bluuebunny/crossref_metadata_2025 huggingface dataset:
Teachers’ views of corporate reputation: Influence on behavioral outcomes
Authors: Martínez‐León Inocencia María , Olmedo‐Cifuentes Isabel
Published: July 2021

The aim of this paper is to analyze the influence of teachers’ views of corporate reputation on behavioral outcomes in educational cooperatives. Educational cooperatives are social companies that must adequately manage their intangible assets to improve their competitiveness in the education sector. However, research on how teachers perceive corporate reputation is limited. Data was obtained through a survey of 101 teachers to test the research model proposed using path analysis. The findings highlight that teachers’ views of corporate reputation in educational cooperatives have significant and positive effects on employee satisfaction, retention and perceived service quality. Likewise, employee satisfaction has significant effects on teacher retention and perceived service quality. Therefore, given that employee satisfaction is a relevant variable in an educational organization's operation, employees’ views of corporate reputation can be used as a strategic tool to manage and improve organizational outcomes.
Control and value appraisals and online multiple‐text comprehension in primary school: The mediating role of boredom and the moderating role of word‐reading fluency
Authors: Raccanello Daniela , Florit Elena , Brondino Margherita , Rodà Antonio , Mason Lucia
Published: July 2021

Background

Online multiple‐text comprehension is a key skill of the 21st Century, yet the study of its relations with boredom in young students has been disregarded. Boredom is an achievement emotion expected to be predicted negatively by antecedents like control and value appraisals and to be associated to a negative performance. Notwithstanding its documented domain‐specificity, scarce attention has been paid to investigating these relations with primary‐school students in the reading domain, and specifically for online multiple‐text comprehension, and to how such relations are moderated by basic cognitive abilities.

Aims

Considering separately two settings (homework, test), we studied the mediation of boredom in the relation between control‐value appraisals and online multiple‐text comprehension in primary‐school students, focusing on the moderating role of word‐reading fluency.

Sample

Participants were 334 fourth and fifth graders.

Methods

We evaluated students’ reading‐related self‐efficacy and task‐value, reading‐related boredom for homework and tests, word‐reading fluency, and online multiple‐text comprehension.

Results

Path analyses revealed negative relations between control‐value appraisals and boredom for homework and tests, and between boredom and online multiple‐text comprehension for tests only. For the latter, word‐reading fluency moderated the relation between appraisals, boredom, and comprehension: Boredom negatively related to comprehension only for students with high word‐reading fluency.

Conclusions

Findings are discussed focusing on antecedents of online multiple‐text comprehension as a literacy skill critical in the 21st Century. We underlined their implications for learning in general and specifically for the current educational changes due to the COVID‐19 pandemic.
Conservation conundrum: Endangered species persists on noxious weed
Authors: Elliott Christine H. , Gillett Conrad P. D. T. , Parsons Elliott , Rubinoff Daniel
Published: July 2021

Some invasive plants are used by native wildlife but may be subject to control measures. We investigated oviposition preferences of an endangered moth dependent upon an invasive weed for survival. By identifying preferred characteristics of invasive host plants, land managers may minimize resource loss for imperiled species dependent upon them.
The future of wildlife conservation funding: What options do U.S. college students support?
Authors: Larson Lincoln R. , Peterson Markus Nils , Furstenberg Richard Von , Vayer Victoria R. , Lee Kangjae Jerry , Choi Daniel Y. , Stevenson Kathryn , Ahlers Adam A. , Anhalt‐Depies Christine , Bethke Taniya , T. Bruskotter Jeremy , Chizinski Christopher J. , Clark Brian , Dayer Ashley A. , Dunning Kelly Heber , Ghasemi Benjamin , Gigliotti Larry , Graefe Alan , Irwin Kris , Keith Samuel J. , Kelly Matt , Kyle Gerard , Metcalf Elizabeth , Morse Wayde , Needham Mark D. , Poudyal Neelam C. , Quartuch Michael , Rodriguez Shari , Romulo Chelsie , Sharp Ryan L. , Siemer William , Springer Matthew T. , Stayton Brett , Stedman Richard , Stein Taylor , Van Deelen Timothy R. , Whiting Jason , Winkler Richelle L. , Woosnam Kyle Maurice
Published: July 2021

Insufficient funding is a major impediment to conservation efforts around the world. In the United States, a decline in hunting participation threatens sustainability of the “user‐pay, public benefit” model that has supported wildlife conservation for nearly 100 years, forcing wildlife management agencies to contemplate alternative funding strategies. We investigated support for potential funding options among diverse college students, a rapidly expanding and politically active voting bloc with a potentially powerful influence on the future of conservation. From 2018 to 2020, we surveyed 17,203 undergraduate students at public universities across 22 states. Students preferred innovative approaches to conservation funding, with 72% supporting funding derived from industry sources (e.g., natural resource extraction companies), 63% supporting state sources (e.g., general sales tax), and 43% supporting conventional user‐based sources such as license fees and excise taxes associated with outdoor recreation activities (e.g., hunting). Findings emphasize the need to broaden the base of support for conservation funding and highlight the importance of considering the preferences and perspectives of young adults and other diverse beneficiaries of wildlife conservation.
Assessment of superior vena cava flow and cardiac output in different patterns of patent ductus arteriosus shunt
Authors: Bischoff Adrianne Rahde , Giesinger Regan E. , Stanford Amy H. , Ashwath Ravi , McNamara Patrick J.
Published: July 2021

