bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvement of oral hypofunction by a comprehensive oral and physical exercise programme including textured lunch gatherings
Authors: Matsuo Koichiro , Kito Norie , Ogawa Koichi , Izumi Ayako , Kishima Masako , Itoda Masataka , Masuda Yuji
Published: October 2020

The deterioration of oral function to a state of oral hypofunction (OHF) is reportedly associated with malnutrition and frailty. Thus, we Investigated the association of OHF with physical characteristics and function and test the effects of a programme including comprehensive oral and physical exercises and textured lunch gatherings (COPE‐TeL programme) on oral and physical function in older adults with OHF. Eighty‐six community‐dwelling older adults were randomly assigned into control (n = 43) or intervention (n = 43) groups. The participants were further divided into OHF and normal oral function (NOF) sub‐groups based on initial oral examinations. The intervention group participated in the 12‐week COPE‐TeL programme, while the control group performed the physical exercise regimen only. The differences in measured variables for physical and oral function between the OHF and NOF groups were statistically tested, and changes in the proportion of participants with OHF were examined. Physical function, such as hand grip strength and walking speed, was significantly lower in the OHF group at the initial assessment. The proportion of participants with OHF was 56% in the intervention group and 67% in the control group before the trial, which became significantly reduced after completing the COPE‐TeL programme in the intervention group (26%, P = .002), but not in the controls (61%, P = .549). Older adults with OHF may have diminished physical function. The COPE‐TeL programme of oral and physical exercises along with textured lunch gatherings may be effective for older adults with OHF.
Incorporating Digital Dentures into Clinical Practice: Flexible Workflows and Improved Clinical Outcomes
Authors: Maragliano‐Muniz Pamela , Kukucka Eric D.
Published: October 2020

Replacement of missing teeth with complete denture prostheses have been successfully accomplished for decades. However, limitations of denture materials and the number of appointments required to fabricate new or replacement complete dentures preclude practicality. New innovations involving a partially or completely digital workflow facilitate the fabrication of complete dentures in fewer, shorter appointments, and by incorporating materials that exhibit improved physical properties. The purpose of this manuscript is to describe the variety of workflows that can be implemented to incorporate digital denture fabrication into clinical practice.
Identification and Characterization of a Periplasmic α‐Carbonic Anhydrase (CA) in the Gametophytes of Saccharina japonica (Phaeophyceae)
Authors: Bi Yan‐Hui , Qiao Ya‐Ming , Wang Zhen , Zhou Zhi‐Gang
Published: October 2020

Periplasmic or external carbonic anhydrases (CAs) have been well accepted as playing a crucial role in the acquisition of dissolved inorganic carbon; however, no cytological evidence or molecular information on these enzymes has been reported in seaweeds to date. In this study, the full‐length cDNA sequence coding for a putative periplasmic Sjα‐CA2 was cloned from the gametophytes of Saccharina japonica, an industrial brown seaweed. It was 1,728 bp in length and included a 263‐bp 5′‐untranslated region (UTR), a 577‐bp 3′‐UTR, and an 888‐bp open reading frame encoding a protein precursor consisting of 295 amino acids. The mature protein, after removal of a predicted 28‐residue signal peptide, was composed of 267 amino acids with a relative molecular weight of 29.27 kDa. Multisequence alignment and phylogenetic analysis indicated that it was a member of the α‐CA family. Enzyme activity assays showed that the recombinant Sjα‐CA2 in Escherichia coli possessed CO2 hydration and esterase activities, thus identifying this gene Sjα‐CA2 in function. Immunogold electron microscopic observations with the prepared anti‐Sjα‐CA2 polyclonal antibody illustrated that Sjα‐CA2 was located in periplasmic space of the kelp gametophyte cells. Quantitative real‐time PCR results revealed that the transcription of Sjα‐CA2 was induced by elevated levels, but it was little changed while the kelp gametophytes were subjected to elevated CO2 concentrations. This study suggests that the periplasmic Sjα‐CA2 might play a role in adapting to elevated environmental levels of by dehydration of to generate CO2, which could be readily taken up by S. japonica gametophytes.
Temporal evolution and global spread of hepatitis B virus genotype G
Authors: Wolf Jonas Michel , De Carli Sílvia , Pereira Vagner Reinaldo Zingalli Bueno , Simon Daniel , Lunge Vagner Ricardo
Published: October 2020

