bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed‐methods systematic review: Childbearing women's views, experiences, and decision‐making related to epidural analgesia in labour
Authors: Borrelli Sara , Evans Kerry , Pallotti Phoebe , Evans Catrin , Eldridge Jeanette , Spiby Helen
Published: September 2020

Aims

To investigate childbearing women's views, experiences and decision‐making related to epidural analgesia in labour.

Design

Mixed‐methods systematic review.

Data Sources

A comprehensive literature search was implemented across Medline, CINAHL and EMBASE from 2000 to September 2018. The literature search was undertaken in January 2018 and updated in September 2018. Thirty papers were selected.

Results

Four overarching synthesized findings were identified: (a) choice; (b) pain management experience; (c) lack of information; and (d) information provision and consent.

Review Methods

Quality appraisal was conducted using JBI levels of evidence and other established tools. NVivo was used to independently dual code and thematically synthesize qualitative data. A narrative synthesis of the quantitative findings from the included studies was undertaken. The GRADE‐CERQual approach was used to assess confidence in the review findings based on the qualitative data. A set of integrated mixed‐methods synthesized findings was produced.

Conclusion

Recommendations for practice based on the systematic review findings are that midwives should dedicate time to discuss epidural with women and birth partners, ideally during the second or third trimester of pregnancy, asking women what coping strategies or pain relief they have been considering, if any. The factors which may influence the woman's choice of epidural, including pain threshold, ability to cope with pain, timing of epidural and length of labour should be continuously evaluated during labour. The midwife should remain with women after an epidural has been sited, demonstrating understanding of the woman's choice and providing an opportunity for discussion of plans for the remaining labour and birth.

Impact

The findings of this systematic review can inform both healthcare professionals and service users on various aspects of the decision‐making process about the use of epidural analgesia in labour. Data can be transferable to similar settings in high‐income countries.
A toy or a friend? Children's anthropomorphic beliefs about robots and how these relate to second‐language word learning
Authors: van den Berghe Rianne , de Haas Mirjam , Oudgenoeg‐Paz Ora , Krahmer Emiel , Verhagen Josje , Vogt Paul , Willemsen Bram , de Wit Jan , Leseman Paul
Published: September 2020

This study investigates the degree to which children anthropomorphize a robot tutor and whether this anthropomorphism relates to their vocabulary learning in a second‐language (L2) tutoring intervention. With this aim, an anthropomorphism questionnaire was administered to 5‐year‐old children (N = 104) twice: prior to and following a seven‐session L2 vocabulary training with a humanoid robot. On average, children tended to anthropomorphize the robot prior to and after the lessons to a similar degree, but many children changed their attributed anthropomorphic features. Boys anthropomorphized the robot less after the lessons than girls. Moreover, there was a weak but significant positive correlation between anthropomorphism as measured before the lessons and scores on a word‐knowledge post‐test administered the day after the last lesson. There was also a weak but significant positive correlation between the change in anthropomorphism over time and scores on a word‐knowledge post‐test administered approximately 2 weeks after the last lesson. Our results underscore the need to manage children's expectations in robot‐assisted education. Also, future research could explore adaptations to individual children's expectations in child‐robot interactions.
Inhibition of microglial receptor‐interacting protein kinase 1 ameliorates neuroinflammation following cerebral ischaemic stroke
Authors: Jiao Yang , Wang Jianjian , Zhang Huixue , Cao Yuze , Qu Yang , Huang Siyu , Kong Xiaotong , Song Chang , Li Jie , Li Qian , Ma Heping , Lu Xiaoyu , Wang Lihua
Published: September 2020

Microglia are rapidly activated following ischaemic stroke and participate in the induction of neuroinflammation, which exacerbates the injury of ischaemic stroke. However, the mechanisms regulating ischaemic microglia remain unclear. In the present study, middle cerebral artery occlusion and oxygen and glucose deprivation models were established for in vivo and vitro monitoring of experimental stroke. We applied recombinant human thioredoxin‐1 (rhTrx‐1) and Necrostatin‐1 (Nec‐1, inhibitor of RIPK1) to examine the role of receptor‐interacting protein kinase 1 (RIPK1) in the development of inflammation in ischaemic microglia via explored the inflammatory responses and the associated mechanisms. Molecular docking results indicated that rhTrx‐1 could directly bind to RIPK1. In vivo and vitro data revealed that rhTrx‐1 reduced necroptosis, mitochondrial membrane potential damage, reactive oxygen species accumulation and NLR Family, pyrin domain‐containing 3 protein (NLRP3) inflammasome activation and regulated the microglial M1/M2 phenotypic changes by inhibiting RIPK1 expression in ischaemic microglia. Consistent with these findings, further in vivo experiments revealed that rhTrx‐1 treatment attenuated cerebral ischaemic injury by inhibiting the inflammatory response. Our data demonstrated the role of RIPK1 in microglia‐induced neuroinflammation following cerebral ischaemia. Administration of rhTrx‐1 provides neuroprotection in ischaemic stroke‐induced microglial neuroinflammation by inhibiting RIPK1 expression.
Is sleep the red flag to psychopathology’s bull?
Authors: Gradisar Michael , Gregory Alice M. , Tikotzky Liat
Published: September 2020