Background

Despite the widespread use of superior vena cava (SVC) flow as a marker of systemic blood flow from the upper body, no previous studies have systematically evaluated the correlation between SVC flow and other echocardiography measures of systemic blood flow in the context of different patterns of patent ductus arteriosus (PDA) shunt direction

Methods

A retrospective cohort study of preterm infants (< 30 weeks, < 21 days of life) who underwent comprehensive targeted neonatal echocardiography (TnECHO) was performed. Patients were categorized as follows: (i) Hemodynamically significant left‐to‐right shunt; (ii): Bidirectional shunt; (iii) No PDA or insignificant shunt. SVC flow, as measured by two distinct methods, was compared to left and right ventricular outputs (LVO and RVO). Intra‐ and inter‐observer reliability testing was performed

Results

In total, 45 patients were included (15 in each group) with a median [IQR] weight of 720 [539, 917] grams at the time of assessment. SVC dimensions and flow measurements were not different between the groups, although patients with left‐to‐right shunt had higher LVO/RVO ratio. SVC flow, as estimated using the modified method, had a strong correlation with LVO (r = .63, p = 0.012) and RVO (r = .635, p = 0.011) in patients with no PDA. Inter‐ and intra‐observer reliability were both stronger for LVO and RVO when compared to SVC flow measurements

Conclusion

SVC flow was comparable across all three groups irrespective of higher LVO and LVO/RVO ratio in patients with left‐to‐right shunts. This may reflect poor measurement reliability or compensation for left‐to‐right ductal shunt by increased LVO to maintain systemic perfusion.
Direct oral anticoagulants in patients with nonvalvular atrial fibrillation and extreme body weight
Authors: Bodega Francesca , Russi Anita , Melillo Francesco , Blunda Fabiana , Rubino Claudia , Leo Giulio , Cappelletti Alberto , Mazzone Patrizio , Mattiello Paolo , Della Bella Paolo , Castiglioni Alessandro , Alfieri Ottavio , De Bonis Michele , Montorfano Matteo , Tresoldi Moreno , Filippi Massimo , Salerno Anna , Cera Michela , Zangrillo Alberto , Alberto Margonato , Godino Cosmo ,   the INSigHT (Italian DOACs San Raffaele Hospital) registry investigators
Published: July 2021

Background

Limited clinical data exist describing the use of direct oral anticoagulants (DOACs) in patient with extreme body weight. Thus, the International Society of Thrombosis and Haemostasis (ISTH) recommends avoiding DOACs in patients with weight >120 Kg, and on the contrary, no restrictions exist for underweight patients.

Objective

To evaluate the effects of extreme body weight on DOAC activity and to compare the clinical outcomes of patients with an extreme body weight versus patients with a normal weight (61‐119 Kg) treated with DOACs.

Methods

Single tertiary care Italian centre multidisciplinary registry including nonvalvular atrial fibrillation (NVAF) patients treated with DOACs. Based on weight, three subcohorts were defined: (i) underweight patients (≤60 Kg); (ii) patients with a normal weight (61‐119 Kg, as control group); and (iii) overweight patients (≥120 Kg). Primary efficacy endpoint was 2‐year rate of thromboembolic events. Primary safety endpoint was 2‐year rate of major bleeding. Event‐free survival curves among groups were compared using Cox‐Mantel test.

Results

812 NVAF patients were included, 108 patients weighed ≤60 Kg (13%, underweight), 688 weighed between 61 and 119 Kg (85%, normal weight), and 16 weighed ≥120 Kg (2%, overweight). In particular, among underweight patients, dabigatran was prescribed in 26% patients, apixaban in 27%, rivaroxaban in 28% and edoxaban in 22% ones. Instead, among overweight patients, 44% were treated with dabigatran, 25% with apixaban, 25% with rivaroxaban and 4% with edoxaban. Underweight patients were older, more frequently women, with lower creatinine clearance and a history of previous strokes, resulting in higher CHA2DS2‐VASc score than in both remaining groups. Up to 2 years, no statistically significant difference was observed between the three groups of weight for thromboembolic events (P = .765) and for overall bleeding (P = .125), but a trend towards decreased overall bleeding rates was noticed as weight increased (24.1% vs 16.7% vs 12.5%, respectively).

Conclusion

In this tertiary care centre registry, 15% of patients treated with DOACs presented an extreme weight. Compared to patients with a normal weight, no significant rates of thromboembolic events were observed for underweight or overweight patients. A trend towards decreased overall bleeding frequency as weight increased was highlighted up to 2 years. The present results should be considered as preliminary and hypothesis generating.
Individualized vocational and educational support and training for youth at clinical high risk for psychosis
Authors: West Michelle L. , Parrish Emma M. , Green James , Howland Caroline , Friedman‐Yakoobian Michelle
Published: July 2021

Aim

Early intervention for psychosis has been of high interest in the past two decades. Research demonstrates that clinical high risk for psychosis (CHR‐p) populations experience impairments in role functioning. Although several vocational and cognitive interventions exist for people living with psychosis, there are no known evidence‐based treatments for role functioning difficulties during the CHR‐p stage. There is clear evidence for a need for interventions that directly target role functioning.

