bluuebunny/crossref_metadata_2025 huggingface dataset:
Metal hypersensitivity screening among frontline healthcare workers—A descriptive study
Authors: Dordunoo Dzifa , Hass Michelle , Smith Catherine , Aviles‐Granados Martha L. , Weinzierl Miriam , Anaman‐Torgbor Judith A. , Shaik Ajijoon , Mallidou Anastasia , Adib Farzad
Published: November 2020

Aims and objectives

The study aims were to (a) assess allergy screening practices, (b) determine the awareness of metal hypersensitivity among frontline healthcare workers and (c) examine perceived barriers to implementing metal hypersensitivity screening into clinical practice.

Background

Adverse device‐related events, such as hypersensitivity to metals, are well documented in the literature. Hypersensitivity to metal is a type IV T‐cell‐mediated reaction that can occur after cardiac, orthopaedic, dental, gynaecological and neurosurgical procedures where a device with metal components is implanted into the body. Patients with hypersensitivity to metal are likely to experience delayed healing, implant failure and stent restenosis. Identifying patients with a history of metal hypersensitivity reaction could mitigate the risk of poor outcomes following device implant. Yet in clinical practice, healthcare workers do not routinely ask about the history of metal hypersensitivity when documenting allergies. The existing literature does not report why this is not included in allergy assessment.

Design

Following the STROBE checklist, a cross‐sectional, descriptive study was conducted.

Methods

Frontline healthcare workers were recruited using professional contacts and social online media to complete an online questionnaire. Quantitative data were summarised descriptively while thematic analysis was used to examine barriers to implementation.

Results

Three hundred forty‐five participants from 14 countries completed the questionnaire, with the majority (187/54%) practicing in Canada, in general medicine and intensive care units. Ninety per cent of the participants did not routinely ask about metal hypersensitivity when evaluating allergy history. Of the respondents, 86% were unaware of the association between metal hypersensitivity and poor patient outcomes. After presented with the evidence, 81% indicated they were likely or very likely to incorporate the evidence into their clinical practice. Common themes about barriers to implementing were ‘Standards of Practice’, ‘Knowledge’ and ‘Futility of Screening’.

Conclusion

The findings suggest lack of awareness as the main reason for not including metal in routine allergy assessment.
Neighborhood Disorder and Risk‐Taking Among Justice‐Involved Youth—The Mediating Role of Life Expectancy
Authors: Kan Emily , Knowles Alissa , Peniche Monica , Frick Paul J. , Steinberg Laurence , Cauffman Elizabeth
Published: November 2020

Neighborhood disorder has been linked to perceptions of shorter life expectancies, and shorter life expectancies have been associated with greater risk‐taking. Yet, no studies have combined these two pathways. Using data from the longitudinal Crossroads study, the present study assessed whether life expectancy mediates the association between neighborhood disorder and risk‐taking—substance use, crime, and risky sex—among 1,093 justice‐involved adolescents. Results indicate that neighborhood disorder was linked to lower estimated life expectancy which in turn related to higher rates of cigarette use, binge drinking, illicit drug use, offending, and casual sex. However, life expectancy did not explain the association between neighborhood disorder and marijuana use or inconsistent condom use.
Specific taxation, asymmetric costs, and endogenous quality
Authors: Schröder Philipp J. H. , Sørensen Allan
Published: November 2020

This paper shows how a specific tax—in contrast to an ad valorem tax—alters industry structure and firm‐level performance in a monopolistic competition framework, where firms chose product quality endogenously and differ exogenously in productivity (i.e., marginal production efficiency). Industry equilibrium mechanisms and selection based on productivity play a significant role: A specific tax shifts market shares and profits toward firms with costs and prices above the industry average at the expense of low‐cost firms. This reallocation of market shares releases a novel scale effect such that low‐cost firms may quality downgrade, while high‐cost firms always quality upgrade. There exists a parameter subspace, where this combines to a decrease on average quality for the industry. In comparison: An ad valorem tax only reduces the number of firms/varieties in the industry due to demand absorption, but affects neither firm‐level performance nor industry structure.
Effects of impaired microvascular flow regulation on metabolism‐perfusion matching and organ function
Authors: Roy Tuhin K. , Secomb Timothy W.
Published: November 2020

Impaired tissue oxygen delivery is a major cause of organ damage and failure in critically ill patients, which can occur even when systemic parameters, including cardiac output and arterial hemoglobin saturation, are close to normal. This review addresses oxygen transport mechanisms at the microcirculatory scale, and how hypoxia may occur in spite of adequate convective oxygen supply. The structure of the microcirculation is intrinsically heterogeneous, with wide variations in vessel diameters and flow pathway lengths, and consequently also in blood flow rates and oxygen levels. The dynamic processes of structural adaptation and flow regulation continually adjust microvessel diameters to compensate for heterogeneity, redistributing flow according to metabolic needs to ensure adequate tissue oxygenation. A key role in flow regulation is played by conducted responses, which are generated and propagated by endothelial cells and signal upstream arterioles to dilate in response to local hypoxia. Several pathophysiological conditions can impair local flow regulation, causing hypoxia and tissue damage leading to organ failure. Therapeutic measures targeted to systemic parameters may not address or may even worsen tissue oxygenation at the microvascular level. Restoration of tissue oxygenation in critically ill patients may depend on restoration of endothelial cell function, including conducted responses.
Museum material of Rhipicephalus sanguineus sensu Roberts (1965) collected in 1902–1964 from Australia is identical to R. sanguineus sensu lato tropical lineage at the mitochondrial DNA 12S rRNA level
Authors: Chandra S. , Halliday B. , Šlapeta J.
Published: November 2020

