bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct‐to‐consumer genetic testing for factor V Leiden and prothrombin 20210G>A: the consumer experience
Authors: Elson Sarah L. , Furlotte Nicholas A. , Hromatka Bethann S. , Wilson Catherine H. , Mountain Joanna L. , Rowbotham Helen M. , Varga Elizabeth A. , Francke Uta
Published: September 2020

Background

Clinical genetic testing for inherited predisposition to venous thromboembolism (VTE) is common among patients and their families. However, there is incomplete consensus about which individuals should receive testing, and the relative risks and benefits.

Methods

We assessed outcomes of receiving direct‐to‐consumer (DTC) results for the two most common genetic risk factors for VTE, factor V Leiden in the F5 gene (FVL) and prothrombin 20210G>A in the F2 gene (PT). Two thousand three hundred fifty‐four customers (1244 variant‐positive and 1110 variant‐negative individuals) of the personal genetics company 23andMe, Inc., who had received results online for F5 and F2 variants, participated in an online survey‐based study. Participants responded to questions about perception of VTE risk, discussion of results with healthcare providers (HCPs) and recommendations received, actions taken to control risk, emotional responses to receiving risk results, and perceived value of the information.

Results

Most participants (90% of variant‐positive individuals, 99% of variant‐negative individuals) had not previously been tested for F5 and/or F2 variants. The majority of variant‐positive individuals correctly perceived that they were at higher than average risk for developing VTE. These individuals reported moderate rates of discussing results with HCPs (41%); receiving prevention advice from HCPs (31%), and making behavioral changes to control risk (e.g., exercising more, 30%). A minority (36%) of variant‐positive individuals worried more after receiving VTE results. Nevertheless, most participants reported that knowing their risk had been an advantage (78% variant‐positive and 58% variant‐negative) and were satisfied knowing their genetic probability for VTE (81% variant‐positive and 67% variant‐negative).

Conclusion

Consumers reported moderate rates of behavioral change and perceived personal benefit from receiving DTC genetic results for VTE risk.
Complex dynamics of some models of antimicrobial resistance on complex networks
Authors: Ahmed Elsayd , Matouk Ahmed E.
Published: September 2020

Studying the spread of epidemics and diseases is a worldwide problem especially during the current time where the whole world is suffering from COVID‐19 pandemic. Antimicrobial resistance (AMR) and waning vaccination are classified as worldwide problems. Both depend on the exposure time to antibiotic and vaccination. Here, a simple model for competition between drug‐resistant and drug‐sensitive bacteria is given. Conditions for local stability are investigated, which agree with observation. Existence of positive solution in the AMR complex networks is proved. Dynamics of the identical AMR models are explored with different topologies of complex networks such as global, star, line, and unidirectional line networks coupled through their susceptible states. Chaotic attractors are shown to exist as the AMR models are located on all these topologies of complex networks. Thus, it is found that the dynamics of the AMR model become more complicated as it is located on either integer‐order or fractional‐order complex networks. Furthermore, a discretized version of the fractional AMR model is presented. Complex dynamics such as existence of Neimark–Sacker, flip bifurcations, coexistence of multiple attractors, homoclinic connections, and multiple closed invariant curves are investigated. Basin sets of attraction are also computed. Finally, the discretized system is located on complex networks with different topologies which show rich variety of complex dynamics. Also, 0–1 test is used to verify the existence of unpredictable dynamics. So, studying the dynamics of AMR models on complex networks is very helpful to understand the mechanism of spread of diseases.
Improving reports of health risks: Life history calendars and measurement of potentially traumatic experiences
Authors: Axinn William G. , Chardoul Stephanie
Published: September 2020

Objectives

Recall error biases reporting of earlier life experiences, even potentially traumatic experiences (PTEs). Better tools for accurate retrospective reporting of PTEs and other health risk factors have the potential for broad scientific and health intervention benefits.

Methods

We designed a life history calendar (LHC) to support this task and randomized more than 1000 individuals to each arm of a retrospective diagnostic interview, including detailed measures of PTEs, with and without the LHC. This is one of the largest experiments ever done to assess the benefit of an LHC approach and the only large‐scale experiment done in a poor, agrarian, non‐Western setting (rural Nepal).

Results

Results demonstrate use of an LHC in retrospective measurement can significantly increase lifetime reports of PTEs, especially reports of two or more PTEs. The LHC increases PTE reporting more for men and those with less education.

Conclusions

The LHC approach is practical for many uses ranging from large surveys of the general population to clinical intake of new patients. It significantly increases reporting of health risk factors.
On the interference from agar in chemical exchange saturation transfer MRI parameter optimization in model solutions
Authors: Mueller Sebastian , Scheffler Klaus , Zaiss Moritz
Published: September 2020

