bluuebunny/crossref_metadata_2025 huggingface dataset:
Low social affiliation predicts increases in callous‐unemotional behaviors in early childhood
Authors: Perlstein Samantha , Waller Rebecca , Wagner Nicholas J. , Saudino Kimberly J.
Published: June 2021

Background

Callous‐unemotional (CU) behaviors predict risk for aggression and rule‐breaking. Low social affiliation (i.e. reduced motivation for and enjoyment of social closeness) is hypothesized to be a phenotypic marker for CU behaviors in early childhood. However, studies need to establish observational methods to objectively assess social affiliation as well as to establish parenting practices that can buffer pathways from low social affiliation to CU behaviors.

Methods

Using data from a longitudinal twin study of 628 children (age 2, 47% females; age 3, 44.9% females), we examined reciprocal associations between observed social affiliation, CU behaviors, and oppositional‐defiant behaviors. We tested whether positive parenting moderated associations over time.

Results

We established that an observed measure of social affiliation derived from the Bayley’s Behavior Rating Scale and Infant Behavior Record showed high inter‐rater reliability and expected convergence with parent‐reported temperament measures. Lower social affiliation at age 2 uniquely predicted CU behaviors, but not oppositional‐defiant behaviors, at age 3. Finally, low social affiliation at age 2 predicted CU behaviors at age 3 specifically among children who experienced low, but not high, levels of parental positivity.

Conclusions

An objective rating scale that is already widely used in pediatric settings reliably indexes low social affiliation and risk for CU behaviors. The dynamic interplay between parenting and low child social affiliation represents an important future target for novel individual‐ and dyadic‐targeted treatments to reduce risk for CU behaviors.
Timing of pyloric stenosis and effectiveness of endoscopic balloon dilation after pyloric endoscopic submucosal dissection
Authors: Takayama Hiroshi , Toyonaga Takashi , Yoshizaki Tetsuya , Abe Hirofumi , Nakai Tatsuya , Ueda Chise , Urakami Satoshi , Kaku Hidetoshi , Shimamoto Yusaku , Matsumoto Kei , Tsuda Kazunori , Sakaguchi Hiroya , Matsuoka Koki , Baba Shinichi , Takihara Hiroshi , Ikezawa Nobuaki , Tanaka Shinwa , Takao Madoka , Takao Toshitatsu , Morita Yoshinori , Kodama Yuzo
Published: June 2021

Background and Aim

There have been studies on risk factors for stenosis after pyloric endoscopic submucosal dissection (ESD). However, the most appropriate strategies for the management of cases with these risk factors have not been established. This study aimed to investigate post‐ESD management by evaluating the timing of stenosis and the effectiveness of endoscopic balloon dilation (EBD) after pyloric ESD.

Methods

We retrospectively reviewed cases of pyloric ESD. We first reassessed risk factors for stenosis in multivariate analysis and receiver operating characteristic curve and defined patients with the identified risk factors as the risk group. The primary outcome was the timing of stenosis in the risk group assessed by the Kaplan–Meier method.

Results

We reviewed 159 cases with pyloric ESD and observed pyloric stenosis in 25 cases. Cases with circumferential mucosal defect ≥ 76% were identified as the risk group. The stenosis‐free probability in the risk group was 97% (95% confidence interval [CI]: 79–100%), 94% (95% CI: 76–98%), and 85% (95% CI: 66–93%) on days 7, 14, and 21, respectively. It decreased every week thereafter and did not significantly change after day 56. Twenty‐three stenosis cases, except for conservative improvement, including six whole circumferential pyloric ESD cases, were improved by EBD without complications.

Conclusions

Post‐ESD stenosis often developed from the third to the eighth week. In all pyloric ESD cases, including whole circumferential pyloric ESD cases, pyloric stenosis was improved following EBD without complications.
The association between neurohormonal therapy and mortality in older adults with heart failure with reduced ejection fraction
Authors: Gilstrap Lauren , Austin Andrea M. , Gladders Barbara , Goyal Parag , O'Malley A. James , Barnato Amber , Tosteson Anna N. A. , Skinner Jonathan S.
Published: June 2021

Background/Objectives

Neurohormonal therapy, which includes beta‐blockers and angiotensin‐converting enzyme inhibitor/angiotensin receptor blockers (ACEi/ARBs), is the cornerstone of heart failure with reduced ejection fraction (HFrEF) treatment. While neurohormonal therapies have demonstrated efficacy in randomized clinical trials, older patients, which now comprise the majority of HFrEF patients, were underrepresented in those original trials. This study aimed to determine the association between short‐ (30 day) and long‐term (1 year) mortality and the use of neurohormonal therapy in HFrEF patients, across the age spectrum.

Design/Setting/Participants

This is a population‐based, retrospective, cohort study between January 2008 and December 2015. We used 100% Medicare Parts A and B and a random 40% sample of Part D to create a cohort of 295,494 fee‐for‐service beneficiaries with at least one hospitalization for HFrEF between 2008 and 2015. All analyses were performed between May 2019 and July 2020.

Exposure

We used Part D data to determine exposure to beta‐blocker and ACEi and ARB therapy.

