bluuebunny/crossref_metadata_2025 huggingface dataset:
Eugenol attenuates inflammatory response and enhances barrier function during lipopolysaccharide-induced inflammation in the porcine intestinal epithelial cells
Authors: Hui Qianru , Ammeter Emily , Liu Shangxi , Yang Runqiang , Lu Peng , Lahaye Ludovic , Yang Chengbo
Published: July 2020

Eugenol (4-allyl-2-methoxyphenol) is an essential oil component, possessing antimicrobial, anti-inflammatory, and antioxidative properties; however, the effect of eugenol on porcine gut inflammation has not yet been investigated. In this study, an in vitro lipopolysaccharide (LPS)-induced inflammation model in porcine intestinal epithelial cells (IPEC-J2) has been set up. Cells were pretreated with 100 μM (16.42 mg/L) eugenol for 2 h followed by 10 μg/mL LPS stimulation for 6 h. Proinflammatory cytokine secretion; reactive oxygen species; gene expression of proinflammatory cytokines, tight junction proteins, and nutrient transporters; the expression and distribution of zonula occludens-1 (ZO-1); transepithelial electrical resistance (TEER); and cell permeability were measured to investigate the effect of eugenol on inflammatory responses and gut barrier function. The results showed that eugenol pretreatment significantly suppressed the LPS-stimulated interleukin-8 level and the mRNA abundance of tumor necrosis factor-α and restored the LPS-stimulated decrease of the mRNA abundance of tight junction proteins, such as ZO-1 and occludin, and the mRNA abundance of nutrient transporters, such as B0 1 system ASC sodium-dependent neutral amino acid exchanger 2, sodium-dependent glucose transporter 1, excitatory amino acid transporter 1, and peptide transporter 1. In addition, eugenol improved the expression and even redistribution of ZO-1 and tended to increase TEER value and maintained the barrier integrity. In conclusion, a low dose of eugenol attenuated inflammatory responses and enhanced selectively permeable barrier function during LPS-induced inflammation in the IPEC-J2 cell line.
Amphipods and sea anemones, an update
Authors: Vader Wim , Tandberg Anne Helene S
Published: July 2020

We present an updated survey of the Amphipoda that live in association with sea anemones. These amphipods can be divided into four groups: 1) symbiotic amphipods using sea anemones mainly for protection, but feeding largely independently; 2) amphipods feeding on sea anemones, but not permanently associated; 3) symbiotic amphipods living permanently among the tentacles of the sea anemones; and 4) symbiotic amphipods living permanently in the gastrovascular cavity of the sea anemones. Contrary to previous speculations, it appears that the amphipods in groups 3 and 4 mainly feed on host tissue, and the anemone-eating amphipods can therefore generally be classified as micropredators (group 2), ectoparasites (group 3), and almost endoparasites (especially those species in group 4 that spend their entire life cycle inside their hosts).

Although the associates in the latter two groups show various minor morphological, reproductive, and physiological adaptations to the symbiosis, these associations evolved many times independently. We provide new information on feeding ecology and a discussion of the evolution of these associations.
A model-theoretic approach to descriptive general frames: the van Benthem characterization theorem
Authors: Bezhanishvili Nick , Henke Tim
Published: July 2020

The celebrated van Benthem characterization theorem states that on Kripke structures modal logic is the bisimulation-invariant fragment of first-order logic. In this paper, we prove an analogue of the van Benthem characterization theorem for models based on descriptive general frames. This is an important class of general frames for which every modal logic is complete. These frames can be represented as Stone spaces equipped with a ‘continuous’ binary relation. The proof of our theorem generalizes Rosen’s proof of the van Benthem theorem for finite frames and uses as an essential technique a new notion of descriptive unravelling. We also develop a basic model theory for descriptive general frames and show that in many ways it behaves like the model theory of finite structures. In particular, we prove the failure of the compactness theorem, of the Beth definability theorem, of the Craig interpolation theorem and of the upward Löwenheim–Skolem theorem.1
COVID-19 and the financial system: a tale of two crises
Authors: Giese Julia , Haldane Andy
Published: July 2020

This paper compares and contrasts the resilience of the financial system, in particular banks, during the Global Financial Crisis and COVID-19. We show that banks are now part of the solution, rather than part of the problem, thanks to regulatory and institutional reforms over the past decade. Heeding the lessons from the Global Financial Crisis has paid dividends. We outline some early lessons from the COVID-19 crisis for the financial system going forward.
The Early-Life Origins of Later-Life Networks
Authors: Goldman Alyssa W
Published: July 2020

Personal social networks profoundly influence a wide range of outcomes throughout the life course. But little research has considered how some features of individuals’ social networks may be shaped by experiences in early life. This study uses nationally representative data from the National Social Life, Health, and Aging Project to examine how childhood circumstances may shape the structure of older adults’ personal social networks. The analyses show that higher childhood socioeconomic status is associated with larger network size and a more expansive, less kin-based network structure. At the same time, higher levels of family happiness in childhood are associated with greater network density and more kin-centric network composition, which may reflect greater access to social support and overall network intimacy across the life course. The results suggest that studies of the relative advantages of social network structure may benefit from contextualizing individuals’ social networks in terms of their social origins. The article discusses the need for additional research on the life-course bases of the link between childhood circumstances and later-life network properties, and what role this connection plays in shaping later-life well-being.
Trustworthiness: a dialectical perspective
Authors: Kumar Senthil
Published: July 2020