Methods

This paper describes the theoretical development and implementation of a novel intervention targeting role functioning impairments: Individualized Vocational and Educational Support and Training (InVEST). The CEDAR Clinic, a specialized CHR‐p coordinated specialty care (CSC) team, has worked to develop InVEST to target core aspects of role functioning, namely executive functioning, stress sensitivity, and task initiation. The intervention is cost‐efficient, as bachelor level clinicians provide the service under supervision of licensed clinicians. This summary describes InVEST, provides a disguised case example, and presents initial exploratory data (N = 135) focused on the intervention's feasibility in this CSC program.

Results

Although these preliminary data are limited, available information suggests that InVEST may provide a core treatment modality within CHR‐p treatment programs.

Conclusions

More research formally investigating InVEST with a larger sample would provide further evidence of the intervention's efficacy.
Detection of neurodegenerative disease in brain using region splitting based segmentation with deep unsupervised neural networks
Authors: Rajive Gandhi C. , Murugesh V.
Published: July 2021

Unsupervised segmentation is a significant pre‐processing task in various computer visualization processes. However, recently used unsupervised segmentation methods are very sensitive to few of the parameters like number of segmentation or numerous training and more inference complication. Neurodegenerative disorders namely Parkinson's and Alzheimer's, add up to main aspects to longer disability and has grown to be a more serious concept in the developed nations. At present, there does not exist efficient therapies. Earlier diagnosis along with avoiding misdiagnosis significantly assists in ensuring a good quality for patient's life. Hence, adopting computer‐aided‐diagnosis tools provides clinical assistance. This paper focus on detecting neurodegenerative disease from CT brain images by segmentation through region splitting based segmentation with deep unsupervised neural networks (RSS‐DUNN).Auto encoder deep neural network is constructed with reconstruction process of input image, which further improves the accuracy. The performance of the proposed model is evaluated by comparing it with two standard methods in terms of accuracy, precision, recall, Jaccard similarity index (JSI) and dice similarity coefficient (DSC). As a result, it achieves 70.4% of accuracy, 70.8% of precision, 75.8% of recall, 73.6% of JSI and 81% of DSC.
Construction land reduction, rural financial development, and industrial structure optimization
Authors: Li Guoxiang , Wang Keqiang , Liu Hongmei
Published: July 2021

Construction land reduction is an important means of promoting the effective allocation of factors and the optimization of industrial structure. Based on analyses of the impact mechanism of construction land reduction on industrial structure rationalization and supererogation, this study adopts the difference‐in‐difference model and threshold regression model to analyze the effects of construction land reduction. The results are as follows: (1) Construction land reduction significantly improves industrial structure rationalization and supererogation, and the positive effect clearly accumulates over time. After PSM‐DID and other series of robustness tests, the conclusion is still valid. (2) Construction land reduction in the outer suburban areas has a greater positive impact on industrial structure rationalization and supererogation than that in other suburban areas. (3) When the scale of the reduction exceeds a certain threshold, rural financial development can significantly promote industrial structure rationalization and supererogation. It is necessary to rationally plan the layout of industry, establish a mechanism of cross‐regional allocation of the reduction index, and provide replicable experiences for popularizing construction land reduction throughout the whole country.
A qualitative research study on the illness perception of chronic pruritus in older Asian adults based on the Common‐Sense Model of self‐regulation
Authors: Moosa Aminath Shiwaza , Leng Natasha Sheng Yeng , Kum Chui Lien , Tan Ngiap Chuan
Published: July 2021

Background

Chronic pruritus (CP), itch lasting more than 6 weeks, is common in community‐dwelling older adults. Understanding their illness perception allows the attending physician to develop a personalised care plan to mitigate CP.

Aim

This study explores the illness perception of CP among older Asian adults in an urban community.

Design

Qualitative research was conducted, framed by the Common‐Sense Model of self‐regulation (CSM). Through in‐depth interviews (IDIs), qualitative data were gathered from Asian patients with CP, and then a thematic analysis was carried out. The emergent themes were grouped according to the five domains of CSM: ‘identity’, ‘cause’, ‘time’, ‘controllability’ and ‘consequence’.

Setting and Patients

IDIs were conducted in a Singapore public primary care clinic before the data were saturated.

Results

The CSM domains illustrate the illness perception of CP. CP was identified as a ‘problem’ rather than a disease and was often described in metaphor. Patients' perception of the cause was diverse due to the lack of provision of a clear explanation by their physicians. They opined that CP continued indefinitely. Without definite time to resolution, patients adapted their help‐ and health‐seeking behaviours to control it. The consequences included therapeutic experimentation, alternative therapy, self‐isolation, avoidance behaviours, emotional disturbance and dermatological complications.