Hepatitis B virus (HBV) infection is considered a major health problem in the world. HBV is classified into genotypes A to J disseminated worldwide. Genotypes A, D and F are the most frequent in the Western World, B and C are predominant in the East, and E, F, H and J are infrequent and restricted to specific regions. HBV‐G is a rare genotype, but it has been detected in different continents. This study aimed to report the temporal evolution and global spread of HBV‐G comparing whole‐genome sequences of this genotype from different regions in the world. Bayesian coalescent analysis was performed to estimate the time to the most recent common ancestor (tMRCA) and the population dynamics in the last decades. The results demonstrated that tMRCA of all HBV‐Gs dated back to 1855 (95% highest posterior density interval [HPD 95%]: 1778 ‐ 1931). This genotype has a possible origin in North America and it was disseminated to other continents (South and Central America, Europe, Asia and Africa) more than one century later (around the 1970s). The viral population demonstrated constant spreading from 1855 to the 1980s, followed by an increase in the 1990s and reached a plateau after the 2000s. Wide spreading at the beginning of the 1990s was probably associated with the dissemination by highly sexual active groups and injecting drug users. In conclusion, the present study demonstrated that HBV‐G was originated in the 19th century with main events of spread at the end of the 20th century.
A Direct Test of Legislative Gatekeeping
Authors: Thieme Sebastian
Published: October 2020

Tests of legislative gatekeeping theories have been hampered by the absence of status quo estimates, making these tests vulnerable to selection bias. I overcome this problem with a novel data set on positions by private interests in Iowa, Nebraska, and Wisconsin because these states’ legislatures record organizations’ positions on lobbied bills irrespective of whether the bills receive floor consideration. This permits an estimation of the ideological locations of status quo policies for bills with and without floor consideration and in turn rigorous empirical tests of agenda‐control theories. The data provide substantial evidence of partisan and nonpartisan gatekeeping and can adjudicate among the two models of gatekeeping in specific circumstances. In particular, they corroborate partisan gatekeeping in the Iowa House and the Wisconsin Assembly and cannot distinguish between the two accounts in the other chambers. Moreover, the results show that strong partisan institutions need not result in predominantly partisan gatekeeping.
The use and misuse of regression models in landscape genetic analyses
Authors: Peterman William E. , Pope Nathaniel S.
Published: October 2020

The field of landscape genetics has been rapidly evolving, adopting and adapting analytical frameworks to address research questions. Current studies are increasingly using regression‐based frameworks to infer the individual contributions of landscape and habitat variables on genetic differentiation. This paper outlines appropriate and inappropriate uses of multiple regression for these purposes, and demonstrates through simulation the limitations of different analytical frameworks for making correct inference. Of particular concern are recent studies seeking to explain genetic differences by fitting regression models with effective distance variables calculated independently on separate landscape resistance surfaces. When moving across the landscape, organisms cannot respond independently and uniquely to habitat and landscape features. Analyses seeking to understand how landscape features affect gene flow should model a single conductance or resistance surface as a parameterized function of relevant spatial covariates, and estimate the values of these parameters by linking a single set of resistance distances to observed genetic dissimilarity via a loss function. While this loss function may involve a regression‐like step, the associated nuisance parameters are not interpretable in terms of organismal movement and should not be conflated with what is actually of interest: the mapping between spatial covariates and conductance/resistance. The growth and evolution of landscape genetics as a field has been rapid and exciting. It is the goal of this paper to highlight past missteps and demonstrate limitations of current approaches to ensure that future use of regression models will appropriately consider the process being modeled, which will provide clarity to model interpretation.
Implicit bias in residency interview allocation? When surveys are silent
Authors: Pusic Martin V. , Wyatt Tasha R.
Published: October 2020

The authors discuss the implications of silence with respect to how surveys about resident selection usually do not include race, ethnicity or other data that could promote the goals of equity, inclusion and diversity.
Identification of Candida auris and related species by multiplex PCR based on unique GPI protein‐encoding genes
Authors: Alvarado María , Bartolomé Álvarez Joaquín , Lockhart Shawn R. , Valentín Eulogio , Ruiz‐Gaitán Alba Cecilia , Eraso Elena , de Groot Piet W. J.
Published: October 2020

Background

The pathogen Candida auris is rapidly gaining clinical importance because of its resistance to antifungal treatments and its persistence in hospital environments. Early and accurate diagnosis of C. auris infections is crucial, and however, the fungus has often been misidentified by commercial systems.

Objectives

To develop conventional and real‐time PCR methods for accurate and rapid identification of C. auris and its discrimination from closely related species by exploiting the uniqueness of certain glycosylphosphatidylinositol (GPI)‐modified protein‐encoding genes.

Methods

Species‐specific primers for two unique putative GPI protein‐encoding genes per species were designed for C. auris, C. haemulonii, C. pseudohaemulonii, C. duobushaemulonii, C. lusitaniae and C. albicans. Primers were blind tested for their specificity and efficiency in conventional and real‐time multiplex PCR set‐up.

Results

All primers combinations showed excellent species specificity. In multiplex mode, correct identification was aided by different‐sized amplicons for each species. Efficiency of the C. auris primers was validated using a panel of 155 C. auris isolates, including all known genetically diverse clades. In real‐time multiplex PCR, different melting points of the amplicons allowed the distinction of C. auris from four related species. C. auris limit of detection was 5 CFU/reaction with a threshold value of 32. The method was also able to detect C. auris in spiked blood and serum.