Ticks identified as Rhipicephalus sanguineus (Latreille, 1806) have been recorded in Australia since 1896. It is now recognized that ticks identified as R. sanguineus belong to different lineages. Recently, the so‐called temperate lineage has been redescribed as R. sanguineus sensu stricto with a designated neotype. In Australia, the evidence suggests that only R. sanguineus sensu lato tropical lineage exists. We present a genetic evaluation of R. sanguineus sensu Roberts (1965) from museum material that was evaluated or identified by Roberts. We evaluated 12 museum specimens collected between 1913 and 1964, from various locations around Australia at the molecular level. DNA isolation was successful for 4/12 specimens. All four museum specimens were 100% identical to each other and to the reference R. sanguineus s.l. tropical lineage. Measurements of morphologically significant structures for male and female museum and contemporary tick specimens were obtained. The morphologically significant structures revealed there was no significant difference (ANOVA, P > 0.05) between these groups of male and female ticks. This study updates and supplement the comprehensive descriptions provided by Roberts (1965), which genetically belong to R. sanguineus s.l. tropical lineage.
Chloroplast phylogeography ofIris dichotoma(Iridaceae), a widespread herbaceous species in East Asia
Authors: Zhang Guoli , Wang Ziyang , Wu Hao , Sun Mingzhou
Published: November 2020

Both a complex topography and climate change have huge impacts on the distribution and genetic structure of extant species. Due to the lack of relevant molecular research, little is definitively known about the phylogeography of herbaceous plants in East Asia. Here we investigate the genetic diversity, population structure and historical population dynamics ofIris dichotomaPallas, a widespread perennial herbaceous species in northeastern and northern China. Twenty‐nine populations, totalling 297 individuals, were sampled throughout the Chinese distributional range ofI. dichotoma. The combined sequences of six chloroplast DNA fragments (petA‐psbE,rps18‐clpp,psbJ‐petA,trnD‐trnT,rps16andndhA) were used to identify 13 haplotypes, of which six were private ones restricted in a single population. Genetic differentiation amongI. dichotomapopulations, enabled us to infer potential refugia during the glacial period in the Yinshan Mountains–Yanshan Mountains, where high levels of haplotype and nucleotide diversity were detected. The results of a neutral test and mismatch distribution analysis both indicated thatI. dichotomaunderwent a recent population expansion. In East Asia, postglacial environmental and climatic changes appear to have promoted genetic diversification not only in better‐studied woody species, but also in herbaceous ones likeI. dichotoma. Future studies of more herbaceous plant species are needed to obtain better insight into how modern temperate biodiversity has developed in East Asia.
Summation anaphylaxis: A challenging diagnosis
Authors: Calvani Mauro , Anania Caterina , Cuomo Barbara , D’Auria Enza , Decimo Fabio , Indirli Giovanni Cosimo , Mastrorilli Violetta , Santoro Angelica , Sartorio Marco U. A. , Veronelli Elisabetta
Published: November 2020

Anaphylaxis is the most severe of allergic reactions. The most frequent triggers of anaphylaxis in childhood are food, insect venom, drugs, exercise, etc. In some cases, the presence of more than one trigger is necessary for the allergic reaction, while one trigger alone is tolerated. This rare condition is called summation anaphylaxis (SA). Food‐dependent exercise‐induced anaphylaxis is the most well‐known SA. However, SA may also occur with the association between food and/or exercise plus one or more of the following other cofactors, such as drugs, especially non‐steroidal anti‐inflammatory (NSAID), alcohol, infections, temperature variation, and menstrual cycle. SA can explain some cases of idiopathic anaphylaxis, as well as cases of an apparent breakdown in a previously acquired tolerance for food, or finally, when faced with a suggestive clinical history of food allergy or exercise anaphylaxis and the provocation test is negative. In these situations, a more careful clinical history looking for other cofactors is necessary.
SARS‐CoV‐2 infection and neonates: a review of evidence and unresolved questions
Authors: Pietrasanta Carlo , Ronchi Andrea , Schena Federico , Ballerini Claudia , Testa Lea , Artieri Giacomo , Mercadante Domenica , Mosca Fabio , Pugni Lorenza
Published: November 2020

SARS‐CoV‐2 infection in the neonatal period poses previously unmet challenges to obstetricians and neonatologists, but several key questions are yet to be answered. Few cases of presumed in utero vertical transmission of the virus from infected mothers to fetuses have been reported, but stronger evidence is needed, from larger datasets with multiple biospecimens rigorously analyzed. Whether acquired before or after birth, SARS‐CoV‐2 infection in neonates can be symptomatic, but our comprehension of neonatal immune response and the subsequent clinical characteristics of COVID‐19 in early life are incomplete. Finally, the pandemic challenged several dogmas regarding the management of mother‐infant dyads, and again more robust data are needed to support the formulation of evidence‐based guidelines. Here, we briefly summarize existing evidence and key unresolved questions about SARS‐CoV‐2 infection and COVID‐19 in the neonatal period.
ControL'Asma Project: new insights
Authors: Tosca Maria Angela , Licari Amelia , Pistorio Angela , Marseglia Gian Luigi , Ciprandi Giorgio ,   “ControL’Asma” Study Group
Published: November 2020

