bluuebunny/crossref_metadata_2025 huggingface dataset:
A state‐of‐the‐art review of the experience of care coordination interventions for people living with multimorbidity
Authors: Peart Annette , Barton Chris , Lewis Virginia , Russell Grant
Published: February 2020

Aim

To explore recent research on care coordination interventions for people living with multimorbidity, from the perspective of the person receiving care.

Background

Care coordination interventions for people living with multimorbidity show some effectiveness in improving management of their health and reducing potentially preventable hospitalisations. The experience of people enrolled in care coordination interventions requires further exploration.

Design

State‐of‐the‐art review.

Methods

A review was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) checklist where five databases (The Cochrane Library, PsycINFO, Scopus, CINAHL and MEDLINE) were searched for qualitative sources published from January 2008–March 2019. Two additional databases focused on multimorbidity and integrated care were included in the search. Titles, abstracts and full texts were screened using inclusion criteria. Reference lists of the included articles were hand‐searched. Summary tables were developed for data extraction, and the data were mapped to the research question.

Results

Eighteen primary research articles were included. Three themes of participant experience were identified: (a) relationships built on trust, (b), a sense of safety and security and (c) feeling cared for and respected.

Conclusion

The contribution of qualitative approaches to evaluating the experiences of care for people living with multimorbidity is growing. Participants’ describe a focus on relationships formed with healthcare professionals during care coordination. Further research incorporating lived experiences of participants could illuminate these concepts further.

Relevance to clinical practice

People living with multimorbidity who require assistance via care coordination value trusting relationships with healthcare professionals, who respect their needs and provide a sense of security. Understanding participant experiences is important to shape care coordination interventions that incorporate person‐centred approaches.
Behavioural disturbances in patients with frontotemporal lobe degeneration focusing on caregiver burden at home and in nursing homes
Authors: Rognstad May‐Karin , Nåden Dagfinn , Ulstein Ingun , Kvaal Kari , Langhammer Birgitta , Sagbakken Mette
Published: February 2020

Aim and objective

To explore the challenges faced by family caregivers of people with frontotemporal dementia and other forms of dementia affecting the frontal and temporal lobes causing behavioural disturbances through a qualitative approach with in‐depth interviews.

Background

Studies of different forms of dementia involving degeneration of the frontal and temporal lobes have mainly focused on the neurophysiology and physiology of the disease and on caregivers’ health. Few studies have described the challenges and burdens connected with everyday life and in relation to suitable nursing home placement that are faced by family caregivers.

Method and design

This study used a descriptive and explorative design. Eleven semi‐structured interviews with family caregivers of patients from special units in four nursing homes were conducted in 2014. Data were analysed based on Kvale and Brinkmann's three contexts of interpretation: self‐understanding, common sense and theoretical understanding. Checklist for qualitative studies: Standards for Reporting Qualitative Research (SRQR) http://www.equator-network.org/reporting-guidelines/srqr/

Results

Two central themes were derived from the data: changes in behaviour and personality were perceived as incomprehensible, frightening and increasingly difficult to manage. Family caregivers experienced challenges in finding suitable care facilities when they were not able to continue providing home care. Due to behavioural disturbances and lack of relevant competencies among health personnel, family members were often moved between nursing homes.

Conclusion

Pronounced personality and behavioural disturbances such as tactlessness and aggression in a family member with dementia are experienced by caregivers as stressful and burdensome and may lead to feelings of shame and guilt. A lack of suitable care facilities adds to the stress and difficulties of the families and entails an additional and unresolved burden.

Relevance to Clinical Practice

The study reveals a need for more knowledge among those organising health services as well as healthcare professional dealing with this patient category to ease the burden on next of kin.
Mediating the interface between voluntariness and coercion: A qualitative study of learning disability nurses’ work in medical examinations of people with intellectual disability
Authors: Sparby Linn Ebeltoft , Olsvold Nina , Obstfelder Aud
Published: February 2020

Aims and Objectives

To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance.

Background

Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability.

Design

We used an ethnographic comparative case design (n = 6).

Methods

The study was carried out in Norway. The analysis is based on data from semi‐structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used.

Results

Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supporting the individual in three phases: preparing for the examination, facilitating the examination and, when facing resistance, intervening to ensure safe and compassionate completion of the examination.

Conclusions

Supporting the person was a precarious process where professionals had to balance considerations of voluntariness and coercion, progress and breakdown, safety and risk of injury, and dignity and violation. Through their support, learning disability nurses helped to constitute the “resistant” individual as “a cooperative patient,” whose body could be examined within the knowledge and methods of medicine, but who could also be safeguarded as a human being through the strain of undergoing examination.

Relevance to clinical practice

The article sheds light on how restraints are used in the medical examination and treatment of people with intellectual disabilities and demonstrates the significance of professional support workers’ contributions, both in facilitating safe and efficient medical care and in ensuring the least restrictive and most compassionate care possible.
Front‐line nurses' perceptions of intra‐hospital handover
Authors: Tobiano Georgia , Ting Christine , Ryan Christine , Jenkinson Kim , Scott Lucie , Marshall Andrea P.
Published: February 2020

Aim and objective

To explore nurses' perceptions of factors that help or hinder intra‐hospital handover.

