bluuebunny/crossref_metadata_2025 huggingface dataset:
Tracing trans-regional discursive flows in Pink Dot Hong Kong promotional videos
Authors: Rowlett Benedict J. L. , Go Christian
Published: July 2021

In this article, we extend discourse analytical research that has focused on Pink Dot events in Singapore to events in Hong Kong. As such we engage queer Sinophone perspectives to examine the simultaneously local and transregional epistemological flows that converge and diverge within the margins of the Sinophone cultural sphere. Using a multimodal analysis of two Pink Dot Hong Kong promotional videos, we investigate the extent to which these videos follow the (homo)normative and (homo)nationalist discursive strategies identified in the literature on Pink Dot Singapore. Our analysis suggests that ambivalences surrounding national identity, citizenship and state-sponsored national values in the Hong Kong videos bring into question readings of the Pink Dot movement as a (homo)nationalist enterprise, thus indicating an emergent relocalization of Pink Dot strategies that draws attention to how queer movements in Hong Kong are currently being shaped within the city’s broader sociopolitical context.
Ideological manoeuvres in and around Pink Dot
Authors: Lazar Michelle M.
Published: July 2021

This commentary comprises two parts. In the first part, different ways ‘ideological manoeuvres’ performed in and around
Pink Dot discourses in Singapore and Hong Kong, as evinced in this special issue, are highlighted. ‘Ideological manoeuvres’ refer to the
ideological actions and skilful management undertaken by social actors, explicitly or implicitly, to bring about or secure a tactical end in
support of, or in opposition to, the Pink Dot LGBT social movement. In the second part, how the ideological manoeuvres are on-goingly shaped
by, and shape, the geopolitics of gender/sexuality in Singapore and Hong Kong are discussed. In this regard, two areas are highlighted: the
politics of Pink Dot’s expressed apoliticism; and the transnational purchase of Pink Dot’s mode of political organising. Both of these areas
‘speak to’ a critical project on the decolonisation of gender/sexual knowledge-making and practice in these two Asian contexts.
Re-examining the role of mood selection type in Spanish heritage speakers’ subjunctive production
Authors: Perez-Cortes Silvia
Published: July 2021

Verbal morphology is a particularly vulnerable domain in the grammars of Spanish heritage speakers (HSs). Among
the most frequently studied phenomena is mood selection, identified as a pervasive locus of variability that affects the
production of subjunctive more prominently. The present article explores this area of research by examining the effects of mood
selection type on HSs’ subjunctive use. In contrast with previous studies, this investigation controls for propositional modality,
focusing its analyses on instances of obligatory and variable subjunctive selection within deontic predicates. Results from a
production task revealed that, despite the presence of between-group differences driven by participants’ levels of proficiency,
type of selection did not significantly modulate their rates of subjunctive use. These findings challenge previous claims about
the extent to which this factor affects Spanish HSs’ performance, and highlight the importance of considering propositional
modality when examining the acquisition of mood.
L-type channel inactivation balances the increased peak calcium current due to absence of Rad in cardiomyocytes
Authors: Ahern Brooke M. , Sebastian Andrea , Levitan Bryana M. , Goh Jensen , Andres Douglas A. , Satin Jonathan
Published: July 2021

The L-type Ca2+ channel (LTCC) provides trigger calcium to initiate cardiac contraction in a graded fashion that is regulated by L-type calcium current (ICa,L) amplitude and kinetics. Inactivation of LTCC is controlled to fine-tune calcium flux and is governed by voltage-dependent inactivation (VDI) and calcium-dependent inactivation (CDI). Rad is a monomeric G protein that regulates ICa,L and has recently been shown to be critical to β-adrenergic receptor (β-AR) modulation of ICa,L. Our previous work showed that cardiomyocyte-specific Rad knockout (cRadKO) resulted in elevated systolic function, underpinned by an increase in peak ICa,L, but without pathological remodeling. Here, we sought to test whether Rad-depleted LTCC contributes to the fight-or-flight response independently of β-AR function, resulting in ICa,L kinetic modifications to homeostatically balance cardiomyocyte function. We recorded whole-cell ICa,L from ventricular cardiomyocytes from inducible cRadKO and control (CTRL) mice. The kinetics of ICa,L stimulated with isoproterenol in CTRL cardiomyocytes were indistinguishable from those of unstimulated cRadKO cardiomyocytes. CDI and VDI are both enhanced in cRadKO cardiomyocytes without differences in action potential duration or QT interval. To confirm that Rad loss modulates LTCC independently of β-AR stimulation, we crossed a β1,β2-AR double-knockout mouse with cRadKO, resulting in a Rad-inducible triple-knockout mouse. Deletion of Rad in cardiomyocytes that do not express β1,β2-AR still yielded modulated ICa,L and elevated basal heart function. Thus, in the absence of Rad, increased Ca2+ influx is homeostatically balanced by accelerated CDI and VDI. Our results indicate that the absence of Rad can modulate the LTCC without contribution of β1,β2-AR signaling and that Rad deletion supersedes β-AR signaling to the LTCC to enhance in vivo heart function.
Multi-objective Optimization of Interferometric Array u–v Coverage
Authors: Zhang Rongyu , Yan Jingye , Wu Lin , Wu Ji
Published: July 2021

