bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of ovule initiation by gibberellins and brassinosteroids in tomato and Arabidopsis: two plant species, two molecular mechanisms
Authors: Barro‐Trastoy Daniela , Carrera Esther , Baños Jorge , Palau‐Rodríguez Julia , Ruiz‐Rivero Omar , Tornero Pablo , Alonso José M. , López‐Díaz Isabel , Gómez María Dolores , Pérez‐Amador Miguel A.
Published: January 2020

Ovule primordia formation is a complex developmental process with a strong impact on the production of seeds. In Arabidopsis this process is controlled by a gene network, including components of the signalling pathways of auxin, brassinosteroids (BRs) and cytokinins. Recently, we have shown that gibberellins (GAs) also play an important role in ovule primordia initiation, inhibiting ovule formation in both Arabidopsis and tomato. Here we reveal that BRs also participate in the control of ovule initiation in tomato, by promoting an increase on ovule primordia formation. Moreover, molecular and genetic analyses of the co‐regulation by GAs and BRs of the control of ovule initiation indicate that two different mechanisms occur in tomato and Arabidopsis. In tomato, GAs act downstream of BRs. BRs regulate ovule number through the downregulation of GA biosynthesis, which provokes stabilization of DELLA proteins that will finally promote ovule primordia initiation. In contrast, in Arabidopsis both GAs and BRs regulate ovule number independently of the activity levels of the other hormone. Taken together, our data strongly suggest that different molecular mechanisms could operate in different plant species to regulate identical developmental processes even, as for ovule primordia initiation, if the same set of hormones trigger similar responses, adding a new level of complexity.
One-to-One Support With a Professional Rugby League Player: A Case for Referral?
Authors: Wadsworth Nick , Paszkowec Ben , Eubank Martin
Published: January 2020

This article presents a reflective case study of an applied consultancy experience with a 22-year-old professional rugby league player. The primary aim of the intervention was to provide the client a confidential space where he could discuss his experiences in and outside of a sporting context while also exploring and challenging his core values and beliefs. The consultancy process lasted for 12 mo, leading to the development of a strong relationship. During this time, the client experienced multiple critical moments such as deselection from the first-team squad and contract negotiations, which at times led to reductions in his well-being and forced the trainee sport and exercise psychologist to consider his scope of practice in relation to mental health and depression. Reflections are provided that explore the possibility of referral during these moments. The case study also provides insight into the trainee sport and exercise psychologist’s philosophy of practice and how influential this can be when considering referral of a client. The importance of supervisor support during uncertain moments is highlighted, and the case study concludes with reflections from the client, trainee practitioner, and peer supervisor regarding the efficacy of the intervention and the decision not to refer.
First Occurrence of the OXA-198 Carbapenemase in
Enterobacterales
Authors: Bonnin Rémy A. , Jousset Agnès B. , Gauthier Lauraine , Emeraud Cécile , Girlich Delphine , Sauvadet Aimie , Cotellon Garance , Jové Thomas , Dortet Laurent , Naas Thierry
Published: January 2020

A carbapenem-resistant
Citrobacter
sp. was recovered from routine screening of multidrug-resistant bacteria. This isolate coproduced OXA-48 and OXA-198. OXA-48 was carried by the prototypical IncL plasmid, whereas OXA-198 was carried by a peculiar IncHI-type plasmid. This carbapenemase gene was inserted within a class 1 integron located on a conjugative plasmid. This report describes the first occurrence of OXA-198 in
Enterobacterales
.
New Evidence and Insights on Dalbavancin and Wound Healing in a Mouse Model of Skin Infection
Authors: Simonetti Oriana , Lucarini Guendalina , Morroni Gianluca , Orlando Fiorenza , Lazzarini Raffaella , Zizzi Antonio , Brescini Lucia , Provinciali Mauro , Giacometti Andrea , Offidani Annamaria , Cirioni Oscar
Published: January 2020

Dalbavancin is an effective antibiotic that is widely used to treat skin infection. Our aim was to determine the effect of dalbavancin administration on wound healing compared to that of vancomycin and to elucidate if epidermal growth factor receptor (EGFR), matrix metalloproteinase 1 (MMP-1), MMP-9, and vascular endothelial growth factor (VEGF) could be involved in its therapeutic mechanism. A mouse model of methicillin-resistant
Staphylococcus aureus
(MRSA) skin infection was established.
Roles of TroA and TroR in Metalloregulated Growth and Gene Expression in
Treponema denticola
Authors: Saraithong Prakaimuk , Goetting-Minesky M. Paula , Durbin Peter M. , Olson Spencer W. , Gherardini Frank C. , Fenno J. Christopher
Published: January 2020