Trustworthiness is the core feature of the most productive and effective organizations. While the market value of an economic or business entity would mostly correspond to its trust-equity, however, an erosion of trust-equity will cause the market-value to nose dive. Studies have demonstrated that the ‘distrust’ or a ‘lack of trustworthiness’ can cost a business or government billions of dollars. Lack of trust within an organization can result in employee disengagement and organizational atrophy. An untrustworthy organization will not only alienate its employees, it will also cause damage to customer interests. In this article, we postulate how trustworthiness can act as a dialectical fulcrum between the diametrically opposing market/social forces within an economic/political organization—such as self-interest versus public good, cooperation versus competition, freedom versus control, labor versus capital, and production versus consumption.
Integrated Management of Stripe Rust and Overwintering of Puccinia striiformis f. sp. tritici in Wisconsin
Authors: Mueller Brian D. , Groves Carol L. , Conley Shawn P. , Chapman Scott A. , Kabbage Mehdi , Smith Damon L.
Published: July 2020

Puccinia striiformis f. sp. tritici (Pst) is the causal agent of stripe rust and is one of the most problematic pathogens of winter and spring wheat in the United States. Planting resistant cultivars and applying foliar fungicides are common management practices to control this pathogen. In this 2-year study, two fungicides applied at three growth stages were tested on three soft red winter wheat cultivars varying in levels of resistance to stripe rust. Both fungicides (prothioconazole + tebuconazole and pyraclostrobin) applied at Feekes 8 and 10 reduced disease index and increased yield compared with the nontreated control in susceptible (‘Pro Seed 420’) and moderately susceptible (‘Kaskaskia’) cultivars. The highly resistant cultivar (‘Pro Seed 380’) had the greatest yields, and fungicide treatments had no effect on disease levels or yield. In an accompanying study, Pst was found to survive over the 2016 to 2017 winter on the susceptible cultivar Pro Seed 420. This study confirmed that resistance and properly timed fungicide applications play a crucial role in managing stripe rust on winter wheat. This study also demonstrated that Pst can overwinter in Wisconsin, and the impact of this occurrence should be examined further.
Limiting Fungal Foliar Diseases on Carrots for Organic and Conventional Markets
Authors: Donne Irene , Higgins Douglas S. , Brisco-McCann Elizabeth , Hausbeck Mary K.
Published: July 2020

Michigan ranks fourth in carrot production for the combined fresh and processing markets. Fungal foliar diseases caused by Alternaria dauci and Cercospora carotae occur annually in the state, causing blighted and weakened leaves and petioles. Our objective was to update current disease management strategies for both organic and conventional production by testing Organic Materials Review Institute (OMRI)–approved and conventional fungicides against C. carotae and A. dauci. Field trials conducted in 2015 and 2016 found that the copper-based fungicides (copper hydroxide and copper hydroxide/copper oxychloride) were the only OMRI-approved products that, as indicated by relative area under the disease progress curve (rAUDPC) data, consistently limited foliar blight. In field trials of conventional fungicides, all treatments limited symptomatic foliar area and protected petiole health compared with the control in both years with one exception: propiconazole was similar to the control in 2016 for petiole health and in 2015 for rAUDPC values. During 2016 when disease pressure was high, pyraclostrobin/fluxapyroxad outperformed iprodione, pyraclostrobin, azoxystrobin/propiconazole, and cyprodinil/fludioxonil for the control of foliar blight. Yields differed significantly among conventional treatments only in 2016. In plots sprayed with pyraclostrobin/boscalid, pyraclostrobin/fluxapyroxad, chlorothalonil, and boscalid had higher yields than penthiopyrad, iprodione, and propiconazole. These results can contribute to management strategies for C. carotae and A. dauci in organic or conventional production systems.
Adult Plant Leaf Rust Resistance in AC Taber Wheat Maps to Chromosomes 2BS and 3BS
Authors: Kolmer J. A. , Turner M. K. , Rouse M. N. , Anderson J. A.
Published: July 2020

AC Taber is a hard red spring wheat cultivar that has had long-lasting resistance to the leaf rust fungus Puccinia triticina. The objective of this study was to determine the chromosome location of the leaf rust resistance genes in AC Taber. The leaf rust-susceptible cultivar Thatcher was crossed with AC Taber to develop an F6 recombinant inbred line (RIL) population. The RILs and parents were evaluated for segregation of leaf rust resistance in five field plot tests and in two seedling tests to race BBBDB of P. triticina. A genetic map of the RIL population was developed using 90,000 single nucleotide polymorphism markers with the Illumina Infinium iSelect 90K wheat bead array. Quantitative trait loci (QTLs) with significant effects for lower leaf rust severity in the field plot tests were found on chromosomes 2BS and 3BS. The same QTLs also had significant effects for lower infection type in seedlings to leaf rust race BBBDB. The gene on 2BS was the adult plant resistance gene Lr13, and the gene on 3BS mapped to the same region as the adult plant resistance gene Lr74 and other QTLs for leaf rust resistance. Kompetitive allele-specific PCR assay markers linked to the 2BS and 3BS regions were developed and should be useful for marker-based selection of these genes.
Esteya floridanum sp. nov.: An Ophiostomatalean Nematophagous Fungus and Its Potential to Control the Pine Wood Nematode
Authors: Li You , Yu Haiying , Araújo João P. M. , Zhang Xinfeng , Ji Yingchao , Hulcr Jiri
Published: July 2020