Conclusions

PCR identification based on unique GPI protein‐encoding genes allows for accurate and rapid species identification of C. auris and related species without need for expensive equipment when applied in conventional PCR set‐up.
Tournament decision theory
Authors: Podgorski Abelard
Published: October 2020

In this paper, I diagnose the problems facing causal decision theory as a special case of the general phenomenon of decision‐dependence–the possibility that some input into our evaluation of options can be affected by the decision we end up making. I go on to develop a new decision theory, which treats each choice as a tournament between options competing in pairs, and show how it can capture attractive features of the causal view while avoiding the problems generated by decision‐dependence.
Seed hemicelluloses tailor mucilage properties and salt tolerance
Authors: Yang Bo , Hofmann Florian , Usadel Björn , Voiniciuc Cătălin
Published: October 2020

While Arabidopsis seed coat epidermal cells have become an excellent genetic system to study the biosynthesis and structural roles of various cell wall polymers, the physiological function of the secreted mucilaginous polysaccharides remains ambiguous. Seed mucilage is shaped by two distinct classes of highly substituted hemicelluloses along with cellulose and structural proteins, but their interplay has not been explored.

We deciphered the functions of four distinct classes of cell wall polymers by generating a series of double mutants with defects in heteromannan, xylan, cellulose, or the arabinogalactan protein SALT‐OVERLY SENSITIVE 5 (SOS5), and evaluating their impact on mucilage architecture and seed germination during salt stress.

We discovered that muci10 seeds, lacking heteromannan branches, had elevated tolerance to salt stress, while heteromannan elongation mutants exhibited reduced germination in calcium chloride (CaCl2). By contrast, xylan made by MUCILAGE‐RELATED21 (MUCI21) was found to be required for the adherence of mucilage pectin to microfibrils made by CELLULOSE SYNTHASE5 (CESA5) as well as to a SOS5‐mediated network.

Our results indicate that the substitution of xylan and glucomannan in seeds can fine‐tune mucilage adherence and salt tolerance, respectively. The study of germinating seeds can thus provide insights into the synthesis, modification and function of complex glycans.
Integrating GWAS and eQTL to predict genes and pathways for non‐syndromic cleft lip with or without palate
Authors: Yang Jing , Yu Xin , Zhu Guirong , Wang Ruimin , Lou Shu , Zhu Weihao , Fu Chengyi , Liu Jinsuo , Fan Liwen , Li Dandan , Shao Qinghua , Ma Lan , Wang Lin , Wang Zhendong , Pan Yongchu
Published: October 2020

Objective

To explore susceptibility genes and pathways for non‐syndromic cleft lip with or without cleft palate (NSCL/P).

Materials and methods

Two genome‐wide association studies (GWAS) datasets, including 858 NSCL/P cases and 1,248 controls, were integrated with expression quantitative trait loci (eQTL) dataset identified by Genotype‐Tissue Expression (GTEx) project in whole‐blood samples. The expression of the candidate genes in mouse orofacial development was inquired from FaceBase. Protein–protein interaction (PPI) network was visualized to identify protein functions. Go and KEGG pathway analyses were performed to explore the underlying risk pathways.

Results

A total of 233 eQTL single‐nucleotide polymorphisms (SNPs) in 432 candidate genes were identified to be associated with the risk of NSCL/P. One hundred and eighty‐three susceptible genes were expressed in mouse orofacial development according to FaceBase. PPI network analysis highlighted that these genes involved in ubiquitin‐mediated proteolysis (KCTD7, ASB1, UBOX5, ANAPC4) and DNA synthesis (XRCC3, RFC3, KAT5, RHNO1) were associated with the risk of NSCL/P. GO and KEGG pathway analyses revealed that the fatty acid metabolism pathway (ACADL, HSD17B12, ACSL5, PPT1, MCAT) played an important role in the development of NSCL/P.

Conclusions

Our results identified novel susceptibility genes and pathways associated with the development of NSCL/P.
Dental caries‐related primary hypertension in children and adolescents: Cross‐sectional study
Authors: Ostalska‐Nowicka Danuta , Paszyńska Elżbieta , Dmitrzak‐Węglarz Monika , Neyman‐Bartkowiak Anna , Rabiega Alina , Zachwieja Jacek , Nowicki Michał
Published: October 2020

Background

Hypertension is a growing clinical problem in pediatric population. Also, the cause of hypertension is usually unknown and it may result from systemic inflammation related to tooth decay.

Aim

To estimate the potential association in cross‐sectional study between tooth decay and hypertension in children and adolescents.

Patients and Methods

Study group—65 children diagnosed with primary arterial hypertension; control subjects—44 normotensive children. Blood pressure, dental examination, measurement of salivary cortisol, alpha‐amylase, secretory IgA, and lysozyme concentrations were performed in all of the children.