Conclusion and Patient Contribution

Patients provided information on their perception of CP, which aligned with the CSM. A multipronged approach is needed to deliver holistic and personalised care to patients with CP, providing clarity on its natural progression, to set their expectations on its timeline, treatment effectiveness and undertake appropriate behaviour modification to adapt to its chronicity.
LOC100996425 acts as a promoter in prostate cancer by mediating hepatocyte nuclear factor 4A and the AMPK/mTOR pathway
Authors: Wang Xiuyan , Song Bin , Zang Mingcui , Ji He , Yang He , Jiang Shuang , Yang Xiao
Published: July 2021

The involvement of long non‐coding RNAs (lncRNAs), differentially expressed genes and signals in prostate cancer (PCa) continues to be a subject of investigation. This study determined effects of LOC100996425 on human PCa by targeting hepatocyte nuclear factor 4A (HNF4A) via the AMPK/mTOR pathway. PCa and adjacent normal tissues were obtained to characterize expression pattern of LOC100996425, HNF4A and the AMPK/mTOR pathway‐related genes. Then, the target gene of LOC100996425 was determined with lncRNA target prediction website and further verification was obtained through luciferase assay and ribonucleoprotein immunoprecipitation. After that, PCa cells were introduced with LOC100996425, HNF4A, siLOC100996425 or siHNF4A to explore the specific significance of LOC100996425 and HNF4A in PCa. The mechanism associated with AMPK/mTOR pathway was investigated using AMPK inhibitor or activator. LOC100996425 was up‐regulated, while HNF4A was down‐regulated in the PCa tissues. HNF4A was a target gene of LOC100996425. PCa cells transfected with either siLOC100996425 or HNF4A displayed reduced rates of PCa cell proliferation and migration while elevating cell apoptosis. HNF4A overexpression reversed the promotive effect of LOC100996425 overexpression on PCa. The activation of AMPK pathway involved in the cancer progression mediated by LOC100996425. Down‐regulation of LOC100996425 retards progression of PCa through HNF4A‐mediated AMPK/mTOR pathway.
A discrete event simulation to evaluate impact of radiology process changes on emergency department computed tomography access
Authors: Maass Kayse Lee , Halter Elizabeth , Huschka Todd R. , Sir Mustafa Y. , Nordland Michelle R. , Pasupathy Kalyan S.
Published: July 2021

Background

Hospitals face the challenge of managing demand for limited computed tomography (CT) resources from multiple patient types while ensuring timely access.

Methods

A discrete event simulation model was created to evaluate CT access time for emergency department (ED) patients at a large academic medical center with six unique CT machines that serve unscheduled emergency, semi‐scheduled inpatient, and scheduled outpatient demand. Three operational interventions were tested: adding additional patient transporters, using an alternative creatinine lab, and adding a registered nurse dedicated to monitoring CT patients in the ED.

Results

All interventions improved access times. Adding one or two transporters improved ED access times by up to 9.8 minutes (Mann‐Whitney (MW) CI: [−11.0,−8.7]) and 10.3 minutes (MW CI [−11.5, −9.2]). The alternative creatinine and RN interventions provided 3‐minute (MW CI: [−4.0, −2.0]) and 8.5‐minute (MW CI: [−9.7, −8.3]) improvements.

Conclusions

Adding one transporter provided the greatest combination of reduced delay and ability to implement. The projected simulation improvements have been realized in practice.
Robust estimates of insurance misrepresentation through kernel quantile regression mixtures
Authors: Li Hong , Song Qifan , Su Jianxi
Published: July 2021

This paper pertains to a class of nonparametric methods for studying the misrepresentation issue in insurance applications. For this purpose, mixture models based on quantile regression in reproducing kernel Hilbert spaces are employed. Compared with the existing parametric approaches, the proposed framework features a more flexible statistics structure which could alleviate the risk of model misspecification, and is in the meantime more robust to outliers in the data. The proposed framework can not only estimate the prevalence of misrepresentation in the data, but also help identify the most suspicious individuals for the validation purpose. Through embedding state‐of‐the‐art machine learning techniques, we present a novel statistics procedure to efficiently estimate the proposed misrepresentation model in the presence of massive data. The proposed methodology is applied to study the Medical Expenditure Panel Survey data, and a significant degree of misrepresentation activity is found on the self‐reported insurance status.
The problem of evil: An economic approach
Authors: Parro Francisco
Published: July 2021

This paper develops an economic model to study the philosophical problem of evil. God's creation of the world is modeled as a problem of optimal incentives. A principal (God) must choose a world so that the populating agents behave according to his benevolent objective. In a world, the physical environment resembles a contract that determines the rewards and punishments for different choices. The agents' behavioral rule determines how they respond to these incentives. I characterize a contract and a behavioral rule that solve the principal's problem, and evil is evidenced. Specifically, evil endogenously aligns the agents' actions with the principal's objective. Other insights on the origin, cause, and role of evil are also derived from the model. The result of this analysis is a theodicy arisen from an economic model. As a byproduct, this paper shows how an economic model can be used to study philosophical or theological questions.
Exploring paramedicine student preferences using Holland's vocational theory: A cross‐sectional study
Authors: van Huizen Pheona , Mason Rod , Williams Brett
Published: July 2021

