bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality improvement in medical schools: vision meets culture
Authors: Blouin Danielle
Published: September 2019

Context

Medical schools face growing pressures to develop quality improvement (QI) strategies to ensure the continuous quality of their education. To best achieve quality, both organisational processes and culture need to be oriented towards quality. Quality processes already exist at medical schools, at least externally driven by accreditation. However, the dominant culture in most medical schools is not typically oriented towards quality.

Objectives

This study explores whether QI practices are recognised as such in organisations not culturally QI‐oriented. Specifically, it examines faculty members’ perceptions about the degree of QI implementation in their medical education programmes. Understanding this perception will inform medical school leadership on how best to use resources for a successful execution of the school's QI vision.

Methods

Leaders, clinical teachers and formal teachers at 16 of the 17 Canadian medical schools were invited to complete the ‘Are We Making Progress?’ questionnaire of the Malcolm Baldrige National Quality Award framework, the results of which have been broadly validated. The questionnaire measures the perceived level of QI implementation within organisations using 40 statements grouped under the framework's seven domains of performance excellence.

Results

A total of 491 respondents from 11 (69%) schools completed the questionnaire; 173 (35%) identified as clinical teachers, 150 (31%) as formal teachers, and 168 (34%) as leaders. Perceived QI implementation levels were low across programmes (0.70–1.90 in Rasch person measures) and for each category of respondents. This was especially true for the domains of ‘Strategy’, ‘Measurement/analysis/knowledge management’ and ‘Operations’. Leaders’ perceptions of QI implementation were higher than those of teachers.

Conclusions

Medical schools’ existing QI processes are not recognised as QI activities. For QI strategies to succeed, a programme's culture must embrace QI. In the execution of their QI visions, medical schools should spend resources on embedding quality in the organisation culture in addition to strengthening existing QI practices, especially in the domains listed above.
Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation
Authors: Lee Wei‐Chieh , Fang Hsiu‐Yu , Chen Huang‐Chung , Chen Yung‐Lung , Tsai Tzu‐Hsien , Pan Kuo‐Li , Lin Yu‐Sheng , Chen Mien‐Cheng
Published: September 2019

Aims

Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional CTI block ablation in patients without AFL.

Methods

Between January 2013 and December 2017, a total of 139 patients who did not have documented AFL and who underwent catheter ablation for AF were recruited. Fifty‐seven patients were classified in additional CTI block ablation group and 82 patients were classified in without CTI group. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence was compared between the two groups.

Results

The additional CTI group had a higher prevalence of persistent or long‐standing AF and larger left atrial volume. The additional CTI group had a higher incidence of late‐onset atrial arrhythmia recurrence (38.6% vs 12.2%; P < .001). When compared to without CTI group, additional CTI therapy did not have a better outcome in terms of freedom of atrial arrhythmia in subgroup analysis. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence did not differ between additional CTI group and without CTI group in paroxysmal AF patients and nonparoxysmal AF patients after propensity scoring matching.

Conclusion

CTI block ablation in addition to PVI for AF patients without a history of AFL or inducible AFL during ablation may not improve the clinical outcome of AF ablation in the patients with larger LA volume, nonparoxysmal AF, or post‐PVI inducible AF.
Stress effects on learning and feedback‐related neural activity depend on feedback delay
Authors: Paul Marcus , Bellebaum Christian , Ghio Marta , Suchan Boris , Wolf Oliver T.
Published: September 2019

Depending on feedback timing, the neural structures involved in learning differ, with the dopamine system including the dorsal striatum and anterior cingulate cortex (ACC) being more important for learning from immediate than delayed feedback. As stress has been shown to promote striatum‐dependent learning, the current study aimed to explore if stress differentially affects learning from and processing of immediate and delayed feedback. One group of male participants was stressed using the socially evaluated cold pressor test, and another group underwent a control condition. Subsequently, participants performed a reward learning task with immediate (500 ms) and delayed (6,500 ms) feedback while brain activity was assessed with electroencephalography (EEG). While stress enhanced the accuracy for delayed relative to immediate feedback, it reduced the feedback‐related negativity (FRN) valence effect, which is the amplitude difference between negative and positive feedback. For the P300, a reduced valence effect was found in the stress group only for delayed feedback. Frontal theta power was most pronounced for immediate negative feedback and was generally reduced under stress. Moreover, stress reduced associations of FRN and theta power with trial‐by‐trial accuracy. Associations between stress‐induced cortisol increases and EEG components were examined using linear mixed effects analyses, which showed that the described stress effects were accompanied by associations between the stress‐induced cortisol increases and feedback processing. The results indicate that stress and cortisol affect different aspects of feedback processing. Instead of an increased recruitment of the dopamine system and the ACC, the results may suggest enhanced salience processing and reduced cognitive control under stress.
The Psychophysics of Terror Attack Casualty Counts
Authors: Baucum Matt , John Richard
Published: September 2019

In communicating the risk that terror attacks pose to the public, government agencies and other organizations must understand which characteristics of an attack contribute to the public's perception of its severity. An attack's casualty count is one of the most commonly used metrics of a terror attack's severity, yet it is unclear whether the public responds to information about casualty count when forming affective and cognitive reactions to terror attacks. This study sought to characterize the “psychophysical function” relating terror attack casualty counts to the severity of the affective and cognitive reactions they elicit. We recruited n = 684 Mechanical Turk participants to read a realistic vignette depicting either a biological or radiological terror attack, whose death toll ranged from 20 to 50,000, and rated their levels of fear and anger along with the attack's severity. Even when controlling for the perceived plausibility of the scenarios, participants’ severity ratings of each attack were logarithmic with respect to casualty count, while ratings of fear and anger did not significantly depend on casualty count. These results were consistent across attack weapon (biological vs. radiological) and time horizon of the casualties (same‐day or anticipated to occur over several years). These results complement past work on life loss valuation and highlight a potential bifurcation between the public's affective and cognitive evaluations of terror attacks.
Optimally Balanced Gaussian Process Propensity Scores for Estimating Treatment Effects
Authors: Vegetabile Brian G. , Gillen Daniel L. , Stern Hal S.
Published: September 2019

