bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of Hospitalization and Death among Newly Diagnosed HIV-Infected Adults in Thailand
Authors: Chanto Sukonthip , Kiertiburanakul Sasisopin
Published: April 2020

More than half of newly diagnosed HIV-infected patients enter to care with a low CD4 count. A retrospective cohort study was conducted among newly diagnosed HIV-infected adults who were hospitalized. Of 148 patients, median (interquartile range [IQR]) age was 39.3 (30.5-47.1) years and 114 (77%) patients were male. Baseline median (IQR) CD4 count was 79 (24-218) cells/mm3. The median (IQR) length of hospital stay was 8 (4-16) days. Half of the patients were hospitalized with AIDS-defining illness (ADI). Common opportunistic infections were Pneumocystis jirovecii pneumonia (20.3%) and tuberculosis (18.9%). CD4 count was statistically significantly associated with hospitalization with ADI (odds ratio: 0.85, per 10 cells/mm3 increased; 95% confidence interval: 0.80-0.90). The mortality was 5.4%. In conclusion, half of newly diagnosed Thai HIV-infected patients were hospitalized with ADI. Early detection of HIV infection leading to early antiretroviral therapy initiation and prevention of serious complications is essential.
Implementation of the Global Compact on Safe, Orderly, and Regular Migration: A Whole-of-Society Approach
Authors: Appleby J. Kevin
Published: April 2020

Executive Summary

The Global Compact on Safe, Orderly, and Regular Migration (GCM) provides a blueprint for nations to manage migration flows through multilateral cooperation. Nations are best served by partnering with a wide range of societal actors to implement the objectives of the GCM. Such civil society actors may include non-profit organizations, faith-based groups, the private sector, trade unions, and academia, among other relevant stakeholders. Each of these actors brings unique strengths to the implementation of the GCM, filling gaps in the care and protection of migrants. They perform tasks that governments are unable or unwilling to undertake, especially in the area of irregular migration. A “whole-of-society” approach is the most effective method for managing migration humanely and in concert with the rule of law.
Innovations in Hemodialysis Care: An Evaluation of Quality and the Patient Experience
Authors: Harwood Lori , Pye Darrin , Clinton Elizabeth , Goettl Kyle , Mullen April , Qubty Janice
Published: April 2020

Hemodialysis (HD) performed in a tertiary care facility is the most prevalent and costly treatment for end-stage renal disease in Canada. This life-sustaining treatment is usually performed thrice weekly in an in-center facility. When people on HD also require a rehabilitation/complex care inpatient program, the burden of transportation for dialysis is immense to both the patient and health-care system. To improve the patient experience, create efficiency, and reduce travel costs, the renal team and a team from a rehabilitation/complex care center collaborated to provide HD services in the rehab/complex care setting. A patient/family representative was involved in all aspects of the design through to evaluation of this project. This study used realistic evaluation to examine the efficacy of this program from the perspective of the patient experience, HD staff, rehab/complex care staff and costs. The decreased travel with having dialysis on-site and adequate resources in the HD unit were the mechanisms for success in improved patient experience, quality of life and rehabilitation patient outcomes, decreased costs as well as increased communication and satisfaction.
Cuyaite, Ca2Mn3+As3+14O24Cl, a new mineral with an arsenite framework from near Cuya, Camarones Valley, Chile.
Authors: Kampf Anthony R. , Mills Stuart J. , Nash Barbara , Dini Maurizio , Molina Donoso Arturo A.
Published: April 2020

Cuyaite (IMA2019-126), Ca2Mn3+As3+14O24Cl, is a new arsenite mineral from near Cuya in the Camarones Valley, Arica Province, Chile. It is associated with anhydrite, native arsenic, arsenolite, calcite, claudetite, ferrinatrite, gajardoite-3R, leiteite, magnesiocopiapite, phosphosiderite, pyrite, realgar and talmessite and formed from the oxidation of As-bearing primary phases and alteration by saline fluids derived from evaporating meteoric water under hyperarid conditions. Cuyaite occurs as pale brown thin needles (elongated on [010]), typically in divergent sprays and subparallel intergrowths. The streak is white. Crystals are transparent with adamantine lustre; subparallel intergrowths exhibit silky lustre. The mineral has Mohs hardness of 2½, is brittle, exhibits no cleavage and has irregular fracture. The calculated density is 4.140 g cm–3. Cuyaite is optically biaxial (–), with α = 1.87(1), β = 1.956(calc) and γ = 1.98(1), determined in white light; 2Vmeas= 60(1)°; and orientation:X=bandY^a= 53° in obtuse β. Electron microprobe analyses provided the empirical formula Ca2.03Mn3+0.95(As3+13.66Sb3+0.65)Σ14.31O24Cl0.88. The six strongest powder X-ray diffraction lines are [dobsÅ(I)(hkl)]: 4.73(45)(111,$\bar{1}$12), 3.162(100)($\bar{3}$14), 3.035(28)(213), 3.004(37)(204), 2.931(90)($\bar{2}$15, 312) and 2.779(28)(020). Cuyaite is monoclinic,Pn,a= 14.7231(6),b= 5.58709(19),c= 17.4185(12) Å, β = 112.451(8)°,V= 1324.23(14) Å3andZ= 2. In the crystal structure of cuyaite (R1= 0.0369 for 2095I> 2σIreflections), AsO3pyramids share O corners to form a ‘loose’ 3D framework; Jahn–Teller distorted Mn3+O6octahedra and CaO8polyhedra link by edges and corners to form columns; the columns also link by edge- and corner-sharing to the AsO3pyramids in the framework; Cl occupies channels along [010] in the framework. The Raman spectrum is consistent with the presence of multiple As3+O3groups.
COVID-19 and its implications for thrombosis and anticoagulation
Authors: Connors Jean M. , Levy Jerrold H.
Published: April 2020

Severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019 (COVID-19)-induced infection can be associated with a coagulopathy, findings consistent with infection-induced inflammatory changes as observed in patients with disseminated intravascular coagulopathy (DIC). The lack of prior immunity to COVID-19 has resulted in large numbers of infected patients across the globe and uncertainty regarding management of the complications that arise in the course of this viral illness. The lungs are the target organ for COVID-19; patients develop acute lung injury that can progress to respiratory failure, although multiorgan failure can also occur. The initial coagulopathy of COVID-19 presents with prominent elevation of D-dimer and fibrin/fibrinogen-degradation products, whereas abnormalities in prothrombin time, partial thromboplastin time, and platelet counts are relatively uncommon in initial presentations. Coagulation test screening, including the measurement of D-dimer and fibrinogen levels, is suggested. COVID-19–associated coagulopathy should be managed as it would be for any critically ill patient, following the established practice of using thromboembolic prophylaxis for critically ill hospitalized patients, and standard supportive care measures for those with sepsis-induced coagulopathy or DIC. Although D-dimer, sepsis physiology, and consumptive coagulopathy are indicators of mortality, current data do not suggest the use of full-intensity anticoagulation doses unless otherwise clinically indicated. Even though there is an associated coagulopathy with COVID-19, bleeding manifestations, even in those with DIC, have not been reported. If bleeding does occur, standard guidelines for the management of DIC and bleeding should be followed.
Implementing lung health interventions in low- and middle-income countries: a FRESH AIR systematic review and meta-synthesis
Authors: Brakema Evelyn A. , Vermond Debbie , Pinnock Hilary , Lionis Christos , Kirenga Bruce , An Pham Le , Sooronbaev Talant , Chavannes Niels H. , van der Kleij M. J. J. Rianne
Published: April 2020

The vast majority of patients with chronic respiratory disease live in low- and middle-income countries (LMICs). Paradoxically, relevant interventions often fail to be effective particularly in these settings, as LMICs lack solid evidence on how to implement interventions successfully. Therefore, we aimed to identify factors critical to the implementation of lung health interventions in LMICs, and weigh their level of evidence.

This systematic review followed Cochrane methodology and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) reporting standards. We searched eight databases without date or language restrictions in July 2019, and included all relevant original, peer-reviewed articles. Two researchers independently selected articles, critically appraised them (using Critical Appraisal Skills Programme (CASP)/Meta Quality Appraisal Tool (MetaQAT)), extracted data, coded factors (following the Consolidated Framework for Implementation Research (CFIR)), and assigned levels of confidence in the factors (viaGrading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual)). We meta-synthesised levels of evidence of the factors based on their frequency and the assigned level of confidence (PROSPERO:CRD42018088687).

We included 37 articles out of 9111 screened. Studies were performed across the globe in a broad range of settings. Factors identified with a high level of evidence were: 1) “Understanding needs of local users”; 2) ensuring “Compatibility” of interventions with local contexts (cultures, infrastructures); 3) identifying influential stakeholders and applying “Engagement” strategies; 4) ensuring adequate “Access to knowledge and information”; and 5) addressing “Resource availability”. All implementation factors and their level of evidence were synthesised in an implementation tool.

To conclude, this study identified implementation factors for lung health interventions in LMICs, weighed their level of evidence, and integrated the results into an implementation tool for practice. Policymakers, non-governmental organisations, practitioners, and researchers may use this FRESH AIR (Free Respiratory Evaluation and Smoke-exposure reduction by primary Health cAre Integrated gRoups) Implementation tool to develop evidence-based implementation strategies for related interventions. This could increase interventions’ implementation success, thereby optimising the use of already-scarce resources and improving health outcomes.
Understanding the renin–angiotensin–aldosterone–SARS-CoV axis: a comprehensive review
Authors: Ingraham Nicholas E. , Barakat Abdo G. , Reilkoff Ronald , Bezdicek Tamara , Schacker Timothy , Chipman Jeffrey G. , Tignanelli Christopher J. , Puskarich Michael A.
Published: April 2020

Importance

Coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a global pandemic with significant morbidity and mortality since first appearing in Wuhan, China, in late 2019. As many countries are grappling with the onset of their epidemics, pharmacotherapeutics remain lacking. The window of opportunity to mitigate downstream morbidity and mortality is narrow but remains open. The renin–angiotensin–aldosterone system (RAAS) is crucial to the homeostasis of both the cardiovascular and respiratory systems. Importantly, SARS-CoV-2 utilises and interrupts this pathway directly, which could be described as the renin–angiotensin–aldosterone–SARS-CoV (RAAS–SCoV) axis. There exists significant controversy and confusion surrounding how anti-hypertensive agents might function along this pathway. This review explores the current state of knowledge regarding the RAAS–SCoV axis (informed by prior studies of SARS-CoV), how this relates to our currently evolving pandemic, and how these insights might guide our next steps in an evidence-based manner.

