bluuebunny/crossref_metadata_2025 huggingface dataset:
Keratoconus in a Rhesus Monkey
Authors: Peiffer Robert L. , Werblin Theodore P. , Patel Anil S.
Published: July 2020

A 15‐year‐old female rhesus monkey was observed to have bilaterally thinned and prominently curved corneas. Slit lamp observations, pachymetry, keratometry, and corneoscopy were consistent with a diagnosis of keratoconus, a relatively common corneal dystrophy in humans heretofore not described in a subhuman primate.
Progesterone Levels During Pregnancy in the Greater Thick‐tailed Galago (Galago crassicaudatus)
Authors: Izard M.K. , Fail P.A.
Published: July 2020

Serum progesterone concentrations in Galago crassicaudatus were quantified at 3‐week intervals throughout the 136‐day pregnancy. Progesterone concentrations were significantly elevated over those of nonpregnant controls as early as 6 weeks after conception. Progesterone continued to increase throughout gestation. The progesterone profile in pregnant G. crassicaudatus quantitatively resembles that of chimpanzees and qualitatively resembles that of humans. In two animals that aborted, progesterone concentrations after abortion decreased to values comparable to those seen in nonpregnant animals.
Real‐Time Ultrasonic Evaluation of the Baboon Pregnancy: Biometric Measurements
Authors: Farine Dan , MacCarter Gregory D. , Timor‐Tritch Ilan E. , Yeh Ming‐Neng , Stark Raymond I.
Published: July 2020

Ultrasonic and direct biometric measurements of nine fetal baboons were made during 23 evaluations. Both the femur length and the biparietal diameter were correlated to gestational age. These initial results have facilitated intrauterine surgery. The data presented will help in determining adequate fetal growth and in dating the baboon pregnancy.
A comparison of the prevalence of health problems among adults with and without intellectual disability: A total administrative population study
Authors: McMahon Martin , Hatton Chris
Published: July 2020

Introduction

There is considerable international research indicating health disparities between people with and without intellectual disabilities. It is important that comparative studies use representative population samples. This study compares a total administrative population of adults with intellectual disability to a random stratified general population sample.

Methods

An administrative population of 217 adults with intellectual disability and a random stratified sample of 2,350 adults without intellectual disability participated. A questionnaire using the International Classification of Diseases (ICD‐10) Chapter Headings was administered to all participants to enable a like‐for‐like comparison.

Findings

Unadjusted comparisons identified that adults with intellectual disability have a greater prevalence of health problems. These problems start early in adulthood and continue throughout life. However, they were less likely to experience cancers and musculoskeletal diseases.

Conclusions

These findings are consistent with the hypothesis that adults with intellectual disabilities have greater prevalence rates of health problems than the general population.
COVID‐19 in Nursing Homes: Calming the Perfect Storm
Authors: Ouslander Joseph G. , Grabowski David C.
Published: July 2020

The pandemic of viral infection with the severe acute respiratory syndrome coronavirus‐2 that causes COVID‐19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID‐19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID‐19 among nursing home residents have created a “perfect storm” in our countryʼs nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policy makers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care to achieve this goal. J Am Geriatr Soc 68:2153–2162, 2020.
Nutrition, growth, and other factors associated with early cognitive and motor development in Sub‐Saharan Africa: a scoping review
Authors: French B. , Outhwaite L.A. , Langley‐Evans S. C. , Pitchford N. J.
Published: July 2020

Background

Food insecurity, poverty and exposure to infectious disease are well‐established drivers of malnutrition in children in Sub‐Saharan Africa. Early development of cognitive and motor skills – the foundations for learning – may also be compromised by the same or additional factors that restrict physical growth. However, little is known about factors associated with early child development in this region, which limits the scope to intervene effectively. To address this knowledge gap, we compared studies that have examined factors associated with early cognitive and/or motor development within this population.

Methods

Predetermined criteria were used to examine four publication databases (PsycInfo, Embase, Web of Science and Medline) and identify studies considering the determinants of cognitive and motor development in children aged 0–8 years in Sub‐Saharan Africa.

Results

In total, 51 quantitative studies met the inclusion criteria, reporting on 30% of countries across the region. Within these papers, factors associated with early child development were grouped into five themes: Nutrition, Growth and Anthropometry, Maternal Health, Malaria and HIV, and Household. Food security and dietary diversity were associated with positive developmental outcomes, whereas exposure to HIV, malaria, poor maternal mental health, poor sanitation, maternal alcohol abuse and stunting were indicators of poor cognitive and motor development.