Propensity scores are commonly employed in observational study settings where the goal is to estimate average treatment effects. The paper introduces a flexible propensity score modelling approach, where the probability of treatment is modelled through a Gaussian process framework. To evaluate the effectiveness of the estimated propensity score, a metric of covariate imbalance is developed that quantifies the discrepancy between the distributions of covariates in the treated and control groups. It is demonstrated that this metric is ultimately a function of the hyperparameters of the covariance matrix of the Gaussian process and therefore it is possible to select the hyperparameters to optimize the metric and to minimize overall covariate imbalance. The effectiveness of the Gaussian process method is compared in a simulation against other methods of estimating the propensity score and the method is applied to data from a study of Dehejia and Wahba in 1999 to demonstrate benchmark performance within a relevant policy application.
Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project
Authors: Acosta‐Manzano Pedro , Acosta Francisco M. , Femia Pedro , Coll‐Risco Irene , Segura‐Jiménez Víctor , Díaz‐Castro Javier , Ochoa‐Herrera Julio J. , Van Poppel Mireille N. M. , Aparicio Virginia A.
Published: September 2019

Objectives

To analyze the association of sedentary time and physical activity (PA) intensity levels with immunometabolic markers during early pregnancy; and to examine if meeting the PA recommendations is associated with the immunometabolic profile of pregnant women.

Methods

Fifty Caucasian pregnant women (age: 32.8 ± 4.7 years old, body mass index: 24.2 ± 4.1kg/m2, gestational age: 17 ± 1.5weeks) participated in this cross‐sectional study (from September 2015 through May 2016). Sedentary time and PA intensity levels were objectively measured with triaxial accelerometer (seven consecutive valid days). Fasting serum glucose, total cholesterol, phospholipids, and triglycerides were assessed with standard methods. Serum pro‐inflammatory and anti‐inflammatory cytokines (fractalkine, interleukin‐1β, interleukin‐6, interleukin‐8, interleukin‐10, interferon‐γ, and tumor necrosis factor‐α) were measured using Luminex xMAP technology.

Results

Sedentary time and PA were not correlated with any glycemic or lipid marker (P > .05). After adjusting for the potential confounders, vigorous PA showed a positive non‐significant association with interleukin‐6 (P = .06), and bouts of moderate‐vigorous PA was inversely associated with interleukin‐1β and interferon‐γ (P = .02 and P = .04, respectively). Meeting the PA guidelines was inversely associated with interleukin‐1β and positively associated with interleukin‐8 (P = .01 and P = .04, respectively). These associations disappeared after controlling for multiplicity.

Conclusions

Increasing the time spent in moderate‐vigorous PA, or meeting the PA recommendations, is associated with the cytokine profile of women without metabolic disruptions in early pregnancy. However, sedentary time and PA do not seem to be associated with glucose or lipid levels. These results should be interpreted cautiously in view of the discrepancies after adjusting for multiple comparisons. Future studies in this novel field of research are warranted before reaching any conclusion.
Parametric Model Based Approach for Consumer Load Prediction
Authors: Abdullateef Ayodele Isqeel , Akorede Mudathir Folohunso , Abdulkarim Abubakar , Eyiomika Salami Momoh-Jimoh
Published: September 2019

Various load prediction techniques have been proposed to predict consumer load which represents the activities of the consumer on the distribution network. Usually, these techniques use cumulative energy consumption data of the consumers connected to the power network to predict consumer load. However, this data fails to reveal and monitor the activities of individual consumers represented by consumer load consumption pattern. A new approach of predicting individual consumer load based on autoregressive moving average model (ARMA) is proposed in this study. Sub- optimal technique of parameter estimation based on Prony method was used to determine the model order of the ARMA models ARMA (10, 8), ARMA (8, 6) and ARMA (6, 4).  ARMA (6, 4) was found to be appropriate for consumer load prediction with an average mean square error of 0.00006986 and 0.0000685 for weekday and weekend loads respectively. The energy consumption data acquired from consumer load prototype for one week, with 288 data points per day used in our previous work, was used and 5-minute step ahead load prediction is achieved. Furthermore, a comparison between autoregressive AR (20) and ARMA (6, 4) was carried out and ARMA (6, 4) was found to be appropriate for consumer load prediction. This facilitates the monitoring of individual consumer activities connected on the power network.
UHF RFID Antenna Tag Design and Analysis for Antenna Miniaturization
Authors: Muhamad Nadzir Norsaidah , A. Rahim Mohamad Kamal , Zubir Farid , A. Majid Huda
Published: September 2019

This paper proposes four designs of UHF RFID antenna tag with two different radiating element, copper and aluminum, for antenna miniaturization. The main contribution of this work is the unique design that involves a meander line traced in a variety shape of a bowtie antenna. The UHF RFID band is achieved by reshaping a 900 MHz straight line dipole antenna into the form of a bowtie, thus reducing the size of the antenna significantly while maintaining the operating frequency. The effectiveness of the method is tested in multiple steps. First, the antenna tag designs are run through CST software simulations and optimized to achieve desired outcome. Next, the designs are transferred to Silhouette Studio software to be fabricated using a cutting machine, and finally measured using a vector network analyzer. The comparison between the measurement result of the reflection coefficient and the radiation pattern to their respective simulation results shows that they have a good agreement between each other. With further research and improvements, the size of the antenna tag could be further reduced while maintaining or even improving the performance of the antenna tag.
On the new wave behavior of the Magneto-Electro-Elastic(MEE) circular rod longitudinal wave equation
Authors: İlhan Onur Alp , Bulut Hasan , Sulaiman Tukur Abdulkadir , Baskonus Haci Mehmet
Published: September 2019

