bluuebunny/crossref_metadata_2025 huggingface dataset:
Stimulators of medical students’ interest in geriatric medicine—A Systematic Review
Authors: Karikari Grace , Lohrmann David K. , Huber Lesa
Published: October 2020

Objectives

This study is a systematic review on stimulators of interest in pursuing a geriatric career among medical students in different countries. The review also assessed whether there were differences or similarities based on geographic regions or income categorisations.

Methods

A 20‐year (1998‐2018) review of quality primary research articles was conducted (n = 10). For analysis, studies were categorised into low‐ and middle‐income countries (LMICs), and high‐income countries, based on World Health Organization and World Bank's income grouping for the 2019 fiscal year.

Results

The frequently mentioned stimulators of interest in geriatrics were as follows: cultivating positive attitudes towards older people, participation in geriatric‐related interventions and positive experiences during a geriatric training. Lack of published peer‐reviewed articles from the LMICs limited the researchers’ ability to compare the two income groups.

Conclusion

Suggestions to improve future systematic reviews that consider global factors, global participation or any aspect of global inclusion are discussed.
USP21 upregulation in cholangiocarcinoma promotes cell proliferation and migration in a deubiquitinase‐dependent manner
Authors: Zhou Peng , Song Ting , Sun Chunjiao , He Na , Cheng Qiang , Xiao Xin , Ran Jie , Liu Min , Xie Songbo
Published: October 2020

Ubiquitin‐specific protease 21 (USP21) has been implicated in several types of cancer. It promotes or suppresses tumor growth in a cell‐context dependent manner. Cholangiocarcinoma is a malignant tumor with a high mortality rate. However, the role of USP21 in cholangiocarcinoma remains unknown. Here, we identify that the level of USP21 is upregulated in cholangiocarcinoma using bioinformatics analysis and confirm this elevation in RBE cell lines. Cell counting and 5‐ethynyl‐2′‐deoxyuridine incorporation assays reveal that USP21 promotes the proliferation of cholangiocarcinoma. Wound healing and transwell assays demonstrate that USP21 accelerates RBE cell migration. In addition, rescue assays reveal that reintroduction of USP21 wildtype other than the deubiquitinase‐deficient C221A mutant restores USP21 depletion‐induced attenuation in cell proliferation and migration, indicative of the requirement of the deubiquitinase activity. Collectively, these data indicate that USP21 is critically involved in cholangiocarcinoma tumorigenesis and may be an effective target for the treatment of cholangiocarcinoma.
Portal flow dynamics after total pancreatectomy and autologous islet cell transplantation
Authors: Williams Brittney M. , Baldwin Xavier , Vonderau Jennifer S. , Hyslop William Brian , Desai Chirag S.
Published: October 2020

Background

Portal vein thrombosis (PVT) is a serious complication of total pancreatectomy and autologous islet cell transplant (TPAIT); therefore, portal flow dynamics are monitored by Doppler ultrasound postoperatively. The practical value of scheduled Doppler ultrasound examinations and the relationship between portal vein velocity, liver function, and complications have not been clearly studied.

Methods

A retrospective review of 16 TPAIT was performed. Correlation analysis of portal vein velocity with indices of liver function, portal pressure, and volume of islet cells infused was conducted.

Results

There was no correlation between portal vein velocity and postoperative liver function tests (LFTs). Larger volume of islet cells infused and higher intraoperative portal pressure correlated with decreased postoperative portal flow. There was no significant difference in portal pressure, portal vein velocity, or LFTs between those with normal and abnormal pre‐infusion liver histopathology. While no PVT occurred, there were two cases of postoperative bleeding related to anticoagulation.

Conclusion

Segmental portal vein velocities are low in the setting of high tissue volume and portal pressure, but are not associated with variation in LFTs. Therefore, patient management in response to changes in velocities without clinical symptoms may be unnecessary.
Topic identification of text‐based expert stock comments using multi‐level information fusion
Authors: Zhao Feng , Zhang Jiahui , Chen Zhiyuan , Zhang Xiaofeng , Xie Qingsong
Published: October 2020

Stock investment is an important mode of asset allocation and a crucial means of financial management. How to grasp the movement of stock price and predict its trend have been the focus of investors and investment companies. Since expert stock comments contain abundant essential information for investment decisions, how to identify the topic of expert stock comments with high precision and efficiency is an important research topic. However, the existing methods usually employ single feature selection strategies for topic identification of stock comments, which may lead to low accuracy. Thus, to deal with this limitation, we propose a multi‐level information fusion method to construct a topic identification system of stock comments. Specifically, we firstly fuse various complementary feature selection methods via a multi‐view learning framework which can comprehensively represent text‐based topics. In addition, regarding the decision process, we propose a fusion strategy based on belief value which can further improve the classification performance. The experimental results indicate that the proposed multi‐level information fusion method is not only superior to other methods in terms of classification, it is also able to accurately capture topics of expert stock comments.
Should research experience be used for selection into graduate school: A discussion and meta‐analytic synthesis of the available evidence
Authors: Miller Anthony , Crede Marcus , Sotola Lukas K.
Published: October 2020