Treponema denticola
is one of numerous host-associated spirochetes, a group including commensals, pathobionts, and at least one frank pathogen. While most
T. denticola
research concerns its role in periodontitis, its relative tractability for growth and genetic manipulation make it a useful model for studying
Treponema
physiology, metabolism, and host-microbe interactions. Metal micronutrient acquisition and homeostasis are highly regulated both in microbial cells and by host innate defense mechanisms that severely limit metal cation bioavailability. Here, we characterized the
T. denticola
troABCDR
operon, the role of TroA-mediated iron and manganese uptake in growth, and the effects of TroR on global gene expression. This study contributes to our understanding of the mechanisms involved in cellular metal homeostasis required for survival in the host environment.
Cell-to-Cell Variation in Defective Virus Expression and Effects on Host Responses during Influenza Virus Infection
Authors: Wang Chang , Forst Christian V. , Chou Tsui-wen , Geber Adam , Wang Minghui , Hamou Wissam , Smith Melissa , Sebra Robert , Zhang Bin , Zhou Bin , Ghedin Elodie
Published: January 2020

Defective influenza virus particles generated during viral replication carry incomplete viral genomes and can interfere with the replication of competent viruses. These defective genomes are thought to modulate the disease severity and pathogenicity of an influenza virus infection. Different defective viral genomes also introduce another source of variation across a heterogeneous cell population. Evaluating the impact of defective virus genomes on host cell responses cannot be fully resolved at the population level, requiring single-cell transcriptional profiling. Here, we characterized virus and host transcriptomes in individual influenza virus-infected cells, including those of defective viruses that arise during influenza A virus infection. We established an association between defective virus transcription and host responses and validated interfering and immunostimulatory functions of identified dominant defective viral genome species
in vitro
. This study demonstrates the intricate effects of defective viral genomes on host transcriptional responses and highlights the importance of capturing host-virus interactions at the single-cell level.
CpG Frequency in the 5′ Third of the
env
Gene Determines Sensitivity of Primary HIV-1 Strains to the Zinc-Finger Antiviral Protein
Authors: Kmiec Dorota , Nchioua Rayhane , Sherrill-Mix Scott , Stürzel Christina M. , Heusinger Elena , Braun Elisabeth , Gondim Marcos V. P. , Hotter Dominik , Sparrer Konstantin M. J. , Hahn Beatrice H. , Sauter Daniel , Kirchhoff Frank
Published: January 2020

Evasion of the zinc-finger antiviral protein (ZAP) may drive CpG dinucleotide suppression in HIV-1 and many other viral pathogens but the viral determinants of ZAP sensitivity are poorly defined. Here, we examined CpG suppression and ZAP sensitivity in a large number of primate lentiviruses and demonstrate that their genomic frequency of CpGs varies substantially and does not correlate with ZAP sensitivity. We further show that the number of CpG residues in a defined region at the 5′ end of the
env
gene together with structural features plays a key role in HIV-1 susceptibility to ZAP and correlates with differences in clinical progression rates in HIV-1-infected individuals. Our identification of a specific part of
env
as a major determinant of HIV-1 susceptibility to ZAP restriction provides a basis for future studies of the underlying inhibitory mechanisms and their potential relevance in the pathogenesis of AIDS.
The U-Rich Untranslated Region of the Hepatitis E Virus Induces Differential Type I and Type III Interferon Responses in a Host Cell-Dependent Manner
Authors: Sooryanarain Harini , Heffron Connie L. , Meng Xiang-Jin
Published: January 2020

Hepatitis E virus (HEV) is an important human pathogen causing both acute and chronic viral hepatitis E infection. Currently, the mechanisms of HEV replication and pathogenesis remain poorly understood. The innate immune response acts as the first line of defense during viral infection. The retinoic acid-inducible gene I (RIG-I)-mediated interferon (IFN) response has been implicated in establishing antiviral response during HEV infection, although the HEV RNA motifs that are recognized by RIG-I are unknown. This study identified that the U-rich region in the 3′ untranslated region (UTR) of the HEV genome acts as a potent RIG-I agonist compared to the HEV 5′ UTR. We further revealed that the HEV RNA pathogen-associated motif patterns (PAMPs) induced a differential IFN response in a cell type-dependent manner: a predominantly type III IFN response in hepatocytes, and a predominantly type I IFN response in enterocytes. These data demonstrate the complexity by which both host and viral factors influence the IFN response during HEV infection.
Distinct but Intertwined Evolutionary Histories of Multiple Salmonella enterica Subspecies
Authors: Park Cooper J. , Andam Cheryl P.
Published: January 2020

S. enterica
is a major foodborne pathogen, which can be transmitted via several distinct routes from animals and environmental sources to human hosts. Multiple subspecies and serotypes of
S. enterica
exhibit considerable differences in virulence, host specificity, and colonization. This study provides detailed insights into the dynamics of recombination and its contributions to
S. enterica
subspecies evolution. Widespread recombination within the species means that new adaptations arising in one lineage can be rapidly transferred to another lineage. We therefore predict that recombination has been an important factor in the emergence of several major disease-causing strains from diverse genomic backgrounds and their ability to adapt to disparate environments.
Transcriptomic Response of Nitrosomonas europaea Transitioned from Ammonia- to Oxygen-Limited Steady-State Growth
Authors: Sedlacek Christopher J. , Giguere Andrew T. , Dobie Michael D. , Mellbye Brett L. , Ferrell Rebecca V. , Woebken Dagmar , Sayavedra-Soto Luis A. , Bottomley Peter J. , Daims Holger , Wagner Michael , Pjevac Petra
Published: January 2020