The analytical solution of the longitudinal wave equation in the MEE circular rod is analyzed by the powerful sine-Gordon expansion method. Sine - Gordon expansion is based on the well-known wave transformation and sine - Gordon equation. In the longitudinal wave equation in mathematical physics, the transverse Poisson MEE circular rod is caused by the dispersion. Some solutions with complex, hyperbolic and trigonometric functions have been successfully implemented. Numerical simulations of all solutions are given by selecting the appropriate parameter values. The physical meaning of the analytical solution explaining some practical physical problems is given.
Decolonialidade, border thinking e organizações: as contribuições de Guerreiro Ramos e Celso Furtado
Authors: Bauer Ana Paula Medeiros , Faria Silva Vanessa , Eduardo de Pinho Velho Wanderley Sergio
Published: September 2019

Este artigo busca contribuir com a opção decolonial para a compreensão da realidade organizacional na América Latina. O projeto Modernidade/Colonialidade/Decolonialidade (MCD) é promovido por autores latino-americanos, predominantemente de língua materna espanhola. Contudo, poucos são os autores do pensamento social brasileiro citados nos trabalhos elaborados a partir desta perspectiva. Diante disso, o objetivo do artigo é trazer a contribuição de dois autores brasileiros, o sociólogo Guerreiro Ramos e o economista Celso Furtado, que muito têm a contribuir com o projeto MCD, bem como para a melhor compreensão das organizações na América Latina. Logo, o artigo investiga, com base na perspectiva border thinking, quais as interseções das obras “A Redução Sociológica” (Ramos, 1958) e “Formação Econômica do Brasil” (Furtado, 1959); e “A Pré-Revolução Brasileira” (Furtado, 1962) e “Mito e Verdade da Revolução Brasileira” (Ramos, 1963).
Desafiando la formación de psicólogos organizacionales desde una perspectiva de aprendizajes situados en el ámbito micro-empresarial peruano
Authors: Vera Ruiz Angela , Llanco Gonzalez Cesar Andres , Guevara Rojas Luis Alberto
Published: September 2019

Se presenta una experiencia de formación académica, donde estudiantes de pregrado de psicología organizacional, de una universidad peruana,  realizan un trabajo de campo con microempresas para analizar su comportamiento organizacional. Bajo un enfoque de responsabilidad social universitaria, se reconoce a las microempresas como actores importantes en la economía nacional. Con la vinculación entre estudiantes y microempresas, se busca decolonizar conocimientos hegemónicos, impartidos en la formación tradicional, evidenciando la necesidad de pensar los saberes y prácticas organizacionales de una manera situada, crítica y compartida por todos los actores participantes. Se plantean los principales aspectos metodológicos y resultados generales operativos de la experiencia, como insumo pedagógico útil en contextos formativos del complejo e inequitativo mundo laboral y organizacional latinoamericano.
Testing a Brief Coping Intervention for High-Performance Youth Soccer Players and Their Parents
Authors: Tamminen Katherine A. , Ferdinand Pennock Kaleigh , Braun Courtney
Published: September 2019

The ability of young athletes to effectively cope with stressors is crucial for sustained sport enjoyment and participation, and parents play a key role in providing coping support. However, there is limited evidence for coping interventions directed at both youth athletes and their parents. The purpose of this study was to implement a coping workshop for youth athletes and also engage parents to provide them with information to support the development of coping skills among young athletes. Athlete–parent dyads from a high-performance soccer academy were assigned to either a 4-wk coping intervention or a control group using a matched quasi-experimental design. Survey data were analyzed using 2-factor repeated-measures ANOVAs and multiple-regression analyses. Results indicated that lower parental pressure and greater coping self-efficacy predicted lower stress in youth athletes. However, findings for the intervention in reducing overall stress and perceptions of parental pressure were not significant. Future coping intervention studies should address study design considerations related to timing, intervention modalities, and skill level of youth athletes.
Perspectives and Determinants for Training-Intensity Distribution in Elite Endurance Athletes
Authors: Bourgois Jan G. , Bourgois Gil , Boone Jan
Published: September 2019

Training-intensity distribution (TID), or the intensity of training and its distribution over time, has been considered an important determinant of the outcome of a training program in elite endurance athletes. The polarized and pyramidal TID, both characterized by a high amount of low-intensity training (below the first lactate or ventilatory threshold), but with different contributions of threshold training (between the first and second lactate or ventilatory threshold) and high-intensity training (above the second lactate or ventilatory threshold), have been reported most frequently in elite endurance athletes. However, the choice between these 2 TIDs is not straightforward. This article describes the historical, evolutionary, and physiological perspectives of the success of the polarized and pyramidal TID and proposes determinants that should be taken into account when choosing the most appropriate TID.
Giant impacts stochastically change the internal pressures of terrestrial planets
Authors: Lock Simon J. , Stewart Sarah T.
Published: September 2019