Prior research experience is widely considered by graduate school admissions committees in the United States of America. Here, we use meta‐analytic methods and data from 18 unique samples and a total sample size of 3,525 students to shed light on the validity of prior research experience as a predictor of graduate school performance. Prior research experience was largely unrelated to academic performance (ρ = .01, k = 8, N = 1,419), degree attainment (ρ = .05, k = 3, N = 140), professional/practice performance (ρ = .06, k = 4, N = 1,120), and publication performance (ρ = .11, k = 7, N = 1,094). We also discuss whether consideration of prior research experience may unfairly disadvantage the students with lower levels of SES, students with childcare or eldercare responsibilities, and students from institutions at which research opportunities are limited.
Safety and efficacy of catheter ablation for atrial fibrillation in abdominal solid organ (renal and hepatic) transplant recipients: A single‐center pilot experience
Authors: Su Xin , Zhao Xin , Long De‐yong , Sang Cai‐hua , Yu Rong‐hui , Tang Ri‐bo , Bai Rong , Liu Nian , Jiang Chen‐xi , Li Song‐nan , Guo Xue‐yuan , Wang Wei , Hu Rong , Du Xin , Dong Jian‐zeng , Ma Chang‐sheng
Published: October 2020

Background

Atrial fibrillation (AF) is common in abdominal solid organ transplant recipients and a cause of morbidity and mortality in this population. However, the outcomes of catheter ablation (CA) in transplant recipients with AF remain unclear. This study aimed to elucidate the outcomes of CA in renal and hepatic transplant recipients.

Methods and Results

Between 2015 and 2019, 14 transplant recipients (nine with kidney transplantation and five with liver transplantation) were enrolled from among 10,741 AF patients and underwent CA at Anzhen Hospital. Another 56 patients matched by age, sex, and AF type were selected as the control group (four controls for each transplant recipient). During a mean follow‐up of 30.0 ± 13.3 months after the initial procedure, 10 (71.4%) of the transplant patients, compared to 41 (73.2%) of the control patients, remained free from AF recurrence (p = 1.000). A repeated procedure was performed in one transplant patient and in six control subjects. Consequently, 11 (78.6%) of the transplant patients, compared to 46 (82.1%) of controls, were in sinus rhythm after the repeated ablation (p = .715). Notably, Kaplan–Meier analysis did not demonstrate any significant differences in the atrial arrhythmia‐free rate after the initial and repeated procedure between the two groups. Vascular complications were identified in one transplant patient and two control subjects, while no life‐threatening complications were observed in either group. There was no transient allograft dysfunction in transplant recipients after CA.

Conclusion

CA is safe and effective in abdominal solid transplant recipients, and maybe an optimal therapeutic strategy for this group.
The role of the shared environment in college attainment: An adoption study
Authors: Anderson Elise L. , Saunders Gretchen R. B. , Willoughby Emily A. , Iacono William G. , McGue Matt
Published: October 2020

Objective

College attainment is one of the few phenotypes to have substantial variance accounted for by environmental factors shared by reared‐together relatives. The shared environment is implicated by the consistently strong parent‐to‐offspring transmission of college attainment. The mechanisms underlying this relationship remain unclear. We use genetically informative methods with a longitudinal, adoption sample to identify possible environmental mechanisms underlying parent‐offspring college transmission.

Method

Data were drawn from the Sibling Interaction and Behavior Study (SIBS), which includes 409 adoptive and 208 nonadoptive families, consisting of two offspring followed from adolescence into young adulthood and their rearing parents. Four domains of environmental mechanisms were examined: (a) skill enhancement; (b) academic support; (c) material advantage; and (d) supportive family environment.

Results

Both shared environmental and genetic factors contributed to the parent‐offspring transmission of college attainment. However, highly educated parents did not appear to be increasing their adopted offspring's attainment through skill development. The environmental factors that were associated with increased odds of offspring college attainment were mother's academic expectations and family income.

Conclusions

While complete mediation of the parent‐offspring transmission of college attainment was not identified, the results shed light on some of the mechanisms associated with the common environment variance in the college attainment phenotype.
Sulfadiazine pharmacokinetics in grass carp (Ctenopharyngodon idellus) receiving oral and intravenous administrations
Authors: Xu Ning , Fu Yu , Chen Fang , Liu Yongtao , Dong Jing , Yang Yibin , Zhou Shun , Yang Qiuhong , Ai Xiaohui
Published: October 2020

This study aimed to examine the bioavailability (BA) and pharmacokinetic (PK) characteristics of sulfadiazine (SDZ) in grass carp (Ctenopharyngodon idellus) after oral and intravenous administrations. Blood samples were collected at predetermined time points of 0.083, 0.17, 0.5, 1, 2, 4, 8, 16, 24, 48, 72, and 96 hr (n = 6). The samples were extracted and purified by organic reagents and determined by the ultra‐performance liquid chromatography. The software named 3P97 was used to calculate relevant PK parameters. The results demonstrated that the concentration–time profile of SDZ was best described by a one‐compartmental open model with first‐order absorption after a single oral dose. The main PK parameters of the absorption rate constant (Kα), the absorption half‐life (t1/2 Kα), the elimination rate constant (Ke), the elimination half‐life (t1/2Ke), and the area under concentration–time profile (AUC0‐∞) were 0.3 1/h, 2.29 hr, 0.039 1/h, 17.64 hr, and 855.78 mg.h/L, respectively. Following intravenous administration, the concentration–time curve fitted to a two‐compartmental open model without absorption. The primary PK parameters of the distribution rate constant (α), the elimination rate constant (β), the distribution half‐life (t1/2α), the elimination half‐life (t1/2β), the apparent distribution volume (VSS), the total clearance (CL), and AUC0‐∞ were 9.62 1/hr, 0.039 1/hr, 0.072 hr, 17.71 hr, 0.33 L/kg, 0.013 L h−1 kg−1, and 386.23 mg.h/L, respectively. Finally, the BA was calculated to be 22.16%. Overall, this study will provide some fundamental information on PK properties in the development of a new formulation SDZ in the future and is partially beneficial for the appropriate usage of SDZ in aquaculture.
Ancestral chemotypes of cultivated grapevine with resistance to Botryosphaeriaceae‐related dieback allocate metabolism towards bioactive stilbenes
Authors: Khattab Islam M. , Sahi Vaidurya P. , Baltenweck Raymonde , Maia‐Grondard Alessandra , Hugueney Philippe , Bieler Eva , Dürrenberger Markus , Riemann Michael , Nick Peter
Published: October 2020

