bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling the joint effects of body size and microclimate on heat budgets and foraging opportunities of ectotherms
Authors: Kearney Michael R. , Porter Warren P. , Huey Raymond B.
Published: November 2020

Body size affects the body temperature of an ectotherm by altering both heating rates and the microclimate experienced. These joint effects are rarely considered in the analyses of climatic constraints on ectotherms but nonetheless influence body temperatures and thus activity periods and foraging opportunities.

Here we develop and test transient heat‐budget models that use height‐specific microclimatic forcing to compute the dynamics of size‐dependent body temperatures of ectotherms in sun and in shade. We incorporate a model of behavioural thermoregulation and use it to compute potential body temperatures and then to map these to ecologically relevant indices, including foraging opportunities and thermal constraints. To illustrate potential applications, we combine a microclimate model driven by a global climate database with the transient behavioural algorithm developed for lizards to explore how body size (10 and 1,000 g) and size‐specific microclimate (at natural heights of 1 and 7.5 cm, respectively) interactively influence body temperatures and ecological indices at a warm, arid location in Australia in both spring and summer. To explore microclimatic effects, we contrast temperatures and indices for animals positioned at their natural versus reciprocal heights above the ground.

Our simulations show that the behavioural and ecological consequences of size can be strongly biased when joint effects of body size and size‐imposed microclimate are ignored. For example, the two body sizes did not differ in total foraging time when compared at their natural heights, but did differ if compared at the same height, the direction of this difference reversing with the height at which they were compared. We show how computed foraging times can be translated to potential foraging radii from a central place (burrow or shade‐providing bush), thereby illustrating how body size can be physiologically translated into habitat connectivity as a function of different shade configurations, for example, as modified by fire regimes or shrub dieback.

All functions are now integrated into the biophysical modelling r package NicheMapR and as a Shiny app, which should provide new insights and avenues for investigation into functional interactions between body size and habitat structure for ectotherms.
ABO blood group is related to bleeding in cardiac surgery
Authors: Hansen Søren Mose , Sprogøe Ulrik , Möller Sören , Andersen Claus
Published: November 2020

Background

Increased bleeding and blood product transfusions during cardiac surgery are associated with poor outcomes. The patient's ABO blood group is related to hemostatic balance, although it is unclear whether this influences bleeding during cardiac surgery. This study aimed to evaluate whether ABO blood group is related to bleeding during cardiac surgery.

Methods

This retrospective study evaluated data from 17,058 cardiac surgical procedures that were performed in four Danish cardiosurgical centers. Data regarding chest tube drainage and transfusion volumes were retrieved from a clinical database and combined with information regarding ABO group. The primary outcome was chest tube drainage volume and the secondary outcomes were transfused volumes of various blood products.

Results

Blood group O had the largest chest tube drainage volume (mean: 745 mL, 95% CI: 720‐771 mL) and blood group AB had the smallest volume (mean: 664 mL, 95% CI: 598‐731 mL). The inter‐group difference in the mean drainage volume was 81 mL (95% CI: 8‐154 mL, P < .05). Patients with blood group A or blood group B had mean drainage volumes that were between the volumes for groups AB and O. Relative to group O, group AB received smaller mean volumes of all blood products. The most pronounced difference was in platelet concentrates, with mean values of 170 mL for group O (95% CI: 157‐184 mL) and 63 mL for group AB (95% CI: 34‐92 mL).

Conclusion

The patient's ABO group appears to be related to volumes of chest tube drainage and transfused blood products during cardiac surgery.
Chronic alcohol exposure differentially modulates structural and functional properties of amygdala: A cross‐sectional study
Authors: Orban Csaba , McGonigle John , Flechais Remy S.A. , Paterson Louise M. , Elliott Rebecca , Erritzoe David , Ersche Karen D. , Murphy Anna , Nestor Liam J. , Passetti Filippo , Reed Laurence J. , Ribeiro Andre S. , Smith Dana G. , Suckling John , Taylor Eleanor M. , Waldman Adam D. , Wing Victoria C. , Deakin J.F. William , Robbins Trevor W. , Nutt David J. , Lingford‐Hughes Anne R. ,   ICCAM Platform
Published: November 2020

Animal models have shown that chronic alcohol exposure is associated with persistent neuroadaptations in amygdala synaptic function, whereas human studies have consistently reported amygdala grey‐matter volume (GMV) reductions in alcohol dependent patients (ADP). We hypothesised that chronic alcohol use associated with neuroadaptations may entail a reconfiguration of the amygdala's functional interactions and that these mechanisms may be affected by structural atrophy. We compared amygdala resting state functional connectivity (RSFC) using a whole brain seed‐based approach and amygdala GMV in abstinent ADP (n = 20) and healthy controls (HC; n = 39), balanced for age, gender and levels of head motion. The potential moderating influence of age, cumulative alcohol exposure, abstinence length and head motion was further examined in the two groups separately using correlational analyses. We found increased amygdala RSFC with substantia nigra/ventral tegmental area (SN/VTA) in ADP compared with HC. As expected, amygdala GMV was lower in ADP. Multiple regression analyses of the ADP group showed that amygdala‐SN/VTA RSFC increases were primarily associated with cumulative alcohol exposure rather than age, whereas amygdala GMV reductions were primarily associated with age rather than cumulative alcohol exposure. The same association between age and amygdala GMV was not observed amongst HC. Importantly, amygdala GMV and amygdala‐SN/VTA RSFC were uncorrelated in ADP, and neither measure was correlated with abstinence length. These results suggest that chronic alcohol exposure is associated with persistent elevations in amygdala‐SN/VTA RSFC and accelerated age‐related grey‐matter atrophy through potentially distinct mechanisms.
Roles of roadside vegetation in insect conservation in Australia
Authors: New Timothy R , Sands Don P A , Taylor Gary S
Published: November 2020