Results

Hyper‐ and normotensive children had similar peripheral blood morphology and serum biochemical parameters, except of uric acid concentration, which was significantly higher in the study group (p = .047). Salivary evening concentrations of cortisol and alpha‐amylase were significantly higher in hypertensive children (p = .002 and p = .004, respectively). Although 24‐hr systolic blood pressure (SBP), including daytime and nighttime SBP, correlated with “decay,” “microalbuminuria,” “BMI,” and “glomerular filtration rate” (r > .75, r > .7, r < .68, and r < .43, respectively), in multivariate analysis only “decay” was associated with hypertension both in children and in adolescents (p < .0001).

Conclusion

Tooth decay in children/adolescents might be regarded as a potent trigger factor of hypertension in individuals in whom all other causes of secondary arterial hypertension have been excluded.
Prevalence of pain in oral cancer: A retrospective study
Authors: Khawaja Shehryar Nasir , Jamshed Arif , Hussain Raza T.
Published: October 2020

Objective

This study aimed to estimate the prevalence of pain among treatment‐naïve patients with oral cancer and to identify the clinical and histopathological characteristics of oral cancer associated with pain occurrence.

Materials and Methods

A retrospective chart review was conducted of patients presenting with biopsy‐proven oral cancer between January 2015 and December 2019. Variables, including demographic data, medical history, clinical presentation, and histopathological information, were extracted and analyzed. Appropriate descriptive and analytic statistics were computed.

Results

Among 1,067 participants, 682(63.9%) were males. The prevalence of pain was 67.5%. It was found to be significantly associated with the duration of symptoms, history of betel or areca nut, squamous cell carcinoma, presence of disease in tongue, palate, and lips, lesion size, clinical nodal involvement, depth of invasion, TNM classification, limited mouth opening, bleeding, and restricted tongue mobility. Logistic regression analysis suggested that pain in oral cancer was positively associated with the occurrence of disease in the tongue and negatively with TNM stage I.

Conclusions

There is a high prevalence of pain among patients with oral cancer even before the initiation of any therapeutic intervention. Occurrence is significantly higher in patients with the presence of disease in the tongue and among those with TNM stage II or more.
Simulated dimensional compatibility of uncuffed and cuffed tracheal tubes for selective endobronchial intubation in children
Authors: Moser Berthold , Kemper Michael , Dullenkopf Alexander , Dave Mital H. , Buehler Philipp K. , Weiss Markus
Published: October 2020

Background

Cuffed tracheal tubes have recently been recommended for selective endobronchial intubation to establish single‐lung ventilation even in smaller children. This implies that, compared with uncuffed tracheal tubes, the cuffed tracheal tubes selected will be smaller and therefore have a shorter length. We hypothesized that cuffed tracheal tubes might be of insufficient length for selective endobronchial intubation if the tube cuff were fully immersed in the left or right mainstem bronchus.

Methods

The distance from the proximal end of the tracheal tube to the upper border of the cuff in cuffed tracheal tubes and to the upper margin of the Murphy eye in uncuffed tracheal tubes, respectively, was assessed in sizes 3.0–7.0 mm internal diameter. The raw data sets of two previously performed studies obtained from 337 children aged from birth to 16 years, including the distances “teeth to tracheal tube tip” and “tracheal tube tip to carina,” were used to calculate age‐, weight‐, and height‐related data for the distance from “teeth to carina.” Tracheal tube dimensions were compared with age‐related distances from “teeth to carina,” applying published recommendations for the selection of uncuffed and cuffed tracheal tubes for selective endobronchial intubation in children.

Results

The differences between the length of the age‐related tracheal tube and the tracheal tube insertion length required to guarantee full insertion of the tracheal tube cuff or the Murphy eye within the mainstem bronchus ranged from −3.5 to 52.6 mm in cuffed tracheal tubes and from 42.3 to 83.3 mm in uncuffed tracheal tubes.

Conclusions

For many age groups of patients requiring selective endobronchial intubation, the lengths of cuffed tracheal tubes, in contrast to those of uncuffed tracheal tubes, were revealed to be critically short for safe taping outside the oral cavity with the cuff placed completely within the right or left mainstem bronchus.
Needle decompression of the abdomen in a premature infant with abdominal compartment syndrome and cardiopulmonary arrest: A case report
Authors: Yang Lei , Yang Di , Wu Yang , Li Yu , Liao Ren , Zuo Yunxia
Published: October 2020

A premature infant with abdominal compartment syndrome underwent cardiopulmonary arrest before receiving decompressive laparotomy, and the effect of cardiopulmonary resuscitation was poor. The abdomen was punctured with an 18‐gauge needle, alleviating the distension and resulting in successful cardiopulmonary resuscitation.
Aesthetic obligations
Authors: Kubala Robbie
Published: October 2020

