bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional status of mechanically ventilated COVID-19 survivors at ICU and hospital discharge
Authors: Musheyev Benjamin , Borg Lara , Janowicz Rebeca , Matarlo Michael , Boyle Hayle , Singh Gurinder , Ende Victoria , Babatsikos Ioannis , Hou Wei , Duong Tim Q.
Published: March 2021

Background

A significant number of COVID-19 patients have been treated using invasive mechanical ventilation (IMV). The ability to evaluate functional status of COVID-19 survivors early on at ICU and hospital discharge may enable identification of patients who may need medical and rehabilitation interventions.

Methods

The modified “Mental Status”, ICU Mobility, and Barthel Index scores at ICU and hospital discharge were tabulated for 118 COVID-19 survivors treated with invasive mechanical ventilation (IMV). These functional scores were compared with pre-admission functional status, discharge durable medical equipment, discharge medical follow-up recommendation, duration on IMV, duration post-IMV, demographics, comorbidities, laboratory tests, and vital signs at ICU and hospital discharge.

Results

The majority of COVID-19 IMV patients were not functionally independent at hospital discharge (22% discharged with cane or rolling walker, 49% discharged with durable medical equipment, and 14% admitted to a rehabilitation facility), although 94% of these patients were functionally independent prior to COVID-19 illness. Half of the patients were discharged with supplemental oxygen equipment. The most prevalent medical follow-up recommendations were cardiology, vascular medicine, pulmonology, endocrinology, and neurology with many patients receiving multiple medical follow-up recommendations. Functional status improved from ICU discharge to hospital discharge (p < 0.001). Worse functional status at hospital discharge was associated with longer IMV duration, older age, male sex, higher number of comorbidities, and the presence of pre-existing comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease, and immunosuppression (p < 0.05, ANOVA).

Conclusions

The majority of IMV COVID-19 survivors were not functionally independent at discharge and required significant follow-up medical care. The COVID-19 circumstance has placed constraints on access to in-hospital rehabilitation. These findings underscore the need for prospective studies to ascertain the short- and long-term sequela in COVID-19 survivors.
Isolating non-subduction-driven tectonic processes in Cascadia
Authors: McKenzie K. A. , Furlong K. P.
Published: March 2021

Several tectonic processes combine to produce the crustal deformation observed across the Cascadia margin: (1) Cascadia subduction, (2) the northward propagation of the Mendocino Triple Junction (MTJ), (3) the translation of the Sierra Nevada–Great Valley (SNGV) block along the Eastern California Shear Zone–Walker Lane and, (3) extension in the northwestern Basin and Range, east of the Cascade Arc. The superposition of deformation associated with these processes produces the present-day GPS velocity field. North of ~ 45° N observed crustal displacements are consistent with inter-seismic subduction coupling. South of ~ 45° N, NNW-directed crustal shortening produced by the Mendocino crustal conveyor (MCC) and deformation associated with SNGV-block motion overprint the NE-directed Cascadia subduction coupling signal. Embedded in this overall pattern of crustal deformation is the rigid translation of the Klamath terrane, bounded on its north and west by localized zones of deformation. Since the MCC and SNGV processes migrate northward, their impact on the crustal deformation in southern Cascadia is a relatively recent phenomenon, since ~ 2 –3 Ma.
Self-efficacy and belonging: the impact of a university makerspace
Authors: Andrews Madison E. , Borrego Maura , Boklage Audrey
Published: March 2021

Background

In recent years, makerspaces have become increasingly common venues of STEM education and are rapidly being incorporated into undergraduate programs. These spaces give students and instructors access to advanced design technology and facilitate the incorporation of a wide variety of projects into the curriculum; however, their impacts on students are not yet fully understood. Using matched survey responses (i.e., repeated measures) from undergraduate students enrolled in engineering courses that assigned a makerspace-based project, we evaluate how the use of a university makerspace impacts students’ attitudes towards design, engineering, and technology. Further, we examine whether there are differences based on students’ year in program, gender, and race.

Results

Pairedt-tests were used to analyze whether and how nine factors changed within individual students over one semester. Analyses revealed that students who visited the facility showed significant gains in measures of innovation orientation, design self-efficacy, innovation self-efficacy, technology self-efficacy, belonging to the makerspace, and belonging to the engineering community. Subsequently, repeated measures analyses of variance (RMANOVAs) on the students who visited the makerspace revealed significant main effects of students’ year in program, gender, and race, as well as interactional effects of both year in program and race with time.

Conclusions

These results affirm the value of incorporating makerspace-based projects into STEM curricula, especially during early coursework. However, our analyses revealed consistent gender gaps in measures of self-efficacy before and after using the makerspace. Similarly, gains in belonging to the makerspace were not equal across racial groups. We conclude that while makerspaces are fulfilling some of their promise for educating innovative problem solvers, more attention needs to be paid to avoid reproducing disparities in STEM education that are already experienced by female students and racial minorities.
Measuring supports from learning assistants that promote engagement in active learning: evaluating a novel social support instrument
Authors: Hernandez Dania , Jacomino Gema , Swamy Uma , Donis Krista , Eddy Sarah L.
Published: March 2021