The extent and variety of roadside environments in Australia in largely anthropogenic landscapes render them substantial remnant habitats for insect biodiversity. The importance of these areas for insect biodiversity conservation and the key threats they face are discussed, as well as the needs for their protection and conservation management. Many rural roadsides harbour significant patches of native vegetation, including rare and threatened flora now scarce elsewhere. Other values of roadside vegetation include habitat remnants, seasonal refuges, corridors and shelters for insect movements and population connectivity. Examples are given of the importance of roadsides for individual threatened insect species. Roadside environments are under substantial threat from clearing, development and unintentional degradation through a variety of activities. The diverse responsibilities of roadside management, increasingly to harmonise human safety and amenity needs with biodiversity conservation, can readily incorporate considerations of insect diversity and occurrence of notable individual species. The conservation of remnant vegetation and ecological restoration of roadside corridors are highlighted as paramount for maintaining biodiversity and connectivity under increased human activity and environmental extremes.
Characterization of farmer‐based cooperative societies in the upper west region of Ghana
Authors: Dary Stanley Kojo , Grashuis Jasper
Published: November 2020

The study describes the ownership and governance characteristics and the challenges of farmer‐based cooperative societies from three districts in the Upper West Region of Ghana. Primary data were obtained from 59 active and 14 inactive cooperatives in the selected districts. The study concludes that Ghanaian cooperatives in the sample bear much resemblance to the traditional form which emerged in Europe and North America in the late 19th and early 20th centuries. Generally, such cooperatives have relatively small memberships from local communities who use a democratic governance system and do not delegate control to outsiders. While the cost of owning and transacting is limited with such characteristics, many traditional cooperatives lack the specific knowledge, economic efficiency, and resource endowment necessary to become or remain competitive. Indeed, the active cooperatives listed finance, access to inputs, tractor services and poor leadership as key challenges, while inactive cooperatives blamed poor member commitment as the primary culprit for their inactivity. Efforts aimed at promoting and supporting farmer cooperatives should focus on addressing these key challenges. Also, financial and technical support should probably be conditional on group performance and not group formation itself.
Nonlinear mediation analysis with high‐dimensional mediators whose causal structure is unknown
Authors: Loh Wen Wei , Moerkerke Beatrijs , Loeys Tom , Vansteelandt Stijn
Published: November 2020

With multiple possible mediators on the causal pathway from a treatment to an outcome, we consider the problem of decomposing the effects along multiple possible causal path(s) through each distinct mediator. Under a path‐specific effects framework, such fine‐grained decompositions necessitate stringent assumptions, such as correctly specifying the causal structure among the mediators, and no unobserved confounding among the mediators. In contrast, interventional direct and indirect effects for multiple mediators can be identified under much weaker conditions, while providing scientifically relevant causal interpretations. Nonetheless, current estimation approaches require (correctly) specifying a model for the joint mediator distribution, which can be difficult when there is a high‐dimensional set of possibly continuous and noncontinuous mediators. In this article, we avoid the need to model this distribution, by developing a definition of interventional effects previously suggested for longitudinal mediation. We propose a novel estimation strategy that uses nonparametric estimates of the (counterfactual) mediator distributions. Noncontinuous outcomes can be accommodated using nonlinear outcome models. Estimation proceeds via Monte Carlo integration. The procedure is illustrated using publicly available genomic data to assess the causal effect of a microRNA expression on the 3‐month mortality of brain cancer patients that is potentially mediated by expression values of multiple genes.
Simultaneous spatial smoothing and outlier detection using penalized regression, with application to childhood obesity surveillance from electronic health records
Authors: Choi Young‐Geun , Hanrahan Lawrence P. , Norton Derek , Zhao Ying‐Qi
Published: November 2020

Electronic health records (EHRs) have become a platform for data‐driven granular‐level surveillance in recent years. In this paper, we make use of EHRs for early prevention of childhood obesity. The proposed method simultaneously provides smooth disease mapping and outlier information for obesity prevalence that are useful for raising public awareness and facilitating targeted intervention. More precisely, we consider a penalized multilevel generalized linear model. We decompose regional contribution into smooth and sparse signals, which are automatically identified by a combination of fusion and sparse penalties imposed on the likelihood function. In addition, we weigh the proposed likelihood to account for the missingness and potential nonrepresentativeness arising from the EHR data. We develop a novel alternating minimization algorithm, which is computationally efficient, easy to implement, and guarantees convergence. Simulation studies demonstrate superior performance of the proposed method. Finally, we apply our method to the University of Wisconsin Population Health Information Exchange database.
Estimating the optimal individualized treatment rule from a cost‐effectiveness perspective
Authors: Xu Yizhe , Greene Tom H. , Bress Adam P. , Sauer Brian C. , Bellows Brandon K. , Zhang Yue , Weintraub William S. , Moran Andrew E. , Shen Jincheng
Published: November 2020

