bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrapartum fetal surveillance education in Victorian hospitals revisited
Authors: Tedesco Stephanie , Wallace Euan M. , Chang Sharon , Beaves Mark
Published: March 2020

Fifteen years ago a survey of Victorian public maternity services showed that the majority of services provided no fetal surveillance education to their staff and that only one in ten undertook any sort of assessment of staff knowledge. Today, all hospitals, public and private, provide training and all public hospitals require their midwifery and medical staff to undertake regular assessment of knowledge. The requirements of specialist obstetricians in private practice remain variable.
Knowing minds: Culture and perceptions of mental state access
Authors: Wice Matthew , Karasawa Minoru , Matsui Tomoko , Miller Joan G.
Published: March 2020

How does culture influence the ways in which individuals reflect upon their knowledge of others’ mental states? We addressed this question in a two‐study cross‐cultural investigation examining perceptions of mental state access in the United States and Japan. Study 1 (n = 100) revealed that American participants reported greater mental state access than did Japanese participants. Study 2 (n = 146) showed that both Americans and Japanese perceived greater access to the mental states of a close friend relative to a casual friend and that the observed cultural differences in perceived mental state access to a close friend’s mental states were mediated by how much access was considered appropriate. Overall, the results indicate that culturally variable norms specifying appropriate levels of mental state access play an important role in how individuals estimate their knowledge of other people’s minds in close relationships.
Are existing self‐ratings of acute manic symptoms in adults reliable and valid?—A systematic review
Authors: Meyer Thomas D. , Crist Nicholas , La Rosa Nikki , Ye Biyu , Soares Jair C. , Bauer Isabelle E.
Published: March 2020

Background

Depression research historically uses both self‐ and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients lack insight and cannot accurately report their symptoms. This delayed the development of self‐rating scales for mania, but several scales now exist and are used in research. Our objective is to systematically review the literature to identify existing self‐ratings of symptoms of (hypo)mania and to evaluate their psychometric properties.

Methods

PubMed, Web of Knowledge, and Ovid were searched up until June 2018 using the keywords: “(hypo)mania,” “self‐report,” and “mood disorder” to identify papers which included data on the validity and reliability of self‐rating scales for (hypo)mania in samples including patients with bipolar disorder.

Results

We identified 55 papers reporting on 16 different self‐rating scales claiming to assess (hypo)manic symptoms or states. This included single item scales, but also some with over 40 items. Three of the scales, the Internal State Scale (ISS), Altman Self‐Rating Mania Scale (ASRM), and Self‐Report Manic Inventory (SRMI), provided data about reliability and/or validity in more than three independent studies. Validity was mostly assessed by comparing group means from individuals in different mood states and sometimes by correlation to clinician ratings of mania.

Conclusions

ASRM, ISS, and SRMI are promising self‐rating tools for (hypo)mania to be used in clinical contexts. Future studies are, however, needed to further validate these measures; for example, their associations between each other and sensitivity to change, especially if they are meant to be outcome measures in studies.
The anti‐mitotic agents PTC‐028 and PTC596 display potent activity in pre‐clinical models of multiple myeloma but challenge the role of BMI‐1 as an essential tumour gene
Authors: Bolomsky Arnold , Muller Joséphine , Stangelberger Kathrin , Lejeune Margaux , Duray Elodie , Breid Helene , Vrancken Louise , Pfeiffer Christina , Hübl Wolfgang , Willheim Martin , Weetall Marla , Branstrom Art , Zojer Niklas , Caers Jo , Ludwig Heinz
Published: March 2020

Future progress in the treatment of multiple myeloma (MM) requires both the characterisation of key drivers of the disease and novel, innovative approaches to tackle these vulnerabilities. The present study focussed on the pre‐clinical evaluation of a novel drug class, BMI‐1 modulators, in MM. We demonstrate potent activity of PTC‐028 and PTC596 in a comprehensive set of in vitro and in vivo models, including models of drug resistance and stromal support. Treatment of MM cells with PTC‐028 and PTC596 downregulated BMI‐1 protein levels, which was found to correlate with drug activity. Surprisingly, BMI‐1 was dispensable for the activity of BMI‐1 modulators and MM cell growth. Our data rather point to mitotic arrest accompanied by myeloid cell leukaemia‐1 (MCL‐1) loss as key anti‐MM mechanisms and reveal impaired MYC and AKT signalling activity due to BMI‐1 modulator treatment. Moreover, we observed a complete eradication of MM after PTC596 treatment in the 5TGM.1 in vivo model and define epigenetic compounds and B cell leukaemia/lymphoma 2 homology domain 3 (BH3) mimetics as promising combination partners. These results bring into question the postulated role of BMI‐1 as an essential MM gene and confirm BMI‐1 modulators as potent anti‐mitotic agents with encouraging pre‐clinical activity that supports their rapid translation into clinical trials.
Pemetrexed sensitizes human lung cancer cells to cytotoxic immune cells
Authors: Okimoto Tamio , Kotani Hitoshi , Iida Yuichi , Koyanagi Akira , Tanino Ryosuke , Tsubata Yukari , Isobe Takeshi , Harada Mamoru
Published: March 2020