Observations

This review discusses the role of the RAAS–SCoV axis in acute lung injury and the effects, risks and benefits of pharmacological modification of this axis. There may be an opportunity to leverage the different aspects of RAAS inhibitors to mitigate indirect viral-induced lung injury. Concerns have been raised that such modulation might exacerbate the disease. While relevant preclinical, experimental models to date favour a protective effect of RAAS–SCoV axis inhibition on both lung injury and survival, clinical data related to the role of RAAS modulation in the setting of SARS-CoV-2 remain limited.

Conclusion

Proposed interventions for SARS-CoV-2 predominantly focus on viral microbiology and aim to inhibit viral cellular injury. While these therapies are promising, immediate use may not be feasible, and the time window of their efficacy remains a major unanswered question. An alternative approach is the modulation of the specific downstream pathophysiological effects caused by the virus that lead to morbidity and mortality. We propose a preponderance of evidence that supports clinical equipoise regarding the efficacy of RAAS-based interventions, and the imminent need for a multisite randomised controlled clinical trial to evaluate the inhibition of the RAAS–SCoV axis on acute lung injury in COVID-19.
Survival benefit of lung transplantation compared with medical management and pulmonary rehabilitation for patients with end-stage COPD
Authors: Timofte Irina , Wijesinha Marniker , Vesselinov Roumen , Kim June , Reed Robert , Sanchez Pablo G. , Ladikos Nicholas , Pham Si , Kon Zachary , Rajagopal Keshava , Scharf Steven M. , Wise Robert , Sternberg Alice L. , Kaczorowski David , Griffith Bartley , Terrin Michael , Iacono Aldo
Published: April 2020

Background

COPD patients account for a large proportion of lung transplants; lung transplantation survival benefit for COPD patients is not well established.

Methods

We identified 4521 COPD patients in the United Network for Organ Sharing (UNOS) dataset transplanted from May 2005 to August 2016, and 604 patients assigned to receive pulmonary rehabilitation and medical management in the National Emphysema Treatment Trial (NETT). After trimming the populations for NETT eligibility criteria and data completeness, 1337 UNOS and 596 NETT patients remained. Kaplan–Meier estimates of transplant-free survival from transplantation for UNOS, and NETT randomisation, were compared between propensity score-matched UNOS (n=401) and NETT (n=262) patients.

Results

In propensity-matched analyses, transplanted patients had better survival compared to medically managed patients in NETT (p=0.003). Stratifying on 6 min walk distance (6 MWD) and FEV1, UNOS patients with 6 MWD <1000 ft (∼300 m) or FEV1<20% of predicted had better survival than NETT counterparts (median survival 5.0 years UNOSversus3.4 years NETT; log-rank p<0.0001), while UNOS patients with 6 MWD ≥1000 ft (∼300 m) and FEV1≥20% had similar survival to NETT counterparts (median survival, 5.4 years UNOSversus4.9 years NETT; log-rank p=0.73), interaction p=0.01.

Conclusions

Overall survival is better for matched lung transplant patients compared with medical management alone. Patients who derive maximum benefit are those with 6 MWD <1000 ft (∼300 m) or FEV1<20% of predicted, compared with pulmonary rehabilitation and medical management.
Efficacy and safety of two doses of budesonide/formoterol fumarate metered dose inhaler in COPD
Authors: Hanania Nicola A. , Papi Alberto , Anzueto Antonio , Martinez Fernando J. , Rossman Kimberly A. , Cappelletti Christy S. , Duncan Elizabeth A. , Nyberg Jack S. , Dorinsky Paul M.
Published: April 2020

Inhaled corticosteroid/long-acting β2-agonist combination therapy is a recommended treatment option for patients with chronic obstructive pulmonary disease (COPD) and increased exacerbation risk, particularly those with elevated blood eosinophil levels. SOPHOS (NCT02727660) evaluated the efficacy and safety of two doses of budesonide/formoterol fumarate dihydrate metered dose inhaler (BFF MDI)versusformoterol fumarate dihydrate (FF) MDI, each delivered using co-suspension delivery technology, in patients with moderate-to-very severe COPD and a history of exacerbations.

In this phase 3, randomised, double-blind, parallel-group, 12–52-week, variable length study, patients received twice-daily BFF MDI 320/10 µg or 160/10 µg, or FF MDI 10 µg. The primary endpoint was change from baseline in morning pre-dose trough forced expiratory volume in 1 s (FEV1) at week 12. Secondary and other endpoints included assessments of moderate/severe COPD exacerbations and safety.

The primary analysis (modified intent-to-treat) population included 1843 patients (BFF MDI 320/10 µg, n=619; BFF MDI 160/10 µg, n=617; and FF MDI, n=607). BFF MDI 320/10 µg and 160/10 µg improved morning pre-dose trough FEV1at week 12versusFF MDI (least squares mean differences 34 mL [p=0.0081] and 32 mL [p=0.0134], respectively), increased time to first exacerbation (hazard ratios 0.827 [p=0.0441] and 0.803 [p=0.0198], respectively) and reduced exacerbation rate (rate ratios 0.67 [p=0.0001] and 0.71 [p=0.0010], respectively). Lung function and exacerbation benefits were driven by patients with blood eosinophil counts ≥150 cells·mm−3. The incidence of adverse events was similar, and pneumonia rates were low (≤2.4%) across treatments.

