bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of manual and femtosecond astigmatic keratotomy in the treatment of postkeratoplasty astigmatism
Authors: Sorkin Nir , Mimouni Michael , Santaella Gisella , Kreimei Mohammad , Trinh Tanya , Yang Yelin , Saeed Danyal , Cohen Eyal , Rootman David S. , Chan Clara C. , Slomovic Allan R.
Published: October 2020

Purpose

To compare the outcomes of femtosecond astigmatic keratotomy (FSAK) and manual astigmatic keratotomy (AK) in treatment of postkeratoplasty astigmatism.

Methods

A retrospective, comparative, pairwise‐matched case series including 150 patients who underwent either FSAK (n = 75) or manual AK (n = 75) for the treatment of astigmatism (>3.00 D) following penetrating keratoplasty or deep anterior lamellar keratoplasty. Pairwise matching for baseline variables (age, visual acuity and astigmatism) was performed.

Results

Mean age was 57.5 ± 16.0 years. The FSAK group had significantly better postoperative best‐corrected visual acuity (BCVA) (p = 0.010), uncorrected visual acuity (UCVA) (p = 0.049), corneal astigmatism (p = 0.020) and manifest astigmatism (p < 0.001) compared with the manual AK group. Gain of ≥3 lines in BCVA (logMAR) was seen in five eyes (6.7%) and 21 eyes (28.0%) in manual AK and FSAK, respectively (p = 0.005). Alpins vector analysis showed lower (closer to 0) index of success (0.50 ± 0.24 and 0.79 ± 0.48, p < 0.001) and higher (closer to 1) correction index (0.94 ± 0.45 and 0.74 ± 0.55, p = 0.020) in FSAK compared with manual AK. Corneal and manifest astigmatism improved significantly in both groups, while BCVA and UCVA improved significantly in FSAK only.

Repeat AK rate was 32% (24 eyes) in manual AK and 4% (three eyes) in FSAK (p < 0.001). Overcorrection‐related re‐suturing rate was 0% in manual AK and 8% (six eyes) in FSAK (p = 0.037). There was one microperforation (1.3%) in FSAK, and there were no occurrences of graft dehiscence, infectious keratitis or graft rejection.

Conclusions

Both manual AK and FSAK were safe and effective in reducing postkeratoplasty astigmatism. FSAK had superior visual and keratometric outcomes compared with manual AK.
The digital transformation of work: A relational view
Authors: Rodriguez‐Lluesma Carlos , García‐Ruiz Pablo , Pinto‐Garay Javier
Published: October 2020

Conversation about the current and potential effects of digital technologies on the nature of work is raging within scholarly and practitioner communities. Artificial intelligence, robotics, data analytics, digital platforms, and automation, among other technologies, are prompting a swift and profound transformation of work. Building on Pierpaolo Donati's relational sociology, we examine the changes these technologies are likely to bring about in work as a human relation. Despite the very real threats of unemployment, job insecurity, precariousness, and surveillance, technology may also encourage the emergence of a work culture that shifts the scales toward a relational realm rather than a transactional one. To this end, we argue that work should be understood as a social relation with four dimensions: exchange value, intrinsic extra‐economic purpose, communication for reciprocal services, and correspondence with primary human needs according to use values. Understanding the digital transformation of work from this point of view requires comprehending the differentiation and integration of these four dimensions.
Asking the teachers: A Delphi study on the selection of skills and behaviours for an assessment of barriers to learning for pupils on the autism spectrum with intellectual disabilities
Authors: Howell Melanie , Bradshaw Jill , Langdon Peter E.
Published: October 2020

Accessible summary

Barriers make it hard for pupils to learn. We wanted to assess barriers to learning. We made an assessment called the Assessment of Barriers to Learning in Education‐Autism (ABLE‐Autism).

We asked teachers to tell us about the barriers to learning. They told us about lots of barriers. We wanted to include the most important barriers.

We used the Delphi method with teachers. The Delphi method helps people to agree what is important.

Teachers told us about the most important barriers to learning. We included the most important barriers to learning in our assessment.

Background

This study outlines how a modified Delphi procedure was used with special educational needs teachers to select skills and behaviours for inclusion in the Assessment of Barriers to Learning in Education‐Autism (ABLE‐Autism). The ABLE‐Autism is a new teacher assessment to show progress in barriers to learning for pupils on the autism spectrum with coexisting intellectual disabilities in special schools. The research aim was to select items for inclusion in the assessment based on teacher ratings of relevance, comprehensibility and comprehensiveness.

Method

Following a review of the literature and teacher focus groups, a list of 86 items was developed and a modified two‐round Delphi exercise was conducted with special needs teachers. Items were selected for inclusion if at least 80% of teachers agreed that the item was (a) able to be understood, (b) important to assess and (c) the median score associated with whether the item was able to be understood and important to assess was 1 (the highest score possible).

Results

In the first round, 56 items met the criteria for inclusion and were retained. Thirty items were amended, and, after three items were amalgamated with other items, 27 amended items were included in the second round. After the second round, 14 additional items met the threshold to be included in the final assessment.