Background

Miscommunication during clinical handover is a leading cause of clinical incidents in hospitals. Intra‐hospital nursing handover between the emergency department and inpatient unit is particularly complex.

Design

A descriptive, qualitative study. This research adheres to the consolidated criteria for reporting qualitative research.

Methods

Forty‐nine nurses participated in group interviews, which were analysed using inductive content analysis.

Results

Three categories emerged: (a) “lacking clear responsibilities for who provides handover”; (b) “strategies to ensure continuity of information”; and (c) “strained relationships during handover.”

Conclusions

Intra‐hospital handover requires clear processes, to promote high‐quality information sharing. Ensuring these processes are broad and acceptable across units may ensure nurses' needs are met. Relational continuity between nurses is an important consideration when improving intra‐hospital handover.

Relevance to clinical practice

Nursing managers are optimally positioned to enhance intra‐hospital handover, by liaising and enforcing standardisation of processes across units. Nurse managers could promote intra‐unit activities that foster front‐line nurses' communication with each other, to encourage problem‐solving and partnerships.
The role of nurses and midwives in the provision of abortion care: A scoping review
Authors: Mainey Lydia , O’Mullan Catherine , Reid‐Searl Kerry , Taylor Annabel , Baird Kathleen
Published: February 2020

Aims and objectives

To define the role and scope of the nurse and midwife within the global context of abortion.

Background

An estimated 56 million women seek abortions each year; nurses and midwives are commonly involved in their care (Singh et al., 2018, https://www.guttmacher.org/sites/default/files/report_pdf/abortion-worldwide-2017.pdf). As new models of abortion care emerge, there is a pressing need to develop a baseline understanding of the role and scope of nurses and midwives who care for women seeking abortions.

Design

The review design was Arksey and O’Malley's five‐stage methodological framework. The review follows the PRISMA‐ScR checklist.

Methods

MEDLINE, CINAHL, Scopus and ScienceDirect were used to identify original research, commentaries and reports, published between 2008–2019, from which we selected 74 publications reporting on the nursing or midwifery role in abortion care.

Results

Nurses and midwives provide abortion care in a variety of practice. Three themes emerged from the literature: the regulated role; providing psychosocial care; and the expanding scope of practice.

Conclusions

The literature on nursing and midwifery practice in abortion care is broad. Abortion‐related practices are potentially over‐regulated. Appropriately trained nurses and midwives can provide abortions as safely as physicians. The preparation of nurses and midwives to provide abortion care requires further research. Also, healthcare organisations should explore person‐centred models of abortion care.

Relevance to clinical practice

Abortion care is a common procedure performed across many healthcare settings. Nurses and midwives provide technical and psychosocial care to women who seek abortions. Governments and regulatory bodies could safely extend their scope of practice to increase women's access to safe abortions. Introduction of education programmes, as well as embedding practice in person‐centred models of care, may improve outcomes for women seeking abortions.
Sequence variant in the CDC42BPB gene is potentially associated with Mullerian duct anomalies
Authors: Luo Li‐Jing , Feng Fan , Li Sheng‐Hui , Lu Dan , Li Lin , Zhou Qi
Published: February 2020

Aim

Mullerian duct anomalies (MDA) are common female genital tract malformations. Genetic and environmental factors are important causes of MDA in women. Although many genes and mutations have been found to be associated with the pathogenesis of MDA, in most cases, the genetic pathogenic factors of MDA are still unknown.

Methods

We first analyzed the three sisters using low coverage whole‐genome sequencing. Then whole‐exome sequencing was carried out in each patient. The identified sequence variant was confirmed by Sanger sequencing. In silico pathogenicity analysis and conservative analysis of the mutation site were also performed. Protein structural modeling was used to analyze the effect of the mutated amino acid.

Results

We first analyzed the three sisters with septate uterus using low coverage whole‐genome sequencing, but no possible pathogenic copy number variation was found. Then whole‐exome sequencing was performed on the three sisters, and a rare homozygous variant, CDC42BPB:c.2012G>A:p.R671Q, was identified. All three patients were found with this variant. Sanger sequencing validated that this variant was segregated within the family. In silico pathogenicity analysis and conservative analysis of the mutation site suggested that the variant might be damaging. Protein structural analysis suggested that R671Q might weaken the electrostatic potential of this region, which may be a significant regulation target or protein interaction surface of CDC42BPB.