The Italian Society of Paediatric Allergy and Immunology has developed the project “ControL’Asma," a nationwide study involved ten third‐level pediatric allergy clinics across Italy. The first findings of the “ControL’Asma” project showed that asthma was more frequent in males, had an early onset and allergic phenotype with very frequent rhinitis comorbidity, uncontrolled, and partly controlled asthma affected about the half of subjects, and the assessment of asthma symptom perception by VAS could be a reliable tool in the asthma management.
Defining the clinical phenotype of COVID‐19 in children
Authors: Giacomet Vania , Stracuzzi Marta , Paradiso Laura , Di Cosimo Maria Elisabetta , Rubinacci Valeria , Zuccotti GianVincenzo
Published: November 2020

On January 7, 2020, a novel coronavirus (SARS‐CoV‐2) was identified as the causative agent of a cluster of pneumonia of unknown origin detected in Wuhan City by Chinese authorities. Since SARS‐CoV‐2 discovery, the corresponding disease (COVID‐19) has rapidly expanded throughout the globe, making as a consequence the World Health Organization (WHO) declaring a pandemic. As of May 19, 2020, over 4.806.299 cases of COVID‐19 had been confirmed worldwide, with more than 318.599 deaths.
Upper airway involvement in pediatric COVID‐19
Authors: Parisi Giuseppe Fabio , Brindisi Giulia , Indolfi Cristiana , Diaferio Lucia , Marchese Giuseppe , Ghiglioni Daniele G. , Zicari Anna Maria , Miraglia del Giudice Michele
Published: November 2020

The clinical spectrum of SARS‐CoV‐2 infection is mixed. It ranges from asymptomatic cases, medium‐intensity forms with mild to moderate symptoms, to severe ones with bilateral lung involvement and respiratory distress, which can require transfer to ICUs and intubation. In most cases, the clinical picture is characterized by a persistent fever, cough, dyspnoea, expectoration, myalgias, arthralgias, headache, gastrointestinal symptoms, nasal congestion, and pharyngodynia. The spread of COVID‐19 in Europe has highlighted an atypical presentation of disease involving upper airways and, above all, dysfunction of olfactory and gustatory senses. There is ample evidence that COVID‐19 is significantly less severe in children than in adults. However, due to difficulties in assessing the disorder in children, especially among very young patients, the olfaction and gustatory dysfunctions remain open issues. This article sheds light on the upper airway involvement in pediatric COVID‐19 subjects.
Epidemiology of rare allergic diseases in children
Authors: Mori Francesca , Barni Simona , Saretta Francesca , Castagnoli Riccardo , Arasi Stefania , Mastrorilli Carla , Pecoraro Luca , Liotti Lucia , Caminiti Lucia , Giovannini Mattia , Novembre Elio ,   from the Rare Allergic Diseases Commission of the Italian Society of Pediatric Allergy and Immunology
Published: November 2020

Allergic diseases have different frequencies. In particular, allergic rhinitis and asthma have high frequencies of about 20% and 10%, respectively. Other allergic diseases have lower frequencies; for example, food allergy has a frequency of 1%‐4%. There are also rare allergic diseases, with a prevalence of 5 cases per 10 000 people in the general population, and they are included in Orphanet. However, other extremely rare allergic diseases still need to be properly known in order to be possibly recognized as rare diseases and cataloged in Orphanet.
Probiotics in the prevention and treatment of atopic dermatitis
Authors: D’Elios Sofia , Trambusti Irene , Verduci Elvira , Ferrante Giuliana , Rosati Sara , Marseglia Gian Luigi , Drago Lorenzo , Peroni Diego G.
Published: November 2020

The use of probiotic supplements might change the composition of the intestinal flora of children, subsequently modulating the immune system's reactivity. The effects of probiotic administration for the prevention/treatment of allergic diseases and atopic dermatitis, in particular, are still so controversial that no definitive recommendation can be made at this stage. Differences in strain specificity, timing, and length of administration all contribute to diversifying the conclusions of this review.
Detection of the SARS‐CoV‐2 in different biologic specimens from positive patients with COVID‐19, in Northern Italy
Authors: Novazzi Federica , Cassaniti Irene , Piralla Antonio , Di Sabatino Antonio , Bruno Raffaele , Baldanti Fausto ,   for the San Matteo Pavia COVID‐19 Task Force
Published: November 2020

Coronavirus disease 2019 (COVID‐19) diagnosis is based on molecular detection of SARS‐CoV‐2 in respiratory samples such as nasal swab (NS). However, the evidence that NS in patients with pneumonia was sometimes negative raises the attention to collect other clinical specimens. SARS‐CoV‐2 was shown in 10.3% rectal swabs (RS), 7.7% plasma, 1% urine, and 0% feces from 143 NS‐positive patients. Potential infection by fluids different from respiratory secretion is possible but unlikely.
Anti‐IL‐5 in pediatric allergic diseases
Authors: Tenero Laura , Arturi Elisa , Piazza Michele , Piacentini Giorgio
Published: November 2020

Interleukin (IL)‐5 is a potent mediator of the inflammatory cascade in the allergic response. Its predominant role in atopic reactions makes this cytokine an ideal target for blocking the eosinophilic inflammatory hyper‐responsiveness to allergens. The management of allergic diseases in childhood—such as severe asthma, atopic dermatitis, and eosinophilic esophagitis—is a challenge. In particular, there are concerns regarding the use of high‐dose corticosteroids. Over the last few years, biologics targeting IL‐5 or IL‐5 receptor—that are mepolizumab, reslizumab, and benralizumab—represent a new, promising, and more personalized therapeutic option.
Cutaneous manifestation during COVID‐19 pandemic
Authors: Galli Elena , Cipriani Francesca , Ricci Giampaolo , Maiello Nunzia
Published: November 2020

Background

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic, causing COVID‐19, is rapidly spread across the world, by posing novel challenges for all physicians. Cutaneous manifestations of COVID‐19 may be present in 20% of patients, but they are still now poorly characterized.

