bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate effects on size‐at‐age and growth rate of Chinook Salmon (Oncorhynchus tshawytscha) in the Fraser River, Canada
Authors: Xu Yi , Scott Decker A. , Parken Charles K. , Ritchie Lynda M. , Patterson David A. , Fu Caihong
Published: May 2020

Decline in size‐at‐age of Chinook Salmon (Oncorhynchus tshawytscha) has been observed for many populations across the entire Northeast Pacific Ocean, and identifying external drivers of this decline is important for sustainable management of these ecologically, economically, and culturally valuable resources. We assessed size‐at‐age of 96,939 Chinook Salmon sampled in the Fraser River watershed (Canada) from 1969 to 2017. A broad decline in size‐at‐age was confirmed across all population aggregates of Fraser River Chinook Salmon, in particular since year 2000. By developing a novel probability‐based approach to calculate age‐ and year‐specific growth rates for Fraser River Chinook Salmon and relating growth rates to environmental conditions in specific years through a machine learning method (boosted regression trees), we were able to disentangle multi‐year effects on size‐at‐age and thus identify environmental factors that were most related to the observed size‐at‐age of Chinook Salmon. Among 10 selected environmental variables, ocean salinity at Entrance Island in spring, the Aleutian Low Pressure Index and the North Pacific Current Bifurcation Index were consistently identified as important contributors for four of the seven age and population aggregate combinations. These top environmental contributors could be incorporated into future stock assessment and forecast models to improve Chinook Salmon fisheries management under climate change.
Enacting leadership professional development and the impediments to organizational and industry change in rural and regional Australia
Authors: Rowlands Julie , Blackmore Jill , Gallant Andrea
Published: May 2020

This article considers the potential for leadership development programmes (LDPs) that focus on individual leaders as change agents to facilitate change in rural and regional industries and organizations over time. The large‐scale study found that graduates returned to their workplaces following programme completion with a heightened sense of purpose and commitment to change. However, many female graduates in particular also found they were unable to lead change in the ways anticipated. The article draws on feminist organizational theory that sees organizations and industries as both gendered and gendering in terms of the production of particular leadership identities. The research confirms that gender change will not happen without executive leadership that removes structural and cultural impediments whilst proactively promoting inclusivity, but that even when all of those factors are present, change will not necessarily occur in gendered industries and organizations. The article concludes by identifying some factors that might potentially enable LDPs to better contribute to gender change in the future.
Complete multivariate flood frequency analysis, applied to northern Algeria
Authors: Karahacane Hafsa , Meddi Mohamed , Chebana Fateh , Saaed Hamoudi A.
Published: May 2020

Extreme hydrologic events are commonly described by several dependent characteristics, such as duration, volume and peak flow for floods. Traditionally in Algeria and North Africa, flood frequency analysis (FFA) is conducted as a univariate approach focusing separately on each single of flood characteristics. On the other hand, elsewhere, multivariate FFA studies have been conducted focusing on some FFA steps (especially modelling). The current study aims to consider complete multivariate FFA at‐site case studies in northern Algeria using 11 hydrometric stations. It is also among the first studies dealing with multivariate FFA in a complete way by considering all the required steps of the analysis (multivariate outliers detection, multivariate assumptions testing and copula fitting) and on datasets from Algeria. Multivariate stationarity, homogeneity and independence assumptions have been well verified before modelling. The Weibull distribution is mostly selected as margin distribution for the duration, volume and peak flow series. Frank, Clayton and Gumbel copulas are commonly selected to describe the dependence structure on the three flood pairs of variables. These findings should be interesting in water management and flood risk assessment in these regions. Combining these flood characteristics enables the design of more efficient hydraulic structures.
Borate bioactive glass prevents zoledronate‐induced osteonecrosis of the jaw by restoring osteogenesis and angiogenesis
Authors: Su Zhifei , Li Jiehang , Bai Xuan , Tay Franklin R. , Zhang Min , Liang Kunneng , He Libang , Yuan He , Li Jiyao
Published: May 2020

Objectives

Bisphosphonate‐related osteonecrosis of the jaw (BRONJ) is a severe complication of systemic nitrogen‐containing bisphosphonate (N‐BP) administration, which leads to osteonecrosis, pain, and infection. Despite much effort, effective remedies are yet to be established. This study aimed to investigate potential recovery effect of borate bioactive glass (BBG) in vitro and in vivo.

Methods

The effect of BBG on zoledronate‐treated bone marrow mesenchymal cells (BMSCs) and human umbilical vein endothelial cells (HUVECs) was explored by cell counting kit‐8, EdU assay, flow cytometry, alkaline phosphatase staining, alizarin red staining, angiogenesis experiment, and real‐time quantitative polymerase chain reaction. The preventive effect of BBG on zoledronate‐induced osteonecrosis of the jaw in rat model was examined by micro‐CT, HE staining, and immunohistochemistry.