Grapevine trunk diseases have devastating consequences on vineyards worldwide. European wild grapevines (Vitis vinifera subs. sylvestris) from the last viable population in Germany along the Rhine river showed variable degrees of resistance against Neofusicoccum parvum (strain Bt‐67), a fungus associated with Botryosphaeriaceae‐related dieback.

Representative genotypes from different subclades of this population were mapped with respect to their ability to induce wood necrosis, as well as their defence responses in a controlled inoculation system.

The difference in colonization patterns could be confirmed by cryo‐scanning electron microscopy, while there was no relationship between vessel diameter and infection success. Resistant lines accumulated more stilbenes, that were in addition significantly partitioned to nonglycosylated viniferin trimers. By contrast, the susceptible genotypes accumulated less stilbenes with a significantly higher proportion of glycosylated piceid.

We suggest a model in which in the resistant genotypes phenylpropanoid metabolism is channelled rapidly and specifically to the bioactive stilbenes. Our study specifies a resistant chemotype against grapevines trunk diseases and paves a way to breed for resistance against grapevine Botryosphaeriaceae‐related dieback.
Second primary tumors in head and neck cancer patients: The importance of a “tailored” surveillance
Authors: Bertolini Federica , Trudu Lucia , Banchelli Federico , Schipilliti Francesca , Napolitano Martina , Alberici Maria Paola , Depenni Roberta , D’Angelo Elisa , Mattioli Francesco , Rubino Laura , Presutti Livio
Published: October 2020

Objective

Head and neck cancer survivors have increased risk of developing second primary tumors compared to overall population. Because second primary represents a major cause of morbidity and mortality in this population, early detection is fundamental.

Materials and Methods

In this 10‐year single‐institution study, we investigated the following: incidence, clinical‐pathological risk factors, and survival of patients with second primary tumor. We included all patients with diagnosis of squamous cell carcinoma of the head and neck seen at the Modena University Hospital from 2008 to 2018.

Results

Among 1,177 patients included, 222 (18.9%) developed second primary tumor; its survival probability at 5 years was 40.6%. Alcohol consumption (p = .0055) and index cancer in oropharynx (p = .0029), supraglottic larynx (p = .0000), glottic larynx (p = .0222) were associated with higher risk of second primary. The most common second primary sites were head and neck district and lung (70, 31.5%, and 67, 30.2%, respectively). Head and neck district were more common in oral cavity (18, 43%) and oropharynx index cancer (20, 31%); lung second primary in hypopharynx (4, 40%), supraglottic larynx (17, 43%), and glottic larynx index cancer (23, 35%).

Conclusion

Head and neck cancer survivors developing a second primary tumor have dismal prognosis. Tailored surveillance is recommended.
Apple BT2 protein negatively regulates jasmonic acid‐triggered leaf senescence by modulating the stability of MYC2 and JAZ2
Authors: An Jian‐Ping , Wang Xiao‐Fei , Zhang Xiao‐Wei , You Chun‐Xiang , Hao Yu‐Jin
Published: October 2020

Jasmonic acid (JA) is shown to induce leaf senescence. However, the underlying molecular mechanism is not well understood, especially in woody plants such as fruit trees. In this study, we are interested in exploring the biological role of MdBT2 in JA‐mediated leaf senescence. We found that MdBT2 played an antagonistic role in MdMYC2‐promoted leaf senescence. Our results revealed that MdBT2 interacted with MdMYC2 and accelerated its ubiquitination degradation, thus negatively regulated MdMYC2‐promoted leaf senescence. In addition, MdBT2 acted as a stabilizing factor to improve the stability of MdJAZ2 through direct interaction, thereby inhibited JA‐mediated leaf senescence. Furthermore, our results also showed that MdBT2 interacted with a subset of JAZ proteins in apple, including MdJAZ1, MdJAZ3, MdJAZ4 and MdJAZ8. Our investigations provide new insight into molecular mechanisms of JA‐modulated leaf senescence. The dynamic JA‐MdBT2‐MdJAZ2‐MdMYC2 regulatory module plays an important role in JA‐modulated leaf senescence.
Anthony Copley and the paradoxes of parody
Authors: Sandberg Julianne
Published: October 2020