Conclusions

After both rounds, 70 items were endorsed by teachers and included in the ABLE‐Autism. The input of special needs teachers provided initial face and content validity for the new outcome measure.
Different responses of repetitive behaviours in juvenile and young adult mice to Δ9‐tetrahydrocannabinol and cannabidiol may affect decision making for Tourette syndrome
Authors: Gorberg Victoria , McCaffery Peter , Anavi‐Goffer Sharon
Published: October 2020

Background and Purpose

Medicinal cannabis is in increasing use by patients with Tourette syndrome, a neuropsychiatric disorder that affects about 1% of the general population and has a childhood onset. However, the pharmacological effects of Δ9‐tetrahydrocannabinol (Δ9‐THC) and cannabidiol (CBD) have not been systematically screened or compared between juvenile and young adult rodents in a model of Tourette syndrome.

Experimental Approach

The administration of 2,5‐dimethoxy‐4‐iodoamphetamine (DOI) increases head twitch response (HTR) and ear scratch response (ESR) and has been proposed as an animal model useful to respectively study motor tics and premonitory urges associated with tic disorders.

Key Results

Comparing the potency of Δ9‐THC to inhibit DOI‐induced repetitive behaviours, the rank order was ESR > grooming > HTR versus ESR = grooming > HTR in young adult versus juvenile mice. Δ9‐THC (5 mg·kg−1) induced severe adverse effects in the form of cataleptic behaviour in control mice and significantly increased ESR in juveniles. The pharmacological effects of CBD have not been studied in models of Tourette syndrome. In juveniles, CBD had no effect on DOI‐induced ESR and grooming behaviours. CBD alone induced side effects, significantly increasing the frequency of HTR in juveniles and young adults.

Conclusion and Implications

Δ9‐THC efficaciously reverses peripheral but not central motor tics. Δ9‐THC may reduce ambulatory movements and evoke premonitory urges in some paediatric patients. The small “therapeutic window” in juveniles suggests that CBD may not effectively treat motor tics in children and may even exacerbate tics in a population of patients with Tourette syndrome.
Youth with disabilities are more likely than their peers to engage in hazardous child labour
Authors: Emerson Eric , Llewellyn Gwynnyth
Published: October 2020

Background

Little is known about the extent to which children and adolescents with disabilities are exposed to child labour.

Objective

To estimate prevalence rates and adjusted rate ratios of exposure to child labour among children and adolescents with/without disability in middle‐ and low‐income countries and to determine whether these rates vary between functional limitations associated with disability.

Participants and Setting

Nationally representative samples involving 142,499 children aged 5–14 from 15 countries.

Methods

Secondary analysis of data collected in UNICEF's Multiple Indicator Cluster Surveys.

Results

Overall children and youth with disability were not at significantly greater risk of exposure than children without disability to child labour when demographic and contextual factors were taken into account. However, children and youth with disability were at significantly greater risk of exposure than children without disability to hazardous child labour (adjusted relative risk [ARR] = 1.15 [1.10–1.21], P < 0.001). Specifically, children and youth with impairments related to poorer mental health or cognitive functioning were at significantly greater risk of exposure to hazardous child labour (e.g., ARR for learning impairment = 1.27 [1.14–1.42], P < 0.001). In contrast, children with impairments related to sensory functioning, mobility and expressive communication were at no greater risk of exposure than children with no disability.

Conclusions

Children and youth with disability are at greater risk of exposure to hazardous child labour than children with no disability in middle‐ and low‐income countries. Responses to eradicate hazardous child labour need to take account of the situation of children and youth with disability.
A physiology‐based Earth observation model indicates stagnation in the global gross primary production during recent decades
Authors: Tagesson Torbern , Tian Feng , Schurgers Guy , Horion Stephanie , Scholes Robert , Ahlström Anders , Ardö Jonas , Moreno Alvaro , Madani Nima , Olin Stefan , Fensholt Rasmus
Published: October 2020

Earth observation‐based estimates of global gross primary production (GPP) are essential for understanding the response of the terrestrial biosphere to climatic change and other anthropogenic forcing. In this study, we attempt an ecosystem‐level physiological approach of estimating GPP using an asymptotic light response function (LRF) between GPP and incoming photosynthetically active radiation (PAR) that better represents the response observed at high spatiotemporal resolutions than the conventional light use efficiency approach. Modelled GPP is thereafter constrained with meteorological and hydrological variables. The variability in field‐observed GPP, net primary productivity and solar‐induced fluorescence was better or equally well captured by our LRF‐based GPP when compared with six state‐of‐the‐art Earth observation‐based GPP products. Over the period 1982–2015, the LRF‐based average annual global terrestrial GPP budget was 121.8 ± 3.5 Pg C, with a detrended inter‐annual variability of 0.74 ± 0.13 Pg C. The strongest inter‐annual variability was observed in semi‐arid regions, but croplands in China and India also showed strong inter‐annual variations. The trend in global terrestrial GPP during 1982–2015 was 0.27 ± 0.02 Pg C year−1, and was generally larger in the northern than the southern hemisphere. Most positive GPP trends were seen in areas with croplands whereas negative trends were observed for large non‐cropped parts of the tropics. Trends were strong during the eighties and nineties but levelled off around year 2000. Other GPP products either showed no trends or continuous increase throughout the study period. This study benchmarks a first global Earth observation‐based model using an asymptotic light response function, improving simulations of GPP, and reveals a stagnation in the global GPP after the year 2000.
Perinatal exposure to earthquake stress increases the risks of hypertension and diabetes in subsequent adult life: A cross‐sectional study
Authors: Li Na , Yu Lu‐Lu , Zhao Xiao‐Chuan , Song Mei , Wang Lan , Gao Yuan‐Yuan , Lu Wen‐Ting , Wang Xue‐Yi , Wang Yu‐Mei
Published: October 2020