Chemical exchange saturation transfer (CEST) MRI is currently set to become part of clinical routine as it enables indirect detection of low concentrated molecules and proteins. Recently, intermediate to fast exchanging functional groups of glucose and its derivatives, glutamate and dextran, have gained attention as promising CEST contrast agents. To increase the specificity of CEST MRI for certain functional groups, the presaturation module is commonly optimized. At an early stage, this is performed in well‐defined model solutions, in which, for instance, the relaxation times are adjusted to mimic in vivo conditions. This often involves agar, assuming the substance would not yield significant CEST effects by itself, which the current study proves to be an invalid assumption. Model solutions at different pH values and concentrations of agar were investigated at different temperatures at a 9.4 T human whole body MR scanner. High power presaturation of around 4 μT, optimal for investigating intermediate to fast exchanging groups, was applied. Postprocessing included spatiotemporal corrections for B0 and spatial corrections for B1+. CEST effects of up to 3 % of the bulk water signal were observed. From pH, concentration and temperature dependency, it was concluded that the observed behavior reflects a CEST effect of agar. It was also shown how to remove this undesirable contribution from CEST MRI data. It was concluded that if agar is involved in the CEST MRI parameter optimization process, its contribution to the observed effects has to be taken into account. CEST agent concentration must be sufficiently high to be able to neglect the contribution of agar, or a control sample at matched pH is necessary for correction. Experiments on pure agarose showed reduced CEST effects compared with agar but did not provide a neutral baseline either.
The relationship between workplace bullying and professional self‐concept in Iranian nurses
Authors: Hosseini Amin , Mousavi Seyed Hossein , Hajibabaee Fatemeh , Haghani Shima
Published: September 2020

Aim

To determine the level of workplace bullying among Iranian nurses and its relationship with their professional self‐concept.

Design

This was a descriptive correlational study.

Methods

This study was performed on 200 nurses working in the emergency departments and intensive care units of Imam Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences, Iran, in 2020. The participants were chosen using the simple random sampling method and data collection tools were Negative Acts Questionnaire—Revised and Nurse Self‐Concept Questionnaire. The Pearson correlation coefficient was used to determine the relationship between workplace bullying and professional self‐concept.

Results

Based on the experience of daily or weekly workplace bullying, the mean scores of workplace bullying in nurses in terms of work‐related bullying, person‐related dimension and physical intimidation were 10.11%, 4.27% and 5.66%, respectively, and the overall mean score was 6.68%. The results of this study also showed that workplace bullying is inversely related to professional self‐concept and almost all of its dimensions (p = .002,r = −.219).
A modified Chebyshev ϑ‐weighted Crank–Nicolson method for analyzing fractional sub‐diffusion equations
Authors: Erfanifar Raziyeh , Sayevand Khosro , Ghanbari Nasim , Esmaeili Hamid
Published: September 2020

This study presents a robust modification of Chebyshev ϑ‐weighted Crank–Nicolson method for analyzing the sub‐diffusion equations in the Caputo fractional sense. In order to solve the problem, by discretization of the sub‐fractional diffusion equations using Taylor's expansion a linear system of algebraic equations that can be analyzed by numerical methods is presented. Furthermore, consistency, convergence, and stability analysis of the suggested method are discussed. In this framework, compact structures of sub‐diffusion equations are considered as prototype examples. The main advantage of the proposed method is that, it is more efficient in terms of CPU time, computational cost and accuracy in comparing with the existing ones in open literature.
Factors associated with achieving target serum uric acid level and occurrence of gouty arthritis: A retrospective observational study of Japanese health insurance claims data
Authors: Koto Ruriko , Nakajima Akihiro , Horiuchi Hideki , Yamanaka Hisashi
Published: September 2020

Purpose

This study assessed factors associated with achieving target serum uric acid (sUA) level and occurrence of gouty arthritis in Japanese clinical practice.

Methods

Japanese health insurance claims and medical check‐up data from October 2015 to March 2017 were analyzed to assess factors associated with target sUA achievement in gout and asymptomatic hyperuricemia and gouty arthritis in gout. Target sUA was further assessed by subgroup analysis of urate‐lowering therapy (ULT) prescriptions and outcomes, stratified by renal function.

Results

Patients achieving target sUA tended toward older, female, higher ULT dose, higher adherence, more comorbidities, and/or antidiabetic drugs prescribed. Renal dysfunction and/or diuretic prescriptions were associated with reduced achievement of target sUA. Severe renal dysfunction was particularly influential (odds ratio [OR] = 0.22 [95% confidence interval (CI): 0.10‐0.48] for <15, 0.15 [0.10‐0.23] for ≥15 to <30, compared with eGFR ≥90 mL/min/1.73 m2). Across all renal function categories, mean prescribed ULT dose was low (febuxostat 17.0‐21.0 mg/day, allopurinol 123.1‐139.6 mg/day), and target sUA achievement was reduced among renal dysfunction patients. Gouty arthritis was more likely in patients with a prior history of such occurrences, and less likely for higher ULT adherence, sUA monitored regularly at medical facilities, and/or more comorbidities.

