bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of Post‐Acute Rehabilitation at Home: A Skilled Nursing Facility‐Substitutive Model
Authors: Augustine Matthew R. , Davenport Claire , Ornstein Katherine A. , Cuan Mitchell , Saenger Pamela , Lubetsky Sara , Federman Alex , DeCherrie Linda V. , Leff Bruce , Siu Albert L.
Published: April 2020

OBJECTIVES

For patients who require frequent and intensive therapy services after hospitalization, rehabilitation is predominantly provided in skilled nursing facilities (SNFs). Delivering post‐acute rehabilitation in patientsʼ homes offers a potential alternative. Our aim was to describe and evaluate services and functional outcomes and then identify factors associated with the provision of a 30‐day post‐acute care (PAC) bundle of rehabilitation, medical, and social services provided via the Rehabilitation at Home (RaH) program.

DESIGN

Single‐arm retrospective review of patients participating in the RaH program.

SETTING

Multidisciplinary home‐based delivery of PAC in Manhattan.

PARTICIPANTS

Individuals 18 years or older residing in a specified catchment area and qualifying for SNF‐based rehabilitation services from October 2015 to September 2017.

RESULTS

A total of 237 patients participated in RaH over 264 episodes of care. Participants were predominantly older than 85 years (57%; mean = 84.2; standard deviation [SD] = 10.0 years) and of non‐Hispanic white (70%) race and ethnicity. Most were admitted after hospitalization (88.2%) for 117 different diagnostic related groups. Average length of stay in RaH was 14.2 (SD = 6.5) days with patients receiving 1.83 (SD = 2.22) medical provider, 1.67 (SD = 1.58) nursing, and 5.24 (SD = 1.05) physical therapist visits weekly. Most of the patients fully or almost fully met their goals for bed mobility (65%), bed transfer (69%), chair transfer (67%), and ambulation (64%) with the majority achieving moderate or considerable (61%) global functional improvement. Achieving moderate or considerable global improvement was negatively associated with dementia diagnosis (odds ratio [OR] = .23; 95% confidence interval [CI] = .08‐.71) and positively associated with higher baseline ambulation (OR = 5.51; 95% CI = 2.22‐13.66). At 30 days, 87.3% of participants were living in the community.

CONCLUSION

Delivering SNF‐level post‐acute rehabilitation care in patientsʼ homes for a broad range of diagnoses is feasible and associated with functional improvement. This approach may help older adults maintain living status in the community. J Am Geriatr Soc 68:1584‐1593, 2020.
Differential mechanisms of tolerance induced by NMDA and 3,5‐dihydroxyphenylglycine (DHPG) preconditioning
Authors: Gerace Elisabetta , Zianni Elisa , Landucci Elisa , Scartabelli Tania , Berlinguer Palmini Rolando , Iezzi Daniela , Moroni Flavio , Di Luca Monica , Mannaioni Guido , Gardoni Fabrizio , Pellegrini‐Giampietro Domenico E.
Published: April 2020

We investigated the molecular events triggered by NMDA and 3,5‐dihydroxyphenylglycine (DHPG) preconditioning, that lead to neuroprotection against excitotoxic insults (AMPA or oxygen and glucose deprivation) in rat organotypic hippocampal slices, with particular attention on glutamate receptors and on cannabinoid system. We firstly evaluated the protein expression of NMDA and AMPA receptor subunits after preconditioning using western blot analysis performed in post‐synaptic densities. We observed that following NMDA, but not DHPG preconditioning, the expression of GluA1 was significantly reduced and this reduction appeared to be associated with the internalization of AMPA receptors. Whole‐cell voltage clamp recordings on CA1 pyramidal neurons of organotypic slices show that 24 hr after exposure to NMDA and DHPG preconditioning, AMPA‐induced currents were significantly reduced. To clarify the mechanisms induced by DHPG preconditioning, we then investigated the involvement of the endocannabinoid system. Exposure of slices to the CB1 antagonist AM251 prevented the development of tolerance to AMPA toxicity induced by DHPG but not NMDA. Accordingly, the MAG‐lipase inhibitor URB602, that increases arachidonoylglycerol (2‐AG) content, but not the FAAH inhibitor URB597, that limits the degradation of anandamide, was also able to induce tolerance versus AMPA and OGD toxicity, suggesting that 2‐AG is responsible for the DHPG‐induced tolerance. In conclusion, preconditioning with NMDA or DHPG promotes differential neuroprotective mechanisms: NMDA by internalization of GluA1‐AMPA receptors, DHPG by producing the endocannabinoid 2‐AG.

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Accuracy of the Implant Replica Positions on the Complete Edentulous Additive Manufactured Cast
Authors: Olea‐Vielba Marina , Jareño‐García Daniel , Methani Mohammed M. , Martinez‐Klemm Iñaki , Revilla‐León Marta
Published: April 2020

Purpose

To compare the implant replica position accuracy on a duplicated complete edentulous maxillary implant definitive cast made either using conventional procedures or material jetting additive manufacturing (AM) technology using a coordinate measuring machine (CMM).