Results

We found that in 295,494 patients admitted for HFrEF between 2008 and 2015, the average age was 80 years, 54% were female and 17% were non‐white. The baseline mortality rate was higher among those aged ≥85, but the mortality benefits of neurohormonal therapy were preserved across the age spectrum. Among those ≥85 years old, the hazard ratio for death within 30 days was 0.59 (95% confidence interval [CI] 0.56–0.62; p < 0.001) for beta‐blockers and 0.47 (95% CI 0.44–0.49; p < 0.001) for ACEi/ARBs. The hazard ratio for death within 1 year was 0.37–0.56 (95% CI 0.35–0.58; p < 0.001) for beta‐blockers and 0.38–0.53 (95% CI 0.37–0.55; p < 0.001) for ACEi/ARB.

Conclusion

At a population level, neurohormonal therapy was associated with lower short‐ and long‐term mortality across the age spectrum.
Effects of macrophage regulation on fat grafting survival: Improvement, mechanisms, and potential application—A review
Authors: Chen Qiuyu , Liu Shuo , Cao Lideng , Yu Mei , Wang Hang
Published: June 2021

Background

Autologous fat grafting has become a popular tool in plastic surgery to solve soft tissue defects and achieve skin rejuvenation, but the volume loss after transplantation remains a disturbing problem. In recent years, some new strategies have improved the outcome to some extent, but the fat graft retention is still far from ideal, so there remains a wide development prospect in this field. Macrophages are closely related to the local microenvironment and tissue regeneration, and their role in fat grafting has been increasingly highlighted.

Aims

This article was aimed to review the efficacy, possible mechanisms, and potential application of macrophage regulation on fat grafting, as well as concerns and future perspectives of this filed.

Methods

A retrospective review of the published data was conducted.

Results

Most studies indicated that up‐regulating M2 macrophages during fat grafting would improve fat retention via promoting neovascularization. M2 macrophages could secrete several pro‐angiogenic factors, accelerate extracellular matrix (ECM) remodeling, and directly function on endothelial cells to encourage vascular expansion. In addition, macrophages could influence the proliferation, apoptosis, and adipogenic differentiation of preadipocytes.

Conclusions

During autologous fat grafting, appropriately regulating macrophages may become a promising method to increase fat retention. Nevertheless, the M2 macrophage polarizing agents, treatment opportunity, and contraindications require further discussion. We hope our work could promote more in‐depth studies in this field, and we are looking forward to a standard procedure for the macrophage therapy in clinical practice.
Nomogram of fetal right portal vein diameter at gestational age 30 to 35 weeks and prediction of small for gestational age at birth
Authors: Jokkaew Neranute , Pleankong Monyada , Smanchat Buppa , Prommas Sinart , Bhamarapravatana Kornkarn , Suwannarurk Komsun
Published: June 2021

Aim

To construct the nomogram of fetal right portal vein (RPV) diameter at 30 to 35 weeks' gestation in Thai pregnant population and the use of RPV measurement to predicting small for gestational age (SGA) fetus.

Methods

A prospective, cross‐sectional study of singleton pregnancies at antenatal visit between 30 and 35+6weeks of gestation in single center, Bhumibol Adulyadej Hospital (BAH) was conducted from January to August 2020. Ultrasonography of fetal biometry and RPV diameter measurement were performed as well as immediate newborn birth weight measurement. The nomogram of fetal RPV was developed for standardization for Thai people.

Results

A total of 219 singleton pregnant women were enrolled and ultrasonographic measurement of RPV and fetal biometry was obtained. Mean maternal age and gestational period were 29.4 years and 33.0 weeks, respectively. One third of participants were classified as obese. RPV diameter ranged from 1.85 to 6.07 mm and increased linearly with gestational age. The optimal threshold of RPV diameter for diagnosis SGA was less than 3.06 mm with area under ROC curve at a level of 0.613 (95%CI 0.496 to 0.731). Sensitivity and specificity were 38.46% and 83.94%, respectively. There was no fetal death or neonatal morbidity in the present study.

Conclusion

RPV diameter increases in size depending on gestational age. RPV diameter at 30 to 35+6weeks gestation was a useful measurement for SGA prediction. RPV measurements greater than 3.06 mm strongly indicated normal fetal growth.
Effect of orofacial physiotherapeutic and hygiene interventions on oral health–related quality of life in patients with Parkinson’s disease: A randomised controlled trial
Authors: Baram Sara , Karlsborg Merete , Øzhayat Esben Boeskov , Bakke Merete
Published: June 2021

Background

Parkinson's disease (PD) has a negative effect on oral health and orofacial function, but the subjective experience of orofacial symptoms and their impact on the quality of life is not fully investigated. In addition, knowledge of how to improve the subjective oral symptoms is lacking.

Objectives

To assess the self‐reported orofacial function and oral health in patients with PD. Furthermore, to investigate the effect of interventions for improvement of oral hygiene and function on oral health–related quality of life (OHRQoL).

Methods

A randomised controlled study with delayed intervention was conducted in 29 patients with moderate to advanced PD. Patients were instructed in a standardised exercise programme for the jaw and orofacial muscles and given an individualised oral hygiene programme. The effect on self‐reported orofacial function and OHRQoL was measured after 2 and 4 months using the Nordic Orofacial Test—Screening (NOT‐S), the oral health impact profile (OHIP‐14), self‐reported drooling score and subjective mastication ability.