‘Hippocrates flagged the value of sleep for good health’ was the first line of the Annual Research Review (ARR) by Gregory and Sadeh (2016) in this journal, titled Sleep problems in childhood psychiatric disorders – a review of the latest science. Where Hippocrates has been referred to as the ‘Father of Medicine’, Professor Avi Sadeh has been respected as a ‘Father of Paediatric Sleep Medicine’ by those who had the privilege to meet him or read his science. Sadly, Avi Sadeh passed away in the same year this ARR was published. What he left behind was a legacy – including his predecessors (Professor Mary Carskadon), successors and those he inspired, who could be guided by the key findings from his 2016 ARR. These include (a) greater attention to the assessment of sleep in children; (b) sleep research on a wider range of psychiatric disorders; (c) a greater focus on and examination of mechanisms underlying associations; (d) a clearer consideration of developmental questions; and (e) large‐scale well‐designed treatment studies.
Indocyanine green‐labeled dasatinib as a new fluorescent probe for molecular imaging of gastrointestinal stromal tumors
Authors: Fujimoto Shota , Muguruma Naoki , Nakao Michiyasu , Ando Hidenori , Kashihara Takanori , Miyamoto Yoshihiko , Okamoto Koichi , Sano Shigeki , Ishida Tatsuhiro , Sato Yasushi , Takayama Tetsuji
Published: September 2020

Background and Aim

It is difficult to differentiate gastrointestinal stromal tumors (GISTs) from other subepithelial lesions under gastrointestinal endoscopy. Because most GISTs express tyrosine kinase receptor c‐KIT, fluorescence‐labeled c‐KIT‐specific tyrosine kinase inhibitors seem to be useful agents for molecular imaging of GIST. We aimed to develop a near‐infrared fluorescent imaging technology for GIST targeting c‐KIT using the novel fluorescent probe indocyanine green‐labeled dasatinib (ICG‐dasatinib) and to investigate the antitumor effect of ICG‐dasatinib on GIST cells.

Methods

Indocyanine green‐labeled dasatinib was synthesized by labeling linker‐induced dasatinib with ICG derivative 3‐indocyanine‐green‐acyl‐1,3‐thiazolidine‐2‐thione. Human GIST cell lines GIST‐T1 and GIST‐882M were incubated with ICG‐dasatinib and observed by fluorescent microscopy. GIST cells were incubated with ICG‐dasatinib, unlabeled dasatinib, or imatinib, and cell viabilities were evaluated. Subcutaneous GIST model mice or orthotopic GIST model rats were intravenously injected with ICG‐dasatinib and observed using an IVIS Spectrum.

Results

Strong fluorescent signals of ICG‐dasatinib were observed in both GIST cell lines in vitro. IC50 values for ICG‐dasatinib, unlabeled dasatinib, and imatinib were 13.9, 1.17, and 16.2 nM in GIST‐T1 and 26.6, 3.63, and 47.6 nM in GIST‐882M cells, respectively. ICG‐dasatinib accumulated in subcutaneous xenografts in mice. Fluorescent signals were also observed in liver and gallbladder, indicating biliary excretion; however, fluorescence intensity of tumors was significantly higher than that of intestine after washing. Strong fluorescent signals were observed in orthotopic xenografts through the covering normal mucosa in rats.

Conclusions

Indocyanine green‐labeled dasatinib could visualize GIST cells and xenografted tumors. The antitumor effect of ICG‐dasatinib was preserved to the same degree as imatinib.
Trichoscopy as an evaluation method for alopecia areata treatment: A comparative study
Authors: Fawzy Marwa M. , Abdel Hay Rania , Mohammed Faisal Nouredin , Sayed Khadiga S. , Ghanem Mona El Desoky , Ezzat Marwa
Published: September 2020

Background

Trichoscopy is a useful tool for diagnosis and follow‐up of alopecia areata (AA) patients. Both platelet‐rich plasma (PRP) and intralesional corticosteroids (ILCs) are important treatment modalities of patchy AA.

Aim

Trichoscopic diagnosis of AA and monitoring the treatment response to PRP versus ILCs in patchy AA treatment.

Patients/Methods

This comparative study included 31 patients with patchy AA, divided into two groups: (group A) received ILCs while (group B) received PRP once monthly for 3 months. Evaluation was done by Severity of Alopecia Tool (SALT) score, Alopecia Areata Symptom Impact Scale (AASIS), photography, and dermoscopy.

Results

There was a significant improvement in trichoscopic findings in both groups with regard to the number of follicular units per opening, black dots, broken hairs, and dystrophic changes. Final SALT score showed significant lower levels in both groups compared to baseline levels (P = .025 & P = .008). Final AASIS showed significant decrease in group B (P = .006) not in group A (P = .062).

Conclusion

Trichoscopy can help in the diagnosis, evaluation of the efficacy and safety of both modalities and might give a clue for treatment response. Both ILCs and PRP were effective in patchy AA treatment.
Presumed optic neuritis of non‐infectious origin in dogs treated with immunosuppressive medication: 28 dogs (2000‐2015)
Authors: Bedos L. , Tetas R. , Crespo V. , Shea A.
Published: September 2020

Objective

To describe the clinical findings, magnetic resonance imaging features, management and outcome of canine cases with presumed optic neuritis of non‐infectious origin that were presented to a UK referral centre from January 2000 to December 2015.

Materials and Methods

The clinical database was searched for optic neuritis. Dogs with acute‐onset vision impairment, systemic immunosuppressive treatment and follow‐up of ≥6 months were included. Information collected included: age; gender; breed; clinical signs and duration; physical, ophthalmic and neurological examination findings; concurrent systemic disease; and results of electroretinogram, magnetic resonance imaging, cerebrospinal fluid analysis, polymerase chain reaction and serology testing forToxoplasma gondii,Neospora caninumand canine distemper virus, haematology and serum biochemistry profiles, abdominal ultrasound, thoracic radiography, treatment and outcome.