SOPHOS demonstrated the efficacy and tolerability of BFF MDI 320/10 µg and 160/10 µg in patients with moderate-to-very severe COPD at increased risk of exacerbations.
Late-onset oro-facial dyskinesia in Spinocerebellar Ataxia type 2: a case report
Authors: Giardina Floriana , Lanza Giuseppe , Calì Francesco , Ferri Raffaele
Published: April 2020

Background

Genetic familiar causes of oro-facial dyskinesia are usually restricted to Huntington’s disease, whereas other causes are often missed or underestimated. Here, we report the case of late-onset oro-facial dyskinesia in an elderly patient with a genetic diagnosis of Spinocerebellar Ataxia type 2 (SCA2).

Case presentation

A 75-year-old man complained of progressive balance difficulty since the age of 60 years, associated with involuntary movements of the mouth and tongue over the last 3 months. No exposure to anti-dopaminergic agents, other neuroleptics, antidepressants, or other drugs was reported. Family history was positive for SCA2 (brother and the son of the brother). At rest, involuntary movements of the mouth and tongue were noted; they appeared partially suppressible and became more evident during stress and voluntary movements. Cognitive examination revealed frontal-executive dysfunction, memory impairment, and attention deficit. Brain magnetic resonance imaging (MRI) disclosed signs of posterior periventricular chronic cerebrovascular disease and a marked ponto-cerebellar atrophy, as confirmed by volumetric MRI analysis. A dopamine transporter imaging scan demonstrated a bilaterally reduced putamen and caudate nucleus uptake. Ataxin-2 (ATXN2) gene analysis revealed a 36 cytosine-adenine-guanine (CAG) repeat expansion, confirming the diagnosis of SCA2.

Conclusions

SCA2 should be considered among the possible causes of adult-onset oro-facial dyskinesia, especially when the family history suggests an inherited cerebellar disorder. Additional clinical features, including parkinsonism and motor neuron disease, may represent relevant cues for an early diagnosis and adequate management.
Effective surgical treatment of life-threatening huge vascular anomalies associated with thrombocytopenia and coagulopathy in infants unresponsive to drug therapy
Authors: Wu Yaohao , Qiu Ronglin , Zeng Lexiang , Liang Liyang , Zhang Jie , Zhou Jiajia , Jiang Wenli , Su Jianhang , Deng Xiaogeng
Published: April 2020

Background

Systemic drug therapy is generally recommended for infant huge vascular anomalies associated with thrombocytopenia and coagulopathy, but some patients are not suitable due to drug unresponsiveness or life threatening conditions before the drug works, who will need to receive surgical treatment. This study retrospectively analyzed the clinical features, imaging features, and surgical outcomes of these patients.

Methods

The clinical data of 4 infants with huge vascular anomalies (2 vein malformations (VMs) and 2 kaposiform hemangioendothelioma (KHE)) associated with thrombocytopenia and coagulopathy treated from June 2016 to December 2017 were retrospectively analyzed. All patients received glucocorticoids, propranolol, vincristine or sirolimus treatment before admission, but the treatment was ineffective. Skin petechia, thrombocytopenia and coagulopathy were present at the time of admission. CT scanning was performed before operation. The patient’s general clinical data, hematological examination results, operation time, surgical bleeding volume, blood transfusion volume and surgical complications were collected for analysis. The patients were followed up for 10–26 months.

Results

CT scanning results of 2 patients showed special CT features without detectable enhancement within the lesion after CT enhanced scanning and multiple phleboliths formation. Four patients underwent surgical treatment successfully. Two patients underwent complete resection of the lesion, and 2 underwent cytoreductive surgery. Preoperative clinical symptoms such as skin petechia, thrombocytopenia and coagulopathy were normal at 1 week after surgery. Postoperative pathological results showed 2 cases of KHE and 2 cases of VMs. All patients were discharged from hospital without physical dysfunction, recurrence, or death.

Conclusions

Timely and appropriate surgical intervention can achieve satisfactory results for infants with huge VMs and KHE who were unresponsive to drug therapy or suffering from life-threatening occasion before the drug become effective.
Residual leg numbness after endoscopic discectomy treatment of lumbar disc herniation
Authors: Yan Denglu , Zhang Zaiheng , Zhang Zhi
Published: April 2020

Background

Transforaminal endoscopic discectomy was popular in the treatment of lumbar disc herniation. Previous study focuses on the leg pain of disc herniation, and little study concern the residual leg numbness after surgery. The purposes of this study were to evaluate the clinical outcomes of transforaminal endoscopic discectomy in the treatment of lumbar disc herniation with leg pain and numbness.

Methods

Patients with one level lumbar disc herniation who had transforaminal endoscopic lumbar discectomy from June 2016 to July 2019 were categorized into two groups according to the leg numbness. 293 patients initially fulfilled the study criteria, and 27 patients were lost to follow-up. Of the remaining 266 patients available for analysis, 81 cases with leg numbness and pain (A group), and 185 cases with leg pain (B). Endoscopic transforaminal lumbar discectomy was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain (Visual Analog Scale, VAS-pain), numbness (VAS-numbness), functional disability (Oswestry Disability Index, ODI), and the disk height and intervertebral foramen height were recorded.

Results

All patients with pain and numbness pre-operation in group A, complain of leg numbness during or just after walking or standing not diminished after surgery in group A, and no one complain numbness after surgery in group B. The pain index and ODI score were better than preoperational in all patients (P < 0.01), and no significant difference between two groups (P > 0.05). The postoperative disk and foramen height were no significant difference compare to preoperative in all patients (P > 0.05), and no significant difference between two groups (P > 0.05). The leg numbness symptoms last longer in central disc herniation patients (10.4 ± 2.2 months) than in paracentral (6.3 ± 2.1 months) and foraminal disc herniation patients (5.6 ± 2.3 months) after surgery (P < 0.01).