A new principle is introduced to optimize the configuration of an interferometric array, based on the trade-off between the uniform and Gaussian u–v distributions. The multi-objective optimization method, nondominated sorting genetic algorithm II (NSGA-II), is applied to achieve the optimal trade-off. The resulting array having a single configuration can meet the observation requirements of both compact and extended sources. This method has been successfully applied to design a 16-element array as the initial stage of the Daocheng Solar Radio Telescope to illustrate its feasibility. NSGA-II is improved by introducing artificial intervention into the genetic operator to solve the equality constraints. The improved NSGA-II is applied to obtain the Pareto optimal set, and a 16-element array configuration is retrieved with the best u–v trade-off between the snapshot mode and Earth rotation synthesis mode.
Eagle for better genome-wide association mapping
Authors: George Andrew W , Verbyla Arunas , Bowden Joshua
Published: July 2021

Eagle is an R package for multi-locus association mapping on a genome-wide scale. It is unlike other multi-locus packages in that it is easy to use for R users and non-users alike. It has two modes of use, command line and graphical user interface. Eagle is fully documented and has its own supporting website, http://eagle.r-forge.r-project.org/index.html. Eagle is a significant improvement over the method-of-choice, single-locus association mapping. It has greater power to detect SNP-trait associations. It is based on model selection, linear mixed models, and a clever idea on how random effects can be used to identify SNP-trait associations. Through an example with real mouse data, we demonstrate Eagle’s ability to bring clarity and increased insight to single-locus findings. Initially, we see Eagle complementing single-locus analyses. However, over time, we hope the community will make, increasingly, multi-locus association mapping their method-of-choice for the analysis of genome-wide association study data.
Combined video-assisted thoracoscopy surgery and posterior midline incision for en bloc resection of non-small-cell lung cancer invading the spine
Authors: Hireche Kheira , Moqaddam Mathieu , Lonjon Nicolas , Marty-Ané Charles , Solovei Laurence , Ozdemir Baris Ata , Canaud Ludovic , Alric Pierre
Published: July 2021

OBJECTIVES

This article aims to evaluate the feasibility and safety of a hybrid video-assisted thoracic surgery (VATS) approach to achieve en bloc lobectomy and spinal resection for non-small-cell lung cancer (NSCLC).

METHODS

Between October 2015 and November 2020, 10 patients underwent VATS anatomical lobectomy and en bloc chest wall and spinal resection through a limited posterior midline incision as a single operation for T4 (vertebral involvement) lung cancer. Nine patients had Pancoast syndrome without vascular involvement and 1 patient had NSCLC of the right lower lobe with invasion of T9 and T10.

RESULTS

There were 5 men and 5 women. The mean age was 61 years (range: 47–74 years). Induction treatment was administered to 9 patients (90%). The average operative time was 315.5 min (range: 250–375 min). The average blood loss was 665 ml (range: 100–2500 ml). Spinal resection was hemivertebrectomy in 6 patients and wedge corpectomy in 4 patients. Complete resection (R0) was achieved in all patients. The average hospitalization stay was 14 days (range: 6–50 days). There was no in-hospital mortality. The mean follow-up was 32.3 months (range: 6–66 months). Six patients (60%) are alive without recurrence.

CONCLUSIONS

VATS is feasible and safe to achieve en bloc resection of NSCLC inviding the spine without compromising oncological efficacy. Further experience and longer follow-up are needed to determine if this approach provides any advantages over thoracotomy.
Excess deaths reveal the true spatial, temporal and demographic impact of COVID-19 on mortality in Ecuador
Authors: Cuéllar Leticia , Torres Irene , Romero-Severson Ethan , Mahesh Riya , Ortega Nathaniel , Pungitore Sarah , Hengartner Nicolas , Ke Ruian
Published: July 2021

Accepted

Background

In early 2020, Ecuador reported one of the highest surges of per capita deaths across the globe.

Methods

We collected a comprehensive dataset containing individual death records between 2015 and 2020, from the Ecuadorian National Institute of Statistics and Census and the Ecuadorian Ministry of Government. We computed the number of excess deaths across time, geographical locations and demographic groups using Poisson regression methods.

Results

Between 1 January and 23 September 2020, the number of excess deaths in Ecuador was 36 402 [95% confidence interval (CI): 35 762–36 827] or 208 per 100 000 people, which is 171% of the expected deaths in that period in a typical year. Only 20% of the excess deaths are attributable to confirmed COVID-19 deaths. Strikingly, in provinces that were most affected by COVID-19 such as Guayas and Santa Elena, the all-cause deaths are more than double the expected number of deaths that would have occurred in a normal year. The extent of excess deaths in men is higher than in women, and the number of excess deaths increases with age. Indigenous populations had the highest level of excess deaths among all ethnic groups.