Optimal individualized treatment rules (ITRs) provide customized treatment recommendations based on subject characteristics to maximize clinical benefit in accordance with the objectives in precision medicine. As a result, there is growing interest in developing statistical tools for estimating optimal ITRs in evidence‐based research. In health economic perspectives, policy makers consider the tradeoff between health gains and incremental costs of interventions to set priorities and allocate resources. However, most work on ITRs has focused on maximizing the effectiveness of treatment without considering costs. In this paper, we jointly consider the impact of effectiveness and cost on treatment decisions and define ITRs under a composite‐outcome setting, so that we identify the most cost‐effective ITR that accounts for individual‐level heterogeneity through direct optimization. In particular, we propose a decision‐tree–based statistical learning algorithm that uses a net‐monetary‐benefit–based reward to provide nonparametric estimations of the optimal ITR. We provide several approaches to estimating the reward underlying the ITR as a function of subject characteristics. We present the strengths and weaknesses of each approach and provide practical guidelines by comparing their performance in simulation studies. We illustrate the top‐performing approach from our simulations by evaluating the projected 15‐year personalized cost‐effectiveness of the intensive blood pressure control of the Systolic Blood Pressure Intervention Trial (SPRINT) study.
Speeding up Monte Carlo simulations for the adaptive sum of powered score test with importance sampling
Authors: Deng Yangqing , He Yinqiu , Xu Gongjun , Pan Wei
Published: November 2020

A central but challenging problem in genetic studies is to test for (usually weak) associations between a complex trait (e.g., a disease status) and sets of multiple genetic variants. Due to the lack of a uniformly most powerful test, data‐adaptive tests, such as the adaptive sum of powered score (aSPU) test, are advantageous in maintaining high power against a wide range of alternatives. However, there is often no closed‐form to accurately and analytically calculate the p‐values of many adaptive tests like aSPU, thus Monte Carlo (MC) simulations are often used, which can be time consuming to achieve a stringent significance level (e.g., 5e‐8) used in genome‐wide association studies (GWAS). To estimate such a small p‐value, we need a huge number of MC simulations (e.g., 1e+10). As an alternative, we propose using importance sampling to speed up such calculations. We develop some theory to motivate a proposed algorithm for the aSPU test, and show that the proposed method is computationally more efficient than the standard MC simulations. Using both simulated and real data, we demonstrate the superior performance of the new method over the standard MC simulations.
EGFR mutation testing in cytology smears of advanced non‐small cell lung carcinomas: Practical applications in low‐resource laboratories
Authors: Singh Varsha , Nambirajan Aruna , Malik Prabhat Singh , Kaur Kanwalpreet , Mohan Anant , Jain Deepali
Published: November 2020

Routine EGFR mutation testing on cytology smears can be incorporated in daily practice in resource‐constrained settings where cell‐block and laser‐capture microdissection facilities are not available.
The multifaceted role of TRAIL signaling in cancer and immunity
Authors: Cardoso Alves Ludmila , Corazza Nadia , Micheau Olivier , Krebs Philippe
Published: November 2020

Tumor necrosis factor (TNF)‐related apoptosis‐inducing ligand (TRAIL) is a member of the TNF superfamily that can lead to the induction of apoptosis in tumor or infected cells. However, activation of TRAIL signaling may also trigger nonapoptotic pathways in cancer and in nontransformed cells, that is, immune cells. Here, we review the current knowledge on noncanonical TRAIL signaling. The biological outcomes of TRAIL signaling in immune and malignant cells are presented and explained, with a focus on the role of TRAIL for natural killer (NK) cell function. Furthermore, we highlight the technical difficulties in dissecting the precise molecular mechanisms involved in the switch between apoptotic and nonapoptotic TRAIL signaling. Finally, we discuss the consequences thereof for a therapeutic manipulation of TRAIL in cancer and possible approaches to bypass these difficulties.
Divergent shrub‐cover responses driven by climate, wildfire, and permafrost interactions in Arctic tundra ecosystems
Authors: Chen Yaping , Hu Feng Sheng , Lara Mark J.
Published: November 2020