Conclusions

Based on the results of this study, transforaminal endoscopic lumbar discectomy was effective and safe procedures in the treatment of disc herniation with leg pain and numbness. The leg numbness symptoms last longer in central disc herniation patients than in paracentral and foraminal disc herniation patients after surgery.
Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials
Authors: Li Yueying , Luo Wenqi , Wu Guangzhi , Cui Shusen , Zhang Zhan , Gu Xiaosong
Published: April 2020

Background

Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) both have advantages and disadvantages for the treatment of carpal tunnel syndrome (CTS). We compared the effectiveness and safety of ECTR and OCTR based on evidence from a high-level randomized controlled trial.

Methods

We comprehensively searched PubMed, EMBASE, Cochrane Library, Web of Science, and Medline to identify relevant articles published until August 2019. Data regarding operative time, grip strength, Boston Carpal Tunnel Questionnaire scores, digital sensation, patient satisfaction, key pinch strength, return to work time, and complications were extracted and compared. All mean differences (MD) and odds ratios (OR) were expressed as ECTR relative to OCTR.

Results

Our meta-analysis contained twenty-eight studies. ECTR was associated with significantly higher satisfaction rates (MD, 3.13; 95% confidence interval [CI], 1.43 to 4.82; P = 0.0003), greater key pinch strengths (MD, 0.79 kg; 95% CI, 0.27 to 1.32; P = 0.003), earlier return to work times (MD, − 7.25 days; 95% CI, − 14.31 to − 0.19; P = 0.04), higher transient nerve injury rates (OR, 4.87; 95% CI, 1.37 to 17.25; P = 0.01), and a lower incidence of scar-related complications (OR, 0.20; 95% CI, 0.07 to 0.59; P = 0.004). The permanent nerve injury showed no significant differences between the two methods (OR, 1.93; 95% CI, 0.58 to 6.40; P = 0.28).

Conclusions

Overall, evidence from randomized controlled trials indicates that ECTR results in better recovery of daily life functions compared to OCTR, as revealed by higher satisfaction rates, greater key pinch strengths, earlier return to work times, and fewer scar-related complications. Our findings suggest that patients with CTS can be effectively managed with ECTR.
Potential utility of targeted Nanopore sequencing for improving etiologic diagnosis of bacterial and fungal respiratory infection
Authors: Chan Wai Sing , Au Chun Hang , Leung Sau Man , Ho Dona N. , Wong Elaine Yue Ling , To Man Yan , Ng Man Kin , Chan Tsun Leung , Ma Edmond Shiu Kwan , Tang Bone Siu Fai
Published: April 2020

Background

Diversified etiology of lower respiratory tract infection renders diagnosis challenging. The mainstay microbial culture is time-consuming and constrained by variable growth requirements. In this study, we explored the use of Nanopore sequencing as a supplementary tool to alleviate this diagnostic bottleneck.

Methods

We developed a targeted Nanopore method based on amplification of bacterial 16S rRNA gene and fungal internal transcribed spacer region. The performance was compared with routine infectious disease workups on 43 respiratory specimens.

Results

Nanopore successfully identified majority of microbes (47/54, 87.04%) and 7 possible pathogens not detected by routine workups, which were attributable to the content of microbiological investigations (n = 5) and negative culture (n = 2). The average sequencing time for first target reads was 7 min (1–43 min) plus 5 h of pre-sequencing preparation.

Conclusions

The Nanopore method described here was rapid, economical and hypothesis-free, which might provide valuable hints to further microbiological follow-up for opportunistic pathogens missed or not detectable by conventional tests.
Correction to: Flash floods mitigation and assessment of groundwater possibilities using remote sensing and GIS applications: Sharm El Sheikh, South Sinai, Egypt
Authors: Yousif Mohamed , Hussien Hussien M.
Published: April 2020

After publication of the original article (Yousif & Hussien, 2020), we were notified that formulas 3 and 4 are incomplete (cut off) in the PDF.
Corticolimbic brain anomalies are associated with cognitive subtypes in psychosis: A longitudinal study
Authors: Ho New Fei , Lee Benjamin J. H. , Tng Jordon X. J. , Lam Max Z. Y. , Chen Guoyang , Wang Mingyuan , Zhou Juan , Keefe Richard S. E. , Sim Kang
Published: April 2020

Background.

Earlier studies examining structural brain abnormalities associated with cognitively derived subgroups were mainly cross-sectional in design and had mixed findings. Thus, we obtained cross-sectional and longitudinal data to characterize the extent and trajectory of brain structure abnormalities underlying distinct cognitive subtypes (“preserved,” “deteriorated,” and “compromised”) seen in psychotic spectrum disorders.

Methods.

Data from 364 subjects (225 patients with psychotic conditions and 139 healthy controls) were first used to determine the relationship of cognitive subtypes with cross-sectional measures of subcortical volume and cortical thickness. To probe neurodevelopmental abnormalities, brain structure laterality was examined. To examine whether neuroprogressive abnormalities persist, longitudinal brain structural changes over 5 years were examined within a subset of 101 subjects. Subsequent discriminant analysis using the identified brain measures was performed on an independent subject group.

Results.