Discussion

In this synthesis of research findings obtained across Sub‐Saharan Africa, factors that restrict physical growth are also shown to hinder the development of early cognitive and motor skills, although additional factors also influence early developmental outcomes. The study also reviews the methodological limitations of conducting research using Western methods in sub‐Saharan Africa.
Florigen trafficking integrates photoperiod and temperature signals in Arabidopsis
Authors: Liu Lu , Zhang Yu , Yu Hao
Published: July 2020

The transition to flowering is the most dramatic phase change in flowering plants and is crucial for reproductive success. A complex regulatory network in plants has evolved to perceive and integrate the endogenous and environmental signals. These signals perceived, including day length and temperature, converge to regulate FLOWERING LOCUS T (FT), which encodes a mobile stimulus required for floral induction in Arabidopsis. Despite the discovery of modulation of FT messenger RNA (mRNA) expression by ambient temperature, whether the trafficking of FT protein is controlled in response to changes in growth temperature is so far unknown. Here, we show that FT transport from companion cells to sieve elements is controlled in a temperature‐dependent manner. This process is mediated by multiple C2 domain and transmembrane region proteins (MCTPs) and a soluble N‐ethylmaleimide‐sensitive factor protein attachment protein receptor (SNARE). Our findings suggest that ambient temperatures regulate both FT mRNA expression and FT protein trafficking to prevent precocious flowering at low temperatures and ensure plant reproductive success under favorable environmental conditions.
Military Families' Stressful Reintegration, Family Climate, and Their Adolescents' Psychosocial Health
Authors: O'Neal Catherine Walker , Mancini Jay A.
Published: July 2020

Objective

Grounded in the Contextual Model of Family Stress, this study sought to identify (a) how military families' postdeployment reintegration experiences relate to the psychosocial health of adolescents and (b) indicators of family climate as a linking mechanism.

Background

Reintegration requires individuals, families, and systems to readjust after a period of family disruption. Assessing reintegration is pivotal for understanding how military families are faring and what leverage points exist for enhancing their well‐being.

Method

The sample included 238 Active Duty (AD) military families with one service member and one civilian parent. Most parents were married and between the ages of 31–40 years. Adolescents (51.3% boys) ranged from 11 to 18 years (M = 14.13). A path analysis model with data from multiple family members examined the associations between (a) AD and civilian parents' perceptions of their family reintegration and military context, (b) their adolescents' perceptions of family climate, and (3) adolescents' psychosocial health (i.e., anxiety, depression, self‐efficacy, and personal well‐being).

Results

Both parents' experiences with family reintegration were indirectly related to adolescents' psychosocial health through indicators of family climate, particularly interparental conflict. The magnitude of significant effects ranged from small to medium, and time since deployment and gender were found to modify select findings.

Conclusion

These findings suggest clear leverage points for interventions with military families as they adjust to deployment reintegration, including a focus on parenting, parents' interactions with one another as a family reorients after deployment, and how adolescents perceive their own adjustment and that of their parents.
Parenthood Wage Gaps Across the Life Course: A Comparison by Gender and Race
Authors: Van Winkle Zachary , Fasang Anette Eva
Published: July 2020

Objective

We map the magnitude, timing, and persistence of parenthood wage gaps in the life course for Black, Hispanic, and White men and women in the United States.

Background

Previous research indicates that penalties only persist into mid‐life for mothers with three or more children without distinguishing by race. The timing and age range in which parenthood wage gaps occur for fathers and mothers of different racial backgrounds are unknown. We develop a theoretical framework based on the gender‐ and race‐specific interplay between labor market dynamics and family demographics over the life course to derive hypotheses.

Method

Age‐specific parenthood wage gaps from ages 20–40 are estimated using 1979 and 1997 National Longitudinal Surveys of Youth data and fixed effects models.

Results

Only White women with three or more children suffer large and persistent adjusted motherhood penalties up to age 40. For Black and Hispanic mothers, penalties are concentrated in a brief age range of 5–10 years around age 30 and then attenuate irrespective of the number of children. Adjusted fatherhood premiums only occur for White men and are confined to brief periods in early adulthood, suggesting that they result from complex selection effects into education, employment, and fatherhood.

Conclusion

For minority men and women, parenthood wage gaps are concentrated in brief periods of the life course. Only White mothers with many children experience persistent wage penalties. The race‐ and gender‐specific interplay between labor market dynamics and family demographics over the life course offers a consistent account of these findings.
Serum cannabidiol, tetrahydrocannabinol (THC), and their native acid derivatives after transdermal application of a low‐THC Cannabis sativa extract in beagles
Authors: Hannon Mary Beth , Deabold Kelly A. , Talsma Bryce N. , Lyubimov Alex , Iqbal Asif , Zakharov Alexander , Gamble Lauri Jo , Wakshlag Joseph J.
Published: July 2020

