bluuebunny/crossref_metadata_2025 huggingface dataset:
Enabling integrated business planning through big data analytics: a case study on sales and operations planning
Authors: Schlegel Alexander , Birkel Hendrik Sebastian , Hartmann Evi
Published: November 2020

Purpose

The purpose of this study is to investigate how big data analytics capabilities (BDAC) enable the implementation of integrated business planning (IBP) – the advanced form of sales and operations planning (S&OP) – by counteracting the increasing information processing requirements.

Design/methodology/approach

The research model is grounded in the organizational information processing theory (OIPT). An embedded single case study on a multinational agrochemical company with multiple geographically distinguished sub-units of analysis was conducted. Data were collected in workshops, semistructured interviews as well as direct observations and enriched by secondary data from internal company sources as well as publicly available sources.

Findings

The results show the relevancy of establishing BDAC within an organization to apply IBP by providing empirical evidence of BDA solutions in S&OP. The study highlights how BDAC increase an organization's information processing capacity and consequently enable efficient and effective S&OP. Practical guidance toward the development of tangible, human and intangible BDAC in a particular sequence is given.

Originality/value

This study is the first theoretically grounded, empirical investigation of S&OP implementation journeys under consideration of the impact of BDAC.
Evaluation of the IR Biotyper for Klebsiella pneumoniae typing and its potentials in hospital hygiene management
Authors: Hu Yanyan , Zhou Hongwei , Lu Jiayue , Sun Qiaoling , Liu Congcong , Zeng Yu , Zhang Rong
Published: November 2020

Klebsiella pneumoniae has emerged as one of the most important pathogens that frequently encounter in community‐acquired or hospital‐acquired infections. Timely epidemiological surveillance could greatly facilitate infection control of K. pneumoniae and many deadly pathogens alike. In this study, we evaluated the performance of the IR Biotyper, a Fourier transform infrared (FTIR) spectroscopy system for K. pneumoniae isolates typing through (i) optimizing the culture scheme and defining the cutoff value (COV) range and (ii) comparing with commonly used typing tools such as multi‐locus sequence typing (MLST), pulsed‐field gel electrophoresis (PFGE) and whole‐genome sequencing (WGS). We found that a non‐selective and non‐chromogenic medium with 24 ± 2 h incubation gives the best discriminatory power for the IR Biotyper (IRBT). COV evaluation indicated that the IRBT is a robust typing method with good reproducibility. Besides, we observed that the modified H2O‐EtOH suspensions preparation method could enhance the quality of the spectrum, especially for those hypermucoviscous strains. For the method comparison study, our data demonstrated that FTIR spectroscopy could accurately cluster K. pneumoniae strains. The typing results of the IRBT were almost entirely in concordance with those from PFGE and WGS. Together with the advantages such as low costs and short turnaround time (less than 3h), the IRBT is a promising tool for strain typing that could make real‐time outbreak investigation a reality.
Sepsis after elective surgery – Incidence, aetiology and outcome
Authors: Vesteinsdottir Edda , Gottfredsson Magnus , Blondal Asbjorn , Sigurdsson Martin I. , Karason Sigurbergur
Published: November 2020

Background

Sepsis requiring admission to intensive care (ICU) is a rare complication of elective surgery, but is associated with high morbidity and mortality. The aim of this study was to describe the incidence and outcome of sepsis following elective surgery.

Methods

This was a retrospective, observational study where all admissions to Icelandic ICUs during calendar years 2006, 2008, 2010, 2012, 2014 and 2016 were screened, identifing patients with sepsis following elective surgery (ACCP/SCCM criteria). The number of elective operations performed at the largest center (Landspitali) during the study years were collected. Descriptive statistics were used to assess the incidence and outcome of patients with sepsis after elective surgery.

Results

During the study years, 88 patients were admitted to Icelandic ICUs with sepsis following elective surgery. Of those, 80 were operated at Landspitali, where the incidence of sepsis was 0.19% per elective procedure, highest following pancreaticoduodenectomies (14%, CI 6‐25) and esophagectomies (13%, CI 4‐27), but the greatest number of patients (30% (26/88)) developed sepsis after a colorectal procedure. The most common infection sources were the abdomen (65% (57/88)) and lungs/mediastinum (22% (19/88)), frequently polymicrobial (58% (36/62) of patients with cultures). The incidence of insufficient empirical antibiotics was high (50% (30/60)). The median ICU and hospital length‐of‐stay were 5.5 and 26 days and the 28‐day and 1‐year mortality rates were 16% (14/88) and 41% (36/87), respectively.

Conclusions

Incidence of sepsis following elective surgery is low in Iceland but mortality is high. Initial antimicrobial therapy needs careful consideration in these hospital‐acquired, often polymicrobial infections.
Next steps in dismantling discrimination: Lessons from ecology and conservation science
Authors: Chaudhury Aadita , Colla Sheila
Published: November 2020

Ecology, conservation, and other scientific disciplines have histories built on the oppression of marginalized groups of people. Modern day discrimination continues in these fields and there is renewed interest in dismantling these system of oppression. In this paper, we offer some examples of historical events which have shaped the field and argue that reckoning with colonial histories is part of the process to dismantle discrimination and achieve equity and inclusion. We discuss ways forward including incorporating different knowledge systems and reflecting on one's own biases and privilege. To truly achieve fields of science which are just, diverse, and equitable will be one of our greatest challenges, but one that is necessary to protect our environment, an endeavor which cannot be detangled from societal injustices.
Transcriptome analysis of a ring chromosome 20 patient cohort
Authors: Myers Kenneth A. , Bennett Mark F. , Hildebrand Michael S. , Coleman Matthew J. , Zhou Geyu , Hollingsworth Georgie , Cairns Anita , Riney Kate , Berkovic Samuel F. , Bahlo Melanie , Scheffer Ingrid E.
Published: November 2020