Are there aesthetic obligations, and what would account for their binding force if so? I first develop a general, domain‐neutral notion of obligation, then critically discuss six arguments offered for and against the existence of aesthetic obligations. The most serious challenge is that all aesthetic obligations are ultimately grounded in moral norms, and I survey the prospects for this challenge alongside three non‐moral views about the source of aesthetic obligations: individual practical identity, social practices, and aesthetic value primitivism. I conclude by raising questions for further work in this area.
Neurocognitive processes mediate the relation between children’s motor skills, cardiorespiratory fitness and response inhibition: Evidence from source imaging
Authors: Ludyga Sebastian , Möhring Wenke , Budde Henning , Hirt Nick , Pühse Uwe , Gerber Markus
Published: October 2020

Accumulating evidence suggests an association between outcomes of sports participation, such as motor skills and cardiorespiratory fitness, and aspects of inhibitory control in children. However, it remains unclear if motor skills and cardiorespiratory fitness are related to different source activity patterns and if neurophysiological indices of response inhibition mediate the relation of these constructs with behavioral performance. We examined the relative contributions of motor skills and cardiorespiratory fitness to response inhibition and a potential mediation by the neurocognitive processes indexed by the N200 and P300 components of event‐related potentials. About 92 children aged 9–13 years completed the Movement ABC‐2, the PWC170 and a Go/NoGo task. We employed electroencephalography (EEG) to record the N200 and P300 components elicited by the task, which are considered to reflect conflict monitoring and the allocation of attentional resources toward task‐relevant stimuli, respectively. Path‐anlayses revealed a moderate association between motor skills and behavioral performance on the Go/NoGo task. This association was fully mediated by the P300 amplitude in the NoGo condition. In contrast, cardiorespiratory fitness was not related to behavioral performance, but accounted for variance in N200. Source analyses supported an association between cardiorespiratory fitness and N200 source activity in prefrontal and primary motor cortex, whereas motor skills were related to P300 source activity in the posterior cingulate cortex. Our findings provide novel insights into the neural mechanisms underlying the relation between motor skills and response inhibition. Moreover, we found that the neural generators of the P300 and N200 varied as a function of children's cardiorespiratory fitness and motor skills.
Employer Branding and Recruitment: Social Media Field Experiments Targeting Future Public Employees
Authors: Keppeler Florian , Papenfuß Ulf
Published: October 2020

Public sector recruitment is an urgent and prevailing challenge in both research and practice. Public employer branding is an important subject in the theoretical debate, but the mechanisms behind how certain signals of public employers affect individuals' interest in a job are under‐researched. By bridging signaling theory, social identity theory, and personnel economics, this study analyzes the effects of signals in advertisements related to societal impact, job security, and performance orientation on different gender/age‐based target groups. This series of pre‐registered social media field experiments (n = 196,822 persons) with four public employers examines the degree to which these signals affect individuals' interest in a job at a public employer. The results do not show an overall impact of the signals but target group‐specific effects—gender has a significant effect and age for certain public employers. Compared with the societal impact signal, the job security signal has a slightly stronger effect.
Psychometric evaluation of the German version of the instrument: Families’ Importance in Nursing Care – Nurses’ Attitudes (FINC‐NA)
Authors: Naef Rahel , Schmid‐Mohler Gabriela , Ernst Jutta
Published: October 2020

Background

The involvement of families in care has long been advocated for acute and critical care settings to improve quality and safety of care. Nurses’ attitudes towards families influence the way they involve and partner with families in the planning and delivery of care. Therefore, instruments with proven psychometric properties are necessary to assess the attitudes of nurses towards involving families in nursing care.

Aims

To cross‐culturally adapt and psychometrically test the German version of the Families’ Importance in Nursing Care – Nurses’ Attitudes (FINC‐NA) scale with acute and critical care nurses.

Methods

A cross‐sectional study was carried out with 316 acute–critical care nurses, who filled in the FINC‐NA between December 2016 and May 2018. Exploratory factor analysis was performed to assess structural validity. Internal consistency and homogeneity were determined using Cronbach’s alpha.

Results

The four‐factor structure of the FINC‐NA – family as partner in care, family as resource in nursing care, family as their own resource and family as burden – was confirmed in the German version. Due to low primary and multiple loadings, seven items were removed. Moreover, five items loaded on different factors than the original version. Cronbach’s alpha of factors ranged between 0.68 and 0.86.

Conclusion

The cross‐cultural adaptation and psychometric testing of the German version of the FINC‐NA resulted in a 19‐item scale that measure nurses’ attitudes towards the importance of families in nursing care. Further testing is needed to refine the structural validity and establish construct validity of the FINC‐NA German version.
The Passion Paradigm: Professional Adherence to and Consequences of the Ideology of “Do What You Love”
Authors: DePalma Lindsay J.
Published: October 2020