Results

Self‐reported oral health and function before the intervention was significantly correlated to the severity and duration of PD. The NOT‐S and drooling score were significantly improved by the interventions after 2 months and the OHIP‐14 after 4 months.

Conclusion

The interventions improve the self‐reported orofacial function and OHRQoL. These simple interventions can be implemented in the allied multidisciplinary health care surrounding the PD patient.
Healthcare of Persons With Complex Developmental Disabilities From Three European Experiences: France, Italy, and Norway
Authors: Rousseau Marie‐Christine , Dagois Jean‐Francois , Lausecker Claire , Humbertclaude Eric , Dominique Alain , Hamouda Ilyes , Auquier Pascal , Billette de Villemeur Thierry , Baumstarck Karine
Published: June 2021

Background

The healthcare pathway of persons with complex developmental disabilities differs by country, depending both on the specificities of the associated healthcare system and the related societal views. In 2017, the French National Organization of Solidarity for Autonomy entrusted to a group of French experts with a specific mission to analyze three European experiences.

Specific Aim

The aim of this article is to report the similarities and differences in the healthcare pathways of persons with complex developmental disabilities between France and two other European countries, Italy and Norway. The three countries present different health policies and different ideologies for the care management of persons with complex developmental disabilities.

Method

A group of six French experts (including a neuro‐pediatrician, an occupational therapist, a specialist of physical medicine and rehabilitation, a responsible member of a residential facility, a family caregiver representative, and the administrative coordinator of the French Polyhandicap Federation) traveled throughout Italy and Norway (3 and 4 days, respectively). Standardized forms were used to collect information, including dedicated structures, care delivery, dedicated physicians and other healthcareworkers, human and financial aid, place of the caregivers, and preventive and therapeutic actions.

Findings

Law and health policies, funding, care coordination, and education differ between the three countries (France, Italy, and Norway) and in their effect on the lives of patients and their families.

Discussion

The three different society models for modalities of care for persons with complex developmental disabilities may have consequences on the lives of patients and their families. This work may help to optimize the level of care according to both patient and family characteristics.
Sexual harassment and assault predict sleep disturbances and is partly mediated by nightmares: Findings from a national survey of all university students in Norway
Authors: Steine Iris M. , Skogen Jens Christoffer , Hysing Mari , Puigvert Lidia , Schønning Viktor , Sivertsen Børge
Published: June 2021

Sexual harassment and assault is common in most domains of society, and has been linked to several adverse outcomes, including reduced sleep quality. However, less is known about the possible impact of sexual harassment and assault on various sleep problems among university students. In a sample of 49,051 students in Norway (69.2% women), we examined i) the associations of varying extents of sexual harassment (unwanted sexual comments, looks or gestures, photographs, indecent exposure, and physical harassment) and sexual assault (attempted or completed rape), with meeting Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM‐5) diagnostic criteria of insomnia and with sleep duration, ii) the association of cumulative exposure to sexual harassment/assault with insomnia and sleep duration, and iii) to what extent nightmares could explain the association between sexual harassment and insomnia and sleep duration. For both genders, all forms of harassments with the exception of “indecent exposure” and “unwanted sexual photographs” for men were negatively associated with sleep duration, with the strongest associations being found for “rape” and “attempted rape”. For both genders, the odds of insomnia increased as a function of cumulative harassment exposure. Similarly, a graded, negative association was found between cumulative harassment and sleep duration for both genders. Mediation analyses showed that 28% of the observed association between cumulative harassment and insomnia, and 15% of the association between cumulative harassment and sleep duration, was mediated by frequency of nightmares.
The status of California yellowtail Seriola dorsalis as a commercially ready species for marine U.S. aquaculture
Authors: Rotman Federico , Stuart Kevin , Silbernagel Constance , Drawbridge Mark
Published: June 2021

California yellowtail (CYT; Seriola dorsalis) is a promising candidate for marine aquaculture in the United States because there is an existing market and cultured Seriola spp. command prices as high as $27.70 per kg for head‐on gutted product. Methods for commercial‐scale Seriola spp. fingerling production and growout have been refined globally in recent years. Spawning can be accomplished without hormone therapy and adults spawn viable eggs when ambient water temperatures are between 15 and 22°C. Larval culture of CYT includes rotifers and Artemia, with the addition of greenwater. Larval survival to 1 g juveniles (45 days post hatch) is typically high at 30–60%. However, poor swim bladder inflation and skeletal malformations require culling and can reduce this yield substantially. Growout of CYT to market size at Hubbs‐SeaWorld Research Institute (HSWRI) has been completed on a very limited basis in flow through tanks where it takes 18–24 months to achieve a market weight of 3.5–4.0 kg. While culture of this species is commercially ready from a technical and business perspective, research is still needed to improve swim bladder inflation, reduce deformities, optimize nutrition across all life stages, and assist with disease diagnosis and control. Most notable among bottlenecks to commercialization in the United States is the need for growout capacity both for net pen and land‐based culture.
Basil, Ocimum basilicum, yield in northern latitudinal aquaponic growing conditions
Authors: Abbey Marie , Anderson Neil O. , Yue Chengyan , Schermann Michele , Phelps Nicholas , Venturelli Paul , Vickers Zata
Published: June 2021