Nitrification is a ubiquitous microbially mediated process in the environment and an essential process in engineered systems such as wastewater and drinking water treatment plants. However, nitrification also contributes to fertilizer loss from agricultural environments, increasing the eutrophication of downstream aquatic ecosystems, and produces the greenhouse gas nitrous oxide. As ammonia-oxidizing bacteria are the most dominant ammonia-oxidizing microbes in fertilized agricultural soils, understanding their responses to a variety of environmental conditions is essential for curbing the negative environmental effects of nitrification. Notably, oxygen limitation has been reported to significantly increase nitric oxide and nitrous oxide production during nitrification. Here, we investigate the physiology of the best-characterized ammonia-oxidizing bacterium,
Nitrosomonas europaea
, growing under oxygen-limited conditions.
Consistent Metagenome-Derived Metrics Verify and Delineate Bacterial Species Boundaries
Authors: Olm Matthew R. , Crits-Christoph Alexander , Diamond Spencer , Lavy Adi , Matheus Carnevali Paula B. , Banfield Jillian F.
Published: January 2020

There is controversy about whether bacterial diversity is clustered into distinct species groups or exists as a continuum. To address this issue, we analyzed bacterial genome databases and reports from several previous large-scale environment studies and identified clear discrete groups of species-level bacterial diversity in all cases. Genetic analysis further revealed that quasi-sexual reproduction via horizontal gene transfer is likely a key evolutionary force that maintains bacterial species integrity. We next benchmarked over 100 metrics to distinguish these bacterial species from each other and identified several genes encoding ribosomal proteins with high species discrimination power. Overall, the results from this study provide best practices for bacterial species delineation based on genome content and insight into the nature of bacterial species population genetics.
Neurodevelopmental outcome descriptions in cohorts of extremely preterm children
Authors: Ding Sharon , Mew Emma J , Chee-A-Tow Alyssandra , Offringa Martin , Butcher Nancy J , Moore Gregory P
Published: January 2020

Background and objectives

Caregivers and clinicians of extremely preterm infants (born before 26 weeks’ gestation) depend on long-term follow-up research to inform clinical decision-making. The completeness of outcome reporting in this area is unknown. The objective of this study was to evaluate the reporting of outcome definitions, selection, measurement and analysis in existing cohort studies that report on neurodevelopmental outcomes of children born extremely preterm.

Methods

We evaluated the completeness of reporting of ‘cognitive function’ and ‘cerebral palsy’ in prospective cohort studies summarised in a meta-analysis that assessed the effect of preterm birth on school-age neurodevelopment. Outcome reporting was evaluated using a checklist of 55 items addressing outcome selection, definition, measurement, analysis, presentation and interpretation. Reporting frequencies were calculated to identify strengths and deficiencies in outcome descriptions.

Results

All 14 included studies reported ‘cognitive function’ as an outcome; nine reported both ‘cognitive function’ and ‘cerebral palsy’ as outcomes. Studies reported between 26% and 46% of the 55 outcome reporting items assessed; results were similar for ‘cognitive function’ and ‘cerebral palsy’ (on average 34% and 33% of items reported, respectively). Key methodological concepts often omitted included the reporting of masking of outcome assessors, methods used to handle missing data and stakeholder involvement in outcome selection.

Conclusions

The reporting of neurodevelopmental outcomes in cohort studies of infants born extremely preterm is variable and often incomplete. This may affect stakeholders’ interpretation of study results, impair knowledge synthesis efforts and limit evidence-based decision-making for this population.
Infant with status epilepticus secondary to systemic lidocaine toxicity from topical application
Authors: Walters Erica , Wurster Ovalle Victoria , Yin Shan , Dribin Timothy
Published: January 2020

A previously healthy 11-month-old infant presented to the emergency department in status epilepticus. There was no clear trigger of her seizure activity which resolved with benzodiazepines and fosphenytoin. On further review, her parents disclosed that she had been prescribed topical 4% lidocaine cream for a groin rash and was ultimately diagnosed with lidocaine toxicity in the emergency department. She was monitored in the intensive care unit without cardiovascular abnormalities or recurrence of seizure activity. Emergency medicine providers must maintain a broader differential of status epileptics and be able to recognise and manage potential complications from systemic lidocaine toxicity.
Gender-specific prevalence and influencing factors of osteopenia and osteoporosis in Chinese rural population: the Henan Rural Cohort Study
Authors: Qiao Dou , Liu Xiaotian , Tu Runqi , Zhang Xia , Qian Xinling , Zhang Haiqing , Jiang Jingjing , Tian zhongyan , Wang Yan , Dong Xiaokang , Luo Zhicheng , Liu Xue , Tian Huiling , Zhang Gongyuan , Pan Jun , Wang Chongjian
Published: January 2020

Objective

The aims of this study were to describe distributions of the prevalence of osteopenia and osteoporosis and identify the potential risk factors by gender in a Chinese rural population.