Pressure changes due to giant impacts require reinterpretation of the geochemical tracers of accretion.
GWAS on longitudinal growth traits reveals different genetic factors influencing infant, child, and adult BMI
Authors: Couto Alves Alexessander , De Silva N. Maneka G. , Karhunen Ville , Sovio Ulla , Das Shikta , Taal H. Rob , Warrington Nicole M. , Lewin Alexandra M. , Kaakinen Marika , Cousminer Diana L. , Thiering Elisabeth , Timpson Nicholas J. , Bond Tom A. , Lowry Estelle , Brown Christopher D. , Estivill Xavier , Lindi Virpi , Bradfield Jonathan P. , Geller Frank , Speed Doug , Coin Lachlan J. M. , Loh Marie , Barton Sheila J. , Beilin Lawrence J. , Bisgaard Hans , Bønnelykke Klaus , Alili Rohia , Hatoum Ida J. , Schramm Katharina , Cartwright Rufus , Charles Marie-Aline , Salerno Vincenzo , Clément Karine , Claringbould Annique A. J. ,   BIOS Consortium, van Duijn Cornelia M. , Moltchanova Elena , Eriksson Johan G. , Elks Cathy , Feenstra Bjarke , Flexeder Claudia , Franks Stephen , Frayling Timothy M. , Freathy Rachel M. , Elliott Paul , Widén Elisabeth , Hakonarson Hakon , Hattersley Andrew T. , Rodriguez Alina , Banterle Marco , Heinrich Joachim , Heude Barbara , Holloway John W. , Hofman Albert , Hyppönen Elina , Inskip Hazel , Kaplan Lee M. , Hedman Asa K. , Läärä Esa , Prokisch Holger , Grallert Harald , Lakka Timo A. , Lawlor Debbie A. , Melbye Mads , Ahluwalia Tarunveer S. , Marinelli Marcella , Millwood Iona Y. , Palmer Lyle J. , Pennell Craig E. , Perry John R. , Ring Susan M. , Savolainen Markku J. , Rivadeneira Fernando , Standl Marie , Sunyer Jordi , Tiesler Carla M. T. , Uitterlinden Andre G. , Schierding William , O’Sullivan Justin M. , Prokopenko Inga , Herzig Karl-Heinz , Smith George Davey , O'Reilly Paul , Felix Janine F. , Buxton Jessica L. , Blakemore Alexandra I. F. , Ong Ken K. , Jaddoe Vincent W. V. , Grant Struan F. A. , Sebert Sylvain , McCarthy Mark I. , Järvelin Marjo-Riitta ,   Early Growth Genetics (EGG) Consortium
Published: September 2019

Longitudinal data find a new variant controlling BMI in infancy and reveal genetic differences between infant and adult BMI.
Boom boom pow: Shock-facilitated aqueous alteration and evidence for two shock events in the Martian nakhlite meteorites
Authors: Daly L. , Lee M. R. , Piazolo S. , Griffin S. , Bazargan M. , Campanale F. , Chung P. , Cohen B. E. , Pickersgill A. E. , Hallis L. J. , Trimby P. W. , Baumgartner R. , Forman L. V. , Benedix G. K.
Published: September 2019

Evidence for impact-generated water on Mars ~633 Ma ago predicts two craters at the nakhlite meteorite’s ejection site.
Multidecadal increase in plastic particles in coastal ocean sediments
Authors: Brandon Jennifer A. , Jones William , Ohman Mark D.
Published: September 2019

Microplastics in ocean sediments increased exponentially from 1945 to 2009, serving as a geological proxy for the Anthropocene.
ITGA5 inhibition in pancreatic stellate cells attenuates desmoplasia and potentiates efficacy of chemotherapy in pancreatic cancer
Authors: Kuninty Praneeth R. , Bansal Ruchi , De Geus Susanna W. L. , Mardhian Deby F. , Schnittert Jonas , van Baarlen Joop , Storm Gert , Bijlsma Maarten F. , van Laarhoven Hanneke W. , Metselaar Josbert M. , Kuppen Peter J. K. , Vahrmeijer Alexander L. , Östman Arne , Sier Cornelis F. M. , Prakash Jai
Published: September 2019

This study proposes a novel strategy to reduce fibrotic barrier and enhance efficacy of chemotherapy in pancreatic cancer.
Human adenovirus type 26 uses sialic acid–bearing glycans as a primary cell entry receptor
Authors: Baker Alexander T. , Mundy Rosie M. , Davies James A. , Rizkallah Pierre J. , Parker Alan L.
Published: September 2019

Human adenovirus type 26 uses sialic acid as a primary cellular receptor—structural insights for this phase 3 vaccine vector.
In vivo detection of cerebral tau pathology in long-term survivors of traumatic brain injury
Authors: Gorgoraptis Nikos , Li Lucia M. , Whittington Alex , Zimmerman Karl A. , Maclean Linda M. , McLeod Claire , Ross Ewan , Heslegrave Amanda , Zetterberg Henrik , Passchier Jan , Matthews Paul M. , Gunn Roger N. , McMillan Tom M. , Sharp David J.
Published: September 2019

Positron emission tomography identified tau pathology after a single traumatic brain injury.
CD3 bispecific antibody–induced cytokine release is dispensable for cytotoxic T cell activity
Authors: Li Ji , Piskol Robert , Ybarra Ryan , Chen Ying-Jiun J. , Li Jason , Slaga Dionysos , Hristopoulos Maria , Clark Robyn , Modrusan Zora , Totpal Klara , Junttila Melissa R. , Junttila Teemu T.
Published: September 2019

Cytokine release induced by anti-HER2/CD3 is mediated by TNF-α and can be suppressed by blocking TNF-α, IL-6, or IL-1 without affecting efficacy.
Correlation of Host Range Expansion of Therapeutic Bacteriophage Sb-1 with Allele State at a Hypervariable Repeat Locus
Authors: Sergueev Kirill V. , Filippov Andrey A. , Farlow Jason , Su Wanwen , Kvachadze Leila , Balarjishvili Nana , Kutateladze Mzia , Nikolich Mikeljon P.
Published: September 2019