Pemetrexed (PEM) is a useful drug that can be combined with immune checkpoint blockade therapy for treatment of patients with advanced non–small‐cell lung cancer (NSCLC). However, its effects on anti–cancer immunity, especially the sensitivity of NSCLC cells to cytotoxic immune cells, have not been fully investigated. In this study, we examined the effects of PEM on the sensitivity of human NSCLC cells to two different types of cytotoxic immune cells. Pre‐treatment with PEM increased the sensitivity of two NSCLC cell lines, PC9 and A549, to activated T cells and natural killer (NK) cells, and decreased the expression of anti–apoptotic proteins, including XIAP and Mcl‐1. In addition, PEM treatment increased the cell surface expression of programmed death‐ligand 1 (PD‐L1) on PC9 cells. PEM‐induced upregulation of PD‐L1 on PC9 cells was at least partially ascribed to activation of ERK and the NFκB pathway. In contrast, PEM treatment increased the expression of UL16‐binding proteins (ULBP), ligands for the NKG2D NK receptor, on PC9 and A549 cells, as well as the induction of senescence. Although the addition of anti–programmed cell death 1 antibody showed no effect on the sensitivity of PEM‐treated PC9 and A549 cells to activated T cells, that of anti–NKG2D antibody decreased the enhanced sensitivity of PEM‐treated A549 cells to NK cells. These results indicate that PEM can effectively sensitize human NSCLC cells to cytotoxic immune cells while modulating the expression of immune‐regulatory molecules.
Relationship among DNA double‐strand break (DSB), DSB repair, and transcription prevents genome instability and cancer
Authors: Ui Ayako , Chiba Natsuko , Yasui Akira
Published: March 2020

DNA double‐strand break (DSB) is a serious type of DNA damage and is known to trigger multiple responses within cells. In these responses, novel relationships among DSB, DSB repair, and transcription machineries are created. First, transcription is repressed if DSB occurs near or at the transcription site, termed DSB‐induced transcriptional repression, which contributes to DSB repair with the aid of DNA damage‐signaling pathways, ATM‐ or DNA‐PKcs‐signaling pathways. DSB‐induced transcriptional repression is also regulated by transcriptional factors TLP1, NELF, and ENL, as well as chromatin remodeling and organizing factors ZMYND8, CDYL1, PBAF, and cohesin. Second, transcription and RNA promote DSB repair for genome integrity. Transcription factors such as LEDGF, SETD2, and transcriptionally active histone modification, H3K36, facilitate homologous recombination to overcome DSB. At transcriptional active sites, DNA:RNA hybrids, termed R‐loops, which are formed by DSB, are processed by RAD52 and XPG leading to an activation of the homologous recombination pathway. Even in a transcriptionally inactive non‐genic sites, noncoding RNAs that are produced by RNA polymerase II, DICER, and DROSHA, help to recruit DSB repair proteins at the DSB sites. Third, transcriptional activation itself, however, can induce DSB. Transcriptional activation often generates specific DNA structures such as R‐loops and topoisomerase‐induced DSBs, which cause genotoxic stress and may lead to genome instability and consequently to cancer. Thus, transcription and DSB repair machineries interact and cooperate to prevent genome instability and cancer.
Double positivity for anti‐N‐methyl‐d‐aspartate receptor and anti‐aquaporin‐4 antibodies in a patient presenting with hypersomnolence, personality change, and reduced spontaneity
Authors: Yoshimura Motoi , Uehara Taira , Tanaka Eizo , Okadome Toshiki , Yamaguchi Takahiro , Maeda Yasuhiro , Isobe Noriko , Matsushita Takuya , Yamasaki Ryo , Kira Jun‐ichi
Published: March 2020

Background

Recently, the coexistence of anti‐aquaporin‐4 antibody (AQP4‐ab) and anti‐N‐methyl‐d‐aspartate receptor antibody (NMDAR‐ab) were reported in a single case. However, its clinical significance is not well defined.

Case presentation

A 42‐year‐old woman developed hypersomnolence, personality change, and childish or bizarre behavior. Four months later, she exhibited marked reduction of verbal and motor spontaneity. Serum AQP4‐ab was positive. Cerebrospinal fluid (CSF) was positive for oligoclonal bands. Brain magnetic resonance imaging (MRI) detected multiple T2‐hyperintense lesions without gadolinium enhancement in the pons, midbrain, bilateral internal capsule, basal ganglia, corpus callosum, and deep cerebral white matter. Spinal MRI was negative. Because clinical symptoms and clinical course were atypical for neuromyelitis optica spectrum disorders (NMOSD), CSF NMDAR‐ab was tested and found to be positive. Whole‐body examination revealed cystic lesions in the right ovary, which were later found not to be malignant tumors. In accordance with the proposed algorithm for the treatment of NMDAR encephalitis (NMDARE), she was treated with three courses of intravenous methylprednisolone pulse therapy, followed by oral prednisolone, intravenous immunoglobulin therapy, and five courses of bimonthly intravenous cyclophosphamide pulse therapy. Her symptoms gradually improved, and she returned to her daily life without major sequelae.