Design

A cross-sectional survey.

Setting and participants

A total of 8475 participants (18–79 years) were obtained from the Henan Rural Cohort Study. Bone mineral density (BMD) of the calcaneus for each individual was measured by ultrasonic bone density apparatus. Logistic regression models were used to evaluate associations of potential risk factors with prevalence of osteopenia and osteoporosis. Furthermore, a meta-analysis of prevalence of osteoporosis which included eight studies was conducted to confirm this study results.

Results

The mean of BMD were 0.42 and 0.32 g/cm2for men with osteopenia and osteoporosis (p<0.001), as well as 0.40 and 0.30 g/cm2(p<0.001) for women with osteopenia and osteoporosis, respectively. The overall age-standardised prevalence of osteopenia and osteoporosis were 42.09% and 11.76% in all participants. The age-standardised prevalence of osteopenia in men (45.98%) was significantly higher than that in women (39.73%), whereas the age-standardised prevalence of osteoporosis in men (7.82%) was lower than that in women (14.38%). Meta-analysis results displayed pooled prevalence of osteoporosis of 18.0% (10.1%–25.8%) in total sample, 7.7% (5.7%–9.7%) in men and 22.4% (17.1%–27.6%) in women. Multivariable logistic regression models showed that ageing, women, low education level or income, drinking or underweight was related to increased risk for osteopenia or osteoporosis.

Conclusions

About one-sixth of the participants suffered osteoporosis in rural China, and the prevalence in women was higher than men. Although the results were lower than that of meta-analysis, osteoporosis still accounts for huge burden of disease in rural population due to limited medical service and lack of health risk awareness rather than urban area.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR-OOC-15006699; Pre-results).
Yoga practice in the UK: a cross-sectional survey of motivation, health benefits and behaviours
Authors: Cartwright Tina , Mason Heather , Porter Alan , Pilkington Karen
Published: January 2020

Objectives

Despite the popularity of yoga and evidence of its positive effects on physical and mental health, little is known about yoga practice in the UK. This study investigated the characteristics of people who practise yoga, reasons for initiating and maintaining practice, and perceived impact of yoga on health and well-being.

Design, setting and participants

A cross-sectional online anonymous survey distributed through UK-based yoga organisations, studios and events, through email invites and flyers. 2434 yoga practitioners completed the survey, including 903 yoga teachers: 87% were women, 91% white and 71% degree educated; mean age was 48.7 years.

Main outcome measures

Perceived impact of yoga on health conditions, health outcomes and injuries. Relationships between yoga practice and measures of health, lifestyle, stress and well-being.

Results

In comparison with national population norms, participants reported significantly higher well-being but also higher anxiety; lower perceived stress, body mass index and incidence of obesity, and higher rates of positive health behaviours. 47% reported changing their motivations to practise yoga, with general wellness and fitness key to initial uptake, and stress management and spirituality important to current practice. 16% of participants reported starting yoga to manage a physical or mental health condition. Respondents reported the value of yoga for a wide range of health conditions, most notably for musculoskeletal and mental health conditions. 20.7% reported at least one yoga-related injury over their lifetime. Controlling for demographic factors, frequency of yoga practice accounted for small but significant variance in health-related regression models (p<0.001).

Conclusion

The findings of this first detailed UK survey were consistent with surveys in other Western countries. Yoga was perceived to have a positive impact on physical and mental health conditions and was linked to positive health behaviours. Further investigation of yoga’s role in self-care could inform health-related challenges faced by many countries.
Efficiency evaluation of public hospitals in Saudi Arabia: an application of data envelopment analysis
Authors: Alatawi Ahmed D , Niessen Louis Wilhelmus , Khan Jahangir A M
Published: January 2020

Objective

In this study, we assess the performance of public hospitals in Saudi Arabia. We detect the sources of inefficiency and estimate the optimal levels of the resources that provide the current level of health services. We enrich our analysis by employing locations and capacities of the hospitals.

Design

We employ data envelopment analysis (DEA) to measure the technical efficiency of 91 public hospitals. We apply the input-oriented Charnes, Cooper and Rhodes, and Banker, Charne, Cooper models under Constant and Variable Returns-to-Scale. The assessment includes four inputs, and six output variables taken from the Ministry of Health databases for 2017. We conducted the assessment via PIM-DEA V.3.2 software.

Setting

Ministry of health-affiliated hospitals in the Kingdom of Saudi Arabia.