The objective of the current study was to determine whether exposure to earthquake stress during pregnancy and infancy impacted on the risk of chronic adult health problems. All subjects were divided into three groups: the infant exposure group, the fetus exposure group, and the non‐exposure group. All subjects completed a standardized interview that included questions on demographic information, traumatic experiences during the earthquake, Anthropomorphic parameters such as body height, weight, and blood pressure were measured. Traumatic events in childhood and adulthood were assessed by the Childhood Trauma Questionnaire (CTQ) and Life Event Scale (LES), respectively. Totally1325 subjects were included; 399 subjects experienced the earthquake as fetuses, 374 subjects who experienced the earthquake as infants and 552 subjects did not experience the earthquake. The three groups were comparable in sociodemographic and baseline characteristics except age (Infant exposure vs Prenatal exposure vs No exposure = 39.5 ± 0.6 vs 38.5 ± 0.8 vs 37.5 ± 0.9, p < .001). Fetal and infant exposure to earthquakes was associated with elevated systolic blood pressure (both were + 3 mm Hg, p < .001). After adjustment for covariates, earthquake exposure in infants (odds ratio [OR] = 2.010, 95% confidence interval [CI] = 1.216 ~ 3.322) and fetuses (OR = 1.509, 95% CI = 1.014 ~ 2.248) was a significant and independent risk factor for hypertension. Earthquake expose in fetuses was a significant and independent risk factor for diabetes (OR = 2.307, 95% CI = 1.136 ~ 4.686). Earthquake exposure in infants and fetuses is a significant and independent risk factor for hypertension. Earthquake exposure in fetuses is significant and independent risk factor for diabetes.
Efficacy of color discrimination tests used in dentistry
Authors: Simionato Andressa , Pecho Oscar E. , Della Bona Alvaro
Published: October 2020

Objective

To evaluate the efficacy of visual discrimination tests used for color research in dentistry.

Materials and methods

Volunteers (N = 120) were divided in three groups of observers (n = 40; gender‐balanced): S‐dental students; D‐dentists; and L‐laypersons. Two general color discrimination tests (I‐Ishihara and FM‐Farnsworth‐Munsell 100 Hue) and the test of color discrimination competency in dentistry using the VITA Classical shade guide (VC) were performed and data were recorded according to manufacturers' or literature recommendations. Data were statistically analyzed using Mann–Whitney U test for the gender influence and Kruskal‐Wallis test for the observer influence, and Bonferroni as post‐hoc test (α = 0.05). Pearson (α = 0.05) was used to examine the correlation among visual tests (I, FM, and VC).

Results

Observers and visual tests were not influenced by gender (P > .05). Different observer groups had no influence on I test (P > .05). S and D showed similar level of color perception using FM and VC (P > .05), but these observers showed greater color perception than L (P ≤ .05). FM and VC also showed significant correlation (P ≤ .05) for the overall D observers (r = −0.362), male D (r = −0.594) and female S (r = −0.457).

Conclusion

Observer experience significantly influenced on color perception, irrespective of gender. FM test showed greater correlation to color correspondence in dentistry (VC) than I test.

Clinical significance

Observer experience is more relevant than gender for the color selection process in dentistry. Considering the visual discrimination tests for color research in dentistry, the Farnsworth‐Munsell 100 Hue test seems to be more efficacious than the Ishihara test.
Detection of early stage gastric cancers in screening laser endoscopy using linked color imaging for patients with atrophic gastritis
Authors: Yamaoka Minoru , Imaeda Hiroyuki , Miyaguchi Kazuya , Ashitani Keigo , Tsuzuki Yoshikazu , Ohgo Hideki , Soma Hiromitsu , Hirooka Nobutaka , Nakamoto Hidetomo
Published: October 2020

Background and Aims

Laser endoscopy involves blue laser imaging in bright mode (BLI‐bright). Linked color imaging (LCI) is superior to white light imaging (WLI) for detecting gastric cancers. This study aimed to detect gastric cancers on screening endoscopy using not only WLI but also BLI‐bright and LCI in patients with atrophic gastritis.

Patients and Methods

A total of 500 patients with atrophic gastritis undergoing screening esophagogastroduodenoscopy were included. The gastric lumen was observed in the WLI mode, followed by the LCI and BLI‐bright modes. When gastric neoplasms were suspected, the mode was changed to WLI, and we sprayed indigo carmine. Finally, biopsy specimens were taken for those lesions and pathological diagnosis was made. We compared the size, morphology, and color of gastric neoplasms found by the first WLI mode and those detected by only the LCI mode or BLI‐bright mode.

Results

We detected 16 gastric neoplasms (3.2%), of which 13 were early gastric cancers (EGCs) and three were gastric adenomas. Ten EGCs and two gastric adenomas (75%) were detected by the first WLI mode; three EGCs and one gastric adenoma (25%) were missed by the first WLI mode and were detected by the LCI mode or BLI‐bright mode. All were less than 1 cm in diameter and were reddish. Mean diameter of the lesions was significantly less for LCI‐detected or BLI‐bright‐detected lesions than for WLI‐detected lesions (7.8 vs 21.2 mm).