Holland's RIASEC typology is a classification of vocational personality types and work environments. Having a predisposition for their vocation, in terms of a personality that is congruent to their work environment, may be protective for paramedics with regards to both their mental and physical health. The purpose of this study was to identify paramedicine students' vocational preference according to Holland's RIASEC model. Bachelor of Paramedicine degree students in the three different year levels completed the 48‐item Brief RIASEC Marker Scales to determine their order of the six RIASEC personality types. In this study, the paramedicine students' three most dominant personality types were Social‐Investigative‐Artistic, differing from the defined Holland Occupational Code for paramedics of Realistic‐Social‐Investigative. Male students scored significantly higher on the Reality personality type, whereas female students scored significantly higher on the Social personality type. Overall, this study found many students to possess two of the three dominant personality traits that form the desired Holland code for paramedics. This suggests that many students may be better able to cope with the demands of the paramedicine profession upon employment.
Pediatric KT in children up to 15 kg: A single‐center experience
Authors: Exeni Andrea Mariana , Falke German Fernando , Montal Silvina , Rigali María Paula , Cisnero Débora Raquel , Berberian Leandro , Marchionatti Sofia , Heredia Soledad , Allegrotti Hernán Eduardo , Torres Silvio Fabio , Russo Ricardo Daniel , Rozanec José
Published: July 2021

Background

KT is the preferred treatment for ESRD in pediatrics. However, it may be challenging in those weighing ≤15 kg with potential complications that impact on morbidity and graft loss.

Methods

This retrospective review reports our experience in KT in children, weighing ≤15 kg, and the strategies to reduce morbidity and mortality.

Results

All patients were on RRT prior to KT. Patients reached ESRD mainly due to urologic malformations (54.54%). LD was performed in 82% of patients. The recipient's median age was 2.83 years, and median weight 12.280 kg. Male sex was predominant (73%). All patients required transfusions of PRBCs. There was a high requirement for ventilated support in patients post‐KT with no relation to weight, amount of resuscitation used intra‐operatively or ml/kg of PRBCs.

One patient presented with stenosis of the native renal artery. No patients presented DGF, graft thrombosis, or surgical complications.

No association was found between cold ischemia and eGFR at 1 year (p = .12). In univariate analysis, eGFR at 1 year is related to AR. eGFR at 3 years is related to the number of UTI. Median follow‐up was 1363 days. Patient and graft survival were 100%.

Conclusions

KT in children ≤15 kg can be challenging and requires a meticulous perioperative management and surgical expertise. Patient and graft survival are excellent with low rate of complications.
The “Good Citizen” as a “Respectable Worker:” State, Unemployment, and Social Policy in the United Kingdom and Italy, 1930 to 1950
Authors: Mioni Michele
Published: July 2021

This article approaches “good citizenship(s)” in its historical connection with the status of “worker.” It scrutinizes how and to what extent the perception of the “good citizen” changed from the Great Depression to the foundations of the post‐war welfare state. It compares unemployment policies in the United Kingdom and Italy from the 1930s to the early 1950s, to grasp how these schemes reflected the shifting features of “good citizenship(s).” The article emphasizes policy legacies that reshaped citizenship and the attached social rights after 1945. These continuities rest in the link between the full participation to the political community and “work” as a distinguishing trait of the “good citizen” deserving social benefits. Apparently diluted by the post‐war “Marshallian consensus,” these deep‐seated understandings resurfaced with contemporary workfare systems. The connection between “good citizenship” and “work” lends itself to further transdisciplinary studies on the theoretical and political foundations of today's welfare systems.

Related Articles in this Special Issue

Barrault‐Stella, Lorenzo, and Thomas Douniès. 2021. “Introduction to the Special Issue: Citizenship as a Tool of Government in Europe.”Politics & Policy49 (4).

Ewert, Benjamin. 2021. “Citizenship as a Form of Anticipatory Obedience? Implications of Preventive Health Policy in Germany.”Politics & Policy49 (4).

Haapajärvi, Linda. 2021. “On the Importance of Playing House: Belonging‐Work and the Making of Relational Citizens in Finnish Immigrant Integration Policies.”Politics & Policy49 (4).
White rot of Panax quinquefolius caused by Sclerotinia nivalis
Authors: Wang Cong‐Hao , Shang Wen‐Jing , Wang Qiang , Fan San‐Hong , Subbarao Krishna V. , Xu Xiang‐Ming , Hu Xiao‐Ping
Published: July 2021

American ginseng (Panax quinquefolius), one of the most well‐known araliaceous perennial herbs, suffered from root rots and mortality in 2020 in Taibai County, Shaanxi Province, China, leading to 40%–60% yield losses. The diseased plants initially showed unevenly yellowing foliage, and yellow‐brownish, water‐soaked roots with internal softening. Subsequently, white fluffy mycelia manifested on the surface of diseased P. quinquefolius roots, followed by the appearance of black irregular sclerotia‐like bodies. In this study, a fungal isolate (SS‐TB, GenBank no. MT830866) was obtained from the infected roots. Based on the culture morphology, pathogenicity tests and phylogenetic analysis of the internal transcribed spacer (ITS) region, this isolate was identified as Sclerotinia nivalis. The optimum temperature for mycelial growth and sclerotial production was 20 ℃ and 15 ℃, respectively; the optimum pH for mycelial growth and sclerotial production was pH 6.0. This isolate grew faster and produced more sclerotia on potato dextrose agar than on other media. It infected ginseng roots with or without wounds, but inoculation of wounded roots led to more severe disease. S. nivalis also infected 43 of the 48 plant species tested, including vegetables, fruits, oil crops, and flowering plants from Fabaceae, Asteraceae, Solanaceae, Cucurbitaceae, Brassicaceae, Apiaceae, Rosaceae, Liliaceae, Chenopodiaceae, and Orchidaceae. It was nonpathogenic on Triticum aestivum, Zea mays, Anemone vitifolia, Ipomoea batatas, and Vaccinium sp. This study is the first report of S. nivalis causing white rot on P. quinquefolius.
Violation of rhythmic expectancies can elicit late frontal gamma activity nested in theta oscillations
Authors: Edalati M. , Mahmoudzadeh M. , Safaie J. , Wallois F. , Moghimi S.
Published: July 2021