Background

Active learning supports student performance, but can be challenging to implement in large courses. The Learning Assistant (LA) Program is a growing intervention to support students in large active learning classrooms. This program places advanced undergraduates who have training in pedagogical methods in active learning classrooms to interact with and support students during in-class activities. LAs increase student performance, but the mechanism behind this is still unclear. Social support is a promising framework to help elucidate the types and extent of assistance LAs provide to students and begin exploring the “how” behind LAs effectiveness. The aim of this study was to develop an instrument measuring undergraduate students’ perceptions of the social supports for active learning available to them in the classroom. This instrument was based on both the broader social support literature and the literature on what factors encourage students to engage deeply in active learning. To provide initial evidence of validity, the instrument was completed in six sections of General Chemistry I at one R1 university. Exploratory and confirmatory factor analyses were applied to determine the internal structure of the instrument. Then the instrument’s relationship to engagement in active learning was evaluated as another form of validity evidence.

Results

These analyses best supported a three-factor instrument that included five items representing supportive feedback provided during active learning (appraisal support), eight items representing emotional support during active learning, and six items representing the communications of norms and values related to active learning (informational support). All three factors were individually correlated with three measures of engagement. In regression analyses with all three factors measured together, only informational support predicted changes in two of the three measures of engagement.

Conclusions

This study supports the use of the Perception of Social Supports for Active Learning (PSSALI) instrument to understand students’ perceptions of the supports they are receiving to engage in active learning in chemistry courses. One implication of this work is that in order to increase engagement, learning assistants should clearly communicate the value of active learning and the classroom norm of active participation.
Tissue dose estimation after extravasation of 177Lu-DOTATATE
Authors: Tylski Perrine , Pina-Jomir Géraldine , Bournaud-Salinas Claire , Jalade Patrice
Published: March 2021

Background

Extravasation of radiopharmaceuticals used for vectorized internal radiotherapy can lead to severe tissue damage (van der Pol et al., Eur J Nucl Med Mol Imaging 44:1234–1243, 2017). Clinical management of these extravasations requires the preliminary estimation of the dose distribution in the extravasation area. Data are scarce regarding the dose estimation in the literature. This work presents a methodology for estimating the dose distribution after an extravasation occurred in September 2017, in the arm of a patient during a 7.4-GBq infusion of Lutathera ® (AAA).

Methods

A local quantification procedure initially developed for renal dosimetry was used. A calibration factor was determined and verified by phantom study. Extravasation volume of interest and its variation in time were determined using 4 whole body (WB) planar acquisitions performed at 2 h (T2h), 5 h (T5h), 20 h (T20h), and 26 h (T26h) after the beginning of the infusion and three SPECT/CT thoracic acquisitions at T5h, T20h, and T26h. For better estimation of initial extravasation volume, 3 volumes were defined on SPECT images using a 3D activity threshold. Cumulated activities and associated absorbed doses (D1, D2, D3) were calculated in the 3 volumes using the MIRD formalism.

Results

Volumes estimated using 3D threshold were V1 = 1000 mL, V2 =400 mL, and V3 =180 mL. Cumulated activities were evaluated using a monoexponential fit on activities calculated on SPECT images. Estimated local absorbed doses in V1, V2, and V3 were D1 = 2.3 Gy, D2 = 4.1 Gy, and D3 = 6.8 Gy. Evolution in time of local activity in the extravasation area was consistent with an effective local half-life (Teff) of 2.3 h.

Conclusions

Rapid local dose estimation was permitted thanks to knowledge of the calibration factor determined previous to accidental extravasation. Lutathera® lymphatic drainage was quick in the arm (Teff = 2.3h). Estimated doses were in the lower range of deterministic effects and far under soft tissue necrosis threshold. Thus, no surgical rinse was proposed. The patient did not show any clinical consequence of the extravasation.
Effect of quantitative values on shortened acquisition duration in brain tumor 11C-methionine PET/CT
Authors: Morimoto Masatoshi , Kudomi Nobuyuki , Maeda Yukito , Kobata Takuya , Oishi Akihiro , Matsumoto Keisuke , Monden Toshihide , Iwasaki Takanobu , Mitamura Katsuya , Norikane Takashi , Yamamoto Yuka , Nishiyama Yoshihiro
Published: March 2021

Background

The amount of signal decreases when the acquisition duration is shortened. However, it is not clear how this affects the quantitative values. This study aims to clarify the effect of acquisition time shortening in brain tumor PET/CT using 11C-methionine on the quantitative values.

Method

This study was a retrospective analysis of 30 patients who underwent clinical 11C-methionine PET/CT examination. PET images were acquired in list mode for 10 min. PET images of acquisition duration from 1 to 10 min with 1-min step were reconstructed. We examined the effect on the quantitative values of acquisition duration. We placed a volume of interest to include the entire tumor and regions of interest in the shape of a large crescent in the contralateral hemisphere in 5 contiguous axial slices as normal tissue. Quantitative values examined were maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, SUVmean), metabolic tumor volume (MTV), and maximum tumor to normal tissue ratio (TNRmax), with each duration compared to that with 10 min.

Results

SUVmax, MTV, and TNRmax showed the highest values due to the effects of statistical noise when the acquisition time was 1 min. These values were stable when the acquisition duration was > 6 min. SUVpeak and SUVmean showed mostly consistent values regardless of duration.