Conclusions

Overall, the exceptionally high level of excess deaths in Ecuador highlights the enormous burden and heterogeneous impact of COVID-19 on mortality, especially in older age groups and Indigenous populations in Ecuador, which was not fully revealed by COVID-19 death counts. Together with the limited testing in Ecuador, our results suggest that the majority of the excess deaths were likely to be undocumented COVID-19 deaths.
Launching an Electronic Patient-Reported Outcomes Initiative in Real-Time Clinical Practice
Authors: Palos Guadalupe R , Suarez-Almazor Maria E
Published: July 2021

Patient-reported outcomes play an essential role in improving care across the cancer continuum. This paper reports on the experience of a tertiary care center to standardize the use, collection, and reporting of patient-reported outcomes (PROs) in 10 disease-specific survivorship clinics. To minimize the burden of patients to complete surveys, an institutional committee with oversight on all patient surveys required an application be reviewed and approved before their distribution in a clinic. To begin collecting PROs, each clinic submitted an application tailored to its clinical operations, staffing, and scheduling characteristics. The dates for the submission of each application were staggered over a 2-year period, which contributed to a lack of uniformity in the project (ie, approval dates, start dates, collection and reporting of results). The delays were primarily due to the time and resources required to build the electronic version of the PRO survey into the institutional electronic medical record. To date, 6 of 10 survivorship clinics submitted applications, 5 were approved, and 4 launched the electronic MD Anderson Symptom Inventory (eMDASI) through the patient portal. Metrics collected between January 2019 and December 2020 for the thyroid, bone marrow transplant, genitourinary, and head and neck clinics indicated the numbers of eMDASIs sent to patients varied by clinic, with the lowest from the bone marrow transplant survivorship clinic (6) and the highest (746) in the thyroid Clinic. The total number of eMDASIs returned by the patients ranged from 2 (bone marrow transplant) to 429 (thyroid). Overall, patients’ return rates of the eMDASI ranged from 33.3% to 57.7%. Several strategies were implemented to increase the delivery, submission, and completion of eMDASIs. Our findings indicate the integration and implementation of PROs in survivorship clinics are achievable. Further work is needed to enhance the ePROs web-based process to adequately compare PROs across diverse cohorts of cancer survivors .
Intussusception after open Roux-en-Y gastric bypass managed with laparoscopic reduction
Authors: Marcoe Jeffrey P , Chau Wai Yip
Published: July 2021

Intussusception is a rare long-term complication following bariatric surgery. With unclear risk factors and a variable presentation, intussusception is often diagnosed in emergency departments on cross-sectional imaging. Due to the nature of the disease process, prompt involvement of a bariatric surgeon and operative intervention offers the best outcome. Here, we discuss two similar cases of jejunojejunal intussusception following open Roux-en-Y gastric bypass and abdominoplasty that were managed with operative reduction of the involved bowel.
The pentatricopeptide repeat protein EMP603 is required for the splicing of mitochondrialNad1intron 2 and seed development in maize
Authors: Fan Kaijian , Ren Zhenjing , Zhang Xiaofeng , Liu Yan , Fu Junjie , Qi Chunlai , Tatar Wurinile , Rasmusson Allan G , Wang Guoying , Liu Yunjun
Published: July 2021

Intron splicing is an essential event in post-transcriptional RNA processing in plant mitochondria, which requires the participation of diverse nuclear-encoded splicing factors. However, it is presently unclear how these proteins cooperatively take part in the splicing of specific introns. In this study, we characterized a nuclear-encoded mitochondrial P-type pentatricopeptide repeat (PPR) protein named EMP603. This protein is essential for splicing of intron 2 in the Nad1 gene and interacts with the mitochondria-localized DEAD-box RNA helicase PMH2-5140, the RAD52-like proteins ODB1-0814 and ODB1-5061, and the CRM domain-containing protein Zm-mCSF1. Further study revealed that the N-terminal region of EMP603 interacts with the DEAD-box of PMH2-5140, the CRM domain of Zm-mCSF1, and OBD1-5061, but not with OBD1-0814, whereas the PPR domain of EMP603 can interact with ODB1-0814, ODB1-5061, and PMH2-5140, but not with Zm-mCSF1. Defects in EMP603 severely disrupt the assembly and activity of mitochondrial complex I, leading to impaired mitochondrial function, and delayed seed development. The interactions revealed between EMP603 and PMH2-5140, ODB1-0814, ODB1-5061, and Zm-mCSF1 indicate a possible involvement of a dynamic ‘spliceosome-like’ complex in intron splicing, and may accelerate the elucidation of the intron splicing mechanism in plant mitochondria.
Using finite-state machines to automatically scan Ancient Greek hexameter
Authors: Schumann Anne-Kathrin , Beierle Christoph , Blößner Norbert
Published: July 2021

This article presents a fully automatic approach to the scansion of Ancient Greek hexameter verse. In particular, the article describes an algorithm that uses deterministic finite-state automata and local linguistic rules to implement a targeted search for valid spondeus patterns and, in addition, a weighted finite-state transducer to correct and complete partial analyses and to reject invalid candidates. The article also details the results of an empirical evaluation of the annotation quality resulting from this approach on hand-annotated data. It is shown that a finite-state approach provides quick and linguistically sound analyses of hexameter verses as well as an efficient formalization of linguistic knowledge. The project code is available online.1
New psychoactive substances, safety and mental health in prison officers
Authors: Kinman G , Clements A J
Published: July 2021

Background

The use of new psychoactive substances (NPS) in UK prisons is believed to have increased substantially. As well as posing a significant threat to prisoners’ health, NPS use can trigger violent, unpredictable and aggressive behaviour. Dealing with the direct and indirect effects of NPS therefore has the potential to compromise the physical and psychological safety of prison staff.