Conclusions

Although her main symptoms were compatible with NMDARE, MRI findings were more compatible with NMOSD. Therefore, we interpreted her clinical and imaging features as a mixed phenotype of NMOSD and NMDARE. This case report provides additional evidence that double positivity for AQP4‐ab and NMDAR‐ab is associated with a mixed phenotype of NMOSD and NMDARE.
Changing Perspective: Building Creative Mindsets
Authors: Chou Yung‐Yi Juliet , Tversky Barbara
Published: March 2020

The search for new ideas often frustratingly cycles back to old ones, a phenomenon known as fixation. Recent research has shown ways to kick‐start finding new uses for familiar objects, a prototypical creativity task: wandering in the mind or the world or working on a messy desk. Those techniques seem to succeed by helping break fixation, but do not guide the search for new ideas. The perspective‐taking or human‐centric or empathic mindset championed by many in HCI and in design firms does provide a search strategy. We compared the mind‐wandering mindset to a perspective‐taking mindset, the latter priming thinking of ways that people in different roles (gardener, artist, etc.) might use the objects. In two studies, the Perspective‐Taking mindset yielded more ideas and more original ideas than Mind‐Wandering, which did not differ from a No‐Mindset control. Original ideas came late, rewarding persistence. The perspective‐taking mindset is productive for problem‐solving, forecasting, and social interactions as well as innovation.
SKA1 regulates actin cytoskeleton remodelling via activating Cdc42 and influences the migration of pancreatic ductal adenocarcinoma cells
Authors: Li Tong , Liu Xu , Xu Bin , Wu Wei , Zang Yi , Li Juanjuan , Wei Lumin , Qian Yuting , Xu Hui , Xie Mingping , Wang Qi , Wang Lifu
Published: March 2020

Objectives

Spindle and kinetochore–associated protein 1(SKA1), originally identified as a protein essential for proper chromosome segregation, has been recently linked to multiple malignancies. This study aimed to explore the biological, clinical role and molecular mechanism of SKA1 in pancreatic carcinogenesis.

Materials and Methods

SKA1 expression was detected in 145 pancreatic ductal adenocarcinoma (PDAC) specimens by immunohistochemistry. Biological behaviour assays were used to determine the role of SKA1 in PDAC progression in vitro and in vivo. Using isobaric tags for relative and absolute quantitation (iTRAQ), SKA1’s downstream proteins were examined. Moreover, cytochalasin B and ZCL278 were used to explore the changes of SKA1‐induced signalling and cell morphology, with further confirmation by immunoblotting and immunofluorescence assays.

Results

Increased SKA1 expression was significantly correlated with tumour size and cellular differentiation degree in PDAC tissues. Furthermore, elevated levels of SKA1 reflected shorter overall survival (P = .019). As for biological behaviour, SKA1 acted as a tumour promotor in PDAC, overexpression of SKA1 facilitates cell proliferation, migration and invasion in vitro and in vivo. Mechanistically, we demonstrated that SKA1 enhanced pancreatic cancer aggressiveness by inhibiting G2/M arrest and regulating actin cytoskeleton organization via activating Cdc42.

Conclusions

This study revealed novel roles for SKA1 as an important regulator of actin cytoskeleton organization and an oncogene in PDAC cells, which may provide insights into developing novel therapeutics.
Feasibility and acceptability of a volunteer peer fidelity assessment model in early psychosis intervention programmes in Ontario: Results from a pilot study
Authors: Selick Avra , Langill Gordon , Cheng Chiachen , Addington Donald , Archie Suzanne , Butt Shannel , Durbin Janet
Published: March 2020

Aim

Fidelity monitoring can support high‐quality service delivery but is resource‐intensive to implement. A fidelity assessment model utilizing volunteer assessors was trialled as a low‐cost strategy for conducting fidelity assessments. This article reports on the acceptability and feasibility of this model.

Methods

Twenty volunteer assessors were trained to conduct fidelity assessments in nine Early Psychosis Intervention programmes across Ontario, Canada. Assessments were conducted using the First‐Episode Psychosis Services Fidelity Scale based on a 2‐day site visit, during which assessors interviewed staff, clients and families; reviewed charts; observed a team meeting and reviewed programme materials. The model was evaluated based on assessor focus groups, programme interviews, consensus meeting data and time‐tracking logs. General inductive analysis was used to code and synthesize qualitative data. Quantitative data were aggregated and summarized.

Results

Participant feedback was positive and indicated that use of peer assessors and the in‐person site visit added value to the process. The model was perceived to provide valuable information to support internal quality improvement efforts. Assessors reported direct benefits from participating, including networking and learning opportunities. Key challenges were the high time demand on assessors and turnover in the assessor team.