The nematophagous fungal genus Esteya is reported as a natural enemy of the pine wood nematode Bursaphelenchus xylophilus, which causes pine wilt in Asia and Europe. During a survey of fungi associated with ambrosia beetles in Florida, an undescribed Esteya species was found. A phylogenetic analysis based on nuclear large subunit and β-tubulin DNA sequences supported this isolate as a new species, E. floridanum. Morphological and phylogenetic characteristics and a species description are provided here. The fungus was observed to kill the pine wood nematode in vitro. To evaluate the ability of E. floridanum to protect trees against the pine wood nematode in vivo, the effect of prophylactic inoculation was tested on Pinus koraiensis and Larix olgensis in Liaoning, China. The results suggest that the fungus is not a plant pathogen and that it delays wilt and postpones death of two conifer trees. This presents a potential new avenue for research on biocontrol of pine wilt disease and stresses the value of research on pest organisms in their native regions.
Will Losing Black Physicians Be a Consequence of the COVID-19 Pandemic?
Authors: Filut Amarette , Carnes Molly
Published: July 2020

A compelling case exists that increasing the number of Black physicians trained and practicing in the United States is one effective intervention to promote health equity and reduce the persistent health disparities that have become glaringly evident during the COVID-19 pandemic. However, the U.S. physician workforce has relatively few Black physicians. Blacks comprise approximately 13% of the U.S. population but only 5% of practicing physicians. In this Invited Commentary, the authors caution that the COVID-19 pandemic may erode the meager progress that has been made in increasing the number of Black physicians. This loss of Black physicians may happen because Black patients are overrepresented among cases of COVID-19, Black physicians care for relatively more Black patients often in settings with less access to SARS-CoV-2 testing and personal protective equipment, and Black physicians have more comorbid chronic conditions that increase their own susceptibility to mortality from COVID-19. All organizations in which physicians train and practice must redouble their efforts to recruit, train, and retain Black physicians. If nothing else, the COVID-19 pandemic must make academic health centers and health care systems recognize Black physicians as the precious resource they are and protect and reward them accordingly.
Relocating IV Pumps for Critically Ill Isolated Coronavirus Disease 2019 Patients From Bedside to Outside the Patient Room
Authors: Shah Ami G. , Taduran Chris , Friedman Seana , Sarosky Kimberly , Jones Mila , Victory-Stewart Marcelina , Dunau Frederick , Liesenfeld Meghan , Pasqualini Darla , Mandel Sarah , Fiol Natalie , Ghia Samit , Puskas John D. , Bhatt Himani V. , Shapiro Janet , Tomey Matthew I. , Yimen Mekeleya
Published: July 2020

Objectives:

Discuss advantages and disadvantages of relocating IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room and characterize reproducible details of an external infusion pump model.

Design:

Brief report.

Setting:

ICUs at a single-center teaching hospital.

Patients:

Critically ill coronavirus disease 2019 patients under contact and special droplet precautions.

Interventions:

Relocation of IV pumps for coronavirus disease 2019 patients from bedside to outside the patient room using extension tubing.

Measurements and Main Results:

Infusion pumps secured to a rolling IV pole are moved immediately outside the patient room with extension tubing, reaching the patient through a closed door. It is anticipated that this practice may reduce unnecessary coronavirus disease 2019 exposure for healthcare professionals, reduce the consumption of personal protective equipment, and promote patient safety by limiting delays of donning personal protective equipment to initiate or adjust medications.

Conclusions:

Risks of situating IV pumps outside the patient room must be carefully weighed against the benefits. Relocation of IV pumps outside the patient room may be considered given shortages of personal protective equipment and high risk of healthcare professional exposure. Institutional review-approved studies investigating the measured impact on decreased exposure, personal protective equipment usage, and patient safety are required.
Long-term Renal Outcomes in Adults With Sepsis-Induced Acute Kidney Injury
Authors: Harris Pamela L. , Umberger Reba A.
Published: July 2020

Background

Despite advances in medical technologies and intervention occurrences, acute kidney injury (AKI) incidence continues to rise. Early interventions after sepsis are essential to prevent AKI and its long-term consequences. Acute kidney injury is the leading cause of organ failure in sepsis; therefore, more research is needed on its long-term consequences and progression to kidney injury.

Objectives

The aim of this study was to review the state of the science on long-term renal outcomes after sepsis-induced AKI and long-term renal consequences.

Methods

We identified research articles from PubMed and CINAHL databases using relevant key words for sepsis-induced AKI within 5 years delimited to full-text articles in English.

Results

Among 1280 abstracts identified, we ultimately analyzed 12 full-text articles, identifying four common themes in the literature: (1) AKI determination criteria, (2) severity/prognosis-related factors, (3) time frame for long-term outcome measures, and (4) chronic kidney disease (CKD) and renal related exclusions. Researchers primarily used KDIGO (Kidney Disease: Improving Global Outcomes) guidelines to define AKI. All of these studies excluded patients with CKD. The range of time for long-term renal outcomes was 28 days to 3 years, with the majority being 1 year. Renal outcomes ranged from recovery to renal replacement therapy to death.