Aims

This study investigates prison officers’ perceptions of NPS use in their workplace and their risk of exposure. Relationships between NPS exposure, the workplace safety climate and mental health were also examined.

Methods

We assessed prison officers’ perceptions of the prevalence of NPS use among prisoners in their workplace, their personal exposure and the safety climate in their institution through an online survey. The General Health Questionnaire-12 measured mental health. Descriptive statistics were used to assess officers’ perceptions of NPS use in their workplace and their personal exposure and correlations examined relationships between variables.

Results

The sample comprised 1956 prison officers (86% male). Most respondents (85%) highlighted NPS as a serious cause for concern in their institution. Two-thirds (66%) reported being personally exposed to NPS at least sometimes, with 22% being exposed once a day or more. Significant relationships were found between officers’ perceived NPS exposure, assessments of safety climate and self-reported mental health.

Conclusions

Our findings highlight the need for urgent action to reduce the use of NPS among prisoners. This is likely to improve the safety climate of UK prisons and the mental health of staff.
Pain Location Is Associated with Fracture Type in Acute Osteoporotic Thoracolumbar Vertebral Fracture: A Prospective Observational Study
Authors: Zhang Haiping , Yang Bo , Hao Dingjun , Wang Biao , He Baorong , Sun Honghui , Li Hui , Zhang Xuefang
Published: July 2021

Objective

This study investigated the relationship between pain location and fracture type in patients with acute osteoporotic vertebral fracture (OVF).

Design

A prospective observational study.

Subject

A total of 306 patients with acute OVF were included.

Methods

The site of pain of each patient was recorded, and the patients were divided into a group with pain at the fracture site (group 1) and a group with pain at a non-fracture site (group 2). Fractures were classified into four types: type I, upper endplate type; type II, central type; type III, lower endplate type; and type IV, burst type.

Results

There were 146 patients in group 1, of whom 20.55% (30/146) had type I fractures, 33.56% (49/146) had type II fractures, 15.75% (23/146) had type III fractures, and 30.14% (44/146) had type IV fractures. There were 227 patients in group 2, of whom 57.27% (130/227) had type I fractures, 5.29% (12/227) had type II fractures, 35.24% (80/227) had type III fractures, and 2.20% (5/227) had type IV fractures. There was a statistical difference in the fracture type distribution between the two groups (P < 0.05). The visual analog scale score in group 1 was higher than that in group 2 at the initial diagnosis (P < 0.05).

Conclusions

For patients with acute OVF, the site of pain is related to the type of fracture. The pain at the fracture site is more often observed in the central type and burst type of fractures, whereas pain at a non-fracture site is more often observed in the upper and lower endplate types of fractures. Additionally, when OVF is suspected, radiological assessment of the thoracic and lumbar spine is recommended to better detect fractures that could cause pain distal to the site of the fracture.
Association of snoring characteristics with predominant site of collapse of upper airway in obstructive sleep apnea patients
Authors: Sebastian Arun , Cistulli Peter A , Cohen Gary , de Chazal Philip
Published: July 2021

Study Objectives

Acoustic analysis of isolated events and snoring by previous researchers suggests a correlation between individual acoustic features and individual site of collapse events. In this study, we hypothesized that multiparameter evaluation of snore sounds during natural sleep would provide a robust prediction of the predominant site of airway collapse.

Methods

The audio signals of 58 obstructive sleep apnea patients were recorded simultaneously with full-night polysomnography. The site of collapse was determined by manual analysis of the shape of the airflow signal during hypopnea events and corresponding audio signal segments containing snore were manually extracted and processed. Machine learning algorithms were developed to automatically annotate the site of collapse of each hypopnea event into three classes (lateral wall, palate, and tongue base). The predominant site of collapse for a sleep period was determined from the individual hypopnea annotations and compared to the manually determined annotations. This was a retrospective study that used cross-validation to estimate performance.

Results

Cluster analysis showed that the data fit well in two clusters with a mean silhouette coefficient of 0.79 and an accuracy of 68% for classifying tongue/non-tongue collapse. A classification model using linear discriminants achieved an overall accuracy of 81% for discriminating tongue/non-tongue predominant site of collapse and accuracy of 64% for all site of collapse classes.

Conclusions

Our results reveal that the snore signal during hypopnea can provide information regarding the predominant site of collapse in the upper airway. Therefore, the audio signal recorded during sleep could potentially be used as a new tool in identifying the predominant site of collapse and consequently improving the treatment selection and outcome.
Selling the Ability to “Have It All”: How Direct Selling Organizations Exploit Intensive Mothering Ideologies
Authors: Rees Mallory E
Published: July 2021