Results

Exposure of BBG to BMSCs and HUVECs increased cell proliferation and restored their osteogenesis and angiogenesis potential in vitro. The BRONJ lesions were satisfactorily repaired and bone mineral density, bone volume/tissue volume, trabecula number, OCN‐positive cells, and CD31‐positive cells were increased in the BBG‐treated groups compared with saline‐treated groups.

Conclusions

Exposure of BMSCs and HUVECs to BBG restores osteogenesis and angiogenesis inhibited by zoledronate. BBG successfully restores extraction socket healing of BRONJ in rat model.
Health‐related quality of life among siblings of kidney transplant recipients
Authors: Velasco Jenny , Ferraris Jorge Roberto , Eymann Alfredo , Ghezzi Lidia Florinda Rosa , Coccia Paula A. , Ferraris Verónica
Published: May 2020

Studies are increasingly recognizing health‐related quality of life (HRQOL) as a key pediatric outcome in both clinical and research settings and an essential health outcome measure to assess the effectiveness of medical treatment. However, it has not yet been studied among the healthy siblings of kidney transplant recipients. The aim of this study, therefore, is to examine HRQOL among this population. We asked the following three groups to complete a validated measure of HRQOL among children (KIDSCREEN‐52): siblings of children who had received kidney transplants (n = 50), kidney transplant recipients (n = 43), and a healthy control group (n = 84). We found that siblings of kidney transplant patients exhibited lower scores for financial resources and autonomy than kidney transplant recipients. They also served lower on physical well‐being, financial resources, autonomy, and parent relations/home life than the control group. However, they scored higher on social acceptance than kidney transplant recipients. Our study underscores the importance of assessing HRQOL in families including a child diagnosed with a chronic illness. Siblings require social and psychological support to promote coping and adaptation.
Ralstonia solanacearum preferential colonization in the shoot apical meristem explains its pathogenicity pattern in tomato seedlings
Authors: Kabyashree Kristi , Kumar Rahul , Sen Piyali , Satapathy Siddhartha S. , Ray Suvendra K.
Published: May 2020

Ralstonia solanacearum causes a lethal bacterial wilt disease in many plants by colonizing the vascular tissues of the hosts. Upon inoculation of tomato seedlings through either leaf or root, the wilting symptoms occur first at the apical region and then proceed downward along the shoot. The systemic order of the disease initiation and progression in the host, independent of the site of pathogen inoculation, is yet to be investigated. To understand the disease progression more clearly, we have carried out a systematic study of the pathogen localization by GUS staining of inoculated tomato seedlings, at 24‐hour intervals from 0 days post‐inoculation (dpi) to 5 dpi. In both inoculation methods, pathogen colonization was observed at 1 dpi at the apical meristem as well as the cotyledon leaves, where the disease initiates. As the disease progressed, colonization by the pathogen towards the lower region of the shoot was observed. Disease consistency and pathogenicity magnitude were observed to be higher using the leaf inoculation method than the root inoculation method. Several R. solanacearum transposon‐induced mutants that were reduced in virulence by root inoculation but virulent by leaf inoculation were obtained. Using GUS staining, it was observed that these mutants were unable to localize in the shoot region when inoculated in the root. Our study indicates that the apical meristem and the cotyledon leaves are the first regions to be colonized in inoculated tomato seedlings, which might explain the disease initiation from this region.
Two androecious mutations reveal the crucial role of ethylene receptors in the initiation of female flower development in Cucurbita pepo
Authors: García Alicia , Aguado Encarnación , Garrido Dolores , Martínez Cecilia , Jamilena Manuel
Published: May 2020

Ethylene is the key regulator of sex determination in monoecious species of the family Cucurbitaceae. This hormone determines which individual floral meristems develop as female or male flowers and the female flowering transition. The sex determination genes discovered so far code for ethylene biosynthesis enzymes, but little is known about the importance of ethylene signaling components. In this paper we characterize two novel ethylene‐insensitive mutations (etr1a‐1 and etr1b) which block the female flowering transition of Cucurbita pepo; this makes plants produce male flowers indefinitely (androecy). Two missense mutations in the ethylene‐binding domain of the ethylene receptors CpETR1A or CpETR1B were identified as the causal mutations of these phenotypes by using whole‐genome resequencing. The distinctive phenotypes of single and double mutants for four etr mutations have demonstrated that the final level of ethylene insensitivity depends upon the strength and dosage of mutant alleles for at least three cooperating ETR genes, and that the level of ethylene insensitivity determines the final sex phenotype of the plant. The sex phenotype ranges from monoecy in ethylene‐sensitive wild‐type plants to androecy in the strongest ethylene‐insensitive ones, via andromonoecy in partially ethylene‐insensitive plants. The induction of female flowering transition was found to be associated with upregulation of CpACS11, CpACO2 and CpACS27, three ethylene biosynthesis genes required for female flower development. A model is proposed herein, integrating both ethylene biosynthesis and receptor genes into the genetic network which regulates sex determination in C. pepo.
Different growth kinetics in blood components and genetic analysis of Lactococcus garvieae isolated from platelet concentrates
Authors: Kozakai Moe , Matsumoto Chieko , Matsumoto Mami , Takakura Akiko , Matsubayashi Keiji , Satake Masahiro
Published: May 2020

BACKGROUND

In 2014, we experienced the first isolation of Lactococcus garvieae from a platelet concentrate (PC). Thereafter, L. garvieae contamination of PCs occurred in two more cases in Japan. It is rare that bacterial contamination with uncommon strains like this species occurs frequently within a short period. Therefore, we performed a detailed analysis of the characteristics of these strains.