Cannabinoids hold promise for treating health problems related to inflammation and chronic pain in dogs, in particular cannabidiol (CBD), and its native acid derivative cannabidiolic acid (CBDA). Information regarding systemic delivery of cannabinoids through transdermal routes is sparse. The purpose of this study was to determine pharmacokinetics of transdermal administration of a low‐THC Cannabis sativa extract in healthy dogs. Six purpose‐bred research beagles were treated with a transdermal CBD‐CBDA‐rich extract, and serum concentrations of CBD, CBDA, tetrahydrocannabinol (THC), and its acid derivative tetrahydrocannabinolic acid (THCA) were examined prior to and at the end of weeks 1 and 2. A 4 mg/kg dose of total cannabinoids twice daily resulted in appx 10 ng/ml of CBD, 21–32 ng/ml of CBDA, trace amounts of THCA, and unquantifiable amounts of THC in serum at the end of weeks 1 and 2 of treatment. Results showed that CBDA and THCA were absorbed better systemically than CBD or THC.
Quantitative trait loci involved in the reproductive success of a parasitoid wasp
Authors: Benoist Romain , Capdevielle‐Dulac Claire , Chantre Célina , Jeannette Rémi , Calatayud Paul‐André , Drezen Jean‐Michel , Dupas Stéphane , Le Rouzic Arnaud , Le Ru Bruno , Moreau Laurence , Van Dijk Erwin , Kaiser Laure , Mougel Florence
Published: July 2020

Dissecting the genetic basis of intraspecific variations in life history traits is essential to understand their evolution, notably for potential biocontrol agents. Such variations are observed in the endoparasitoid Cotesia typhae (Hymenoptera: Braconidae), specialized on the pest Sesamia nonagrioides (Lepidoptera: Noctuidae). Previously, we identified two strains of C. typhae that differed significantly for life history traits on an allopatric host population. To investigate the genetic basis underlying these phenotypic differences, we used a quantitative trait locus (QTL) approach based on restriction site‐associated DNA markers. The characteristic of C. typhae reproduction allowed us generating sisters sharing almost the same genetic content, named clonal sibship. Crosses between individuals from the two strains were performed to generate F2 and F8 recombinant CSS. The genotypes of 181 clonal sibships were determined as well as the phenotypes of the corresponding 4,000 females. Informative markers were then used to build a high‐quality genetic map. These 465 markers spanned a total length of 1,300 cM and were organized in 10 linkage groups which corresponded to the number of C. typhae chromosomes. Three QTLs were detected for parasitism success and two for offspring number, while none were identified for sex ratio. The QTLs explained, respectively, 27.7% and 24.5% of the phenotypic variation observed. The gene content of the genomic intervals was investigated based on the genome of C. congregata and revealed 67 interesting candidates, as potentially involved in the studied traits, including components of the venom and of the symbiotic virus (bracovirus) shown to be necessary for parasitism success in related wasps.
Post‐traumatic stress disorder in critical illness survivors and its relation to memories of ICU
Authors: Askari Hosseini Seyyed Mohsen , Arab Mansoor , Karzari Zahra , Razban Farideh
Published: July 2020

Background

Stressors in intensive care units (ICUs) are sometimes so severe that they result in Post‐traumatic Stress Disorder (PTSD) in ICU survivors. The memories that survivors have from the ICU may play a role in developing PTSD.

Aim

This study aimed to determine the prevalence of PTSD‐related symptoms in ICU survivors in Southeast Iran and its relationship with their memories of the ICU.

Methods

In this descriptive correlational study, 100 people discharged from ICUs in southeastern Iran completed the Impact of Event Scale‐Revised (IES‐R) and ICU memory tool (ICU‐MT).

Results

Findings indicated that, from 100 participants who, on average, were assessed 3.19 ± 5.37 months after discharge, 13% were suffering from PTSD. The total mean IES‐R score and the scores of “Intrusion,” “Avoidance,” and “Hyperarousal” subscales in patients with delusional memories were higher compared with the patients who did not have such memories. In the patients who were mechanically ventilated at the time of their stay in the ICU, the total mean IES‐R score was 6.86 times higher (P = .03).

Conclusion

This research provided further evidence of the relationship between delusional memories and PTSD in patients who had been discharged from the ICU.

Relevance to clinical practice

In the care of patients admitted to the ICU, preventive strategies should be used to minimize delusional memories and PTSD. It is necessary to detect post‐ICU psychiatric morbidities and provide early psychological intervention in post‐discharge follow‐up programmes to improve psychological outcomes after critical illness.
Status of IL‐4 and IL‐10 driven markers in experimental models of Visceral Leishmaniasis
Authors: Moulik Srija , Karmakar Joyshree , Joshi Sumit , Dube Anuradha , Mandal Chitra , Chatterjee Mitali
Published: July 2020

Aim

Leishmania donovani, the causative agent for visceral leishmaniasis (VL), modulates host monocytes/macrophages to ensure its survival. However, knowledge regarding the host‐parasite interactions underpinning the disease remains limited. As disease progression is associated with polarization of monocytes/macrophages towards M2, which is regulated by cytokines IL‐4/IL‐13 and IL‐10, this study evaluated the status of key IL‐4‐ and IL‐10 driven markers in experimental models of VL, as also evaluated their correlation, if any, with parasite load.

Methods

In liver and splenic tissues from L donovani–infected hamsters and BALB/c mice, the parasite burden was determined along with mRNA expression of IL‐4–driven markers, that is CD206, Arginase‐I, CCL17, CCL22, PPAR‐γ, STAT6, KLF4, FIZZ1 and YM1 along with IL‐10–driven markers, CXCL13, IL‐10, TGF‐β, VDR, CCR2 and CYP27A1.