Conclusions

The volunteer peer fidelity model was perceived to be a valuable improvement process by participants, but the high cost and reliance on ongoing volunteerism makes its sustainability uncertain. Next steps may include exploring remote assessment strategies or direct payments, although these strategies risk reducing the acceptability, and therefore uptake, of the assessment.
Effects of neuropsychiatric symptoms of dementia on reductions in activities of daily living in patients with Alzheimer's disease
Authors: Okabe Kiwamu , Nagata Tomoyuki , Shinagawa Shunichiro , Inamura Keisuke , Tagai Kenji , Nukariya Kazutaka , Shigeta Masahiro
Published: March 2020

Aim

In patients with Alzheimer's disease (AD), cognitive impairments cause a progressive reduction in Activities of Daily Living (ADL). Neuropsychiatric symptoms (NPS) also appear in most patients; however, the association between NPS and reductions in ADL remains unclear. The present study evaluated whether NPS influence such reductions using two different ADL measures in patients with AD.

Methods

Among 546 consecutive outpatients who visited the memory clinic at the Jikei University Kashiwa Hospital, we recruited 208 patients with AD and investigated the correlations between either the Physical Self‐Maintenance Scale (PSMS) score or the Instrumental ADL (IADL) level, and each of the Behavioral Pathology in AD (Behave‐AD) subscales. To clarify the causal relationships of these correlations, we then verified the associations between statistically significant demographic variables and the Behave‐AD subscales as well as the two ADL scales (PSMS score and IADL percentage) using a general linear model.

Results

Neither the PSMS nor the IADL results were significantly influenced by the aberrant motor behaviors score. However, the IADL was significantly influenced by the Mini‐Mental State Exam (MMSE) score. Furthermore, diurnal rhythm disturbances and the interaction between diurnal rhythm disturbances score and the MMSE score significantly influenced the PSMS results.

Conclusion

Basic ADL reductions may be influenced by diurnal rhythm disturbances, in addition to cognitive impairments in patients with AD. Furthermore, the interaction between the diurnal rhythm disturbances score and cognitive function may also influence basic ADL. Geriatr Gerontol Int 2020; ••: ••–••.
New histories of marronage in the Anglo‐Atlantic world and early North America
Authors: Nevius Marcus P.
Published: March 2020

This essay surveys the scholarship ofmarronage, the most pervasive form of fugitive slave community formation, resistance, negotiation, and enslaver accommodation in the history of the Atlantic world. It begins with a brief survey of the subject's historiographic roots, with particular emphasis on its foundational definition as slave resistance and rebellion; on scholarly debates of thegrand/petitmarronage binary; and on the validity and definitions of maroon identity, forged by processes of ethnogenesis and grounded in maroon communities, past and present. The essay then centers on recent histories of marronage in the Caribbean, the Global South, and in early North America. In doing so, it seeks to draw out explicit thematic connections otherwise implicit in new maroon studies. The essay closes with a brief mention of forthcoming works that, informed by extant maroon studies, examine the challenges contemporary maroon communities face and that signal present‐day maroon descended communities' contributions to an increasingly globalizing world.
From panopticon to heautopticon: A new form of surveillance introduced by quantified‐self practices
Authors: De Moya Jean‐François , Pallud Jessie
Published: March 2020

In this research, we investigate whether quantified‐self (QS) technologies, based on wearable technologies, enable individuals' empowerment or lead to their disempowerment. To understand better the potential paradoxical effects of QS technologies, we adopt a critical approach by mobilising the panopticon metaphor from Foucault's original writings and more precisely, his four core concepts, namely power, knowledge, body and space. Relying on a qualitative study that consists of the analysis of 12 interviews, 14 142 messages extracted from online forums, and 30 blogs, we explore the discourses associated with the usage of QS technologies. Our findings indicate that self‐quantification has ambivalent, conflicting effects—13 empowering and 11 disempowering—spanning the dimensions of power, knowledge, body and space. Our research also shows the emergence of micro‐surveillance of oneself, which we name the heautopticon. The implications of this critical research also offer possibilities for change by discussing social and individual emancipation.
Perovskite quantum dots growth in situ in transparent medium for short wavelength shielding
Authors: Yang Ze , Zhao Lei , Li Moxiang , Yang Qihua , Fang Zhaohui , Yang Liuli , Yu Xue , Qiu Jianbei , Yang Yang , Xu Xuhui
Published: March 2020