STUDY DESIGN AND METHODS

Three bacterial strains were identified by biochemical testing and molecular analysis. Genomic diversity was characterized by multilocus sequence typing (MLST). To observe growth kinetics in blood components, PCs were inoculated with the three different strains.

RESULTS

All three strains were identified as L. garvieae by molecular analysis. Each strain belonged to a different phylogenetic group according to MLST analysis. In the spiking trial, the three strains demonstrated differences in their final concentrations and changes in appearance of PCs.

CONCLUSION

In this study, all three L. garvieae strains were correctly identified by molecular analysis. Since the three strains were collected in different regions of Japan and belonged to different phylogenetic groups according to MLST analysis, it is suggested that L. garvieae have a wide distribution with diversity in Japan. In PCs, the three L. garvieae strains showed clear differences in growth kinetics and changes in appearance of PCs. These differences may have been the primary determinant of whether PC contamination was detected before transfusion. Moreover, L. garvieae represents an emerging foodborne bacterium that can cause transfusion‐transmitted bacteremia. Understanding our cases may help prevent bacterial contamination of blood products.
Hypotheses on Leadership Decapitation
Authors: Jordan Jenna
Published: May 2020

Chapter 3 introduces the dataset created for this study and explains the measures used to assess the efficacy of leadership targeting. It develops hypotheses to answer the following questions: Does decapitation result in organizational collapse? Does decapitation have an effect upon the occurrence and frequency of terrorist attacks? Does decapitation increase or shorten a group’s life span? The following variables are examined to determine whether they are correlated with the efficacy of decapitation: position of a leader within the organization, the type of decapitation, organizational variables (size, age, or type), GDP, and regime type. Data on the survival rate of targeted and nontargeted groups is also analyzed to determine whether decapitation is an effective means by which to reduce organization’s life span.
Conclusion
Authors: Jordan Jenna
Published: May 2020

The book concludes with a discussion of the overall findings and theoretical arguments regarding the efficacy of leadership targeting. It then examines 198 instances of targeting efforts against ISIS leaders. The theory suggests that targeting is not likely to result in the demise or even a significant weakening of ISIS. It is an Islamist organization, bureaucratized, and with considerable amounts of communal support, albeit decentralized and in many cases coerced. Even if Abu Bakr al-Baghdadi is captured or killed and the organization undergoes a brief period of disruption, given the group’s hierarchy of authority and chain of command, it should ultimately choose a successor easily and recover quickly. Furthermore, the statistical results regarding the resilience of large and Islamist organization is consistent with ISIS’s resilience. The chapter concludes with policy recommendations regarding the use and impact of leadership decapitation as a counterterrorism policy.
The Sacred Cause
Authors: Needell Jeffrey
Published: May 2020

This work is focused on the abolitionist movement in Rio de Janeiro. It offers a careful reconstruction of the movement’s context and evolution in Rio, and the related formal parliamentary history. An understanding of the nature of the political parties of the Brazilian monarchy, the role of the crown, and the significance of ideology and individual statesmen has been brought to bear in order to comprehend how the regime actually interacted with abolitionism and how both the movement and the regime shaped each other as a consequence. One cannot understand the movement’s history as something apart from the elite political world that it challenged and changed. A central element in this study is an examination of the role of racial identity and racial solidarity in the abolitionist movement’s history. Previous analyses of the movement have always argued that the movement was an urban, middle-class, white movement (with a few significant Afro-Brazilian leaders), one that only gathered Afro-Brazilian mass support over time. A more careful analysis of the evidence transforms our understanding, disclosing Afro-Brazilian middle-class membership and the Afro-Brazilian masses present and mobilized in the movement from its beginning to its end.
This study interweaves the imperial capital’s Afro-Brazilian components, its parliament and monarchy, and the nature and evolution of a reformist movement. It explains how the seemingly impossible was made possible: how an urban political movement ended slavery and did so within the confines of a monarchy dominated and maintained by elite
Legacies and Oblivion
Authors: Needell Jeffrey D.
Published: May 2020

