and implement a bespoke evidence‐based framework in your department
Authors: Shrivastava Prani P. , McDonald Jane M.
Published: November 2020

Background

All anesthetists are at risk of mental ill health and pediatric anesthetists face additional stressors that may impact upon well‐being, particularly after an adverse outcome. The SARS COV‐2 pandemic has resulted in a plethora of resources to support the well‐being of frontline workers. Developing a well‐being system for an anesthesia department using these resources may be complex to implement.

Aims

In this article we outline how an anesthesia department can design and implement a framework for wellbeing, regardless of resources and financial constraints. We use the example of a free online toolkit developed in Australia for anesthetists.

Methods

The “Long lives, Healthy Workplaces toolkit” is a framework which has been specifically developed by mental health experts for anesthetists, and does not require departments to pay for external experts.1 Departments can design a long‐term model of evidence‐based mental health strategies to meet their unique needs using five steps outlined in the toolkit and detailed in this article. The framework uses cycles of assessment and review to create an adaptable approach to incorporate emerging evidence. We explain how culture can impact the implementation of a well‐being framework and we outline how departments can set goals and priorities.

Conclusion

Departments have different constraints which will alter how they approach supporting anaesthetists’ wellbeing. Regardless of location or funding all departments should explicitly address anesthetists well‐being. Long term sustainable well‐being programs require a strategic and coordinated approach.
Development and initial validation of self‐report measures of general health, preoperative anxiety, and postoperative pain in young children using computer‐administered animation
Authors: Kaplan Sherrie H. , Fortier Michelle A. , Shaughnessy Marilou , Maurer Eva , Vivero‐Montemayor Marla , Masague Sergio Gago , Hayes Dylan , Stern Hal S. , Dai Maozhu , Kain Zeev N.
Published: November 2020

Background

For young children, existing measures of children's health‐related quality of life must be parent‐reported or interviewer‐administered for those who cannot read or complete measures independently. Parents’ and childrens’ reports about the child's health have been shown to disagree.

Aims

(a) To test the reliability and validity of an animated, computer‐administered Child Health Rating Inventories (CHRIS2.0) among children aged 4‐12 undergoing surgery; and (b) to develop and test two CHRIS measures of preoperative anxiety and postoperative pain management.

Methods

We conducted a longitudinal cohort study of a diverse group of 542 children aged 4‐12 undergoing surgery. We compared the CHRIS measures to Pediatric Quality of Life Inventory (PedsQL), the Functional Disabilities Inventory (FDI), State‐Trait Anxiety Inventory for children (STAI‐CH), and the Parent Postoperative Pain Measure (PPPM).

Results

Factor analyses supported the construct validity of the 12‐item general physical health and the 8‐item mental health CHRIS scales, as well as a composite 20‐item scale, and the CHRIS preoperative anxiety and postoperative pain scales. Internal consistency reliability for all CHRIS scales exceeded the standard for group comparisons (Cronbach's α ≥0.70). The CHRIS general health composite was significantly correlated with composite PedsQL and FDI (r = 0.28, P < .001 and r = 0.43, P < .001, respectively). The CHRIS peri‐operative anxiety measure was significantly correlated with the STAI‐CH (r = 0.44, P < .001), as was the CHRIS postoperative pain scale with the PPPM (r = 0.52, P < .001).

Conclusions

The CHRIS measures were reliable and valid in this diverse sample of young children (4‐12). Because CHRIS measures are self‐administered, scored in real time, and run on multiple different platforms, this approach provides a feasible method for the collection of health‐related quality of life in young children and those with limited literacy. Our data indicate that this approach is psychometrically sound and has the potential for adding the child's voice to pediatric outcomes.
Can hydraulic design explain patterns of leaf water isotopic enrichment in C3 plants?
Authors: Barbour Margaret M. , Loucos Karen E. , Lockhart Erin L. , Shrestha Arjina , McCallum Daniel , Simonin Kevin A. , Song Xin , Griffani Danielle S. , Farquhar Graham D.
Published: November 2020