Material and methods

A complete edentulous maxillary cast with 6 implant replicas was prepared. The definitive cast was duplicated using two manufacturing procedures namely conventional (CNV group) and additive manufacturing procedures (AM group). On the CNV, an AM Co‐Cr framework and a custom AM custom tray with a polyether impression material were used to obtain an impression of the definitive cast at room temperature (23°C). On the AM group, the definitive cast was digitized using a laboratory scanner. The standard tessellation language (STL) file was exported and used to manufacture the polymeric AM specimens using a multijet printer following manufacturer´s recommendations. A new digital implant replica was located on each corresponding housing of each AM specimen. A total of 10 specimens per group was obtained. A CMM was selected to measure the position of each implant replica on the definitive cast, CNV, and AM specimens. Linear and angular discrepancies were computed for each specimen. Thus, the Mann Whitney U test was used to analyze the data (p = 0.05).

Results

There was no significant difference in x‐, y‐, and z‐ linear and XZ angular discrepancy between both groups. However, the AM group revealed a significantly higher median YZ angular discrepancy than the CNV group (p = 0.007).

Conclusions

Material jetting AM technology demonstrated no significant difference in trueness and precision values of the linear and angular implant replica positions when compared to the conventional technique.
Fibrolytic enzymes improving in vitro rumen degradability of tropical forages
Authors: Sakita Gabriel Zanuto , Bompadre Thiago Francisco Ventoso , Dineshkumar Dhanasekaran , Lima Paulo de Mello Tavares , Abdalla Filho Adibe Luiz , Campioni Tania Sila , de Oliva Neto Pedro , Bremer Neto Herman , Louvandini Helder , Abdalla Adibe Luiz
Published: April 2020

During specific times of the year, especially dry seasons, tropical forages typically have poor nutritional value due to high contents of neutral and acid detergent fibres, and low crude protein in their composition, which may reduce productivity of ruminant livestock production and lead to increased enteric methane (CH4) emissions per unit of generated product in forage‐bases systems. In order to increase fibre degradability and the efficiency of energy utilisation from low‐quality forages, exogenous fibrolytic enzymes have been studied. In this assay, we evaluated the effects of increasing dose levels of fibrolytic enzymes extract (FEE) produced by Trichoderma reesei on in vitro rumen organic matter degradability, fermentation parameters, total gas and CH4 production of tropical forages. Forage samples were analysed for their bromatological composition, and enzyme activity from FEE was performed for xylanase and endoglucanase. The in vitro gas production technique was used in a 5 × 3 factorial arrangement with five FEE dose levels (0, 5, 50, 500 and 5,000 µl) and three substrates (Cynodon spp., Panicum maximum and Cenchrus ciliaris L.). The highest dose level of FEE increased degradability, total gas and CH4 production in all substrates (p < .05). Butyrate concentration also increased while acetate:propionate ratio and pH decreased with the addition of FEE (p < .05). These results indicated that the use of fibrolytic enzymes can be a reliable strategy to improve degradability of low‐quality forages, contributing to the sustainability and intensification of livestock production in tropical countries.
Teachers and Supervisors Negotiating Identities of Experience and Power in Feedback Talk
Authors: DONAGHUE HELEN
Published: April 2020

This article focuses on the identities constructed and negotiated during work‐based talk between in‐service English language teachers and a supervisor during dyadic post‐observation feedback meetings. Meetings were recorded with participants working in a tertiary institution in a Gulf state. Microanalysis of discourse excerpts shows how both participants (i.e., supervisor and teacher) negotiate identities of power and experience. Analysis reveals that identities are fluid and co‐constructed and that power can shift between interactants, regardless of institutional status. Analysis is framed within the ambiguous but influential role of feedback and aims to understand how identities shape and are shaped by the goal of the meeting. In this context, identities of experience and power are prioritized, so feedback is primarily evaluative, despite institutional requirements that a focus on teacher development should be included. This compromises the ultimate aim of improving teaching and learning within the institution. Implications of this study include practical recommendations for supervisor training and critical review of institutional observation forms as well as a call for more language teacher identity research to focus on in‐service teachers and on situated work‐based talk.
Begonia mengdongensis, a new tuberous species of Begonia (Begoniaceae) from southeastern Yunnan, China
Authors: Xi Hui‐Hui , Xiao Si‐Yue , Wang Yi-Qing , Xiao Bo , Wang Wen‐Guang
Published: April 2020