This essay investigates the parodic structure of A Fig for Fortune (Anthony Copley’s 1596 parody of The Faerie Queene) and argues that greater attention to the poem’s parodic features illuminates its incongruities and expands our understanding of early modern parody at the intersection of religion and politics. Given parody’s dual commitments to both echoing and diverging from its source material, the essay highlights key examples of each, demonstrating how and why Copley imitates and deviates from Spenser as he does. While Fig’s divergence from FQ accentuates Copley’s pacifist, anti‐jesuitical, and firmly Catholic impulse, the poem’s echo of Spenser threatens to undermine this very message, which ultimately points, to the paradoxes that define both Catholic dissent and the parodic mode. It is the poem’s structure as a parody – as much as its expression of the religious and political experience of English Catholics – that makes it valuable to our understanding of early modern literature.
Impact of natural zeolite on chemical and biochemical properties of vineyard soils
Authors: Doni Serena , Gispert Maria , Peruzzi Eleonora , Macci Cristina , Mattii Giovan Battista , Manzi Davide , Masini Cosimo M. , Grazia Masciandaro
Published: October 2020

Sustained tillage and continual applications of phytopharmaceutical and fertilizers using heavy machineries frequently give rise to soil erosion, loss of soil organic matter (SOM) and contamination phenomena in Mediterranean vineyards. Because of their distinctive properties, applying natural zeolites to vineyard soils can conceivably affect the efficient use of fertilizers and reduce nutrient leaching losses. This work assesses the impact of zeolite amendment at differing rates (0, 5 and 10 t/ha) on the chemical and biochemical soil properties of three vineyard soils after 6 months from initial treatments. In particular, chemical properties usually related to soil fertility were evaluated along with more sensitive indicators of soil functionality and indicators of chemical–structural characteristics of SOM. The vineyard soils amended with zeolite showed higher nutrient availability and dehydrogenase activity if compared with the control soils. In addition, even though total organic carbon (TOC) content was unchanged, a decrease in humic substances was observed in the zeolite‐treated soils. These results suggested that the stimulation of soil microbial processes by adding zeolite triggered a microbial mineralization process of soil organic carbon stocks. In addition, the modification in the chemical–structural composition of soil organic matter in zeolite‐treated soils was shown by the pyrolysis–gas chromatography (Py‐GC) results. Py‐CG of soil organic matter clearly demonstrated an increase in the labile aliphatic compound furfural and a decline in the more stable aromatic pyrolytic fragments in zeolite‐treated soils in contrast with the control soils, thus indicating the higher extent of decomposition of the SOM more stable pool.
A new HLA‐B*39 allele, B*39:168, closely related to B*39:05:01:02
Authors: Planelles Dolores , Balas Antonio , Rodríguez‐Cebria Manuel , Vicario Jose L.
Published: October 2020

A new HLA‐B*39:168 was characterized in a Caucasian Spanish individual.
Characterization of 15 novel HLA alleles by next generation sequencing in Brazilian individuals
Authors: Fabreti‐Oliveira Raquel A. , Vale Eliane M. G. , Oliveira Cintia K. F. , Nascimento Evaldo
Published: October 2020

Fifteen novel HLA alleles in the HLA‐A, ‐B, ‐C, DRB1, and DQB1 loci were described.
Leukocytapheresis for AML hyperleukocytosis: Failing to make the grade
Authors: Connelly‐Smith Laura , Linenberger Michael L.
Published: October 2020

See article on page 2360–2369, in this issue
Predictive factors for the development of anemia after hematopoietic stem cell donation
Authors: Steuer Lia V. , Kondo Andrea T. , Cipolletta Andrea N. , Sakashita Araci M. , Hamerschlak Nelson , Kutner José M.
Published: October 2020

Background

Although Hematopoietic Stem Cells (HSC) donation through bone marrow (BM) and peripheral blood (PB) are usually safe procedures, adverse events are expected. One of the most common events especially among BM donors (BMD) is the development of anemia. To protect the BMD and preserve the hemoglobin levels, many centers collect autologous pre‐procedure blood, but the actual benefits of this procedure is controversial.

Methods and Materials

This study analyzed retrospectively data to observe what factors may influence the occurrence of post‐donation anemia and also evaluate the relevance of autologous red blood cell pre procedure donation (PAD).

Results

The development of immediately post donation anemia (IP) was higher in BMD than in PB donors (64.2% BMD and 10.7% PBD, P < .001) and also in late post donation (LP) (28.4% BMD and 3.6% PBD, P = .007). The study demonstrated an association between PAD and anemia in IP (72.7% with anemia and 27.3% without anemia, P = .006) and an association between the volume of red blood cells in the donated hematopoietic product and the development of anemia in LP (356.3 mL and 297.8 mL, P = .037).

Conclusion

In conclusion, collection of HSC through BM is a risk factor for anemia and PAD is a risk factor for IP anemia.
Biophysical and morphological changes in inner hair cells and their efferent innervation in the ageing mouse cochlea
Authors: Jeng Jing‐Yi , Carlton Adam J. , Johnson Stuart L. , Brown Steve D. M. , Holley Matthew C. , Bowl Michael R. , Marcotti Walter
Published: October 2020

Key points

Age‐related hearing loss is a progressive hearing loss involving environmental and genetic factors, leading to a decrease in hearing sensitivity, threshold and speech discrimination.

We compared age‐related changes in inner hair cells (IHCs) between four mouse strains with different levels of progressive hearing loss.

The surface area of apical coil IHCs (9–12 kHz cochlear region) decreases by about 30–40% with age.

The number of BK channels progressively decreases with age in the IHCs from most mouse strains, but the basolateral membrane current profile remains unchanged.