Ring chromosomes occur when the ends of normally rod‐shaped chromosomes fuse. In ring chromosome 20 (ring 20), intellectual disability and epilepsy are usually present, even if there is no deleted coding material; the mechanism by which individuals with complete ring chromosomes develop seizures and other phenotypic abnormalities is not understood. We investigated altered gene transcription as a contributing factor by performing RNA‐sequencing (RNA‐seq) analysis on blood from seven patients with ring 20, and 11 first‐degree relatives (all parents). Geographic analysis did not identify altered expression in peritelomeric or other specific chromosome 20 regions. RNA‐seq analysis revealed 97 genes potentially differentially expressed in ring 20 patients. These included one epilepsy gene, NPRL3, but this finding was not confirmed on reverse transcription Droplet Digital polymerase chain reaction analysis. Molecular studies of structural chromosomal anomalies such as ring chromosome are challenging and often difficult to interpret because many patients are mosaic, and there may be genome‐wide chromosomal instability affecting gene expression. Our findings nevertheless suggest that peritelomeric altered transcription is not the likely pathogenic mechanism in ring 20. Underlying genetic mechanisms are likely complex and may involve differential expression of many genes, the majority of which may not be located on chromosome 20.
A rapid detection of Escherichia coli O157:H7 by competition visual antigen macroarray
Authors: Xia Junfang , Qiu Shi , Zeng Haijuan , Liu Cheng , Liu Qing
Published: November 2020

Pathogenic bacterial contamination is a serious problem for the food industry and in public health. Rapid, accurate and affordable testing for pathogenic bacterial strains is desirable. In this study, a competition visual antigen macroarray (CVAM) for rapid detection of Escherichia coli O157:H7 (E. coli O157:H7) has been developed. This array was able to utilize an HRP‐labeled anti‐E. coli O157:H7 MAb at a concentration of 1:20000 while having a similar sensitivity of 10 5 CFU/ml for E. coli O157:H7 detection as double antibody sandwich array and conventional ELISA. The detection time of CVAM was short as 2 h and can be examined directly by the naked eye. Moreover, there was no cross‐reactivity in the detection of tested in this study. Application of CVAM for the detection of E. coli O157:H7 artificially contaminated milk samples was feasible that showed the antigen array could be applied in the detection of food pathogen infections.
Correspondence between physiological and behavioural responses to vibratory stimuli during the sleep onset period: A quantitative electroencephalography analysis
Authors: Scott Hannah , Lechat Bastien , Lovato Nicole , Lack Leon
Published: November 2020

Behavioural responses to auditory stimuli cease in late N1 or early N2 sleep. Yet, responsiveness to minimal intensity tactile stimuli and the correspondence with sleep microstructure during the sleep onset period is unknown. The aim of the present study was to investigate sleep microstructure using quantitative electroencephalography analysis when participants behaviourally responded to minimal intensity vibratory stimuli compared to when participants did not respond to stimuli during the sleep onset period. Eighteen participants wore a device that emitted vibratory stimuli to which individuals responded by tapping their index finger. A fast Fourier transform using multitaper‐based estimation was applied to electroencephalography signals in 5‐s epochs. Participants exhibited increases in higher frequencies 5 s before and immediately after the stimulus presentation when they responded to the stimulus compared to when they did not respond during all sleep stages. They also had greater delta power after stimulus onset when they did not respond to stimuli presented in N1 and N2 sleep compared to when they did respond. Participants responded to a significantly greater proportion of stimuli in wake than in N1 sleep (p < .001, d = 2.38), which was also significantly greater than the proportion of responses in N2 sleep (p < .001, d = 1.12). Participants showed wake‐like sleep microstructure when they responded to vibratory stimuli and sleep‐like microstructure when they did not respond during all sleep stages. The present study adds to the body of evidence characterising N1 sleep as a transitional period between sleep and wake containing rapid fluctuations between these two states.
Detection of circulating tumour cells enables early recurrence prediction in hepatocellular carcinoma patients undergoing liver transplantation
Authors: Wang Peng‐Xiang , Xu Yang , Sun Yun‐Fan , Cheng Jian‐Wen , Zhou Kai‐Qian , Wu Sui‐Yi , Hu Bo , Zhang Ze‐Fan , Guo Wei , Cao Ya , Huang Xiao‐Wu , Zhou Jian , Fan Jia , Yang Xin‐Rong
Published: November 2020

Background & Aims

Liver transplantation (LTx) is one of the most effective treatments for hepatocellular carcinoma (HCC); however, tumour recurrence after LTx often leads to poor outcomes. This study investigated the value of circulating tumour cells (CTCs) as a predictor of recurrence following LTx in patients with HCC.

Methods

This analysis included 193 patients with HCC who underwent LTx at our institute and accepted pre‐ and post‐operative CTC detection; 38 were selected for serial CTC monitoring. The predictive value of CTCs for tumour recurrence in patients with HCC following LTx was evaluated. Single‐cell whole genome sequencing was used to characterize CTCs.