If changes to the material structures of work have ushered us into a “new economy,” cultural scholars assume that there must also be changes to ideological structures of work. Extant scholarship on precarious professionals and on the role of emotions in 21st‐century work find that passion may be an important cultural component of white‐collar work in the new economy. Using data from engineers, nurses, and graphic designers who work in either less precarious or more precarious contexts, this paper contributes the first emic definition of work passion as the experiences of attraction, enjoyment, motivation, and perseverance. Because I find overwhelming adherence and conceptual consistency among professionals in my sample, I argue that the pursuit of work passion constitutes a coherent ideology of work, which I call the passion paradigm. I argue that the passion paradigm is compatible with and protects structures of work in the new economy because its logic of hyper individualism motivates workers to work hard and work well as a practice of self‐care, shifting the locus of critique further away from institutions and more toward the self. Adherence to and institutionalization of the passion paradigm may have myriad consequences, opening up broad areas of future research.
The HLA diversity of the Anthony Nolan register
Authors: Leen Gayle , Stein Jeremy E. , Robinson James , Maldonado Torres Hazael , Marsh Steven G. E.
Published: October 2020

While the success of allogeneic stem cell transplantation depends on a high degree of HLA compatibility between donor and patient, finding a suitable donor remains challenging due to the hyperpolymorphic nature of HLA genes. We calculated high‐resolution allele, haplotype and phenotype frequencies for HLA‐A, ‐C, ‐B, ‐DRB1 and ‐DQB1 for 10 subpopulations of the Anthony Nolan (AN) register using an in‐house expectation‐maximisation (EM) algorithm run on mixed resolution HLA data, covering 676 155 individuals. Sample sizes range from 599 410 for British/Irish North West European (BINWE) individuals, the largest subpopulation in the United Kingdom to 1105 for the British Bangladeshi population. Calculation of genetic distance between the subpopulations based on haplotype frequencies shows three broad clusters, each following a major continental group: European, African and Asian. We further analysed the HLA haplotype and phenotype diversity of each subpopulation, and found that 35.52% of BINWE individuals ranging to 98.34% of Middle Eastern individuals on the register had a unique phenotype within their subpopulation. These analyses and the allele, haplotype and phenotype frequency data of the subpopulation on the AN register are a valuable resource in understanding the HLA diversity in the United Kingdom and can be used to improve the accuracy of match likelihoods and to inform future donor recruitment strategies.
Systematic prediction of autophagy‐related proteins using Arabidopsis thaliana interactome data
Authors: Cheng Lixin , Zeng Yonglun , Hu Shuai , Zhang Ning , Cheung Kenneth C. P. , Li Baiying , Leung Kwong‐Sak , Jiang Liwen
Published: October 2020

Autophagy is a self‐degradative process that is crucial for maintaining cellular homeostasis by removing damaged cytoplasmic components and recycling nutrients. Such an evolutionary conserved proteolysis process is regulated by the autophagy‐related (Atg) proteins. The incomplete understanding of plant autophagy proteome and the importance of a proteome‐wide understanding of the autophagy pathway prompted us to predict Atg proteins and regulators in Arabidopsis. Here, we developed a systems‐level algorithm to identify autophagy‐related modules (ARMs) based on protein subcellular localization, protein–protein interactions, and known Atg proteins. This generates a detailed landscape of the autophagic modules in Arabidopsis. We found that the newly identified genes in each ARM tend to be upregulated and coexpressed during the senescence stage of Arabidopsis. We also demonstrated that the Golgi apparatus ARM, ARM13, functions in the autophagy process by module clustering and functional analysis. To verify the in silico analysis, the Atg candidates in ARM13 that are functionally similar to the core Atg proteins were selected for experimental validation. Interestingly, two of the previously uncharacterized proteins identified from the ARM analysis, AGD1 and Sec14, exhibited bona fide association with the autophagy protein complex in plant cells, which provides evidence for a cross‐talk between intracellular pathways and autophagy. Thus, the computational framework has facilitated the identification and characterization of plant‐specific autophagy‐related proteins and novel autophagy proteins/regulators in higher eukaryotes.
Compressor Stall Warning Using Nonlinear Feature Extraction Algorithms
Authors: Lou Fangyuan , Key Nicole L.
Published: October 2020

Stall is a type of flow instability in compressors that sets the low-flow limit for compressor operation. During the past few decades, efforts to develop a reliable stall warning system have had limited success. This paper focuses on the small nonlinear disturbances prior to deep surge and introduces a new approach to identify these disturbances using nonlinear feature extraction algorithms including phase-reconstruction of time-series signals and evaluation of a parameter called approximate entropy. To the best of our knowledge, this is the first time approximate entropy has been used for stall warning, and thus, its definition and utility are presented in detail. The technique is applied to stall data sets from two different compressors: a high-speed centrifugal compressor that unexpectedly entered rotating stall during a speed transient and a multistage axial compressor with both modal- and spike-type stall inception. In both cases, nonlinear disturbances appear, in terms of spikes in approximate entropy, prior to surge. The presence of these presurge spikes indicates the potential of using the approximate entropy parameter for small disturbance detection and stall warning. The details of the nonlinear feature extraction algorithm, including guidelines for its application as well as results from applying the algorithm to rig-level data, are presented.
Health Literacy and Physical Activity: A Systematic Review
Authors: Buja Alessandra , Rabensteiner Andrea , Sperotto Milena , Grotto Giulia , Bertoncello Chiara , Cocchio Silvia , Baldovin Tatjana , Contu Paolo , Lorini Chiara , Baldo Vincenzo
Published: October 2020