Cross-sectional comparisons showed that cortical thinning and limbic volume reductions were most widespread in “deteriorated” cognitive subtype. Laterality comparisons showed more rightward amygdala lateralization in “compromised” than “preserved” subtype. Longitudinal comparisons revealed progressive hippocampal shrinkage in “deteriorated” compared with healthy controls and “preserved” subtype, which correlated with worse negative symptoms, cognitive and psychosocial functioning. Post-hoc discrimination analysis on an independent group of 52 subjects using the identified brain structures found an overall accuracy of 71% for classification of cognitive subtypes.

Conclusion.

These findings point toward distinct extent and trajectory of corticolimbic abnormalities associated with cognitive subtypes in psychosis, which can allow further understanding of the biological course of cognitive functioning over illness course and with treatment.
Hospitalization Rates Related to Coordinated Home Health Care Services With a Community Oncology Practice
Authors: Sandbach John F. , Bachelor John , Larson Kimberly , Jordan Denize , Mullins Janet , Davis Dave , Sheff Gregory
Published: April 2020

PURPOSE:

Oncology care reimbursement has been shifting from a traditional fee-for-service model to either 1- or 2-sided risk models during the past 5 years. A major expense associated with the total cost of care is hospitalization cost. The study set out to investigate whether the creation of an Advanced Community Care Model (ACCM) of home health care would affect 60-day hospitalization and 30-rehospitalization rates in a community oncology setting.

METHODS:

In conjunction with a single home health care organization, an ACCM was modified for oncology care to include intervention protocols to address antiemetic issues, pain control, dehydration, shortness of breath, diarrhea, and fever. Weekly and monthly joint management meetings began. Quality metrics were defined.

RESULTS:

Overall, 457 unique home health care admissions were evaluated. Hospitalization associated with intervention protocols was evaluated. Sixty-day hospitalization rates decreased from 14% to 8%. Thirty-day rehospitalization rates decreased from 25% to 10%.

CONCLUSION:

An oncology ACCM, as created in this study, appears to have reduced both 60-day hospitalization and 30-day rehospitalization rates.
Null hypotheses for developmental evolution
Authors: Church Samuel H. , Extavour Cassandra G.
Published: April 2020

How much evolutionary change in development do we expect? In this Spotlight, we argue that, as developmental biologists, we are in a prime position to contribute to the definition of a null hypothesis for developmental evolution: in other words, a hypothesis for how much developmental evolution we expect to observe over time. Today, we have access to an unprecedented array of developmental data from across the tree of life. Using these data, we can now consider development in the light of evolution, and vice versa, more deeply than ever before. As we do this, we may need to re-examine previous assumptions that appeared to serve us well when data points were fewer. Specifically, we think it is important to challenge assumptions that change is very rare for all developmental traits, especially if this assumption is used to sustain an erroneous view that evolution always optimizes adaptive traits toward increasing complexity.
Spatial orientation based on multiple visual cues in non-migratory monarch butterflies
Authors: Franzke Myriam , Kraus Christian , Dreyer David , Pfeiffer Keram , Beetz M. Jerome , Stöckl Anna L. , Foster James J. , Warrant Eric J. , el Jundi Basil
Published: April 2020

Monarch butterflies (Danaus plexippus) are prominent for their annual long-distance migration from North America to their overwintering area in Central Mexico. To find their way on this long journey, they use a sun compass as their main orientation reference but will also adjust their migratory direction with respect to mountain ranges. This indicates that the migratory butterflies also attend to the panorama to guide their travels. While the compass has been studied in detail in migrating butterflies, little is known about the orientation abilities of non-migrating butterflies. Here we studied if non-migrating butterflies - that stay in a more restricted area to feed and breed - also use a similar compass system to guide their flights. Performing behavioral experiments on tethered flying butterflies in an indoor LED flight simulator, we found that the monarchs fly along straight tracks with respect to a simulated sun. When a panoramic skyline was presented as the only orientation cue, the butterflies maintained their flight direction only during short sequences suggesting that they potentially use it for flight stabilization. We further found that when we presented the two cues together, the butterflies incorporate both cues in their compass. Taken together, we here show that non-migrating monarch butterflies can combine multiple visual cues for robust orientation, an ability that may also aid them during their migration.
Biased-Belief Equilibrium
Authors: Heller Yuval , Winter Eyal
Published: April 2020

We investigate how distorted, yet structured, beliefs can persist in strategic situations. Specifically, we study two-player games in which each player is endowed with a biased-belief function that represents the discrepancy between a player’s beliefs about the opponent’s strategy and the actual strategy. Our equilibrium condition requires that (i) each player choose a best-response strategy to his distorted belief about the opponent’s strategy, and (ii) the distortion functions form best responses to one another. We obtain sharp predictions and novel insights into the set of stable outcomes and their supporting stable biases in various classes of games. (JEL C73, D83)
Revealed Preference Implications of Backward Induction and Subgame Perfection
Authors: Schenone Pablo
Published: April 2020

Consider a decision-maker (DM) who must select an alternative from a set of mutually exclusive alternatives but must take this decision sequentially. If the DM’s choice correspondence over subsets of alternatives satisfies the weak axiom of revealed preference (WARP), then the subgame perfect Nash equilibrium (SPNE) and backward induction (BI) strategies coincide. We study the relation between the SPNE and BI strategies when the DM’s choice correspondence fails to satisfy WARP. First, Sen’s axiom α is necessary and sufficient for the set of SPNE strategies to be a subset of the set of BI strategies; moreover, a mild strengthening of Sen’s axiom β is necessary and sufficient for the set of BI strategies to be a subset of the set of SPNE strategies. These results extend to multiplayer games. (JEL D11, C72, C73)
Incomplete Information Games with Ambiguity Averse Players
Authors: Hanany Eran , Klibanoff Peter , Mukerji Sujoy
Published: April 2020