H218O enrichment develops when leaves transpire, but an accurate generalized mechanistic model has proven elusive. We hypothesized that leaf hydraulic architecture may affect the degree to which gradients in H218O develop within leaves, influencing bulk leaf stable oxygen isotope enrichment (ΔL) and the degree to which the Péclet effect is relevant in leaves. Leaf hydraulic design predicted the relevance of a Péclet effect to ΔL in 19 of the 21 species tested. Leaves with well‐developed hydraulic connections between the vascular tissue and the epidermal cells through bundle sheath extensions and clear distinctions between palisade and spongy mesophyll layers (while the mesophyll is hydraulically disconnected) may have velocities of the transpiration stream such that gradients in H218O develop and are expressed in the mesophyll. In contrast, in leaves where the vascular tissue is hydraulically disconnected from the epidermal layers, or where all mesophyll cells are well connected to the transpiration stream, velocities within the liquid transport pathways may be low enough that gradients in H218O are very small. Prior knowledge of leaf hydraulic design allows informed selection of the appropriate ΔL modelling framework.
Survey on children with cerebral palsy in Tochigi Prefecture, Japan
Authors: Yamagishi Hirokazu , Osaka Hitoshi , Toyokawa Satoshi , Kobayashi Yasuki , Shimoizumi Hideo
Published: November 2020

Background

The incidence of cerebral palsy (CP) is influenced by perinatal medicine and regional medical systems. We investigated the recent incidence of CP and the current problems of children with CP in living at home under an advanced perinatal medical system in Tochigi Prefecture, Japan.

Methods

A clinical datasheet survey was performed among 13 hospitals and six rehabilitation facilities treating children with CP born in Tochigi Prefecture to estimate the incidence of CP among children born between 2009 and 2013. The severity of motor and intellectual impairment, presumed causal factors, complications, and provided medical interventions were investigated and compared between preterm and term‐born children with CP.

Results

The incidence of CP was 1.6 per 1000 live births. Shorter gestation period and lower birthweight were associated with a higher incidence of CP. Fifty‐one percent of children with CP were non‐ambulatory and 55% had severe to profound intellectual impairment. Episodes of neonatal asphyxia and periventricular leukomalacia were the most frequent causal factors; both were significantly more frequent in preterm than in term‐born children. Approximately 30% of children with CP had respiratory disorders, dysphagia, or epilepsy; 62% received medical interventions, including medication, mechanical ventilation, oxygen therapy, tube feeding, and intraoral/intranasal suction.

Conclusion

We found the incidence of CP to be lower in comparison to previous Japanese studies. However, the motor and intellectual impairments were severe, and many children with CP and their families were burdened by daily medical care. Public support systems should be developed, as well as the perinatal medical system.
Justice, Conscience, and War in Imperial Britain
Authors: Kelly Tobias
Published: November 2020

This article explores the political implications of opposition to war, focusing on the example of conscientious objection to military service. Conscientious objection is often treated as a fundamentally ethical issue; however, this article argues for centering questions of justice in analyses of responses to war. There is a risk that starting with ethics takes for granted the social significance of ethical responses and overlooks particular ethical practices in the reproduction of wider inequalities. More specifically, when an issue is narrowly framed in terms of ethics, it can have implications for who is allowed to speak and what they can speak about. Thinking about war as an issue of justice—in the sense of how society allocates the things that it values—allows the broader issues of hierarchy, distribution, and recognition to be in the foreground. The article focuses on the example of an Indian subject of the British Empire who applied for exemption from military service during the Second World War. The valorization on conscience by the British state prioritized a limited form of opposition to bloodshed grounded in personal moral scruples, to the exclusion of anti‐imperial self‐determination, and turned the war into an issue of individual ethics rather than global inequality.
In vivo reflectance confocal microscopy for evaluating seborrheic keratosis, verruca plana, syringoma and lichen nitidus
Authors: Dai Hui , Jiang Hong‐yan , Xu Ai‐e
Published: November 2020

Background

In clinical, common facial papule dermatosis such as seborrheic keratosis (SK), verruca plana (VP), syringoma and lichen nitidus (LN) is often misdiagnosed. Summarizing in vivo reflectance confocal microscopy (RCM) features of the facial papule dermatosis is helpful in the diagnosis of ambiguous lesions. The purpose of this study was to evaluate the features of SK, VP, syringoma, and LN in RCM.