High energy ultraviolet (UV) and blue light (short wavelength) radiation is proved to be harmful to human eyes, skin, and biological genomes. However, developing effective shielding materials providing protect from short wavelength is still a great challenge. Here, Eu3+‐doped CsPbBr3 embedded in a transparent glass medium is proved to shield the short wavelength from 200 to 475 nm with high performance, which is prepared by a facile and efficient melting‐quenching technique. The uniform distribution of the CsPbBr3 quantum dots (QDs) growth in situ from the transparent glass matrix ensures the high transmittance (>90%) at the long wavelength (520‐800 nm). In addition, the excellent short wavelength shielding ability of the Eu3+‐doped CsPbBr3 glass ceramics (EGC) is demonstrated even suffered with accelerated weathering tests as long as 480 hours. Moreover the cell viability of A549 cells is well preserved thanks to the completely blocked blue light by the as‐obtained EGC, which unambiguously demonstrates the promising application of EGC as short wavelength shielding materials.
Both New and Chronic Potentially Inappropriate Medications Continued at Hospital Discharge Are Associated With Increased Risk of Adverse Events
Authors: Weir Daniala L. , Lee Todd C. , McDonald Emily G. , Motulsky Aude , Abrahamowicz Michal , Morgan Steven , Buckeridge David , Tamblyn Robyn
Published: March 2020

BACKGROUND

Admission to hospital provides the opportunity to review patient medications; however, the extent to which the safety of drug regimens changes after hospitalization is unclear.

OBJECTIVE

To estimate the number of potentially inappropriate medications (PIMs) prescribed to patients at hospital discharge and their association with the risk of adverse events 30 days after discharge.

DESIGN

Prospective cohort study.

SETTING

Tertiary care hospitals within the McGill University Health Centre Network in Montreal, Quebec, Canada.

PARTICIPANTS

Patients from internal medicine, cardiac, and thoracic surgery, aged 65 years and older, admitted between October 2014 and November 2016.

MEASURES

Abstracted chart data were linked to provincial health databases. PIMs were identified using AGS (American Geriatrics Society) Beers Criteria®, STOPP, and Choosing Wisely statements. Multivariable logistic regression and Cox models were used to assess the association between PIMs and adverse events.

RESULTS

Of 2,402 included patients, 1,381 (57%) were male; median age was 76 years (interquartile range [IQR] = 70‐82 years); and eight discharge medications were prescribed (IQR = 2‐8). A total of 1,576 (66%) patients were prescribed at least one PIM at discharge; 1,176 (49%) continued a PIM from prior to admission, and 755 (31%) were prescribed at least one new PIM. In the 30 days after discharge, 218 (9%) experienced an adverse drug event (ADE) and 862 (36%) visited the emergency department (ED), were rehospitalized, or died. After adjustment, each additional new PIM and continued community PIM were respectively associated with a 21% (odds ratio [OR] = 1.21; 95% confidence interval [CI] = 1.01‐1.45) and a 10% (OR = 1.10; 95% CI = 1.01‐1.21) increased odds of ADEs. They were also respectively associated with a 13% (hazard ratio [HR] = 1.13; 95% CI = 1.03‐1.26) and a 5% (HR = 1.05; 95% CI = 1.00‐1.10) increased risk of ED visits, rehospitalization, and death.

CONCLUSIONS

Two in three hospitalized patients were prescribed a PIM at discharge, and increasing numbers of PIMs were associated with an increased risk of ADEs and all‐cause adverse events. Improving hospital prescribing practices may reduce the frequency of PIMs and associated adverse events. J Am Geriatr Soc 68:1184–1192, 2020.
Clinician Perspectives on Overscreening for Cancer in Older Adults With Limited Life Expectancy
Authors: Schoenborn Nancy L. , Massare Jacqueline , Park Reuben , Pollack Craig E. , Choi Youngjee , Boyd Cynthia M.
Published: March 2020

BACKGROUND/OBJECTIVES

Guidelines recommend against routine screening for breast, colorectal, and prostate cancers in older adults with less than 10 years of life expectancy. However, clinicians often continue to recommend cancer screening for these patients. We examined primary care cliniciansʼ perspectives regarding overscreening, as defined by limited life expectancy.

DESIGN

Semistructured, in‐depth individual interviews.

SETTING

Twenty‐one academic and nonacademic primary care clinics in Maryland.

PARTICIPANTS

Thirty primary care clinicians from internal medicine, family medicine, medicine/pediatrics, and geriatric medicine.

MEASUREMENTS

Interviews explored whether the clinicians believed that overscreening for breast, colorectal, or prostate cancers existed in older adults and their views on using life expectancy to decide on stopping routine screening. Audio recordings of the interviews were transcribed verbatim. Two investigators independently coded all transcripts using qualitative content analysis.

RESULTS

Most clinicians were physicians (24/30) and women (16/30). Content analysis generated three major themes. (1) Many, but not all, clinicians perceived overscreening in older adults as a problem. (2) There was controversy around using limited life expectancy to define overscreening due to concerns that the guidelines did not capture potential nonmortality benefits of screening; that population‐based screening data could not be easily applied to individuals; that this approach failed to account for patient choice; and that life expectancy predictions were inaccurate. (3) Some clinicians worried that using life expectancy to define overscreening may inadvertently introduce bias and lead to unintended harms.