Conclusions

Laser endoscopy is useful for detecting EGCs by LCI for patients with atrophic gastritis.
Laser therapy in the treatment of cicatricial ectropion
Authors: Ouyang Hua‐Wei , Gold Michael H. , Lei Ying , Tan Jun
Published: October 2020

Introduction

The objective of this study was to investigate the clinical effects of laser therapy in treating cicatricial ectropion.

Methods

Seven patients with cicatricial ectropion were entered into this clinical study. The ectropions were pretreated with the 595‐nm pulsed dye laser if the scar color was red. If there was no red, the UltraPulse fractional CO2 laser was used and parameters were adapted according to the height of scar. MEBT/MEBO was used after laser treatment for wound healing. The degree of ectropion was measured for changes before and after treatment, and the scars were evaluated for changes in melanin, height, vascularity, and pliability using the Vancouver Scar Scale (VSS) before and after treatment.

Results

All seven patients with cicatricial ectropion entered into this protocol were completely corrected after 1‐2 treatment sessions. The total VSS score, as well as the score for melanin and pliability in 7 patients, showed a decrease following the treatments, and this was statistically significant (P < 0.05). The scores for height and vascularity showed a decrease following the treatments, but there was no significant difference by statistical analysis (P ≥ 0.05). There were no adverse reactions reported.

Conclusions

The treatment of cicatricial ectropion with laser therapy can not only correct the ectropion, but also improve the scars in the treatment area. Compared with the traditional repair of cicatricial ectropion, the use of fractional CO2 laser provides surgical precision and the advantage of a timely treatment without the need to wait for the scar to stabilize.
The melatonin metabolite N1‐acetyl‐5‐methoxykynuramine facilitates long‐term object memory in young and aging mice
Authors: Iwashita Hikaru , Matsumoto Yukihisa , Maruyama Yusuke , Watanabe Kazuki , Chiba Atsuhiko , Hattori Atsuhiko
Published: October 2020

Melatonin (MEL) has been reported to enhance cognitive processes, making it a potential treatment for cognitive decline. However, the role of MEL’s metabolites, N1‐acetyl‐N2‐formyl‐5‐methoxykynuramine (AFMK) and N1‐acetyl‐5‐methoxykynuramine (AMK), in these effects are unknown. The current study directly investigated the acute effects of systemic MEL, AFMK, and AMK on novel object recognition. We also analyzed MEL, AFMK, and AMK levels in hippocampus and temporal lobe containing the perirhinal cortex following systemic MEL and AMK treatment. AMK administered post‐training had a more potent effect on object memory than MEL and AFMK. AMK was also able to rescue age‐associated declines in memory impairments when object memory was tested up to 4 days following training. Results from administering AMK at varying times around the training trial and the metabolism time course in brain tissue suggest that AMK’s memory‐enhancing effects reflect memory consolidation. Furthermore, inhibiting the MEL‐to‐AMK metabolic pathway disrupted object memory at 24 hours post‐training, suggesting that endogenous AMK might play an important role in long‐term memory formation. This is the first study to report that AMK facilitates long‐term object memory performance in mice, and that MEL crosses the blood‐brain barrier and is immediately converted to AMK in brain tissue. Overall, these results support AMK as a potential therapeutic agent to improve or prevent memory decline.
Post‐fire regeneration strategies in a frequently burned Cerrado community
Authors: Zupo Talita , Daibes Luis Felipe , Pausas Juli G. , Fidelis Alessandra
Published: October 2020

Aim

Fire is a natural disturbance in many ecosystems throughout the world where plant populations can persist by the resprouting of individuals and/or by recruiting from seeds. We evaluated the post‐fire regeneration response for 41 coexisting species, including grasses, forbs, and shrubs, from an open Cerrado community (campo sujo) in Central Brazil.

Location

The study was conducted at the Reserva Natural Serra do Tombador (RNST) in Central Brazil. The vegetation of the study area is characterized by a continuous herbaceous layer dominated by grasses and scattered shrubs, which produces fine fuel loads that can burn frequently.

Methods

We examined both resprouting ability after experimental fires, accounting for bud location, and seed response to heat shocks caused by fire, where seeds were subjected to heat shocks of 100°C for one and three minutes, 200°C for one minute, and a control (untreated seeds).

Results

All species were able to resprout (R+) after fire, mainly from buds located in underground structures, but also from aerial and basal buds. Seeds of most species tolerated heat shocks of 100°C for one and three minutes, but heat treatments of 200°C decreased seed viability of nearly 50% of species. Seven species, all of which had dormant seeds, showed heat‐stimulated germination. In sum, 81% of the community was classified as R+PT (resprouters with heat‐tolerant propagules) and 17% was R+PS (resprouters with heat‐stimulated propagules). The remaining 2% (one species) was classified as R+P−, showing heat‐sensitive seeds.