Conclusions

To better understand the long-term renal outcomes after sepsis-induced AKI, more consistent measures are needed across all studies regarding the time frame and specific renal outcomes. Because all of these articles excluded patients with CKD, a gap exists on long-term renal outcome in acute on CKD.
Do Illness Perception Predict Perceived Learning Needs Among Patients Treated With Percutaneous Coronary Intervention
Authors: Ashour Ala , Al-Smadi Ahmed , Tawalbeh Loai , Alshraifeen Ali , Al-Rawashdeh Sami , Gharaibeh Besher
Published: July 2020

Background

The number of coronary heart disease (CHD) patients treated with percutaneous coronary intervention (PCI) has increased. The illness perception (IP) of PCI recipients needs to be evaluated. Yet, little is known whether patients' IP predicts perceived learning needs among patients treated with PCI.

Objective

The aim of this study was to assess patients' IP and to examine its influence on perceived learning needs post PCI.

Methods

A cross-sectional design was used. A convenience sample of 208 patients who had undergone first-time PCI participated in the study. Data were collected before patients were discharged from the hospital using the Brief Illness Perception Questionnaire and the Percutaneous Coronary Intervention Learning Need Scale.

Results

Patients were highly concerned about their illness and perceived high consequences and symptoms related to CHD. They perceived low levels of personal and treatment control over their illness. Patients reported high learning needs. Multiple linear regression showed that low perception of personal control (P < .037), treatment control (P < .041), and high perception of disease symptoms (P < .018) significantly predicted high perceived learning needs.

Conclusion

Hence, the patients' IP influences perceived learning needs, which may be included in routine clinical assessments. Tailored health education programs are needed for patients treated with PCI; such a program should target patients who perceived low levels of personal and treatment control over illness and have a high perception of symptoms.
Genetic Susceptibility to Life-threatening Respiratory Syncytial Virus Infection in Previously Healthy Infants
Authors: López Eduardo Luis , Ferolla Fausto Martin , Toledano Analía , Yfran Eduardo Walter , Giordano Ana Clara , Carrizo Bárbara , Feldman Florencia , Talarico Laura Beatriz , Caratozzolo Ana , Contrini María Marta , Acosta Patricio Leandro
Published: July 2020

Background:

Genetic background may be an important host determinant of respiratory syncytial virus (RSV) disease severity, but full characterization of susceptibility genes remains unclear. This study aimed to assess the presence of specific single-nucleotide polymorphisms (SNPs) in selected genes codifying for different components of the antiviral innate immune response, to determine their role for developing RSV life-threatening disease (LTD).

Methods:

Prospective cohort study including previously healthy full-term infants hospitalized with a first RSV infection during 2017–2018. RSV detection, quantification and subgroup determination, and genotyping for SNPs in Toll-like receptor 4 (TLR4 rs4986790, rs4986791), Toll-like receptor 8 (TLR8 rs3761624), macrophage receptor with collagenous structure(MARCO rs1318645) and myxovirus resistance 1(MX1 rs469390) were performed by real-time polymerase chain reaction in nasopharyngeal aspirates obtained on admission. Patients with LTD were those admitted to the intensive care unit requiring ventilatory support.

Results:

Seventy-five patients were studied, 15 (20%) developed LTD. Infants with concurrent SNPs in MX1 and TLR8, MARCO and TLR8 or MARCO, MX1 and TLR8 had an increased risk of developing LTD. Multivariable logistic regression analysis confirmed this significant association (odds ratio [OR] = 3.75, P = 0.046; OR = 3.92, P = 0.040; OR = 5.56, P = 0.010, respectively). No differences were seen in viral load of patients with LTD compared with those with better outcome (P = 0.737). In addition, no differences in viral load were seen in patients with the described high-risk SNPs compared with those without these polymorphisms.

Conclusions:

Life-threatening RSV infection in previously healthy infants was significantly associated with the presence of combined SNPs in MARCO, MX1 and TLR8.
Thrombosis and Bleeding in Extracorporeal Membrane Oxygenation (ECMO) Without Anticoagulation: A Systematic Review
Authors: Olson Sven R. , Murphree Catherine R. , Zonies David , Meyer Andrew D. , Mccarty Owen J. T. , Deloughery Thomas G. , Shatzel Joseph J.
Published: July 2020

Extracorporeal membrane oxygenation (ECMO) causes both thrombosis and bleeding. Major society guidelines recommend continuous, systemic anticoagulation to prevent thrombosis of the ECMO circuit, though this may be undesirable in those with active, or high risk of, bleeding. We aimed to systematically review thrombosis and bleeding outcomes in published cases of adults treated with ECMO without continuous systemic anticoagulation. Ovid MEDLINE, Cochrane CENTRAL and CDSR, and hand search via SCOPUS were queried. Eligible studies were independently reviewed by two blinded authors if they reported adults (≥18 years) treated with either VV- or VA-ECMO without continuous systemic anticoagulation for ≥24 hours. Patient demographics, clinical data, and specifics of ECMO technology and treatment parameters were collected. Primary outcomes of interest included incidence of bleeding, thrombosis of the ECMO circuit requiring equipment exchange, patient venous or arterial thrombosis, ability to wean off of ECMO, and mortality. Of the 443 total publications identified, 34 describing 201 patients met our inclusion criteria. Most patients were treated for either acute respiratory distress syndrome or cardiogenic shock. The median duration of anticoagulant-free ECMO was 4.75 days. ECMO circuity thrombosis and patient thrombosis occurred in 27 (13.4%) and 19 (9.5%) patients, respectively. Any bleeding and major or “severe” bleeding was reported in 66 (32.8%) and 56 (27.9%) patients, respectively. Forty patients (19%) died. While limited by primarily retrospective data and inconsistent reporting of outcomes, our systematic review of anticoagulant-free ECMO reveals an incidence of circuity and patient thrombosis comparable to patients receiving continuous systemic anticoagulation while on ECMO.
A Simple Approach for Gas Blender on Extracorporeal Membrane Oxygenation in Resource Shortage Context
Authors: De Roux Quentin , Delage Mathilde , Lê Minh Pierre , Vincent Thomas , Mongardon Nicolas
Published: July 2020