Begonia mengdongensis, a new species in Begonia sect. Reichenheimia (Begoniaceae) from Malipo County (SE Yunnan, China), is described and fully illustrated. Begonia mengdongensis is similar to B. fimbristipula and B. poilanei. The new species can be distinguished from other similar species by its leaf margin being dentate or crenate, flowers white, male flower pedicel puberulous, and placentae undivided. A key to Begonia sect. Reichenheimia species in China is provided. Comparison with similar species and pollen morphology are also provided. Moreover, we propose that this new species should be listed as Critically Endangered.
Effect of geometric dimensions and material models of the periodontal ligament in orthodontic tooth movement
Authors: Shokrani Parinaz , Hashemi Ata , Bostan Shirin Mehdi , Oskui Iman Z.
Published: April 2020

Objectives

The aim of the present work was set to explore the role of root diameter, root length, and thickness of periodontal ligament (PDL) and its material properties (linear and non‐linear elastic material models) on the stress and strain distribution, tooth displacement and centre of resistance (CR) location.

Setting and Sample Population

Both the bone and the tooth were considered as rigid bodies, and the PDL was modelled as a paraboloid with different geometric dimensions and material properties.

Materials and Methods

To achieve this goal, a horizontal force of 1 N was applied in the CR location and the stress and strain distribution and tooth displacement were quantified. Locations of CR were estimated through iterative finite element procedure.

Results

It was predicted that the position of CR is in the range of 34%‐39% of the root length, slightly higher than one‐third of the root length reported in the literature. The geometrical dimensions of the PDL had no significant effect on the position of CR, especially in the non‐linear material model of the PDL, while the initial displacement of the tooth was found to be highly dependent on the geometrical and mechanical properties of the PDL.

Conclusion

The simplified PDL modelling approach with non‐linear material behaviour can be suggested for the estimation of initial tooth movement for individual clinical applications without the use of advanced 3D scans.
Interactions between winter and summer herbivory affect spatial and temporal plant nutrient dynamics in tundra grassland communities
Authors: Petit Bon Matteo , Gunnarsdotter Inga Katarina , Jónsdóttir Ingibjörg Svala , Utsi Tove Aagnes , Soininen Eeva Marjatta , Bråthen Kari Anne
Published: April 2020

In the long‐term, herbivores can alter nutrient dynamics in terrestrial ecosystems by changing the functional composition of plant communities. Here, we ask to what extent herbivores can affect plant‐community nutrient dynamics in the short‐term. We provide theoretical expectations for immediate effects of herbivores on tundra‐grassland plant‐community nutrient levels throughout a single growing season and empirically evaluate these predictions. We established an experiment within two forb‐dominated and two grass‐dominated tundra‐grassland communities. We selected tundra‐patches disturbed by small rodents during the previous winter, and neighbouring undisturbed tundra‐patches. Within each tundra‐patch, we set up a reindeer‐open and a reindeer‐exclusion plot. Throughout the summer, we randomly collected over 2800 leaf samples from 34 vascular plant species/genera and analysed their nitrogen and phosphorus contents. Plant‐community nutrient levels were consistently higher in tundra‐patches affected by small rodents, both across tundra‐grassland types and throughout the growing season. Forbs and grasses growing in small‐rodent disturbed tundra‐patches had 11% and 25% higher nutrient content, respectively, compared to undisturbed tundra‐patches. Reindeer affected only grasses growing in grass‐dominated tundra‐grasslands and the outcome was dependent on small‐rodent winter disturbance. Reindeer increased grass nitrogen content in undisturbed tundra‐patches (+7%) and weakened the positive effects of small rodents in disturbed tundra‐patches (from 25% to 15% higher nutrient content [both nitrogen and phosphorus]). By enhancing plant nutrient levels throughout a single growing season, herbivores were key, immediate modifiers of plant‐community nutrient dynamics in tundra‐grasslands. Higher nutrient contents still detected in senescent leaves at the end of the summer in herbivore‐affected tundra suggest that herbivory is accelerating short‐term tundra‐grassland nutrient cycling rates. Our findings from tundra‐grassland communities align with theoretical expectations of positive herbivore effects on nutrient cycling in relatively productive ecosystems.
Dwarfism in close continental amphibian populations despite lack of genetic isolation
Authors: Hyeun‐Ji Lee , Broggi Juli , Sánchez‐Montes Gregorio , Díaz‐Paniagua Carmen , Gomez‐Mestre Ivan
Published: April 2020