Conclusion

In a real‐world setting, severe renal dysfunction is the most important risk factor for failure to achieve the target sUA, suggesting suboptimal disease management in patients with gout or hyperuricemia complicated by this condition. Findings associated with gouty arthritis suggest that these occurrences could be successfully managed by regular monitoring of sUA and closer adherence to ULT.
Biosourced vanillin Schiff base platform monomers as substitutes for DGEBA in thermoset epoxy
Authors: Desnoes Eric , Toubal Lotfi , Bouazza Amel Hadj , Montplaisir Daniel
Published: September 2020

Diglycidyl ether Schiff base monomers were prepared from vanillin and various diamines. FT‐IR, 1H NMR, 13C NMR, and mass spectroscopy were used to determine their structure. Cured thermoset epoxies made with them were compared to commercial epoxy in terms of mechanical properties. Tensile strengths ranged from 35.1 to 60.4 MPa, Young's modulus from 3.9 to 6.9 GPa, similar to the commercial product. The glass transition ranged from 80 to 117°C, the phase transition Tα from 80 to 121°C and the storage modulus from 2 to 3.5 GPa. Thermogravimetric analysis showed that the vanillin‐based epoxies were less heat resistant but had higher residual mass (20‐30% wt/wt). Hydrolysis, hydrophobicity and degradation were also monitored to evaluate their potential for coating applications.
Regulation of autophagy by high‐ and low‐risk human papillomaviruses
Authors: Aranda‐Rivera Ana Karina , Cruz‐Gregorio Alfredo , Briones‐Herrera Alfredo , Pedraza‐Chaverri José
Published: September 2020

While high‐risk human papillomavirus (HR‐HPV) infection is related to the development of cervical, vulvar, anal, penile and oropharyngeal cancer, low‐risk human papillomavirus (LR‐HPV) infection is implicated in about 90% of genital warts, which rarely progress to cancer. The carcinogenic role of HR‐HPV is due to the overexpression of HPV E5, E6 and E7 oncoproteins which target and modify cellular proteins implicated in cell proliferation, apoptosis and immortalization. LR‐HPV proteins also target and modify some of these processes; however, their oncogenic potential is lower than that of HR‐HPV. HR‐HPVs have substantial differences with LR‐HPVs such as viral integration into the cell genome, induction of p53 and retinoblastoma protein degradation, alternative splicing in HR‐HPV E6‐E7 open reading frames, among others. In addition, LR‐HPV can activate the autophagy process in infected cells while HR‐HPV infection deactivates it. However, in cancer HR‐HPV might reactivate autophagy in advance stages. Autophagy is a catabolic process that maintains cell homoeostasis by lysosomal degradation and recycling of damaged macromolecules and organelles; nevertheless, depending upon cellular context autophagy may also induce cell death. Therefore, autophagy can contribute either as a promotor or as a suppressor of tumours. In this review, we focus on the role of HR‐HPV and LR‐HPV in autophagy during viral infection and cancer development. Additionally, we review key regulatory molecules such as microRNAs in HPV present during autophagy, and we emphasize the potential use of cancer treatments associated with autophagy in HPV‐related cancers.
Invasive Japanese knotweed (Reynoutria japonica Houtt.) and related knotweeds as catalysts for streambank erosion
Authors: Colleran Brian , Lacy Shaw Nozaki , Retamal Maria Rafaela
Published: September 2020

Japanese knotweed (Reynoutria japonica) and the other invasive knotweeds, collectively known as knotweed s.l., are significant invasives worldwide, especially of riparian areas. While R. japonica and other knotweed s.l. can reproduce sexually, their dispersal to and spread within new regions is often accomplished through vegetative reproduction from rhizome and stem fragments. Once established, knotweed s.l. can displace riparian plants, meaning that soil stability once provided by displaced roots is lost, carrying significant knock‐on implications for watershed management. We propose that knotweed s.l. rhizomes both displace roots and the structure they provide to soil, and also amplify bank‐erosion forces, especially during floods. Further, erosive forces create propagules, with larger flow events creating larger numbers of propagules and providing the vector for short‐ and long‐distance downstream spread within the watershed. Induced erosion is therefore the main driver of knotweed s.l. invasions along waterways. As some hydrological regimes shift towards more frequent and severe storm events in response to climate change, positive feedback loops may develop in these regions between existing knotweed s.l. populations, sudden riverbank failure, and increased flood‐related damage, with presumably significant impacts on riparian infrastructure. While the continued spread of this invasive could have significant riparian flood resiliency consequences if left unchecked, mindful action to control these plants is likely to be beneficial financially, socially, and ecologically within any invaded watershed.
Boost morale and productivity, decrease stress by engaging in authentic conversations
Authors: McCarthy Claudine
Published: September 2020

Remote work, Zoom meetings, emails, texts, and social media can help you stay connected to career and family while limiting your exposure to the COVID‐19 virus, but they won't protect you from catching the loneliness bug triggered by limiting your exposure to chit‐chat.
Apply 10 tips for more effective communication
Authors: McCarthy Claudine
Published: September 2020

Sometimes it just seems easier to send a quick text or email rather than actually talking. After all, conversations take time and sometimes don't go well, but that's the other person's fault, right?
Autocombustion‐Promoted Synthesis of Lanthanum Iron Oxide: Application as Heterogeneous Catalyst for Synthesis of Piperidines, Substituted Amines and Light‐Assisted Degradations
Authors: Pratibha  , Rajput Jaspreet K.
Published: September 2020