The need for yield research is increasing with the popularity of aquaponic food production systems where plants and fish are grown together in a recirculating system. Our objective was to compare the yield of three basil cultivars (“Elenora,” “Genovese,” “Nufar,” Ocimum basilicum) in four configurations (greenhouses: floating raft DWS, ebb & flow, A‐frame; warehouse: floating raft; 1–8 tank replications/treatment) as well as a soilless control to establish a baseline for aquaponic producers in northern latitudes. We also tested whether basil yield varied among fish types: yellow perch, Perca flavescens, goldfish, Carassius auratus, tilapia, Oreochromis spp., and koi, Cyprinus carpio. Fish tank water temperature, nitrite, and alkalinity levels differed significantly over seasons (summer, winter). There was a significant decrease in basil production in all aquaponic systems that used koi (greenhouse, warehouse). No significant difference in basil yield was found among greenhouse and aquaponic systems for perch, tilapia, or goldfish nor among the basil “Elenora,” “Genovese,” and “Nufar.” Considerable variation occurred in yield although most of it occurred in fresh weights, being reduced significantly in dry weights. The effects of growing koi fish on reducing aquaponic production of basil is noteworthy, although future research is needed to the exact cause.
Ordering and inequalities for mixtures on risk aggregation
Authors: Chen Yuyu , Liu Peng , Liu Yang , Wang Ruodu
Published: June 2021

Aggregation sets, which represent model uncertainty due to unknown dependence, are an important object in the study of robust risk aggregation. In this paper, we investigate ordering relations between two aggregation sets for which the sets of marginals are related by two simple operations: distribution mixtures and quantile mixtures. Intuitively, these operations “homogenize” marginal distributions by making them similar. As a general conclusion from our results, more “homogeneous” marginals lead to a larger aggregation set, and thus more severe model uncertainty, although the situation for quantile mixtures is much more complicated than that for distribution mixtures. We proceed to study inequalities on the worst‐case values of risk measures in risk aggregation, which represent conservative calculation of regulatory capital. Among other results, we obtain an order relation on VaR under quantile mixture for marginal distributions with monotone densities. Numerical results are presented to visualize the theoretical results and further inspire some conjectures. Finally, we provide applications on portfolio diversification under dependence uncertainty and merging p‐values in multiple hypothesis testing, and discuss the connection of our results to joint mixability.
Protecting pegged currency markets from speculative investors
Authors: Neuman Eyal , Schied Alexander
Published: June 2021

We consider a stochastic game between a trader and a central bank in a target zone market with a lower currency peg. This currency peg is maintained by the central bank through the generation of permanent price impact, thereby aggregating an ever‐increasing risky position in foreign reserves. We describe this situation mathematically by means of two coupled singular control problems, where the common singularity arises from a local time along a random curve. Our first result identifies a certain local time as that central bank strategy for which this risk position is minimized. We then consider the worst‐case situation the central bank may face by identifying that strategy of the strategic investor that maximizes the expected inventory of the central bank under a cost criterion, thus establishing a Stackelberg equilibrium in our model.
Role of optical coherence tomography in determining specific diagnostic pattern of retinal nerve fiber layer involvement in various central nervous system demyelinating diseases: An observational study
Authors: Khandelwal Dinesh , Dadarwal Kishor , Hiremath Ashwini , Mathur Vaibhav
Published: June 2021

Aims

To assess retinal nerve fiber layer thickness by optical coherence tomography (OCT) in various central nervous system demyelinating diseases.

Methods and Material

A total of 40 patients were selected. There were 8 patients of multiple sclerosis, 12 patients of neuromyelitis optica spectrum disorders (NMOSD), 9 patients of optic neuritis, and 11 patients of longitudinally extensive transverse myelitis (LETM). The fast retinal nerve fiber layer (RNFL) thickness protocol was used to compute the overall average RNFL thickness for each eye. Average RNFL thickness for 360° around the optic disk, for the superior, nasal, inferior, and temporal quadrants around the optic disk as well as in the twelve 30° segments (with 3 o'clock position as nasal) were recorded.

Results

Average RNFL thicknesses were lower in NMOSD group. Superior, inferior, and temporal quadrants are the preferentially affected while 8 o'clock position RNFL was the thinnest. MS involved 8 o'clock position and temporal quadrant. Of 9 o'clock position and temporal quadrant were the thinnest in LETM. In idiopathic optic neuritis, lowest RNFL value was recorded in the nasal quadrant. In 3 o'clock position, maximum thinning was noted in idiopathic ON. At 9 o'clock position, maximum thinning was seen in LETM patients.