Conclusions

SUVmax, MTV, and TNRmax are affected by acquisition time. If the acquisition duration was > 6 min, the fluctuation could be suppressed within 5% in these quantitative values. However, SUVpeak was suggested to be a robust index regardless of the acquisition duration.
Coupled microbiome analyses highlights relative functional roles of bacteria in a bivalve hatchery
Authors: Timmins-Schiffman Emma , White Samuel J. , Thompson Rhonda Elliott , Vadopalas Brent , Eudeline Benoit , Nunn Brook L. , Roberts Steven B.
Published: March 2021

Background

Microbial communities are ubiquitous throughout ecosystems and are commensal with hosts across taxonomic boundaries. Environmental and species-specific microbiomes are instrumental in maintaining ecosystem and host health, respectively. The introduction of pathogenic microbes that shift microbiome community structure can lead to illness and death. Understanding the dynamics of microbiomes across a diversity of environments and hosts will help us to better understand which taxa forecast survival and which forecast mortality events.

Results

We characterized the bacterial community microbiome in the water of a commercial shellfish hatchery in Washington state, USA, where the hatchery has been plagued by recurring and unexplained larval mortality events. By applying the complementary methods of metagenomics and metaproteomics we were able to more fully characterize the bacterial taxa in the hatchery at high (pH 8.2) and low (pH 7.1) pH that were metabolically active versus present but not contributing metabolically. There were shifts in the taxonomy and functional profile of the microbiome between pH and over time. Based on detected metagenomic reads and metaproteomic peptide spectral matches, some taxa were more metabolically active than expected based on presence alone (Deltaproteobacteria, Alphaproteobacteria) and some were less metabolically active than expected (e.g., Betaproteobacteria, Cytophagia). There was little correlation between potential and realized metabolic function based on Gene Ontology analysis of detected genes and peptides.

Conclusion

The complementary methods of metagenomics and metaproteomics contribute to a more full characterization of bacterial taxa that are potentially active versus truly metabolically active and thus impact water quality and inter-trophic relationships.
Sudden paraparesis due to spinal cord ischemia with initial contrast enhancement of the cauda equina and time-delayed owl-eyes sign on follow-up MR imaging: a case report
Authors: Breitling Benedict , Schmeel Frederic Carsten , Radbruch Alexander , Kaut Oliver
Published: March 2021

We report on a case of a 52-year-old male with sudden paraparesis. The initial MRI showed contrast enhancement of the conus medullaris and the complete cauda equina. Follow-up MRI revealed a spinal ischemia in the anterior portion of the spinal cord. Only a few reports with similar findings have been published. We suggest that contrast enhancement of the conus medullaris and descending nerve roots can be a potential first indicator of a spinal cord ischemia.
Consequences of COVID-19 pandemic lockdown on emergency and stroke care in a German tertiary stroke center
Authors: Jansen Robin , Lee John-Ih , Turowski Bernd , Kaschner Marius , Caspers Julian , Bernhard Michael , Hartung Hans-Peter , Jander Sebastian , Ruck Tobias , Meuth Sven G. , Gliem Michael
Published: March 2021

Background

COVID-19 pandemic caused a decline in stroke care in several countries. The objective was to describe lockdown stroke care in a tertiary stroke center in Düsseldorf, Germany near Heinsberg, a German hot spot for COVID-19 in spring 2020.

Methods

In a retrospective, observational, single-center study, we compared all patients treated in our emergency department (ED), patients seen by a neurologist in the ED, ED patients suffering from ischemic and hemorrhagic strokes and transient ischemic attacks (TIAs) as well as stroke patients admitted to our stroke unit during lockdown in spring 2020 (16 March 2020–12 April 2020) to those cared for during the same period in 2019 and lockdown light in fall 2020 (2 November – 29 November 2020).

Results

In spring 2020 lockdown the mean number of patients admitted to our ED dropped by 37.4%, seen by a neurologist by 35.6%, ED stroke patients by 19.2% and number of patients admitted to our stroke unit by 10% compared to the same period in 2019. In fall lockdown light 2020 effects were comparable but less pronounced. Thrombolysis rate was stable during spring and fall lockdown, however, endovascular treatment (EVT) rate declined by 58% in spring lockdown and by 51% in fall lockdown compared to the period in 2019.

Conclusions

Our study indicates a profound reduction of overall ED patients, neurological ED patients and EVT during COVID-19 pandemic caused lockdowns. Planning for pandemic scenarios should include access to effective emergency therapies.
Mental well-being among health science specialty female students in Riyadh, Saudi Arabia
Authors: Alshehri Elham Ali R.
Published: March 2021

Background

Well-being includes the physical, social, and emotional dimensions of a person’s state. University students experience increased levels of psychological and academic distress, mostly affecting their mental well-being. This study employed a descriptive, correlational, cross-sectional design to assess the level of mental well-being among health sciences students at three health science colleges at King Saud University in Riyadh, Saudi Arabia. Convenience total sampling was used to select 339 female undergraduate students from the three faculties. A questionnaire consisting of two parts—a sociodemographic datasheet and the Arabic version of the Warwick–Edinburgh Mental Well-being Scale (WEMWBS) without modifications to assess individuals’ mental well-being—was distributed, with data collection lasting for one month (February 2019).