An autocombustion technique was adopted to synthesize the Perovskite structured Lanthanum iron oxide nanoparticles (LaFeO3, abbreviated as LFO NPs). This technique offered lots of benefits such as short reaction time along with quick heating rate. LFO NPs were fabricated at different calcination temperatures (300‐800 °C) through the aid of sucrose as chelating agent. The prepared LFO NPs were well characterized by various techniques like X‐ray diffraction (XRD), Fourier transform infrared spectroscopy (FT‐IR), Vibrating sample magnetometer (VSM), Ultraviolet‐Visible spectroscopy (UV‐Vis), Brunauer–Emmett–Teller (BET), X‐ray Photo‐Electron Spectroscopy (XPS) and Transmission electron microscopy (TEM) which affirmed that highly crystalline LFO NPs were obtained at 700 °C. Subsequently, the catalytic activity of the LFO NPs was surveyed for three independent approaches: (i) for the synthesis of functionalized piperidines through activation of carbonyl groups in the reacting partners (ii) for the sunlight‐assisted mineralization of health hazardous food colorant, Allura Red AC (iii) for the hydrogenation of nitro aromatic compounds (NACs) using NaBH4 (sodium borohydride) as source of hydrogen in aqueous medium at room temperature.
Idiopathic multifocal myocardial atrophy with fibrosis and fatty infiltration involving Purkinje fibres in a 13‐year‐old Arabian broodmare: Histopathological features
Authors: Goto Asakawa Midori , Mehmood Wasiq , Ali Mohammad , Oikawa Masa‐aki
Published: September 2020

Myocardial atrophy with fibrosis and fatty infiltration involving the cardiac conduction system is relatively unusual in horses. We herein report of such a case in a 13‐year‐old Arabian broodmare that had spontaneously died on a paddock. An autopsy revealed multifocal myocardial atrophy with concomitant fibrosis and fatty infiltration in both the ventricles and interventricular septum. The Purkinje fibres in the ventricles and interventricular septum were surrounded by thick fibrous or adipose tissues adjacent to atrophic myocardial cells. Myocardial fibrosis and fatty infiltration were likely secondary to myocardial atrophy, occurring as a pathological response triggered by the repair of muscular wall injury. However, there were no major vascular pathologies (e.g. atherosclerosis and arteriosclerosis); hence, the pathogenesis of myocardial atrophy was unclear. There was no evidence of myocardial atrophy ̵ induced pathologies such as infarct, ischaemic lesions, myocardial degeneration, myocarditis and endocarditis. However, such an unusual histopathological pattern may be associated with rapid clinical deterioration and death.
Inequalities in the Impact of the Carbon Tax in Japan
Authors: Inoue Nozomu , Matsumoto Shigeru , Morita Minoru
Published: September 2020

Although Japan’s current carbon tax rate is much lower than the rates applied in European countries, the Japanese government may increase the tax rate in the near future, in order to strengthen measures to combat global warming. Since a country’s carbon-pricing policy does not distort its economy, it is considered to be an efficient policy measure. However, the burden of carbon pricing varies across regions and across households. Since low-income households generally allocate a larger proportion of their disposable income to energy costs than high-income households, the burden of carbon taxes on low-income households tends to be higher than for high-income households. In addition, households in cold regions spend more money for space heating, and those in rural areas spend more money for gasoline. Unless the government objectively analyzes the impact of carbon pricing and proposes convincing countermeasures to deal with these unequal impacts, the government is unlikely to obtain public support for a carbon tax increase. In this study, we analyze microlevel data from the Japanese National Survey of Family Income and Expenditure (NSFE) collected from 1989 to 2014, and examine how past energy price changes affected the welfare of different types of households. We then propose countermeasures to address the problems arising from the regressive nature of taxing energy use.
Double Dividend of the Carbon Tax in Japan: Can We Increase Public Support for Carbon Pricing?
Authors: Asakawa Kenji , Kimoto Kouichi , Takeda Shiro , Arimura Toshi H.
Published: September 2020

Carbon pricing is difficult to introduce in many countries because it is not easy to obtain public support for carbon pricing due to the burden associated with it. One way to overcome this difficulty is to rely on the double dividend of a carbon tax. If a government uses revenue from a carbon tax to reduce existing distorting taxes, such as corporate taxes or labor taxes, a carbon tax can improve economic efficiency while reducing greenhouse gas (GHG) emissions. This chapter examines the net burden of a carbon tax with revenue recycling (RR) for two types of stakeholders: firms and households. Using dynamiccomputable general equilibrium (CGE) modeling, we examine the carbon prices needed to achieve the emission targets set for 2030 and 2050. Then, we simulate two types of RR: corporate tax reduction and a reduction in social security payments. We compare the benefit of the tax reduction to the increase in the burden from the carbon tax in scenarios for 2030/2050. In the scenario of corporate tax reduction, by selecting firms from the land transportation sector and power sector, we examine how profit changes due to the carbon tax. We find that the tax burden for a firm in the land transportation sector can be eased greatly with the corporate tax reduction. In the scenario of the social security payment reduction, we find that some households are better off under carbon pricing despite expenditure increases due to the carbon tax. Thus, we show that RR can increase support for the carbon tax.
Climate Policy in Transportation Sector: Role of Carbon Pricing
Authors: Iwata Kazuyuki
Published: September 2020

This chapter focuses on climate countermeasures in the Japanese transport sector. We introduce the Japanese complexed automobile tax system and then calculate the Japanese effective carbon rate (ECR) on automobiles. In addition to the discussion of the ECR, this chapter offers a simple examination of the efficiency of electric vehicles (EVs) from the viewpoint of cost-benefit because it is expected that EVs will become the most popular eco-friendly vehicle in the future. Two remarks are found in our analysis. First, although the carbon tax rate on fuel consumption is small in Japan, compared to the European countries, the ECR is rather high. For further improvement of climate policy, the Japanese government should shift its attention to vehicle usage from vehicle purchase and possession. Second, under the basic assumption (i.e., representative owners do not recharge their EVs at home but at outdoor fast chargers), the diffusion of EVs is not an efficient measure for reducing GHG emissions. If owners recharge their EVs at home once of every two charges, the net benefit becomes positive Therefore, the opportunity cost of waiting for recharges is a key factor in whether EVs can play a role in mitigating climate change.
An Assessment of Carbon Taxation by Input–Output Analysis: Upstream or Downstream?
Authors: Washizu Ayu , Nakano Satoshi
Published: September 2020