CONCLUSIONS

Several clinicians disagreed with guideline frameworks of using limited life expectancy to guide cancer screening cessation. Some disagreement stems from inadequate knowledge about the benefits and harms of cancer screening and indicates a need for education or decision support. Other reasons for disagreement highlight the need to refine the current recommended cancer screening approaches and identify strategies to avoid unintended consequences, such as introducing bias or exacerbating existing disparities. J Am Geriatr Soc 68:1462‐1468, 2020.
Medical Education Adaptations: Really Good Stuff for educational transition during a pandemic
Authors: Eva Kevin W. , Anderson M. Brownie
Published: March 2020

Hear ye, hear ye … submissions now being accepted for a new Adaptations series aimed at sharing insights gained from the widespread educational transitions currently taking place.
Usefulness of autocidal gravid ovitraps for the surveillance and control of Aedes (Stegomyia) aegypti (Diptera: Culicidae) in eastern Colombia
Authors: Montenegro D. , Martinez L. , Tay K. , Hernandez T. , Noriega D. , Barbosa L. , Muñoz J. , Mateus H. , Daza J. , Teherán A. , Ramírez J. D.
Published: March 2020

In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8‐week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.
Effectiveness of an educational intervention on vulvo‐vaginal discharge for family healthcare workers: A nonrandomized controlled trial
Authors: Ilankoon Ilankoon M. P. Sumudrika , Goonewardena Christine S. E. , Fernandopulle Rukshan C. , Perera Poruthotage P. Rasika
Published: March 2020

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2‐day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between‐within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub‐competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in‐service program for family healthcare workers to improve health education practices.
Researching South African Englishes
Authors: Botha Werner , van Rooy Bertus , Coetzee‐Van Rooy Susan
Published: March 2020

In this paper we provide an overview of the current status as well as broad functions of Englishes in South Africa. We also provide a discussion of some of the contemporary concerns related to the complex and multivaried nature of English in the country. This paper further serves to introduce the major themes that are of concern to those researchers that are interested in the study of South African Englishes, through an introduction of the papers that form part of this Special Issue. Finally, we discuss the current state of the art with regards to researching English in the country where we suggest potential future areas of investigation.
Longitudinal Seismic Response of Train–Bridge Interaction System With Slip in Moderate Earthquakes
Authors: Lu Xuzhao , Kim Chul-Woo , Chang Kai-Chun
Published: March 2020

This study assesses the seismic responses of viaduct structures in the Japanese high-speed rail system under moderate earthquake forces considering the slip between tracks and wheels. Equations of motion for the train–bridge interaction system were derived, where the track–wheel interaction was described by the Coulomb friction law. A full train–bridge finite element model incorporating nonslip and stick–slip interaction models was built using commercial finite element analysis software: abaqus. Simulation results indicate that the slip phenomenon might occur under a moderate earthquake and that a conventional nonslip model with an infinitely large friction coefficient is inappropriate. A parametric study revealed that the braking-train-induced slip friction little influenced the bridge response to moderate earthquake forces. The bridge's dynamic motions were dominated by ground motion irrespective of the values assigned as the train's initial speed and track–wheel friction coefficient. A computationally efficient method was proposed for calculating the longitudinal seismic responses of a bridge interacting with a braking train, following the linear superposition principle. As illustrated, this method could be helpful in reliability or uncertainty analysis when a great number of computationally expensive seismic analyses are required for train–bridge interaction systems.
Design and Biomechanical Analysis of a Novel Retrievable Peripheral Vascular Stent
Authors: Guo Jingzhen , Mao Lin , Yu Xitong , Song Chengli , Zhao Xue
Published: March 2020

Structurally retrievable drug-eluting stents may have valuable clinical applications because they do not leave any foreign materials inside the patient's body. This article presents a novel design of retrievable peripheral vascular stent and the results from biomechanical analysis of its performance. Using the finite element analysis method, principal parameters of the stent were studied. Moreover, to ensure the practicability of the retrieval process, simulation, and in vitro experiments were performed. The retrieval force reached the maximum value when the whole retrievable part had been retrieved. Furthermore, the force was gradually increased during the retrieval process and remained constant after the main part had been retrieved. When the stent was being compressed, the maximum strain of the stent occurred at the connection between the stent's retrieval part and the main body part, at a value of 4%. The index of nonuniformity of the stent was too small to be counted both at the end of the compression and self-expansion processes. With the increase of moment, the bending stiffness (EI) of the stent decreased gradually. After bending moment was applied, the large strain region was mainly located in the stent's main body part rather than the retrieval part. The results of preliminary stent retrieval experiments demonstrated that the stent could be retrieved successfully. This novel retrievable stent displays promising biomechanical performance. The preliminary experiments demonstrated that the stent could be retrieved smoothly from the blood vessels.
Evaluation of an Improved Suspension System Concept for Surgical Luminaires
Authors: Knulst Arjan J. , Harms Jan Jouke , Dankelman Jenny
Published: March 2020