Results

Participants had an average level of mental well-being, with the highest recorded among students from the College of Pharmacy and the lowest recorded among the students from the College of Nursing. The study findings revealed no significant correlations or differences in the mental well-being of the questionnaire respondents according to sociodemographic variables.

Conclusions

It is important to assess the mental well-being of students to detect any possible mental illnesses or disturbances and address any issues so as to support their academic achievement.
Effects of information on consumer attitudes towards gene-edited foods: a comparison between livestock and vegetables
Authors: Kato-Nitta Naoko , Inagaki Yusuke , Maeda Tadahiko , Tachikawa Masashi
Published: March 2021

Background

This study statistically explores the relationship between information provision and peoples’ attitudes towards the application of gene-editing technology to food, by contrasting cases of gene-edited livestock and vegetables in Japan. Japanese food producers and researchers are optimistic about the application of the clustered regularly interspaced short palindromic repeats (CRISPR) approach to food. Due to the strict regulations regarding genetically modified (GM) food, GM crops are not commercially cultivated in Japan. Consumers worldwide have concerns about application of this technology to food. Further examination of this issue for Japanese consumers with lower acceptance towards GM food should provide essential information for global agricultural communities.

Methods

Using a web survey, split-ballot experimental design was used to randomly assign the respondents into two groups: (1) the animal group, for which information on breeding technologies, including gene editing, was provided using pig illustrations. (2) The plant group, for which information was provided using tomato illustrations. Multivariate analysis of variance and post-hoc t-tests were applied to examine the statistical differences between the plant and animal groups for attitudes towards gene-edited livestock and vegetables. Statistical analyses were conducted to examine if scientific knowledge influences these attitudes.

Results

Respondents found gene-edited vegetables more beneficial than gene-edited livestock. Their agreement was stronger for vegetables than for livestock. Respondents’ attitudes towards gene-edited livestock differed depending on whether they were shown pig illustrations or tomato illustrations. The plant group scored significantly lower regarding gene-edited livestock compared to the animal group. No statistical difference was observed between the two groups in the case of gene-edited vegetables. Furthermore, the higher science literacy group always scored higher regarding improvements in vegetable breeding, but this was not concordant regarding improvements in livestock breeding.

Conclusions

People were more concerned about gene-edited livestock than gene-edited vegetables. The respondents who were provided information with tomato illustrations in advance demonstrated lower acceptance towards gene-edited livestock than those who were provided information with pig illustrations. Applying the technology to livestock, such as size enlargement for improvements, might be considered as risky by the public, in contrast with vegetables.
Novel Inpatient Radiation Oncology Consult Service Model Reduces Hospital Length of Stay
Authors: Xu Amy J. , Yerramilli Divya , Cahlon Oren , Powell Simon N. , Yang Jonathan T. , Gomez Daniel R.
Published: March 2021

Palliative care and radiation therapy have played an expanding role in the management of patients with advanced cancers. Recent advances in our understanding of oligometastatic disease have led to increasing demand for familiarity with ablative techniques. Recognizing the demands of hospitalized patients for rapid access to care, we created an inpatient radiation oncology consult service (IROC) with consolidated expertise in palliative radiation and ablative techniques. In this quality improvement cohort study, we analyzed inpatient radiation oncology consults placed before and after IROC implementation and found that IROC led to increased delivery of specialty care and decreased hospital length of stay (median 8 days v 7 days, P = .005). This difference was most pronounced for patients for whom radiation therapy was indicated (14.5 v 11 days, P = .007). Our institutional experience demonstrates the value of recognizing metastatic disease as a distinct discipline and providing rapid access to palliative treatments for patients with advanced malignancies.
Combined Beneficial Effect of Voluntary Physical Exercise and Vitamin D Supplementation in Diet-induced Obese C57BL/6J Mice
Authors: MARZIOU ALEXANDRA , AUBERT BENJAMIN , COUTURIER CHARLÈNE , ASTIER JULIEN , PHILOUZE CLOTHILDE , OBERT PHILIPPE , LANDRIER JEAN-FRANÇOIS , RIVA CATHERINE
Published: March 2021

Purpose

Physical exercise (PE) combined with nutritional approaches has beneficial effects that are widely advocated to improve metabolic health. Here we used voluntary PE together with vitamin D (VD) supplementation, which has already shown beneficial effects in primary and tertiary prevention in obese mice models, to study their combined additive effects on body weight management, glucose homeostasis, metabolic inflammation, and liver steatosis as key markers of metabolic health.

Methods

Ten-week-old male C57BL/6J mice were fed a high-fat/sucrose (HFS) diet for 10 wk, then assigned to a 15-wk intervention period with PE, VD supplementation, or both PE and VD supplementation. Morphological, histological, and molecular phenotype data were characterized.

Results

The HFS-induced increases in body mass, adiposity, and adipocyte hypertrophy were improved by PE but not by VD supplementation. The HFS-induced inflammation (highlighted by chemokines mRNA levels) in inguinal adipose tissue was decreased by PE and/or VD supplementation. Furthermore, the intervention combining PE and VD showed additive effects on restoring insulin sensitivity and improving hepatic steatosis, as demonstrated through a normalization of size and number of hepatic lipid droplets and triglyceride content and a significant molecular-level decrease in the expression of genes coding for key enzymes in hepatic de novo lipogenesis.