To analyze the ripple effects of CO2 emissions from the introduction of renewable energy power plants, this study developed input–output tables for analysis of next-generation energy systems (IONGES). The results revealed that the environmental benefits obtained from investing in power plants of the same capacity vary significantly depending on the type of renewable energy. Using the IONGES, under assumptions of three carbon taxation methods (upstream, midstream, and downstream), we calculated the taxable CO2 emissions induced when producing each good or service and estimated the carbon tax burden associated with the final demand. We found that, in the upstream method, the taxation effects of one unit of carbon tax is concentrated in energy goods such as coal products and petroleum basic, while the effects are relatively dispersed in the downstream taxation method. If renewable energy is added to the government target level in 2030, taxable CO2 emissions will decrease by 12–13.3%. Compared with the upstream taxation method, in the midstream and downstream methods, the CO2 emissions induced by each final demand are distributed more evenly across various goods and services. Compared to the downstream taxation method, upstream taxation leads to higher CO2 emissions from exports, but lower CO2 emissions from household consumption. This is because energy-intensive industries such as machinery have high export ratios. We analyzed which expenditure categories contribute to the carbon tax burden associated with household consumption. In the case of upstream taxation, households mainly focus on reducing electricity consumption; in the case of downstream taxation, households reduce consumption of various energy-intensive goods and services.
The νR-philic scalar: its loop-induced interactions and Yukawa forces in LIGO observations
Authors: Xu Xun-Jie
Published: September 2020

Abstract

Right-handed neutrinos (νR) are often considered as a portal to new hidden physics. It is tempting to consider a gauge singlet scalar (ϕ) that exclusively couples to νR via a νRνRϕ term. Such a νR-philic scalar does not interact with charged fermions at tree level but loop-induced effective interactions are inevitable, which are systematically investigated in this work. The magnitude of the loop-induced couplings coincidentally meets the current sensitivity of fifth-force searches. In particular, the loop-induced coupling to muons could be tested in the recent LIGO observations of neutron star mergers as there might be a sizable Yukawa force in the binary system mediated by the νR-philic scalar.
A global analysis strategy to resolve neutrino NSI degeneracies with scattering and oscillation data
Authors: Dutta Bhaskar , Lang Rafael F. , Liao Shu , Sinha Samiran , Strigari Louis , Thompson Adrian
Published: September 2020

Abstract

Neutrino non-standard interactions (NSI) with the first generation of standard model fermions can span a parameter space of large dimension and exhibit degeneracies that cannot be broken by a single class of experiment. Oscillation experiments, together with neutrino scattering experiments, can merge their observations into a highly informational dataset to combat this problem. We consider combining neutrino-electron and neutrino-nucleus scattering data from the Borexino and COHERENT experiments, including a projection for the upcoming coherent neutrino scattering measurement at the CENNS-10 liquid argon detector. We extend the reach of these data sets over the NSI parameter space with projections for neutrino scattering at a future multi-ton scale dark matter detector and future oscillation measurements from atmospheric neutrinos at the Deep Underground Neutrino Experiment (DUNE). In order to perform this global anal- ysis, we adopt a novel approach using the copula method, utilized to combine posterior information from different experiments with a large, generalized set of NSI parameters. We find that the contributions from DUNE and a dark matter detector to the Borexino and COHERENT fits can improve constraints on the electron and quark NSI parameters by up to a factor of 2 to 3, even when relatively many NSI parameters are left free to vary in the analysis.
Antibiotikaverordnungen bei Atemwegsinfektionen im Kindesalter
Authors: Exner Valentin , Höser Christoph , Trapp Stefan , Simon Arne
Published: September 2020

Hintergrund

Ambulant behandelte Kinder mit Atemwegsinfektionen (AWI) sind eine wichtige Zielgruppe für Interventionen zum rationalen und verantwortungsvollen Einsatz von Antibiotika (Antibiotic Stewardship, ABS).

Ziel der Studie

Qualitative Studie zur Identifizierung von klinischen und kontextualen Faktoren mit signifikantem Einfluss auf die Antibiotikatherapie (ABT) bei Kindern mit AWI.

Material und Methoden

In Kooperation mit dem Berufsverband der Kinder- und Jugendärzte e. V. und der Deutschen Gesellschaft für Pädiatrische Infektiologie wurde ein Online-Survey entwickelt. Bundesweit wurden Pädiater und Allgemeinmediziner zur Teilnahme eingeladen.