Conclusion

We demonstrated that CDC42BPB genetic variant might be potentially associated with the pathogenesis of MDA.
Effectiveness of the Visual–Auditory Shadowing Method on Learning the Pronunciation of Kanji
Authors: Nakayama Tomokazu
Published: February 2020

This study investigates whether the visual–auditory (VA) shadowing method can better facilitate vocabulary learning for learners of Japanese as a second language (JSL) than the visual–visual (VV) shadowing method in K‐8 immersion education. Learning vocabulary involves three aspects: meaning, orthography, and pronunciation. The Japanese language has complex orthography and pronunciation. Learners of Japanese need to learn three kinds of orthographic characters: ideographs (kanji) and two kinds of syllabic characters (hiragana and katakana). In addition, because the pronunciation of kanji can vary by context, learners must learn several pronunciations for a single kanji character. This study explores a reasonable way to learn pronunciations of kanji and compares VA shadowing (n = 48) and VV shadowing (n = 47) to investigate which condition better facilitates learning the pronunciation of Japanese ideographs. The analysis suggests that compared to the VV shadowing condition (p < .05), the VA shadowing condition is more effective for Level 3 learners but not for Level 2 or Level 1 learners.
Exploring the Impact of ACA on Rural‐Urban Disparity in Oral Health Services Among US Noninstitutionalized Adults
Authors: Lee Wei‐Chen , Li Chih‐Ying , Serag Hani , Tabrizi Maryam , Kuo Yong‐Fang
Published: February 2020

Purpose

To explore the effect of the Affordable Care Act (ACA) on rural disparities in oral health services utilization based on disability status.

Methods

Comparing the 2011‐2013 with the 2014‐2016 Medical Expenditure Panel Survey, the study estimated the impacts of ACA on the likelihood of having preventive checkup and utilization of dental treatments in adults older than 18.

Findings

The sample consists of 216,184 noninstitutionalized adults with 14.5% living in rural areas. There was a slight improvement in the receipt of oral health services after ACA, but the improvement was not statistically significant. Disability remains a barrier to receiving preventive oral health checkups, and living in rural areas is a barrier for both utilization of preventive checkups and dental treatments.

Conclusions

Unmet needs for preventive checkups may result in unnecessary, costly dental treatments. More strategies are needed to reduce the disparities in oral health services.
eDNA metabarcoding survey reveals fine‐scale coral reef community variation across a remote, tropical island ecosystem
Authors: West Katrina M. , Stat Michael , Harvey Euan S. , Skepper Craig L. , DiBattista Joseph D. , Richards Zoe T. , Travers Michael J. , Newman Stephen J. , Bunce Michael
Published: February 2020

Environmental DNA (eDNA) metabarcoding, a technique for retrieving multispecies DNA from environmental samples, can detect a diverse array of marine species from filtered seawater samples. There is a growing potential to integrate eDNA alongside existing monitoring methods in order to establish or improve the assessment of species diversity. Remote island reefs are increasingly vulnerable to climate‐related threats and as such there is a pressing need for cost‐effective whole‐ecosystem surveying to baseline biodiversity, study assemblage changes and ultimately develop sustainable management plans. We investigated the utility of eDNA metabarcoding as a high‐resolution, multitrophic biomonitoring tool at the Cocos (Keeling) Islands, Australia (CKI)—a remote tropical coral reef atoll situated within the eastern Indian Ocean. Metabarcoding assays targeting the mitochondrial 16S rRNA and CO1 genes, as well as the 18S rRNA nuclear gene, were applied to 252 surface seawater samples collected from 42 sites within a 140 km2 area. Our assays successfully detected a wide range of bony fish and elasmobranchs (244 taxa), crustaceans (88), molluscs (37) and echinoderms (7). Assemblage composition varied significantly between sites, reflecting habitat partitioning across the island ecosystem and demonstrating the localisation of eDNA signals, despite extensive tidal and oceanic movements. In addition, we document putative new occurrence records for 46 taxa and compare the efficiency of our eDNA approach to visual survey techniques at CKI. Our study demonstrates the utility of a multimarker metabarcoding approach in capturing multitrophic biodiversity across an entire coral reef atoll and sets an important baseline for ongoing monitoring and management.
Differences in teaching female and male intimate examinations: A qualitative study
Authors: Gleisner Jenny , Siwe Karin
Published: February 2020

Context

Teaching intimate examinations to medical students has been recognised as difficult because of the anxious feelings that the students may experience. For their professional development, previously incorporated understandings need to be relearned: how to transgress boundaries that regulate intimacy and physical closeness, learning to examine and touch other peoples' bodies, and talking about things that are otherwise taboo.

Objectives

This paper compares how students learn to perform two intimate examinations: (i) the digital rectal examination (DRE) of the prostate, and (ii) the bimanual pelvic examination (PE) and analyses how norms and expectations affect how students learn to approach them.

Methods

This study is based on ethnographic work: in‐depth qualitative interviews with two urologists and nine medical students in semesters four, eight and 11 of a medical education programme in Sweden, observations of three learning sessions where 16 students performed the PE on professional patients, and 2 days of observations at a urology outpatient clinic.