Surgeons have indicated ergonomic problems with the surgical luminaire, which have been observed to occur during repositioning. The possibility of singularity, within the movement space of the translational subsystem of the current double-arm suspension systems, is confirmed to be the cause of these problems. In this study, a redesign of the translational subsystem is compared to the conventional translational subsystem. A user experiment with 14 participants is setup to compare the redesigned and alternative system. The experiment is performed outside the operating room (OR), with one setup that can be altered between two designs; an uncoupled state with the kinematics of the conventional subsystem, and a coupled state with the redesigned kinematics. Work cost, duration, and jerk cost are compared, as well as NASA TLX score. The work cost of a movement in the conventional uncoupled state is confirmed to depend on the spatial orientation of the mechanism, which is not the case in the new coupled state. Due to these different kinetics, the movement patterns with the coupled mechanism are more consistent between participants, the duration of movements is shorter, less problems occur, and participants are able to better control the movements as demonstrated by lower jerk costs. This result validates the redesign and confirms the hypothesis that a translational subsystem without the possibility of singularity within its movement space will improve luminaire repositioning. The conceptual design can now be used as base for a clinically usable design.
Low-temperature chemical vapor deposition growth of graphene films enabled by ultrathin alloy catalysts
Authors: Olson Samuel , Zietz Otto , Tracy Joshua , Li Yanlong , Tao Chenggang , Jiao Jun
Published: March 2020

This report introduces a method for fabricating graphene at low temperatures via chemical vapor deposition enabled by ultrathin (∼1 nm) nickel-gold (Ni-Au) catalysts. The unique combination of high carbon (C) solubility Ni, low C solubility Au, and an ultrathin layer of a catalyst demonstrates the effectiveness to produce graphene at 450 °C with the layer number independent of growth duration. In contrast to grain-boundary defined catalyst morphology found in thicker (>20 nm) metal catalysts, the ultrathin catalyst morphology leads to the formation of nanoscale metal “islands” during the growth process, which results in curved graphene covering the catalyst. To test the effect of preactivation of the ultrathin catalyst for the formation of graphene, a preanneal process of the catalyst followed by the introduction of a carbon precursor was also investigated. The preanneal process resulted in the formation of carbon nanotubes (CNTs) in lieu of graphene, displaying the impact of the catalytic surface treatment in relation to the produced materials. The results and discussion presented here detail a low-temperature nanoscale manufacturing process that allows for the production of either graphene or CNTs on an ultrathin catalyst.
An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China
Authors: Tian Huaiyu , Liu Yonghong , Li Yidan , Wu Chieh-Hsi , Chen Bin , Kraemer Moritz U. G. , Li Bingying , Cai Jun , Xu Bo , Yang Qiqi , Wang Ben , Yang Peng , Cui Yujun , Song Yimeng , Zheng Pai , Wang Quanyi , Bjornstad Ottar N. , Yang Ruifu , Grenfell Bryan T. , Pybus Oliver G. , Dye Christopher
Published: March 2020

The most effective interventions

By 23 January 2020, China had imposed a national emergency response to restrict travel and impose social distancing measures on its populace in an attempt to inhibit the transmission of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2). However, which measures were most effective is uncertain. Tian
et al.
performed a quantitative analysis of the impact of control measures between 31 December 2019 and 19 February 2020, which encompasses the Lunar New Year period when millions of people traveled across China for family visits. Travel restrictions in and out of Wuhan were too late to prevent the spread of the virus to 262 cities within 28 days. However, the epidemic peaked in Hubei province on 4 February 2020, indicating that measures such as closing citywide public transport and entertainment venues and banning public gatherings combined to avert hundreds of thousands of cases of infection. It is unlikely that this decline happened because the supply of susceptible people was exhausted, so relaxing control measures could lead to a resurgence.

Science
, this issue p.
638
Low intrinsic efficacy for G protein activation can explain the improved side effect profiles of new opioid agonists
Authors: Gillis Alexander , Gondin Arisbel B. , Kliewer Andrea , Sanchez Julie , Lim Herman D. , Alamein Claudia , Manandhar Preeti , Santiago Marina , Fritzwanker Sebastian , Schmiedel Frank , Katte Timothy A. , Reekie Tristan , Grimsey Natasha L. , Kassiou Michael , Kellam Barrie , Krasel Cornelius , Halls Michelle L. , Connor Mark , Lane J. Robert , Schulz Stefan , Christie Macdonald J. , Canals Meritxell
Published: March 2020

Low intrinsic efficacy can explain the reduced side effects of apparently biased μ-opioid receptor agonists.
Characterization of RelA inAcinetobacter baumannii
Authors: Pérez-Varela María , Tierney Aimee R. P. , Kim Ju-Sim , Vázquez-Torres Andrés , Rather Philip
Published: March 2020