Ergebnisse

555 Antwortdatensätze waren auswertbar. Diagnostische Unsicherheit, fehlende Zeitressourcen für wiederholte Konsultationen und die Angst vor Komplikationen waren bei 50 % der Teilnehmenden wichtige Kontextfaktoren für eine ABT. Das Risiko schwerer Komplikationen (z. B. Mastoiditis) wurde von der Mehrheit der Teilnehmenden überschätzt oder war unbekannt. Mehr als 40 % kannten die Konsensusleitlinien der Fachgesellschaften nicht. Fieber, das länger als 3 Tage anhält, war für 30–40 % ein klinisches Argument für eine ABT. Weniger als 60 % nutzten eine Point-of-Care-Diagnostik zur Bestimmung des C‑reaktiven Proteins.

Schlussfolgerung

Die überwiegende Mehrheit der Teilnehmenden erkannte die Zunahme antibiotikaresistenter Erreger als wichtiges Problem. Dieser Survey zeigt Ansatzpunkte für ABS bei Kindern mit AWI. Die kontinuierliche Vermittlung von Kenntnissen zur adäquaten ABT sollte obligater Bestandteil der ärztlichen Fortbildung werden. Dazu gehören Kommunikationsstrategien in der Interaktion mit den Eltern. Für die Umsetzung einer rationalen Antibiotikatherapie wird in der Praxis ein größeres refinanziertes Zeitkontingent zur Beratung der Eltern benötigt.
GOPS: efficient RBF surrogate global optimization algorithm with high dimensions and many parallel processors including application to multimodal water quality PDE model calibration
Authors: Xia Wei , Shoemaker Christine
Published: September 2020

This paper describes a new parallel global surrogate-based algorithm Global Optimization in Parallel with Surrogate (GOPS) for the minimization of continuous black-box objective functions that might have multiple local minima, are expensive to compute, and have no derivative information available. The task of pickingPnew evaluation points forPprocessors in each iteration is addressed by sampling around multiple center points at which the objective function has been previously evaluated. The GOPS algorithm improves on earlier algorithms by (a) new center points are selected based on bivariate non-dominated sorting of previously evaluated points with additional constraints to ensure the objective value is below a target percentile and (b) as iterations increase, the number of centers decreases, and the number of evaluation points per center increases. These strategies and the hyperparameters controlling them significantly improve GOPS’s parallel performance on high dimensional problems in comparison to other global optimization algorithms, especially with a larger number of processors. GOPS is tested with up to 128 processors in parallel on 14 synthetic black-box optimization benchmarking test problems (in 10, 21, and 40 dimensions) and one 21-dimensional parameter estimation problem for an expensive real-world nonlinear lake water quality model with partial differential equations that takes 22 min for each objective function evaluation. GOPS numerically significantly outperforms (especially on high dimensional problems and with larger numbers of processors) the earlier algorithms SOP and PSD-MADS-VNS (and these two algorithms have outperformed other algorithms in prior publications).
Inclusion and equity in education: Making sense of global challenges
Authors: Ainscow Mel
Published: September 2020

This article provides an introductory commentary to the papers in this Prospects special issue on inclusive education. In so doing, it stresses the need to be cautious as we read accounts of inclusive education from other parts of the world: whilst lessons can undoubtedly be learned from the accounts in this special issue, they must be adopted with care. There is no doubt that evidence of various kinds can help in identifying the barriers facing some learners and the resources that can be used to overcome these difficulties. However, efforts to promote inclusion and equity within education systems should be based on an analysis of particular contexts. To that end, this article outlines a research-based framework that can be used to carry out such contextual analyses. The article concludes by arguing that an emphasis on inclusion and equity can potentially improve the quality of education for all young people within a national education system.
A new methodology for analyzing vehicle network topologies for critical hacking
Authors: Ghadi Maen , Sali Ádám , Szalay Zsolt , Török Árpád
Published: September 2020

This study aims to provide a new approach for describing and measuring the vulnerability of in-vehicle networks regarding cyberattacks. Cyberattacks targeting in-vehicle networks can result in a reasonable threat considering passenger safety. Unlike previous literature, the methodology focuses on a comparatively large sample of vehicle networks (114 objects) by proposing a new framework of statistical techniques for measuring, classifying, and modelling in-vehicle networks concerning the changed vulnerability, instead of dealing with each vehicle network individually. To facilitate understanding of the vulnerability patterns of in-vehicle networks, the dataset has been evaluated through three analytic stages: vulnerability identification, classification, and modeling. The result has helped in ranking vehicles based on their network vulnerability level. The result of the modeling has shown that every additional remote endpoint installation causes a relevant weakening in security. Higher cost vehicles have also appeared to be more vulnerable to cyberattacks, while the increase in the number of segmented network domains has had a positive effect on network security.
Geoelectric evaluation of groundwater potential: a case study at Omuma local government area, Rivers State, Nigeria
Authors: Abbey M. E. , Onyebueke D. E.
Published: September 2020

Rivers State as the nomenclature depicts is a state richly blessed with both surface and subsurface water. As a result of this, there is less problem of water scarcity, especially in the elite cities of the state, but so many other communities due to one reason or the other still wallow in abject water scarcity. In this survey, a total of seven (7) vertical electric soundings were carried out using Schlumberger configuration at Obibi community in Omuma local government area, Rivers State, to ascertain the location and depths to aquifer. ABEM terrameter SAS 300 was used in the survey with electrode spacing AB/2 of 150 m, thus probing to a depth of about 200 m. Geoelectric software (IPI2WIN) was utilized in the plotting, iteration and interpretation of the resistivity data obtained. From the quantitative interpretation and the lithology of the areas, five different subsurface layers were delineated with their geoelectric curve given as AK, AKQ and AKH. Aquifer in these areas is highly prolific and mostly located at an average depth of 52 m.
Biochar from co-pyrolysis of urban organic wastes—investigation of carbon sink potential using ATR-FTIR and TGA
Authors: Nair Rahul Ramesh , Mondal Moni M , Weichgrebe Dirk
Published: September 2020