Conclusions

Most o'clock positions and superior, inferior, and temporal quadrants were affected in NMOSD. MS mainly involved 8 o’clock position and temporal quadrant. LETM preferentially affected 9 o’clock position and the temporal quadrant. Hence, observing the pattern of RNFL thinning with OCT in CNS demyelinating diseases can intimate the etiological cause. However, larger studies are needed further to confirm the same.
Taxonomic studies on Amomum and related genera (Zingiberaceae) in China IV. Meistera vespertilio, the correct name for a widespread species in China, Laos and Vietnam previously misidentified as M. muricarpa
Authors: Ye Xing‐Er , Xia Nian‐He , Nguyễn Quốc Bình , Trần Hữu Đăng , Leong‐Škorničková Jana
Published: June 2021

The identity of Meistera vespertilio is clarified based on a recent collection of flowering material from the type locality in northern Vietnam. We show that this name has to be applied to a yellow‐flowered species with echinate fruits widespread in southern China, northern Laos and Vietnam. This species was misidentified in all previous works as Meistera muricarpa (≡ Amomum muricarpum), another species with white and yellow flowers originally described from the Philippines. The previous lectotypification of M. vespertilio is amended by excluding infructescences and seeds of Zingiber cf. recurvatum from the type material. Meistera verrucosa, morphologically the only closely related species to M. vespertilio in China, is newly reported to occur also in Vietnam. Descriptions of both species, colour plates and notes on their distribution, ecology, phenology and IUCN conservation assessments are provided. The differences between these two species are highlighted, to allow their recognition even in herbarium material.
Time to retire? A life‐changing decision made by NAC transcription factors
Authors: Kelly Olivia J. M. , Allan Andrew C.
Published: June 2021

This article is a Commentary on D'Incà et al. (2021), 231: 726–746.
Overview on domestication, breeding, genetic gain and improvement of tuber quality traits of potato using fast forwarding technique (GWAS): A review
Authors: Naeem Muhammad , Demirel Ufuk , Yousaf Muhammad Farhan , Caliskan Sevgi , Caliskan Mehmet Emin
Published: June 2021

Tuber quality is the subject of great interest among the processing industry and consumers worldwide. Being a polygenic trait, its enhancement requires a systematic understanding of their genetic complexity. Molecular genetics offered valuable solutions to the challenging endeavours of slow genetic gains in conventional potato breeding. With the advent of linkage maps, molecular markers and availability of next‐generation sequencing (NGS) platforms, the plant breeding programmes worldwide have achieved faster genetic gain due to marker‐assisted selection (MAS). Linkage mapping detects QTLs in biparental population; alternatively, genomic and phenotypic differences can be identified by extensive genotyping and phenotyping of a germplasm panel depicting natural biological diversity to reveal QTLs, in other words, marker‐trait associations. Due to advancements in the fields of genome sequencing and bioinformatics, researchers have preferred to use the genome‐wide association mapping (GWAS) method for detecting QTLs due to its higher resolution. In potato, GWAS identified causative allele(s)/loci and provides reliable platform for the development of diagnostic SNP markers by employing Infinium SolCAP SNP array. Later, KASP validation markers can be developed to be used as selection markers in order to bred improved cultivars. The current review focuses on recently used approaches for genetic analyses (linkage mapping or association mapping) regarding potato tuber quality traits, provides comprehensive knowledge about breeding, genetic gain, basic genetic and statistical GWAS concepts and subsequently highlights the genetic discoveries using GWAS and KASP markers.
Multiple in vivo Effects of Cadmium on Photosynthetic Electron Transport in Pea Plants
Authors: Todorenko Daria , Volgusheva Alena , Timofeev Nyurgun , Kovalenko Ilya , Matorin Dmitry , Antal Taras
Published: June 2021

The inhibitory effects of cadmium (CdSO4) on the primary photosynthetic processes were studied in vivo in Pisum sativum by using Multi‐function Plant Efficiency Analyser (M‐PEA‐2). Photosynthetic parameters related to photosystem (PS) II, PS I and intersystem electron carriers were calculated from the light‐induced kinetics of prompt chlorophyll a fluorescence (OJIP transient), delayed chlorophyll a fluorescence (DF), and 820 nm modulated reflection (MR). Low‐dose exposure to cadmium (20 μm CdSO4 for 48 h) reduced probability of electron transfer from plastoquinones to the terminal electron acceptors of PSI (δRo) accompanied by a decrease in the rate of P700+ and PC reduction (Vred) and the magnitude of the I2 step on the DF kinetics. Electron transport through PSI remained unaltered. The obtained results allowed us to propose existence of the potential site of inhibition of photosynthetic electron flow by cadmium between PSII and PSI. We propose to use parameters δRo, Vred, and I2/I1 as sensitive indicators of an early contamination by heavy metals.
Project-Based Teaching of a Manufacturing Class During the COVID-19 Pandemic
Authors: Masato Davide , Johnston Stephen
Published: June 2021