Results

Overall, the CTC burden decreased after LTx (P < .05). Post‐operative CTC count ≥ 1 per 5 mL peripheral blood was identified as a potential biomarker for predicting tumour recurrence after LTx, especially in patients with no detectable CTCs prior to LTx and negative tumour serological biomarkers. The predictive value of post‐operative CTC count ≥ 1 per 5 mL blood was retained in patients who did not meet the Milan criteria, University of California San Francisco (UCSF) criteria, or Fudan criteria (all P < .05). Furthermore, post‐operative serial CTC detection may be useful in post‐surgical surveillance for HCC recurrence.

Conclusions

CTCs may be a useful biomarker to evaluate recurrence risk following LTx in patients with HCC. Evaluation based on CTC detection may enhance the post‐transplant management of HCC, and improve the therapeutic efficacy of LTx.
Patterns and mechanisms of spatial variation in tropical forest productivity, woody residence time, and biomass
Authors: Muller‐Landau Helene C. , Cushman K. C. , Arroyo Eva E. , Martinez Cano Isabel , Anderson‐Teixeira Kristina J. , Backiel Bogumila
Published: November 2020

Tropical forests vary widely in biomass carbon (C) stocks and fluxes even after controlling for forest age. A mechanistic understanding of this variation is critical to accurately predicting responses to global change. We review empirical studies of spatial variation in tropical forest biomass, productivity and woody residence time, focusing on mature forests. Woody productivity and biomass decrease from wet to dry forests and with elevation. Within lowland forests, productivity and biomass increase with temperature in wet forests, but decrease with temperature where water becomes limiting. Woody productivity increases with soil fertility, whereas residence time decreases, and biomass responses are variable, consistent with an overall unimodal relationship. Areas with higher disturbance rates and intensities have lower woody residence time and biomass. These environmental gradients all involve both direct effects of changing environments on forest C fluxes and shifts in functional composition – including changing abundances of lianas – that substantially mitigate or exacerbate direct effects. Biogeographic realms differ significantly and importantly in productivity and biomass, even after controlling for climate and biogeochemistry, further demonstrating the importance of plant species composition. Capturing these patterns in global vegetation models requires better mechanistic representation of water and nutrient limitation, plant compositional shifts and tree mortality.
NRF2‐dependent stress defense in tumor antioxidant control and immune evasion
Authors: Friedmann Angeli José Pedro , Meierjohann Svenja
Published: November 2020

The transcription factor NRF2 is known as the master regulator of the oxidative stress response. Tumor entities presenting oncogenic activation of NRF2, such as lung adenocarcinoma, are associated with drug resistance, and accumulating evidence demonstrates its involvement in immune evasion. In other cancer types, the KEAP1/NRF2 pathway is not commonly mutated, but NRF2 is activated by other means such as radiation, oncogenic activity, cytokines, or other pro‐oxidant triggers characteristic of the tumor niche. The obvious effect of stress‐activated NRF2 is the protection from oxidative or electrophilic damage and the adaptation of the tumor metabolism to changing conditions. However, data from melanoma also reveal a role of NRF2 in modulating differentiation and suppressing anti‐tumor immunity. This review summarizes the function of NRF2 in this tumor entity and discusses the implications for current tumor therapies.
Physical activity and cardiorespiratory fitness—A ten‐year follow‐up
Authors: Bahls Martin , Ittermann Till , Ewert Ralf , Stubbe Beate , Völzke Henry , Friedrich Nele , Felix Stephan B. , Dörr Marcus
Published: November 2020

Physical activity (PA) may influence cardiorespiratory fitness (CRF). Yet, PA takes place in different domains (i.e., sports‐related physical activity [SPA], leisure time related physical activity [LTPA], and work‐related physical activity [WPA]) and not all domain‐specific PA may help to maintain high CRF levels throughout life. We assessed the relationship between changes in domain‐specific PA and the age‐related decline in CRF. We analyzed data of 353 men (median age 50 years; inter‐quartile range [IQR] 40 to 60) and 335 women (median age 50 years; IQR 41 to 59) with data for domain‐specific PA as well as CRF testing measured ten years apart. CRF was assessed with cardiorespiratory exercise testing. Domain‐specific PA was measured using the Baecke questionnaire. During the 10‐year follow‐up, CRF decreased in men from 29.3 (IQR 25.0 to 34.7) mL/min/kg to 24.3 (IQR 20.8 to 27.3) mL/min/kg. In women, CRF declined from 26.0 (IQR 21.0 to 30.9) to 21.4 (IQR 18.3 to 25.6) mL/min/kg. A one point higher SPA at baseline was related to a 1.14 (95% confidence interval [CI] −1.50 to −0.53) mL/min/kg greater decrease in VO2peak. A one point greater SPA and LTPA over time was associated with a 1.68 (95% CI 1.06 to 2.29) mL/min/kg and 1.24 (95% CI 0.57 to 1.90) mL/min/kg lower decrease in VO2peak, respectively. Neither baseline values nor changes of WPA were associated with CRF. Sports and leisure time related PA may attenuate the age‐related decline in CRF.
Maintaining adequate donations and a sustainable blood supply: Lessons learned
Authors: Gammon Richard R. , Rosenbaum Lizabeth , Cooke Rhonda , Friedman Mark , Rockwood Linda , Nichols Tracie , Vossoughi Sarah
Published: November 2020

Background

The availability of a safe blood supply is a key component of transfusion medicine. A decade of decreased blood use, decreased payment for products, and a dwindling donor base have placed the sustainability of the US blood supply at risk.