Because of limited therapeutic options, infections caused by methicillin-resistant
Staphylococcus aureus
represent a serious problem in both civilian and military health care settings. Phages have potential as alternative antibacterial agents that can be used in combination with antibiotic drugs. For decades, phage Sb-1 has been used in former Soviet Union countries for antistaphylococcal treatment in humans. The therapeutic spectrum of activity of Sb-1 can be increased by selecting mutants of the phage with expanded host ranges. In this work, the host range of phage Sb-1 was expanded in the laboratory, and a hypervariable region in its genome was identified with a distinct allele state that correlated with this host range expansion. These results provide a genetic basis for better understanding the mechanisms of phage host range expansion.
Human Antiviral Protein MxA Forms Novel Metastable Membraneless Cytoplasmic Condensates Exhibiting Rapid Reversible Tonicity-Driven Phase Transitions
Authors: Davis Deodate , Yuan Huijuan , Liang Feng-Xia , Yang Yang-Ming , Westley Jenna , Petzold Chris , Dancel-Manning Kristen , Deng Yan , Sall Joseph , Sehgal Pravin B.
Published: September 2019

There is a long-standing belief that interferon (IFN)-inducible human myxovirus resistance protein A (MxA), which displays antiviral activity against several RNA and DNA viruses, associates with the endoplasmic reticulum (ER) and Golgi apparatus. We provide data to correct this misinterpretation and further report that MxA forms membraneless metastable (shape-changing) condensates in the cytoplasm consisting of variably sized spherical or irregular bodies, filaments, and even a reticulum. Remarkably, MxA condensates showed the unique property of rapid (within 1 to 3 min) reversible disassembly and reassembly in intact cells exposed sequentially to hypotonic and isotonic conditions. Moreover, GFP-MxA condensates included the VSV nucleocapsid (N) protein, a protein previously shown to form liquid-like condensates. Since intracellular edema and ionic changes are hallmarks of cytopathic effects of a viral infection, the tonicity-driven regulation of MxA condensates may reflect a mechanism for modulation of MxA function during viral infection.
Evolution of Outbreak-Causing Carbapenem-Resistant Klebsiella pneumoniae ST258 at a Tertiary Care Hospital over 8 Years
Authors: Marsh Jane W. , Mustapha Mustapha M. , Griffith Marissa P. , Evans Daniel R. , Ezeonwuka Chinelo , Pasculle A. William , Shutt Kathleen A. , Sundermann Alexander , Ayres Ashley M. , Shields Ryan K. , Babiker Ahmed , Cooper Vaughn S. , Van Tyne Daria , Harrison Lee H.
Published: September 2019

The carbapenem class of antibiotics is invaluable for the treatment of selected multidrug-resistant Gram-negative pathogens. The continued transmission of carbapenem-resistant bacteria such as ST258
K. pneumoniae
is of serious global public health concern, as treatment options for these infections are limited. This genomic epidemiologic investigation traced the natural history of ST258
K. pneumoniae
in a single health care setting over nearly a decade. We found that distinct ST258 subpopulations have caused both device-associated and ward-associated outbreaks, and some of these populations remain endemic within our hospital to the present day. The finding of virulence determinants among emergent ST258 clones supports the idea of convergent evolution of drug-resistant and virulent CRKP strains and highlights the need for continued surveillance, prevention, and control efforts to address emergent and evolving ST258 populations in the health care setting.
Whole-Genome Sequence of Burkholderia pseudomallei Strain HNBP001, Isolated from a Melioidosis Patient in Hainan, China
Authors: Kang Xun , Fu Zengzhen , Rajaofera Mamy Jayne Nelly , Li Chenchu , Zhang Nan , Liu Lin , Sun Qinghui , Chen Chuizhe , Dong Sufang , Xiu Hao , Ou Xiuyu , Liu Chengli , Pei Hua , He Na , Xia Qianfeng
Published: September 2019

Here, we report the complete genome sequence of
Burkholderia pseudomallei
HNBP001, an epidemic strain isolated from a melioidosis patient with pneumonia in Hainan, China.
Complete Genome Sequence of a New Mastrevirus, Chickpea Redleaf Virus 2, from Australia
Authors: Filardo Fiona F. , Sharman Murray
Published: September 2019

We present here the complete genome sequence of a novel mastrevirus isolated from
Cicer arietinum
(chickpea) from Australia. We propose the name chickpea redleaf virus 2.
16S rRNA Gene Amplicon Sequencing of Microbial Communities Involved in Anaerobic Bulking in a Mesophilic Expanded Granular Sludge Bed Reactor Treating Wastewater Discharged from a Japanese-Style Thickened Worcestershire Sauce-Producing Factory
Authors: Yamada Takeshi , Harada Jun , Okazaki Yuki , Yamaguchi Tsuyoshi , Nakano Atsushi
Published: September 2019

We analyzed the prokaryotes in bulking and healthy sludge from a mesophilic expanded granular sludge bed reactor treating wastewater with high organic content by 16S rRNA gene amplicon sequencing. We tabulated the microbiota at the phylum level, providing a framework for avoiding sludge bulking.
Future-Proofing Your
Microbiology Resource Announcements
Genome Assembly for Reproducibility and Clarity
Authors: Baltrus David A. , Cuomo Christina A. , Dennehy John J. , Dunning Hotopp Julie C. , Maresca Julia A. , Newton Irene L. G. , Rasko David A. , Rokas Antonis , Roux Simon , Stajich Jason E.
Published: September 2019