Results

Findings identified 75.8% (69 of 91) of public hospitals as technically inefficient. The average efficiency score was 0.76, indicating that hospitals could have reduced their inputs by 24% without reduction in health service provision. Small hospitals (efficiency score 0.79) were more efficient than medium-sized and large hospitals. Hospitals in the central region were more efficient (efficiency score 0.83), than those located in other geographical locations. More than half of the hospitals (62.6%) were operating suboptimally in terms of the scale efficiency, implying that to improve efficiency, they need to alter their production capacity. Performance analysis identified overuse of physician’s numbers and shortage of health services production, as major causes of inefficiency.

Conclusion

Most hospitals were technically inefficient and operating at suboptimal scale size and indicate that many hospitals may improve their performance through efficient utilisation of health resources to provide the current level of health services. Changes in the production capacity are required, to facilitate optimal use of medical capacity. The inefficient hospitals could benefit from these findings to benchmarking their system and performance in light of the efficient hospital within their capacity and geographical location.
Comparisons of body mass index, waist circumference, waist-to-height ratio and a body shape index (ABSI) in predicting high blood pressure among Malaysian adolescents: a cross-sectional study
Authors: Tee Joyce Ying Hui , Gan Wan Ying , Lim Poh Ying
Published: January 2020

Objective

To compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds.

Design

Cross-sectional study.

Setting

Probability proportionate to size was used to randomly select two schools in Selangor state, Malaysia.

Participants

A total of 513 adolescents (58.9% women and 41.1% men) aged 12–16 years were recruited.

Primary and secondary outcome measures

Weight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve.

Results

BMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes.

Conclusions

These findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.
Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis
Authors: Leite Renata Giacomini Oliveira Ferreira , Banzato Luísa Rocco , Galendi Julia Simões Corrêa , Mendes Adriana Lucia , Bolfi Fernanda , Veroniki Areti Angeliki , Thabane Lehana , Nunes-Nogueira Vania dos Santos
Published: January 2020

Introduction

Despite the increasing number of drugs and various guidelines on the management of type 2 diabetes mellitus (T2DM), several patients continue with the disease uncontrolled. There are several non-pharmacological treatments available for managing T2DM, but various of them have never been compared directly to determine the best strategies.

Objective

This study will evaluate the comparative effects of non-pharmacological strategies in the management of T2DM in primary care or community settings.

Methods and analysis

We will perform a systematic review and network meta-analysis (NMA), and will include randomised controlled trials if one of the following interventions were applied in adult patients with T2DM: nutritional therapy, physical activity, psychological interventions, social interventions, multidisciplinary lifestyle interventions, diabetes self-management education and support (DSMES), technology-enabled DSMES, interventions delivered only either by pharmacists or by nurses, self-blood glucose monitoring in non-insulin-treated T2DM, health coaching, benchmarking and usual care. The primary outcome will be glycaemic control (glycated haemoglobin (HbA1c) (%)), and the secondary outcomes will be weight loss, quality of life, patient satisfaction, frequency of cardiovascular events and deaths, number of patients in each group with HbA1c <7, adverse events and medication adherence. We have developed search strategies for Embase, Medline, Latin American and Caribbean Health Sciences Literature, Cochrane Central Register of Controlled Trials, Trip database, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature Australasian Medical Index and Chinese Biomedical Literature Database. Four reviewers will assess the studies for their eligibility and their risk of bias in pairs and independently. An NMA will be performed using a Bayesian hierarchical model, and the treatment hierarchy will be obtained using the surface under the cumulative ranking curve. To determine our confidence in an overall treatment ranking from the NMA, we will follow the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

As no primary data collection will be undertaken, no formal ethical assessment is required. We plan to present the results of this systematic review in a peer-reviewed scientific journal, conferences and the popular press.

PROSPERO registration number

CRD42019127856.
Mental healthcare and palliative care: barriers
Authors: O'Malley Kelly , Blakley Laura , Ramos Katherine , Torrence Nicole , Sager Zachary
Published: January 2020

Context

Psychological symptoms are common among palliative care patients with advanced illness, and their effect on quality of life can be as significant as physical illness. The demand to address these issues in palliative care is evident, yet barriers exist to adequately meet patients’ psychological needs.

Objectives

This article provides an overview of mental health issues encountered in palliative care, highlights the ways psychologists and psychiatrists care for these issues, describes current approaches to mental health services in palliative care, and reviews barriers and facilitators to psychology and psychiatry services in palliative care, along with recommendations to overcome barriers.

Results

Patients in palliative care can present with specific mental health concerns that may exceed palliative care teams’ available resources. Palliative care teams in the USA typically do not include psychologists or psychiatrists, but in palliative care teams where psychologists and psychiatrists are core members of the treatment team, patient well-being is improved.