Results

Twenty‐eight dogs were included, with a total of 48 affected optic nerves. Age at presentation ranged from 6 months to 10.5 years. Fundoscopic evidence of optic nerve disease was present in 34 of 48 (71%) optic nerves. Magnetic resonance imaging revealed enlargement of 32 of 48 (67%) nerves and contrast enhancement of 28 of 48 (58%) nerves. Cerebrospinal fluid analysis performed in 25 of 28 (89%) dogs revealed pleocytosis (>5 nucleated cells/uL) in 11 of 25 (44%) and increased protein (>0.35 g/L) in 11 of 25 (44%). Immunosuppressive prednisolone was administered to all dogs. Prednisolone was used alone in 9 of 28 (32%) dogs; the remaining 19 dogs received a combination of prednisolone with cytosine arabinoside, cyclosporine and/or azathioprine. Vision was recovered in 24 eyes (50%) of 18 affected dogs.

Clinical Significance

A positive response to treatment was observed in 64% of dogs with presumptively diagnosed optic neuritis treated with immunosuppressive medication.
Diversity and genotypic analysis of tick‐borne pathogens carried by ticks infesting horses in Korea
Authors: Seo M.‐G. , Kwon O.‐D. , Kwak D.
Published: September 2020

Ticks account for an extensive range of health and welfare issues in horses. In addition, tick‐borne pathogens (TBPs) limit global animal trading and equine sporting events. Here, we assess the prevalence, co‐infectivity and risk factors of TBPs in horse ticks in Korea. A total of 245 hard ticks, including 103 male and 142 female adults, were obtained from horses on Jeju Island during the spring to autumn seasons of 2013–2019. All collected ticks were identified as adult Haemaphysalis longicornis. We screened and analyzed each tick for the presence of several TBPs by polymerase chain reaction (PCR) analysis. Among the 245 ticks, we detected genes for three TBPs, Candidatus Rickettsia longicornii (22.9%), Ehrlichia canis (0.4%) and Theileria luwenshuni (0.4%), while Anaplasma spp. was not detected. TBPs were most prevalent in ticks harvested during the autumn season, and more abundant in the female than male adults. This is the first report of the genera Ehrlichia, Rickettsia and Theileria in horse ticks in Korea. TBPs in horse ticks are likely a reservoir for zoonotic transmission to other animals, including humans. Our findings demonstrate the need for further understanding of the prevalence and epidemiology of TBPs in wild and domestic animals.
Retinoid combined with photodynamic therapy against hyperkeratotic chromoblastomycosis: A case report and literature review
Authors: Lan Yu , Lu Sha , Zhang Junmin
Published: September 2020

Chromoblastomycosis (CBM) is a chronic granulomatous fungal infection caused by melanised or brown‐pigmented fungi. It can lead to chronic persistent infections and may cause incapacity for labour in some severe clinical forms. The optimal therapy for CBM is still uncertain. Here, we reported the case of a 66‐year‐old male who has had red plaque and recurrent keratinised protrusions on his right forearm for 20 years. He was treated orally with terbinafine, itraconazole and isotretinoin. He also received carbon dioxide(CO2) laser to eradicate the keratinised protrusions and promote the penetration of photosensitiser. After the CO2 laser, 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) was adopted immediately to inhibiting the growth of fungi in subcutaneous tissue. The patient received an important improvement with a plaque and crust reduction after 4 months. For such recalcitrant case of chromoblastomycosis, the use of retinoid, CO2 laser combined with ALA‐PDT may be a new adjuvant therapy. We further reviewed the cases of chromoblastomycosis treated with laser, photodynamic therapy or retinoic acid.
Renal supportive care, palliative care and end‐of‐life care: Perceptions of similarities, differences and challenges across Australia and New Zealand
Authors: Ducharlet Kathryn , Philip Jennifer , Kiburg Katerina , Gock Hilton
Published: September 2020

Renal supportive care (RSC) is an approach integrating nephrology and palliative care to improve quality of life for people with chronic kidney disease (CKD). RSC practice varies across services; therefore, understanding clinicians' perspectives is important to the evolution and definition of RSC.

Aim

To understand renal clinicians' views and experiences of RSC, palliative care and end‐of‐life care.

Method

A cross‐sectional online survey was undertaken across Australia and New Zealand between February and May 2018. Participants were asked about end‐of‐life care, RSC, palliative care and an ideal model of RSC.

Results

Estimated response rate 13% included 382 clinicians; doctors (32%), nurses (68%); of whom 84% access specialist palliative care and 59% RSC. A lack of agreed treatment goals (86%) and late or rushed treatment decision making (85%) was associated with challenging end‐of‐life experiences.

Variable concepts of RSC were described, with RSC being considered the same as: usual care for all CKD patients (40%), conservative (30%) or palliative care (22%). The term RSC was generally distinct from (77%) and more acceptable than palliative care (80%) with preferential RSC referral for symptoms (86% vs 69%, P < .01) and complex treatment decision making (82% vs 58%, P < .01). Aspirations for RSC included improving symptoms and quality of life (89%), with an ideal model comprising: symptom management (98%), improved nephrology and community service integration (96%) and clinician education (94%).