Study Design and Methods

A literature review was performed for blood center (BC) and hospital disaster management, chronically transfusion‐dependent diseases, and appropriate use of group O‐negative red blood cells (RBCs), and the Choosing Wisely campaign. The aim was to identify current practice and to make recommendations for BC and hospital actions.

Results

While BCs are better prepared to handle disasters than after the 9/11 attacks, messaging to the public remains difficult, as donors often do not realize that blood transfused during a disaster was likely collected before the event. BCs and transfusion services should participate in drafting disaster response plans. Hospitals should maintain inventories adequate for patients in the event supply is disrupted. Providing specialty products for transfusion‐dependent patients can strain collections, lead to increased use of group O RBCs, and create logistical inventory challenges for hospitals. The AABB Choosing Wisely initiative addresses overuse of blood components to optimally use this precious resource. Group O‐negative RBCs should be transfused only to patients who truly need them.

Conclusions

Collecting and maintaining a blood supply robust enough to handle disasters and transfusion‐dependent patients in need of specialty products is challenging. Collaboration of all parties should help to optimize resources, ensure appropriate collections, improve patient care, and ultimately result in a robust, sustainable blood supply.
Draft Whole-Genome Sequence of the Alkane-Synthesizing Polar Cyanobacterium Pseudanabaena biceps Strain O-153
Authors: Péquin Bérangère , Tremblay Julien , Maynard Christine , Wasserscheid Jessica , Greer Charles W.
Published: November 2020

Alkane biosynthesis by polar cyanobacteria has not yet been reported. We present here the draft whole-genome sequence of an alkane-synthesizing polar cyanobacterium,
Pseudanabaena biceps
strain O-153. The genes coding for the two key enzymes involved in the alkane biosynthetic pathway were found contiguously in the genome.
Towards HCV elimination among people who inject drugs in Hai Phong, Vietnam: study protocol for an effectiveness-implementation trial evaluating an integrated model of HCV care (DRIVE-C: DRug use & Infections in ViEtnam–hepatitis C)
Authors: Rapoud Delphine , Quillet Catherine , Pham Minh Khue , Vu Hai Vinh , Nguyen Thanh Binh , Nham Thi Tuyet Thanh , Tran Thi Hong , Molès Jean-Pierre , Vallo Roselyne , Michel Laurent , Feelemyer Jonathan , Weiss Laurence , Lemoine Maud , Vickerman Peter , Fraser Hannah , Duong Thi Huong , Khuat Thi Hai Oanh , Des Jarlais Don , Nagot Nicolas , Laureillard Didier
Published: November 2020

Introduction

In Vietnam, people who inject drugs (PWID), who are the major population infected by hepatitis C virus (HCV), remain largely undiagnosed and unlinked to HCV prevention and care despite recommended universal hepatitis C treatment. The data on the outcomes of HCV treatment among PWID also remain limited in resource-limited settings. The DRug use & Infections in ViEtnam–hepatitis C (DRIVE-C) study examines the effectiveness of a model of hepatitis C screening and integrated care targeting PWID that largely uses community-based organisations (CBO) in Hai Phong, Vietnam. In a wider perspective, this model may have the potential to eliminate HCV among PWID in this city.

Methods and analysis

The model of care comprises large community-based mass screening, simplified treatment with direct-acting antivirals (DAAs) and major involvement of CBO for PWID reaching out, linkage to care, treatment adherence and prevention of reinfection. The effectiveness of DAA care strategy among PWID, the potential obstacles to widespread implementation and its impact at population level will be assessed. A cost-effectiveness analysis is planned to further inform policy-makers. The enrolment target is 1050 PWID, recruited from the DRIVE study in Hai Phong. After initiation of pan-genotypic treatment consisting of sofosbuvir and daclatasvir administrated for 12 weeks, with ribavirin added in cases of cirrhosis, participants are followed-up for 48 weeks. The primary outcome is the proportion of patients with sustained virological response at week 48, that will be compared with a theoretical expected rate of 70%.

Ethics and dissemination

The study was approved by Haiphong University of Medicine and Pharmacy's Ethics Review Board and the Vietnamese Ministry of Health. The sponsor and the investigators are committed to conducting this study in accordance with ethics principles contained in the World Medical Association's Declaration of Helsinki (Ethical Principles for Medical Research Involving Human Subjects). Informed consent is obtained before study enrolment. The data are anonymised and stored in a secure database. The study is ongoing. Results will be presented at international conferences and submitted to international peer-review journals.

Trial registration number

NCT03537196.
Evaluation of a wearable wireless device with artificial intelligence, iThermonitor WT705, for continuous temperature monitoring for patients in surgical wards: a prospective comparative study
Authors: Liu Yuwei , Liu Changqing , Gao Min , Wang Yan , Bai Yangjing , Xu Ruihua , Gong Renrong
Published: November 2020

Objectives

To evaluate a new-generation, non-invasive, wireless axillary thermometer with artificial intelligence, iThermonitor (WT705, Raiing Medical, Beijing, China), and to ascertain its feasibility for perioperative continuous body temperature monitoring in surgical patients.

Setting

Departments of Biliary Surgery and Operating Room and the post-anaesthesia care unit of a university teaching hospital in Chengdu, China.

Participants

A total of 526 adult surgical patients were consecutively enrolled.

Design

This was a prospective observational study. Axillary temperatures were continuously recorded with iThermonitor throughout the whole perioperative period. The temperatures of the contralateral armpit were measured with mercury thermometers at 8:00, 12:00, 16:00 and 20:00 every day and were used as references.