Conclusions

Taken together, our data show beneficial effects of combining PE and VD supplementation on obesity-associated comorbidities such as insulin resistance and hepatic disease in mice. This combined exercise–nutritional support strategy could prove valuable in obesity management programs.
Nausea after Repeated Sprints: Is Lactic Acidosis Really the Culprit?
Authors: MERRELLS ROBERT J. , MADON SANI B. , CHIVERS PAOLA T. , FOURNIER PAUL A.
Published: March 2021

Introduction

Nausea caused by exhaustive sprinting is associated with high lactate ([La−]) and hydrogen ion concentrations ([H+]) and fall in blood pCO2, thus raising the issue of whether there is a causal link between nausea and these variables. For this reason, this study aimed to determine whether interspersing repeated sprints (RS) with periods of active, compared with passive, recovery results in lower levels of both nausea and changes in [La−], [H+], and pCO2.

Methods

Twelve male participants completed two separate sessions comprising four 30-s sprints separated by 20 min of either active (AR; cycling at 40% V˙O2peak) or passive recovery (PR). At 6 and 18 min of each recovery period, nausea was assessed via a visual analog scale (VAS), and blood samples were collected to measure [La−], [H+], and pCO2.

Results

RS significantly increased VAS score in both AR (P < 0.001) and PR (P < 0.01). After the first sprint, VAS was higher than preexercise in only AR (P < 0.01). AR was associated with lower VAS, [La−], [H+], and higher pCO2 (all P = 0.001) compared with PR after sprints 2–4. Linear mixed modeling indicated that each of the variables significantly predicts VAS scores (P < 0.0001). Repeated-measures correlation (r
rm

2
) indicated that [La−] had the closest association with VAS (r
rm

2
= 0.22, P < 0.0001).

Conclusion

The lower levels of both nausea and changes in [La−], [H+], and pCO2 in response to AR suggest that nausea associated with RS may be causally related with these variables. However, the absence of a close relationship between these variables after the first sprint and the findings that [La−], [H+], and pCO2 only account for 13%–22% of the variation in VAS indicate that other mechanisms may also mediate nausea.
Νεότεροι υπερηχοκαρδιογραφικοί δείκτες στη διάγνωση και εκτίμηση της βαρύτητας του ηπατοπνευμονικού συνδρόμου σε ασθενείς με κίρρωση του ήπατος
Authors: Σουλαϊδόπουλος Στέργιος
Published: March 2021

Στόχος: Σκοπός της παρούσας μελέτης είναι η διερεύνηση των πιθανών συσχετισμών μεταξύ ηπατοπνευμονικού συνδρόμου (ΗΠΣ) και καρδιακής λειτουργίας σε ασθενείς με μη αντιρροπούμενη κίρρωση. Μέθοδοι: Ασθενείς με σταθερή μη αντιρροπούμενη κίρρωση που αξιολογήθηκαν στην κλινική μας ως υποψήφιοι για μεταμόσχευση ήπατος συμπεριελήφθησαν προοπτικά στη μελέτη. Ως ΗΠΣ ορίστηκε ως η παρουσία αυξημένης κυψελιδο-αρτηριακής διαφοράς οξυγόνου και ενδοπνευμονικών αγγειακών διατάσεων – ενδοπνευμονικού shunt α, που ανιχνεύθηκε από ηχωκαρδιογραφία ενισχυμένης σκιαγραφικής αντίθεσης. Η σοβαρότητα του ΗΠΣ προσδιορίστηκε με βάση την μερική πίεση αρτηριακού οξυγόνου, ενώ με τη χρήση μιας ημι-ποσοτικής μεθόδου αξιολογήθηκε ο βαθμός του ενδοπνευμονικού shunt. Συλλέχθηκαν δημογραφικά, κλινικά και εργαστηριακά δεδομένα. Αποτελέσματα: Συνολικά, στη μελέτη συμπεριελήφθησαν 130 ασθενείς (μέση ηλικία 56,5 έτη, Α / Γ: 94/36, MELD score 14.6 ± 5.6), εκ των οποίων 45 (34.6%) πληρούσαν τα κριτήρια διάγνωσης για τη διάγνωση ΗΠΣ (ήπιο: 57.7%, μέτριο: 33.3%, σοβαρό 4.4% και πολύ σοβαρό 4.4%). Σημαντικά χαμηλότερες απόλυτες τιμές ολικού γραμμικού strain (global longitudinal strain – GLS) της αριστερής κοιλίας καταγράφηκαν σε ασθενείς με ΗΠΣ σε σύγκριση με κιρρωτικούς ασθενείς χωρίς ΗΠΣ (-21.62,3 έναντι -22.62.5%, p = 0.041), ενώ δεν διαπιστώθηκε στατιστικά σημαντική διαφορά σχετικά GLS της δεξιάς κοιλίας μεταξύ των δύο ομάδων (-22.13.3 έναντι -23.23.5%, p = 0.061). Χαμηλότερες τιμές κλάσματος εξώθησης της αριστερής κοιλίας καταγράφηκαν επίσης στους ασθενείς με ΗΠΣ (53.9-3.5 έναντι 56.3-4.5%, ρ <0,01). Καμία άλλη ηχωκαρδιογραφική παράμετρος δεν συσχετίστηκε με την παρουσία του ΗΠΣ. Η σταδιοποίηση του ενδοπνευμονικού shunt συσχετίστηκε με την σταδιοποίηση της βαρύτητας του ΗΠΣ (χ2 = 19,8, p <0,01), με χαμηλότερες τιμές μερικής πίεσης αρτηριακού οξυγόνου να καταγράφονται σε υψηλότερα βαθμού ενδοπνευμονικού shunt. Συμπέρασμα: Σε ασθενείς με κίρρωση, η παρουσία ΗΠΣ σχετίζεται με μειωμένη συστολική απόδοση της αριστερής κοιλίας.
Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England
Authors: Duncan Lorna J. , Cheng Kelly F.D.
Published: March 2021