Results

The educational approach to the PE and DRE differ. The PE is taught as sensitive and to be handled with care, using a well‐documented learning concept including interpersonal and technical skills. The patient's exposed position in the gynaecological chair, possible previous negative experiences of PE or sexual exploitation are taken into account. In contrast, there is no educational concept for teaching the DRE. The students perform their first DRE on a clinical patient. The DRE is also handled with care, but with less sensitivity. The patients' possible previous negative experiences are not discussed and are thus made invisible.

Conclusions

Well‐established routines in performing the PE help doctors and students to be attentive to patients' emotions and previous experiences, and remind them to perceive the examination as sensitive. Aligning the teaching of the DRE with that of the PE will improve how the male prostate patient is approached.
Histopathological determinants of autofluorescence patterns in oral carcinoma
Authors: Meleti Marco , Giovannacci Ilaria , Vescovi Paolo , Pedrazzi Giuseppe , Govoni Paolo , Magnoni Cristina
Published: February 2020

Biological tissues (including oral mucosa) can absorb and re‐emit specific light wavelengths, detectable through spectrophotometric devices. Such a phenomenon is known as “autofluorescence” (AF). Several devices evaluating tissue AF have been developed and commercialized in the last two decades. Among these, the VELscope® system has been proposed as a visual diagnostic aid for potentially malignant disorders and malignant lesions of the oral mucosa. In the present pilot study, we investigated which are the main histopathological features possibly related to variations in AF patterns in a set of 20 oral squamous cell verrucous carcinoma. Among all the histological features investigated, only the mean width of keratin was significantly different between hypofluorescent and hyperfluorescent carcinomas. The results of the present study demonstrate that AF features of oral malignant lesions are significantly associated with the width of their keratin layer.
IGS region polymorphisms are responsible for failure of commonly used species‐specific primers in Fusarium proliferatum isolates from diseased garlic
Authors: Gálvez Laura , Clarkson John P. , Palmero Daniel
Published: February 2020

Fusarium proliferatum is a globally distributed fungal pathogen that affects a range of crop hosts and is one of the main producers of mycotoxins, such as fumonisins, in foods. Specific PCR primers are commonly used for detection and identification of this pathogen. The aim of this study was to validate previously published F. proliferatum‐specific primers targeting the intergenic spacer (IGS) region and characterize intraspecific variation and homologous recombination events for isolates obtained from diseased garlic bulbs in Spain. Sixty‐nine isolates were morphologically identified as F. proliferatum, and their identity was confirmed by sequencing of the translation elongation factor; however, specific IGS primers did not result in an amplification product for nine of these isolates. Further analysis showed that this was due to polymorphism in the IGS region and six isolates were classified as IGS type I, while the remaining isolates were type II. Sequencing of the complete IGS region revealed numerous sequence polymorphisms amongst F. proliferatum isolates, and regions of recombination. Duplication and deletion events may have occurred via unequal crossing over during mitotic or meiotic recombination. These results suggest that the IGS region may be too variable as a reliable target for F. proliferatum‐specific identification.
The effects of acceptance and commitment therapy on lifestyle and behavioral changes: A systematic review of randomized controlled trials
Authors: Yıldız Erman
Published: February 2020

Purpose

To determine, evaluate, and synthesize the best available evidence about the evidence‐based pragmatic effects of acceptance and commitment therapy (ACT) on lifestyle and behavioral changes (LBCs).

Design and Methods

The PICOS formulations were used to improve the search strategy of this systematic review with the aim to find the right evidence and ask the right questions. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's standardized critical assessment and data extraction tools.

Findings

This study involved 30 randomized controlled trials (RCTs) which met the research criteria. Although the included RCTs have several limitations in themselves, the results of this study suggested that the ACT will help maintain long‐term LBCs (eg, weight management, effective coping with substance‐related and addictive problems, eating and physical activity).

Practice Implications

Given that ACT is a trandiagnostic approach that promotes health‐related LBCs in many diseases and populations, it seems reasonable for clinicians to use and test ACT to achieve pragmatic results.
“If the Big Fish are Doing It Then Why Not Me Down Here?”: Informal Fee Payments and Reproductive Health Care Provider Motivation in Kenya
Authors: Tumlinson Katherine , Gichane Margaret W. , Curtis Siân L.
Published: February 2020

Informal fees are payments made by patients to their health care provider that are over and above the official cost of services. Payments may be motivated by a combination of factors such as low supervision, weak sanctions, and inadequate provider salaries. The practice of soliciting informal fees from patients may result in restricted access to medical care and reduced care‐seeking behavior among vulnerable populations. The objective of this study is to examine nuanced health care provider perspectives on informal fee payments solicited from reproductive health patients in Kenya. We conducted in‐depth semistructured interviews in 2015–2016 among a sample of 20 public and private‐sector Kenyan health care workers. Interviews were coded and analyzed using an iterative thematic approach. More than half of participants reported that solicitation of informal fees is common practice in health care facilities. Providers reported low public‐sector wages were a primary driver of informal fee solicitation coupled with collusion among senior staff. Additionally, patients may be unaware that they are being asked to pay more than the official cost of services. Strategies for reducing this behavior include more adequate and timely remuneration within the public sector, educating patient populations of free or low‐cost services, and evidence‐based methods to increase provider motivation.
Journal Bearing Surface Topography Design Based on Transient Lubrication Analysis
Authors: Gu Thomas , Jane Wang Q. , Gangopadhyay Arup , Liu Zhiqiang
Published: February 2020