Methods

We search literature to describe all the various cutaneous manifestation observed during COVID‐19 pandemic.

Results

Different cutaneous clinical patterns were described, showing a wide polymorphism.

Conclusion

We provided an overview of all the various cutaneous manifestations of COVID‐19 described in the literature today, to improve our knowledge and lead a more prompt and accurate diagnosis, especially in asymptomatic or paucisymptomatic cases.
Phylogenetic response of naraoiid arthropods to early–middle Cambrian environmental change
Authors: Bond Andrew D. , Edgecombe Gregory D.
Published: November 2020

The Cambrian Period, primarily known for animal life diversifying, experienced global extinctions. Pulses of extinction in Cambrian Series 2 are exemplified by the disappearance of archaeocyath sponges and olenelline and redlichiid trilobites. However, the effect of such extinctions on outer shelf organisms, as typify Burgess Shale‐type (BST) deposits, remains relatively unknown. The phylogeny of naraoiid arthropods, represented in BST deposits globally, has consequently been reconstructed from either side of the Series 2 – Miaolingian extinction event to evaluate the response of offshore marine organisms to Cambrian environmental perturbation. As soft anatomy is known for only a subset of naraoiid species, exoskeletal morphology has proven important. Misszhouia and Naraoia (Naraoia) are distinguished morphometrically by posterior shield length/width and anterior shield length/posterior shield length. Morphometry has also been used to strengthen the identification of some cryptic naraoiid species and revise stratigraphic ranges. A revised naraoiid phylogeny reveals Misszhouia as a monophyletic subgenus, the former genus Pseudonaraoia nests within Naraoia and is placed in synonymy, and the systematic position and status of the Subfamily Liwiinae are sensitive to character weighting. Ten species of Naraoiidae range across the Series 2 – Miaolingian boundary, all naraoiid lineages originating during the main BST window. The persistence of outer shelf naraoiids throughout the Series 2 extinctions suggests that deeper offshore marine environments were resilient to extinction during periods of environmental stress. This study provides novel empirical support for the asylum of BST communities, which may contribute to the taxonomic longevity and widespread geographic distribution of taxa in these biotas.
Histiocytic and dendritic cell neoplasms: Reappraisal of a Japanese series based on t(14;18) and neoplastic PD‐L1 expression
Authors: Okada Kanae , Takahara Taishi , Suzuki Yuka , Kohno Kei , Sakakibara Ayako , Satou Akira , Takahashi Emiko , Nakamura Shigeo
Published: November 2020

Histiocytic and dendritic cell (H/DC) neoplasms are heterogeneous, originating from myeloid‐ or stromal‐derived cells. Multiple reports describe the cross‐lineage transdifferentiation of neoplastic B cells into H/DC neoplasms. Most such cases are from Western countries, and rarely from Japan or East Asia. Here we report 17 cases of H/DC neoplasms in Japanese patients, with analysis of t(14;18) by fluorescence in situ hybridization, and of neoplastic programmed death‐ligand 1 (PD‐L1) expression by immunostaining (clones SP142, E1J2J, and 28‐8). These 17 cases were diagnosed according to the 2017 World Health Organization (WHO) classification, and included two histiocytic sarcomas (HS), two interdigitating cell (IDC) sarcomas, one Langerhans cell sarcoma, two dendritic cell sarcomas, and 10 follicular dendritic cell (FDC) sarcomas. No case had any past history of follicular lymphoma (FL). Two cases of HS and one IDC sarcoma, all of which were myeloid‐driven, were found to exhibit t(14;18). In the latter case, at 30 months after IDC sarcoma diagnosis, FL development was detected. Three (30%) FDC sarcoma cases exhibited neoplastic PD‐L1 expression with all the three PD‐L1 antibody clones. This is the first report of t(14;18) and neoplastic PD‐L1 expression on H/DC neoplasms among Japanese patients, each of which appeared to be associated with HS and FDC sarcoma, respectively.
Effect of temperature and insect herbivory on the regulation of glucosinolate‐myrosinase system in Lepidium latifolium
Authors: Bhat Rohini , Faiz Sheenam , Ali Villayat , Khajuria Manu , Mukherjee Debaraj , Vyas Dhiraj
Published: November 2020

The glucosinolate‐myrosinase (GLS‐MYR) system is an important component of plant‐insect interactions. However, there is no report on its performance in field conditions where the plants are subjected to both abiotic and biotic pressures simultaneously. We investigated the GLS‐MYR system in a Himalayan ecotype of Lepidium latifolium that is recognized for its adaptive potential in field conditions. In order to understand the independent contribution of temperature and Pieris brassicae herbivory on the components of the GLS‐MYR system, different conditions were simulated in the growth chamber. During field conditions, the final GLS hydrolysis products were found to be regulated by the metabolic GLS levels, the temperature conditions, and the density of insect interactions. These factors influence the expression of the hydrolyzing and specifier proteins, which further affects the GLS hydrolysis products. Our results suggest that the production of hydrolysis products is differentially affected under field conditions. While allyl isothiocyanate is significantly (P ≤ 0.05) affected by temperature but not insect density, 1‐cyano‐2,3‐epithiopropane is not affected by either. The study shows that the outcome of the GLS‐MYR system in a plant is a consequence of the combinatorial effect of ecophysiological factors and the insect interactions that eventually decide the performance of a plant in an environment.
Diagnosis and management of connective tissue disease‐associated interstitial lung disease in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand*
Authors: Jee Adelle S. , Sheehy Robert , Hopkins Peter , Corte Tamera J. , Grainge Christopher , Troy Lauren K. , Symons Karen , Spencer Lissa M. , Reynolds Paul N. , Chapman Sally , de Boer Sally , Reddy Taryn , Holland Anne E. , Chambers Daniel C. , Glaspole Ian N. , Jo Helen E. , Bleasel Jane F. , Wrobel Jeremy P. , Dowman Leona , Parker Matthew J.S. , Wilsher Margaret L. , Goh Nicole S.L. , Moodley Yuben , Keir Gregory J.
Published: November 2020