The mechanoelectrical transducer current is smaller in mice harbouring the hypomorphic Cdh23 allele Cdh23ahl (C57BL/6J; C57BL/6NTac), but not in Cdh23‐repaired mice (C57BL/6NTacCdh23+), indicating that it could contribute to the different progression of hearing loss among mouse strains.

The degree of efferent rewiring onto aged IHCs, most likely coming from the lateral olivocochlea fibres, was correlated with hearing loss in the different mouse strains.

Inner hair cells (IHCs) are the primary sensory receptors of the mammalian cochlea, transducing acoustic information into electrical signals that are relayed to the afferent neurons. Functional changes in IHCs are a potential cause of age‐related hearing loss. Here, we have investigated the functional characteristics of IHCs from early‐onset hearing loss mice harbouring the allele Cdh23ahl (C57BL/6J and C57BL/6NTac), from late‐onset hearing loss mice (C3H/HeJ), and from mice corrected for the Cdh23ahl mutation (C57BL/6NTacCdh23+) with an intermediate hearing phenotype. There was no significant loss of IHCs in the 9–12 kHz cochlear region up to at least 15 months of age, but their surface area decreased progressively by 30–40% starting from ∼6 months of age. Although the size of the BK current decreased with age, IHCs retained a normal KCNQ4 current and resting membrane potential. These basolateral membrane changes were most severe for C57BL/6J and C57BL/6NTac, less so for C57BL/6NTacCdh23+ and minimal or absent in C3H/HeJ mice. We also found that lateral olivocochlear (LOC) efferent fibres re‐form functional axon‐somatic connections with aged IHCs, but this was seen only sporadically in C3H/HeJ mice. The efferent post‐synaptic SK2 channels appear prior to the establishment of the efferent contacts, suggesting that IHCs may play a direct role in re‐establishing the LOC‐IHC synapses. Finally, we showed that the size of the mechanoelectrical transducer (MET) current from IHCs decreased significantly with age in mice harbouring the Cdh23ahl allele but not in C57BL/6NTacCdh23+mice, indicating that the MET apparatus directly contributes to the progression of age‐related hearing loss.
Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children
Authors: Roslund Marja I. , Puhakka Riikka , Grönroos Mira , Nurminen Noora , Oikarinen Sami , Gazali Ahmad M. , Cinek Ondřej , Kramná Lenka , Siter Nathan , Vari Heli K. , Soininen Laura , Parajuli Anirudra , Rajaniemi Juho , Kinnunen Tuure , Laitinen Olli H. , Hyöty Heikki , Sinkkonen Aki ,   ADELE research group
Published: October 2020

Forest floor, sod, and gardening facilities in daycare environment modulate skin and gut microbiota and immunoregulation.
Tailoring nanocomposite interfaces with graphene to achieve high strength and toughness
Authors: Song Ningning , Gao Zan , Li Xiaodong
Published: October 2020

Tailoring the composite interfaces with graphene enabled effective utilization of the nanofillers.
Transcriptional suppression of ribosomal DNA with phase separation
Authors: Ide Satoru , Imai Ryosuke , Ochi Hiroko , Maeshima Kazuhiro
Published: October 2020

Single-molecule imaging and tracking reveal how rRNA transcription is regulated by phase separation in the nucleolus.
Networks with controlled chirality via self-assembly of chiral triblock terpolymers
Authors: Wang Hsiao-Fang , Chiu Po-Ting , Yang Chih-Ying , Xie Zhi-Hong , Hung Yu-Chueh , Lee Jing-Yu , Tsai Jing-Cherng , Prasad Ishan , Jinnai Hiroshi , Thomas Edwin L. , Ho Rong-Ming
Published: October 2020

By taking advantage of chirality transfer, nanonetwork with controlled chirality can be obtained from self-assembly.
Genomic Assemblies of Members of
Burkholderia
and Related Genera as a Resource for Natural Product Discovery
Authors: Mullins Alex J. , Jones Cerith , Bull Matthew J. , Webster Gordon , Parkhill Julian , Connor Thomas R. , Murray James A. H. , Challis Gregory L. , Mahenthiralingam Eshwar
Published: October 2020

The genomes of 450 members of
Burkholderiaceae
, isolated from clinical and environmental sources, were sequenced and assembled as a resource for genome mining. Genomic analysis of the collection has enabled the identification of multiple metabolites and their biosynthetic gene clusters, including the antibiotics gladiolin, icosalide A, enacyloxin, and cepacin A.
Genome Sequences of Two Pathogens of Cruciferous Crops, Xanthomonas campestris pv. raphani MAFF 106181 and
X. campestris
pv. campestris MAFF 301176
Authors: Fujikawa Takashi , Inoue Yasuhiro
Published: October 2020

Xanthomonas campestris
pv.
raphani
and
X. campestris
pv.
campestris
are the causal bacteria of bacterial spot and black rot of crucifers (
Brassicaceae
), respectively. Both pathogens are threats in the cultivation of cruciferous crops such as cabbage. Here, we sequenced a strain of each of these pathogens.
Complete Genome Sequences of Streptococcus pyogenes Serotype M3, M28, and M89 Strains Isolated from Human Patients in Japan, 1994 to 2009
Authors: Murase Kazunori , Nozawa Takashi , Aikawa Chihiro , Nagao Miki , Ikebe Tadayoshi , Yoshida Akemi , Kikuchi Taisei , Nakagawa Ichiro
Published: October 2020