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of general practice consultations has been modified to enable the separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations are currently the default model, with adapted face-to-face contact used when clinically necessary. This study aimed to identify the modified face-to-face delivery models used across England, and evidence for their effectiveness.

Methods: In June 2020, a national survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was sent to Public Health England (PHE) requesting information about COVID-19 outbreaks or clusters linked to general practice.

Results: All CCGs responded. Separation of COVID-19 patients from others was achieved using combinations of the following models:

zoned surgeries (used in 47% of CCGs), where COVID-19 and other patients are separated within their own practice;

‘hot’ or ‘cold’ hubs (used in 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices are seen;

‘hot’ and ‘cold’ home visits (used in 70% of CCGs).

One of seven model combinations was used across each CCG, with some flexibility according to changing need shown through hub availability. Concomitant PHE data showed less than 2% of COVID-19 outbreaks or clusters in England were linked to general practice.

Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified. While COVID-19 outbreaks or clusters linked to general practice constituted a small proportion of totals, their investigation, together with evaluations of the modified delivery models in terms of management of COVID-19 and other conditions and impacts on staff and patients, may aid future management of the pandemic and identify aspects of adapted practice of benefit beyond this.
The existential stakes of platform governance and online content regulation: a critical conceptual model
Authors: Papaevangelou Charilaos
Published: March 2021

This study introduces a comprehensive yet non-exhaustive overview of literature concerning the concepts of regulation and governance, and attempts to connect them to scholarly works that deal with social media platforms’ content regulation. The paper provides fundamental definitions of regulation and governance, along with a critique of polycentricity, in order to contextualise the discussion around platform governance and online content regulation. Regulation is framed here as a governance mechanism within a polycentric governance model where stakeholders have competing interests, even if sometimes they coincide. Moreover, where traditional governance literature conceptualised stakeholders as a triangle, this article proposes imagining them as overlapping circles of governance clusters with competing interests, going beyond the triad of public, private and non-governmental actors. Finally, the paper contends that that there exists a timely need to reimagine the way in which we understand and study phenomena appertaining to public discourse by adopting the platform governance perspective, which is framed as the advancement of internet governance. Finally, the article ascertains to study the governance of online content and social media platforms not as a sub-section of internet governance but as a conceptual evolution with existential stakes.
The New York Christian Inquirer on Slavery: Progressive and Progressing Viewpoints?
Authors: Snow Talia
Published: March 2021

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A bit of a ‘pinch me’ moment
Authors: Greenley Mitch
Published: March 2021

Mitch Greenley shares his thrill of qualifying as a dental nurse – and how he fell in love with dentistry
The art of drawing on a skillset
Authors: Thompson Anne-Marie
Published: March 2021

Former dental nurse Anne-Marie Thompson shares a career move that took her from lead dental nurse to semi-permanent make-up artist
Photography: helping patients to see
Authors: Tonkinson Cheryl
Published: March 2021

Does your dentist have a camera sitting in a cupboard collecting dust? Here, Cheryl Tonkinson reveals why this skill will enhance your role as well as raise the bar with patient care
Visualise a new career perspective
Authors: Schroven Danielle , Mac
Published: March 2021

Dental nurse Danielle Schroven and general and paediatric dentist Makbule Ogretme talk about the power of the photograph
Lung-protective ventilation vs conventional ventilation in emergency surgery
Authors: Briggs Christopher , Melia David
Published: March 2021

Lung-protective ventilation significantly reduces mortality in patients with acute respiratory distress syndrome, but do the advantages of this approach transfer from the intensive care unit to the operating room?
Care home industry facing customer exodus due to infection fears
Authors: Ramadan Francesca
Published: March 2021

It has long been suspected that the COVID-19 pandemic will affect public confidence in care homes, and research is now emerging to confirm these fears. Francesca Ramadan explores the findings of a recent public survey on expectations around hygiene and infection control in care homes.
Canine arthritis management and the new norm
Authors: Capon Hannah
Published: March 2021

Canine arthritis is considered a welfare concern, and patients could benefit greatly from nurse-led clinics. As a result of the COVID-19 pandemic telehealth has been embraced, and nurses are well placed to run these following a few simple rules. This workshop outlined the benefits of the nurse-led clinic and the best way to approach online consultations.
Clinical assessment of muscle condition in cats
Authors: Rayhel Laura , Quimby Jessica
Published: March 2021