Urban organic wastes (UOW) strain the infrastructures for solid waste treatment (SWT) in emerging economies. This study investigated biochar gained from three major UOW sources in India—banana peduncles (BP), a fibrous waste, from fruit markets; sewage sludge (SS) from wastewater treatment plants; and anaerobic digestate (AD) from food and market waste processing facilities—in terms of its potential to sequester and become long-term carbon sink in soils. Herein, the chemical properties (using ATR-FTIR) and thermal oxidative stability (using TGA) of biochars derived from these UOW and their three blends were examined. Biochar from SS and AD and the blends were found to possess more ash content, Cl, and alkali and alkaline earth metals (AAEM) than that from BP. The conventional recalcitrance index (R50) could not quantify and compare the stability of these mineral- and ash-rich biochars. Hence, a modified thermal oxidative recalcitrance index (TORi) is proposed. All the biochar from blends prepared at highest treatment temperature of 650 °C shows similar aromaticity. However, biochar from blend of 50% SS, 30%BP, and 20% AD exhibits the highest recalcitrance (TORi = 0.193) to become a long-term carbon sink in soil. More than aromaticity, the influence of Si, Fe, and AAEM on the biochar matrix affects its recalcitrance. Variations in the structural properties and recalcitrance of biochars from blends are attributable to the synergy among their constituents SS, AD, and BP. The determined TORi confirms the potential of biochar from the blends of UOW as a long-term carbon sink.
Remote sensing of fish-processing in the Sundarbans Reserve Forest, Bangladesh: an insight into the modern slavery-environment nexus in the coastal fringe
Authors: Jackson Bethany , Boyd Doreen S. , Ives Christopher D. , Decker Sparks Jessica L. , Foody Giles M. , Marsh Stuart , Bales Kevin
Published: September 2020

Land-based fish-processing activities in coastal fringe areas and their social-ecological impacts have often been overlooked by marine scientists and antislavery groups. Using remote sensing methods, the location and impacts of fish-processing activities were assessed within a case study of Bangladesh’s Sundarbans mangrove forests. Ten fish-processing camps were identified, with some occurring in locations where human activity is banned. Environmental degradation included the removal of mangroves, erosion, and the destruction of protected areas. Previous studies have identified cases of labour exploitation and modern slavery occurring within the Sundarbans, and remote sensing was used to triangulate these claims by providing spatial and temporal analysis to increase the understanding of the operational trends at these locations. These findings were linked to the cyclical relationship between modern slavery and environmental degradation, whereby environmental damage is both a driver and result of workers subjected to modern slavery. Remote sensing can be used as an additional methodological tool to support the achievement of the Sustainable Development Goals (SDGs) and provide evidence to support the promotion of the “freedom dividend” which would have far-reaching economic, social, cultural, and environmental benefits. Satellite remote sensing is likely to play an important role going forward for understanding these issues but should be augmented with ground-based data collection methods.
Factors influencing dissolution of carbonaceous materials in liquid Fe–Mn
Authors: Kaffash Hamideh , Tangstad Merete
Published: September 2020

Carbon dissolution from four types of metallurgical cokes and graphite was investigated by using immersion rods in a resistance furnace to clarify the influence of factors governing the rate of carbon dissolution from carbonaceous materials into Fe–Mn melts at 1550 °C. The factors studied were the microstructure of carbonaceous materials, roughness, porosity and the wettability between carbonaceous materials and the melt. Carbon/metal interface was characterised by scanning electron microscopy accompanied with energy-dispersive X-ray spectrometry to investigate the formation of an ash layer. The results showed that coke E had the highest dissolution rate. Surface roughness and porosity of the carbonaceous materials seemed to be dominant factors affecting the dissolution rates. Further, crystallite size did not have a significant effect on the dissolution rates. Solid/liquid wettability seemed to affect the initial stage of dissolution reaction. The dissolution mechanism was found to be both mass transfer and interfacial reactions.
Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using midazolam or fentanyl associated with propofol
Authors: Magnus Gisela , de Freitas Flausino Gustavo , de Siqueira Caroline Guimaraes Dantas , Coelho Gabriela Carvalho Simões , Caetano Maria Eduarda Casasanta , Gomez Renato Santiago
Published: September 2020

Objective Comparison of post-anesthesia recovery time in sedated patients for colonoscopy using two drug combinations: midazolam and propofol or fentanyl and propofol.

Method Fifty patients ASA I and II, from 18 to 65 years of age, candidates for elective colonoscopy under sedation administered by an anesthesiologist, were randomized in two groups: Group A (midazolam and propofol) and Group B (fentanyl and propofol). Each patient was evaluated as for the length of the exam (Exam length), length of stay in the post-anesthesia care unit 1 and 2 (LSPACU1 and LSPACU2) and hospital discharge. Episodes of awakening, and of movement, drop in SpO2 < 90%, need for mechanical ventilation, propofol consumption, heart rate (HR) and mean blood pressure (MBP) were also evaluated.