Conclusions

Resprouting is the main post‐fire regeneration strategy in Cerrado open savannas, while fire‐stimulated germination, although possible, is less common in comparison to the frequency in other fire‐prone ecosystems. However, in Cerrado open savannas, heat tolerance is an important trait that enables germination when favorable conditions arise.
Thiazolidinediones were associated with higher risk of cardiovascular events in patients with type 2 diabetes and cirrhosis
Authors: Yen Fu‐Shun , Wei James Cheng‐Chung , Chiu Lu‐Ting , Hsu Chih‐Cheng , Hou Ming‐Chih , Hwu Chii‐Min
Published: October 2020

Background& Aims

Type 2 diabetes mellitus (T2DM) management in patients with cirrhosis is complicated. No clinical trials have investigated appropriate antidiabetic drug use in these patients. This study compared the risks of all‐cause mortality, major adverse cardiovascular events (MACE) and hepatic outcomes between patients with T2DM and cirrhosis using and not using thiazolidinedione (TZD).

Methods

We selected 1,705 propensity score–matched TZD users and nonusers from a Taiwan National Health Insurance Research Database cohort of T2DM patients with compensated cirrhosis between January 1, 2000, and December 31, 2012 and followed them until December 31, 2013. Cox proportional hazards models with robust sandwich standard error estimates were used to assess risks of investigated outcomes for TZD users.

Results

MACE incidence rates during follow‐up were 2.14 and 1.30 per 100 patient‐years for TZD users and nonusers, respectively (adjusted hazard ratio [aHR] 1.70; 95% confidence interval [CI], 1.32‐2.19). On the basis of TZD use, the aHRs (95% CIs) for stroke, ischemic heart disease and heart failure were 1.81 (1.28‐2.55), 1.59 (1.03‐2.44) and 2.09 (1.22‐3.60) respectively. Compared with TZD nonusers, rosiglitazone users had significantly higher aHR [1.67 (1.26‐2.20)] and pioglitazone users had no significant difference of aHR [1.12 (0.90‐1.64)]. All‐cause mortality, hepatocellular carcinoma, decompensated cirrhosis and hepatic failure risks did not differ significantly between TZD users and nonusers.

Conclusions

Compared with nonuser, TZD users demonstrated significantly higher MACE risks. Therefore, the risks of cardiovascular complications should be considered when prescribing TZDs to patients with T2DM and cirrhosis.
Parents' experiences of VOICE: A novel support programme in the NICU
Authors: van den Hoogen Agnes , Eijsermans Rian , Ockhuijsen Henriette D. L. , Jenken Floor , Oude Maatman Sabine M. , Jongmans Marian J. , Verhage Lianne , van der Net Janjaap , Latour Jos M.
Published: October 2020

Background

Admission of an infant to a neonatal intensive care unit (NICU) is often a stressful experience for parents and can be associated with feelings of inadequacy to fulfil the desirable parental role. The values, opportunities, integration, control, and evaluation (VOICE) programme was developed to engage parents in care, to decrease stress, and to increase empowerment.

Aim

To explore the experiences of parents regarding involvement in the VOICE programme during admission of their infant to the NICU.

Design

The VOICE programme includes at least five personal structured meetings between parents, nurses, and other health care professionals throughout the pathway from birth, NICU, and follow up. A qualitative design was adopted using semi‐structured interviews. Interviews with 13 parents of 11 infants born at <27 weeks' gestational age were conducted: nine mothers and two couples of father and mother. Thematic analysis was deployed.

Results

The findings have been described in one overarching theme: “parental empowerment.” Parents felt strengthened and were empowered in the development of their role as primary caretaker by the VOICE programme. The parental empowerment theme emerged from four related interpretive themes that were derived: (a) involvement in care, (b) personalized information and communication, (c) transition to a parental role, and (d) emotional support.

Conclusion

The VOICE programme can be a structured approach used to implement family support in a NICU to empower parents to become a partner in the care of their infant and feel confident.

Relevance to clinical practice

This study encourages health care professionals to provide parental support through a structured intervention programme, which contributes to the empowerment of parents in the NICU and encouraged them to participate in care and decision‐making.
British Association of Critical Care Nurses: Evidence‐based consensus paper for oral care within adult critical care units
Authors: Collins Tim , Plowright Catherine , Gibson Vanessa , Stayt Louise , Clarke Sarah , Caisley Jo , Watkins Claire Harcourt , Hodges Emily , Leaver Gillian , Leyland Sarah , McCready Patricia , Millin Sara , Platten Julie , Scallon Michelle , Tipene Patsy , Wilcox Gabby
Published: October 2020

Background

Patients who are critically ill are at increased risk of hospital acquired pneumonia and ventilator associated pneumonia. Effective evidence based oral care may reduce the incidence of such iatrogenic infection.

Aim

To provide an evidence‐based British Association of Critical Care Nurses endorsed consensus paper for best practice relating to implementing oral care, with the intention of promoting patient comfort and reducing hospital acquired pneumonia and ventilator associated pneumonia in critically ill patients.

Design

A nominal group technique was adopted. A consensus committee of adult critical care nursing experts from the United Kingdom met in 2018 to evaluate and review the literature relating to oral care, its application in reducing pneumonia in critically ill adults and to make recommendations for practice. An elected national board member for the British Association of Critical Care Nurses chaired the round table discussion.