Streptococcus pyogenes
(group A
Streptococcus
[GAS]) is a major human pathogen that occasionally causes severe and life-threatening invasive diseases. Here, we report the complete genome sequences of four GAS strains of three M types, which were isolated from patients with severe invasive disease in Japan.
A Family of Viral Satellites Manipulates Invading Virus Gene Expression and Can Affect Cholera Toxin Mobilization
Authors: Barth Zachary K. , Netter Zoe , Angermeyer Angus , Bhardwaj Pooja , Seed Kimberley D.
Published: October 2020

Viral satellites are found in all domains of life and can have profound fitness effects on both the viruses they parasitize and the cells they reside in. In this study, we have acquired the first RNA sequencing (RNA-seq) transcriptomes of viral satellites outside plants, as well as the transcriptome of the phage ICP1, a predominant predator of pandemic
Vibrio cholerae
. Capsid downregulation, previously observed in an unrelated phage satellite, is conserved among
p
hage inducible chromosomal island-
l
ike
e
lements (PLEs), suggesting that viral satellites are under strong selective pressure to reduce the capsid expression of their larger host viruses. Despite conserved manipulation of capsid expression, PLEs exhibit divergent effects on CTXΦ transcription and mobility. Our results demonstrate that PLEs can influence both their hosts’ resistance to phage and the mobility of virulence-encoding elements, suggesting that PLEs can play a substantial role in shaping
Vibrio cholerae
evolution.
Sudden irreversible hearing loss post COVID-19
Authors: Koumpa Foteini Stefania , Forde Cillian T , Manjaly Joseph G
Published: October 2020

Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.
Incentive programmes for smoking cessation: cluster randomized trial in workplaces in Thailand
Authors: White Justin S , Lowenstein Christopher , Srivirojana Nucharee , Jampaklay Aree , Dow William H
Published: October 2020

Objective

To compare several monetary incentive programmes for promoting smoking abstinence among employees who smoke at workplaces in a middle income country.

Design

Parallel group, open label, assessor blinded, cluster randomized controlled trial.

Setting

Large industrial workplaces in metropolitan Bangkok, Thailand.

Participants

Employees who smoked cigarettes and planned to quit within six months recruited from 101 worksite clusters (84 different companies).

Interventions

Worksites were digitally cluster randomized by an independent investigator to usual care or usual care plus one of eight types of incentive programmes. Usual care consisted of one time group counseling and cessation support through a 28 day text messaging programme. The incentive programmes depended on abstinence at three months and varied on three intervention components: refundable deposits, assignment to a teammate, and bonus size ($20 (£15; €17) or $40).

Main outcome measures

The primary outcome was biochemically verified seven day point prevalence smoking abstinence at 12 months. Secondary outcomes were programme acceptance at enrollment and smoking abstinence at three months (end of intervention) and at six months. All randomized participants who had complete baseline information were included in intention-to-treat analyses; participants with missing outcomes were coded as continuing smokers.

Results

Between April 2015 and August 2016, the trial enrolled 4190 participants. Eighteen were omitted because of missing baseline covariates and death before the primary endpoint, therefore 4172 participants were included in the intention-to-treat analyses. Programme acceptance was relatively high across all groups: 58.7% (2451/4172) overall and 61.3% (271/442) in the usual care group. Abstinence rates at 12 months did not differ among deposit programmes (336/2253, 14.9%) and non-deposit programmes (280/1919, 14.6%; adjusted difference 0.8 points, 95% confidence interval −2.7 to 4.3, P=0.65), but were somewhat lower for team based programmes (176/1348, 13.1%) than individual based programmes (440/2824, 15.6%; −3.2 points, −6.6 to −0.2, P=0.07), and higher for $40 bonus programmes (322/1954, 16.5%) than programmes with no bonus (148/1198, 12.4%; 5.9 points, 2.1 to 9.7, P=0.002). The $40 individual bonus was the most efficacious randomization group at all endpoints. Intervention components did not strongly interact with each other.

Conclusions

Acceptance of monetary incentive programmes for promoting smoking abstinence was high across all groups. The $40 individual bonus programmes increased long term smoking abstinence compared with usual care, although several other incentive designs did not, such as team based programmes and deposit programmes. Incentive design in workplace wellness programmes might influence their effectiveness at reducing smoking rates in low resource settings.

Trial registration

ClinicalTrials.gov (
NCT02421224
).
Gendered lived experiences of marriage and family following exposure to chemical warfare agents: content analysis of qualitative interviews with survivors in Halabja, Kurdistan-Iraq
Authors: Moradi Faraidoun , Moradi Fazil , Söderberg Mia , Olin Anna-Carin , Lärstad Mona
Published: October 2020

Objective

To study gendered experiences of the long-term effects of a chemical warfare agent (CWA; sulfur mustard).

Design

Qualitative face-to-face semi-structured in-depth interview study using content analysis approach with thematic analysis and anthropological inquiries.

Setting

The city of Halabja in the Kurdistan Region of Iraq.

Participants

Survivors of CWA (n=16, female:male 10:6, mean age 45.5 years (range 34 to 67)) with lung damage diagnosis and with a range of sociodemographic variables.