Background: The importance of health literacy (HL) in health promotion is increasingly clear and acknowledged globally, especially when addressing noncommunicable diseases. This paper aimed to collect and summarize all current data from observational studies generating evidence of the association between HL and physical activity (PA) and to analyze intervention studies on the promotion of PA to ascertain whether HL moderates the efficacy of such intervention. Methods: A comprehensive systematic literature search of observational studies investigating the association between HL and PA was performed. Intervention studies on the promotion of PA that also measured the HL levels of participants and its effect on the outcome of the intervention were also identified. Results: Of the 22 studies included in this review, 18 found a significant positive association between high HL and high levels of PA. The only intervention study among them indicated that HL was not a significant moderator of the intervention’s effectiveness. Conclusion: HL can enable individuals to make deliberate choices about their PA and thus contribute to preventing many chronic noncommunicable diseases. That said, low levels of HL do not seem to influence the efficacy of health promotion interventions.
Non-ST-segment elevation myocardial infarction with evidence of transmural infarction complicated by left ventricular rupture during percutaneous coronary intervention
Authors: Connolly Niall PE , Hennessey Breda , Mylotte Darren
Published: October 2020

We report a case of a 68-year-old man presenting with a non-ST-segment elevation myocardial infarction, complicated by fatal left ventricular free wall rupture with electromechanical disassociation and cardiac tamponade during percutaneous coronary intervention. The aetiology for the sudden haemodynamic collapse was initially unclear; however, transthoracic echocardiography confirmed pericardial tamponade and postmortem revealed complete transmural myocardial infarction with left ventricular free wall rupture. This serves as an important lesson that transmural infarction and subsequent mechanical complications, including ventricular rupture, can occur in non-ST-segment myocardial infarction and not just ST-segment myocardial infarction.
Undetectable SARS-CoV-2 in a nasopharyngeal swab but persistent viral RNA from deep lung swabs: findings from an autopsy
Authors: Seetulsingh Prema , Kannangara Chiranthi Iresha , Richman Paul
Published: October 2020

During the global pandemic of COVID-19 accurate diagnosis of the infection by demonstrating SARS-CoV-2 viral RNA by PCR in specimens is crucial for therapeutic and preventative interventions. There have been instances where nasal and throat swabs have been negative despite the patient having typical clinical and radiological findings compatible with the disease. We report a case of a man in his late 50s, brought to the hospital following a cardiac arrest and prolonged unsuccessful resuscitation. The history was typical for COVID-19 with fever for 10 days and worsening shortness of breath. His throat and nasal swabs (after death) were negative for SARS-CoV-2. A limited diagnostic autopsy was performed after 27 days, and lung swabs confirmed presence of SARS-CoV-2. This case highlights the importance of lung swabs when initial upper respiratory tract swabs are negative and proves that the virus can be detected from dead human tissue almost a month later.
Oesophageal GIST
Authors: Costa Filipa , Casaca Rui , Monteiro Cecilia , Ramos Paulo
Published: October 2020

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract. Oesophageal GISTs are extremely uncommon, accounting for 0.7% of all GISTs, and their management is surrounded by some debate. We report a case of a 70-year-old man who was incidentally diagnosed with an oesophageal lesion on a 18F-fluorodeoxyglucose positron emission tomography. An endoscopic study revealed a non-obstructing 40 mm oesophageal lesion. Endoscopic ultrasound showed a well-circumscribed submucosal tumour on the middle oesophagus. Fine-needle aspiration was positive for CD117 and the overall features were of a GIST. After an initial thoracoscopic approach, the tumour was completely enucleated through a thoracotomy incision. The patient experienced no surgical complications and was discharged on day 4. Histopathology and immunohistochemical staining confirmed a low-risk GIST.
Oral mucous membrane grafts for total symblepharon and lid margin keratinisation post Stevens-Johnson syndrome
Authors: Sudana Priyanka , Basu Sayan , Shanbhag Swapna S
Published: October 2020

A female patient in her late 40s presented with severe visual impairment and a history of oral ulcers, necrolysis of skin and hospitalisation after using gabapentin for neck pain 10 months ago. She was a diagnosed case of Stevens-Johnson syndrome (SJS) with chronic ocular sequelae—with total symblepharon and keratinised lid margins in the left eye and limbal stem cell deficiency and severe dryness in the right eye. Her visual acuity was perception of light in both eyes. She underwent left eye symblepharon release with autologous labial mucous membrane grafts (MMGs) for surface reconstruction and subsequent lid margin MMG for lid margin keratinisation. Best-corrected visual acuity improved to 20/25 with scleral lens in the left eye, which was sustained over 1 year of follow-up. Labial mucosa acts as a useful and easily accessible alternative to conjunctiva in eyes with bilateral severe ocular surface damage and total symblepharon secondary to SJS.
Adaptation and piloting of an integrated intervention model for alcohol use disorders in primary healthcare in rural Tanzania: a study protocol
Authors: Mushi Dorothy Peter , Hanlon Charlotte , Francis Joel Msafiri , Teferra Solomon
Published: October 2020