Results

The mRNA expression of IL‐4‐ and IL‐10–driven markers was enhanced in both models, but only in the hamster model, the splenic tissues demonstrated a positive correlation between all the IL‐10–driven markers and parasite load.

Conclusions

Contrary to human VL, both models demonstrated an increased expression of IL‐4‐ and IL‐10–driven markers.
Improved control of septoria tritici blotch in durum wheat using cultivar mixtures
Authors: Ben M'Barek Sarrah , Karisto Petteri , Abdedayem Wided , Laribi Marwa , Fakhfakh Moez , Kouki Hajer , Mikaberidze Alexey , Yahyaoui Amor
Published: July 2020

Mixtures of cultivars with contrasting levels of resistance can suppress infectious diseases in wheat, as demonstrated in numerous field experiments. Most studies focus on airborne pathogens in bread wheat, while splash‐dispersed pathogens have received less attention, and no studies have been conducted in durum wheat. We conducted a 2‐year field experiment in Tunisia to evaluate the performance of cultivar mixtures with varying proportions of resistance (0%–100%) in controlling the polycyclic, splash‐dispersed disease septoria tritici blotch (STB) in durum wheat. To measure STB severity, we used a high‐throughput method based on digital image analysis of 3,074 infected leaves collected from 42 and 40 experimental plots during the first and second years, respectively. This allowed us to quantify pathogen reproduction on wheat leaves and to acquire a large data set that exceeds previous studies with respect to accuracy and precision. Our analyses show that introducing only 25% of a disease‐resistant cultivar into a pure stand of a susceptible cultivar provides a substantial reduction of almost 50% in disease severity compared to the susceptible pure stand. However, incorporating two resistant cultivars instead of one did not further improve disease control, contrary to predictions of epidemiological theory. Susceptible cultivars can be agronomically superior to resistant cultivars or be better accepted by growers for other reasons. Hence, if mixtures with only a moderate proportion of the resistant cultivar provide a similar degree of disease control as resistant pure stands, as our analysis indicates, such mixtures are more likely to be accepted by growers.
Influence of stroke rate on coordination and sprint performance in elite male and female swimmers
Authors: Simbaña‐Escobar David , Hellard Philippe , Seifert Ludovic
Published: July 2020

This study investigated the effects of gender and the manipulation of the preferred stroke rate on swimming performance and arm coordination in elite front crawl swimmers. Nineteen swimmers performed a dual task, that is, imposed stroke rate and maximal speed. They swam nine 25‐m trials at maximal speed twice: one trial at the preferential stroke rate, one trial at maximal stroke rate and seven trials at stroke rates between 41 and 59 cycles/min imposed by an Aquapacer. Stroke rate, arm stroke phases, and arm coordination were computed from an inertial measurement unit on each forearm and one on the sacrum. Time on the 25‐m was recorded to assess swimming speed. Results indicated that the error between the imposed and performed stroke rates was lowest at the preferred stroke rate for women. An increase in stroke rate led to an increase in swimming speed and the index of coordination, but these changes could be influenced by the preferred stroke rate. Individual analysis revealed that some swimmers exhibited higher flexibility (larger range of stroke rate) around their preferred stroke rate. This stroke rate flexibility appeared more functional in swimmers who reached higher speeds when swimming at the maximal stroke rate than at the preferred stroke rate.
The importance of body weight status on motor competence development: From preschool to middle childhood
Authors: Lima Rodrigo A. , Soares Fernanda C. , Queiroz Daniel R. , Aguilar Javiera A. , Bezerra Jorge , Barros Mauro V. G.
Published: July 2020

We evaluated the association between weight status and motor competence from preschool age (3‐5 years of age) until middle childhood (7‐9 years of age). Longitudinal study with three to five‐year‐old preschool children (n = 1155) enrolled in public and private preschools in Recife, Brazil. Children were followed twice (2010, 2012, and 2014) for four years. Köperkoordinationstest für kinder (KTK) assessed the children's motor competence (KTK Motor Quotient). Weight status (underweight, normal weight, overweight, and obesity) was classified according to the children's sex and age. Preschool children with normal weight exhibited higher motor competence at 5‐7 years of age compared to preschool children with overweight (+3.73 MQ, P = .03) and obesity (+5.09 MQ, P < .01). Preschool children with normal weight presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+6.00 MQ, P = .03) and obesity (+5.88 MQ, P = .01). Children with normal weight at 5‐7 years of age presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+3.33 MQ, P = .02) and obesity (+4.00 MQ, P = .02). Independent of the childhood phase and extension of the period evaluated (2‐ or 4‐year period), children who had excessive weight (overweight or obesity) and changed their weight status to underweight or normal weight presented similar motor competence compared to children who continued underweight or normal weight. Weight status already at preschool age is an important predictor of the children's motor competence until middle childhood. Interventions improving the children's weight status, already at preschool age, might impact their motor competence development positively.
Airway cholinergic history modifies mucus secretion properties to subsequent cholinergic challenge in diminished chloride and bicarbonate conditions
Authors: Liao Yan Shin J. , Collins Emily N. , Guevara Maria Valentina , Schurmann Veronica , Atanasova Kalina R. , Bravo Laura , Sponchiado Mariana , Hoegger Mark J. , Reznikov Leah R.
Published: July 2020

New Findings

What is the central question of this study?