With the massive influx of patients during COVID-19 pandemic into intensive care unit, resources have quickly been stretched to the limit, including extracorporeal membrane oxygenation (ECMO). Gas blender attached to ECMO is used to allow precise adjustment of characteristics of fresh gas flow, that is, blood oxygen delivery and carbon dioxide removal. To cope with the gas blender shortage, we describe a back-up system set up in our French tertiary referral ECMO center using air and oxygen flowmeters. A table has been created to facilitate medical prescription but also nurse monitoring. This extraordinary situation forces physicians to adapt medical devices, and that could be useful in future viral pandemics.
Assessment of Procedural Distress in Sedated/Intubated Children Under 3 Years Old Using the Newborn Infant Parasympathetic Evaluation: A Diagnostic Accuracy Pilot Study*
Authors: Recher Morgan , Rousseaux Jérémie , Flocteil Mathilde , Jouancastay Mylène , Potisek Alice , Lampin Marie-Emilie , Leteurtre Stéphane , De jonckheere Julien
Published: July 2020

Objectives:

Newborn infant parasympathetic evaluation index is based on heart rate variability and is related to the autonomic response to pain or stress. The Comfort Behavior Scale is used to assess distress intensity in sedated intubated children. The objective of this study was to assess the validity and performance of newborn infant parasympathetic evaluation as a distress indicator during procedural distress.

Design:

Monocentric, prospective, noninterventional pilot study of diagnostic accuracy between October 1, 2017, and April 30, 2019.

Setting:

PICU in a tertiary care university hospital.

Patients:

Sedated intubated children under 3 years old.

Interventions:

We continuously obtained mean newborn infant parasympathetic evaluation and instantaneous newborn infant parasympathetic evaluation scores and compared them to Comfort Behavior scores obtained before (T1 period), during (T2 period), and after (T3 period) care procedures.

Measurements and Main Results:

We obtained 54 measurements from 32 patients. The median age was 4 months (23 d to 31 mo). Between T1 and T2, there was a significant decrease in the instantaneous newborn infant parasympathetic evaluation and mean newborn infant parasympathetic evaluation scores (64 ± 2 to 42 ± 1 [p
< 0.0001] and 64 ± 1 to 59 ± 1 [p = 0.007], respectively) and a significant increase in the Comfort Behavior scores (from 12 ± 0 to 16 ± 1; p
< 0.0001). Comfort Behavior scores and instantaneous newborn infant parasympathetic evaluation and mean newborn infant parasympathetic evaluation scores were significantly inversely correlated (r = –0.44, p
< 0.0001 and r = –0.19, p = 0.01, respectively). With a instantaneous newborn infant parasympathetic evaluation score threshold of 53, the sensitivity, specificity, positive predictive, and negative predictive values to predict a Comfort Behavior Scale up to 17 were 80.0%, 73.5%, 43.8%, and 93.5%, respectively.

Conclusions:

Instantaneous newborn infant parasympathetic evaluation is valid for assessing distress in sedated/intubated children in the PICU. Further studies are needed to confirm these results and for newborn infant parasympathetic evaluation-based comparisons of sedation-analgesia protocols.
Clinical Characteristics and Outcomes for Neonates, Infants, and Children Referred to a Regional Pediatric Intensive Care Transport Service for Extracorporeal Membrane Oxygenation*
Authors: Annicq Ariane S. J. M. , Randle Elise , Ramnarayan Padmanabhan
Published: July 2020

Objectives:

To describe the clinical characteristics and outcomes of referrals for extracorporeal membrane oxygenation to a regional pediatric intensive care transport service, and identify clinical features at initial referral that predict the eventual need for extracorporeal membrane oxygenation.

Design:

Retrospective analysis of prospectively collected data.

Setting:

Specialist pediatric intensive care transport service based at a large U.K. extracorporeal membrane oxygenation center.

Patients:

All referrals made for potential extracorporeal membrane oxygenation transport between January 2014 and July 2017.

Interventions:

None.

Measurements and Main Results:

Demographic and clinical data at the time of referral, referral outcome, and 90-day mortality status were extracted. Univariate and multivariate analyses were used to identify clinical features at initial referral in neonates that predicted the need for extracorporeal membrane oxygenation. Of 253 extracorporeal membrane oxygenation referrals, 203 were included: 64 of 203 received extracorporeal membrane oxygenation (31.5%), 18 were accepted for extracorporeal membrane oxygenation but died before extracorporeal membrane oxygenation could be provided (8.8%), and 121 did not receive extracorporeal membrane oxygenation (59.6%). The transport team mobilized in 136 of 203 referrals (66.9%); conventional transport to an extracorporeal membrane oxygenation center was successful in 127 of 136 (93.4%), while nine of 136 were too unstable to transport. The 90-day mortality for the cohort was 17.7% (36/203). In logistic regression analysis, the odds ratio of requiring extracorporeal membrane oxygenation for diaphragmatic hernia was 12.0 (95% CI, 2.8–52.1) compared to meconium aspiration syndrome. Oxygenation index and Vasoactive-Inotropic Score were independent predictors of the need for extracorporeal membrane oxygenation in neonates.