Outcome measures

The outcomes were the accuracy and precision of the temperatures measured with iThermonitor, the validity to detect fever and the feasibility of continuous wear. Pairs of temperatures were evaluated with Student’s t-test, Pearson’s correlation and repeated-measures Bland-Altman plot.

Results

A total of 3621 pairs of body temperatures were obtained. The temperatures measured with iThermonitor agreed with those measured with the mercury thermometers overall, with a mean difference of 0.03°C±0.35°C and a moderate correlation (r=0.755, p<0.001). The 95% limits of agreement (LoA) ranged from −0.63°C to 0.73°C, with 5.11% of the differences outside the 95% LoA. The intraclass correlation coefficient was 0.753. Continuous temperature monitoring captured more fevers than intermittent observation (117/526 vs 91/526, p<0.001), detected fever up to 4.35 hours earlier, and captured a higher peak temperature (0.29°C±0.27°C, 95% CI: 0.26–0.31). All subjects felt that wearing iThermonitor was more or less comfortable and did not affect their daily activities.

Conclusions

iThermonitor is promising for continuous remote temperature monitoring in surgical patients. However, further developments are still needed to improve the precision of this device, especially for temperature detection in underweight patients and those with lower body temperature.

Trial registration number

ChiCTR1900024549; Results (registered on 5 July 2019).
Predicting treatment outcomes for bilinguals with aphasia using computational modeling: Study protocol for the PROCoM randomised controlled trial
Authors: Peñaloza Claudia , Dekhtyar Maria , Scimeca Michael , Carpenter Erin , Mukadam Nishaat , Kiran Swathi
Published: November 2020

Introduction

Bilinguals with aphasia (BWA) present varying degrees of lexical access impairment and recovery across their two languages. Because both languages may benefit from therapy, identifying the optimal target language for treatment is a current challenge for research and clinical practice. Prior research has demonstrated that the BiLex computational model can accurately simulate lexical access in healthy bilinguals, and language impairment and treatment response in bilingual aphasia. Here, we aim to determine whether BiLex can predict treatment outcomes in BWA in the treated and the untreated language and compare these outcome predictions to determine the optimal language for rehabilitation.

Methods and analysis

The study involves a prospective parallel-group, double-blind, randomised controlled trial. Forty-eight Spanish–English BWA will receive 20 sessions of semantic treatment for lexical retrieval deficits in one of their languages and will complete assessments in both languages prior and after treatment. Participants will be randomly assigned to an experimental group receiving treatment in the optimal language determined by the model or a control group receiving treatment in the language opposite to the model’s recommendation. Primary treatment outcomes include naming probes while secondary treatment outcomes include tests tapping additional language domains. Treatment outcomes will be compared across the two groups using 2×2 mixed effect models for repeated measures Analysis of variance (ANOVA) on metrics of treatment effects commonly employed in rehabilitation studies (ie, effect size and percentage change).

Ethics and dissemination

All procedures included in this protocol (protocol number 29, issue date: 19 March 2019) were approved by the Boston University Charles River Campus Institutional Review Board at Boston, Massachusetts (reference number: 4492E). The results of this study will be published in peer-reviewed scientific journals and will be presented at national and international conferences.

Trial registration number

NCT02916524.
Challenges, experience and coping of health professionals in delivering healthcare in an urban slum in India during the first 40 days of COVID-19 crisis: a mixed method study
Authors: George Carolin Elizabeth , Inbaraj Leeberk Raja , Rajukutty Shon , de Witte Luc P
Published: November 2020

Objectives

To describe the initial dilemmas, mental stress, adaptive measures implemented and how the healthcare team collectively coped while providing healthcare services in a large slum in India, during the COVID-19 pandemic.

Setting

Community Health Division, Bangalore Baptist Hospital, Bangalore.

Study design

We used mixed methods research with a quantitative (QUAN) paradigm nested in the primary qualitative (QUAL) design. QUAL methods included ethnography research methods, in-depth interviews and focus group discussions.

Participants

A healthcare team of doctors, nurses, paramedical and support staff. Out of 87 staff, 42 participated in the QUAL methods and 64 participated in the QUAN survey.

Results

Being cognizant of the extreme vulnerability of the slums, the health team struggled with conflicting thoughts of self-preservation and their moral obligation to the marginalised section of society. Majority (75%) of the staff experienced fear at some point in time. Distracting themselves with hobbies (20.3%) and spending more time with family (39.1%) were cited as a means of emotional regulation by the participants in the QUAN survey. In the QUAL interviews, fear of death, the guilt of disease transmission to their loved ones, anxiety about probable violence and stigma in the slums and exhaustion emerged as the major themes causing stress among healthcare professionals. With positive cognitive reappraisal, the health team collectively designed and implemented adaptive interventions to ensure continuity of care. They dealt with the new demands by positive reframing, peer support, distancing, information seeking, response efficacy, self-efficacy, existential goal pursuit, value adherence and religious coping.