The expansion of shrubs across the Arctic tundra may fundamentally modify land–atmosphere interactions. However, it remains unclear how shrub expansion pattern is linked with key environmental drivers, such as climate change and fire disturbance. Here we used 40+ years of high‐resolution (~1.0 m) aerial and satellite imagery to estimate shrub‐cover change in 114 study sites across four burned and unburned upland (ice‐poor) and lowland (ice‐rich) tundra ecosystems in northern Alaska. Validated with data from four additional upland and lowland tundra fires, our results reveal that summer precipitation was the most important climatic driver (r = 0.67, p < 0.001), responsible for 30.8% of shrub expansion in the upland tundra between 1971 and 2016. Shrub expansion in the uplands was largely enhanced by wildfire (p < 0.001) and it exhibited positive correlation with fire severity (r = 0.83, p < 0.001). Three decades after fire disturbance, the upland shrub cover increased by 1077.2 ± 83.6 m2 ha−1, ~7 times the amount identified in adjacent unburned upland tundra (155.1 ± 55.4 m2 ha−1). In contrast, shrub cover markedly decreased in lowland tundra after fire disturbance, which triggered thermokarst‐associated water impounding and resulted in 52.4% loss of shrub cover over three decades. No correlation was found between lowland shrub cover with fire severity (r = 0.01). Mean summer air temperature (MSAT) was the principal factor driving lowland shrub‐cover dynamics between 1951 and 2007. Warmer MSAT facilitated shrub expansion in unburned lowlands (r = 0.78, p < 0.001), but accelerated shrub‐cover losses in burned lowlands (r = −0.82, p < 0.001). These results highlight divergent pathways of shrub‐cover responses to fire disturbance and climate change, depending on near‐surface permafrost and drainage conditions. Our study offers new insights into the land–atmosphere interactions as climate warming and burning intensify in high latitudes.
Global patterns of rainfall partitioning by invasive woody plants
Authors: Whitworth‐Hulse Juan I. , Magliano Patricio N. , Zeballos Sebastián R. , Aguiar Sebastián , Baldi Germán
Published: November 2020

Aim

Invasive species have the potential to alter hydrological processes by changing the local water balance. However, general patterns of how rainfall is partitioned into interception, throughfall and stemflow for invasive species worldwide have been seldom explored. We (a) describe the percentage of interception, throughfall and stemflow for invasive woody plant species; (b) analyse the influence of morphological attributes (i.e. life‐form, bark roughness, leaf type, leaf phenology and leaf area index) of invasive species on rainfall partitioning; and (c) compare the rainfall partitioning fluxes for co‐occurring invasive and native species, testing whether the variation in these fluxes depends on water availability of the study location.

Location

Global.

Time period

Present.

Major taxa studied

Plants.

Methods

We compiled data of 100 studies that assessed rainfall partitioning by invasive species (n = 67) and registered their morphological attributes. By means of a meta‐analysis we compared the rainfall partitioning by native and invasive species (n = 47 comparisons) and assessed how their fluxes were affected by water availability.

Results

Interception, throughfall and stemflow ranged from 1.6–59.5, 39.1–92.7 and 0.1–31.6% of total rainfall, respectively. The bark roughness and leaf type were the most important attributes driving rainfall partitioning fluxes. While rough‐barked species constrain rainfall inputs by promoting higher losses due to interception, smooth‐barked species with broad leaves enhance the amount of rainwater reaching the soil by maximizing stemflow. For pairwise comparisons, invasive species have higher stemflow values than native species for both drylands and humid areas, and higher throughfall in drylands, but less in humid areas.

Main conclusions

Our findings suggest that specific morphological attributes of invasive species determine higher localized water inputs, which may represent an ecohydrological advantage, particularly in water‐limited ecosystems. These insights also suggest that the ecological role of stemflow, throughfall and interception should be considered in future plant invasions research.
Changes in public perceptions and experiences of the Australian health‐care system: A decade of change
Authors: Ellis Louise A. , Pomare Chiara , Gillespie James A. , Root Jo , Ansell James , Holt Joanna , Wells Leanne , Tran Yvonne , Braithwaite Jeffrey , Zurynski Yvonne
Published: November 2020

Background

The views and experiences of the Australian public are an important barometer of the health system. This study provides key findings about the changing views held by Australians over time regarding their individual experiences and perceptions of the overall performance of the health system.

Methods

A population‐based online survey was conducted in 2018 (N = 1024). Participants were recruited through market research panels. The results were compared with previous Australian population survey data sets from 2008 (N = 1146), 2010 (N = 1201) and 2012 (N = 1200), each of which used different population samples. The survey included questions consistent with previous surveys regarding self‐reported health status, and questions about use, opinions and experiences of the health system.

Results

Overall, there has been a shift in views from 2008 to 2018, with a higher proportion of respondents now viewing the Australian health‐care system more positively (X2 (2, N = 4543) = 96.59, P < .001). In 2018, areas for attention continued to include the following: the need for more doctors, nurses and other health workers (29.0%); lower costs for care or Orion medicines (27.8%); more access to care (13.1%); and enhancements in residential aged care (17.3% rated these services as ‘bad’ or ‘very bad’).