Results Patients of group B had a recovery time in LSPACU1 statistically shorter than that for those in group A. In both groups, LSPACU1 was considered inversely proportional to LSPACU2. Hospital discharge time was similar between groups. Patients of group B had a significant decrease in MBP during and at the end of the exam, when compared to the initial measurement and that during sedation. Nevertheless, this variation was lower than 20%. No adverse event was observed. All patients were discharged on the same day, with no unexpected hospitalization.

Conclusions The combined use of fentanyl and propofol for colonoscopy sedation had a post-anesthesia recovery time in LSPACU1 shorter than that with the combination of midazolam and propofol. Nevertheless hospital discharge time was similar between groups.
Repair of the middle and posterior compartments of the pelvic floor via perineal and vaginal routes without the use of mesh - technique description and case series
Authors: Nogueira Raquel Ferreira , Macedo Renata Soares Paolinelli Botinha , Mônica de Oliveira Leite Sinara
Published: September 2020

Introduction Currently, problems such as constipation due to outlet obstruction, rectal/vaginal prolapse and fecal and urinary incontinence have become increasingly more frequent because of the population aging process, with great impact on the quality of life.

Objective To describe a technique for surgical repair of middle/posterior pelvic floor compartments and extra-mucosal rectal wall treatment by transperineal and vaginal approach, using native tissues and present the results in twenty patients submitted to this surgical technique.

Method Patients with symptoms secondary to middle/posterior pelvic floor descent and anatomical changes confirmed by proctological exam and pelvic MRI defecography. Results were evaluated through the Agachan constipation score, using pre- and post-operative questionnaires.

Results Immediate repair of rectocele and musculature, with prompt improvement of constipation, sustained by 42 months. There were no severe complications in the postoperative period.

Conclusion This is an effective technique, with adequate anatomic repair, improvement of constipation scores and with low risk.
The impact of beta-lactam allergy labels on hospitalized children
Authors: Jones Trahern W. , Fino Nora , Olson Jared , Hersh Adam L.
Published: September 2020

Background and objectives:

Antibiotic allergy labels are common and are frequently inaccurate. Previous studies among adults demonstrate that β-lactam allergy labels may lead to adverse outcomes, including prescription of broader-spectrum antibiotics, increased costs, and increased lengths of stay, among others. However, data among pediatric patients are lacking, especially in the United States. In this study, we sought to determine the impact of β-lactam allergy labels in hospitalized children with regards to clinical and economic outcomes.

Method:

This retrospective cohort study included pediatric patients 30 days to 17 years old, hospitalized at Intermountain Healthcare facilities from 2007 to 2017, who received ≥1 dose of an antibiotic during their admission. Patients with β-lactam allergies were matched to nonallergic patients based on age, sex, clinical service line, admission date, academic children’s hospital or other hospital admission, and the presence of chronic, comorbid conditions. Outcomes included receipt of broader-spectrum antibiotics, clinical outcomes including length of stay and readmission, and antibiotic and hospitalization costs.

Results:

In total, 38,906 patients were identified. The prevalence of antibiotic allergy increased from 0.9% among those < 1 year peaked at 10.6% by age 17. Patients with β-lactam allergy received broader-spectrum antibiotics and experienced higher antibiotic costs than nonallergic controls. However, there were no differences in the length of stay, readmission rates, or total number of days of antibiotics between allergic and nonallergic patients.

Conclusions:

Hospitalized pediatric patients with β-lactam allergy labels receive broader-spectrum antibiotics and experience increased antibiotic costs. This represents an important opportunity for allergy delabeling and antibiotic stewardship.
Attachment and Relationship Satisfaction: Mediating Role of Perception of the Partner's Investment
Authors: Londero-Santos Amanda , Natividade Jean Carlos , Féres-Carneiro Terezinha
Published: September 2020

This study investigated the role of perception of the partner's investment (PPI) as a mediator of the relation between attachment and relationship satisfaction. The participants in the study were 1088 Brazilians who were involved in a committed monogamous romantic relationship. Relations between study variables were tested using structural equations. The results showed that PPI fully mediated the relation between attachment-related anxiety and avoidance and relationship satisfaction. Attachment factors that were mediated by PPI explained 80.7% of the variance of relationship satisfaction. The results revealed that higher levels of attachment-related avoidance and anxiety were associated with a lower PPI and consequently lower relationship satisfaction. Therapeutic interventions for couples may reduce perceptual bias, mainly when attachment levels of the dyad are known.
Optimal global asymptotic behaviour of the solution to a class of singular Dirichlet problems
Authors: Zhang Zhijun
Published: September 2020

This paper is mainly concerned with the global asymptotic behaviour of the unique solution to a class of singular Dirichlet problems − Δu=b(x)g(u),u> 0,x∈ Ω,u|∂Ω= 0, where Ω is a bounded smooth domain in ℝn,g∈C1(0, ∞) is positive and decreasing in (0, ∞) with$\lim _{s\rightarrow 0^+}g(s)=\infty$,b∈Cα(Ω) for some α ∈ (0, 1), which is positive in Ω, but may vanish or blow up on the boundary properly. Moreover, we reveal the asymptotic behaviour of such a solution when the parameters onbtend to the corresponding critical values.