Conclusion

The novel threat of the COVID-19 pandemic threw insurmountable challenges potentiating disastrous consequences; slums becoming a threat to themselves, threat to the health providers and a threat for all. Perhaps, a lesson we could learn from this pandemic is to incorporate ‘slum health’ within universal healthcare.
WAVE PROPAGATION IN THE CRANIUM AND THE CEREBROSPINAL FLUID
Authors: MISRA J. C. , DANDAPAT S. , ADHIKARY S. D.
Published: November 2020

In this paper, wave propagation in head generated by a local axisymmetric impact on its outer surface is studied. The skull material is treated as isotropic and homogeneous, but presence of the cerebrospinal fluid (considered as a compressible but inviscid irrotational fluid) inside the cranium has been accounted for in the analysis. Some numerical results obtained on the basis of the analytical study, are also presented.
Child Night Blindness and Bitot’s Spots Are Public Health Problems in Lay Armachiho District, Central Gondar Zone, Northwest Ethiopia, 2019: A Community-Based Cross-Sectional Study
Authors: Bantihun Ajebew , Gonete Kedir Abdela , Getie Azeb Atnafu , Atnafu Asmamaw
Published: November 2020

Background. Night blindness (XN) is a condition in which a person cannot see in dim light and is the earliest clinical manifestation of vitamin A deficiency. Globally, vitamin A deficiency is a public health problem in 122 countries, of which 45 countries have moderate to severe child night blindness. Therefore, this study is aimed at assessing the prevalence and associated factors of night blindness and Bitot’s spot among children aged 24-59 months. Methods. A community-based cross-sectional study was employed from February to March 2019 among children aged 24-59 months in the Lay Armachiho District, Amhara region. A structured and pretested questionnaire was used for data collection. Descriptive summary statistics were used to describe the study population. Bivariate and multivariable logistic regression models were used to identify associated factors. Results. Out of 1007 children, 1.9% and 2.2% had night blindness and Bitot’s spot, respectively. Illiterate mothers (AOR=2.94;95%CI=1.12,6.72), age of 48 to 59 months (AOR=9.81;95%CI=1.24,77.36), ≥4 family sizes (AOR=4.52;95%CI=1.02,19.90), had diarrhea (AOR=5.00;95%CI=1.73,14.54), and had a respiratory tract infection (AOR=3.14;95%CI=1.02,9.70) were significantly associated with night blindness. Age of 48-59 months (AOR=4.23;95%CI=1.13,14.86) and mothers who did not wash their hands after using the toilet (AOR=3.02;95%CI=1.01,9.13) were predictor variables for Bitot’s spots. Conclusion. The prevalence of night blindness and Bitot’s spots was high. Child’s age, mother’s educational status, family size, diarrhea in the last 2 weeks, and respiratory tract infection in the last 2 weeks were predictive variables for night blindness. Besides, handwashing practice after using the toilet and child’s age were significantly associated with Bitot’s spot among children. Therefore, both night blindness and Bitot’s spots are a public health problem and call for the attention of health professionals in primary health care facilities.
Major Histocompatibility Complex Genes as Therapeutic Opportunity for Immune Cold Molecular Cancer Subtypes
Authors: Karpiński Paweł , Łaczmański Łukasz , Sąsiadek Maria M.
Published: November 2020

Current immunotherapies are effective only in a subset of patients, likely due to several factors including defects in tumor cell antigen presentation, decreased response to immune effectors, and molecular heterogeneity of cancers. Recent molecular classifications enable the categorization of many tumor types. However, deregulation of major histocompatibility complex (MHC) gene expression is poorly characterized in the context of molecular cancer subtypes. To suppress the confounding effect of immune infiltrates on expression patterns of immunoregulators, we identified and removed genes with strong correlation to estimated immune compartment levels in each tumor type. Next, we reanalyzed a total of 13 TCGA cancer types encompassing 5651 tumors and 485 normal adjacent tissues by performing unsupervised clustering of 14 MHC genes. Subsequently, resultant clusters were statistically compared in terms of expression of other immune-related genes. Three MHC expression clusters were discovered by unsupervised clustering. We identified concordantly decreased expression of MHC genes (MHC-low) in 26 out of 55 molecular subtypes. Consequently, our study underlines the urgent need for designing strategies to enhance tumor MHC expression that could improve immune cold tumor rejection by cytotoxic T lymphocytes.
The Role of Gait Speed in Dementia: A Secondary Analysis from the SABE Colombia Study
Authors: Garcia-Cifuentes Elkin , Márquez Isabel , Vasquez Daniel , Aguillon David , Borda Miguel G. , Lopera Francisco , Cano-Gutierrez Carlos
Published: November 2020

Introduction: Gait speed (GS) is a predictor of negative outcomes in older adults and in those in risk to develop cognitive impairment; as such, it has been associated with dementia. Studies in Latin-American older adults showing this association are scarce. This study aimed to evaluate the relationship between GS and dementia in a representative sample of Colombian older adults. Methods: This study is a secondary analysis from the Survey on Health, Well-Being, and Aging, SABE (from initials in Spanish: Salud, Bienestar & Envejecimiento) Colombia’s survey conducted in 2015 with a sample of 23,694 elderly adults aged 60 years or older. Results: A total of 19,470 participants from the SABE Colombia survey were available for analysis. The multivariate analysis shows that dementia was associated with slow GS (PR 2.39; CI 1.91–3.01) independently to the other variables (p < 0.001). Similarly, GS as a continuous variable shows a statistically significant association with dementia in the adjusted analysis (OR 0.06; CI 0.04–0.09; p < 0.001). Conclusion: Dementia was associated with slow GS. This finding provides evidence to include GS as a complementary parameter in the assessment of Colombian elderly adults.
Karyotype Characterisation of Two Australian Dragon Lizards (Squamata: Agamidae: Amphibolurinae) Reveals Subtle Chromosomal Rearrangements Between Related Species with Similar Karyotypes
Authors: Alam Shayer M.I. , Sarre Stephen D. , Georges Arthur , Ezaz Tariq
Published: November 2020