A transient mixed lubrication model is used to study the performance of a journal bearing subjected to impulse loading, considering mass conservation and the effects of asperities on flow and contact, to explore a novel journal bearing surface design methodology. The bearing surface features include an outlet pocket and axial lip for topographical design consideration. A data-driven approach for a steadily loaded bearing was first presented to illustrate the behavior of an indented pocket design at low and high loads, and Pareto optimization and sensitivity analysis methods were employed to analyze the data and provide insight to the design. The results show that the pocket location was the most influential parameter for the optimal bearing surface design for energy-efficient lubrication performance. For transient operation, a comprehensive parametric study was conducted, and the results reveal that, when compared to the results of the unmodified bearing, the bearing designed with the optimal outlet pocket can run at 9% lower mean friction while maintaining the baseline film thickness. The bearing with the lip feature shows a 20% minimum film thickness increase and 3% mean friction reduction. The design with outlet pocket and lip features combined can lead to 20% film thickness increase and 10% mean friction reduction.
Maximizing the Lubricant Film Thickness Between a Rigid Microtextured and a Smooth Deformable Surface in Relative Motion, Using a Soft Elasto-Hydrodynamic Lubrication Model
Authors: Allen Quentin , Raeymaekers Bart
Published: February 2020

We design a pattern of microtexture features to increase hydrodynamic pressure and lubricant film thickness in a hard-on-soft bearing. We use a soft elastohydrodynamic lubrication model to evaluate the effect of microtexture design parameters and bearing operating conditions on the resulting lubricant film thickness and find that the maximum lubricant film thickness occurs with a texture density between 10% and 40% and texture aspect ratio between 1% and 14%, depending on the bearing load and operating conditions. We show that these results are similar to those of hydrodynamic textured bearing problems because the lubricant film thickness is almost independent of the stiffness of the bearing surfaces in full-film lubrication.
Revealing the Linear and Nonlinear Dynamic Behaviors of Metabeams With a Dynamic Homogenization Model
Authors: Lou Jia , He Liwen , Du Jianke , Wu Huaping
Published: February 2020

Metastructures can be designed to exhibit extraordinary properties and thus are widely applicable in various fields, such as vibration suppression, wave control, and energy harvesting. In the present work, a dynamic homogenization model is strictly derived for a metabeam (a beam with periodic resonators) by using the asymptotic homogenization method. The homogenization model is validated via comparing the vibration frequencies and associated vibration modes of the metabeam predicted by the present model with exact ones, and it is then used to analyze the linear (or nonlinear) vibration responses of the metabeam subject to a harmonic excitation with a small- (or large-) amplitude. Furthermore, the effect of periodic resonators on the vibration suppression performance of the metabeam is discussed. It is demonstrated that such kind of dynamic homogenization model is of great convenience to predict the vibration responses of metastructures besides the widely studied dispersion relation. Thus, it is expected to be useful for the vibration suppression and control of engineering structures.
Deep Reinforcement Learning for Procedural Content Generation of 3D Virtual Environments
Authors: López Christian E. , Cunningham James , Ashour Omar , Tucker Conrad S.
Published: February 2020

This work presents a deep reinforcement learning (DRL) approach for procedural content generation (PCG) to automatically generate three-dimensional (3D) virtual environments that users can interact with. The primary objective of PCG methods is to algorithmically generate new content in order to improve user experience. Researchers have started exploring the use of machine learning (ML) methods to generate content. However, these approaches frequently implement supervised ML algorithms that require initial datasets to train their generative models. In contrast, RL algorithms do not require training data to be collected a priori since they take advantage of simulation to train their models. Considering the advantages of RL algorithms, this work presents a method that generates new 3D virtual environments by training an RL agent using a 3D simulation platform. This work extends the authors’ previous work and presents the results of a case study that supports the capability of the proposed method to generate new 3D virtual environments. The ability to automatically generate new content has the potential to maintain users’ engagement in a wide variety of applications such as virtual reality applications for education and training, and engineering conceptual design.
Multilayer film passivation for enhanced reliability of power semiconductor devices
Authors: Busca Roberta , Cimmino Davide , Ferrero Sergio , Scaltrito Luciano , Pirri Candido Fabrizio , Richieri Giovanni , Carta Rossano
Published: February 2020