Rhythm processing involves building expectations according to the hierarchical temporal structure of auditory events. Although rhythm processing has been addressed in the context of predictive coding, the properties of the oscillatory response in different cortical areas are still not clear. We explored the oscillatory properties of the neural response to rhythmic incongruence and the cross‐frequency coupling between multiple frequencies to further investigate the mechanisms underlying rhythm perception. We designed an experiment to investigate the neural response to rhythmic deviations in which the tone either arrived earlier than expected or the tone in the same metrical position was omitted. These two manipulations modulate the rhythmic structure differently, with the former creating a larger violation of the general structure of the musical stimulus than the latter. Both deviations resulted in an MMN response, whereas only the rhythmic deviant resulted in a subsequent P3a. Rhythmic deviants due to the early occurrence of a tone, but not omission deviants, seemed to elicit a late high gamma response (60–80 Hz) at the end of the P3a over the left frontal region, which, interestingly, correlated with the P3a amplitude over the same region and was also nested in theta oscillations. The timing of the elicited high‐frequency gamma oscillations related to rhythmic deviation suggests that it might be related to the update of the predictive neural model, corresponding to the temporal structure of the events in higher‐level cortical areas.
Ultrasonographic anatomy of the dorsal region of the carpus of the dog
Authors: González‐Rellán Sonia , Fdz‐de‐Trocóniz Patricia , Barreiro Andrés
Published: July 2021

The dorsal region of the canine carpus is anatomically complex and its normal ultrasonographic characteristics have not been published. The aims of this prospective, descriptive, anatomic study were (a) to describe the normal ultrasonographic appearance of the dorsal carpal structures in medium to large breed dogs, and (b) to describe a standardized protocol for evaluations. The final study, based on the methodology developed in a pilot study performed in twenty‐two carpi, comprised two phases: (a) identification phase, in which a correlation between ultrasound and dissection and anatomic slices was performed in forty‐eight cadaver carpi and the ultrasonographic protocol was developed; and (b) descriptive phase, in which the ultrasonographic characteristics of the examined structures in 23 carpi of 12 alive adult and healthy dogs were recorded. The tendons of the abductor pollicis longus and the extensor muscles of the carpus and digits, the dorsal ligaments of the carpus – including the medial and lateral collateral ligaments – the extensor retinaculum, a distal radioulnar fibrocartilage and the regional osseous surfaces were ultrasonographically identified and described. Findings from the current study can be used as a reference for ultrasonographic examinations in dogs with injuries or other diseases affecting the dorsal region of the carpus.
Effects of High-Intensity Interval Training on the Vascular and Autonomic Components of the Baroreflex at Rest in Adolescents
Authors: Oliveira Ricardo S. , Barker Alan R. , Kranen Sascha H. , Debras Florian , Williams Craig A.
Published: July 2021

Purpose: In a sample of healthy adolescents, the authors aimed to investigate the effects of high-intensity interval exercise (HIIE) training and detraining on baroreflex sensitivity (BRS) and it’s vascular and autonomic components at rest. Methods: Nineteen volunteers were randomly allocated to (1) 4 weeks HIIE training performed 3 times per week or (2) a control condition with no intervention for the same duration as HIIE training. PRE, POST, and following 2 weeks of detraining resting supine heart rate and blood pressure were measured, and a cross-spectral method (integrated gain [gain in low frequency]) was used to determine BRS gain. Arterial compliance (AC) was assessed as the BRS vascular component. LFgain divided by AC (LFgain/AC) was used as the autonomic determinant of BRS. Results: The HIIE training was completed with 100% compliance. HIIE did not change resting gain in low frequency (LFgain) (P = .66; effect size = 0.21), AC (P = .44; effect size = 0.36), or LFgain/AC (P = .68; effect size = 0.19) compared to control. Conclusion: Four weeks of HIIE training does not change BRS and its autonomic and vascular determinant in a sample of healthy adolescents at rest.
Renal and Hepatic Toxicity Analysis of Remdesivir Formulations: Does What Is on the Inside Really Count?
Authors: Shah Sunish , Ackley Tyler W. , Topal Jeffrey E.
Published: July 2021

It has been postulated that the injectable solution formulation of remdesivir could be more nephrotoxic than the lyophilized powder since it contains twice as much sulfobutylether-β-cyclodextrin (SBECD). Therefore, we evaluated 1,000 hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who received remdesivir lyophilized powder or solution.
Plasma and Breast Milk Pharmacokinetics of Tenofovir Disoproxil Fumarate in Nursing Mother with Chronic Hepatitis B-Infant Pairs
Authors: Erturk U. S. , Mete B. , Ozaras R. , Saltoglu N. , Balkan I. I. , Mert A. , Kacmaz B. , Saglam O. , Guney B. , Sayman O. A. , Tabak F.
Published: July 2021