Pulmonary complications in CTD are common and can involve the interstitium, airways, pleura and pulmonary vasculature. ILD can occur in all CTD (CTD‐ILD), and may vary from limited, non‐progressive lung involvement, to fulminant, life‐threatening disease. Given the potential for major adverse outcomes in CTD‐ILD, accurate diagnosis, assessment and careful consideration of therapeutic intervention are a priority. Limited data are available to guide management decisions in CTD‐ILD. Autoimmune‐mediated pulmonary inflammation is considered a key pathobiological pathway in these disorders, and immunosuppressive therapy is generally regarded the cornerstone of treatment for severe and/or progressive CTD‐ILD. However, the natural history of CTD‐ILD in individual patients can be difficult to predict, and deciding who to treat, when and with what agent can be challenging. Establishing realistic therapeutic goals from both the patient and clinician perspective requires considerable expertise. The document aims to provide a framework for clinicians to aid in the assessment and management of ILD in the major CTD. A suggested approach to diagnosis and monitoring of CTD‐ILD and, where available, evidence‐based, disease‐specific approaches to treatment have been provided.
Improved finite‐time zeroing neural network for time‐varying division
Authors: Gerontitis Dimitris , Behera Ratikanta , Sahoo Jajati Keshari , Stanimirović Predrag S.
Published: November 2020

A novel complex varying‐parameter finite‐time zeroing neural network (VPFTZNN) for finding a solution to the time‐dependent division problem is introduced. A comparative study in relation to the zeroing neural network (ZNN) and finite‐time zeroing neural network (FTZNN) is established in terms of the error function and the convergence speed. The error graphs of the VPFTZNN design show promising results and perform better than corresponding ZNN and FTZNN graphs. The proposed dynamical systems are suitable tools for overcoming the division by zero difficulty, which appears in the time‐varying division. An application of the introduced VPFTZNN model in an output tracking control time‐varying linear system is demonstrated.
Successful treatment of CMV, EBV, and adenovirus tissue infection following HLA‐mismatched allogeneic stem cell transplant using infusion of third‐party T cells from multiple donors in addition to antivirals, rituximab, and surgery
Authors: Di Ciaccio Pietro R. , Avdic Selmir , Sutrave Gaurav , Clancy Leighton , Withers Barbara , Blyth Emily , McLeod Duncan , Gottlieb David J.
Published: November 2020

Viral infections, principally cytomegalovirus, Epstein Barr virus (EBV) and adenovirus, are a leading cause of morbidity and mortality after allogeneic stem cell transplantation. The use of systemic antivirals is limited by limited efficacy and organ toxicities. Inability to clear infection is exacerbated by transplant‐related immunosuppression and prophylaxis or treatment of acute graft versus host disease. We report the first patient to clear three serious viral infections after stem cell transplant using third‐party donor partially human leukocyte antigen (HLA) matched virus‐specific cytotoxic T cells. The patient, a 53 year old female with transplanted for relapsed leukemia, with severe graft versus host disease received five T cell infusions from three separate donors that ultimately cleared serious systemic infections with cytomegalovirus and adenovirus, and an EBV‐driven lymphoma. Systemic antivirals had resulted in failed clinical responses. Use of repeated infusions of partially HLA matched virus‐specific T cells from banks containing cryopreserved cells should be strongly considered in transplant recipients with single or multiple refractory viral infections.
Implementation of an anaemia walk‐in clinic: Feasibility and preliminary data from the Orthopedic University Hospital
Authors: Neef Vanessa , Meisenzahl David , Kessler Paul , Raimann Florian J. , Piekarski Florian , Choorapoikayil Suma , Fleege Christoph , Zacharowski Kai D. , Meybohm Patrick , Meurer Andrea
Published: November 2020

Background

Approximately one in three patients suffers from preoperative anaemia. Even though haemoglobin is measured before surgery, anaemia management is not implemented in every hospital.

Objective

Here, we demonstrate the implementation of an anaemia walk‐in clinic at an Orthopedic University Hospital. To improve the diagnosis of iron deficiency (ID), we examined whether reticulocyte haemoglobin (Ret‐He) could be a useful additional parameter.

Material and Methods

In August 2019, an anaemia walk‐in clinic was established. Between September and December 2019, major orthopaedic surgical patients were screened for preoperative anaemia. The primary endpoint was the incidence of preoperative anaemia. Secondary endpoints included Ret‐He level, red blood cell (RBC) transfusion rate, in‐hospital length of stay and anaemia at hospital discharge.

Results

A total of 104 patients were screened for anaemia. Preoperative anaemia rate was 20.6%. Intravenous iron was supplemented in 23 patients. Transfusion of RBC units per patient (1.7 ± 1.2 vs. 0.2 ± 0.9; p = 0.004) and hospital length of stay (13.1 ± 4.8 days vs. 10.6 ± 5.1 days; p = 0.068) was increased in anaemic patients compared to non‐anaemic patients. Ret‐He values were significantly lower in patients with ID anaemia (33.3 pg [28.6–40.2 pg]) compared to patients with ID (35.3 pg [28.9–38.6 pg]; p = 0.015) or patients without anaemia (35.4 pg [30.2–39.4 pg]; p = 0.001).