Loss of muscle occurs in feline patients as a result of multiple chronic conditions, and muscle atrophy may worsen the prognosis for cats that are living with these diseases. In states of health, a balance exists between cellular processes that build muscle and processes that break it down. Disease states such as kidney disease, cancers, cardiac disease, and metabolic conditions promote chronic systemic inflammation which shifts this balance in favour of muscle breakdown. If noted, muscle loss should prompt a thorough medical investigation including nutritional and clinical history, laboratory work, and imaging studies, as well as the creation of an in-depth nutritional management plan. Veterinary nurses are the first line in recognising muscle loss, identifying historical clues as to its cause, and educating clients about diagnostic and therapeutic plans for associated disease management.
A prognostic model of excessive lung function decline among Québec apprentices: a cohort exposed to occupational sensitizing agents
Authors: Parfi Alfi Afadiyanti , Taghiakbari Mahsa , Achore Meshack , Gautrin Denyse , Bezgin Gleb , Suarthana Eva
Published: March 2021

BACKGROUND Forced expiratory volume in 1 second (FEV1) decline as a predictor of lung-related health problems is widely observed, but not fully investigated. This study aimed to develop models to predict FEV1 decline among apprentices exposed to sensitizing agents. METHODS Of 692 apprentices recruited and followed in 3.6–17.3 years, 292 were exposed to low-molecular weight agents. The analysis was restricted to 357 apprentices with complete lung function assessment at the end of their training with a minimum of 5-year follow-up. According to the American Thoracic Society guideline, a mean FEV₁ decline >60 ml/year was defined as “accelerated.” Descriptive statistics and Cox regression analysis were utilized to determine its predictors. To develop the prognostic models, we used a logistic regression analysis adjusted for the follow-up duration. The accuracy of the models was quantified using calibration and discrimination measures. RESULTS Of 357 subjects, 62 (17.4%) had an excessive FEV1 decline post-apprenticeship. The questionnaire model (model 1), which included male sex, wheezing, and exposure to isocyanate or animal allergens during the apprenticeship, showed a reasonable discriminative ability (area under the receiver operating characteristics curve [AUC] of 0.67, 95% CI = 0.59–0.75). Adding the percent-predicted FEV₁ value at the end of apprenticeship significantly increased the discriminative ability of the model (model 4) (AUC = 0.762, 95% CI = 0.694–0.829) with a good calibration and reasonable internal validity. CONCLUSIONS We developed a model for accelerated lung function decline with a good accuracy and internal validity. However, external validation of the model is necessary.
Teenagers’ access to digital technologies and refuge life: balancing safety, risk and protectionism
Authors: Bracewell Kelly , Larkins Cath , Stanley Nicky
Published: March 2021

Refuges or shelters have been central to UK domestic violence service provision since the 1970s. In 2013, UK policy transformed teenagers into primary service users of domestic violence refuges. Digital technology is central to teenagers’ lives but moving to a refuge can cause serious disruption in this respect.

The study was undertaken in 20 refuges in England. Repeat qualitative interviews with 20 young people aged 13–18 and single interviews with refuge staff explored teenagers’ experiences of refuge life. Access to digital technology emerged as a central theme for this group of young people.

Teenagers described difficulties in accessing digital technology and the internet in refuges and this impacted on their education, support networks and leisure. Restrictions concerning online access in refuges were attributed to safety concerns and resource shortfalls. This study found that restrictions on internet access lacked consistency across refuges and were underpinned by protectionist attitudes towards teenagers. Refuges need to seek a balance between risk and protectionism and identify opportunities to use digital technologies to increase the safety and support available to teenagers.
Low-threshold and controllable nanolaser based on quasi-BIC supported by an all-dielectric eccentric nanoring structure
Authors: Bi Weilin , Zhang Xin , Yan Meng , Zhao Lina , Ning Tingyin , Huo Yanyan
Published: March 2021

High-Q factor can enhance the interaction between light and matter, which is an important parameter to decrease the threshold of nanolasers. Here, we theoretically propose an eccentric nanoring structure with a high and controllable Q factor to realize a low-threshold and controllable nanolaser by amplifying the quasi-bound states in the continuum (quasi-BIC). The designed nanostructure supports a quasi-BIC because of the symmetry protection-breaking of the nanostructure. The quasi-BIC has a very high Q factor of about 9.6×104 and can also be adjusted by changing structural parameters. We use the energy level diagram of the four-level two-electron system to study the lasing action of the eccentric nanoring structure. The results show that the nanolaser has a relatively low threshold of about 6.46 μJ/cm2. Furthermore, the lasing behavior can be tuned by controlling the structural parameters of the eccentric circular ring structure.
Atmospheric refraction corrections in ground-to-satellite optical time transfer
Authors: Stuhl Benjamin K.
Published: March 2021

Free-space optical time and frequency transfer techniques can synchronize fixed ground stations at the femtosecond level, over distances of tens of kilometers. However, optical time transfer will be required to span intercontinental distances in order to truly unlock the performance of optical frequency standards and support an eventual redefinition of the SI second. Fiber dispersion and Sagnac uncertainty severely limit the performance of long-range optical time transfer over fiber networks, so satellite-based free-space time transfer is a promising solution. In pursuit of ground-to-space optical time transfer, previous work has considered a number of systematic shifts and concluded that all of them are manageable. One systematic effect that has not yet been substantially studied in the context of time transfer is the effect of excess optical path length due to atmospheric refraction. For space-borne objects, orbital motion causes atmospheric refraction to be imperfectly canceled even by two-way time and frequency transfer techniques, and so will require a temperature-, pressure-, and humidity-dependent correction. This systematic term may be as large as a few picoseconds at low elevations and remains significant at elevations up to ~35°. It also introduces biases into previously-studied distance- and velocity-dependent corrections.
Underwater acoustic source localization based on phase-sensitive optical time domain reflectometry
Authors: Liu Zhichao , Zhang Liang , Wei Heming , Xiao Zhelan , Qiu Zenghuan , Sun Ruoqi , Pang Fufei , Wang Tingyun
Published: March 2021