This chapter analyzes the constitutional issues raised by the law, its impact, the monarchy’s fall, race relations after that fall, and the fate of key Abolitionist leaders. It examines the law in the context of constitutional history, ranging from the emperor’s role to the monarchy’s transformation and the consequences for either the parties’ collapse or institutional and national transformation. It explains the divisions among the Conservatives, how the Abolitionists’ further reforms were forestalled, and why João Alfredo fell, to be followed by an incompetent Liberal cabinet and the 1889 coup that ended the monarchy and set up an oligarchical republic. It pursues the issue of the movement’s Afro-Brazilian solidarity and its apparent failure to affect Brazilian racism under the republic. It concludes with an account of the key Abolitionist leaders’ fates and posterity’s assessment, with its obscurity and its relationship to the detail of the movement’s complicated, interwoven history.
The Connected Condition
Authors: Igarashi Yohei
Published: May 2020

How can Romantic poetry, motivated by the poet’s intense yearning to impart his thoughts and feelings, be so often difficult and the cause of readerly misunderstanding? How did it come to be that a poet can compose a verbal artwork, carefully and lovingly put together, and send it out into the world at the same time that he is adopting a stance against communication? This book addresses these questions by showing that the period’s writers were responding to the beginnings of our networked world of rampant mediated communication. The Connected Condition reveals that major Romantic poets shared a great attraction and skepticism toward the dream of perfectible, efficient connectivity that has driven the modern culture of communication. Samuel Taylor Coleridge, William Wordsworth, Percy Shelley, and John Keats all experimented with their artistic medium of poetry to pursue such ideals of speedy, transparent communication at the same time that they tried out contrarian literary strategies: writing excessively ornate verse, prolonging literary reading with tedious writing, being obscure, and questioning the allure of quickly delivered information. This book shows that the Romantic poets have much to teach us about living in—and living with—the connected condition, as well as the fortunes of literature in it.
Conclusion
Authors: Igarashi Yohei
Published: May 2020

The conclusion offers a theory of literariness based on the “dream of communication” discussed in this study. The conclusion goes on to discuss Walter J. Ong’s critique of the “media model” of communication, Roman Jakobson’s definition of poetic communication, and Jonathan Culler’s idea of “literary competence.” Responding to these other theories, this chapter ultimately recommends a new kind of literary competence for today, one that would include a sensitivity to the different forms of verbal communication in our media-saturated environment.
Soccer Artistry and the Secret Police
Authors: Scott Erik R.
Published: May 2020

Among Soviet footballers, Georgians were known to represent a flamboyant, artistic, and ethnic style likened to the “beautiful game” played by successful South American teams. Georgian football and the mythology surrounding it emerged from the encounter between a centralizing imperial Soviet state and an assertive Georgian republic. The republic’s footballers gained global recognition during the Cold War, both as stars of the Soviet national team and the dominant Dinamo Tbilisi side that defeated top European clubs. Moscow sought to ensure that Georgian difference on the pitch served the needs of the state by showcasing multiethnic Socialist harmony for international audiences. Simultaneously, the Soviet promotion of Georgian soccer backfired, as supporters in Georgia claimed its successes as evidence of their own national triumph.
Eulogy to Theft
Authors: McDougall Alan
Published: May 2020

One club towered above all others in the final decade of East German football. Berliner FC Dynamo (BFC), the team sponsored by the secret police (Stasi), won the league title for ten straight seasons between 1979 and 1988, often in highly controversial circumstances. BFC’s success triggered unprecedented nationwide protests. This essay examines these protests, situating BFC’s hegemony in the complex web of domestic club rivalries and the transnational framework of Cold War sport. The BFC problem symbolized a deep popular disillusionment with “existing socialism” and ultimately prefaced the demise of Communist rule in 1989.
Ambivalent Solidarities
Authors: Elsey Brenda
Published: May 2020

This essay examines the way in which the Cold War shaped the use of sport as a tool of diplomacy in Latin America during the 1950s. It focuses on the Pan American Games in Argentina, Mexico, and the United States. Cultural exchanges failed to dispel suspicion of US intervention; however, athletes shared experiences beyond diplomatic agendas. Recent research has examined how international events shaped participants’ understanding of national, racial, and gender identities. By focusing on women athletes, who historically occupied precarious positions as representatives of the nation, and examining interactions among Latin American delegations, we can understand the Pan American Games as a site of grassroots diplomacy.
Case clustering emerges as key pandemic puzzle
Authors: Kupferschmidt Kai
Published: May 2020

Why do some patients infect many others, whereas many don't spread the virus at all?
Tropical forests store carbon despite warming
Authors: Pennisi Elizabeth
Published: May 2020

But if global temperatures reach key threshold, dying trees will release warming gases.
Butterflies and the people who love them
The Language of Butterflies
Wendy Williams
Simon and Schuster, 2020. 240 pp.
Authors: Agrawal Anurag A.
Published: May 2020

A meandering investigation hints at how much is left to learn about these charismatic insects
John Horton Conway (1937–2020)
Authors: Baker Matt
Published: May 2020