What is the impact of airway cholinergic history on the properties of airway mucus secretion in a cystic fibrosis‐like environment?

What is the main finding and its importance?

Prior cholinergic challenge slightly modifies the characteristics of mucus secretion in response to a second cholinergic challenge in a diminished bicarbonate and chloride transport environment. Such modifications might lead to retention of mucus on the airway surface, thereby potentiating exacerbations of airway disease.

Viral infections precipitate exacerbations in many airway diseases, including asthma and cystic fibrosis. Although viral infections increase cholinergic transmission, few studies have examined how cholinergic history modifies subsequent cholinergic responses in the airway. In our previous work, we found that airway resistance in response to a second cholinergic challenge was increased in young pigs with a history of airway cholinergic stimulation. Given that mucus secretion is regulated by the cholinergic nervous system and that abnormal airway mucus contributes to exacerbations of airway disease, we hypothesized that prior cholinergic challenge would also modify subsequent mucus responses to a secondary cholinergic challenge. Using our established cholinergic challenge–rechallenge model in pigs, we atomized the cholinergic agonist bethanechol or saline control to pig airways. Forty‐eight hours later, we removed tracheas and measured mucus secretion properties in response to a second cholinergic stimulation. The second cholinergic stimulation was conducted in conditions of diminished chloride and bicarbonate transport to mimic a cystic fibrosis‐like environment. In pigs previously challenged with bethanechol, a second cholinergic stimulation produced a mild increase in sheet‐like mucus films; these films were scarcely observed in animals originally challenged with saline control. The subtle increase in mucus films was not associated with changes in mucociliary transport. These data suggest that prior cholinergic history might modify mucus secretion characteristics with subsequent stimulation in certain environmental conditions or disease states. Such modifications and/or more repetitive stimulation might lead to retention of mucus on the airway surface, thereby potentiating exacerbations of airway disease.
Confidence-Based Uncertainty Quantification and Model Validation for Simulations of High-Speed Impact Problems
Authors: Moon Min-Yeong , Sen Oishik , Rai Nirmal Kumar , Gaul Nicholas J. , Choi Kyung K. , Udaykumar H. S.
Published: July 2020

Validation exercises for computational models of materials under impact must contend with sparse experimental data as well as with uncertainties due to microstructural stochasticity and variabilities in thermomechanical properties of the material. This paper develops statistical methods for determining confidence levels for verification and validation of computational models subject to aleatoric and epistemic uncertainties and sparse stochastic experimental datasets. To demonstrate the method, the classical problem of Taylor impact of a copper bar is simulated. Ensembles of simulations are performed to cover the range of variabilities in the material properties of copper, specifically the nominal yield strength A, the hardening constant B, and the hardening exponent n in a Johnson–Cook material model. To quantify uncertainties in the simulation models, we construct probability density functions (PDFs) of the ratios of the quantities of interest, viz., the final bar diameter Df to the original diameter D0 and the final length Lf to the original length L0. The uncertainties in the experimental data are quantified by constructing target output distributions for these QoIs (Df/D0 and Lf/L0) from the sparse experimental results reported in literature. The simulation output and the experimental output distributions are compared to compute two metrics, viz., the median of the model prediction error and the model confidence at user-specified error level. It is shown that the median is lower and the model confidence is higher for Lf/L0 compared to Df/D0, implying that the simulation models predict the final length of the bar more accurately than the diameter. The calculated confidence levels are shown to be consistent with expectations from the physics of the impact problem and the assumptions in the computational model. Thus, this paper develops and demonstrates physically meaningful metrics for validating simulation models using limited stochastic experimental datasets. The tools and techniques developed in this work can be used for validating a wide range of computational models operating under input uncertainties and sparse experimental datasets.
Foot Rotation Gait Modifications Affect Hip and Ankle, But Not Knee, Stance Phase Joint Reaction Forces During Running
Authors: Bennett Hunter J. , Valenzuela Kevin A. , Lynn Scott K. , Weinhandl Joshua T.
Published: July 2020