Methods

We recruited 144 patients referred for unequivocal facial papule dermatosis including 60 patients with SK, 60 patients with VP, 10 patients with syringoma, and 14 patients with LN. The RCM images were evaluated at the epidermis, the dermoepidermal junction, and the dermis from both papule lesions and normal skin.

Results

In the epidermis, the cerebriform shape was the main RCM characteristic of SK and the “petal‐like” structure was the main RCM characteristic of VP. In the dermoepidermal junction, the RCM features we found were as follows: For SK, the bright dermal papillary rings, the abnormal dermal papilla and the looped vessels were also observed at the abnormal dermal papilla. For VP, the bright dermal papillary rings and the point‐like blood vessels were also observed at the round dermal papills. For LN, the round, enlarged, well‐circumscribed dermal papillae and the enlarged dermal papillaes were heavily laden with individual highly refractive cells. In the dermis, RCM examination revealed brightly refractile teratogenous sweat tube, designing variably visible bright “moon” structures in all syringoma patients.

Conclusion

Considering our results, RCM may be useful to non‐invasively discriminate SK, VP, syringoma and LN in vivo.
Reproducibility, Replicability, and Revisiting the Insta-Dead and the Human Remains Trade
Authors: Graham Shawn , Huffer Damien
Published: November 2020

The trade in human remains on social media happens in an ever-changing field of digital media technologies. We attempt to replicate our earlier study, exploring the differences in what we can observe now in the trade on Instagram versus our first foray in 2016 (published in Huffer and Graham 2017). While the previous study cannot be reproduced, it can be replicated, and we find that the trade is accelerating.
Critical Review of ASME III Plasticity Correction Factors for Fatigue Design-By-Analysis of Nuclear Power Plant Components
Authors: Clarkson David M. , Bell Christopher D. , Mackenzie Donald
Published: November 2020

Despite significant technological progress in recent years, elastic–plastic fatigue analysis of pressure-retaining components remains a time-consuming venture. Accordingly, nuclear pressure vessel design codes such as ASME Section III provide simplified elastic–plastic analysis procedures as a practical alternative. This approach can be excessively conservative under certain conditions due to the bounding nature of the applied plasticity correction factor, Ke. While this over conservatism was tolerable in the past, recent technical challenges arising due to consideration of environmentally assisted fatigue and design for long-term operation have posed difficulty in achieving acceptable fatigue usage based on extant Code assessment procedures for certain components. The incorporation of more accurate Ke factors has since been identified as a nuclear industry priority. This paper presents a critical review of Ke factors within ASME Section III, with particular attention given to an approach proposed by Ranganath, which has recently been approved for publication as an ASME Section III Code Case. Correction factors adopted within other nuclear and nonnuclear codes and standards (C&S) were also considered. The code-based Ke factors were compared with Ke factors obtained directly from various elastic–plastic finite element (FE) models of representative plant components. The results revealed a considerable difference in conservatism between the code-based methods. Based on the elastic–plastic finite element analysis (FEA) results, an alternative improved plasticity correction method is proposed in this paper. The need for a harmonized approach to determining Ke based on elastic–plastic FE analysis and further development of efficient plasticity correction methods for total life assessment are highlighted as desirable industry objectives.
Fatigue Evaluation of a New Two-Piece Dental Implant, Having a Replaceable Titanium Sleeve
Authors: Chaushu Liat , Chaushu Gavriel
Published: November 2020