Innovative mathematician and passionate educator
Suspend tests and rankings
Authors: Thorp H. Holden
Published: May 2020

The notion that U.S. colleges and universities will open this fall in “normal” mode should not be in any forecast. As Dr. Anthony Fauci (of the White House's coronavirus task force) testified last week before the Senate, it's unlikely that a vaccine or treatments for coronavirus disease 2019 (COVID-19) will be available by the time students return to campus. I sympathize with the predicament of college and university administrators who need to reopen in ways that are safe and supportive for all their students while also planning for the possibility that they won't be able to reopen in-person classes. To help them grapple with this, let's suspend two things, at least temporarily—test scores and rankings.
Early warning scores for detecting deterioration in adult hospital patients: systematic review and critical appraisal of methodology
Authors: Gerry Stephen , Bonnici Timothy , Birks Jacqueline , Kirtley Shona , Virdee Pradeep S , Watkinson Peter J , Collins Gary S
Published: May 2020

Objective

To provide an overview and critical appraisal of early warning scores for adult hospital patients.

Design

Systematic review.

Data sources

Medline, CINAHL, PsycInfo, and Embase until June 2019.

Eligibility criteria for study selection

Studies describing the development or external validation of an early warning score for adult hospital inpatients.

Results

13 171 references were screened and 95 articles were included in the review. 11 studies were development only, 23 were development and external validation, and 61 were external validation only. Most early warning scores were developed for use in the United States (n=13/34, 38%) and the United Kingdom (n=10/34, 29%). Death was the most frequent prediction outcome for development studies (n=10/23, 44%) and validation studies (n=66/84, 79%), with different time horizons (the most frequent was 24 hours). The most common predictors were respiratory rate (n=30/34, 88%), heart rate (n=28/34, 83%), oxygen saturation, temperature, and systolic blood pressure (all n=24/34, 71%). Age (n=13/34, 38%) and sex (n=3/34, 9%) were less frequently included. Key details of the analysis populations were often not reported in development studies (n=12/29, 41%) or validation studies (n=33/84, 39%). Small sample sizes and insufficient numbers of event patients were common in model development and external validation studies. Missing data were often discarded, with just one study using multiple imputation. Only nine of the early warning scores that were developed were presented in sufficient detail to allow individualised risk prediction. Internal validation was carried out in 19 studies, but recommended approaches such as bootstrapping or cross validation were rarely used (n=4/19, 22%). Model performance was frequently assessed using discrimination (development n=18/22, 82%; validation n=69/84, 82%), while calibration was seldom assessed (validation n=13/84, 15%). All included studies were rated at high risk of bias.

Conclusions

Early warning scores are widely used prediction models that are often mandated in daily clinical practice to identify early clinical deterioration in hospital patients. However, many early warning scores in clinical use were found to have methodological weaknesses. Early warning scores might not perform as well as expected and therefore they could have a detrimental effect on patient care. Future work should focus on following recommended approaches for developing and evaluating early warning scores, and investigating the impact and safety of using these scores in clinical practice.

Systematic review registration

PROSPERO CRD42017053324.
Accidental poisoning, intentional self-harm and event of undetermined intent mortality over 20 years in Iceland: a population-based cohort study
Authors: Gunnarsdottir Oddny Sigurborg , Rafnsson Vilhjálmur
Published: May 2020

Objectives

The aim was to study mortality due to suicide, accidental poisoning, event of undetermined intent and drug-related deaths through 20 years in Iceland.

Design

A population-based register study.

Participants

Individuals who died due to road traffic injury, suicide, accidental poisoning, event of undetermined intent and drug-related deaths in the population of Iceland during the years 1996–2015. Annual age-standardised rates were calculated, and the trend analysed by Pearson correlation and joinpoint regression.

Setting

The population of Iceland framed the study material, and the data were obtained from nationwide registries for information on number of deaths and age-specific mean population in each year by gender.

Results

The crude overall suicide rate during the last 10 years was 12.2 per 100 000 persons per year (95% CI 7.4 to 18.1), while the crude overall rate due to road traffic injuries was 4.6 per 100 000 persons per year (95% CI 2.0 to 8.3). Among men, suicide rates decreased, however not significantly (r(19)=−0.22, p=0.36), and for overdose by narcotics the rates increased significantly (r(19)=0.72, p<0.001) during the study period. Among women, the suicide rates increased, however not significantly (r(19)=0.35, p=0.13), for accidental poisoning, suicide and event of undetermined intent combined the rates increased significantly (r(19)=0.60, p=0.006); and the rates for overdose by sedative and overdose by narcotics both increased significantly r(19)=0.49, p=0.03, and r(19)=0.67, p=0.001, respectively.