Descriptions of resources, like the genome assemblies reported in
Microbiology Resource Announcements
, are often frozen at their time of publication, yet they will need to be interpreted in the midst of continually evolving technologies. It is therefore important to ensure that researchers accessing published resources have access to all of the information required to repeat, interpret, and extend these original analyses.
Risk factors for death among children aged 5–14 years hospitalised with pneumonia: a retrospective cohort study in Kenya
Authors: Macpherson Liana , Ogero Morris , Akech Samuel , Aluvaala Jalemba , Gathara David , Irimu Grace , English Mike , Agweyu Ambrose
Published: September 2019

Introduction

There were almost 1 million deaths in children aged between 5 and 14 years in 2017, and pneumonia accounted for 11%. However, there are no validated guidelines for pneumonia management in older children and data to support their development are limited. We sought to understand risk factors for mortality among children aged 5–14 years hospitalised with pneumonia in district-level health facilities in Kenya.

Methods

We did a retrospective cohort study using data collected from an established clinical information network of 13 hospitals. We reviewed records for children aged 5–14 years admitted with pneumonia between 1 March 2014 and 28 February 2018. Individual clinical signs were examined for association with inpatient mortality using logistic regression. We used existing WHO criteria (intended for under 5s) to define levels of severity and examined their performance in identifying those at increased risk of death.

Results

1832 children were diagnosed with pneumonia and 145 (7.9%) died. Severe pallor was strongly associated with mortality (adjusted OR (aOR) 8.06, 95% CI 4.72 to 13.75) as were reduced consciousness, mild/moderate pallor, central cyanosis and older age (>9 years) (aOR >2). Comorbidities HIV and severe acute malnutrition were also associated with death (aOR 2.31, 95% CI 1.39 to 3.84 and aOR 1.89, 95% CI 1.12 to 3.21, respectively). The presence of clinical characteristics used by WHO to define severe pneumonia was associated with death in univariate analysis (OR 2.69). However, this combination of clinical characteristics was poor in discriminating those at risk of death (sensitivity: 0.56, specificity: 0.68, and area under the curve: 0.62).

Conclusion

Children >5 years have high inpatient pneumonia mortality. These findings also suggest that the WHO criteria for classification of severity for children under 5 years do not appear to be a valid tool for risk assessment in this older age group, indicating the urgent need for evidence-based clinical guidelines for this neglected population.
Designing and evaluating a novel mobile application for Helping Babies Breathe skills retention in Uganda: comparative study protocol
Authors: Merali Hasan Shamsh , Chan Natalie Hoi-Man , Mistry Niraj , Kealey Ryan , Campbell Douglas , Morris Shaun K , Data Santorino
Published: September 2019

Introduction

Over 600 000 newborns die each year of intrapartum-related events, many of which are preventable in the presence of skilled birth attendants. Helping Babies Breathe (HBB) is a neonatal resuscitation training programme designed for low-resource settings that can reduce both early neonatal mortality and stillbirths. However, as in other similar educational programmes, knowledge and skill retention deteriorate over time. This trend may be counteracted by strategies such as regular simulated exercises. In this study, a mobile application (app) ‘HBB Prompt’ will be developed to assist providers in retaining HBB knowledge and skills.

Methods and analysis

This is a comparative study in Uganda with two phases: an app development phase and an assessment phase. In the first phase, HBB trainers and providers will explore barriers and facilitators to enhance learning and maintenance of HBB skills and knowledge through focus group discussions (FGDs). The FGDs are designed with a human factors perspective, enabling collection of relevant data for the prototype version of HBB Prompt. The app will then undergo usability and feasibility testing through FGDs and simulations. In the second phase, a minimum of 10 healthcare workers from two district hospitals will receive HBB training. Only the intervention hospital will have access to HBB Prompt. All participants will be asked to practise HBB skills every shift and record this in a logbook. In the intervention site, app usage data will also be collected. The primary outcome will be comparing skills retention 12 months after training, as determined by Objective Structured Clinical Examination B scores.

Ethics and dissemination

This study received ethics approval from The Hospital for Sick Children and Mbarara University of Science and Technology. The authors plan to publish all relevant findings from this study in peer-reviewed journals.

Trial registration number

NCT03577054
Sex-specific differences in white matter microvascular integrity after ischaemic stroke
Authors: Etherton Mark R , Wu Ona , Cougo Pedro , Lorenzano Svetlana , Li Hua , Cloonan Lisa , Bouts Mark J R J , Lauer Arne , Arai Ken , Lo Eng H , Feske Steve K , Furie Karen L , Rost Natalia S
Published: September 2019

Background and purpose

Functional outcomes after ischaemic stroke are worse in women, despite adjusting for differences in comorbidities and treatment approaches. White matter microvascular integrity represents one risk factor for poor long-term functional outcomes after ischaemic stroke. The aim of the study is to characterise sex-specific differences in microvascular integrity in individuals with acute ischaemic stroke.

Methods

A retrospective analysis of subjects with acute ischaemic stroke and brain MRI with diffusion-weighted (DWI) and dynamic-susceptibility contrast-enhanced (DSC) perfusion-weighted imaging obtained within 9 hours of last known well was performed. In the hemisphere contralateral to the acute infarct, normal-appearing white matter (NAWM) microvascular integrity was measured using theK2coefficient and apparent diffusion coefficient (ADC) values. Regression analyses for predictors ofK2coefficient, DWI volume and good outcome (90-day modified Rankin scale (mRS) score <2) were performed.