This paper demonstrates an underwater localization system based on an improved phase-sensitive optical time domain reflectometry (φ-OTDR). To localize the underwater acoustic source, 3D-printed materials with relatively high Poisson's ratio and low elastic modulus are wrapped by single-mode optical fibers to serve as an L-shaped planar sensing array, yielding a high-fidelity retrieval of acoustic wave signals. Based on the time difference of arrival (TDOA) algorithm, the time delay of signals detected by multiple sensing elements is used to locate the underwater acoustic source. Consequently, the three-dimensional localization feasibility of the proposed system is experimentally verified, showing a measurement error of about 2% in the localization range. It indicates that the proposed scheme is of great potential for applications in the underwater environment, such as trajectory tracking, oil/gas pipeline security monitoring and coastal defense.
Modeling of a SiGeSn quantum well laser
Authors: Marzban Bahareh , Stange Daniela , Rainko Denis , Ikonic Zoran , Buca Dan , Witzens Jeremy
Published: March 2021

We present comprehensive modeling of a SiGeSn multi-quantum well laser that has been previously experimentally shown to feature an order of magnitude reduction in the optical pump threshold compared to bulk lasers. We combine experimental material data obtained over the last few years with

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theory to adapt transport, optical gain, and optical loss models to this material system (drift-diffusion, thermionic emission, gain calculations, free carrier absorption, and intervalence band absorption). Good consistency is obtained with experimental data, and the main mechanisms limiting the laser performance are discussed. In particular, modeling results indicate a low non-radiative lifetime, in the 100 ps range for the investigated material stack, and lower than expected Γ-L energy separation and/or carrier confinement to play a dominant role in the device properties. Moreover, they further indicate that this laser emits in transverse magnetic polarization at higher temperatures due to lower intervalence band absorption losses. To the best of our knowledge, this is the first comprehensive modeling of experimentally realized SiGeSn lasers, taking the wealth of experimental material data accumulated over the past years into account. The methods described in this paper pave the way to predictive modeling of new (Si)GeSn laser device concepts.
Microbial colonization induces histone acetylation critical for inherited gut-germline-neural signaling
Authors: Hong Chunlan , Lalsiamthara Jonathan , Ren Jie , Sang Yu , Aballay Alejandro
Published: March 2021

The gut-neural axis plays a critical role in the control of several physiological processes, including the communication of signals from the microbiome to the nervous system, which affects learning, memory, and behavior. However, the pathways involved in gut-neural signaling of gut-governed behaviors remain unclear. We found that the intestinal distension caused by the bacteriumPseudomonas aeruginosainduces histone H4 Lys8 acetylation (H4K8ac) in the germline ofCaenorhabditis elegans, which is required for both a bacterial aversion behavior and its transmission to the next generation. We show that induction of H4K8ac in the germline is essential for bacterial aversion and that a 14-3-3 chaperone protein family member, PAR-5, is required for H4K8ac. Our findings highlight a role for H4K8ac in the germline not only in the intergenerational transmission of pathogen avoidance but also in the transmission of pathogenic cues that travel through the gut-neural axis to control the aversive behavior.
Loss of the abasic site sensor HMCES is synthetic lethal with the activity of the APOBEC3A cytosine deaminase in cancer cells
Authors: Biayna Josep , Garcia-Cao Isabel , Álvarez Miguel M. , Salvadores Marina , Espinosa-Carrasco Jose , McCullough Marcel , Supek Fran , Stracker Travis H.
Published: March 2021

Analysis of cancer mutagenic signatures provides information about the origin of mutations and can inform the use of clinical therapies, including immunotherapy. In particular, APOBEC3A (A3A) has emerged as a major driver of mutagenesis in cancer cells, and its expression results in DNA damage and susceptibility to treatment with inhibitors of the ATR and CHK1 checkpoint kinases. Here, we report the implementation of CRISPR/Cas-9 genetic screening to identify susceptibilities of multiple A3A-expressing lung adenocarcinoma (LUAD) cell lines. We identify HMCES, a protein recently linked to the protection of abasic sites, as a central protein for the tolerance of A3A expression. HMCES depletion results in synthetic lethality with A3A expression preferentially in a TP53-mutant background. Analysis of previous screening data reveals a strong association between A3A mutational signatures and sensitivity to HMCES loss and indicates that HMCES is specialized in protecting against a narrow spectrum of DNA damaging agents in addition to A3A. We experimentally show that both HMCES disruption and A3A expression increase susceptibility of cancer cells to ionizing radiation (IR), oxidative stress, and ATR inhibition, strategies that are often applied in tumor therapies. Overall, our results suggest that HMCES is an attractive target for selective treatment of A3A-expressing tumors.