Introduction

Integration of evidence-based interventions for alcohol use disorders (AUDs) into primary healthcare has potential to increase coverage and reduce population burden. However, these interventions are rarely implemented in low- and middle-income countries and there is little existing guidance on how this could be achieved. The aim of the proposed study is to adapt and pilot an integrated model for AUDs in Tanzanian primary healthcare.

Methods and analysis

The study design will include a situational analysis, a qualitative study, a series of participatory Theory of Change (ToC) workshops and pilot intervention study. The evidence-based packages of care for AUD from the WHO mental health Gap Intervention Guide will form the basis of intervention. The situation analysis will use publicly available data to identify existing resources and system functioning. In-depth interviews will be conducted with key stakeholders (people with lived experience of substance use problems, health workers, health planners and community-based organisations) to identify barriers and facilitators to integration and recommended implementation strategies. Thematic analysis will be used. Triangulation of findings will inform the ToC map for the adapted model of integrated services for AUDs. This model will then be piloted. Change in knowledge, skills and attitudes of health workers will be measured pre-implementation and post-implementation. Interrupted time series analysis will be used to identify change in the rate of identification of AUDs beyond that observed due to secular trends or by chance. The integrated model will be finalised for future implementation and larger-scale evaluation.

Ethics and dissemination

Ethical approval was obtained from Addis Ababa University College of Health Science Institutional Review Board and Muhimbili University of Health and Allied Sciences Institutional Review Board. Findings will be disseminated to inform strategies for scale up of integrated interventions for people with AUDs in Tanzania and similar contexts.
Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit: results from a 32-year follow-up study
Authors: Probert-Lindström Sara , Berge Jonas , Westrin Åsa , Öjehagen Agneta , Skogman Pavulans Katarina
Published: October 2020

Objectives

The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective.

Design

Prospective study with register-based follow-up for 21–32 years.

Setting

Medical emergency inpatient unit in the south of Sweden.

Participants

1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987–1998.

Outcome measures

Suicide and all-cause mortality.

Results

At follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide attempt as measured by SIS (Suicide Intent Scale) showed a non-proportional association with the hazard for suicide over time and was a relevant risk factor for suicide only within the first 5 years after an attempted suicide.

Conclusions

The risk of suicide after a suicide attempt persists for up to 32 years after the index attempt. A baseline diagnosis of psychosis or major depression or earlier suicide attempts continued to be relevant risk factors in the very long term. The SIS score is a better predictor of suicide risk at short term, that is, within 5 years than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.
New geographic model of care to manage the post-COVID-19 elective surgery aftershock in England: a retrospective observational study
Authors: Clarke Jonathan , Murray Alice , Markar Sheraz Rehan , Barahona Mauricio , Kinross James
Published: October 2020

Objectives

The suspension of elective surgery during the COVID-19 pandemic is unprecedented and has resulted in record volumes of patients waiting for operations. Novel approaches that maximise capacity and efficiency of surgical care are urgently required. This study applies Markov multiscale community detection (MMCD), an unsupervised graph-based clustering framework, to identify new surgical care models based on pooled waiting-lists delivered across an expanded network of surgical providers.

Design

Retrospective observational study using Hospital Episode Statistics.

Setting

Public and private hospitals providing surgical care to National Health Service (NHS) patients in England.

Participants

All adult patients resident in England undergoing NHS-funded planned surgical procedures between 1 April 2017 and 31 March 2018.

Main outcome measures

The identification of the most common planned surgical procedures in England (high-volume procedures (HVP)) and proportion of low, medium and high-risk patients undergoing each HVP. The mapping of hospitals providing surgical care onto optimised groupings based on patient usage data.

Results

A total of 7 811 891 planned operations were identified in 4 284 925 adults during the 1-year period of our study. The 28 most common surgical procedures accounted for a combined 3 907 474 operations (50.0% of the total). 2 412 613 (61.7%) of these most common procedures involved ‘low risk’ patients. Patients travelled an average of 11.3 km for these procedures. Based on the data, MMCD partitioned England into 45, 16 and 7 mutually exclusive and collectively exhaustive natural surgical communities of increasing coarseness. The coarser partitions into 16 and seven surgical communities were shown to be associated with balanced supply and demand for surgical care within communities.

Conclusions

Pooled waiting-lists for low-risk elective procedures and patients across integrated, expanded natural surgical community networks have the potential to increase efficiency by innovatively flexing existing supply to better match demand.