Drawing on 27 interviews with consultants in the direct selling industry, this article argues that consultants’ motivations to do stigmatized work with low financial rewards are tied to cultural pressures to adhere to intensive mothering ideologies. Some direct selling organizations in the United States are changing from a home party model—selling products out of homes—to a social commerce model—selling and recruiting using social media. Using a gendered organizations approach, these organizations portray themselves as feminine organizations, celebrating caregiving and allowing consultants—predominantly women—to reconcile work-family tensions through flexible work. Yet, this business model incentivizes a small number of financially successful consultants to train a much larger group to perform costly emotional labor for low pay. Consultants use the guilt tied to intensive mothering ideologies as a motivational tool in which they portray the cultural benefits of being a “good mother”—always available to and cultivating her children—as outweighing the emotional cost of doing stigmatized work that strains personal relationships. Rather than financially or emotionally supporting women, these organizations exploit women’s investments in finding individualized solutions to work-family conflict and reaffirm racialized, classed, and sexualized ideologies.
Identification, Laboratory, Greenhouse, and Field Handling of Aphanomyces euteiches on Pea (Pisum sativum)
Authors: Zitnick-Anderson Kimberly , Porter Lyndon D. , Hanson Linda E. , Pasche Julie S.
Published: July 2021

Aphanomyces euteiches is a destructive soilborne plant pathogen, causing economic losses when adequate to excess soil moisture is available. This oomycete organism survives in the soil for decades and infects and degrades roots of plants from 11 families. Symptoms of Aphanomyces root rot are similar across the major economic hosts alfalfa (Medicago sativa subsp. sativa L.), lentil (Lens culinaris Medik.), and pea (Pisum sativum L.). Initial symptoms include the appearance of grey, water-soaked root tissue. Roots develop a golden-brown color, and lateral roots begin to disintegrate as the disease worsens. In the most severe cases, the entire root system is destroyed and aboveground chlorosis and necrosis are observed. A. euteiches isolation can be successful from both infested soil and infected plant tissue. Macroscopically, colony growth is generally nondescript and white in color. A. euteiches is self-fertile (homothallic) and produces sexual oospores in culture in addition to asexual zoosporangia and zoospores (primary and secondary) on hyphae lacking regular septa (coenocytic). Numerous molecular techniques have been developed for successful A. euteiches detection. A. euteiches can be stored in frozen soil or on agar slants, but viability should be evaluated regularly. Oospores or zoospores have been utilized for inoculation under greenhouse and field conditions; although the generation of a field site using soil infestation techniques can take several seasons of productions of a susceptible crop to be utilized to effectively screen for Aphanomyces root rot.
Detection of Phytophthora capsici from Irrigation Ponds in South Georgia
Authors: Hudson Owen , Waliullah Sumyya , Ji Pingsheng , Hand Justin , Price Jake , Hancock Guy , Carlson Scott , Kichler Jeremy , Price Tucker , Dowdy Michasia , Hayes Brian , Ali Emran
Published: July 2021

Phytophthora capsici, the causal agent of Phytophthora blight, is a prominent and economically damaging oomycete pathogen in South Georgia. P. capsici causes crown, root, leaf, stem, and fruit infections on a wide range of vegetable crops. Oomycete pathogens such as P. capsici are dispersed in water, as their zoospores are flagellated and can move through runoff. Irrigation ponds are often reservoirs for different pathogens, and reusing the captured runoff is increasing in popularity to decrease irrigation costs. This combination allows for unintended outbreaks of diseases by pumping the contaminated runoff onto susceptible crops. Detection and identification of these pathogens are crucial steps in disease management, and rapid detection can ensure timely application of disease control measures. In this study, 42 irrigation ponds in nine counties from South Georgia were surveyed for the presence of P. capsici using a novel filtration method in conjunction with a LAMP assay specific for P. capsici. Ten ponds in five counties were found to have P. capsici as detected from the assay, suggesting that testing of irrigation ponds for P. capsici and other pathogens should be conducted to assist in preventing disease outbreaks.
Optimizing a Seedling Screening Method for Anthracnose Resistance in Watermelon
Authors: Correa Edgar , Crosby Kevin , Malla Subas
Published: July 2021

Among three races of Colletotrichum orbiculare, which cause anthracnose of cucurbits, screening for race 2 resistance was studied under greenhouse conditions at various inoculum concentrations, and plants were rated on different days postinoculation (DPI). The objectives of this study were optimizing inoculum concentration and phenotyping DPI for seedling resistance. Five inoculum concentrations were compared (2.5 × 104, 5 × 104, 1 × 105, 2.5 × 105, and 5 × 105 conidial spores/ml). Four watermelon genotypes (‘Black Diamond’, ‘Charleston Gray 133’, PI 543210, and PI 189225) and two cucumber genotypes (‘Marketer’ and ‘H19 Little Leaf’) were evaluated. Disease was recorded on the percentage of cotyledon area lesion, severity of hypocotyl lesion (SHL), severity of petiole lesion (SPL), and percentage of leaf area lesion (PLL), as well as a disease index (INDX) from 5 to 14 DPI. There was a significant difference among genotypes and inoculum concentrations. The resistant PI 189225 was significantly different (P < 0.05) from the highly susceptible PI 543210. Inoculum 1 × 105 spores/ml was at par with 5 × 105 and 2.5 × 105 but significantly different from 5 × 104 and 2.5 × 104 for AUDPS PLL, AUDPS INDX, AUDPS SPL, and AUDPS SHL. Inoculum at 1 × 105 spores/ml was optimal to differentiate germplasm. A genotype plus genotype-by-environment biplot showed that PLL was a representative rating. A single PLL rating on 9 DPI would optimize resources for screening a large set of germplasm for anthracnose resistance in a watermelon breeding program.
First Report of Alternaria alternata and Fusarium spp. Causing Brown Apical Necrosis in Walnut Fruit in Southern Chile
Authors: Moya-Elizondo Ernesto A. , Lagos María José , San Martin Juan , Ruiz Braulio
Published: July 2021