Alterations of foot rotation angles have successfully reduced external knee adduction moments during walking and running. However, reductions in knee adduction moments may not result in reductions in knee joint reaction forces. The purpose of this study was to examine the effects of internal and external foot rotation on knee, hip, and ankle joint reaction forces during running. Motion capture and force data were recorded of 19 healthy adults running at 3.35 m/s during three conditions: (1) preferred (normal) and with (2) internal and (3) external foot rotation. Musculoskeletal simulations were performed using opensim and the Rajagopal 2015 model, modified to a two degree-of-freedom knee joint. Muscle excitations were derived using static optimization, including muscle physiology parameters. Joint reaction forces (i.e., the total force acting on the joints) were computed and compared between conditions using one-way analyses of variance (ANOVAs) via statistical parametric mapping (SPM). Internal foot rotation reduced resultant hip forces (from 18% to 23% stride), while external rotation reduced resultant ankle forces (peak force at 20% stride) during the stance phase. Three-dimensional and resultant knee joint reaction forces only differed at very early and very late stance phase. The results of this study indicate, similar to previous findings, that reductions in external knee adduction moments do not mirror reductions in knee joint reaction forces.
Functional definition of a transcription factor hierarchy regulating T cell lineage commitment
Authors: Garcia-Perez Laura , Famili Farbod , Cordes Martijn , Brugman Martijn , van Eggermond Marja , Wu Haoyu , Chouaref Jihed , Granado David San León , Tiemessen Machteld M. , Pike-Overzet Karin , Daxinger Lucia , Staal Frank J. T.
Published: July 2020

The major transcription factors that regulate how stem cells commit to become T lymphocytes are functionally defined
Tracking California’s sinking coast from space: Implications for relative sea-level rise
Authors: Blackwell Em , Shirzaei Manoochehr , Ojha Chandrakanta , Werth Susanna
Published: July 2020

InSAR analysis improves California coastal subsidence rate measurement; this can refine relative sea-level rise rate estimates.
Giant spin signals in chemically functionalized multiwall carbon nanotubes
Authors: Bonnet Roméo , Martin Pascal , Suffit Stéphan , Lafarge Philippe , Lherbier Aurélien , Charlier Jean-Christophe , Della Rocca Maria Luisa , Barraud Clément
Published: July 2020

A spin information is efficiently transmitted through a chemically modified multiwall carbon nanotube.
Controlling ice formation on gradient wettability surface for high-performance bioinspired materials
Authors: Zhao Nifang , Li Meng , Gong Huaxin , Bai Hao
Published: July 2020

The architecture of the ice-templated material can be effectively controlled by designing the properties of the cold surface.
Giant, unconventional anomalous Hall effect in the metallic frustrated magnet candidate, KV
3
Sb
5
Authors: Yang Shuo-Ying , Wang Yaojia , Ortiz Brenden R. , Liu Defa , Gayles Jacob , Derunova Elena , Gonzalez-Hernandez Rafael , Šmejkal Libor , Chen Yulin , Parkin Stuart S. P. , Wilson Stephen D. , Toberer Eric S. , McQueen Tyrel , Ali Mazhar N.
Published: July 2020

The anomalous Hall effect soars when Dirac quasiparticles meet frustrated magnetism.
Surprisingly Effective Priming of CD8+T Cells by Heat-Inactivated Vaccinia Virus Virions
Authors: Croft Sarah , Wong Yik Chun , Smith Stewart A. , Flesch Inge E. A. , Tscharke David C.
Published: July 2020

The design of viral vectored vaccines is often considered to require a trade-off between efficacy and safety. This is especially the case for vaccines that aim to induce killer (CD8+) T cells, where there is a well-established dogma that links infection in vaccinated individuals with effective induction of immunity. However, we found that some proteins of vaccinia virus generate strong CD8+T cell responses even when the virus preparation was inactivated by heat prior to administration as a vaccine. We took advantage of this finding by engineering a new vaccine vector virus that could be used as an inactivated vaccine. These results suggest that vaccinia virus may be a more versatile vaccine vector than previously appreciated and that in some instances safety can be prioritized by the complete elimination of viral replication without a proportional loss of immunogenicity.
Knowledge, attitudes and eye health-seeking behaviours in a population-based sample of people with diabetes in rural China
Authors: Chen Tingting , Jin Ling , Zhu Wenhui , Wang Congyao , Zhang Guoshan , Wang Xiuqin , Wang Jun , Yang Ke , Cochrane Gillian M , Lamoureux Ecosse Luc , Friedman David S , Gilbert Suzanne , Lansingh Van C , Resnikoff Serge , Zhao Jialiang , Xiao Baixiang , He Mingguang , Congdon Nathan
Published: July 2020

Aims

To assess knowledge of diabetes and acceptance of eye care among people with diabetes in rural China, to improve service uptake.

Methods

Population-based study of people in Guangdong, China, with glycosylated haemoglobin A1c≥6.5% and/or known history of diabetes. Between August and November 2014, participants answered a questionnaire (based on Delphi process/previous focus groups) on medical history, demographic characteristics, self-rated health and vision, knowledge about diabetes and diabetic retinopathy, quality of local healthcare, barriers to treatment, likely acceptance of eye exams and treatment, and interventions rated most likely to improve service uptake. Presenting visual acuity was assessed, fundus photography performed and images graded by trained graders. Potential predictors of accepting care were evaluated and confounders adjusted for using logistic regression.