Conclusion

The suicide rates have not changed during 1996 to 2015; however, the rates for the combined accidental poisoning, suicide and event of undetermined intent increased significantly for women. The rise of the overdose rates for sedative among women and for narcotics among both genders are consistent with reports elsewhere.
Understanding the patient experience of early unplanned hospital readmission following acute care discharge: a qualitative descriptive study
Authors: Considine Julie , Berry Debra , Sprogis Stephanie K , Newnham Evan , Fox Karen , Darzins Peteris , Rawson Helen , Street Maryann
Published: May 2020

Objectives

To understand from a patient and carer perspective: (1) what features of the discharge process could be improved to avoid early unplanned hospital readmission (within 72 hours of acute care discharge) and (2) what elements of discharge planning could have enhanced the discharge experience.

Design

A qualitative descriptive design was used. Study data were collected using semi-structured interviews that were transcribed verbatim and analysed using inductive thematic analysis. Data related to participant characteristic were collected by medical record audit and summarised using descriptive statistics.

Setting

Three acute care hospitals from one health service in Australia.

Participants

Patients who had an early unplanned hospital readmission and/or their carers, if present during the interviews and willing to participate, with patient permission.

Findings

Thirty interviews were conducted (23 patients only; 6 patient and carer dyads; 1 carer only). Five themes were constructed: ‘experiences of care’, ‘hearing and being heard’, ‘what’s wrong with me’, ‘not just about me’ and ‘all about going home’. There was considerable variability in patients’ and carers’ experiences of hospital care, discharge processes and early unplanned hospital readmission. Features of the discharge process that could be improved to potentially avoid early unplanned hospital readmission were better communication, optimal clinical care including ensuring readiness for discharge and shared decision-making regarding discharge timing and goals on returning home. The discharge experience could have been enhanced by improved communication between patients (and carers) and the healthcare team, not rushing the discharge process and a more coordinated approach to patient transport home from hospital.

Conclusions

The study findings highlight the complexities of the discharge process and the importance of effective communication, shared decision-making and carer engagement in optimising hospital discharge and reducing early unplanned hospital readmissions.
Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol
Authors: Evans Catrin , Poku Brenda , Pearce Ruth , Eldridge Jeanette , Hendrick Paul , Knaggs Roger , McLuskey John , Tomczak Philippa , Thow Ruaridh , Harris Peter , Conway Joy , Collier Richard
Published: May 2020

Introduction

A global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.

Methods and analysis

This scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).

Dissemination

The review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.
Understanding quality systems in the South African prehospital emergency medical services: a multiple exploratory case study
Authors: Howard Ian , Cameron Peter , Wallis Lee , Castrén Maaret , Lindström Veronica
Published: May 2020

Introduction

In South Africa (SA), prehospital emergency care is delivered by emergency medical services (EMS) across the country. Within these services, quality systems are in their infancy, and issues regarding transparency, reliability and contextual relevance have been cited as common concerns, exacerbated by poor communication, and ineffective leadership. As a result, we undertook a study to assess the current state of quality systems in EMS in SA, so as to determine priorities for initial focus regarding their development.

Methods

A multiple exploratory case study design was used that employed the Institute for Healthcare Improvement’s 18-point Quality Program Assessment Tool as both a formative assessment and semistructured interview guide using four provincial government EMS and one national private service.

Results

Services generally scored higher forstructureandplanning. Measurementandimprovementwere found to be more dependent on utilisation and perceived mandate. There was a relatively strong focus on clinical quality assessment within the private service, whereas in the provincial systems, measures were exclusively restricted to call times with little focus on clinical care.Staff engagementandprogramme evaluationwere generally among the lowest scores. A multitude of contextual factors were identified that affected the effectiveness of quality systems, centred around leadership, vision and mission, and quality system infrastructure and capacity, guided by the need for comprehensive yet pragmatic strategic policies and standards.

Conclusion

Understanding and accounting for these factors will be key to ensuring both successful implementation and ongoing utilisation of healthcare quality systems in emergency care. The result will not only provide a more efficient and effective service, but also positively impact patient safety and quality of care of the services delivered.
Mechanical ventilation withdrawal in motor neuron disease: an evaluation of practice
Authors: Faull Christina , Wenzel David
Published: May 2020

Objectives

Clinicians report that withdrawal of mechanical ventilation in motor neuron disease is challenging. We report on the evaluation of the process and outcomes called for by the Association for Palliative Medicine of Great Britain and Ireland (APM) guidance.

Methods

Excel analysis of a core data set, defined in the APM guidance, and thematic analysis of free-text comments, submitted by a UK clinician soon after withdrawal of mechanical ventilation in any care setting.

Results

Thirty-seven professionals submitted 46 data sets from 4 patients with tracheostomy ventilation (TV) and 42 with non-invasive ventilation (NIV) in 35 months. These took place at home (43%), inpatient hospice (48%), hospital and care homes. Eighty-nine per cent received opioid and/or sedative medication at the initiation of withdrawal, majority of which were subcutaneous. A median of 2 doses (range 1–9) were used to manage symptoms before ventilation withdrawal. Subsequently 73% of patients required either none or one dose of medication. In addition to any background opioid, symptom management required a total parenteral morphine equivalent mean of 20.6 mg (range 0–60 mg) and midazolam mean of 25.8 mg (range 0–120 mg). The median time from first medication to removal of mechanical ventilation was 45 min. Patients with TV died within 30 min of withdrawal. The mode (14 of 42 patients) time to death after NIV withdrawal was 15 min, but ranged between <15 min and 54 hours.