Conclusions

This research suggests that Australians’ perceptions of their health‐care system have significantly improved over the last decade; however, concerns have emerged over access to medicines, inadequate workforce capacity and the quality of aged care facilities. Our study highlights the value of periodically conducting public sentiment surveys to identify potential emerging health system problems.
Midland non‐invasive ventilation score: a tool to predict non‐invasive ventilation failure in people with acute hypercapnic respiratory failure
Authors: Quigley David , Jones Simon , Piccolo Francesco , Huseini Taha , Manners David
Published: November 2020

Use of non‐invasive ventilation (NIV) in patients with hypercapnic respiratory failure has clear benefits over invasive ventilation. Existing risk prediction models are complex and difficult to apply in the acute setting. We developed the Midland NIV score comprising only five parameters for use to predict NIV failure (in‐hospital death or intubation) at initiation. Individuals with Midland NIV score of ≤11 (average 13% NIV failure) may be suitable for general ward care, compared to intensive care for those with Midland NIV score ≥12 (average 66% NIV failure rate). Prospective external validation is required.
Investigation the sodium storage kinetics of H1.07Ti1.73O4@rGO composites for high rate and long cycle performance
Authors: Hou Lijuan , Xu Tingting , Liu Ruichao , Yuan Huiyu , Kong Dezhi , Shen Weixia , Zang Jinhao , Li Xinjian , Wang Ye
Published: November 2020

Insertion type material has been attracted plenty of attentions as the anode of sodium ion batteries (SIBs) due to the low volume change induced long cycle stability. H1.07Ti1.73O4(HTO), a two‐dimensional layered material, is a new insertion type anode material for SIBs reported in this study. Layered HTO composites were decorated with rGO nanosheets via an electrostatic assembly method followed by hydrothermal treatment. When adapted as the anode material of SIBs, HTO@rGO composite exhibits an enhanced sodium ion storage behavior, including high rate capability and long cycle stability. It can deliver high capacities of 142.8 and 66.7 mA h g−1at 100 and 10 000 mA g−1, respectively. Moreover, it can keep a capacity of 75.1 mA h g−1at 5 A g−1after even 5000 cycles, corresponding to a high capacity retention of 70.8% (0.0058% capacity decay per cycle). HTO exhibits a small volume expansion of 19.6% by in‐situ transmission electron microscopy (in‐situ TEM). The diffusion coefficient of sodium ions is increased from 1.77 × 10−14 cm2 s−1in HTO composites to 4.80 × 10−14 cm2 s−1in HTO@rGO composites. Our designed and synthesized HTO@rGO provides a new route for high rate and long cycle stable SIBs anode materials.
Cost Avoidance: Not Everything that Counts is Counted
Authors: Ellram Lisa M. , Tate Wendy L.
Published: November 2020

It is widely recognized that one of the purchasing function’s primary objectives is to generate cost saving through cost reduction and cost avoidance as it works with the supply base to provide high quality materials and services on a timely basis. This research develops mid‐range theory by incorporating empirical evidence and the tenets of agency theory to the specific domain of a purchasing agent working within an organization. This domain differs from other agency relationships because there are multiple principals with misaligned goals within the organization that influence how purchasing cost saving are counted and thus influence the impact of those savings on purchasing performance. Agency theory helps articulate propositions in this context by providing insight into how purchasing agents perform their organizational duties related to cost saving and avoiding cost increases. The focus is specifically on examining how the challenging area of cost avoidance savings are tracked, measured, and recognized. Case studies from eight organizations reveal that there is significant prospect for suboptimal performance due to the design of reward and measurement systems and the reluctance of purchasing to challenge these systems. However, this can be addressed through an investment in robust systems supported by top management and finance.
Intraspecific variation in tolerance of warming in fishes
Authors: McKenzie David J. , Zhang Yangfan , Eliason Erika J. , Schulte Patricia M. , Claireaux Guy , Blasco Felipe R. , Nati Julie J.H , Farrell Anthony P.
Published: November 2020

Intraspecific variation in key traits such as tolerance of warming can have profound effects on ecological and evolutionary processes, notably responses to climate change. The empirical evidence for three primary elements of intraspecific variation in tolerance of warming in fishes is reviewed. The first is purely mechanistic that tolerance varies across life stages and as fishes become mature. The limited evidence indicates strongly that this is the case, possibly because of universal physiological principles. The second is intraspecific variation that is because of phenotypic plasticity, also a mechanistic phenomenon that buffers individuals’ sensitivity to negative impacts of global warming in their lifetime, or to some extent through epigenetic effects over successive generations. Although the evidence for plasticity in tolerance to warming is extensive, more work is required to understand underlying mechanisms and to reveal whether there are general patterns. The third element is intraspecific variation based on heritable genetic differences in tolerance, which underlies local adaptation and may define long‐term adaptability of a species in the face of ongoing global change. There is clear evidence of local adaptation and some evidence of heritability of tolerance to warming, but the knowledge base is limited with detailed information for only a few model or emblematic species. There is also strong evidence of structured variation in tolerance of warming within species, which may have ecological and evolutionary significance irrespective of whether it reflects plasticity or adaptation. Although the overwhelming consensus is that having broader intraspecific variation in tolerance should reduce species vulnerability to impacts of global warming, there are no sufficient data on fishes to provide insights into particular mechanisms by which this may occur.
Observational study evaluating the nutritional impact of changing from 1% to 2% propofol in a cardiothoracic adult critical care unit
Authors: Terblanche Ella , Remmington Chris
Published: November 2020

Background

Nutritional support in the critically ill aims to avoid under and overfeeding, adjusting to changes in energy expenditure during critical illness. The sedation propofol provides significant fat and energy load. We investigated whether changing from 1% to a 2% propofol, would decrease non‐nutritional energy, avoid energy overfeeding and increase the amount of protein delivered.