Automotive requirements are becoming ever more severe in terms of device operation under high stress and in harsh working conditions. In this context, passivation layers play a fundamental role in determining electrical performance and reliability. This study focuses on the primary and secondary passivation layers applied to the state-of-the-art power devices and their influence on reliability. Power diodes assembled in standard module packages are used as test vehicles, and high-voltage temperature humidity bias tests are performed to stress the structures. A complete failure mode analysis highlights the phenomena behind the degradation of the passivation layers. Different passivation schemes are evaluated through the application of specific inorganic and organic combinations of layers. Finally, a summary of the typical degradation mechanisms and interactions is presented.
Photoluminescence from carbon structures grown by inductively coupled plasma chemical vapor deposition
Authors: Musheghyan-Avetisyan Arevik , Güell Frank , Martínez-Alanis Paulina R. , Amade Roger , Martí-González Joan , Bertran-Serra Enric
Published: February 2020

Carbon micro/nanostructures were grown by inductively coupled plasma chemical vapor deposition (ICP-CVD) at low pressure into a tubular reactor under pure methane and using substrates of SAE 304 stainless steel. The samples show diverse structures and properties depending on the position inside the quartz tube, due to the different temperatures and environmental conditions. In this experiment, the authors have obtained structures with different scales (micro and nano), depending on the growing temperature and the position inside the reactor. Carbon microstructures were obtained on the extreme parts of the tubular reactor at low temperatures. In contrast, carbon nanostructures appeared after the plasma resonator at temperatures higher than 700 °C. X-ray photoelectron spectroscopy and Fourier transform infrared spectrometry evidenced functional groups with hydrogen and oxygen atoms except for nanostructures at 750 °C showing vertical carbon nanowalls with more than ten crystalline layers, such as it was verified by field emission SEM, TEM, and Raman shift spectroscopy. An intense photoluminescence in the visible range was revealed from the samples excited by laser (325 nm), except the nanowall samples, which exhibited a poor photoluminescence. The purpose of this work is to study the photoluminescence of carbon structures produced by ICP-CVD and to evidence the role of hydrogen and oxygen functional groups with hydrogen and oxygen atoms. The understanding of these processes provides additional criteria for designing new materials based on carbon, which is environmentally friendly, for application to luminescent devices.
Anomalous diffusion of acoustic waves in 2D periodic media: Radiative transport and renormalization analysis
Authors: Buonocore Salvatore , Sen Mihir , Semperlotti Fabio
Published: February 2020

This work investigates the occurrence of anomalous transport of acoustic waves propagating in two-dimensional (2D) perfectly periodic media and presents dedicated analysis tools to explore and understand the properties of the medium controlling the transitions between different transport regimes. By leveraging a two-fold approach that combines both radiative transport and renormalization theory, the propagation properties of the inhomogeneous medium can be characterized both near and at the transition from normal to anomalous diffusion. The proposed approach builds upon the classical radiative transfer theory of bulk materials, and it is specifically designed to study 2D systems. The ability to simulate and interpret the field quantities that describe such transport mechanisms can play a significant role in the development of wave-based imaging technology for highly inhomogeneous and scattering media.
Acute Ketone Supplementation and Exercise Performance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Valenzuela Pedro L. , Morales Javier S. , Castillo-García Adrián , Lucia Alejandro
Published: February 2020

Purpose: To determine the acute effects of ketone supplementation on exercise performance (primary outcome) and physiological and perceptual responses to exercise (secondary outcomes). Methods: A systematic search was conducted in PubMed, Web of Science, and SPORTDiscus (since inception to July 21, 2019) to find randomized controlled trials assessing the effects of acute ketone supplementation compared with a drink containing no ketones (ie, control intervention). The standardized mean difference (Hedges g) between interventions and 95% confidence interval (CI) were computed using a random-effects model. Results: Thirteen studies met all inclusion criteria. No significant differences were observed between interventions for overall exercise performance (Hedges g = −0.05; 95% CI, −0.30 to 0.20; P = .68). Subanalyses revealed no differences between interventions when analyzing endurance time-trial performance (g = −0.04; 95% CI, −0.35 to 0.28; P = .82) or when assessing the separate effects of supplements containing ketone esters (g = −0.07; 95% CI, −0.38 to 0.24; P = .66) or salts (g = −0.02; 95% CI, −0.45 to 0.41; P = .93). All studies reported increases in plasma ketone concentration after acute ketone supplementation, but no consistent effects were reported on the metabolic (plasma lactate and glucose levels), respiratory (respiratory exchange ratio, oxygen uptake, and ventilatory rate), cardiovascular (heart rate), or perceptual responses to exercise (rating of perceived exertion). Conclusions: The present findings suggest that ketone supplementation exerts no clear influence on exercise performance (from sprints to events lasting up to ∼50 min) or metabolic, respiratory, cardiovascular, or perceptual responses to exercise. More research is needed to elucidate if this strategy could provide ergogenic effects on other exercise types (eg, ultraendurance exercise).
Modifiable Physical Factors Associated With Physical Functioning for Patients Receiving Dialysis: A Systematic Review
Authors: Tarca Brett D. , Wycherley Thomas P. , Bennett Paul , Meade Anthony , Ferrar Katia E.
Published: February 2020