Conclusion

Preoperative anaemia is common in orthopaedic patients. Our results proved the feasibility of an anaemia walk‐in clinic to manage preoperative anaemia. Furthermore, our analysis supports the use of Ret‐He as an additional parameter for the diagnosis of ID in surgical patients.
Biomechanical properties of canine staphylectomies closed with barbed or smooth suture
Authors: Gleason Hadley E. , Phillips Heidi , McCoy Annette M. , Gutierrez‐Nibeyro Santiago D. , McKiernan Brendan C. , Duffy Daniel J. , Feign Ian M. , Kim Woojae Jason , Kersh Mariana E.
Published: November 2020

Objective

To compare the duration of closure and biomechanical properties of staphylectomies closed with absorbable bidirectional barbed suture or smooth monofilament suture in a simple continuous or interrupted pattern

Study design

Ex vivo study

Sample population

Soft palates (n = 60) harvested from mesaticephalic canine cadavers

Methods

One centimeter of tissue was excised from the caudal border of each soft palate, and the oral and nasopharyngeal mucosal surfaces were apposed with 2‐0 bidirectional Quill Monoderm knotless closure device barbed suture (Q), 3‐0 Monocryl in a simple continuous (MC) pattern, or 3‐0 Monocryl in a simple interrupted (MI) pattern (n = 20 per group). Duration of closure was compared between groups. Tissues were tested under tension to failure, and mode of failure data were collected by video capture.

Results

Closure time was longer for MI closures than for Q and MC closures, with means of 259.9, 215.4, and 196.7 seconds, respectively (P < .0001). No difference was detected in yield force, force to first tissue rupture, maximum force, and energy required for yield and maximum force between groups. Energy to yield was 190.0, 167.8, and 188.95 N‐mm for MI, Q, and MC closures, respectively.

Conclusion

Biomechanical properties of staphylectomies closed with barbed or smooth sutures did not differ in this cadaveric model.

Clinical significance

Barbed suture can be considered as an alternative for closure of canine staphylectomies. These results provide evidence to justify additional research to evaluate clinical outcomes in dogs undergoing staphylectomy.
IRBIT activates NBCe1‐B by releasing the auto‐inhibition module from the transmembrane domain
Authors: Su Pan , Wu Han , Wang Meng , Cai Lu , Liu Ying , Chen Li‐Ming
Published: November 2020

Key points

The electrogenic Na+/HCO3−cotransporter NBCe1‐B is widely expressed in many tissues, including pancreas, submandibular gland, brain, heart, etc. NBCe1‐B has very low activity under basal condition due to auto‐inhibition, but can be fully activated by protein interaction with the IP3R‐binding protein released with inositol 1,4,5‐trisphosphate (IRBIT).

The structural components of the auto‐inhibition domain and the IRBIT‐binding domain of NBCe1‐B are finely characterized based on systematic mutations in the present study and data from previous studies.

Reducing negative charges on the cytosol side of the transmembrane domain greatly decreases the magnitude of the auto‐inhibition of NBCe1‐B.

We propose that the auto‐inhibition domain functions as a brake module that inactivates NBCe1‐B by binding to, via electrostatic attraction, the transmembrane domain; IRBIT activates NBCe1‐B by releasing the brake from the transmembrane domain via competitive binding to the auto‐inhibition domain.

The electrogenic Na+/HCO3− cotransporter NBCe1‐B is widely expressed in many tissues in the body. NBCe1‐B exhibits only basal activity due to the action of the auto‐inhibition domain (AID) in its unique amino‐terminus. However, NBCe1‐B can be activated by interaction with the IP3R‐binding protein released with inositol 1,4,5‐trisphosphate (IRBIT). Here, we investigate the molecular mechanism underlying the auto‐inhibition of NBCe1‐B and its activation by IRBIT. The IRBIT‐binding domain (IBD) of NBCe1‐B spans residues 1−52, essentially consisting of two arms, one negatively charged (residues 1−24) and the other positively charged (residues 40−52). The AID mainly spans residues 40−85, overlapping with the IBD in the positively charged arm. The magnitude of auto‐inhibition of NBCe1‐B is greatly decreased by manipulating the positively charged residues in the AID or by replacing a set of negatively charged residues with neutral ones in the transmembrane domain. The interaction between IRBIT and NBCe1‐B is abolished by mutating a set of negatively charged Asp/Glu residues (to Asn/Gln) plus a set of Ser/Thr residues (to Ala) in the PEST domain of IRBIT. However, this interaction is not affected by replacing the same set of Ser/Thr residues in the PEST domain with Asp. We propose that: (1) the AID, acting as a brake, binds to the transmembrane domain via electrostatic interaction to slow down NBCe1‐B; (2) IRBIT activates NBCe1‐B by releasing the brake from the transmembrane domain.
Comunicarnos sin daño: convivencia y salud mental
Authors: Cano Busquets Marisol , Gómez-Restrepo Carlos , Forero Ariza Miriam , Sarmiento Suárez María José
Published: November 2020