A new two-piece dental implant, having a replaceable thin titanium sleeve in its 5 mm crestal part was designed. The use of a sleeve of near 0.2 mm thickness reduces implant diameter by 0.4 mm. Narrower diameter implants may increase the likelihood of component fracture in dental implant systems. 14 two-piece dental implants, with 25 deg abutment angle were subjected to a dynamic fatigue test according to DIN EN ISO 14801. The highest load at which a runout (nonfailure) occurred at 5 × 106 cycles, amounted to 575 N. This load level was confirmed with n = 3 samples. The Wöhler curve was determined. Accordingly, the runout at 106 cycles can be anticipated as 625 N. The new two-piece Implant B™ design using a 0.2 mm sleeve is compatible with the DIN EN ISO 14801 standards for dimensions of 4.2 mm diameter and 13 mm length. It withstands dynamic fatigue test at least as good as any other standard endosseous implant.
Design Synthesis and Preliminary Evaluation of a Novel Tool to Noninvasively Characterize Pressurized, Physiological Vessels
Authors: Jacobson Natasha , Driscoll Mark
Published: November 2020

A prolonged increase in intra-abdominal pressure (IAP) is life-threatening, yet commonly seen in intensive care units (ICUs). Despite this, existing clinically accepted IAP measurement techniques are invasive and not inter-rater reliable. As such, it is the effort of this research to develop a direct, noninvasive, handheld tool to measure internal pressures in pressurized, physiological vessels. The novel device uses a localized known pressure (namely, aspiration) to measure resulting tissue deformation, from which internal pressures can be divulged considering the extended Hencky solution. Two male participants were tested with the device to confirm feasibility of the theoretical device function for IAP measurement. Participants' Young's moduli of the abdominal wall were calculated with measured IAP values. Results were consistent with participant body mass indices and overall health. Average measured IAP was 0.42 kPa and 0.46 kPa at supine and inclined positions, respectively. Average measured abdominal wall elasticity was 14.91 kPa and 23.09 kPa at supine and inclined positions, respectively. These preliminary findings suggest the potential use of the device described herein as a measurement system for pressurized vessels, whereas the system will be tested on a larger sample size before recommending clinical use.
Application of Spectral Method for Vibration-Induced High-Cycle Fatigue Evaluation of an High-Pressure Turbine Blade
Authors: Ubulom Iroizan
Published: November 2020

A method of fluid–structure interaction coupling is implemented for a forced-response, vibration-induced fatigue life estimation of a high-pressure turbine blade. Two simulations approaches; a two-way (fully coupled) and one-way (uncoupled) methods are implemented to investigate the influence of fluid–solid coupling on a turbine blade structural response. The fatigue analysis is performed using the frequency domain spectral moments estimated from the response power spectral density (PSD) of the two simulation cases. The method is demonstrated in relation to the time-domain method of the rainflow cycle counting method with mean stress correction. Correspondingly, the mean stress and multi-axiality effects are also accounted for in the frequency domain spectral approach. In this case, a multiplication coefficient is derived based on the Morrow equation, while the case of multi-axiality is based on a criterion which reduces the triaxial stress state to an equivalent uniaxial stress using the critical plane assumption. The analyses show that while the vibration-induced stress histories of both simulation approaches are stationary, they violate the assumption of normality of the frequency domain approaches. The stress history profile of both processes can be described as platykurtic with the distributions having less mass near its mean and in the tail region, as compared to a Gaussian distribution with an equal standard deviation. The fully coupled method is right leaning with positive skewness while the uncoupled approach is left leaning with negative skewness. The directional orientation of the principal axes was also analyzed based on the Euler angle estimation. Although noticeable differences were found in the peak distribution of the normal stresses for both methods, the predicted Euler angle orientations were consistent in both cases, depicting a similar orientation of the critical plane during a crack initiation and propagation process. Finally, the fatigue life estimation was shown to be conservative in the fully coupled solution approach.