Methods

The committee focused on 5 aspects of oral care practice relating to critically ill adult patients. The evidence was evaluated for each practice within the context of reducing pneumonia in the mechanically ventilated patient or pneumonia in the non‐ventilated patient. The five practices included the frequency for oral care; tools for oral care; oral care technique; solutions used and oral care in the non‐ventilated patient who is critically ill and is at risk of aspiration. The group searched the best available evidence and evaluated this using the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of evidence from high to very low, and to formulate recommendations as strong, moderate, weak, or best practice consensus statement when applicable.

Results

The consensus group generated recommendations, delineating an approach to best practice for oral care in critically ill adult patients. Recommendations included guidance for frequency and procedure for oral assessment, toothbrushing, and moisturising the mouth. Evidence on the use of chlorhexidine is not consistent and caution is advised with its routine use.

Conclusion

Oral care is an important part of the care of critically ill patients, both ventilated and non‐ventilated. An effective oral care programme reduces the incidence of pneumonia and promotes patient comfort.

Relevance to Clinical practice

Effective oral care is integral to safe patient care in critical care.
Jasmonates induce Arabidopsis bioactivities selectively inhibiting the growth of breast cancer cells through CDC6 and mTOR
Authors: Bömer Moritz , Pérez‐Salamó Imma , Florance Hannah V. , Salmon Deborah , Dudenhoffer Jan‐Hendrik , Finch Paul , Cinar Aycan , Smirnoff Nicholas , Harvey Amanda , Devoto Alessandra
Published: October 2020

Phytochemicals are used often in vitro and in vivo in cancer research. The plant hormones jasmonates (JAs) control the synthesis of specialized metabolites through complex regulatory networks. JAs possess selective cytotoxicity in mixed populations of cancer and normal cells.

Here, direct incubation of leaf explants from the non‐medicinal plant Arabidopsis thaliana with human breast cancer cells, selectively suppresses cancer cell growth. High‐throughput LC‐MS identified Arabidopsis metabolites. Protein and transcript levels of cell cycle regulators were examined in breast cancer cells.

A synergistic effect by methyljasmonate (MeJA) and by compounds upregulated in the metabolome of MeJA‐treated Arabidopsis leaves, on the breast cancer cell cycle, is associated with Cell Division Cycle 6 (CDC6), Cyclin‐dependent kinase 2 (CDK2), Cyclins D1 and D3, indicating that key cell cycle components mediate cell viability reduction. Bioactives such as indoles, quinolines and cis‐(+)‐12‐oxophytodienoic acid, in synergy, could act as anticancer compounds.

Our work suggests a universal role for MeJA‐treatment of Arabidopsis in altering the DNA replication regulator CDC6, supporting conservation, across kingdoms, of cell cycle regulation, through the crosstalk between the mechanistic target of rapamycin, mTOR and JAs. This study has important implications for the identification of metabolites with anti‐cancer bioactivities in plants with no known medicinal pedigree and it will have applications in developing disease treatments
Overcoming the trade‐off between grain weight and number in wheat by the ectopic expression of expansin in developing seeds leads to increased yield potential
Authors: Calderini Daniel F. , Castillo Francisca M. , Arenas‐M Anita , Molero Gemma , Reynolds Matthew P. , Craze Melanie , Bowden Sarah , Milner Matthew J. , Wallington Emma J. , Dowle Adam , Gomez Leonardo D. , McQueen‐Mason Simon J.
Published: October 2020

Wheat is the most widely grown crop globally, providing 20% of all human calories and protein. Achieving step changes in genetic yield potential is crucial to ensure food security, but efforts are thwarted by an apparent trade‐off between grain size and number. Expansins are proteins that play important roles in plant growth by enhancing stress relaxation in the cell wall, which constrains cell expansion.

Here, we describe how targeted overexpression of an α‐expansin in early developing wheat seeds leads to a significant increase in grain size without a negative effect on grain number, resulting in a yield boost under field conditions.

The best‐performing transgenic line yielded 12.3% higher average grain weight than the control, and this translated to an increase in grain yield of 11.3% in field experiments using an agronomically appropriate plant density.

This targeted transgenic approach provides an opportunity to overcome a common bottleneck to yield improvement across many crops.
Loss of COMT activity reduces lateral root formation and alters the response to water limitation in sorghum brown midrib (bmr) 12 mutant
Authors: Saluja Manny , Zhu Feiyu , Yu Hongfeng , Walia Harkamal , Sattler Scott E.
Published: October 2020

Lignin is a key target for modifying lignocellulosic biomass for efficient biofuel production. Brown midrib 12 (bmr12) encodes the sorghum caffeic acid O‐methyltransferase (COMT) and is one of the key enzymes in monolignol biosynthesis. Loss of function mutations in COMT reduces syringyl (S) lignin subunits and improves biofuel conversion rate. Although lignin plays an important role in maintaining cell wall integrity of xylem vessels, physiological and molecular consequences due to loss of COMT on root growth and adaptation to water deficit remain unexplored.

We addressed this gap by evaluating the root morphology, anatomy and transcriptome of bmr12 mutant. The mutant had reduced lateral root density (LRD) and altered root anatomy and response to water limitation. The wild‐type exhibits similar phenotypes under water stress, suggesting that bmr12 may be in a water deficit responsive state even in well‐watered conditions.

bmr12 had increased transcript abundance of genes involved in (a)biotic stress response, gibberellic acid (GA) biosynthesis and signaling. We show that bmr12 is more sensitive to exogenous GA application and present evidence for the role of GA in regulating reduced LRD in bmr12.