Conclusion

This study revealed challenges for renal clinicians in providing end‐of‐life care and variation of views and experiences of RSC. It represents opportunities to develop RSC aligned with clinician priorities to improve patient care.
Reproductive season and male effect on quantitative and qualitative traits of individually collected Muscovy duck (Cairina moschata) semen
Authors: Łukaszewicz Ewa , Jerysz Anna , Kowalczyk Artur
Published: September 2020

Males of Muscovy duck (Cairina moschata) are mainly used for mule duck production via artificial insemination of females originated from wild mallard duck (Anas platyrhynchos); therefore, the quantity and quality of drake semen play a crucial role. The assessment results of male reaction to sexual stimulation by dummy female and basic semen characteristic (ejaculate volume, sperm concentration and morphology) of 12 individually kept Muscovy drakes carried out during the entire reproductive season are described. The male and period of the reproductive season effect on scored semen traits are documented. In total, 792 individual semen collections and evaluations were performed. The average of positive reaction in the entire reproductive season varied from 90.6% in December and April to 50.0% in July, while for individual males, it varied between 97.1% and 29.0%. Throughout the season, the ejaculate volumes ranged from 0.05 to 2.45 ml, sperm concentration from 0.15 × 109 ml−1 to 4.44 × 109 ml−1, total number of live spermatozoa from 68.0% to 100% and live normal (properly formed, with any deformations) from 51.0% to 99.0%. Our study indicates the necessity of male breeders pre‐selection before the onset of the reproductive season, and the need to leave an appropriate number of males to ensure adequate amount of semen for female insemination, especially when using Muscovy drakes (Cairina moschata) for interspecies crossing with Anas platyrhynchos ducks.
Treatment of immunocompromised COVID‐19 patients with convalescent plasma
Authors: Fung Monica , Nambiar Ashok , Pandey Suchi , Aldrich J. Matthew , Teraoka Justin , Freise Christopher , Roberts John , Chandran Sindhu , Hays Steven R. , Bainbridge Emma , DeVoe Catherine , Roque Gardner Annelys , Yokoe Deborah , Henrich Timothy J. , Babik Jennifer M. , Chin‐Hong Peter
Published: September 2020

Immunosuppressed patients such as solid organ transplant and hematologic malignancy patients appear to be at increased risk for morbidity and mortality due to coronavirus disease 2019 (COVID‐19) caused by SARS coronavirus 2 (SARS‐CoV‐2). Convalescent plasma, a method of passive immunization that has been applied to prior viral pandemics, holds promise as a potential treatment for COVID‐19. Immunocompromised patients may experience more benefit from convalescent plasma given underlying deficits in B and T cell immunity as well as contraindications to antiviral and immunomodulatory therapy. We describe our institutional experience with four immunosuppressed patients (two kidney transplant recipients, one lung transplant recipient, and one chronic myelogenous leukemia patient) treated with COVID‐19 convalescent plasma through the Expanded Access Program (NCT 04338360). All patients clinically improved after administration (two fully recovered and two discharged to skilled nursing facilities) and none experienced a transfusion reaction. We also report the characteristics of convalescent plasma product from a local blood center including positive SARS‐CoV‐2 IgG and negative SARS‐CoV‐2 PCR in all samples tested. This preliminary evidence suggest that convalescent plasma may be safe among immunosuppressed patients with COVID‐19 and emphasizes the need for further data on the efficacy of convalescent plasma as either primary or adjunctive therapy for COVID‐19.
Pyogranulomatous panniculitis in a domestic cat associated with Pseudomonas luteola infection
Authors: Milliron Sarai M. , Seyler Zachary G. , Myers Alexandra N. , Rodrigues Hoffmann Aline , Hnot Melanie , Wiener Dominique J.
Published: September 2020

Pseudomonas luteola, a pathogen causing disease in humans, has in animals been reported only in rainbow trout and ferrets. This case report describes pyogranulomatous panniculitis in a cat associated with P. luteola infection. Organisms were seen histologically and identified with PCR and sequencing. Lesions resolved after treatment with marbofloxacin.
Negative‐pressure wound therapy for III/IV pressure injuries: A meta‐analysis
Authors: Song Yi‐Ping , Wang Lei , Yuan Bao‐Fang , Shen Hong‐Wu , Du Lin , Cai Ji‐Yu , Chen Hong‐Lin
Published: September 2020

This meta‐analysis was conducted to identify the potential benefits and the efficacy of negative‐pressure wound therapy (NPWT) for III/IV pressure injuries (PIs) compared with standard wound care (SWC). Sixteen RCTs with 629 patients were included in our analysis. The methodological quality was assessed by the Cochrane Collaboration Tool. The outcomes included complete ulcer healing rate, wound healing time, pain score, the frequency of dressing change, hospitalization cost, the condition of the exudate, and the wound improvement. The percentage of healing rate was 61.45% for the NPWT group and 36.90% for SWC (95% CI: 1.32‐1.70). There were significant differences in wound healing time (WMD = −16.47 days, 95% [CI (−22.36, − 10.59) days, P ≤ .001]). The pain score and hospitalization cost in NPWT was lower compared with SWC group (WMD = −2.39, 95% CI [−3.47, −1.30], P ≤ .001); (SMD = −2.55, 95% CI [−4.07, −1.03], P < .01). The frequency of dressing change in both NPWT groups was greatly reduced (SMD = −3.61, 95% [CI (−4.57, − 2.66) times, P ≤ .001]). Our meta‐analysis indicated that NPWT was associated with greater improvements in improving PIs and shorting healing time for III/IV PIs. However, this conclusion needs to be confirmed by high‐quality multicenter RCTs.
Reviewer Acknowledgements
Authors: Oscar William
Published: September 2020