Conclusions:

In this large cohort of neonatal and pediatric extracorporeal membrane oxygenation referrals to a pediatric intensive care transport service, a considerable portion of extracorporeal membrane oxygenation referrals (59.6%) continued on conventional management; however, 8.8% of the referrals died before extracorporeal membrane oxygenation could be provided. Earlier referral for extracorporeal membrane oxygenation; targeted referral triage using primary diagnosis, oxygenation index, and Vasoactive-Inotropic Score; and access to mobile extracorporeal membrane oxygenation services and faster mobilization of transport teams are important factors that could improve outcomes.
Methadone’s Effect on Cardiac Repolarization: Safety in the PICU
Authors: Friedman Samantha D. , Kovach Joshua R. , Thompson Nathan E.
Published: July 2020

Objectives:

Opioids are routinely used in the PICU. Methadone is an effective method of preventing and treating iatrogenic opioid withdrawal; however, it carries an Food and Drug Administration Boxed Warning due to the potential to prolong the corrected QT interval and potentially lead to life-threatening arrhythmias. Guidelines on the safe use of methadone have limited applicability to children since their cardiac intervals differ from those of adults. There is little data on the electrophysiologic effects in the pediatric population. We set out to describe the safety of methadone use in the PICU, hypothesizing that methadone does not cause a significant change in corrected QT interval from baseline.

Design:

Retrospective cohort study.

Setting:

Children’s Hospital of Wisconsin, Milwaukee, WI.

Patients:

Fifty-one patients, age less than or equal to 18 years old, initiated on methadone during PICU admission, over an 11-month period, for the prevention or treatment of opioid withdrawal.

Interventions:

Retrospective data queried from the electronic health record and stored telemetry waveforms obtained from an automated real-time patient data acquisition software system (BedMasterEx; Anandic Medical Systems AG, Feuerthalen, Switzerland).

Measurements and Main Results:

Corrected QT intervals were not significantly different at 12 hours, 96 hours, or PICU discharge (p values: 0.57, 0.54, and 0.34) when compared to baseline. The median change in corrected QT from baseline to 12 hours after the first dose of methadone was 5 ms (interquartile range, –12 to 11 ms), 0 ms to steady state (interquartile range, –18 to 18 ms), and 5 ms from baseline to 12 hours after the highest dose of methadone (interquartile range, –14 to 16 ms). The most common primary diagnosis was structural heart disease (29% of subjects) in our cohort and every subject that experienced an increase in corrected QT interval greater than or equal to 40 ms had some form of structural heart disease.

Conclusions:

Methadone did not significantly prolong the corrected QT interval in a population of critically ill children, suggesting that it can be safely used in this population, although patients with structural heart disease may warrant closer monitoring.
Skin-to-Skin Care Is a Safe and Effective Comfort Measure for Infants Before and After Neonatal Cardiac Surgery
Authors: Lisanti Amy J. , Demianczyk Abigail C. , Costarino Andrew , Vogiatzi Maria G. , Hoffman Rebecca , Quinn Ryan , Chittams Jesse L. , Medoff-Cooper Barbara
Published: July 2020

Objectives:

To determine the effect of skin-to-skin care on stress, pain, behavioral organization, and physiologic stability of infants with critical congenital heart disease before and after neonatal cardiac surgery.

Design:

A baseline response-paired design was used, with infants acting as their own controls before, during, and after skin-to-skin care at two distinct time points: once in the preoperative period (T1) and once in the postoperative period (T2).

Setting:

Cardiac ICU and step-down unit in a large metropolitan freestanding children’s hospital.

Subjects:

Convenience sample of 30 infants admitted preoperatively for critical congenital heart disease.

Interventions:

Eligible infants were placed into skin-to-skin care for 1 hour with their biological mothers once each at T1 and T2.

Measurements and Main Results:

Measurements of stress (salivary cortisol), pain and behavior state (COMFORT scale), and physiologic stability (vital signs) were assessed immediately before skin-to-skin care, 30 minutes into skin-to-skin care, and 30 minutes after skin-to-skin care ended.

At both T1 and T2, infant pain scores were significantly decreased (p < 0.0001) and infants moved into a calmer behavior state (p < 0.0001) during skin-to-skin care as compared to baseline. At T1, infants also had significantly reduced heart rate (p = 0.002) and respiratory rate (p < 0.0001) and increased systolic blood pressure (p = 0.033) during skin-to-skin care. At both T1 and T2, infant cortisol remained stable and unchanged from pre-skin-to-skin care to during skin-to-skin care (p = 0.096 and p = 0.356, respectively), and significantly increased from during skin-to-skin care to post-skin-to-skin care (p = 0.001 and p = 0.023, respectively). Exploratory analysis revealed differences in cortisol reactivity for infants with higher baseline cortisol (> 0.3 μg/dL) versus lower (≤ 0.3 μg/dL) prior to skin-to-skin care. Infants with higher baseline cortisol at T2 experienced significantly reduced cortisol during skin-to-skin care (p = 0.025). No significant differences in demographics or baseline variables were found between infants in either group.