These findings elucidate the phenotypic and molecular consequences of COMT deficiency under optimal and water stress environments in grasses.
Three‐dimensional assessment of accelerating orthodontic tooth movement—micro‐osteoperforations vs piezocision: A randomized, parallel‐group and split‐mouth controlled clinical trial
Authors: Alqadasi Basema , Xia Hou Yu , Alhammadi Maged Sultan , Hasan Hadeel , Aldhorae Khalid , Halboub Esam
Published: October 2020

Objective

To compare the effects of micro‐osteoperforations (MOPs) vs piezocision (Piezo) in accelerating orthodontic tooth movement in adults.

Setting and Sample Population

In this randomized, single‐blinded, parallel‐group, split‐mouth clinical trial, 24 patients aged 15‐40 years were recruited.

Subjects and Methods

Patients were randomly allocated into two groups: MOPs and Piezo groups. One side of the maxilla was allocated randomly for treatment with one of these techniques, and the other side was treated conventionally to act as a split‐mouth control. The rate of canine retraction was evaluated up to 3 months by three‐dimensional digital models using a conventional labial appliance. Root resorption and bone height were evaluated using cone beam computed tomography.

Results

The MOPs and Piezo groups showed a significantly higher rate of tooth movement after 3 months on the experimental sides than the control sides. However, the net movements in the MOPs and Piezo groups did not reveal a higher rate of tooth movement. Similarly, the overall net movement was −0.32 ± 1.14 and ‐0.55 ± 0.89 mm for MOPs and Piezo, respectively (P = .606). Regarding root resorption, the overall changes in intra‐ or intergroup comparisons were insignificant. Decreased canine palatal bone height was reported on the experimental side of the Piezo group (P = .015) after 3 months, but the overall changes were insignificant.

Conclusions

The effect of MOPs and Piezo techniques in accelerating the orthodontic canine retraction was comparable to each other, and to the conventional methods. Neither technique caused root resorption or increased vertical bone loss.
Not a “first world problem”—Care of the anesthetist in East and Southern Africa
Authors: Workneh Rediet Shimeles , Tuyishime Eugene , Mumbwe Mbangu , Igaga Elizabeth Namugaya , Bould M. Dylan
Published: October 2020

Burnout and related concepts such as resilience, wellness, and taking care of healthcare professionals have become increasingly prevalent in the medical literature. Most of the work in this area comes from high‐income countries, with the remainder from upper‐middle‐income countries, and very little from lower‐middle‐income or low‐income countries. Sub‐Saharan Africa is particularly poorly represented in this body of literature. Anglo‐American concepts are often applied to different jurisdictions without consideration of cultural and societal differences. However, anesthesia providers in this region have unique challenges, with both the highest burden of “surgical” disease in the world and the least resources, both in terms of human resources for health and in terms of essential drugs and equipment. The effect of burnout on healthcare systems is also likely to be very different with the current human resources for the health crisis in East and Central Africa. According to the Joint Learning Initiative Managing for Performance framework, the three essential factors for building a workforce to effectively support a healthcare system are coverage, competence, and motivation. Current efforts to build capacity in anesthesia in East and Southern Africa focus largely on coverage and competence, but neglect motivation at the risk of failing to support a sustainable workforce. In this paper, we include a review of the relevant literature, as well as draw from personal experience living and working in East and Southern Africa, to describe the unique issues surrounding burnout, resilience, and wellness in this region.
Infantile toxic epidermal necrolysis: Successful treatment of an 8‐week‐old with intravenous immunoglobulin and amniotic membrane transplant
Authors: Nassim Janelle S. , Karim Sabrina A. , Grenier Pierre‐Olivier , Schmidt Birgitta , Jones Krystal M.
Published: October 2020

Stevens‐Johnson syndrome and toxic epidermal necrolysis comprise a spectrum of severe mucocutaneous hypersensitivity reactions. A paucity of data limits current understanding of the etiology, treatment options, and prognosis of this entity in the infantile population compared to that in the adult and pediatric literature. We describe the case of an 8‐week‐old male with toxic epidermal necrolysis treated successfully with intravenous immunoglobulin and amniotic membrane transplant. This patient is the youngest surviving infant with toxic epidermal necrolysis to be reported.
Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students
Authors: Mårtensson Sophie , Hodges Eric A. , Knutsson Susanne , Hjelm Carina , Broström Anders , Swanson Kristen M. , Björk Maria
Published: October 2020

Rationale

To maintain patients’ dignity and well‐being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non‐caring behaviours. Defining and measuring both verbal and nonverbal caring and non‐caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.

Aim

The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.

Method

An instrument development process was used for behavioural coding including observational data from thirty‐eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.

Result

The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non‐caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed‐event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter‐rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.

Discussion/Conclusion

The CBCS is a theory‐based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non‐caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well‐being.
Diagnosis and clinical management of auricular chondritis in a dog presenting for evaluation of severe pain
Authors: Noxon James O. , Berger Darren J. , Ackermann Mark A. , Petersen Jennifer R. , Smith Jodi D.
Published: October 2020

Background

The aetiology and appropriate treatment for auricular chondritis in the dog are currently unclear. This report describes a unique presentation and successful treatment of a dog with auricular chondritis.