The plastics engineering program at the University of Massachusetts Lowell has taught mold design and engineering to undergraduate students for over 60 years. In 2020, the unexpected arrival of the COVID-19 pandemic in March forced the instructors to revisit the class program and objectives. Similar to other academic courses, the class became virtual. This meant redesigning an intensive hands-on manufacturing class into one that could be taught and taken from our home offices while maintaining academic rigor and continuing to meet critical student learning objectives. The timing of the pandemic meant that students, who were completing tooling split designs and starting computer numerical control programming, could not move forward with machining, assembly, and molding. Instead, their projects became virtual learning experiences. This paper provides the analysis and discussion of how new ideas in teaching were implemented to virtually introduce engineering students to the world of plastic manufacturing. The students' work was carried out on plastic part designs of their choice, some of which included thin walls (<2 mm) and microscale features (∼800 μm) typical of a micro-injection molding process.
Review of Heterostigmatic species (Acari: Prostigmata) in Turkey with four new records
Authors: Çobanoğlu Sultan , ERDOĞAN Tuğba , CILBIRCIOĞLU Cihan
Published: June 2021

This paper reviews the Heterostigmata (Acari: Prostigmata) in Turkey, with an updated checklist of 41 species belonging to 7 families and 16 genera. Heterostigmatic mites Kerdabania variabilis Khaustov (Neopygmephoridae), Tarsonemus talpae Schaarschmidt (Tarsonemidae); T. bilobatus Suski and T. aequalis Livshits, Mitrofanov & Sharonov were identified as new records for mite fauna of Turkey. Tarsonemus smithi Ewing and T. waitei Banks have also been found during this study. The samples were collected during the vegetation periods from garlic growing areas and fruit orchards in Kastamonu and Ankara, Turkey, during the period 2012–2015. The plant samples were extracted by using Berlese funnel and the specimens were mounted in micro slides in Hoyer’s medium. Collection data and geographical distribution of these species are provided. Besides, Heterostigmata species which were previously reported from Turkey are also presented here.
Acoustofluidic device for acoustic capture of Bacillus anthracis spore analogues at low concentration
Authors: Plazonic Filip , Fisher Adam , Carugo Dario , Hill Martyn , Glynne-Jones Peter
Published: June 2021

A portable device for the rapid concentration of Bacillus subtilis var niger spores, also known as Bacillus globigii (BG), using a thin-reflector acoustofluidic configuration is described. BG spores form an important laboratory analog for the Bacillus anthracis spores, a serious health and bioterrorism risk. Existing systems for spore detection have limitations on detection time and detection that will benefit from the combination with this technology. Thin-reflector acoustofluidic devices can be cheaply and robustly manufactured and provide a more reliable acoustic force than previously explored quarter-wave resonator systems. The system uses the acoustic forces to drive spores carried in sample flows of 30 ml/h toward an antibody functionalized surface, which captures and immobilizes them. In this implementation, spores were fluorescently labeled and imaged. Detection at concentrations of 100 CFU/ml were demonstrated in an assay time of 10 min with 60% capture. We envisage future systems to incorporate more advanced detection of the concentrated spores, leading to rapid, sensitive detection in the presence of significant noise.
Lymph nodes lose their nerve
Authors: Foley John F.
Published: June 2021

Loss of sciatic innervation of the popliteal lymph node causes IFN-γ–dependent lymph node expansion.
The Termite Fungal CultivarTermitomycesCombines Diverse Enzymes and Oxidative Reactions for Plant Biomass Conversion
Authors: Schalk Felix , Gostinčar Cene , Kreuzenbeck Nina B. , Conlon Benjamin H. , Sommerwerk Elisabeth , Rabe Patrick , Burkhardt Immo , Krüger Thomas , Kniemeyer Olaf , Brakhage Axel A. , Gunde-Cimerman Nina , de Beer Z. Wilhelm , Dickschat Jeroen S. , Poulsen Michael , Beemelmanns Christine
Published: June 2021

Fungus-growing termites have optimized the decomposition of recalcitrant plant biomass to access valuable nutrients by engaging in a tripartite symbiosis with complementary contributions from a fungal mutualist and a codiversified gut microbiome. This complex symbiotic interplay makes them one of the most successful and important decomposers for carbon cycling in Old World ecosystems.
Atypical case of Crohn’s colitis in a patient with adult-onset Still’s disease
Authors: Narayanan Anantha , Kim Chris , Dennett Elizabeth R
Published: June 2021

A 65-year-old woman with a background of adult-onset Still’s disease (AOSD) presented acutely to a general surgical unit with signs of bowel obstruction and sepsis. A CT scan was indicative of a mesenteric lymphadenopathy suspicious of malignancy. At the time of the surgery, a clinical diagnosis of lymphoma was made given the large number of lymph nodes; however, histological diagnosis was resulted as Crohn’s colitis. There is only one other case of AOSD and Crohn’s disease in the literature, and there is no clear pathological connection between the two inflammatory conditions. This case highlights the surgical management of an unusual presentation.
Denosumab and bisphosphonate associated bilateral osteonecrosis of the external auditory canal
Authors: True Harry David , Ricks Rupert George , Smith Joel Anthony
Published: June 2021