Methods

A retrospective observational study was performed. The primary outcome was protein delivery. Secondary outcomes were energy from propofol fat and the total energy delivered from nutrition and propofol.

Results

In total, 100 patients were investigated, with 50 patients in each group. The propofol dose was comparable for each group. The nutrition energy prescribed was significantly less for the 1% compared to 2% group, taking the energy from propofol into consideration. Both groups had similar protein targets, although the amount delivered was significantly higher in the 2% group. Thirty‐six percent of individuals receiving 1% exceeded 45% of total energy from fat. The poor delivery of nutrition resulted in inadequate energy and protein, irrespective of propofol dose.

Conclusions

We investigated the impact of propofol on energy overfeeding and under delivery of protein, and highlighted suboptimal nutritional provision. Work is needed to investigate the harm that high‐fat delivery may pose in light of poor nutrition delivery.
Evaluation and application of a new scintillator‐based heat‐resistant back‐scattered electron detector during heat treatment in the scanning electron microscope
Authors: Podor R. , Mendonça J. , Lautru J. , Brau H. P. , Nogues D. , Candeias A. , Horodysky P. , Kolouch A. , Barreau M. , Carrier X. , Ramenatte N. , Mathieu S. , Vilasi M.
Published: November 2020

A new high‐temperature detector dedicated to the collection of backscattered electrons is used in combination with heating stages up to 1050°C, in high‐vacuum and low‐vacuum modes in order to evaluate its possibilities through signal‐to‐noise ration measurements and different applications. Four examples of material transformations occurring at high temperature are herein reported: grain growth during annealing of a rolled platinum foil, recrystallisation of a multiphased alloy, oxidation of a Ni‐based alloy and complex phase transformations occurring during the annealing of an Al‐Si coated boron steel. The detector could be potentially adapted to any type of SEM and it offers good opportunities to perform high‐temperature experiments in various atmospheres.
The effect of a short‐term Balint group on the communication ability and self‐efficacy of pre‐examination and triage nurses during COVID‐19
Authors: Yang Chenghui , Zhou Bo , Wang Jinyu , Pan Shuya
Published: November 2020

Aims and objectives

To investigate the effect of a short‐term Balint group on the improvement in communication ability and self‐efficacy of pre‐examination and triage nurses during coronavirus disease 2019 (COVID‐19).

Background

Working on the front lines of COVID‐19 has brought unprecedented psychological stress on pre‐examination and triage nurses. Nurse–patient communication ability and the level of self‐efficacy are both significant for nurses’ psychosomatic health and work input. However, limited empirical evidence exists regarding nurse–patient communication and self‐efficacy and specific psychological intervention effects.

Design

Cross‐sectional research fulfilling the completed checklist of items that should be included in reports of cross‐sectional studies (Appendix S1).

Methods

Nurses (n = 41) in the first layer of pre‐examination and triage were engaged in a Balint group activity twice a week for two weeks. They were assessed with the General Self‐Efficacy Scale (GSES) pre‐ and postintervention, and a nurse–patient communication survey form was developed for further postintervention evaluation. The sample was recruited from a class A third‐grade hospital in Sichuan, China.

Results

Most of the subjects reported improvement in nurse–patient communication, increased cooperation between patients and their families, and a decreased missed examination rate after the intervention. Moreover, the total mean score of the GSES of nurses after the intervention was increased, but the difference was not statistically significant. The scores of all items in the GSES were improved, and the scores increase for item 4 (I am confident that I can effectively deal with any unexpected event) was statistically significant.

Conclusions

During the COVID‐19 pandemic, a short‐term Balint group activity can improve the communication ability and self‐efficacy level of front‐line nurses to some extent.

Relevance to clinical practice

This information may provide some theoretical support for the development of early psychological interventions during major epidemic situations.
Causal effects of the fracking boom on long‐term resident workers
Authors: Winters John V. , Cai Zhengyu , Maguire Karen , Sengupta Shruti
Published: November 2020

Horizontal drilling innovations revolutionized the U.S. oil and gas industry and facilitated a boom in production in the mid‐2000s in regions with shale and tight‐sands reservoirs. This paper examines the effects of the boom on individual employment and earnings within boom states. We account for endogenous migration decisions by using a novel instrument for oil and gas production in workers' state of residence. We find statistically significant and economically meaningful positive effects of the oil and gas boom for long‐term resident workers, those who were born in and reside in their home state.
Clinical practice of health professionals working in early detection for infants with or at risk of cerebral palsy across New Zealand
Authors: Williams Sîan A , Mackey Anna , Sorhage Alexandra , Battin Malcolm , Wilson Nichola , Spittle Alicia , Stott N Susan
Published: November 2020

Aim

A diagnosis of cerebral palsy (CP) can, and should, be made as early as possible. This work describes current clinical practice around the awareness and use of diagnostic tools for the detection of CP in New Zealand (NZ).