Agamid lizards (Squamata: Agamidae) are karyotypically heterogeneous. Among the 101 species currently described from Australia, all are from the subfamily Amphibolurinae. This group is, with some exceptions, karyotypically conserved, and all species involving heterogametic sex show female heterogamety. Here, we describe the chromosomes of 2 additional Australian agamid lizards, Tympanocryptis lineata and Rankinia diemensis. These species are phylogenetically and cytogenetically sisters to the well-characterised Pogona vitticeps, but their sex chromosomes and other chromosomal characteristics are unknown. In this study, we applied advanced molecular cytogenetic techniques, such as fluorescence in situ hybridisation (FISH) and cross-species gene mapping, to characterise chromosomes and to identify sex chromosomes in these species. Our data suggest that both species have a conserved karyotype with P. vitticeps but with subtle rearrangements in the chromosomal landscapes. We could identify that T. lineata possesses a female heterogametic system (ZZ/ZW) with a pair of sex microchromosomes, while R. diemensis may have heterogametic sex chromosomes, but this requires further investigations. Our study shows the pattern of chromosomal rearrangements between closely related species, explaining the speciation within Australian agamid lizards of similar karyotypes.
Diabetes Affects the A1 Adenosine Receptor-Dependent Action of Diadenosine Tetraphosphate (Ap4A) on Cortical and Medullary Renal Blood Flow
Authors: Kreft Ewelina , Sałaga-Zaleska Kornelia , Sakowicz-Burkiewicz Monika , Dąbkowski Kamil , Szczepánska-Konkel Miroslawa , Jankowski Maciej
Published: November 2020

Diabetes through adenosine A1 receptor (A1R) and P2 receptors (P2Rs) may lead to disturbances in renal microvasculature. We investigated the renal microvascular response to Ap4A, an agonist of P2Rs, in streptozotocin-induced diabetic rats. Using laser Doppler flowmetry, renal blood perfusion (RBP) was measured during infusion of Ap4A alone or in the presence of A1R antagonist, either DPCPX (8-cyclopentyl-1,3-dipropylxanthine) or 8-cyclopentyltheophylline (CPT). Ap4A induced a biphasic response in RBP: a phase of rapid decrease was followed by a rapid increase, which was transient in diabetic rats but extended for 30 min in nondiabetic rats. Phase of decreased RBP was not affected by DPCPX or CPT in either group. Early and extended increases in RBP were prevented by DPCPX and CPT in nondiabetic rats, while in diabetic rats, the early increase in RBP was not affected by these antagonists. A1R mRNA and protein levels were increased in isolated glomeruli of diabetic rats, but no changes were detected in P2Y1R and P2Y2R mRNA. Presence of unblocked A1R is a prerequisite for the P2R-mediated relaxing effect of Ap4A in nondiabetic conditions, but influence of A1R on P2R-mediated renal vasorelaxation is abolished under diabetic conditions.
The Karyotype of Blainville’s Beaked Whale, Mesoplodon densirostris
Authors: Brookwell Ross , Finlayson Kimberly , van de Merwe Jason P.
Published: November 2020

The karyotype of the Odontocete whale, Mesoplodon densirostris, has not been previously reported. The chromosome number is determined to be 2n = 42, and the karyotype is presented using G-, C-, and nucleolar organizer region (NOR) banding. The findings include NOR regions on 2 chromosomes, regions of heterochromatic variation, a large block of heterochromatin on the X chromosome, and a relatively large Y chromosome. The karyotype is compared to published karyograms of 2 other species of Mesoplodon.
Sérgio Settani Giglio: Cobertura midiática poliesportiva e reção entre os Jogos Abertos do Interior e os Jogos Olímpicos
Authors: Longo Gustavo de Araujo
Published: November 2020

Professor de graduação e pós-graduação da Universidade Estadual de Campinas (UNICAMP), Sérgio Settani Giglio é uma das referências sobre estudos interdisciplinares envolvendo o Futebol e os Jogos Olímpicos. Mestre pela UNICAMP e Doutor em Educação Física pela Universidade de São Paulo (USP), é autor de livros e artigos sobre os temas como Futebol, Copa do Mundo, Jogos Olímpicos, Esporte e Política e Ensino dos Esportes Coletivos. Nesta entrevista, ele analisa a cobertura midiática dos Jogos Abertos do Interior, principal evento esportivo do estado de São Paulo, e a relação que possui com os Jogos Olímpicos.
Possibilidades de atuação para as organizações no universo científico brasileiro: estudo de caso do Grupo Claudino
Authors: Fortaleza Keynayanna Késsia Costa
Published: November 2020

A sociedade brasileira passa por um momento extremamente delicado no que diz respeito ao reconhecimento, a importância social e a validação de projetos ligados ao universo científico. Divulgar a ciência e seus resultados positivos para a vida em sociedade tornou-se um grande desafio para a classe científica do país. Diante desta realidade, este artigo se caracteriza como  bibliográfico (STUMPF, 2005) e documental (MOREIRA, 2005) e tem como objetivo explorar como as organizações, enquanto agentes sociais diretos nas comunidades onde atuam podem investir e beneficiar a ciência no Brasil. O estudo de caso se dará junto a um conglomerado sediado no Piauí, o Grupo Claudino, que desde a década de 1970 investe em projetos de ordem educativos, sociais e científicos. Para fundamentar teoricamente  essa  reflexão, foi realizada uma revisão bibliográfica embasada nos seguintes autores dos campos da Comunicação, Educação e Jornalismo Científico: Burkett (1990), Bacegga (2009), Citelli (2009), Lima ( 2017), Kaplún (1998), dentre outros pesquisadores do tema.
Abstract 13611: Prognostic Value of Shock Index in Patients Admitted With Non ST-Segment Elevation Myocardial Infarction: The ARIC Study Community Surveillance
Authors: Chunawala Zainali , Hall Michael E , Arora Sameer , Dai Xuming , Menon Venu , Matsushita Kunihiro , Caughey Melissa
Published: November 2020