We present a case of non-surgically managed bilateral osteonecrosis of the external auditory canal with a history of long-term medical therapy for osteoporosis. A 79-year-old woman with severe osteoporosis and destructive osteoarthritis received >10 years of once weekly bisphosphonate therapy before switching to denosumab. Four months later, the patient presented with bilateral loss of hearing and right-sided otalgia. Necrotising otitis externa, cholesteatoma and malignancy were considered but with histology, microbiological and CT assessment, bilateral osteonecrosis of the external auditory canal was diagnosed. Surgical debridement with canalplasty was avoided due to our patient’s comorbidities. Treatment continued for 5 months with regular aural toilet, Terra-Cortril ointment and bismuth-iodine-paraffin paste packing. At 1-year follow-up, bilateral external auditory canals were completely re-epithelialised with no pain or affected hearing. We report the first case of bilateral osteonecrosis of the external auditory canal associated with denosumab and bisphosphonates with successful conservative management.
ANCA associated glomerulonephritis in tuberculosis: a paradoxical reaction
Authors: OBrien Shane , Griffin Brenda , McLaughlin Anne Marie , Keane Joseph
Published: June 2021

We present a case of antineutrophil cytoplasmic antibodies (ANCA)-associated rapidly progressive glomerulonephritis in the context of treatment of pulmonary tuberculosis (TB). A 42-year-old woman was treated for drug-susceptible pulmonary TB and represented with paradoxical worsening of symptoms and radiological features. She was HIV negative. A severe acute kidney injury with features of glomerulonephritis was evident on admission. Perinuclear ANCA and antimyeloperoxidase antibodies were present in serum and renal biopsy was consistent with ANCA-associated vasculitis. The patient was successfully treated with both antituberculous therapy and immunosuppression (corticosteroids and mycophenolate mofetil) with subsequent clinical improvement and amelioration of renal function. We propose this is the first case that describes the association between paradoxical reactions during TB treatment and ANCA-associated glomerulonephritis.
Surgery and COVID-19: a rapid scoping review of the impact of the first wave of COVID-19 on surgical services
Authors: O'Rielly Connor , Ng-Kamstra Joshua , Kania-Richmond Ania , Dort Joseph , White Jonathan , Robert Jill , Brindle Mary , Sauro Khara
Published: June 2021

Objectives

To understand how surgical services have been reorganised during and following public health emergencies, particularly the first wave of the COVID-19 pandemic, and the consequences for patients, healthcare providers and healthcare systems.

Design

A rapid scoping review.

Setting

We searched the MEDLINE, Embase and grey literature sources for documents and press releases from governments and surgical organisations or associations.

Participants

Studies examining surgical service delivery during public health emergencies including COVID-19, and the impact on patients, providers and healthcare systems were included.

Primary and secondary outcome measures

Primary outcomes were strategies implemented for the reorganisation of surgical services. Secondary were the impacts of reorganisation and resuming surgical services, such as: adverse events (including morbidity and mortality), primary care and emergency department visits, length of hospital and ICU stay, and changes to surgical waitlists.

Results

One hundred and thirty-two studies were included in this review; 111 described reorganisation of surgical services, 55 described the consequences of reorganising surgical services; and 6 reported actions taken to rebuild surgical capacity in public health emergencies. Reorganisations of surgical services were grouped under six domains: case selection/triage, personal protective equipment (PPE) regulations and practice, workforce composition and deployment, outpatient and inpatient patient care, resident and fellow education, and the hospital or clinical environment. Service reorganisations led to large reductions in non-urgent surgical volumes, increases in surgical wait times and impacted medical training (ie, reduced case involvement) and patient outcomes (eg, increases in pain). Strategies for rebuilding surgical capacity were scarce but focused on the availability of staff, PPE and patient readiness for surgery as key factors to consider before resuming services.

Conclusions

Reorganisation of surgical services in response to public health emergencies appears to be context dependent and has far-reaching consequences that must be better understood in order to optimise future health system responses to public health emergencies.
Managing violence against healthcare personnel in the emergency settings of Pakistan: a mixed methods study
Authors: Khan Muhammad Naseem , Khan Ikram , Ul-Haq Zia , Khan Mirwais , Baddia Faryal , Ahmad Fayaz , Khan Salman
Published: June 2021

Objectives

The primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients’ aggression of the healthcare personnel in the two hospitals.

Design

Mixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components.

Setting

Emergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018.

Participants

Healthcare personnel in the emergency departments of the two hospitals (trained vs untrained).

Outcome measures

Violence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals.

Results

The demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals.

Conclusion

The study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.
Risk factors for severity on admission and the disease progression during hospitalisation in a large cohort of patients with COVID-19 in Japan
Authors: Terada Mari , Ohtsu Hiroshi , Saito Sho , Hayakawa Kayoko , Tsuzuki Shinya , Asai Yusuke , Matsunaga Nobuaki , Kutsuna Satoshi , Sugiura Wataru , Ohmagari Norio
Published: June 2021

Objectives

To investigate the risk factors contributing to severity on admission. Additionally, risk factors of worst severity and fatality were studied. Moreover, factors were compared based on three points: early severity, worst severity and fatality.

Design

An observational cohort study using data entered in a Japan nationwide COVID-19 inpatient registry, COVIREGI-JP.

Setting

As of 28 September 2020, 10480 cases from 802 facilities have been registered. Participating facilities cover a wide range of hospitals where patients with COVID-19 are admitted in Japan.

Participants

Participants who had a positive test result on any applicable SARS-CoV-2 diagnostic tests were admitted to participating healthcare facilities. A total of 3829 cases were identified from 16 January to 31 May 2020, of which 3376 cases were included in this study.