Methods

A purpose‐developed survey distributed electronically to NZ clinicians working with young children with or at risk of CP.

Results

A total of 159 clinicians (including paediatricians, physiotherapists and occupational therapists) participated in this cross‐sectional study. Ninety‐six percent were aware that a diagnosis of CP can be made by 12 months of age, with high levels of awareness of the use of magnetic resonance imaging (94%), Prechtl's qualitative assessment of general movements (GMs) (70%) and Hammersmith Infant Neurological Examination (HINE) (77%). Only 40% were aware of the HINE optimality scoring. Fifty‐four clinicians provided a diagnosis of CP as part of their role: 48% never used the GMs or HINE to assess children <1 year, and 57% never used the HINE for children between 1 and 2 years. Clinicians not providing a diagnosis within their professional role (n = 104) also indicated infrequent use of assessment tools with 74% and 54% never using the GM's or HINE (respectively) in their assessment of children at risk of CP. Barriers to use included lack of time and funding, lack of clear pathways and management support.

Conclusion

Despite high awareness, current use of international best practice tools in NZ clinical practice appears low. Multiple barriers are reported to the use of these tools, which need to be addressed to improve the timeliness of diagnosis.
Xylella fastidiosa causes transcriptional shifts that precede tylose formation and starch depletion in xylem
Authors: Ingel Brian , Reyes Clarissa , Massonnet Mélanie , Boudreau Bailey , Sun Yuling , Sun Qiang , McElrone Andrew J. , Cantu Dario , Roper M. Caroline
Published: November 2020

Pierce's disease (PD) in grapevine (Vitis vinifera) is caused by the bacterial pathogen Xylella fastidiosa. X. fastidiosa is limited to the xylem tissue and following infection induces extensive plant‐derived xylem blockages, primarily in the form of tyloses. Tylose‐mediated vessel occlusions are a hallmark of PD, particularly in susceptible V. vinifera. We temporally monitored tylose development over the course of the disease to link symptom severity to the level of tylose occlusion and the presence/absence of the bacterial pathogen at fine‐scale resolution. The majority of vessels containing tyloses were devoid of bacterial cells, indicating that direct, localized perception of X. fastidiosa was not a primary cause of tylose formation. In addition, we used X‐ray computed microtomography and machine‐learning to determine that X. fastidiosa induces significant starch depletion in xylem ray parenchyma cells. This suggests that a signalling mechanism emanating from the vessels colonized by bacteria enables a systemic response to X. fastidiosa infection. To understand the transcriptional changes underlying these phenotypes, we integrated global transcriptomics into the phenotypes we tracked over the disease spectrum. Differential gene expression analysis revealed that considerable transcriptomic reprogramming occurred during early PD before symptom appearance. Specifically, we determined that many genes associated with tylose formation (ethylene signalling and cell wall biogenesis) and drought stress were up‐regulated during both Phase I and Phase II of PD. On the contrary, several genes related to photosynthesis and carbon fixation were down‐regulated during both phases. These responses correlate with significant starch depletion observed in ray cells and tylose synthesis in vessels.
Selected updates in molecular and genomic pathology of esophageal cancer
Authors: Liu Yueping , Zhao Lei , Xue Liyan , Hou Yingyong
Published: November 2020

Recent years have seen rapid advances in the field of molecular and genomic pathology that have not only improved understanding of esophageal carcinogenesis and tumor immune environment in general but also have reshaped pathology practice and clinical management. In this article, we provide updates on three topics (1) human epidermal growth factor receptor 2, the first and most important biomarker in targeted therapy of esophageal cancer; (2) programmed death 1/programmed death ligand 1, recent biomarkers that have shown promise in treating both esophageal adenocarcinoma and esophageal squamous cell carcinoma; and (3) human papillomavirus involvement in esophageal carcinogenesis, one of the most debated topics in the field, discussed here with a renewed understanding from recent genomic and molecular data.
Oral and oropharyngeal cancer mortality in Brazil, 1983–2017: Age–period–cohort analysis
Authors: Perea Lillia Magali Estrada , Antunes José Leopoldo Ferreira , Peres Marco Aurélio
Published: November 2020

Aim

To estimate the effect of age, period, and birth cohort on mortality from oral and oropharyngeal cancer in Brazil.

Methods

Deaths due to oral and oropharyngeal cancer from 1983 to 2017 were analyzed. The effect of age, period, and cohort was calculated using the Poisson regression model.

Results

Between 1983 and 2017, 142,634 deaths were recorded from oral and oropharyngeal cancer in Brazil, 54% from oropharyngeal cancer. The male sex contributed to 81% of the deaths. The average mortality rate for men was 4.5 deaths per 100,000 inhabitants, and for women, it was 0.9 deaths per 100,000 inhabitants. There was a strong effect of age on mortality rates from oral and oropharyngeal cancer. The risk increases from 40 years of age in men and 55 years of age in women. An overall period effect was observed. The 2000 period showed the greatest risk when compared to the 1985 period in men. In women, the period of highest risk was 2010. The cohorts born between 1958 and 1962 had a higher risk of death.