International Journal of Contemporary Education (IJCE) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether IJCE publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 3, Number 2 Aurora Q. Pestano, University of San Jose Recoletos, PhilippinesAziz Moummou, Ministry of Education, MoroccoBlessing Dwumah Manu, Jiangsu University, GhanaBožić-Lenard Dragana, University of Osijek Croatia, CroatiaBruna Gabriela Augusto Marçal Vieira, CEFET-MG, BrazilDina Radeljas, Mohawk Valley Community College, USAEdward Bolden, Case Western Reserve University, USAFederica Cornali, University of Turin, ItalyFroilan Delute Mobo, Philippine Merchant Marine Academy, PhilippinesGiuseppe Maugeri, Ca' Foscari University, ItalyGraziano Serragiotto, Ca' Foscari University of Venice, ItalyInaad M Sayer, University of Human Development, IraqIosif Fragkoulis, Hellenic Open University, GreeceJavier Fombona, Univ. Oviedo, SpainLi Li, Bath Spa University, UKMatthew Schatt, University of Florida, USAMurat Tezer, Near East University, CyprusNesrin Ozturk, Ege University, TurkeyRaymond Aaron Younis, ACU Australia, AustraliaSaid K. Juma, State University of Zanzibar, TanzaniaSandro Sehic, Oneida BOCES, USASuriadi Samsuri, Institute of Islamic Religion Sultan Muhammad Syafiuddin Sambas, IndonesiaTeresa Pozo-Rico, University of Alicante, SpainVassiliki Pliogou, Metropolitan College of Thessaloniki, Greece William OscarEditorial AssistantInternational Journal of Contemporary Education------------------------------------------------------------Redfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USATel: 1-503-828-0536 ext. 509Fax: 1-503-828-0537E-mail 1: ijce@redfame.comE-mail 2: ijce@redfame.orgURL: http://ijce.redfame.com
Ash Fusion During Combustion of Single Corn Straw Pellets
Authors: Zhai Ming , Wang Xinyu , Zhang Yichi , Panahi Aidin , Dong Peng , Levendis Yiannis A.
Published: September 2020

This investigation identified conditions at which corn straw ash melts and examined how this phenomenon affects the combustion of char residues. Corn straw was pelletized in cylinders and was burned at elevated temperatures in the range of 1200–1400 °C, and at different air flow velocities. The pellets were inserted in a preheated furnace, where they were subjected to moderately high heating rates. Their combustion behavior was observed with cinematography, thermometry, and thermogravimetry. Upon insertion in the furnace, the pellets devolatilized and formed volatile envelope flames, upon extinction of which, the chars experienced concurrent heterogeneous combustion and ash fusion. Residues were assessed by X-ray diffraction (XRD) and scanning electron microscopy (SEM), coupled to energy dispersive spectroscopy (EDS). The burnout times of the volatiles and the chars decreased drastically with increasing temperature. At 1300 °C and 1400 °C, the remaining ash underwent complete melting and the final structures of the pellets collapsed to molten pools. At 1400 °C, all of the chlorine and most of the potassium were released into the gas phase. The straw ash was identified as a high-density silicate melt. Although surface ash melted completely, it flowed to the base of the pellet. Therefore, it did not significantly hinder the oxidation of the carbonaceous char. Hence, to increase the likelihood of complete corn straw carbon burnout and of ash melting and flowing to the bottom of the furnace, operating temperatures higher than 1300 °C, in conjunction with mild air flow rates, are recommended.
The purinergic receptor P2Y11 choreographs the polarization, mitochondrial metabolism, and migration of T lymphocytes
Authors: Ledderose Carola , Bromberger Sophie , Slubowski Christian J. , Sueyoshi Koichiro , Aytan Dilan , Shen Yong , Junger Wolfgang G.
Published: September 2020

Relocalization of P2Y11 purinergic receptors enables the polarization needed for T cell migration.
High-resolution structures of the SARS-CoV-2 2′-
O
-methyltransferase reveal strategies for structure-based inhibitor design
Authors: Rosas-Lemus Monica , Minasov George , Shuvalova Ludmilla , Inniss Nicole L. , Kiryukhina Olga , Brunzelle Joseph , Satchell Karla J. F.
Published: September 2020

Crystal structures of an mRNA-capping enzyme from SARS-CoV-2 in complex with its substrates suggest targets for drug design.
Coblation of paediatric cystic laryngeal lymphovascular malformations: a safe and effective alternative to tracheostomy
Authors: Thompson Christopher St Clair Gaston , Li Lucy Qian , Sharma Alok
Published: September 2020

We describe the case of a 12-hour-old, full-term newborn girl referred to the Ear, Nose and Throat emergency team with increased work of breathing and stridor present at birth. Flexible nasendoscopy revealed a cystic laryngeal lesion obstructing the glottis that prompted securing of the airway with intubation and transfer to a tertiary paediatric centre. On further investigation with MRI and direct visualisation, the lesion was identified as a mixed macro/microcystic laryngeal lymphovascular malformation. The patient successfully underwent a series of microlaryngo–bronchoscopy and coblations of the laryngeal lesion with the aim of avoiding a tracheostomy. We describe the presentation, diagnosis and management of this rare condition in a paediatric case, along with a literature review of the subject.
Leclercia adecarboxylatacausing necrotising soft tissue infection in an immunocompetent adult
Authors: Lonneman Molly K , Devasahayam Rebekah J , Phillips Cody J
Published: September 2020