Esta segunda edición de Comunicarnos sin daño parte de las inquietudes de los autores de incorporar nuevos elementos de reflexión acerca de cómo promover formas de comunicación que alienten la reconciliación nacional y favorezcan la salud mental de los colombianos y las colombianas. Desaprender y desnaturalizar las formas violentas de comunicación que han permeado la vida en sociedad con el fin de aprender a comunicarnos para una convivencia pacífica y saludable no es una tarea fácil, pues no solo demanda esfuerzo, creatividad y compromiso, sino también apertura y suficiente disposición para hacer lo que las dinámicas de violencia nos han impedido hacer: escucharnos y comprendernos mutuamente para avanzar en la búsqueda de consensos que permitan mejorar nuestra calidad de vida. Siguiendo ese propósito, todos como ciudadanos debemos pensar en el poder de la información, el lenguaje y la palabra en la salud mental, en la resolución pacífica de los conflictos y en la reconciliación. En ese sentido, Comunicarnos sin daño es un llamado a entender la comunicación como un fertilizante que puede abonar el terreno social para que la convivencia pacífica y el bienestar germinen con suficiente vigor, respaldo y legitimidad. Este es un libro de reflexiones y recomendaciones prácticas en el que los lectores encuentran una ruta para comunicarse en pro de la sana convivencia y la reconciliación.
Comparative Study of Physical Models for Particle Sedimentation Using SIMMER Code
Authors: Csengeri Eszter , Bachrata Andrea , Trotignon Laurent , Merle Elsa
Published: November 2020

In the context of improved safety requirements for Generation IV sodium-cooled fast reactors (SFR), an innovative severe accident mitigation scenario is being investigated. In the French frame of SFR research, the mitigation strategy consists of transfer tubes and a core catcher. The transfer tubes are dedicated to discharge molten fissile materials from the core center region and to guide them toward the core catcher where long-term cooling and subcritical state may be assured. The physical phenomena occurring during the discharge process are introduced in this paper. The current demonstration of the mitigation strategy uses best-estimate calculations with the reference computer code SIMMER. Previous analyses showed that the material discharge through the transfer tubes might be efficient; however, uncertainties of SIMMER approach are identified on the molten material mobility during the relocation process. It is related to a blockage formation due to particulate solid debris accumulation inside the transfer tube, in case of low energy accumulation in the degraded fuel, is believed to originate from the solid particle treatment in the code. As the performance of mitigation strategy strongly depends on the mobility of the relocating mixture, the most predictive behavior of particle flows is of great importance to SFR safety. Therefore, the SIMMER modeling of such flows is analyzed in this work. The first verification and validation test cases regarding the gravitational settling of particle clouds at varying volume fractions are presented. Recommendations for reactor calculations and first orientations for future research and development are highlighted.
Anthropause on audio: The effects of the COVID-19 pandemic on church bell ringing and associated soundscapes in New South Wales (Australia)
Authors: Parker Murray , Spennemann Dirk HR
Published: November 2020

The use of religious bells as symbolism and ritual is prevalent in many faiths worldwide. However, the sound of bells emanating from churches is by nature not exclusive to the church, as these sounds can effectively become part of the “public domain.” The value of church bell ringing can therefore be attributed to the church community and clergy as well as the wider community. Cessation of these sounds affects not only the soundscape of the area, but the people who place value on these sounds or soundscapes. Data are presented from a previous survey from 2018 investigating church bell practices in New South Wales (Australia) and compared to the current practice of bell ringing, which has been heavily influenced by regulations introduced due to the COVID-19 pandemic.
Kallikrein 13 serves as a priming protease during infection by the human coronavirus HKU1
Authors: Milewska Aleksandra , Falkowski Katherine , Kulczycka Magdalena , Bielecka Ewa , Naskalska Antonina , Mak Pawel , Lesner Adam , Ochman Marek , Urlik Maciej , Diamandis Elftherios , Prassas Ioannis , Potempa Jan , Kantyka Tomasz , Pyrc Krzysztof
Published: November 2020

The protease kallikrein 13 cleaves the spike protein of the human coronavirus HKU1 to facilitate viral entry.
Paleomagnetic insights into the Cambrian biogeographic conundrum: Did the North China craton link Laurentia and East Gondwana?
Authors: Zhao Hanqing , Zhang Shihong , Zhu Maoyan , Ding Jikai , Li Haiyan , Yang Tianshui , Wu Huaichun
Published: November 2020

Redlichiid trilobite and small shelly fossils indicate strong ties of the North China craton (NCC) to Gondwana during the early Cambrian, while recent discoveries of the characteristic fossils of Laurentia in Wuliuan shales in the eastern NCC imply its possible connection with Laurentia during the middle Cambrian. Here we report a new paleomagnetic pole at 31.8°S, 140.4°E (radius of 95% confidence cone of paleomagnetic pole, A95, = 5.3°), obtained from the Wuliuan (ca. 505 Ma) Hsuchuang Formation, by averaging our new data and existing virtual geomagnetic poles acquired from different parts of the NCC. A positive regional tilt test and the presence of geomagnetic reversals demonstrate that the remanence was primary. The paleomagnetic data permit placing the NCC near 20°N between Laurentia and Australia at ca. 505 Ma, suggesting that the NCC may have played the role of biogeographic link between East Gondwana and Laurentia in the middle Cambrian. Low-latitudinal westward ocean currents may have facilitated faunal migrations from Laurentia to East Gondwanan blocks via the NCC as well as the newly formed tectono-paleogeographic archipelago, which likely further enhanced biological exchange in the late Cambrian.
Zinc isotope evidence for paleoenvironmental changes during Cretaceous Oceanic Anoxic Event 2
Authors: Chen Xi , Sageman Bradley B. , Yao Hanwei , Liu Sheng’Ao , Han Kaibo , Zou Yi , Wang Chengshan
Published: November 2020