Background: Patients receiving dialysis have reduced physical function, which is associated with unfavorable clinical outcomes and decreased quality of life. The authors aimed to identify and explore modifiable physical factors associated with physical function for patients receiving dialysis. Methods: Searches were performed in MEDLINE, Embase, Ovid Emcare, and The Cochrane Library in October 2018. Etiological studies involving dialysis populations that report association or predictive statistics between a modifiable physical factor and physical function were eligible for inclusion. Predictor variables were (1) modifiable via exercise and (2) considered an impairment in the International Classification of Functioning, Disability and Health. Results: Of 5384 titles screened, 23 studies were included. Thirteen studies focused on physical activity levels and muscle strength and the relationship with physical function while 2 studies investigated sedentary behavior. Twenty-one studies focused on hemodialysis populations. Studies related to physical activity levels displayed a moderately strong relationship with physical function, whereas muscle strength displayed a predominantly weak to moderate relationship. Conclusions: Physical activity levels, sedentary behavior levels, and muscle strength are related to physical function status for patients receiving dialysis. There is a need for robust longitudinal data to confirm the results of this investigation and for more focus on populations receiving peritoneal dialysis.
Identification of Genes Required for Glucan Exopolysaccharide Production in Lactobacillus johnsonii Suggests a Novel Biosynthesis Mechanism
Authors: Mayer Melinda J. , D’Amato Alfonsina , Colquhoun Ian J. , Le Gall Gwénaëlle , Narbad Arjan
Published: February 2020

Exopolysaccharides are key components of the surfaces of their bacterial producers, contributing to protection, microbial and host interactions, and even virulence. They also have significant applications in industry, and understanding their biosynthetic mechanisms may allow improved production of novel and valuable polymers. Four categories of bacterial exopolysaccharide biosynthesis have been described in detail, but novel enzymes and glycosylation mechanisms are still being described. Our findings that a putative bactoprenol glycosyltransferase and flippase are essential to homopolysaccharide biosynthesis in
Lactobacillus johnsonii
FI9785 indicate that there may be an alternative mechanism of glucan biosynthesis to the glucansucrase pathway. Disturbance of this synthesis leads to a slow-growth phenotype. Further elucidation of this biosynthesis may give insight into exopolysaccharide production and its impact on the bacterial cell.
Immunomodulatory Strategies in Herpes Simplex Virus Encephalitis
Authors: Piret Jocelyne , Boivin Guy
Published: February 2020

Herpes simplex virus 1 (HSV-1) can be responsible for life-threatening HSV encephalitis (HSE). The mortality rate of patients with HSE who do not receive antiviral treatment is 70%, with most survivors suffering from permanent neurological sequelae. The use of intravenous acyclovir together with improved diagnostic technologies such as PCR and magnetic resonance imaging has resulted in a reduction in the mortality rate to close to 20%. However, 70% of surviving patients still do not recover complete neurological functions.
Staphylococcus aureus Fibronectin Binding Protein A Mediates Biofilm Development and Infection
Authors: Gries Casey M. , Biddle Trevor , Bose Jeffrey L. , Kielian Tammy , Lo David D.
Published: February 2020

Implanted medical device-associated infections pose significant health risks, as they are often the result of bacterial biofilm formation.
Staphylococcus aureus
is a leading cause of biofilm-associated infections which persist due to mechanisms of device surface adhesion, biofilm accumulation, and reprogramming of host innate immune responses. We found that the
S. aureus
fibronectin binding protein A (FnBPA) is required for normal biofilm development in mammalian serum and that the SaeRS two-component system is required for functional FnBPA activity in serum.
Toxoplasma
Cathepsin Protease B and Aspartyl Protease 1 Are Dispensable for Endolysosomal Protein Digestion
Authors: McDonald Christian , Smith David , Di Cristina Manlio , Kannan Geetha , Dou Zhicheng , Carruthers Vern B.
Published: February 2020

Roughly one-third of the human population is chronically infected with the intracellular single-celled parasite
Toxoplasma gondii
, but little is known about how this organism persists inside people. Previous research suggested that a parasite proteolytic enzyme, termed cathepsin protease L, is important for
Toxoplasma
persistence; however, it remained possible that other associated proteolytic enzymes could also be involved in the long-term survival of the parasite during infection. Here, we show that two proteolytic enzymes associated with cathepsin protease L play dispensable roles and are dependent on cathepsin L to reach maturity, which differs from the corresponding enzymes in humans. These findings establish a divergent hierarchy of proteases and help focus attention principally on cathepsin protease L as a potential target for interrupting
Toxoplasma
chronic infection.
Acute Sleep-Wake Cycle Shift Results in Community Alteration of Human Gut Microbiome
Authors: Liu Zhi , Wei Zhi-Yuan , Chen Junyu , Chen Kun , Mao Xuhua , Liu Qisha , Sun Yu , Zhang Zixiao , Zhang Yue , Dan Zhou , Tang Junming , Qin Lianhong , Chen Jian-Huan , Liu Xingyin
Published: February 2020