Tenofovir use is associated with lower risk of mother-to-infant transmission of the virus, and discontinuation of the treatment is not safe. However, the safety of the drug during pregnancy and breastfeeding is not clear.
Late Paleoproterozoic mafic magmatism and the Kalahari craton during Columbia assembly
Authors: Djeutchou Cedric , de Kock Michiel O. , Wabo Hervé , Gaitán Camilo E. , Söderlund Ulf , Gumsley Ashley P.
Published: July 2021

The 1.87–1.84 Ga Black Hills dike swarm of the Kalahari craton (South Africa) is coeval with several regional magmatic provinces used here to resolve the craton's position during Columbia assembly. We report a new 1850 ± 4 Ma (U-Pb isotope dilution–thermal ionization mass spectrometry [ID-TIMS] on baddeleyite) crystallization age for one dike and new paleomagnetic data for 34 dikes of which 8 have precise U-Pb ages. Results are constrained by positive baked-contact and reversal tests, which combined with existing data produce a 1.87–1.84 Ga mean pole from 63 individual dikes. By integrating paleomagnetic and geochronological data sets, we calculate poles for three magmatic episodes and produce a magnetostratigraphic record. At 1.88 Ga, the Kalahari craton is reconstructed next to the Superior craton so that their ca. 2.0 Ga poles align. As such, magmatism forms part of a radiating pattern with the coeval ca. 1.88 Ga Circum-Superior large igneous province.
Presumed complement-mediated, checkpoint inhibitor-induced, thrombotic microangiopathy in a patient with metastatic melanoma
Authors: Muniz Thiago P. , Patriquin Christopher J. , Saibil Samuel D
Published: July 2021

Immune checkpoint inhibitors (ICIs) are associated with a variety of immune-related adverse events (irAEs), but haematological irAEs are rare. We report a case of presumed complement-mediated thrombotic microangiopathy (CM-TMA) in a 78-year-old man with metastatic melanoma following treatment with ICIs. Following two doses of combination nivolumab and ipilimumab therapy, he developed microangiopathic haemolytic anaemia, thrombocytopenia and increased creatinine. ADAMTS13 activity was preserved, CH50 was high, haptoglobin was depleted and a blood film demonstrated fragments. Given this constellation of findings, a diagnosis of CM-TMA was made. Immunotherapy was held and the patient received steroids and supportive care. Six months after his last dose of immunotherapy, he has no evidence of melanoma or CM-TMA. CM-TMA should be suspected in patients on ICI with unexplained anaemia and thrombocytopenia with preserved ADAMTS13 activity. Suspicion of complement dysregulation may have therapeutic implications, such as the necessity of complement pathway inhibition.
Impact evaluation of the Care Tipping Point Initiative in Nepal: study protocol for a mixed-methods cluster randomised controlled trial
Authors: Yount Kathryn M , Clark Cari Jo , Bergenfeld Irina , Khan Zara , Cheong Yuk Fai , Kalra Sadhvi , Sharma Sudhindra , Ghimire Shuvechha , Naved Ruchira T , Parvin Kausar , Al Mamun Mahfuz , Talukder Aloka , Laterra Anne , Sprinkel Anne
Published: July 2021

Introduction

Girl child, early and forced marriage (CEFM) persists in South Asia, with long-term consequences for girls. CARE’s Tipping Point Initiative (TPI) addresses the causes of CEFM by challenging repressive gender norms and inequalities. The TPI engages different participant groups on programmatic topics and supports community dialogue to build girls’ agency, shift inequitable power relations, and change community norms sustaining CEFM.

Methods/analysis

The Nepal TPI impact evaluation has an integrated, mixed-methods design. The quantitative evaluation is a three-arm, cluster randomised controlled trial (control; Tipping Point Programme (TPP); TPP+ with emphasised social norms change). Fifty-four clusters of ~200 households were selected from two districts (27:27) with probability proportional to size and randomised. A household census ascertained eligible study participants, including unmarried girls and boys 12–16 years (1242:1242) and women and men 25+ years (270:270). Baseline participation was 1134 girls, 1154 boys, 270 women and 270 men. Questionnaires covered agency; social networks/norms; and discrimination/violence. Thirty in-depth interviews, 8 key-informant interviews and 32 focus group discussions were held across eight TPP/TPP+ clusters. Guides covered gender roles/aspirations; marriage decisions; girls’ safety/mobility; collective action; perceived shifts in child marriage; and norms about girls. Monitoring involves qualitative interviews, focus groups and session/event observations over two visits. Qualitative analyses follow a modified grounded theory approach. Quantitative analyses apply intention to treat, regression-based difference-in-difference strategies to assess impacts on primary (married, marriage hazard) and secondary outcomes, targeted endline tracing and regression-based methods to address potential selection bias.

Ethics/dissemination

The Nepal Social Welfare Council approved CARE Nepal to operate in the study districts. Emory (IRB00109419) and the Nepal Health Research Council (161–2019) approved the study. We follow UNICEF and CARE guidelines for ethical research involving children and gender-based violence. Study materials are here or available on request. We will share findings through clinicaltrials.gov, CARE reports/briefs and publications.