Results

Latent content was expressed as: To get or not to get married? Two categories—social abandonment and uncertain marriage—emerged as expressions of the manifest content. The majority of the participants showed uncertainty as a central concern that affects all decision-making in their private and social life. Uncertainty over marriage and family were huge, corresponding to their fear of giving birth to children with congenital birth defects. Exposure to CWAs was conceptualised in terms of stigmatised illnesses, and consequently resulted in loneliness and social isolation, leading to negative impacts on other aspects of professional and social life. The results demonstrated a gendered pattern: CWA-exposed women were more affected psychosocially than CWA-exposed men. More CWA-exposed women were unemployed, divorced or single, or lived under vulnerable circumstances compared with men.

Conclusion

Survivors of CWA exposure have developed a sense of gendered uncertainty around getting married and building a family. Sulfur mustard-exposed women, in particular, long to be desired in the community as they face social exclusion. Survivors should be provided evidence-based consultancy to optimise their decision-making around marriage and other social and family challenges.
An interview study to determine the experiences of cellulitis diagnosis amongst health care professionals in the UK
Authors: Patel Mitesh , Lee Siang Ing , Levell Nick J , Smart Peter , Kai Joe , Thomas Kim S , Leighton Paul
Published: October 2020

Objectives

To explore healthcare professionals (HCPs) experiences and challenges in diagnosing suspected lower limb cellulitis.

Setting

UK nationwide.

Participants

20 qualified HCPs, who had a minimum of 2 years clinical experience as an HCP in the national health service and had managed a clinical case of suspected cellulitis of the lower limb in the UK. HCPs were recruited from departments of dermatology (including a specialist cellulitis clinic), general practice, tissue viability, lymphoedema services, general surgery, emergency care and acute medicine. Purposive sampling was employed to ensure that participants included consultant doctors, trainee doctors and nurses across the specialties listed above. Participants were recruited through national networks, HCPs who contributed to the cellulitis priority setting partnership, UK Dermatology Clinical Trials Network, snowball sampling where participants helped recruit other participants and personal networks of the authors.

Primary and secondary outcomes

Primary outcome was to describe the key clinical features which inform the diagnosis of lower limb cellulitis. Secondary outcome was to explore the difficulties in making a diagnosis of lower limb cellulitis.

Results

The presentation of lower limb cellulitis changes as the episode runs its course. Therefore, different specialties see clinical features at varying stages of cellulitis. Clinical experience is essential to being confident in making a diagnosis, but even among experienced HCPs, there were differences in the clinical rationale of diagnosis. A group of core clinical features were suggested, many of which overlapped with alternative diagnoses. This emphasises how the diagnosis is challenging, with objective aids and a greater understanding of the mimics of cellulitis required.

Conclusion

Cellulitis is a complex diagnosis and has a variable clinical presentation at different stages. Although cellulitis is a common diagnosis to make, HCPs need to be mindful of alternative diagnoses.
Cross-sectional questionnaire study to gather the teaching preferences and expectations of UK undergraduate medical students for culinary medicine learning
Authors: Xie Jessica Ying-Yi , Poduval Shoba , Vickerstaff Victoria , Park Sophie
Published: October 2020

Aim

To determine undergraduate medical students’ teaching preferences and expectations for Culinary Medicine (CM) learning with a view to informing development of a CM course at a UK medical school.

Setting

A single, urban UK medical school.

Participants

180 undergraduate medical students.

Study design

A cross-sectional questionnaire study collecting quantitative and qualitative (free-text) data.

Methods and outcome measures

An online questionnaire consisting of 16 questions of various styles (Likert-type, multiple choice and free-text). Quantitative analysis of multiple choice and Likert-type scale questions was conducted. Qualitative thematic analysis was used to analyse the free-text responses and identify themes.

Results

Three core themes related to students’ understanding of CM were identified: (1) ‘CM Learning’: students’ perceived relevance of CM knowledge, perceived relevance of CM to healthcare and their expectations for teaching; (2) ‘The Relationship between Food and Health’: links between diet, social factors and health; and (3) ‘Evidence-based Medicine’: students’ perceptions about scientific principles underlying CM. Quantitative analysis revealed that, although 83% of students felt that learning CM is important for their future clinical practice, 56% felt unable to take a dietary history. 73% of students were dissatisfied with the quality, and 78% were dissatisfied with the quantity, of existing medical school teaching understood to be relevant to CM. Topics that students would like to be taught on a CM course included weight management and portion control. Students felt that problem-based style learning would be the most appropriate method for delivering CM teaching.

Conclusions

This study revealed that medical students felt their dietary counsulting skills could be improved with further clinically relevant teaching in the undergraduate medical curriculum. Students’ preferences for CM learning have been taken into consideration in the development of a CM course for fifth-year undergraduate students at a UK medical school, which is delivered during their General Practice placement.
Intermittent antegrade warm-blood versus cold-blood cardioplegia in children undergoing open heart surgery: a protocol for a randomised controlled study (Thermic-3)
Authors: Heys Rachael , Stoica Serban , Angelini Gianni , Beringer Richard , Evans Rebecca , Ghorbel Mohamed , Lansdowne William , Parry Andrew , Pieles Guido , Reeves Barnaby , Rogers Chris , Saxena Rohit , Sheehan Karen , Smith Stella , Walker-Smith Terrie , Tulloh Robert MR , Caputo Massimo
Published: October 2020

Introduction

Surgical repair of congenital heart defects often requires the use of cardiopulmonary bypass (CPB) and cardioplegic arrest. Cardioplegia is used during cardiac surgery requiring CPB to keep the heart still and to reduce myocardial damage as a result of ischaemia–reperfusion injury. Cold cardioplegia is the prevalent method of myocardial protection in paediatric patients; however, warm cardioplegia is used as part of usual care throughout the UK in adults. We aim to provide evidence to support the use of warm versus cold blood cardioplegia on clinical and biochemical outcomes during and after paediatric congenital heart surgery.