Conclusion

Psychologists and psychiatrists can help meet the complex mental health needs of palliative care patients, reduce demands on treatment teams to meet these needs and are interested in doing so; however, barriers to providing this care exist. The focus on integrated care teams, changing attitudes about mental health, and increasing interest and training opportunities for psychologists and psychiatrists to be involved in palliative care, may help facilitate the integration of psychology and psychiatry into palliative care teams.
Refractory pruritus from malignant cholestasis: management
Authors: Fernando GVMC , Preston Nancy
Published: January 2020

This case report deals with a patient managed in a tertiary-care cancer hospital who suffered pruritus associated with malignant cholestasis. His symptoms were resistant to conventional treatment with ursodeoxycholic acid, chlorpheniramine and cholestyramine. Hence, the multifactorial origin of malignancy-associated pruritus was considered. Correctable factors were corrected and generally the treatment was aimed at possible aetiologies. There were barriers related to insufficient resources available for symptom palliation in this particular setting, which could potentially reduce optimum symptom control. However, various pharmacotherapies and non-pharmacological measures which could potentially have helped relieve pruritus are described and future scope for research in this area discussed.
Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use
Authors: van Loon Merel , Van der Mast Roos C , van der Linden M Christien , van Gaalen Floris A
Published: January 2020

Background

Routine screening programmes for hazardous alcohol use in the ED miss large numbers of patients. We investigated whether patient-related or staff-related factors cause screening failures and whether unscreened patients are at increased risk of hazardous alcohol use.

Methods

This is a secondary analysis of a prospective study. From November 2012 to November 2013, all adult patients visiting a Dutch inner city ED were screened for hazardous alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption. Reasons for failure of screening were categorised as: (A) patient is unable to cooperate (due to illness or pain, decreased consciousness or incomprehension due to intoxication, psychiatric, cognitive or neurological disorder or language barrier), (B) healthcare professional forgot to ask, (C) patient refuses cooperation and (D) screening was recently performed (<6 months ago). Presence of risk factors for hazardous alcohol use was compared between screened and unscreened patients.

Results

Of the 28 019 ED patients, 18 310 (65%) were screened and 9709 (35%) were not. In 7150 patients staff forgot to screen, whereas 2559 patients were not screened due to patient factors (2340 being unable and 219 unwilling). Patients with any of these risk factors were less likely to be screened: male sex, alcohol-related visit, any intoxication, head injury, any kind of wound and major trauma. In multivariate analysis, all these risk factors were independently associated with not being screened. Patients with at least one risk factor for hazardous alcohol use were less likely to be screened. Highest prevalence of risk factors was found in patients unable or unwilling to cooperate.

Conclusion

Patients who do not undergo routine screening for alcohol use at triage in the ED have an increased risk for hazardous alcohol use. These data highlight the importance of screening patients, especially those initially unwilling or unable to cooperate, at a later stage.
Validation of the PredAHT-2 prediction tool for abusive head trauma
Authors: Pfeiffer Helena , Cowley Laura Elizabeth , Kemp Alison Mary , Dalziel Stuart R , Smith Anne , Cheek John Alexander , Borland Meredith L , O'Brien Sharon , Bonisch Megan , Neutze Jocelyn , Oakley Ed , Crowe Louise M , Hearps Stephen , Lyttle Mark D , Bressan Silvia , Babl Franz E
Published: January 2020

Objective

The validated Predicting Abusive Head Trauma (PredAHT) clinical prediction tool calculates the probability of abusive head trauma (AHT) in children <3 years of age who have sustained intracranial injuries (ICIs) identified on neuroimaging, based on combinations of six clinical features: head/neck bruising, seizures, apnoea, rib fracture, long bone fracture and retinal haemorrhages. PredAHT version 2 enables a probability calculation when information regarding any of the six features is absent. We aimed to externally validate PredAHT-2 in an Australian/New Zealand population.

Methods

This is a secondary analysis of a prospective multicentre study of paediatric head injuries conducted between April 2011 and November 2014. We extracted data on patients with possible AHT at five tertiary paediatric centres and included all children <3 years of age admitted to hospital who had sustained ICI identified on neuroimaging. We assigned cases as positive for AHT, negative for AHT or having indeterminate outcome following multidisciplinary review. The estimated probability of AHT for each case was calculated using PredAHT-2, blinded to outcome. Tool performance measures were calculated, with 95% CIs.

Results

Of 87 ICI cases, 27 (31%) were positive for AHT; 45 (52%) were negative for AHT and 15 (17%) had indeterminate outcome. Using a probability cut-off of 50%, excluding indeterminate cases, PredAHT-2 had a sensitivity of 74% (95% CI 54% t o89%) and a specificity of 87% (95% CI 73% to 95%) for AHT. Positive predictive value was 77% (95% CI 56% to 91%), negative predictive value was 85% (95% CI 71% to 94%) and the area under the curve was 0.80 (95% CI 0.68 to 0.92).

Conclusion

PredAHT-2 demonstrated reasonably high point sensitivity and specificity when externally validated in an Australian/New Zealand population. Performance was similar to that in the original validation study.