Introduction:
Shock index (SI), defined as the ratio of heart rate (HR) to systolic blood pressure (SBP), is easily obtained and has been reported to predict all-cause mortality in acute myocardial infarction (AMI) hospitalizations, primarily among patients with STEMI. Large-scale investigations examining the prognostic value of SI in patients with NSTEMI are lacking.

Methods:
Hospitalizations for acute myocardial infarction were sampled from 4 US areas by the ARIC Study and classified by physician review. HR and SBP at first presentation were abstracted from the medical record. Pulseless patients, those with unobtainable SBP, and transfer patients were excluded. An SI value ≥0.7 was considered high. The TIMI risk score for NSTE-ACS was calculated using the established algorithm. Predictions of all-cause 28-day mortality were analyzed using receiver operating characteristics (ROC).

Results:
From 2000-2014, 18,301 weighted hospitalizations for NSTEMI patients were sampled and had vitals successfully obtained. Of these, 5753 (31%) had high SI (≥0.7). Patients with high SI were more often female (46% vs 39%) and older (65 vs 63 years), with more prevalent chronic kidney disease (40% vs. 32%), pneumonia (16% vs 8%), and complication by acute heart failure (42% vs 30%). However, the TIMI risk score was comparable for the 2 groups (4.3 vs. 4.2). Angiography (36% vs 58%), revascularization (19% vs 41%), and guideline-directed medications were less often administered to patients with high SI, and the 28-day mortality was nearly 3 times higher (13% vs 5%). Continuous values of SI were more predictive of 28-day mortality than the TIMI risk score, both overall (ROC-AUC: 0.68 vs 0.54;
P
<0.0001) and among the subset of patients who were revascularized (ROC-AUC: 0.72 vs. 0.56;
P
<0.0001).

Conclusion:
The SI outperformed the TIMI risk score for prediction of short-term mortality in patients hospitalized with NSTEMI, and may be useful for risk stratification in emergency settings.
Central Command and the Regulation of Exercise Heart Rate Response in Heart Failure With Preserved Ejection Fraction
Authors: Sarma Satyam , Howden Erin , Lawley Justin , Samels Mitchel , Levine Benjamin D.
Published: November 2020

Background:

Chronotropic incompetence is common in heart failure with preserved ejection fraction (HFpEF) and is linked to impaired aerobic capacity. Whether upstream autonomic signaling pathways responsible for raising exercise heart rate are impaired in HFpEF is unknown. We investigated the integrity of central command and muscle metaboreceptor function, 2 predominant mechanisms responsible for exertional increases in heart rate, in patients with HFpEF and senior controls.

Methods:

Fourteen healthy senior controls (7 men, 7 women) and 20 carefully screened patients with HFpEF (8 men, 12 women) underwent cardiopulmonary exercise testing (peak V
o
2
) and static handgrip exercise at 40% of maximal voluntary contraction to fatigue with postexercise circulatory arrest for 2 minutes to assess central command and metaboreceptor function, respectively.

Results:

Peak V
o
2
(13.1±3.4 versus 22.7±4.0 mL/kg/min;
P
<0.001) and heart rate (122±20 versus 155±14 bpm;
P
<0.001) were lower in patients with HFpEF than senior controls. There were no significant differences in peak heart rate response during static handgrip between groups (patients with HFpEF versus controls: 90±13 versus 93±10 bpm;
P
=0.49). Metaboreceptor function, defined as mean arterial blood pressure at the end of postexercise circulatory arrest, was not significantly different between groups.

Conclusions:

Central command (vagally mediated) and metaboreceptor function (sympathetically mediated) in patients with HFpEF were not different from those in healthy senior controls despite significantly lower peak whole-body exercise heart rates. These results demonstrate key reflex autonomic pathways regulating exercise heart rate responsiveness are intact in HFpEF.
covid-19 and the Role of the Security Council as Global Health Peacekeeper
Authors: Kondoch Boris
Published: November 2020

The covid-19 pandemic has become one of the greatest challenges the world has faced since the founding of the United Nations. The following article provides a short overview, which addresses the United Nations’ efforts in minimizing the negative impact of the virus on peace and security by focusing on the potential role of the Security Council from a normative perspective.
The Rule of Law and Its Application to the United Nations: Conference Report
Authors: Wagner Edith
Published: November 2020

The rule of law applies to the United Nations and should guide all its activities. As promising as this key statement of the United Nations General Assembly Resolution 67/1 may sound, its meaning is not entirely clear. How is the rule of law to be defined, and what is its legal basis at the international level? What does the rule of law mean for the different activities of the United Nations with external effects such as sanctions, peacekeeping and development, what for its internal administration and justice system? The conference on the Rule of Law and Its Application to the United Nations held at the Max Planck Institute Luxembourg on 11–12 September 2014 addressed these questions inter alia and took a comprehensive look at Resolution 67/1. The conference provided both the academic perspective and the reality of practice due to the participation of various practitioners and United Nations officials.