Conclusions

Individualised, proportionate, titrated opioid and sedative medications were used to provide good symptom management, and provided new insight into the substantial variability in what patients require to manage their symptoms and how long the process takes. Most patients required lower doses than in previous literature.
PD-L1 targeting high-affinity NK (t-haNK) cells induce direct antitumor effects and target suppressive MDSC populations
Authors: Fabian Kellsye P , Padget Michelle R , Donahue Renee N. , Solocinski Kristen , Robbins Yvette , Allen Clint T. , Lee John H. , Rabizadeh Shahrooz , Soon-Shiong Patrick , Schlom Jeffrey , Hodge James W
Published: May 2020

Background

Although immune checkpoint inhibitors have revolutionized cancer treatment, clinical benefit with this class of agents has been limited to a subset of patients. Hence, more effective means to target tumor cells that express immune checkpoint molecules should be developed. For the first time, we report a novel natural killer (NK) cell line, programmed death-ligand 1 (PD-L1) targeting high-affinity natural killer (t-haNK), which was derived from NK-92 and was engineered to express high-affinity CD16, endoplasmic reticulum-retained interleukin (IL)-2, and a PD-L1-specific chimeric antigen receptor (CAR). We show that PD-L1 t-haNK cells also retained the expression of native NK receptors and carried a high content of granzyme and perforin granules.

Methods

NanoString, flow cytometry, and immunofluorescence analyses were performed to characterize the phenotype of irradiated PD-L1 t-haNK cells. In vitro PD-L1 t-haNK cell activity against cancer cell lines and human peripheral blood mononuclear cells (PBMCs) was determined via flow-based and111In-release killing assays. The antitumor effect of PD-L1 t-haNK cells in vivo was investigated using MDA-MB-231, H460, and HTB1 xenograft models in NOD-scid IL2Rgammanull(NSG) mice. Additionally, the antitumor effect of PD-L1 t-haNK cells, in combination with anti-PD-1 and N-803, an IL-15 superagonist, was evaluated using mouse oral cancer 1 syngeneic model in C57BL/6 mice.

Results

We show that PD-L1 t-haNK cells expressed PD-L1-targeting CAR and CD16, retained the expression of native NK receptors, and carried a high content of granzyme and perforin granules. In vitro, we demonstrate the ability of irradiated PD-L1 t-haNK cells to lyse 20 of the 20 human cancer cell lines tested, including triple negative breast cancer (TNBC) and lung, urogenital, and gastric cancer cells. The cytotoxicity of PD-L1 t-haNK cells was correlated to the PD-L1 expression of the tumor targets and can be improved by pretreating the targets with interferon (IFN)-γ. In vivo, irradiated PD-L1 t-haNK cells inhibited the growth of engrafted TNBC and lung and bladder tumors in NSG mice. The combination of PD-L1 t-haNK cells with N-803 and anti-PD-1 antibody resulted in superior tumor growth control of engrafted oral cavity squamous carcinoma tumors in C57BL/6 mice. In addition, when cocultured with human PBMCs, PD-L1 t-haNK cells preferentially lysed the myeloid-derived suppressor cell population but not other immune cell types.

Conclusion

These studies demonstrate the antitumor efficacy of PD-L1 t-haNK cells and provide a rationale for the potential use of these cells in clinical studies.
Knowledge Management for Climate Change Adaptation to Enhance Urban Agriculture Among Selected Organisations in Zimbabwe
Authors: Chisita Collence Takaingenhamo , Fombad Madeleine
Published: May 2020

Just like any other country in the world, Zimbabwe is vulnerable to climate change because of its position in a semi-arid exposed temperature variations among other vulnerabilities. The paper draws on various definitions, studies, policies and frameworks for knowledge management as the basis for recommending knowledge management strategy for climate change adaptation to enhance urban farming in Harare. It seeks to build on the existing knowledge management strategies for climate change adaptation to enhance urban farming in Harare. Currently, knowledge management strategies for climate change adaptation among selected environmental organisations and libraries in Zimbabwe are not being leveraged to actualise national development goals, however this paper seeks to examine these strategies in order to support urban farming. A well-coordinated national knowledge management strategy for climate change adaptation can contribute towards sustainable urban farming. The paper seeks to recommend knowledge management strategy for climate change adaptation among urban farmers in Harare.
R&D Investments and Strategic Use of Financial Models
Authors: Harris Wesley L. , Wonglimpiyarat Jarunee
Published: May 2020