Trial registration number

ACTRN12614000463673.
Longitudinal neural exposure to local anesthetic and nerve block duration: a retrospective analysis of experimental data from healthy volunteer trials
Authors: Madsen Mikkel Herold , Christiansen Claus Behrend , Rothe Christian , Lundstrøm Lars Hyldborg , Lange Kai Henrik Wiborg
Published: January 2020

Background and objectives

Characteristics of a nerve block depend on the distribution of local anesthetic (LA) close to the nerve. The relationship between longitudinal distribution of LA and nerve block characteristics has not been investigatedin vivo, but onein vitrostudy showed decrements in action potential amplitudes with increasing exposure length. We describe the influence of longitudinal neural exposure to LA on nerve block duration adjusted for other likely influential factors.

Methods

We analyzed data from an ethical board approved prospective consecutive collected dataset of 180 healthy volunteers with a common peroneal nerve block (2.5–20 mL, 5–40 mg of ropivacaine). Data were retrieved from three independent randomized controlled trials. The longitudinal neural exposure to LA in millimeters was evaluated using ultrasound. Interventional covariates and demographics were retrieved. Nerve block duration, the dependent variable in the primary assessment, was defined as time of insensitivity to a cold stimulus and was evaluated blinded to all other covariates. Using a multiple linear mixed-effects model, we explored the association between neural exposure to LA and nerve block duration.

Results

We found a significant positive association between longitudinal neural exposure to LA and block duration (p<0.01). A 10% increase in longitudinal exposure resulted in an 8.7 (2.5; 15) min increase in block duration. LA dose was associated to block duration (p<0.001) but LA volume had no impact (p=0.93).

Conclusions

Longitudinal neural exposure to LA was significantly associated with nerve block duration. LA dose was the strongest determinant for block duration whereas LA volume had no influence.
Material properties for fracture mechanics based strength assessment of cast iron water mains
Authors: Debnath Suborno , Ali Ismail M. , Dhar Ashutosh Sutra , Thodi Premkumar
Published: January 2020

Municipal water distribution systems in Canada and other countries include a large number of cast iron pipes that were installed almost 50 years ago. For structural integrity assessment of these pipes, the fracture mechanics approach is found to be more effective than the conventional continuum mechanics-based approach. This paper presents the mechanical properties for fracture mechanics-based strength assessment of water mains determined through testing of cast iron pipes exhumed from two cities in Canada. Microstructure analysis is conducted to understand the materials’ inherent properties. Uniaxial tensile tests are conducted to determine the stress–strain relations. The influence of the rate of loading on stress–strain behaviour and loading-unloading responses are investigated. A simplified single-edge notch beam test is used to obtain the fracture toughness. Probabilistic distributions of the parameters are provided to account for the uncertainty and variabilities observed in the test results.
An experimental and numerical investigation of pullout behavior of ductile iron water pipes buried in sand
Authors: Murugathasan Parththeeban , Dhar Ashutosh Sutra , Hawlader Bipul C.
Published: January 2020

Buried pipelines, used for transporting liquid and gas, are often subjected to axial pulling forces due to seasonal temperature changes and (or) relative ground movements. The axial pullout force is exerted through soil–pipe interaction, which depends on the pipe material, surrounding soil and pipe–soil interface properties. In this research, axial pullout force on ductile iron pipe buried in sand is first experimentally investigated through development of a new laboratory facility. Based on the test results, simplified methods for predicting the axial forces are discussed. Finite element modelling is then used to investigate the mechanism of soil–pipe interaction and identify the key parameters contributing to the axial pullout force, which could not be measured during the laboratory tests. The constrained dilation of sand near the pipe–soil interface and arching effects due to a different stiffness of the pipe with respect to the soil are found to influence the mobilized axial forces on pipes.
Cannibalism of contourites by gravity flows: explanation of the facies distribution of the Ordovician Pingliang Formation along the southern margin of the Ordos Basin, China
Authors: Li Hua , van Loon A.J. , He Youbin
Published: January 2020

The Late Ordovician Pingliang Formation accumulated along the southern margin of the Ordos Basin in China. The convergence of the Yangtze Plate and Sino-Korean Plate led to a trench–arc–basin system during the Middle Ordovician, with a platform- and slope-dominated setting in the east where a graben complicated the overall simple paleogeographical picture, relatively parallel zones of a platform and a slope setting in the middle, and a change from platform to slope to deep marine to a trench setting in the west. This configuration resulted in various types of gravity flow deposits and contourites with different compositions and pathways. The present study focuses on the typical characteristics of contourites in the geological record and the relationships between contour currents and gravity flows. The Pingliang Formation contains eleven lithofacies grouped into five facies associations. These facies associations represent deep sea autochthonous deposits, several types of debrites, turbidites, and contourites, as well as turbidites within which the fine-grained top portion was reworked by a contour current. The various lithofacies are concentrated in different parts of the study area: micritic contourites and debrites are concentrated in the eastern part; debrites, and sandstone and siltstone turbidites are concentrated in the middle part; and calcarenitic turbidites, contourites, and reworked turbidites occur in the western part. The main contour current ran parallel to the contour lines from east to west. Although most of the contour current continually moved westward in the eastern part of the study area, a minor part split off and followed a semicircular pathway through the Fuping Graben; its velocity became reduced here so that micritic contourites were deposited. The velocity of the contour current was increased locally when it entered a confined trough in the western part of the study area. The relatively high energy of the contour current here resulted in calcarenitic contourites. The velocity of the contour current was low where it ran through an open environment, resulting in fine-grained, thin contourites in the middle part of the study area. Large turbidity currents and debris flows occurred here, and their high energy destroyed almost all earlier deposited contourites. This explains why traces of contour currents in the middle part of the study are very scarce, although the east–west-running contour current must have passed through this area.
Perspectives for early-career researchers on plagiarism and scientific integrity
Authors: Young Robert G. , Mitterboeck T. Fatima
Published: January 2020