Results

105 men and 79 women met inclusion criteria for analysis. Despite no difference in age, women had increased NAWMK2coefficient (1027.4 vs 692.7×10–6/s; p=0.006). In women, atrial fibrillation (β=583.6; p=0.04) and increasing NAWM ADC (β=4.4; p=0.02) were associated with increased NAWMK2coefficient. In multivariable regression analysis, theK2coefficient was an independent predictor of DWI volume in women (β=0.007; p=0.01) but not men.

Conclusions

In women with acute ischaemic stroke, increased NAWMK2coefficient is associated with increased infarct volume and chronic white matter structural integrity. Prospective studies investigating sex-specific differences in white matter microvascular integrity are needed.
Seismic performance improvement of GFRP-RC moment frames
Authors: Ghomi Shervin K. , El-Salakawy Ehab
Published: September 2019

Although structures made of concrete reinforced with fiber-reinforced polymers (FRP) have shown promising performance under gravity loads, their performance under cyclic loading is still one of the main concerns. Although the linear nature of FRP reinforcement could be advantageous in terms of limiting the residual damage after an earthquake event, it lowers the energy dissipation of the structure, which can compromise its seismic performance. In this research, adding steel plates at selected locations in moment-resisting frames is proposed as a solution to improve seismic performance of FRP-reinforced concrete (FRP-RC) structures. Three full-scale cantilever beams, one steel-RC, one FRP-RC, and one FRP-RC with proposed steel plates, were constructed and tested under reversed cyclic loading. The results indicated that the proposed mechanism effectively improves the seismic performance of FRP-RC beams by increasing their initial stiffness and energy dissipation. Moreover, a computer simulation, using the moment–curvature determination process, was conducted to calculate bending moment capacity of FRP-RC beams with steel plates.
AN ANALYSIS OF THE TRENDS AND DETERMINANTS OF INTRA-INDUSTRY TRADE BETWEEN CHINA AND ASIA-PACIFIC ECONOMIC COOPERATION MEMBER COUNTRIES
Authors: WOOD JACOB , LI YILIN , WU JIE
Published: September 2019

This study examines the intra-industry trade relationship that China has with its 20 Asia-Pacific Economic Cooperation partners during the 2000–2014 period. By providing both a developing and developed country focus this research examines both the trends and determinants of these trade relationships from inter-industry trade, vertical inter-industry trade, horizontal inter-industry trade, and inter-industry perspectives. This study found that China’s highest levels of inter-industry trade are with Japan, Korea, and Taiwan and that these relationships have been trending upwards from both horizontal inter-industry trade and vertical inter-industry trade perspectives since 2000. While our empirical assessment using country- and industry-specific variables showed that tariff rates, market size, and factor endowments play an important role within the make-up of inter-industry trade. Finally, from a policy perspective, our study highlights the need for China to not only push forward with its Regional Comprehensive Economic Partnership trade negotiations, but also branch out by gaining additional support from other Asia-Pacific Economic Cooperation partners so as to further enhance its role in the region.
Efficient and bright phosphorescent organic light-emitting diodes adopting MoO3/PEDOT:PSS as dual hole injection layers
Authors: Zhang Nan , Chen Yang , Wang Yan-Hui
Published: September 2019

It has been demonstrated that high efficiency and brightness can be achieved in phosphorescent organic light-emitting diodes (PHOLEDs) by using molybdenum oxide (MoO3)/poly(3,4-ethylenedioxythiophene) poly(styrenesulfonate) (PEDOT:PSS) as dual hole injection layers (HILs) on indium tin oxide (ITO) substrate. The dual HILs were simply fabricated by spin-coating PEDOT:PSS solution on a thin MoO3layer deposited by vacuum thermal evaporation. This work reveals that PEDOT:PSS coating on MoO3resulted in a smoother surface, simultaneously MoO3lamella prevented acid corrosion of PEDOT:PSS on ITO. Meanwhile, with the insertion of PEDOT:PSS and MoO3as HILs between anode and hole transporting layer (HTL), the energy barrier has been reduced and gave rise to effective hole injection. OLEDs with dual HILs resulted in the maximum current efficiency (CE) of 61.3 cd A[Formula: see text] and maximum luminance of 112200 cd cm[Formula: see text], which showed a superior performance compared to those devices with single HIL of PEDOT:PSS or MoO3. Our results proved the composition of PEDOT:PSS and MoO3as HILs were beneficial for high performance OLEDs.
HEMODYNAMIC INVESTIGATION OF SUBCLAVIAN-CORONARY STEAL SYNDROME IN DIALYSIS PATIENTS WITH CORONARY ARTERY OCCLUSION AND DIFFERENT STENOSIS PERCENTAGES IN SUBCLAVIAN ARTERY
Authors: RAHMANI SHAHROKH , EBRAHIMI BEHDAD SHAARBAF , HEIDARI ALIREZA , NAVIDBAKHSH MAHDI , ALIZADEH MANSOUR , TAFTI HOSSEIN AHMADI
Published: September 2019

Purpose: Diseases of the coronary arteries represent critical cardiovascular bleakness and mortality around the world. The main focus of this study is to simulate hemodialysis patients undergoing Coronary Artery Bypass Graft (CABG) surgery by the left internal mammary artery. The survey is to investigate whether subclavian-coronary steal syndrome will occur in patients with stenosis in their left subclavian.

Methods: A three-dimensional model of Brachial—Radial—Ulnar tree arterial system and dialysis graft are constructed and then simulated by the implementation of fluid–structure interaction (FSI) and non-FSI models. After consent was obtained, data attributed to dialysis patients who had undergone coronary bypass surgery at the Tehran Heart Center (THD) was collected.