Given that making research and development (R&D) investments has the potential to generate high profits in the future, this research aims to discuss the merits and demerits of using the major financial models — net present value (NPV), internal rate of return (IRR) and Black–Scholes — in assessing R&D investments. The study follows the appreciative theorizing to examine the strategic implications of financial models for managing R&D and building firm’s competitiveness. Conclusively, the analyses point out how conventional financial models fail to recognize the importance of strategic positioning as there are limits in terms of using the quantified approaches to measure the performance of R&D investments. The main contribution of this paper is the insights as well as the comprehensive and deeper understanding of using the financial models for evaluating investments in new technologies.
Optimizing Design of Fuzzy Model for Software Cost Estimation Using Particle Swarm Optimization Algorithm
Authors: Chhabra Sonia , Singh Harvir
Published: May 2020

Estimation of software cost and effort is of prime importance in software development process. Accurate and reliable estimation plays a vital role in successful completion of the project. To estimate software cost, various techniques have been used. Constructive Cost Model (COCOMO) is amongst most prominent algorithmic model used for cost estimation. Different versions of COCOMO consider different types of parameters affecting overall cost. Parameters involved in estimation using COCOMO possess vagueness which introduces some degree of uncertainty in algorithmic modelling. The concept of fuzzy logic can deal with uncertainty involved in Intermediate COCOMO cost driver measurements via Fuzzy Inference System (FIS). In the proposed research, an effort has been made wherein, for each cost driver, an FIS is designed to calculate the corresponding effort multiplier. Proposed research provides an insight through evolutionary-based optimization techniques to optimize fuzzy logic-based COCOMO using Particle Swarm Optimization Algorithm. The magnitude of relative error and its mean, calculated using COCOMO NASA2 and COCOMONASA datasets are used as evaluation metrics to validate the proposed model. The model outperforms when compared to other optimization techniques like Genetic Algorithm.
Time bounded adaptive information coverage in social networks
Authors: Fan Lidan , Zhang Linlan
Published: May 2020

In this paper, we study the time-bounded adaptive information coverage problem with myopic feedback (TBAIC) under a variant of the independent cascade (IC) model. In practical applications, time or deadline is a critical factor to evaluate the effectiveness of a strategy. Along this line, with considering deadline [Formula: see text], we sequentially select [Formula: see text] ([Formula: see text]) nodes as seed nodes, one at a time step, from a social network, and after a seed is selected at step [Formula: see text], it reveals the set of its activated neighbors, which will be valuable information for selecting subsequent seeds. On the other hand, during information propagation, if an active node fails to activate its neighbors, though not become active, those neighbors will know the information and may become active at a later step, we name them as covered nodes. In terms of information coverage, those covered nodes also make contributions. Therefore, our problem aims to choose a policy to maximize the expected cumulative number of both active and covered nodes throughout the time within deadline. We prove that our problem is adaptive monotone and adaptive submodular, which guarantees the adaptive greedy policy with myopic feedback to achieve an approximation ratio of [Formula: see text]. Additionally, we propose two algorithms to speed up the greedy policy.
Overcharge and Aging Analytics of Li-Ion Cells
Authors: Juarez-Robles Daniel , Vyas Anjul Arun , Fear Conner , Jeevarajan Judith A. , Mukherjee Partha P.
Published: May 2020

Overcharge presents a serious safety concern for large scale applications of Li-ion batteries. Despite the availability of several studies of aging-induced and overcharge-induced degradation, there still exists a knowledge gap of what would happen if both degradation mechanisms simultaneously occur. In this work, commercial graphite/LCO pouch cells (5 Ah) are continuously cycled at different upper cutoff voltages, 4.2 through 4.8 V, to elucidate the cumulative effect of the overcharge process on the long-term cycling. As the upper cutoff voltage is extended, the cell gains a higher initial capacity but the cycle life diminishes significantly. Cells overcharged beyond 4.5 V experience significant volume expansion and a high rate of capacity fade, as well as a considerable increase in the temperature and internal resistance. Lithium plating and electrolyte decomposition are observed in cells charged beyond 4.5 V, with SEM-EDS verifying their presence. Electrochemical evidence of both degradation modes appears as a voltage undershoot in the discharge curves. A comparative study of various State of Health (SoH) estimation parameters is presented with the introduction of a new dimensionless SoH indicator, ΦR, based on internal resistance measurement. The proposed degradation number is found to be a good indicator of aggravated degradation in Li-ion cells.
European Spread Option Pricing with the Floating Interest Rate for Uncertain Financial Market
Authors: Zhang Lidong , Sun Yanmei , Meng Xiangbo
Published: May 2020

In this paper, we investigate the pricing problems of European spread options with the floating interest rate. In this model, uncertain differential equation and stochastic differential equation are used to describe the fluctuation of stock price and the floating interest rate, respectively. We derive the pricing formulas for spread options including the European spread call option and the European spread put option. Finally, numerical algorithms are provided to illustrate our results.