Trial registration number

NCT04015856.
Determining a safe upper limit of oxygen supplementation for adult patients: a systematic review
Authors: Lassen Mathilde Languille , Risgaard Bjarke , Baekgaard Josefine S , Rasmussen Lars S
Published: July 2021

Objective

This systematic review aimed to describe the connection between the inspired oxygen fraction and pulmonary complications in adult patients, with the objective of determining a safe upper limit of oxygen supplementation.

Methods

MEDLINE and Embase were systematically searched in August 2019 (updated July 2020) for studies fulfilling the following criteria: intubated adult patients (Population); high fractions of oxygen (Intervention) versus low fractions of (Comparison); atelectasis, acute respiratory distress syndrome (ARDS), pneumonia and/or duration of mechanical ventilation (Outcome); original studies both observational and interventional (Studies). Screening, data extraction and risk of bias assessment was done by two independent reviewers.

Results

Out of 6120 records assessed for eligibility, 12 were included. Seven studies were conducted in the emergency setting, and five studies included patients undergoing elective surgery. Eight studies reported data on atelectasis, two on ARDS, four on pneumonia and two on duration of mechanical ventilation. There was a non-significant increased risk of atelectasis if an oxygen fraction of 0.8 or above was used, relative risk (RR): 1.37 (95% CI 0.95 to 1.96). One study showed an almost threefold higher risk of pneumonia in the high oxygen fraction group (RR: 2.83 (95% CI 2.25 to 3.56)). The two studies reporting ARDS and the two studies with data on mechanical ventilation showed no association with oxygen fraction. Four studies had a high risk of bias in one domain.

Conclusions

In this systematic review, we found inadequate evidence to identify a safe upper dosage of oxygen, but the identified studies suggest a benefit of keeping inspiratory oxygen fraction below 0.8 with regard to formation of atelectases.

PROSPERO registration number

CRD42020154242.
Role of community drug and alcohol services in physical healthcare for people who use illicit opioids: a qualitative study of clinical staff in the UK
Authors: Bradbury Molly , Lewer Dan
Published: July 2021

Objectives

To understand how clinicians working in addiction services perceive their responsibilities for physical healthcare of clients who use opioids, and how physical healthcare could be improved for this group.

Design

Qualitative study comprising semistructured interviews.

Participants

16 clinicians, including nurses and nurse practitioners, nurse consultants, addiction psychiatrists, specialist general practitioners and psychiatry specialty registrars.

Setting

Community-based drug and alcohol treatment services in the UK, with services including outpatient opioid agonist therapy.

Results

We identified three overarching themes. First, clients have unmet physical health needs that are often first identified in community drug and alcohol services. Participants reported attempts to improve their clients’ access to healthcare by liaising directly with health services and undertaking other forms of health advocacy, but report limited success, with many referrals ending in non-attendance. Second, most participants saw their role as supporting access to mainstream health services rather than providing physical healthcare directly, though sometimes reported frustration at being unable to provide certain treatments such as antibiotics for a respiratory infection. A minority of participants felt that people who use illicit opioids would be best served by an integrated ‘one-stop-shop’ model, but felt this model is currently unlikely to receive funding. Third, participants felt isolated from other health services, in part due to commissioning arrangements in which funding is provided through local government rather than the National Health Service.

Conclusions

Clinicians participating in this study serve a patient group with unmet physical health needs, but lack the resources to respond effectively to these needs.
Development of a Good Clinical Practice inspection checklist to assess clinical trial sites in Vietnam
Authors: Nguyen Quang Ngo , Nguyen Nam Vinh , Nguyen Dung Thi Phuong , Vidaillac Celine , Trinh Phuong Thi Minh , van Doorn H Rogier , Thwaites Guy E , Kestelyn Evelyne , Vo Ha Thi Nhi
Published: July 2021

Background

Assessing the capacity of a healthcare institution to conduct and manage clinical research studies is challenging, especially in developing countries where resources are limited. The objective of this study was to develop a practical and transparent tool for the Vietnam Ministry of Health (MOH) to assess institutions’ capacity to lead clinical trials in line with local and international regulations.

Methods

We reviewed the literature, relevant official international and national guidelines, regulations and checklists for clinical sites’ assessment to identify key indicators of clinical research capacity. We developed a Good Clinical Practice (GCP) inspection checklist consisting of a questionnaire with 30 key criteria, including 16 core criteria and 14 recommended criteria, related to four central aspects of clinical research management (ie, governance, operations, infrastructures and human resources). Following a detailed review and assessment by a panel of experts, sponsors and academic investigators, we assessed the checklist’s applicability in a pilot study involving 10 sites with various clinical research experiences.

Results

Independently of their clinical research experience, all participating institutions fulfilled most of the core criteria. In contrast, a significant variability was observed in the compliance to recommended capacity criteria, especially those related to governance (certifications and reporting) as well as operations (existence of a clinical research coordination unit or electronic trial management system).

Conclusions

A GCP inspection checklist was successfully developed to support the MOH in the assessment of institutions’ capacity to conduct clinical research. Additional efforts from all stakeholders are now warranted to provide local sites with sustainable capacity development resources that will further build up and harmonise Vietnamese clinical research settings.