A 72-year-old woman presented with concern for a necrotising soft tissue infection (NSTI) 6 days after a tree branch impaled her left lower extremity while hiking in Hawaii. The wound was irrigated and closed at a local clinic in Hawaii. She completed a 5-day course of clindamycin. She presented to our emergency department 1 day after completion of antibiotics due to worsening erythema and malodorous drainage. Local wound exploration revealed bullae and easy dissection of fascial planes. CT scan revealed complex heterogeneous fluid and inflammatory stranding in the posterior calf. Clinical and radiographic findings raised concern for NSTI prompting initiation of broad spectrum antibiotics and urgent operative debridement. Wound cultures and deep tissues cultures returned positive for pansusceptibleLeclercia adecarboxylata. She underwent two additional operative debridements and transitioned to negative pressure wound therapy during her hospitalisation. She was discharged home on oral amoxicillin/clavulanate on hospital day 6.
Late prosthetic shoulder joint infection due toActinomyces neuiiin an adult man
Authors: Chen Benjamin C , Kobayashi Takaaki , Ford Bradley , Sekar Poorani
Published: September 2020

A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder. Arthrocentesis was performed and synovial fluid gram stain revealed gram-positive rods. Clinical diagnosis of prosthetic shoulder joint infection was made. Orthopaedic surgeons performed irrigation and debridement with resection of the right shoulder prothesis and implantation of an antimicrobial spacer. Operative cultures grewActinomyces neuii. The patient was treated with 6 weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values.Actinomycesspecies remain a rare cause of late prosthetic joint infection (PJI) due to their slow growing and indolent course. While generalised actinomycosis is often treated with 6–12 months of antibiotics, the treatment course ofActinomycesPJI is not well characterised, with some sources suggesting a minimum of 6 weeks of antimicrobial therapy.
Bridging Western and Indigenous knowledge through intercultural dialogue: lessons from participatory research in Mexico
Authors: Sarmiento Iván , Zuluaga Germán , Paredes-Solís Sergio , Chomat Anne Marie , Loutfi David , Cockcroft Anne , Andersson Neil
Published: September 2020

Indigenous communities in Latin America and elsewhere have complex bodies of knowledge, but Western health services generally approach them as vulnerable people in need of external solutions. Intercultural dialogue recognises the validity and value of Indigenous standpoints, and participatory research promotes reciprocal respect for stakeholder input in knowledge creation.

As part of their decades-long community-based work in Mexico’s Guerrero State, researchers at theCentro de Investigación de Enfermedades Tropicalesresponded to the request from Indigenous communities to help them address poor maternal health. We present the experience from this participatory research in which both parties contributed to finding solutions for a shared concern. The aim was to open an intercultural dialogue by respecting Indigenous skills and customs, recognising the needs of health service stakeholders for scientific evidence.

Three steps summarise the opening of intercultural dialogue.Trust building and partnershipbased on mutual respect and principles of cultural safety. This focused on understanding traditional midwifery and the cultural conflicts in healthcare for Indigenous women. A pilot randomised controlled trial was an opportunity tolisten and to adjust the lexiconidentifying and testing culturally coherent responses for maternal health led by traditional midwives.Codesign, evaluation and discussionhappened during a full cluster randomised trial to identify benefits of supporting traditional midwifery on maternal outcomes. A narrative mid-term evaluation and cognitive mapping of traditional knowledge offered additional evidence to discuss with other stakeholders the benefits of intercultural dialogue. These steps are not mechanistic or invariable. Other contexts might require additional steps. In Guerrero, intercultural dialogue included recovering traditional midwifery and producing high-level epidemiological evidence of the value of traditional midwives, allowing service providers to draw on the strengths of different cultures.
Using critical information to strengthen pandemic preparedness: the role of national public health agencies
Authors: Khan Mishal S , Dar Osman , Erondu Ngozi A , Rahman-Shepherd Afifah , Hollmann Lara , Ihekweazu Chikwe , Ukandu Okechukwu , Agogo Emmanuel , Ikram Aamer , Rathore Tayyab Razi , Okereke Ebere , Squires Neil
Published: September 2020

COVID-19 has demonstrated that most countries’ public health systems and capacities are insufficiently prepared to prevent a localised infectious disease outbreak from spreading. Strengthening national preparedness requires National Public Health Institutes (NPHIs), or their equivalent, to overcome practical challenges affecting timely access to, and use of, data that is critical to preparedness. Our situational analysis in collaboration with NPHIs in three countries—Ethiopia, Nigeria and Pakistan—characterises these challenges. Our findings indicate that NPHIs’ role necessitates collection and analysis of data from multiple sources that do not routinely share data with public health authorities. Since initiating requests for access to new data sources can be a lengthy process, it is essential that NPHIs are routinely monitoring a broad set of priority indicators that are selected to reflect the country-specific context. NPHIs must also have the authority to be able to request rapid sharing of data from public and private sector organisations during health emergencies and to access additional human and financial resources during disease outbreaks. Finally, timely, transparent and informative communication of synthesised data from NPHIs will facilitate sustained data sharing with NPHIs from external organisations. These actions identified by our analysis will support the availability of robust information systems that allow relevant data to be collected, shared and analysed by NPHIs sufficiently rapidly to inform a timely local response to infectious disease outbreaks in the future.
Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana
Authors: Lartey Stella , Si Lei , Lung Thomas , Magnussen Costan G , Boateng Godfred O , Minicuci Nadia , Kowal Paul , Hayes Alison , de Graaff Barbara , Blizzard Leigh , Palmer Andrew J
Published: September 2020

Introduction

Prior studies have revealed the increasing prevalence of obesity and its associated health effects among ageing adults in resource poor countries. However, no study has examined the long-term and economic impact of overweight and obesity in sub-Saharan Africa. Therefore, we quantified the long-term impact of overweight and obesity on life expectancy (LE), quality-adjusted life years (QALYs) and total direct healthcare costs.