We study incomplete information games with ambiguity averse players. Our focus is on equilibrium concepts satisfying sequential optimality—each player’s strategy is optimal at each information set given opponents’ strategies. We show sequential optimality, which does not make any explicit assumption on updating, is equivalent to sequential optimality with respect to beliefs updated using a particular generalization of Bayesian updating. Ambiguity aversion expands the set of equilibria compatible with players sharing common ambiguous beliefs. We connect ambiguity aversion with belief robustness. Examples illustrate new strategic behavior, including strategic use of ambiguity, under ambiguity aversion. (JEL C73, D81, D83)
The impact of mediterranean diet in perioperative nurses’ health
Authors: Agriopoulou Sofia , Koutelekos Ioannis
Published: April 2020

Perioperative nurses are involved in the care of surgery patients, in a highly stressful environment with various risks. Unrealistic schedules and long working hours standing, and working shifts, make them more vulnerable to potential risks. Their health is affected by the quality of the work environment. Problems that may arise from the highly stressful work involve chronic stress, burnout, dissatisfaction, obesity and sleeping disorders. Nutritional problems result from the lack of time between shifts for food preparation, the extended time without food or liquid, reduced hydration, the irregular hours and times to eat, the less substantial meals and more caloric snacks. Mediterranean diet is a scientifically proven healthy diet, indicated for fighting obesity, heart disease and cancer. The consumption of fruit, vegetables, grains, nuts, and olive oil in the framework of Mediterranean diet which is rich in beneficial nutrients, could significantly improve perioperative nurses’ quality life, and their eating habits.
Product Price Risk and Liquidity Management: Evidence from the Electricity Industry
Authors: Lin Chen , Schmid Thomas , Weisbach Michael S.
Published: April 2020

Product price risk is a potentially important factor for firms’ liquidity management. A natural place to evaluate the impact of this risk on liquidity management is the electricity industry, because producing firms face substantial price volatility in wholesale markets. Empirically, higher volatility of electricity prices leads to an increase in cash holdings, and this effect is robust to instrumenting for price risk using weather volatility. Cash increases more with price risk in firms using inflexible production technologies and those that cannot easily hedge electricity prices, indicating that operating flexibility and hedging are substitutes for liquidity management.

This paper was accepted by Karl Diether, finance.
O ENSINO DE HISTÓRIA EM COVERGÊNCIA: DISPUTAS E RESISTÊNCIAS EM TEMPOS DE CIBERESPAÇO E MOVIMENTOS CONSERVADORES
Authors: Cassin Maia Ferreira Raone
Published: April 2020

Este artigo propõe tecer reflexões sobre como professores de história tem buscado refletir sobre questões relativas à sua prática nos diferentes espaços de produção do conhecimento histórico, principalmente a partir da emergência de projetos de lei, narrativas conservadoras e práticas que tem produzido disputas pelo Ensino de História no Ciberespaço. Defendemos, portanto, a tese de que o Ensino de História se encontra em Convergência entre as mídias e as três esferas de produção do conhecimento histórico: a Escola, a Universidade e o Espaço Público.
PUBLICIZAÇÃO E SENTIDOS DAS NARRATIVAS HISTÓRICAS NA (IN)FORMAÇÃO DE SENSIBILIDADES SOBRE AS TRAGÉDIAS-CRIMES DE MINAS GERAIS
Authors: Cunha Nara Rúbia De Carvalho , Bechler Rosiane Ribeiro , França Cyntia Simioni
Published: April 2020

Neste artigo, mobilizado por inquietações sobre o Ensino de História em tempos de crise democrática, problematizamos o tratamento de tragédias-crime humano-ambientais em processos de produção de conhecimento histórico-educacional, especialmente em comunidades diretamente afetadas pelas mesmas. Focalizamos o caso de Brumadinho-MG, que apenas três anos após a tragédia-crime de Mariana-MG, é mais uma cidade mineira obrigada a conviver com a dor da perda repentina de centenas de vidas e de referenciais ambientais e humanos que estruturam a vida em comunidade. A partir desse trauma coletivo imposto pela complacência em relação à forma de exploração implantada pelas grandes mineradoras no estado de Minas Gerais, discorremos sobre a relação entre a historiografia vigente, notadamente no âmbito escolar, e o desafio de tratar temas sensíveis no Ensino de História em uma democracia frágil.
ENSINO DE HISTÓRIA NO SISTEMA SOCIOEDUCATIVO: DESAFIOS E POSSIBILIDADES PARA PROBLEMATIZAÇÃO DA CONSCIÊNCIA HISTÓRICA
Authors: Ribeiro Andréa Sannazzaro
Published: April 2020

No regime socioeducativo, parte da sentença para ressocialização, implica que os adolescentes estejam dentro da vivência escolar, fazendo valer o estatuto da criança e adolescente (ECA) e tornando a frequência na escola obrigatória. O repertório de vida trazido pela vivência desses educandos carrega a possibilidade de expressões de narrativas permeadas por consciência histórica muitas vezes negligenciada pelo ensino de história tradicional. Tentarei no presente artigo a partir da minha vivência no ensino regular e integral do sistema socioeducativo, a partir da reflexão de  autores já conhecidos no ensino da História e da teoria da História, entender como é possível aproximação com adolescentes que precisam construir suas possibilidades de futuro e se reconhecerem enquanto sujeitos históricos, podendo assim, ter sua ressocialização enriquecida através da disciplina História.
DITADURA CIVIL-MILITAR E FORMAÇÃO DEMOCRÁTICA COMO PROBLEMAS HISTORIOGRÁFICOS: INTERROGAÇÕES DESDE A CRISE
Authors: Pinha Daniel
Published: April 2020