In response to nutrient depletion, the RelA and SpoT proteins generate the signaling molecule (p)ppGpp, which then controls a number of downstream effectors to modulate cell physiology. InAcinetobacter baumanniistrain AB5075, arelAortholog (ABUW_3302) was identified by a transposon insertion that conferred an unusual colony phenotype. An in-frame deletion inrelA(ΔrelA) failed to produce detectable levels of ppGpp when amino acid starvation was induced with serine hydroxamate. The ΔrelAmutant was blocked from switching from the virulent opaque colony variant (VIR-O) to the avirulent translucent colony variant (AV-T), but the rate of AV-T to VIR-O switching was unchanged. In addition, the ΔrelAmutation resulted in a pronounced hypermotile phenotype on 0.35% agar plates. This hypermotility was dependent on the activation of a LysR regulator ABUW_1132, which was required for expression of AbaR, a LuxR family quorum-sensing regulator. In the ΔrelAmutant, ABUW_1132 was also required for the increased expression of an operon composed of theABUW_3766-ABUW_3773genes required for production of the surfactant-like lipopeptide acinetin 505. Additional phenotypes identified in the ΔrelAmutant included (i) cell elongation at high density, (ii) reduced formation of persister cells tolerant to colistin and rifampin, and (iii) decreased virulence in aGalleria mellonellamodel.

IMPORTANCEAcinetobacter baumanniiis a pathogen of worldwide importance. Due to the increasing prevalence of antibiotic resistance, these infections are becoming increasingly difficult to treat. New therapies are required to combat multidrug-resistant isolates. The role of RelA inA. baumanniiis largely unknown. This study demonstrates that like in other bacteria, RelA controls a variety of functions, including virulence. Strategies to inhibit the activity of RelA and the resulting production of ppGpp could inhibit virulence and may represent a new therapeutic approach.
Computational Inference of Selection Underlying the Evolution of the Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2
Authors: Cagliani Rachele , Forni Diego , Clerici Mario , Sironi Manuela
Published: March 2020

Coronaviruses are dangerous zoonotic pathogens; in the last 2 decades, three coronaviruses have crossed the species barrier and caused human epidemics. One of these is the recently emerged SARS-CoV-2. We investigated how, since its divergence from a closely related bat virus, natural selection shaped the genome of SARS-CoV-2. We found that distinct coding regions in the SARS-CoV-2 genome evolved under conditions of different degrees of constraint and are consequently more or less prone to tolerate amino acid substitutions. In practical terms, the level of constraint provides indications about which proteins/protein regions are better suited as possible targets for the development of antivirals or vaccines. We also detected limited signals of positive selection in three viral ORFs. However, we warn that, in the absence of knowledge about the chain of events that determined the human spillover, these signals should not be necessarily interpreted as evidence of an adaptation to our species.
Lymphoproliferative disorder in a lung transplant recipient
Authors: Haji Hassan A , Corwin Douglas S , So Jennifer Y , Reed Robert M
Published: March 2020

Post-transplantation lymphoproliferative disorder (PTLD) is uncommon following solid organ transplantation. We present a case of PTLD presenting as hematochezia and abdominal pain in a 66-year-old man, who had undergone bilateral lung transplantation with alemtuzumab induction 7 months prior to presentation. The transplant serologic status was “high-risk” for the presence of both Epstein-Barr virus (EBV) serologies in the donor and negative serologies in the recipient. Biopsies taken during colonoscopy stained strongly positive for EBV-encoded RNA. Mediastinal lymph node biopsies also showed atypical, EBV-positive lymphohistiocytic infiltration with focal necrosis. The patient’s hospital course was complicated by treatment side effects, most notably bowel perforation following rituximab. In this case report the topic of PTLD is reviewed and consideration is given to whether alemtuzumab induction may have contributed to the patient’s development of PTLD.
Data for tracking SDGs: challenges in capturing neonatal data from hospitals in Kenya
Authors: Hagel Christiane , Paton Chris , Mbevi George , English Mike
Published: March 2020

Background

Target 3.2 of the United Nations Sustainable Development Goals (SDGs) is to reduce neonatal mortality. In low-income and middle-income countries (LMICs), the District Health Information Software, V.2 (DHIS2) is widely used to help improve indicator data reporting. There are few reports on its use for collecting neonatal hospital data that are of increasing importance as births within facilities increase. To address this gap, we investigated implementation experiences of DHIS2 in LMICs and mapped the information flow relevant for neonatal data reporting in Kenyan hospitals.

Methods

A narrative review of published literature and policy documents from LMICs was conducted. Information gathered was used to identify the challenges around DHIS2 and to map information flows from healthcare facilities to the national level. Two use cases explore how newborn data collection and reporting happens in hospitals. The results were validated, adjusted and system challenges identified.

Results

Literature and policy documents report that DHIS2 is a useful tool with strong technical capabilities, but significant challenges can emerge with the implementation. Visualisations of information flows highlight how a complex, people-based and paper-based subsystem for inpatient information capture precedes digitisation. Use cases point to major challenges in these subsystems in accurately identifying newborn deaths and appropriate data for the calculation of mortality even in hospitals.

Conclusions

DHIS2 is a tool with potential to improve availability of health information that is key to health systems, but it critically depends on people-based and paper-based subsystems. In hospitals, the subsystems are subject to multiple micro level challenges. Work is needed to design and implement better standardised information processes, recording and reporting tools, and to strengthen the information system workforce. If the challenges are addressed and data quality improved, DHIS2 can support countries to track progress towards the SDG target of improving neonatal mortality.