Methods

A Markov simulation model projected health and economic outcomes associated with three categories of body mass index (BMI): healthy weight (18.5≤BMI <25.0); overweight (25.0≤BMI < 30.0) and obese (BMI ≥30.0 kg/m2) in simulated adult cohorts over a 50-year time horizon from age fifty. Costs were estimated from government and patient perspectives, discounted 3% annually and reported in 2017 US$. Mortality rates from Ghanaian lifetables were adjusted by BMI-specific all-cause mortality HRs. Published input data were used from the 2014/2015 Ghana WHO Study on global AGEing and adult health data. Internal and external validity were assessed.

Results

From age 50 years, average (95% CI) remaining LE for females were 25.6 (95% CI: 25.4 to 25.8), 23.5 (95% CI: 23.3 to 23.7) and 21.3 (95% CI: 19.6 to 21.8) for healthy weight, overweight and obesity, respectively. In males, remaining LE were healthy weight (23.0; 95% CI: 22.8 to 23.2), overweight (20.7; 95% CI: 20.5 to 20.9) and obesity (17.6; 95% CI: 17.5 to 17.8). In females, QALYs for healthy weight were 23.0 (95% CI: 22.8 to 23.2), overweight, 21.0 (95% CI: 20.8 to 21.2) and obesity, 19.0 (95% CI: 18.8 to 19.7). The discounted total costs per female were US$619 (95% CI: 616 to 622), US$1298 (95% CI: 1290 to 1306) and US$2057 (95% CI: 2043 to 2071) for healthy weight, overweight and obesity, respectively. QALYs and costs were lower in males.

Conclusion

Overweight and obesity have substantial health and economic impacts, hence the urgent need for cost-effective preventive strategies in the Ghanaian population.
Evaluating an implementation programme for medication review with follow-up in community pharmacy using a hybrid effectiveness study design: translating evidence into practice
Authors: Varas-Doval Raquel , Gastelurrutia Miguel A , Benrimoj Shalom I , Zarzuelo Maria Jose , Garcia-Cardenas Victoria , Perez-Escamilla Beatriz , Martínez-Martínez Fernando
Published: September 2020

Objectives

To evaluate an implementation programme of a community pharmacy medication review with follow-up (MRF) service using a hybrid effectiveness-implementation study design, and to compare the clinical and humanistic outcomes with those in a previously conducted cluster randomised controlled trial (cRCT).

Setting

Community pharmacies in Spain.

Participants

135 community pharmacies and 222 pharmacists providing MRF to polymedicated patients aged 65 or over.

Intervention

The intervention was an implementation programme for the MRF service. A national level group was established, mirrored with a provincial level group. A series of interventions were defined (1) to engage pharmacy owners with the implementation model and (2) to provide training to pharmacists consisting of clinical case studies, process of MRF, communication skills and data collection methods and (3) practice change facilitators.

Primary and secondary outcome measures

The primary outcomes for the implementation programme were progress, reach, fidelity and integration. The secondary outcomes were number of medications, non-controlled health problems, emergency visits, hospitalisations and health-related quality of life, which were compared with a previous 6-month cluster RCT.

Results

55% of pharmacies reached the implementation phase and 35.6% remained in the testing phase at 12 months. A reach of 89.3% (n=844) was achieved. Fidelity average score was 8.45 (min: 6.2, max: 9.3) out of 10. The integration mean score was 3.39 (SD: 0.72) out of 5. MRF service outcomes were similar to the cluster RCT study; however, the magnitude of the outcomes was delayed.

Conclusions

The implementation of pharmacy services is a complex multifactorial process, conditioned by numerous implementation factors. In the absence of remuneration, the implementation of the MRF service is a slow process, taking at least 12 months to complete.

Trial registration number

CGFTRA-2017-01.
Documenting and characterising gestational weight gain beliefs and experiences among Marshallese pregnant women in Arkansas: a protocol for a longitudinal mixed-methods study
Authors: Ayers Britni L , Bogulski Cari A , Haggard-Duff Lauren , Andres Aline , Børsheim Elisabet , McElfish Pearl A
Published: September 2020

Introduction

Arkansas has the largest population of Marshallese Pacific Islanders residing in the continental USA. The Marshallese have higher rates of obesity, type 2 diabetes, pre-term births, low birthweight babies, infant mortality, and inadequate or no prenatal care. Despite the high rates of cardiometabolic and maternal and child health disparities among Marshallese, there are no studies documenting gestational weight gain or perceptions about gestational weight gain among the Marshallese population residing in the USA.

Methods and analysis

This paper describes the protocol of a mixed-methods concurrent triangulation longitudinal study designed to understand gestational weight gain in Marshallese women. The mixed-methods design collects qualitative and quantitative data during simultaneous data collection events, at both first and third trimester, and then augments that data with postpartum data abstraction. Quantitative and qualitative data will be analysed separately and then synthesised during the interpretation phase.