Conclusions:

Skin-to-skin care is a low-cost, low-risk intervention that promotes comfort and supports physiologic stability in infants before and after neonatal cardiac surgery.
Investigating the Efficacy of Hydrocolloid Dressing for Preventing Nasotracheal Tube-Related Pressure Injury in the PICU
Authors: Chen Jie , Chen Jinlu , Yang Jine , Chen Yanxuan , Liang Yufeng , Lin Yan
Published: July 2020

Objectives:

To investigate the efficacy of hydrocolloid dressing in reducing the occurrence rate and severity of nasotracheal tube-related pressure injury.

Design:

Randomized controlled trial.

Setting:

A PICU in a tertiary medical center in southern China.

Patients:

Pediatric patients received invasive mechanical ventilation via nasotracheal tubes.

Interventions:

The hydrocolloid dressing was cut into an optimal square size, which should cover the area from the nasal columella to the ala.

Measurements and Main Results:

Eligible participants were randomly allocated to the control group and the experimental group. The participants in the experimental group received hydrocolloid dressing to protect nasal skin from the beginning of nasotracheal intubation, while the participants in the control group received the current care procedure (without hydrocolloid dressing) unless pressure injuries occurred. The hydrocolloid dressing was changed daily to assess the nasal skin. The pressure injury staging system that was redefined and updated by the National Pressure Ulcer Advisory Panel in 2016 was used. The mean duration of nasotracheal intubation was 150.10 ± 117.09 hours in the experimental group and 161.75 ± 120.72 hours in the control group. Forty-five participants had nasotracheal tube-related pressure injuries in control group, whereas 26 patients had in experimental group (72.6% vs 43.3%; absolute difference, 29.3%, 95% CI, 12.5–46%; p = 0.001). The median survival times of the nasal skin integrity were 95.5 hours in the control group and 219.5 hours in the experimental group (p < 0.001).

Conclusions:

Hydrocolloid dressing can not only reduce the occurrence rate of nasotracheal tube-related pressure injury in the child with long-term nasotracheal intubation but also improve the endurance of the nasal skin significantly.
Polyunsaturated phospholipids increase cell resilience to mechanical constraints
Authors: Ferreira Thierry , Kadri Linette , Bacle Amélie , Khoury Spiro , Vandebrouck Clarisse , Bescond Jocelyn , Faivre Jean-François , Sebille Stéphane
Published: July 2020

Despite the fact that PolyUnsaturated Fatty Acids (PUFA) are generally accepted to be good for health, the mechanisms of their bona fide benefits still remain elusive. PUFA are particularly enriched in the membrane Phospholipids (PLs) of selective organs, among which skeletal muscles and the cardiovascular system are prime examples. The fatty acid composition of PLs is known to regulate crucial membrane properties, including rigidity, elasticity and plasticity. Since muscle cells undergo repeated cycles of elongation and relaxation and are constantly exposed to mechanical stress, we postulated in the present study that PUFA-containing PLs could be central players for muscle cell adaptation to mechanical constraints. By a combination of in cellulo and in silico approaches, we show that PUFA, and particularly the ω-3 DocoHexaenoic Acid (DHA), regulate important properties of the plasma membrane that improve muscle cell resilience to mechanical constraints. Thanks to their unique property to contortionate within the bilayer plane, they facilitate the formation of Vacuole-like dilation (VLD) which, in turn, reduce membrane stress and avoid cell breakage under mechanical constraints.
Circulating Mitochondrial DNA is an Early Indicator of Severe Illness and Mortality from COVID-19
Authors: Scozzi Davide , Cano Marlene , Ma Lina , Zhou Dequan , Zhu Ji Hong , O’Halloran Jane A , Goss Charles , Rauseo Adriana M. , Liu Zhiyi , Peritore Valentina , Rocco Monica , Ricci Alberto , Amodeo Rachele , Aimati Laura , Ibrahim Mohsen , Hachem Ramsey , Kreisel Daniel , Mudd Philip A. , Kulkarni Hrishikesh S. , Gelman Andrew E.
Published: July 2020

Mitochondrial DNA (MT-DNA) are intrinsically inflammatory nucleic acids released by damaged solid organs. Whether the appearance of cell-free MT-DNA is linked to poor COVID-19 outcomes remains undetermined. Here, we quantified circulating MT-DNA in prospectively collected, cell-free plasma samples from 97 subjects with COVID-19 at the time of hospital presentation. Circulating MT-DNA were sharply elevated in patients who eventually died, required ICU admission or intubation. Multivariate regression analysis revealed that high circulating MT-DNA levels is an independent risk factor for all of these outcomes after adjusting for age, sex and comorbidities. Additionally, we found that circulating MT-DNA has a similar or superior area-under-the curve when compared to clinically established measures of systemic inflammation, as well as emerging markers currently of interest as investigational targets for COVID-19 therapy. These results show that high circulating MT-DNA levels is a potential indicator for poor COVID-19 outcomes.
A new model of chronicMycobacterium abscessuslung infection in immunocompetent mice
Authors: Riva Camilla , Tortoli Enrico , Cugnata Federica , Sanvito Francesca , Esposito Antonio , Rossi Marco , Colarieti Anna , Canu Tamara , Cigana Cristina , Bragonzi Alessandra , Loré Nicola Ivan , Miotto Paolo , Cirillo Daniela Maria
Published: July 2020