Clinical summary

A 12‐year‐old, female spayed, Labrador retriever dog was presented for severe pain thought to be neurological in origin. The pain was located to the right pinna and two punch biopsies were acquired and evaluated, revealing lymphoplasmacytic to pyogranulomatous inflammation involving the auricular cartilage with no infectious agents. Treatment with systemic oral prednisone resulted in resolution of clinical signs within four weeks of initiation of treatment. The dog remained free of clinical signs for six months following discontinuation of treatment before being euthanized for an unrelated reason.

Conclusions

Further evaluation of canine auricular chondritis is needed, yet pain may be a prominent finding; monotherapy with systemic prednisone may provide quick and complete resolution of clinical sysmptoms.
Direct imprinting of TiO2 patterns on highly curved substrates
Authors: Luo Ming , Hu Xin
Published: October 2020

In this paper, we demonstrate the fabrication of TiO2 patterns on both planar and various highly curved substrates via nanoimprint lithography followed by thermal treatment. First, a photocurable Ti-containing monomer is synthesized by reacting titanium (IV) ethoxide with 2-(methacryloyloxy)ethyl acetoacetate. The monomer is formulated with a visible light photoinitiator system to prepare a photocurable nanoimprint resin (TiO2-resin). Afterward, the resin is able to be patterned onto highly curved substrates using a soft mold via the double transfer technique. Resin patterns can be simply transformed to TiO2 patterns after thermal treatment. Refractive index of TiO2 can also be tuned by changing the calcination condition.
May the Work I Have Done Speak for Me
Authors: Hehn Jack G.
Published: October 2020

In January of 2019 I received the AAPT Melba Phillips award. The award provided me the opportunity to reflect on the many programs in which I had participated and the outstanding AAPT leaders that I had the privilege to know. Those reflections are represented in the following narrative that I delivered at the AAPT Winter Meeting in Houston. I will tell you a few short stories about working with these individuals. (There is a theme to these stories: working together, we can accomplish much more than any individual effort.)
A FAN-C Exploration of RC Circuits
Authors: Silar Rebekah , Glasscock Michael , Mitchell Brandon , Ekey Robert
Published: October 2020

Recently, small computer fans have been demonstrated to be an effective method for teaching simple resistive circuits both qualitatively and quantitatively. The current through the fans is related to the rotational speed of the fans and allows multiple senses to be engaged (touch, sight, and hearing). Methods for learning simple circuits in an effective and accessible way have been explored for decades, and the prevailing approach has been the use of incandescent light bulbs. However, light bulbs can only be used to build a qualitative foundation. Quantitative experiments require non-bulb circuits, as the resistance of incandescent light bulbs changes with current. When fans are used, plots of current vs. voltage exhibit a linear relationship, which provides a nearly constant effective resistance for the fan. This suggests that fans can also be used to explore RC circuits both qualitatively and quantitatively, where the fans act as the resistive elements as well as the indicator. In this contribution, we will demonstrate that computer fans can be used to qualitatively explore the charging and discharging times for RC circuits. By monitoring the voltage across the capacitor as a function of time, we will also show that fans can be used for quantitative RC analysis.
Labs to Accompany Treatment of General Relativity in a General Education Astronomy Course
Authors: Andersen W. L.
Published: October 2020

It often falls to a physicist to teach a conceptual astronomy course. It is easy to justify a treatment of general relativity in the context of massive stars, black holes, and cosmology. There are a number of good books available to serve as texts or references, including Thorne’s Black Holes and Time Warps: Einstein’s Outrageous Legacy and Robert Geroch’s General Relativity from A to B. The purpose of this article is to describe three experimental introductions to the mathematical and physical concepts of general relativity. These can be accomplished at little expense and require no advanced mathematics on the part of students.
An Experiment to Verify the Current Dependence of Ampère's Law for a “Long” Straight Current-Carrying Conductor
Authors: Maheswaranathan Ponn
Published: October 2020

A simple experiment is described to verify the current dependence of Ampère's law for a long straight current-carrying conductor. A narrow and long rectangular multi-loop design is used to increase the strength of the magnetic field in between the long sides. As expected, the magnetic field is found to be linearly proportional to the electric current. The current dependence of the magnetic field is used to determine the value of a fundamental constant—the permeability of free space—with acceptable experimental error. Theory predicts that the effect of narrow sides is only 2% for a width-to-length ratio of 0.2, hence smaller dimensions, down to 20 cm × 4 cm, can be employed conveniently for good results.
The Promotion and Implementation of Exercise is Medicine® in Kinesiology
Authors: Winters Carena
Published: October 2020

Evidence supporting exercise as a medicine in the prevention and management of chronic disease is indisputable. Created in 2007, Exercise is Medicine® (EIM) aims to make physical activity assessment and promotion a standard in clinical care, connecting health care professionals with qualified exercise professionals to provide evidence-based physical activity resources and programs to everyone of all abilities. Opportunities exist for exercise professionals in several areas within EIM, including exercise referral and prescription, EIM on Campus, and physical activity and EIM education. Connections between EIM and kinesiology and the need for exercise professionals to contribute to the EIM evidence are discussed.