Ethics and dissemination

The study used a community engaged approach approved by the University of Arkansas for Medical Sciences Institutional Review Board (#228023). The research team will disseminate results to study participants, research stakeholders (clinics, faith-based organisations and community-based organisation), the broader Marshallese community and fellow researchers. Results will be disseminated to study participants through a one-page summary that show the aggregated research results using plain language and infographics.
Proton pump inhibitors versus histamine-2 receptor antagonists for stress ulcer prophylaxis during extracorporeal membrane oxygenation: a propensity score-matched analysis
Authors: Kondo Yutaka , Ohbe Hiroyuki , Matsui Hiroki , Fushimi Kiyohide , Tanaka Hiroshi , Yasunaga Hideo
Published: September 2020

Purpose

Patients receiving extracorporeal membrane oxygenation (ECMO) generally receive proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) to avoid major gastrointestinal bleeding. Our aim was to compare outcomes between patients receiving PPIs and H2RAs for stress ulcer prophylaxis during ECMO.

Materials and methods

We performed a retrospective cohort study using the Japanese Diagnosis Procedure Combination Database, using data recorded from 1 July 2010 to 31 March 2017. We defined patients who received PPIs within 2 days after starting ECMO as the PPIs group and those who received H2RAs within 2 days after starting ECMO as the H2RAs group. We performed propensity score matching to compare outcomes. The primary outcomes were gastrointestinal bleeding requiring endoscopic haemostasis and in-hospital mortality. The secondary outcomes were red blood cell transfusion, hospital-acquired pneumonia and Clostridium difficile infection during hospitalisation.

Results

Of 11 328 eligible patients, 9738 received PPIs and 1590 received H2RAs. Propensity score matching created 1556 pairs. No significant differences were seen regarding endoscopic haemostasis (1.2% vs 0.8%; p=0.37), in-hospital mortality (53.0% vs 53.1%; p=0.94), red blood cell transfusion rates (91.4% vs 89.7%; p=0.11), hospital-acquired pneumonia (13.0% vs 12.4%; p=0.59) or C. difficile infection (0.1% vs 0.2%; p=0.32) between the PPIs and H2RAs groups, respectively.

Conclusion

We found no differences in the evaluated outcomes between the PPIs and H2RAs groups. Both PPIs and H2RAs are treatment options for stress ulcer prophylaxis in patients undergoing ECMO.
Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial
Authors: Williams Kendra N. , Thompson Lisa M. , Sakas Zoe , Hengstermann Mayari , Quinn Ashlinn , Díaz-Artiga Anaité , Thangavel Gurusamy , Puzzolo Elisa , Rosa Ghislaine , Balakrishnan Kalpana , Peel Jennifer , Checkley William , Clasen Thomas F , Miranda J Jaime , Rosenthal Joshua P , Harvey Steven A
Published: September 2020

Introduction

Increasing use of cleaner fuels, such as liquefied petroleum gas (LPG), and abandonment of solid fuels is key to reducing household air pollution and realising potential health improvements in low-income countries. However, achieving exclusive LPG use in households unaccustomed to this type of fuel, used in combination with a new stove technology, requires substantial behaviour change. We conducted theory-grounded formative research to identify contextual factors influencing cooking fuel choice to guide the development of behavioural strategies for the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial will assess the impact of exclusive LPG use on air pollution exposure and health of pregnant women, older adult women, and infants under 1 year of age in Guatemala, India, Peru, and Rwanda.

Methods

Using the Capability, Opportunity, Motivation–Behaviour (COM–B) framework and Behaviour Change Wheel (BCW) to guide formative research, we conducted in-depth interviews, focus group discussions, observations, key informant interviews and pilot studies to identify key influencers of cooking behaviours in the four countries. We used these findings to develop behavioural strategies likely to achieve exclusive LPG use in the HAPIN trial.

Results

We identified nine potential influencers of exclusive LPG use, including perceived disadvantages of solid fuels, family preferences, cookware, traditional foods, non-food-related cooking, heating needs, LPG awareness, safety and cost and availability of fuel. Mapping formative findings onto the theoretical frameworks, behavioural strategies for achieving exclusive LPG use in each research site included free fuel deliveries, locally acceptable stoves and equipment, hands-on training and printed materials and videos emphasising relevant messages. In the HAPIN trial, we will monitor and reinforce exclusive LPG use through temperature data loggers, LPG fuel delivery tracking, in-home observations and behavioural reinforcement visits.

Conclusion

Our formative research and behavioural strategies can inform the development, implementation, monitoring and evaluation of theory-informed strategies to promote exclusive LPG use in future stove programmes and research studies.

Trial registration number

NCT02944682, Pre-results.
Which aspects of neighbourhood environment are most associated with meeting physical activity recommendations in American adults: an NHIS study
Authors: Gebauer Sarah C , Salas Joanne , Scherrer Jeffrey , Callahan Leigh F
Published: September 2020

Objectives

To investigate which perceived neighbourhood characteristics are most strongly linked with adequate physical activity (PA) in a nationally representative sample of adults in the USA.

Design

Cross-sectional.

Setting

USA via 2015 National Health Interview Survey Data.

Participants

A group of 28 697 non-institutionalised adults with complete data.

Primary outcome measures

Meeting PA was defined as 150 min/week of moderate to vigorous activity.

Results

The population had a mean age of 49.6 (±18.3) years and was 51.3% female and 66.2% non-Hispanic white. In adjusted, weighted analysis, places to walk and relax was mostly strongly associated with meeting PA recommendations (OR=1.40 (95% CI 1.27 to 1.54)). Other elements associated with meeting PA were presence of bus or transit stops to walk to and presence of movies, libraries or churches to walk to (OR=1.12 (95% CI 1.03 to 1.23) and OR=1.19 (95% CI 1.08 to 1.31), respectively).

Conclusions

In this analysis, the characteristic most strongly associated with PA was presence of places to walk and relax. Identifying communities that may lack amenities such as this, like a park, may help direct community investment to enhance structures that encourage activity.