Pulmonary infections caused byMycobacterium abscessus(MA) have increased over recent decades affecting individuals with underlying pathologies such as chronic obstructive pulmonary disease, bronchiectasis and, especially, cystic fibrosis. The lack of a representative and standardized model of chronic infection in mice has limited steps forward in the field of MA pulmonary infection. To overcome this challenge we refined the method of agar beads to establish MA chronic infection in immunocompetent mice. We evaluated bacterial count, lung pathology and markers of inflammation and we performed longitudinal studies with magnetic resonance imaging (MRI) up to three months after MA infection. In this model, MA was able to establish a persistent lung infection up to two months and with minimal systemic spread. Lung histopathological analysis revealed granulomatous inflammation around bronchi characterized by the presence of neutrophils, lymphocytes and aggregates of vacuolated foamy cells, mimicking the damage observed in humans. Furthermore, MA lung lesions were successfully monitored for the first time by MRI. The availability of this murine model and the introduction of the successfully longitudinal monitoring of the murine lung lesions with MRI pave the way for further investigations on the impact of MA pathogenesis and the efficacy of novel treatments.
Synthesis, crystal structure and charge-distribution validation of a new alluaudite-type phosphate, Na2.22Mn0.87In1.68(PO4)3
Authors: Badri Abdessalem , Alvarez-Serrano Inmaculada , Luisa López María , Ben Amara Mongi
Published: July 2020

Na2.22Mn0.87In1.68(PO4)3, sodium manganese indium tris(phosphate) (2.22/0.87/1.68), was obtained in the form of single crystals by a flux method and was structurally characterized by single-crystal X-ray diffraction. The compound belongs to the alluaudite structure type (space group C2/c) with general formula X(2)X(1)M(1)M(2)2(PO4)3. The X(2) and X(1) sites are partially occupied by sodium [occupancy 0.7676 (17) and 1/2] while the M(1) and M(2) sites are fully occupied within a mixed distribution of sodium/manganese(II) and manganese(II)/indium, respectively. The three-dimensional anionic framework is built up on the basis of M(2)2O10 dimers that share opposite edges with M(1)O6 octahedra, thus forming infinite chains extending parallel to [10\overline{1}]. The linkage between these chains is ensured by PO4 tetrahedra through common vertices. The three-dimensional network thus constructed delimits two types of hexagonal channels, resulting from the catenation of M(2)2O10 dimers, M(1)O6 octahedra and PO4 tetrahedra through edge- and corner-sharing. The channels are occupied by Na+ cations with coordination numbers of seven and eight.
Analysis of damping performance of frame structure with viscoelastic dampers
Authors: Zhang Min , Pang Huaying
Published: July 2020

Purpose

The purpose of this paper is to equip damping performance of frame structure with viscoelastic dampers connected to supports is studied, the influence of the damper supports and the damping parameters on the damping performance of the structure is analyzed, the practical economical arrangement of viscoelastic dampers on each floor is researched and the calculation method of the seismic effect of the damping structure is presented.

Design/methodology/approach

In this paper, Fourier transform is applied to the vibration equation of the structure equipped with viscoelastic dampers, the frequency domain solution of the vibration equation is solved and the time-domain solution of the equation is obtained by Fourier inverse transform, from which effects of the support coefficient and the relaxing time coefficient on the seismic response of the structure are analyzed.

Findings

The seismic effect of each floor and the bottom shear force of each vibration mode of a structure are analyzed, which indicates that the relaxing time coefficient of the damper should be controlled reasonably.

Originality/value

In this paper, the vibration equation is solved in the frequency domain for frame structure equipped with viscoelastic dampers. The time-domain solution of the equation is obtained by Fourier inverse transform, from which the seismic response of frame structure equipped with viscoelastic damper connected to supports is studied.
Smartschool.com’s performance review- an opportunity for growth or to quit?
Authors: Khan Saleena , K Varun , Raiza Ameera
Published: July 2020

Learning outcomes

This case will help students to improve their understanding of several important aspects of an organization’s culture and the importance of ethics in developing an organization’s culture. Students will be able to demonstrate their understanding of the concept of values and their importance in business and learn what organizations should do to make their culture more value-driven. Students will be able to identify the impact an organization’s blurred culture causes and understand the concept of “value congruence” and its need to get higher employee performance. Students will be able to understand the importance of Holland’s person-job fit theory, in an organizational context, along with the impact of Hofstede’s national culture on the organizations’ culture of a country. Students will realize how a result-driven performance management system impacts an employee’s morale negatively, and discover why an organization should balance on giving equal importance to both result and behavior-based performance appraisal system. Students will develop sensitivity to the application of the “triple bottom line” and deontological approach in ethics, and determine how to formulate policies for sustainable and ethical process-driven organizations.

Case overview/synopsis

There are two aspects to this case. On the one hand, it talks about the ethical dilemma faced by the protagonist Mr. Vijay Shekhar while working with Smartschool.com, with its head office in Bangalore, India. On the other hand, the case focuses on the performance management system at Smartschool.com, its existing framework and the impact it has on employees and other stakeholders. It also emphasizes the importance of establishing a value-driven culture in an organization for its long term sustenance.

Complexity academic level

Graduate and under-graduate business students/MBA level.

Supplementary materials

Teaching Notes are available for educators only.

Subject code

CSS 6: Human resource management.