Circadian rhythm misalignment due to social jet lag, shift work, early morning starts, and delayed bedtimes is becoming common in our modern society. Disturbances of sleep and the underlying circadian rhythms are related to multiple human diseases, such as obesity, diabetes, cardiovascular disorders, and cognitive impairments. Given the crucial role of microbiota in the same pathologies as are caused by sleep disturbance, how the gut microbiota is affected by sleep is of increasing interest. The results of this study indicate that the acute circadian rhythm disturbance caused by sleep-wake shifts affect the human gut microbiota, especially the functional profiles of gut microbes and interactions among them. Further experiments with a longer-time-scale intervention and larger sample size are needed to assess the effects of chronic circadian rhythm disruption on the gut microbiome and to guide possible microbial therapies for clinical intervention in the related diseases.
Permo–Triassic granitoids, Hainan Island, link to Paleotethyan not Paleopacific tectonics
Authors: He Huiying , Wang Yuejun , Cawood Peter A. , Qian Xin , Zhang Yuzhi , Zhao Guofeng
Published: February 2020

Hainan Island may have lain at the boundary between the Tethyan and Pacific domains since the late Paleozoic. Permo–Triassic granitoids outcropped on the island provide insight into Mesozoic tectonic evolution and potential dynamics. Based on analyses of zircon U-Pb geochronological and Hf-O isotopic data, along with whole-rock elemental and Sr-Nd isotopic data, the Permo–Triassic granitoids are divided into three groups: Late Permian (256–252 Ma) gneissic granitoids (Group 1), Early–Middle Triassic (247–244 Ma) massive granitoids (Group 2), and Middle-Late Triassic (242–225 Ma) massive granitoids (Group 3). Groups 1 and 2 exhibit similar elemental and Sr-Nd isotopic compositions with εNd(t) values ranging from –6.71 to –3.25. Group 1 is characterized by gneissic foliation and calc-alkaline I-type geochemical affinities with negative Nb-Ta and Ti anomalies; it has low εHf(t) (–4.2∼+0.2) and high δ18O values (9.35–10.46‰), possibly related to derivation of a metabasite source in a continental arc setting. The Group 2 samples are peraluminous massive granitoids with slightly high A/CNK ratios of 1.00–1.31, δ18O values (8.85–11.75‰), and high Sr/Y ratios but low εHf(t) (–8.7∼+1.6) values. They may have originated from the mixed source of greywacke and metabasite, indicating a compressive tectonic setting. The Group 3 high-K calc–alkaline granitoids have high zircon temperatures (842–867 °C) and show the geochemical signatures of A-type granites. They are featured by slightly low whole-rock εNd(t) and zircon εHf(t) values, suggestive of the derivation from a metabasite–greywacke source in an extensional setting. In combination with other geochronological and geochemical data from Hainan Island, it is proposed that the Permian–Triassic igneous magmatism in Hainan Island reflects a continuous amalgamation process from back-arc consumption (272–252 Ma) to orogenic assembly (251–243 Ma) and orogenic collapse (242–225 Ma) between the South China and Indochina Blocks. Such a temporal–spatial pattern for the Hainan granitoids is consistent with that along the Truong Son, Jinshajiang–Ailaoshan–Song Ma tectonic zone, suggesting dominant control of Paleotethyan domain instead of Paleopacific tectonics.
Radiation-induced undifferentiated pleomorphic sarcoma of the breast
Authors: Kong Joshua , Shahait Awni D , Kim Steve , Choi Lydia
Published: February 2020

Breast sarcoma is a rare form of malignancy that arises from connective tissue within the breast, comprising less than 5% of all sarcomas. They develop as primary tumours or as secondary following radiation therapy. Diagnosis can be challenging as breast sarcomas are often asymptomatic and resemble benign breast tissue changes. Radiation-induced breast sarcomas present in various forms with an average latency period of 10–20 years following initial radiation therapy. Angiosarcomas are the most common form, while other types such as undifferentiated pleomorphic sarcomas remain rare. Here, we report a case of radiation-induced undifferentiated pleomorphic breast sarcoma in a 75-year-old woman that developed nearly 20 years following breast conserving surgery and radiation for invasive ductal carcinoma. The patient initially noticed a mass in 2017 on self-examination. The mammogram, ultrasound and biopsy at the time showed a benign 2.2 cm nodular fasciitis without malignancy. The mass grew rapidly in the next 6 months to 5.6 cm and repeat biopsy diagnosed undifferentiated pleomorphic sarcoma. The mass abutted the pectoralis muscle but staging workup ruled out distant metastasis and the patient underwent wide local resection of the mass with clear margins. The patient subsequently underwent further postoperative radiation due to insufficient posterior margin width on wide local excision, as chest wall resection would have been required for a wider posterior margin. Prognosis for postradiation sarcomas is generally poor with 27%–36% 5-year survival, with surgical resection as the main line of treatment. The patient currently remains disease-free after 15 months of surveillance.