O artigo examina a dimensão pedagógico formativa do texto historiográfico que aborda temas sensíveis, examinando o caso da história da Ditadura Militar Brasileira e, mais particularmente, o debate acerca do apoio da sociedade civil na construção do regime ditatorial. Levando em conta o recorte cronológico entre 2004 e 2014, aniversários de 40 e 50 anos do Golpe, o texto se desenvolve em dois movimentos: evidenciação da dimensão pedagógico-formativa do topos “Ditadura Civil-Militar”, associada a uma perspectiva de afirmação democrática no presente; lugar do contexto de recepção e dos efeitos de leitura do texto historiográfico em temas de abrangência pública. Estas questões ganham novas interrogações diante do contexto de crise democrática contemporânea.
Research Roundup
Authors: Russell Sarah
Published: April 2020

Sarah Russell provides a synopsis and brief review of a selection of recently published research articles that are of interest to neuroscience nurses, highlighting key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Frontotemporal dementia: diagnosis, treatment and medical management
Authors: Nazarko Linda
Published: April 2020

Frontotemporal dementia is a rare form of dementia and around 2% of people with dementia have frontotemporal dementia ( Warren et al, 2013 ). This article explains the pathophysiology and clinical features of frontotemporal dementia and how it is diagnosed, treated and managed.
The Glasgow Coma Scale Pupils score: a nurse's perspective
Authors: Waterhouse Catheryne
Published: April 2020

The Glasgow Coma Scale Pupils (GCS–P) score is calibrated from 1 to 15 and is calculated by subtracting the patient's pupil reactivity score (PRS) from their Glasgow Coma Scale score. The additional clinical information gained from the patient's PRS (0–2) enables practitioners to access a more qualitative framework to facilitate discussion of predictive information with families regarding the patient's potential for recovery or good outcome following a severe brain injury.
Clinical testing: some legal lessons from history
Authors: Finch John
Published: April 2020

John Finch, an independent journalist specialising in legal and ethical aspects of clinical practice, has previously examined the fundamentals of consent to treatment. In this article, he focuses on testing for medical conditions, including suspected transmissible disease. The alarming and rapid spread of COVID-19 has highlighted the larger question of whether and to what extent consent by a person to be tested, as well knowledge as to the precise reason for the test, is a legal requirement. Taking a broader view of clinical testing, this article examines the legal basis of consent and places it in context by briefly examining the law relating to negligence and the nature of assault and battery.
Sir James Young Simpson: pioneer of anaesthesia in childbirth
Authors: Harold Ellis
Published: April 2020

This year is the 150th anniversary of James Young Simpson's death in 1870. As well as being responsible for the introduction of general anaesthesia into obstetric practice, he made other important contributions to obstetrics and also to surgery as well as in the control of hospital infection.
Diversity and distribution of immature vectors of malaria and rift valley fever in habitats along an altitudinal gradient in Barigo, Kenya
Authors: DANCAN KOBIA , ONG’AMO GEORGE O. , NDEGWA PAUL
Published: April 2020

Dancan K. 2018. Diversity and distribution of immature vectors of malaria and rift valley fever in habitats along an altitudinal gradient in Baringo County, Kenya. Bonorowo Wetlands 2: 25-32. Malaria and RVF are two diseases whose onset of epidemics leads to massive losses in human lives. Infected Anopheles mosquitoes transmit Plasmodium parasites that cause malaria while infected floodwater Aedes species are responsible for primary transmission of RVF viruses. The high mobility of adult mosquito species has made interventions targeting their behavior are rendered ineffective. Thus, interventions that target immature stages more advantageous. For effective implementation of immature stage based control strategies, information on their diversity and distribution in various habitats distributed along altitudinal gradients is important. This study investigated the diversity and distribution of malaria and RVF mosquito vectors at immature stages along an altitudinal gradient in Baringo County, Kenya during the short rains season. The species identified in the entire study area (800 m to 2300 m above sea level) were Culex quinquefaciatus, Cx. annulioris, Cx. pipiens, Cx. poicilipes, Cx. tigripes, Anopheles pharoensis, An. gambiae s.l, An. coustani, An. funestus, and Aedes taylori. Altitude was divided into three classes; 800 m to 1300 m, 1301 m to 1800 m and 1801 m to 2300 m. Aedes taylori and Cx. tigripes were only in the 1801 m to 2300 m altitudinal class while An. funestus was only in the 800 m to 1300 m altitudinal class. The altitudinal class between 1801 m to 2300 m had the lowest Shannon-wiener diversity index (Hʹ = 0.9836) of species (9species). Comparison of mosquitoes collected in habitats in different altitudinal classes revealed variations in the respective species counts (χ = 127.47; p-value < 0.001). The only species whose distribution showed correlation with altitude was An. pharoensis (r = -0.40; t32 = -2.50; p = 0.02). The highest species diversity was recorded in river banks where the water was clear and vegetation present. Stepwise regression analysis revealed that suitability of a habitat for vector breeding was mainly dictated by water quality and the presence of vegetation. The results in this study reveal the need for continuous monitoring of vectors not only in the low land areas but also in the highland areas to avoid sudden epidemics of malaria and RVF.