This is the first report of Alternaria alternata and Fusarium spp. causing brown apical necrosis (BAN) in walnut fruit in southern Chile. English walnut (Juglans regia L.) is the second most widely grown fruit in Chile. The bacterial pathogen Xanthomonas arboricola pv. juglandis affects walnut production in Chile and has been associated with apical necrosis symptom and premature fruit drop; this research focused on determining if fungal pathogens were associated with this damage. The presence of BAN in commercial walnut orchards in southern Chile reveals the need for improved phytosanitary programs to control this disease.
Reducing the sting
Authors: Boburka Samantha M.
Published: July 2021

Hymenoptera species include stinging insects such as wasps, hornets, bees, and fire ants. Allergic reaction to the venom of these insects is a common presenting complaint for patients in primary care and emergency medicine during warmer months. Patients' clinical presentations may vary, and clinicians must identify the type of reaction to determine treatment and follow-up plans. Treatment of patients allergic to Hymenoptera venom should be individualized based on risk factors, reaction type, and associated comorbidities. This article reviews common features of clinical presentation, diagnosis, and the current mainstays in management of Hymenoptera venom allergy.
Complex Adaptive Systems
Authors: Gilman Patricia R.
Published: July 2021

Chronic care management is a multidimensional phenomenon involving multilayered interaction, reaction, and adaptation responses to feedback within chronic care micro/macro- systems. Complex adaptive systems (CASs) consider interconnected dynamic relationships between discrete components of systems' internal and external environments. CAS is an applicable framework to examine components and networks within chronic care models. This article considers CAS as a framework for an alternate integrated patient-centered model that incorporates a holistic approach to chronic care. Recognizing relationships, behavioral patterns, and adaptive mechanisms informs health systems and health policy to influence service excellence improvements and quality of care and life within chronic disease populations.
A Middle-Range Theory of Nurses' Psychological Trauma
Authors: Foli Karen J.
Published: July 2021

Vicarious trauma, secondary trauma, and workplace violence are the common forms of psychological trauma associated with nurses. Additional areas of nurses' trauma have not been adequately described, defined, or conceptually organized in the literature. In this article, a new middle-range theory of nurses' psychological trauma is presented with a novel discourse of nurse-specific traumas, theoretical statements, and outcomes of psychological traumas that are unique to nurses and the professional worlds in which they live. A middle-range theory is forwarded so that future scholars may test this theory and derive implications for practice, education, policy, and research.
Early Opiate Analgesic Requirements Following Nonsurgically Managed Tibial Fractures in Children
Authors: Yap Rye Y. , Sultan Sanaah , Ahmad Husham , Marson Ben , Ikram Adeel , Ollivere Benjamin , Lawniczak Dominik
Published: July 2021

Background:

Many children with tibial fractures are currently being managed as outpatients. It is unclear how much opiates should be prescribed to ensure adequate analgesia at home without overprescription. This study aimed to evaluate the risk factors for requiring opiates following admission for tibial fractures and to estimate opiate requirements for children being discharged directly from the emergency department (ED).

Methods:

All children aged 4 to 16 years admitted with closed tibial fractures being treated in a molded circumferential above-knee plaster cast between October 2015 and April 2020 were included. Case notes were reviewed to identify demographics, analgesic prescriptions, and complications. Risk factors were analyzed using logistic regression.

Results:

A total of 75 children were included, of which 64% were males. The mean age was 9.5 (SD 3.4) years. Opiates were required by 36 (48%) children in the first 24 hours following admission. The median number of opiate doses in the first 48 hours was 0 (range: 0 to 5), with 93% of children receiving ≤3 doses. The odds of requiring opiates in the first 24 hours were unchanged for age above 10 years [odds ratio (OR)=0.85, 95% confidence interval (CI): 0.33-2.23], male sex (OR=1.58, 95% CI: 0.59-4.19), high-energy injury (OR=1.65, 95% CI: 0.45-6.04), presence of a fibula fracture (OR=2.21, 95% CI: 0.72-6.76), or need for fracture reduction in the ED (OR=0.57, 95% CI: 0.20-1.65). No children developed compartment syndrome, and the mean length of stay was 1.4 (SD 1.2) days. No children were readmitted following discharge.

Conclusions:

We have found no cases of compartment syndrome or extensive requirement for opiates following closed tibial fractures treated in plaster cast. These children are candidates to be discharged directly from the ED. We have not identified any specific risk factors for the targeting of opiate analgesics. We recommend a guideline prescription of 6 doses of opiates for direct discharge from the ED to ensure adequate analgesia without overprescription.

Level of Evidence:

Level IV—case series.
Development of Tuberculosis Spine Instability Score (TSIS)
Authors: Ahuja Kaustubh , Kandwal Pankaj , Ifthekar Syed , Sudhakar Pudipetti Venkata , Nene Abhay , Basu Saumyajit , Shetty Ajoy Prasad , Acharya Shankar , Chhabra Harvinder Singh , Jayaswal Arvind
Published: July 2021

Study Design.

An expert-panel consensus-based content validation and case-based clinical validation study.

Objective.