Results

A total of 562 people (9.6% (256/5825), mean age 66.2±9.84 years, 207 (36.8%) men) had diabetes, 118 (22.3%) previously diagnosed. ‘Very likely’ or ‘likely’ acceptance of laser treatment (140/530=26.4%) was lower than for eye exams (317/530=59.8%, p<0.001). Predictors of accepting both exams and laser included younger age (p<.001) and prior awareness of diabetes diagnosis (p=0.004 and p=0.035, respectively). The leading barrier to receiving diabetes treatment was unawareness of diagnosis (409/454, 97.2%), while interventions rated most likely to improve acceptance of eye exams included reimbursement of travel costs (387/562, 73.0%), video or other health education (359/562, 67.7%) and phone call reminders (346/562, 65.3%).

Conclusions

Improving diagnosis of diabetes, along with incentives, education and communication strategies, is most likely to enhance poor acceptance of diabetic eye care in this setting.
Remdesivir for severe covid-19: a clinical practice guideline
Authors: Rochwerg Bram , Agarwal Arnav , Zeng Linan , Leo Yee-Sin , Appiah John Adabie , Agoritsas Thomas , Bartoszko Jessica , Brignardello-Petersen Romina , Ergan Begum , Ge Long , Geduld Heike , Gershengorn Hayley B , Manai Hela , Huang Minhua , Lamontagne François , Kanda Seema , Kawano-Dourado Leticia , Kurian Linda , Kwizera Arthur , Murthy Srinivas , Qadir Nida , Siemieniuk Reed , Silvestre Maria Asuncion , Vandvik Per Olav , Ye Zhikang , Zeraatkar Dena , Guyatt Gordon
Published: July 2020

Clinical question

What is the role of remdesivir in the treatment of severe covid-19? This guideline was triggered by the ACTT-1 trial published in the New England Journal of Medicine on 22 May 2020.

Current practice

Remdesivir has received worldwide attention as a potentially effective treatment for severe covid-19. After rapid market approval in the US, remdesivir is already being used in clinical practice.

Recommendations

The guideline panel makes a weak recommendation for the use of remdesivir in severe covid-19 while recommending continuation of active enrolment of patients into ongoing randomised controlled trials examining remdesivir.

How this guideline was created

An international panel of patients, clinicians, and methodologists produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The recommendations are based on a linked systematic review and network meta-analysis. The panel considered an individual patient perspective and allowed contextual factors (such as resources) to be taken into account for countries and healthcare systems.

The evidence

The linked systematic review (published 31 Jul 2020) identified two randomised trials with 1300 participants, showing low certainty evidence that remdesivir may be effective in reducing time to clinical improvement and may decrease mortality in patients with severe covid-19. Remdesivir probably has no important effect on need for invasive mechanical ventilation. Remdesivir may have little or no effect on hospital length of stay.

Understanding the recommendation

Most patients with severe covid-19 would likely choose treatment with remdesivir given the potential reduction in time to clinical improvement. However, given the low certainty evidence for critical outcomes and the fact that different perspectives, values, and preferences may alter decisions regarding remdesivir, the panel issued a weak recommendation with strong support for continued recruitment in randomised trials.
Prognostic significance of occlusion length in recanalized chronic total occlusion lesion: a retrospective cohort study with 5-year follow-up
Authors: Tian Tao , Guan Changdong , Gao Lijian , Song Lei , Yuan Jiansong , Hu Fenghuan , Dou Kefei , Tang Yida , Wu Yongjian , Yang Yuejin , Bai Yinxiao , Cui Jingang , Xu Bo , Qiao Shubin , Yang Weixian
Published: July 2020

Objectives

This study sought to investigate the relationship between occlusion length and long-term outcomes of patients with recanalised chronic total occlusion (CTO) lesion.

Design

A retrospective cohort study.

Setting

Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China

Participants

Consecutive patients with successfully recanalised CTO were included from January 2010 to December 2013.

Primary and secondary outcome measures

The primary endpoint of the present study was a composite event of all-cause death and myocardial infarction (MI). The secondary endpoints included target lesion revascularisation (TLR) and target vessel revascularisation (TVR).

Results

A total of 1987 patients were included and 1801 (90.6%) subjects completed 5-year follow-up in this study. Based on occlusion length, the patients were divided equally into two groups: short (length <15 mm, n=957) and long (length ≥15 mm, n=1030) CTO group. Kaplan-Meier survival curve showed no significant difference in the risk of the composite primary endpoint between short and long CTO groups (p=0.242). Receiver operating characteristic curve analysis also established occlusion length ≥15 mm as a cut-off value for predicting TLR and TVR, with an area under the curve of 0.604 (95% CI: 0.569 to 0.638, p<0.001) and 0.605 (95% CI: 0.572 to 0.638; p<0.001). Kaplan-Meier analysis revealed that the risks for TLR (p=0.002) and TVR (p=0.002) were higher in a patient with long CTO lesion. Multivariate Cox analysis also identified long CTO lesion as an independent predictor of TLR (HR: 1.539, 95% CI: 1.033 to 2.293; p=0.034) and TVR (HR: 1.476, 95% CI: 1.012 to 2.151; p=0.043).