Lapses in scientific integrity, such as plagiarism, persist in the scientific realm. To be successful and contributory, early-career researchers (ECRs), including graduate students, need to be able to effectively navigate the literature, peer-review process, and scientific research with integrity. Here we discuss different aspects of scientific integrity related to ECRs. Our discussion centres on the concepts of plagiarism and intellectual property, predatory journals, aspects of peer review, transparency in publishing, and false advanced accreditations. Negative elements within these topics may be especially damaging to ECRs, who may be less familiar with the research landscape. We highlight the need for ECRs to approach scientific investigation cautiously and thoughtfully to promote integrity through critical thinking.
A New Efficient Algorithm Based on Multi-Classifiers Model for Classification
Authors: Zheng Yifeng , Li Guohe , Zhang Wenjie
Published: January 2020

Classification is one of the most important problems in data mining and machine learning. The quality and quantity of classification rules are two factors to influence the accuracy of classification. In this paper, we propose a new algorithm to enhance the final classification accuracy, called CMCM (Classification based on Multiple Classifier Models), which consists of two classification models. Model1 centers on the improvement of quality. The optimal attribute values are obtained as the first item of a classification rule from both the items and their complements. While in Model2, quantity is taken into consideration, so it constructs two candidate sets and uses the one-versus-many strategy to generate several rules at one time. The experiment results demonstrate that CMCM can achieve higher classification accuracy than the proposed classification approaches. CMCM can extract sufficient high-quality rules for imbalanced data. Meanwhile, it can also obtain sufficient latent information for classification.
Semantic Provenance Based Trustworthy Users Classification on Book-Based Social Network using Fuzzy Decision Tree
Authors: Teekaraman Dhanalakshmi , Sendhilkumar S. , Mahalakshmi G. S.
Published: January 2020

As web-based social network allows anyone to post the content without any restriction, the trustworthiness of the content creator plays an important role before using the content. An effiective way to find the trustworthiness is, by analyzing the web resources related to the content creator. Therefore the trustworthiness is assessed using the provenance based ontological model called W7 model. Since it is a real time data, the computed trust for each reviewer using the ontological model is uncertain and vague. An appropriate way to classify such data is using the fuzzy logic with gradual trust level. As the computed trust data are feature-based and non-symbolic, the classification ambiguity need to be reduced greatly. This is achieved with the fuzzy decision tree approach, which is a fusion of fuzzy sets with decision tree. The truth of the rule is crucial in trustworthy user classification, as highly truthful rules really increase the credibility of the user in their domain. Therefore, in the proposed model, degree of truth is used as a pruning criteria that classifies the users with minimum number of fuzzy evidence or knowledge. This paper proposes a semantic provenance based gradual trust model to classify the trustworthy reviewers in a book-based social networks using fuzzy decision tree approach. Performance analysis of the proposed model in the terms of classifier accuracy, precision, recall, the number of rules generated and its time complexity are discussed. The analysis shows that the proposed learning model outperforms other classification models. This method is also applied to other data sets and the performance of the classifier is assessed.
Double Frontier Two-Stage Fuzzy Data Envelopment Analysis
Authors: Amirteimoori Alireza , Azizi Hossein , Kordrostami Sohrab
Published: January 2020

Data envelopment analysis (DEA) is a mathematical programming approach with widespread applications in productivity and efficiency analysis. Compared with traditional DEA models, two-stage DEA models show the performance of each process and make available more information for decision making. In an article by Kao and Liu, models were proposed for combining a two-stage process to achieve overall fuzzy efficiency measures. Their method follows the simple geometric average approach and uses the product of two efficiencies. The present article applies a different angle for efficiency analysis in the two-stage fuzzy DEA. We suggest that the overall efficiency score of a decision-making unit (DMU) is defined as total weight of stage efficiencies, not as the simple product of their efficiency. Moreover, the proposed fuzzy DEA models are different from the model by Kao and Liu for fuzzy data in that our models are linear without the need for additional changes in variables and use the same set of constraints to measure the efficiency of DMUs with fuzzy input and output data. While the models by Kao and Liu are a nonlinear optimization problem that need additional changes in variables, and use different sets of constraints to measure fuzzy efficiencies. Additionally, our proposed approach evaluates the performance of DMUs from both optimistic and pessimistic viewpoints. Finally, using the proposed approach, the Taiwanese non-life insurance company problem will be investigated.