Paleoclimate during the Cenomanian-Turonian Oceanic Anoxic Event 2 (OAE 2, 94.5–93.9 Ma) was characterized by elevated atmospheric CO2 concentrations and peak global temperatures. In this study, we employ δ66Zn measured on samples spanning OAE 2 in an expanded hemipelagic section in Tibet to trace changes in the major fluxes that influence biogeochemical cycles. The prominent feature of the δ66Zn record in the studied section is a continuous decrease from ∼1‰ at the onset of OAE 2 to a minimum of ∼0.2‰ within the Plenus Cold Event (ca. 94.3 Ma), followed by a stepwise recovery through the upper part of OAE 2. The negative shift in δ66Zn corresponds with higher terrigenous inputs, as revealed by previously published detrital index and TOC/TN (total organic carbon to total nitrogen) ratio records, and covaries with a notable decreasing trend recorded in compiled pCO2 data of different basins. We propose that influx of isotopically light Zn from weathered volcanic rocks associated with submarine large igneous provinces and/or (sub)tropic Indian continental volcanics is likely responsible for the δ66Zn decrease. We infer that the recovery of δ66Zn was caused by continued high primary production and an inevitable decline in the flux of light Zn as volcanic terrains were progressively weathered. The ultimate cessation of OAE 2 may have been a consequence of the same effect, with the nutrient supply from weathering reaching a minimum threshold to maintain productivity-anoxia feedback.
Patients’ experiences regarding self-monitoring of the disease course: an observational pilot study in patients with inflammatory rheumatic diseases at a rheumatology outpatient clinic in The Netherlands
Authors: Renskers Lisanne , Rongen-van Dartel Sanne AA , Huis Anita MP , van Riel Piet LCM
Published: November 2020

Objectives

Self-monitoring the disease course is a relatively new concept in the management of patients with inflammatory rheumatic diseases (IRDs). The aims of this pilot study were to obtain patients’ experiences with online self-monitoring, to assess information about the agreement between the disease course assessed with patient-reported outcome measures (PROMs) and an objectively measured Disease Activity Score 28 (DAS28) by the rheumatologist, and to assess adherence to predetermined PROM frequency intervals.

Design

Observational study using qualitative and quantitative methods.

Setting

The rheumatology outpatient clinic of a teaching hospital in The Netherlands (secondary care).

Participants

47 patients with an IRD who regularly attended the outpatient clinic.

Methods

Patients completed PROMs by using an online self-monitoring program. Their experiences regarding self-monitoring were qualitatively assessed through a focus group discussion and telephone interviews using a thematic analysis approach. Adherence to the predefined PROM frequency (completed PROM assessments within the predetermined frequency) and the agreement between the DAS28 course and PROM values (Rheumatoid Arthritis Disease Activity Index-5 and the Rheumatoid Arthritis Impact of Disease (RAID)) were quantitatively assessed using descriptives.

Results

Forty-seven patients participated, most of them diagnosed with rheumatoid arthritis (n=38, 80.9%). Three themes were identified: knowledge about and insight into the disease (activity), patient–professional interaction and functionality of the program. Mean adherence to the predetermined PROM frequency was 68.1%. The RAID showed the best agreement with the DAS28 course. Mean participation time was 350 days.

Conclusion

Patients were predominantly positive about online self-monitoring. They indicated that they gained more knowledge about their disease, felt less dependent on the healthcare professional and valued the insight into their long-term disease course. Barriers were mostly related to technical factors. Patients were able to and willing to self-monitor their disease, which could contribute to a more efficient allocation of outpatient consultations in the future.
Restrictive transfusion strategy for critically injured patients (RESTRIC) trial: a study protocol for a cluster-randomised, crossover non-inferiority trial
Authors: Hayakawa Mineji , Tagami Takashi , IIjima Hiroaki , Kudo Daisuke , Sekine Kazuhiko , Ogura Takayuki , Yumoto Tetsuya , Kondo Yutaka , Endo Akira , Ito Kaori , Matsumura Yosuke , Kushimoto Shigeki
Published: November 2020

Introduction

Resuscitation using blood products is critical during the acute postinjury period. However, the optimal target haemoglobin (Hb) levels have not been adequately investigated. With the restrictive transfusion strategy for critically injured patients (RESTRIC) trial, we aim to compare the restrictive and liberal red blood cell (RBC) transfusion strategies.

Methods and analysis

This is a cluster-randomised, crossover, non-inferiority trial of patients with severe trauma at 22 hospitals that have been randomised in a 1:1 ratio based on the use of a restrictive or liberal transfusion strategy with target Hb levels of 70–90 or 100–120 g/L, respectively, during the first year. Subsequently, after 1-month washout period, another transfusion strategy will be applied for an additional year. RBC transfusion requirements are usually unclear on arrival at the emergency department. Therefore, patients with severe bleeding, which could lead to haemorrhagic shock, will be included in the trial based on the attending physician’s judgement. Each RBC transfusion strategy will be applied until 7 days postadmission to the hospital or discharge from the intensive care unit. The outcomes measured will include the 28-day survival rate after arrival at the emergency department (primary), the cumulative amount of blood transfused, event-free days and frequency of transfusion-associated lung injury and organ failure (secondary). Demonstration of the non-inferiority of restrictive transfusion will emphasise its clinical advantages.

Ethics and dissemination

The trial will be performed according to the Japanese and International Ethical guidelines. It has been approved by the Ethics Committee of each participating hospital and The Japanese Association for the Surgery of Trauma (JAST). Written informed consent will be obtained from all patients or their representatives. The results of the trial will be disseminated to the participating hospitals and board-certified educational institutions of JAST, submitted to peer-reviewed journals for publication, and presented at congresses.

Trial registration number

UMIN Clinical Trials Registry; UMIN000034405. Registered 8 October 2018.