Conclusion

Patients with long CTO lesion did not show a higher risk of death and MI after recanalisation, but had higher risks of TLR and TVR. Lesion with occlusion length ≥15 mm should be under close surveillance for restenosis after recanalisation.
Impact of the Norwegian National Patient Safety Program on implementation of the WHO Surgical Safety Checklist and on perioperative safety culture
Authors: Haugen Arvid Steinar , Søfteland Eirik , Sevdalis Nick , Eide Geir Egil , Nortvedt Monica Wammen , Vincent Charles , Harthug Stig
Published: July 2020

Objectives

Our primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was associations between SSC fidelity and safety culture. We hypothesised that the programme influenced on SSC use and operating theatre personnel’s safety culture perceptions.

Setting

A longitudinal cross-sectional study was conducted in a large Norwegian tertiary teaching hospital.

Participants

We invited 1754 operating theatre personnel to participate in the study, of which 920 responded to the surveys at three time points in 2009, 2010 and 2017.

Primary and secondary outcome measures

Primary outcome was the results of the patient safety culture measured by the culturally adapted Norwegian version of the Hospital Survey on Patient Safety Culture. Our previously published results from 2009/2010 were compared with new data collected in 2017. Secondary outcome was correlation between SSC fidelity and safety culture. Fidelity was electronically recorded.

Results

Survey response rates were 61% (349/575), 51% (292/569) and 46% (279/610) in 2009, 2010 and 2017, respectively. Eight of the 12 safety culture dimensions significantly improved over time with the largest increase being ‘Hospital managers’ support to patient safety’ from a mean score of 2.82 at baseline in 2009 to 3.15 in 2017 (mean change: 0.33, 95% CI 0.21 to 0.44). Fidelity in use of the SSC averaged 88% (26 741/30 426) in 2017. Perceptions of safety culture dimensions in 2009 and in 2017 correlated significantly though weakly with fidelity (r=0.07–0.21).

Conclusion

The National Patient Safety Program, fostering engagement from trust boards, hospital managers and frontline operating theatre personnel enabled effective implementation of the SSC. As part of a wider strategic safety initiative, implementation of SSC coincided with an improved safety culture.
The day the residents left: lessons learnt from COVID-19 for ambulatory clinics
Authors: Doolittle Benjamin R , Richards Bradley , Tarabar Amerisa , Ellman Matthew , Tobin Daniel
Published: July 2020

As the COVID-19 pandemic began, the residents from our ambulatory clinics were pulled to cover the increasing numbers of hospitalised patients. To provide care for our 40 000 patients, without resident support, we needed to develop quickly a new culture of communication and innovation. We accomplished this by regular, transparent meetings with senior leadership and key stakeholders who were empowered to make rapid decisions. We then convened regular meetings with clinic leadership and frontline providers to receive feedback and implement new practices. These rapid meeting cycles allowed for a nimble response to a changing landscape. We optimised our video-conferencing and telehealth services, reached out to our most vulnerable patients and engaged other providers and medical students who were not engaged in patient care due to social isolation practices. We discuss the implications of these innovations on our future practice.
Combined lenvatinib and pembrolizumab as salvage therapy in advanced adrenal cortical carcinoma
Authors: Bedrose Sara , Miller Kevin Charles , Altameemi Lina , Ali Mohamed S , Nassar Sameh , Garg Naveen , Daher Marilyne , Eaton Keith D , Yorio Jeffrey Thomas , Daniel Davey B , Campbell Matthew , Bible Keith C , Ryder Mabel , Chintakuntlawar Ashish V , Habra Mouhammed Amir
Published: July 2020

Background

There is no effective systemic therapy for metastatic adrenal cortical carcinoma (ACC) after failure of platinum-based chemotherapy. The efficacies of single-agent oral multikinase inhibitors (MKIs) or salvage immune checkpoint inhibitors (CPIs) have been very limited. It is unknown whether combining CPIs, such as pembrolizumab (PEM), with other therapies, such as MKIs, could yield higher response rates in ACC, yet this combination has shown promise in other cancers. Herein, we describe the first case series using PEM in combination with the MKI lenvatinib (LEN) in patients with progressive, metastatic ACC.

Methods

A retrospective case series describing the use of LEN/PEM as salvage therapy in patients with progressive/metastatic ACC.

Results

Eight patients were treated with the LEN/PEM combination therapy. Half were female, and the median age at time of diagnosis was 38 years (range 21–49). Three (37.5%) patients had hormonally active ACC. The median number of prior lines of systemic therapy was 4 (range 2–9). Six (75%) patients had had disease progression on prior CPIs and five (62.5%) patients had progressed on prior MKI therapy. The median progression-free survival was 5.5 months (95% CI 1.8–not reached) and median duration of therapy was 8.5 months (range 2–22). Two (25%) patients had a partial response, one (12.5%) patient had stable disease, and five (62.5%) patients had progressive disease. None of the eight patients stopped therapy because of adverse events.

Conclusions

In our small cohort of heavily pretreated patients with ACC, the combination of LEN/PEM was associated with objective responses in a subset of patients without significant toxicity. This combination should be formally investigated in phase II clinical trial with robust correlative studies to identify predictors for response.