Conclusions

The period effect is mainly attributed to mortality from oropharyngeal cancer. Most significant values regarding the effect on the cohort groups were observed in female mortality from oral cancer.
Sickle cell osteomyelitis: A novel approach and review of the literature
Authors: Mahendran Krishantini , Wali Rana , Patel Vinod
Published: November 2020

Aim

Sickle cell disease is a well‐recognized risk factor for the development of osteomyelitis. Its occurrence in the mandible is both complex and challenging. Antibiotics and surgery remain the main treatment modalities, but both have varying success in refractory osteomyelitis. With increasing individual clinical cases highlighting the successful management of both primary and secondary chronic osteomyelitis with bisphosphonate therapy, it was considered a viable last line trial medication prior to aggressive surgery in refractory sickle cell osteomyelitis.

Materials and methods

Two cases are retrospectively reported for the use of oral bisphosphonates.

Results

Both cases showed positive outcomes both clinically and radiographically in response to oral bisphosphonates with no recurrence of acute episodes even on the background of recurring sickle crises.

Conclusion

The current cases are the first in the literature to report successful management of sickle cell osteomyelitis with oral bisphosphonates and explores the literature on previous reports of the condition.
Biomechanical Comparison of INTERTAN Nail and Gamma3 Nail for Intertrochanteric Fractures
Authors: Luo Wei , Fu Xin , Ma Jian‐xiong , Huang Jing‐min , Wu Jiang , Ma Xin‐long
Published: November 2020

Objective

To compare the biomechanical stabilities of Gamma3 nail and INTERTAN nail (ITN) for stable (AO/OTA 31A1.1) and unstable (AO/OTA 31A2.2) femoral intertrochanteric fracture.

Methods

Twenty‐four synthetic femora were randomly divided into four groups. After internal fixation (Gamma3 nail or ITN) had been implanted, stable and unstable intertrochanteric fracture models were produced. A cyclic testing protocol with increasing loads was performed for both stable and unstable intertrochanteric fracture models, and then torsional test and axial compression failure test were conducted. Stiffness, failure load, torque, and fragment displacement were recorded.

Results

For stable fracture model: fragment displacement in ITN group were smaller than Gamma3 nail group (Gamma3 nail: 1.66 ± 0.13 mm; ITN: 1.55 ± 0.1 mm); stiffness (Gamma3 nail: 1142.6 ± 161.1 N/mm, ITN: 1159.3 ± 203.5 N/mm, P = 0.872) and failure load (Gamma3 nail: 5715.42 ± 616.34 N, ITN: 5690.27 ± 625.59 N, P = 0. 951) of the two nails were similar after cyclic test; torque of the ITN group was larger than the Gamma3 nail group. For unstable fracture model: fragment displacement in ITN group was significantly smaller than in the Gamma3 nail group when the axial load was larger than 800 N (Gamma3 nail: 3.59 ± 0.19 mm; ITN: 2.93 ± 0.28 mm); ITN group showed a significantly higher failure load than Gamma3 nail group (Gamma3 nail: 2942.77 ± 573.4 N, ITN: 3672.3 ± 790.5 N, P = 0. 011); torque was significantly higher for the ITN group compared to the Gamma3 nail group for three different angles.

Conclusions

Both ITN and Gamma3 nail can maintain sufficient biomechanical stability for stable intertrochanteric fractures, but ITN was a better choice for unstable intertrochanteric fractures.
Cardiac‐specific beta‐blockers and asthma: An end to fear?
Authors: Harrington John
Published: November 2020

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Physical characterization of swine and human skin: Correlations between Raman spectroscopy, Tensile testing, Atomic force microscopy (AFM), Scanning electron microscopy (SEM), and Multiphoton microscopy (MPM)
Authors: Labroo Pratima , Irvin Jennifer , Johnson Joshua , Sieverts Michael , Miess James , Robinson Ian , Baetz Nicholas , Garrett Caroline , Sopko Nikolai
Published: November 2020

Background

Swine dorsum is commonly utilized as a model for studying skin wounds and assessment of dermatological and cosmetic medicaments. The human abdomen is a common location for dermatological intervention.

Objective

This study provides a correlation between spectral, mechanical, and structural characterization techniques, utilized for evaluating human abdominal skin and swine dorsum.

Methods

Raman spectroscopy (RS), tensile testing, ballistometry, AFM, SEM, and MPM were utilized to characterize and compare full‐thickness skin properties in swine and human model.

Results

RS of both species' skin types revealed a similar assignment of vibrations in the fingerprint and the high wavenumber spectral regions. Structural imaging and mechanical characterization using ballistometry and tensile testing displayed differences in the inherent functional properties of human and swine skin. These differences correlated with variations in the Raman peak ratios, collagen intensity measured using SEM and MPM and collagen density measured using AFM.

Conclusion

A comprehensive evaluation of swine skin as a suitable substitute for human skin for mechanical and structural comparisons was performed. This data should be considered for better understanding the swine skin model for cutaneous drug delivery and wound applications. Additionally, correlation between RS, tensile testing, AFM, SEM, and MPM was performed as skin characterization tools.