Primary and secondary outcome measures

Primary outcome was severe or nonsevere on admission, determined by the requirement of mechanical ventilation or oxygen therapy, SpO2 or respiratory rate. Secondary outcome was the worst severity during hospitalisation, judged by the requirement of oxygen and/orinvasive mechanical ventilation/extracorporeal membrane oxygenation.

Results

Risk factors for severity on admission were older age, men, cardiovascular disease, chronic respiratory disease, diabetes, obesity and hypertension. Cerebrovascular disease, liver disease, renal disease or dialysis, solid tumour and hyperlipidaemia did not influence severity on admission; however, it influenced worst severity. Fatality rates for obesity, hypertension and hyperlipidaemia were relatively lower.

Conclusions

This study segregated the comorbidities influencing severity and death. It is possible that risk factors for severity on admission, worst severity and fatality are not consistent and may be propelled by different factors. Specifically, while hypertension, hyperlipidaemia and obesity had major effect on worst severity, their impact was mild on fatality in the Japanese population. Some studies contradict our results; therefore, detailed analyses, considering in-hospital treatments, are needed for validation.

Trial registration number

UMIN000039873. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045453
Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices
Authors: Cheraghi-Sohi Sudeh , Holland Fiona , Singh Hardeep , Danczak Avril , Esmail Aneez , Morris Rebecca Lauren , Small Nicola , Williams Richard , de Wet Carl , Campbell Stephen M , Reeves David
Published: June 2021

Background

Diagnostic error is a global patient safety priority.

Objectives

To estimate the incidence, origins and avoidable harm of diagnostic errors in English general practice. Diagnostic errors were defined as missed opportunities to make a correct or timely diagnosis based on the evidence available (missed diagnostic opportunities, MDOs).

Method

Retrospective medical record reviews identified MDOs in 21 general practices. In each practice, two trained general practitioner reviewers independently conducted case note reviews on 100 randomly selected adult consultations performed during 2013–2014. Consultations where either reviewer identified an MDO were jointly reviewed.

Results

Across 2057 unique consultations, reviewers agreed that an MDO was possible, likely or certain in 89 cases or 4.3% (95% CI 3.6% to 5.2%) of reviewed consultations. Inter-reviewer agreement was higher than most comparable studies (Fleiss’ kappa=0.63). Sixty-four MDOs (72%) had two or more contributing process breakdowns. Breakdowns involved problems in the patient–practitioner encounter such as history taking, examination or ordering tests (main or secondary factor in 61 (68%) cases), performance and interpretation of diagnostic tests (31; 35%) and follow-up and tracking of diagnostic information (43; 48%). 37% of MDOs were rated as resulting in moderate to severe avoidable patient harm.

Conclusions

Although MDOs occurred in fewer than 5% of the investigated consultations, the high numbers of primary care contacts nationally suggest that several million patients are potentially at risk of avoidable harm from MDOs each year. Causes of MDOs were frequently multifactorial, suggesting the need for development and evaluation of multipronged interventions, along with policy changes to support them.
Symptom prevalence and severity in palliative cancer medicine
Authors: Webber Kath , Davies Andrew Neil , Leach Charlotte , Waghorn Melanie
Published: June 2021

Objectives

To establish symptom prevalence and associated distress in a large cohort of UK patients with cancer referred to a palliative care team.

Methods

This is a secondary analysis of two large data sets of patients with advanced cancer. Each patient had completed the Memorial Symptom Assessment Scale-Short Form to assess 32 symptoms and related distress. Data frequencies were conducted in Excel.

Results

1507 patients were recruited. The most common symptoms were lack of energy (89%), pain (83%), feeling drowsy (77%) and dry mouth (70%). 67% of patients had psychological symptoms, with 31% of all patients having significant psychological distress.

Conclusions

Symptom burden is significant in palliative patients with cancer. Structured symptom assessment with access to relevant supportive services is recommended.
Radial variation of wood anatomical and chemical properties in eight poplar clones
Authors: Liu Yamei , Zhou Liang , Guan Ying , Hu Jianjun , Zhao Zicheng , Gao Hui , Liu Shengquan
Published: June 2021

Wood properties are crucial for the development and application of poplar clones. Here, the effects of clone and age on anatomical and chemical properties were analyzed in eight poplar clones (50, Zhonglin46, 108, 36, N179, Danhong, Sangju, and Nanyang) from Henan province, China. The results show that the effects of clone and age are both significant for these wood properties. The eight clones were grouped into three clusters according to their annual ring width, fiber quality, and chemical properties. For some properties, including annual ring width, fiber length, and microfibril angle, all clones displayed the same radial variation trends; however, for other properties, such as holocellulose content, the radial variation trends were different depending on the clones. The culmination of the mean annual increment corresponded to the turning ages of wood properties such as annual ring width in the eight clones, and holocellulose content in the partial clones except for fiber length, microfibril angle, and vessel length. The recommended rotation age of these poplar clones is 8–9 years based on the fiber quality and chemical components. These results indicate strong genetic and age control of the wood properties and highlight the rich source of variation for poplar clone selection.