Results: Stenosis in the subclavian artery causes the left internal mammary artery (LIMA) graft to lack flow that, in CABG cases, is supplying the heart muscle. With the increase of stenosis from zero to 54%, the flow results show a negative flow indicating reversed flow in the artery. Meanwhile, the comparison between flow quantity of a normal Left Anterior Descending (LAD) and LIMA in case of 38% stenosis in subclavian shows that the amount of flow reaching the heart is less than standard. The threshold stenosis in the subclavian artery for which subclavian-coronary steal phenomena occurs is simulated to be around 54%. Furthermore, investigation of the effect of flow quantity in cases of hemodialysis versus nonhemodialysis shows that the flow is lessened in case of hemodialysis.

Conclusions: In hemodialysis patients with more than 38% stenosis in left subclavian, it is well advised that LIMA bypass graft is not the preferred graft choice, and at 54% of subclavian stenosis, the steal phenomenon occurs.
Proteomics in gastroparesis: unique and overlapping protein signatures in diabetic and idiopathic gastroparesis
Authors: Grover Madhusudan , Dasari Surendra , Bernard Cheryl E. , Chikkamenahalli Lakshmikanth L. , Yates Katherine P. , Pasricha Pankaj J. , Sarosiek Irene , McCallum Richard , Koch Kenneth L. , Abell Thomas L. , Kuo Braden , Shulman Robert J. , Gibbons Simon J. , McKenzie Travis J. , Kellogg Todd A. , Kendrick Michael L. , Tonascia James , Hamilton Frank A. , Parkman Henry P. , Farrugia Gianrico
Published: September 2019

Macrophage-based immune dysregulation plays a critical role in development of delayed gastric emptying in diabetic mice. Loss of anti-inflammatory macrophages and increased expression of genes associated with pro-inflammatory macrophages has been reported in full-thickness gastric biopsies from gastroparesis patients. We aimed to determine broader protein expression (proteomics) and protein-based signaling pathways in gastric biopsies of diabetic (DG) and idiopathic gastroparesis (IG) patients. Additionally, we determined correlations between protein expressions, gastric emptying, and symptoms. Full-thickness gastric antrum biopsies were obtained from nine DG patients, seven IG patients, and five nondiabetic controls. Aptamer-based SomaLogic tissue scan that quantitatively identifies 1,305 human proteins was used. Protein fold changes were computed, and differential expressions were calculated using Limma. Ingenuity pathway analysis and correlations were carried out. Multiple-testing corrected P < 0.05 was considered statistically significant. Seventy-three proteins were differentially expressed in DG, 132 proteins were differentially expressed in IG, and 40 proteins were common to DG and IG. In both DG and IG, “Role of Macrophages, Fibroblasts and Endothelial Cells” was the most statistically significant altered pathway [DG false discovery rate (FDR) = 7.9 × 10−9; IG FDR = 6.3 × 10−12]. In DG, properdin expression correlated with GCSI bloating ( r = −0.99, FDR = 0.02) and expressions of prostaglandin G/H synthase 2, protein kinase C-ζ type, and complement C2 correlated with 4 h gastric retention ( r = −0.97, FDR = 0.03 for all). No correlations were found between proteins and symptoms or gastric emptying in IG. Protein expression changes suggest a central role of macrophage-driven immune dysregulation in gastroparesis, specifically, complement activation in diabetic gastroparesis.

NEW & NOTEWORTHY This study uses SOMAscan, a novel proteomics assay for determination of altered proteins and associated molecular pathways in human gastroparesis. Seventy-three proteins were changed in diabetic gastroparesis, 132 in idiopathic gastroparesis compared with controls. Forty proteins were common in both. Macrophage-based immune dysregulation pathway was most significantly affected in both diabetic and idiopathic gastroparesis. Proteins involved in the complement and prostaglandin synthesis pathway were associated with symptoms and gastric emptying delay in diabetic gastroparesis.
Role of dual-specificity protein phosphatase DUSP10/MKP-5 in pulmonary fibrosis
Authors: Xylourgidis Nikos , Min Kisuk , Ahangari Farida , Yu Guoying , Herazo-Maya Jose D. , Karampitsakos Theodoros , Aidinis Vassilis , Binzenhöfer Leonhard , Bouros Demosthenes , Bennett Anton M. , Kaminski Naftali , Tzouvelekis Argyrios
Published: September 2019

Mitogen-activated protein kinase (MAPK) phosphatase 5 (MKP-5) is a member of the dual-specificity family of protein tyrosine phosphatases that negatively regulates p38 MAPK and the JNK. MKP-5-deficient mice exhibit improved muscle repair and reduced fibrosis in an animal model of muscular dystrophy. Here, we asked whether the effects of MKP-5 on muscle fibrosis extend to other tissues. Using a bleomycin-induced model of pulmonary fibrosis, we found that MKP-5-deficient mice were protected from the development of lung fibrosis, expressed reduced levels of hydroxyproline and fibrogenic genes, and displayed marked polarization towards an M1-macrophage phenotype. We showed that the profibrogenic effects of the transforming growth factor-β1 (TGF-β1) were inhibited in MKP-5-deficient lung fibroblasts. MKP-5-deficient fibroblasts exhibited enhanced p38 MAPK activity, impaired Smad3 phosphorylation, increased Smad7 levels, and decreased expression of fibrogenic genes. Myofibroblast differentiation was attenuated in MKP-5-deficient fibroblasts. Finally, we found that MKP-5 expression was increased in idiopathic pulmonary fibrosis (IPF)-derived lung fibroblasts but not in whole IPF lungs. These data suggest that MKP-5 plays an essential role in promoting lung fibrosis. Our results couple MKP-5 with the TGF-β1 signaling machinery and imply that MKP-5 inhibition may serve as a therapeutic target for human lung fibrosis.