To develop a novel scoring system for diagnosing instability in tuberculosis (TB) spine using an expert-panel consensus followed by clinical validation for validating the content.

Summary of Background Data.

Currently, diagnosis of instability is primarily experience-based which may lead to considerable variability and misdiagnosis in the hands of a relatively in-experienced spine surgeon. Considering the potential complications this entity entails, a universally accepted scoring criteria is very important for accurate and uniform diagnosis of instability in TB spine.

Methods.

The development of TB spine instability score (TSIS) followed a two-step process, one designing the instrument and the other obtaining judgemental evidence. For judgemental evidence a panel of experts was appointed to make appropriate modifications and content validation for finalizing the scoring instrument. This score was applied on 30 patients of TB spine and receiver operating characteristic (ROC) curves were drawn for sensitivity and specificity analysis.

Results.

The comprehensive scoring criteria to diagnose instability in TB spine was approved after three rounds of expert panel discussions with an index of content validation more than 0.75 after final round of panel discussion. On case-based validation after plotting ROC curves, sensitivity and specificity for diagnosing stable and potentially unstable lesions at a cut-off score of 6 was 92.9% and 86.8% respectively whereas for diagnosing potentially unstable and unstable lesions at a cut-off score of 10 was 94.3% and 81.9%, respectively.

Conclusion.

TSIS is a comprehensive scoring system integrating demographic, anatomical, clinical, and radiological factors aimed at diagnosing instability in TB spine. The classification determines indications for surgical stabilization in patients with TB spine, with no or little neurological deficit.

Level of Evidence: 4
Monitoring Antihypertensive Medication Adherence by Liquid Chromatography–Tandem Mass Spectrometry: Method Establishment and Clinical Application
Authors: Wang Yue , Wang Joanne W. , Wang Yanbin , Yang Bing , Yinghua Du Alicia , Kong Ziqing , Chen Minglong , Wang Jie
Published: July 2021

Proper medication compliance is critical for the integrity of clinical practice, directly related to the success of clinical trials to evaluate both pharmacological-based and device-based therapies. Here, we established a liquid chromatography–tandem mass spectrometry method to accurately detect 55 chemical entities in the human urine sample, which accounting for the most commonly used 172 antihypertensive drugs in China. The established method had good accuracy and intraday and interday precision for all analyses in both bench tests and validated in 21 hospitalized patients. We used this method to monitor and ensure drug compliance and exclude the inferring impacts of medication compliance as a key confounder for our pivotal trial of a catheter-based, renal mapping and selective renal denervation to treat hypertension. It is found that in the urine samples from 92 consecutive subjects, 85 subjects (92.4%) were consistent with their prescriptions after 28 days run-in periods, 90 (97.8%) and 85 (95.5%) patients completely complied with their medications during the 3-month and 6-month follow-up period, respectively. Thus, using the liquid chromatography–tandem mass spectrometry method with specificity, accuracy, and precision, we ensured drug compliance of patients, excluded the key confounder of drug interferences, and ensured the quality of our device-based clinical trial for treatment of hypertension.
Precut Cast: An Easier and Less Stressful Cast Removal Procedure for Pediatric Patients
Authors: Tamaki Megumi , Dogo Kyoko , Fukuba Michiko , Komuro Yuzo , Okochi Masayuki
Published: July 2021

During hospitalization, pediatric patients or their parents may feel stressed. If patients need to stay in the hospital with a cast, they are prone to feeling more stressed. Fixation using a cast is an important clinical option, particularly in the case of skin grafts wherein fixation of the foot and ankle is essential to ensure the survival of the graft skin. However, the removal of the cast is also stressful for patients because it needs to be removed with a cast saw. To avoid further stress in pediatric patients, we cut the cast intraoperatively and then fixed the cast again using nylon cable ties. One week after surgery, we separated the patient’s cast. Instead of using a cast saw, we used only scissors or nippers. Our cast removal method was easy, safe, and less stressful.
Impact of Anaerobic Antibacterial Spectrum on Cystic Fibrosis Airway Microbiome Diversity and Pulmonary Function
Authors: Bozzella Michael J. , Chaney Hollis , Sami Iman , Koumbourlis Anastassios , Bost James E. , Zemanick Edith T. , Freishtat Robert J. , Crandall Keith A. , Hahn Andrea
Published: July 2021

Background:

The role of anaerobic organisms in the cystic fibrosis (CF) lung microbiome is unclear. Our objectives were to investigate the effect of broad (BS) versus narrow (NS) spectrum antianaerobic antibiotic activity on lung microbiome diversity and pulmonary function, hypothesizing that BS antibiotics would cause greater change in microbiome diversity without a significant improvement in lung function.

Methods:

Pulmonary function tests and respiratory samples were collected prospectively in persons with CF before and after treatment for pulmonary exacerbations. Treatment antibiotics were classified as BS or NS. Gene sequencing data from 16S rRNA were used for diversity analysis and bacterial genera classification. We compared the effects of BS versus NS on diversity indices, lung function and anaerobic/aerobic ratios. Statistical significance was determined by multilevel mixed-effects generalized linear models and mixed-effects regression models.