Methods and analysis

We are conducting a single-centre randomised controlled trial in paediatric patients undergoing operations requiring CPB and cardioplegic arrest at the Bristol Royal Hospital for Children. We will randomise participants in a 1:1 ratio to receive either ‘cold-blood cardioplegia’ or ‘warm-blood cardioplegia’. The primary outcome will be the difference between groups with respect to Troponin T levels over the first 48 postoperative hours. Secondary outcomes will include measures of cardiac function; renal function; cerebral function; arrythmias during and postoperative hours; postoperative blood loss in the first 12 hours; vasoactive-inotrope score in the first 48 hours; intubation time; chest and wound infections; time from return from theatre until fit for discharge; length of postoperative hospital stay; all-cause mortality to 3 months postoperative; myocardial injury at the molecular and cellular level.

Ethics and dissemination

This trial has been approved by the London – Central Research Ethics Committee. Findings will be disseminated to the academic community through peer-reviewed publications and presentation at national and international meetings. Patients will be informed of the results through patient organisations and newsletters to participants.

Trial registration number

ISRCTN13467772; Pre-results.
Determinants of usefulness in professional behaviour change interventions: observational study of a 15-year national program
Authors: Andrade Andre Q , LeBlanc Vanessa T , Kalisch-Ellett Lisa M , Pratt Nicole L , Moffat Anna , Blacker Natalie , Westaway Kerrie , Barratt John D , Roughead Elizabeth E
Published: October 2020

Objective

Educational, and audit and feedback interventions are effective in promoting health professional behaviour change and evidence adoption. However, we lack evidence to pinpoint which particular features make them most effective. Our objective is to identify determinants of quality in professional behaviour change interventions, as perceived by participants.

Design

We performed a comparative observational study using data from the Veterans’ Medicines Advice and Therapeutics Education Services program, a nation-wide Australian Government Department of Veterans’ Affairs funded program that provides medicines advice and promotes physician adoption of best practices by use of a multifaceted intervention (educational material and a feedback document containing individual patient information).

Setting

Primary care practices providing care to Australian veterans.

Participants

General practitioners (GPs) targeted by 51 distinct behaviour change interventions, implemented between November 2004 and June 2018.

Primary and secondary outcome measures

We extracted features related to presentation (number of images, tables and characters), content (polarity and subjectivity using sentiment analysis, number of external links and medicine mentions) and the use of five behaviour change techniques (prompt/cues, goal setting, discrepancy between current behaviour and goal, information about health consequences, feedback on behaviour). The main outcome was perceived usefulness, extracted from postintervention survey.

Results

On average, each intervention was delivered to 9667 GPs. Prompt and goal setting strategies in the audit and feedback were independently correlated to perceived usefulness (p=0.030 and p=0.005, respectively). The number of distinct behaviour change techniques in the audit and feedback was correlated with improved usefulness (Pearson’s coefficient 0.45 (0.19, 0.65), p=0.001). No presentation or content features in the educational material were correlated with perceived usefulness.

Conclusions

The finding provides additional evidence encouraging the use of behaviour change techniques, in particular prompt and goal setting, in audit and feedback interventions.
Readability in printed education materials for Chinese patients with systemic lupus erythematosus: a mixed-method design
Authors: Wang Qiuyi , Xie Lunfang , Wang Lei , Li Xing , Xu Liangmei , Chen Peiling
Published: October 2020

Objectives

To assess the readability of printed education materials (PEMs) for patients with systemic lupus erythematosus (SLE) and to explore the perceptions of patients with SLE with different health literacy regarding the readability of PEMs.

Design

A mixed-methods study, including a cross-sectional survey and semistructured interviews.

Setting

The SLE PEMs were collected from 13 hospitals in China. The interviews were conducted in the Department of Rheumatology of a hospital in Hefei, China.

Participants

In the cross-sectional survey, convenience sampling was used to select the Chinese SLE PEMs, with 20 PEMs included. In the qualitative study, the patients with SLE were divided into two groups based on their health literacy. Then, purposive sampling was used to select participants in each group, with 18 patients recruited.

Outcome measures

The readability of PEMs was assessed by the language analysis technology and the Chinese version of the Suitability Assessment of Materials (SAM-C) instrument.

Results

For text factors of readability, the mean Chinese language difficulty coefficient was 67.09±8.03, which indicates that the text of PEMs was difficult to read. For non-text factors, the mean SAM-C score was 45.62±9.51. Eight PEMs were rated not suitable, 12 were adequate and none were superior. In the interviews, eight categories were identified: information source, content, actionability, plain language, pictures, tables, numbers and layout. Patients with different health literacy had discrepant views on the detail of basic information, the necessity of question list, the location of functional pictures and the application of mathematical symbols.

Conclusions

The readability of Chinese SLE PEMs does not perform well, and it is necessary to reduce the difficulty of words, shorten the length of sentences and improve the picture design and actionability. To develop PEMs tailored to patients’ level of health literacy, patients’ unique view of readability should be integrated into the design of PEMs.