Results:

Twenty patients, 6–20 years of age, experienced 30 exacerbations. BS therapy had a greater effect on beta diversity than NS therapy when comparing time points before antibiotics to after and at recovery. After antibiotics, the NS therapy group had a greater return toward baseline forced expiratory volume at 1 second and forced expiratory flow 25%–75% values than the BS group. The ratio of anaerobic/aerobic organisms showed a predominance of anaerobes in the NS group with aerobes dominating in the BS group.

Conclusions:

BS antianaerobic therapy had a greater and possibly longer lasting effect on the lung microbiome of persons with CF, without achieving the recovery of pulmonary function seen with the NS therapy. Specific antibiotic therapies may affect disease progression by changing the airway microbiome.
Orbital Lipofibromatosis in a Pediatric Patient
Authors: Chang Angela Y. , North Victoria S. , Tran Ann Q. , Kazim Michael
Published: July 2021

A 10-month-old boy presented with a 3-month history of progressive left lower eyelid swelling. Examination demonstrated left lower eyelid fullness and hyperglobus with a fatty appearing inferior fornix mass. Imaging showed a mass isointense to fat in the left lower eyelid extending posteriorly, surrounding the inferior oblique with complete fatty infiltration, obscuration of the inferior rectus, and adherence to the globe. The patient underwent orbitotomy with biopsy and debulking of the tumor. Surgical pathology showed multiple fragments of adipose tissue with foci of plump and spindle-shaped cells arranged in bundles and fascicles, consistent with lipofibromatosis. This case illustrates a rare presentation of orbital lipofibromatosis in a pediatric patient.
Understanding Return to Work After Stroke Internationally: A Scoping Review
Authors: Green Theresa L. , McGovern Hugh , Hinkle Janice L.
Published: July 2021

BACKGROUND: Internationally, the changing landscape of diagnosis, treatment, and follow-up post stroke is resulting in a concomitant rise in the number of survivors still in the workforce. Return to work (RTW) is a common goal for adults after stroke; however, poststroke disabilities may limit occupational opportunities. This scoping review was undertaken to gain an understanding of the concept of RTW, how it is defined in the literature, types of research conducted on RTW after stroke, and characteristics of patients who do and do not RTW. We also wanted to gain an understanding of the interventions that were successful for RTW, their efficacy, and which healthcare professionals conducted such interventions. METHODS: Two authors reviewed articles using a customized data extraction tool. Adhering to current scoping review guidelines, data were collated and described using narrative and tables. RESULTS: A total of 48 studies were included in this scoping review: 34 quantitative, 11 qualitative, and 3 mixed method studies. The studies were conducted between the years 1998 and 2018, with more than half undertaken within the past decade and primarily in economically developed countries. DISCUSSION: Few interventions specifically targeted RTW as a primary outcome; most interventions were conducted by rehabilitation professionals with RTW measured by self-report. The nursing contribution was noticeably absent in the literature. CONCLUSIONS: Return to work has not been consistently operationalized in the literature. Although nurses are in a unique position to assist stroke survivors in their goal of RTW, how to do so remains elusive.
The Current Status of the Administrative Dispositions of Nurses: A Nationwide Survey in South Korea
Authors: KIM Suyoung , KIM Sanghee
Published: July 2021

Background

In South Korea, the professional role of nurse has been redefined from “assistant to” to “partner of” doctors as part of an overall national health promotion strategy.

Purpose

This descriptive survey was designed to describe the current status of administrative dispositions related to nurses in South Korea.

Methods

Data were collected between January 2014 and December 2018. The raw data were obtained from 3,553 public health centers nationwide after a request for the disclosure of information related to the administrative disposition of nurses in each city and province. The data included details on administrative dispositions, laws related to administrative dispositions, violations, and standards for administrative dispositions.

Results

Most of the nurses affected by administrative dispositions worked for primary and secondary healthcare providers. The most common type of administrative disposition was license suspension (n = 66, 80.5%), and most violations for administrative disposition involved unlicensed medical practice (n = 38, 46.3%). Nurses who had more-specific standards provided as evidence of the disposition faced longer periods of license suspension (p = .035).

Conclusions/Implications for Practice

Nurses should avoid providing nursing care to patients that is not in compliance with medical laws because the administrative action may vary depending on the violation and the severity of their legal infractions. This study was the first to examine administrative actions specifically affecting nurses in South Korea. The administrative actions of medical personnel were found to depend on the number and degree of violations. Nurses must understand the details of nurse-related administrative dispositions to avoid violating medical laws.
The Effect of Introduction of Motorized Stretchers on Hospital-Based Patient Transporter Injuries and Resultant Workers’ Compensation Costs
Authors: Mansfield Blythe , Shofer Frances S. , Green-McKenzie Judith
Published: July 2021

Manual stretchers cause more injuries than hydraulic stretchers in workers who transport patients.

Objective:

To evaluate the impact of introducing motorized stretchers on transporter injuries and resultant workers’ compensation costs.

Methods:

The number of transporters who sustained injuries related to stretcher manipulation, and associated workers’ compensation costs, before and after the introduction of motorized stretchers, was determined. The Wilcoxon Rank Sum test was used to examine costs and lost and restricted workdays.

Results:

The number of injuries and restricted work days decreased after motorized stretchers were introduced. Transporters incurred less lost work days (median 24.5 vs 7 days, P = 0.050).

Conclusions:

Motorized stretchers were associated with decreased injuries and lost work days.