Ample variation in body size is common in vertebrates over extensive geographical distances, or in isolated populations, where effective geographical barriers may cause dwarfism or gigantism. Here we study potential causes of extreme size reduction in continental populations of amphibians within a short geographical distance and in the absence of geographical barriers. Natterjack toads Epidalea calamita in Doñana National Park (Spain) experience up to 2.1‐fold difference in body mass in as little as 37 km. Studying six populations divergent in body size, we tested for genetic isolation of the dwarf populations using multilocus genotypes (16 microsatellites), and explored whether populations differ in trophic status (through stable isotope analysis), standard metabolic rate and growth pattern, senescence and age structure (conducting telomere length assays and skeletochronology). We also recorded advertisement calls across populations and experimentally tested for behavioural reinforcement of the body size variation through female preferences. Local dwarfism in these populations occurs in the absence of genetic isolation while maintaining relatively high effective population sizes. Dwarf populations, however, are exposed to drier and warmer climatic conditions, have different trophic status, show lower mass‐specific metabolic rate, and male advertisement calls with a higher dominant frequency. Juvenile growth differed among populations, reaching the adult stage at different body sizes. Altogether, our results suggest a significant influence of environmental conditions on the physiology and ecology of the Doñana E. calamita populations, mainly affecting toads between metamorphosis and sexual maturity. Further experimental and genomic studies focusing on these early life stages are necessary to dissect the relative roles of the environment and adaptive genetic differentiation on this phenomenon.
Evaluating Sphagnum traits in the context of resource economics and optimal partitioning theories
Authors: Oke Tobi A. , Turetsky Merritt R.
Published: April 2020

Tradeoffs between key aspects of plant performance such as resource acquisition and allocation underpin several trait‐based theories that have been derived for vascular plants. However, due to difficulty in quantifying traits in nonvascular plants, our theoretical understanding of how traits govern the physiological and ecological preferences of nonvascular plant species is quite limited. Here, we used the resource economics theory (RET) and optimal partitioning theory (OPT) to evaluate functional traits in mosses. We evaluated aspects of these theories in two common but ecologically different Sphagnum moss species. We used a suite of morpho‐physiological traits across a range of environmental treatments to test whether Sphagnum is capable of functional tissue partitioning and whether the two Sphagnum species studied conform to a fast or slow strategy often observed in vascular plants. Consistent with the predictions of RET, the fast‐growing species maintained a faster growth rate and low biomass across treatments. However, some of the traits responded contrary to predictions for respiration and photosynthetic rates. Consistent with OPT, Sphagnum diverted biomass from branch to capitulum to connect with the primary source of moisture when under drought stress. Overall, this study showed that moss traits could be used to test ecological theories that were developed primarily for vascular plants.
Myopia Control 2020: Where are we and where are we heading?
Authors: Bullimore Mark A , Richdale Kathryn
Published: April 2020

Purpose

This review arms practitioners with the evidence‐based information they need to fully manage myopia.

Recent findings

The recent peer‐reviewed literature is critically evaluated to provide a comprehensive analysis of the safety and efficacy of behavioural, optical and pharmaceutical myopia management. Importantly, the paper addresses not only who to treat, but how to treat them, and when to stop or modify treatments. Finally, the paper discusses expectations for treatment and why slowing myopia by even 1 dioptre improves long term health outcomes.

The management of an individual child should be underpinned by the evidence‐based literature and clinicians must stay alert to ongoing myopia research that will undoubtedly result in an evolution of the standard of care for the myopic and pre‐myopic child.
Agnosticism II: Actions and attitudes
Authors: Wilczewska Sylwia
Published: April 2020

Within contemporary philosophy, practical consequences of agnosticism about the existence of God have mostly been discussed on the margins of other topics—such as the nature of faith or the problem of divine hiddenness. The aim of this article is to present the existing views on the practical upshots of suspending one's judgment on God's existence, briefly discussing the way in which agnosticism relates to practical atheism, non‐doxastic faith, fictionalism, apophaticism, and spiritual inquiry.
Global trends in incidence rates of childhood liver cancers: A systematic review and meta‐analysis
Authors: Dasgupta Paramita , Henshaw Chloe , Youlden Danny R. , Aitken Joanne F. , Sullivan Ashleigh , Irving Helen , Baade Peter D.
Published: April 2020

Background

Childhood liver cancers are relatively rare, hence inferences on incidence trends over time are limited by lack of precision in most studies.

Objective

To conduct a systematic review and meta‐analysis of published contemporary trends on childhood liver cancer incidence rates worldwide.

Data sources

PubMed, EMBASE, CINAHL, Web of Science.

Study selection and data extraction

English‐language peer‐reviewed articles published from 1 January 2008 to 1 December 2019 that presented quantitative estimates of incidence trends for childhood liver cancer and diagnostic subgroups. Review was conducted per PRISMA guidelines. Two authors independently extracted data and critically assessed studies.

Synthesis

Random effects meta‐analysis models were used to estimate pooled incidence trends by diagnostic subgroups. Heterogeneity was measured using the Q and I2 statistics and publication bias evaluated using Egger’s test.

Results

Eighteen studies were included, all based on population‐based cancer registries. Trends were reported on average for 18 years. Overall pooled estimates of the annual percentage change (APC) were 1.4 (95% confidence interval [CI] 0.5, 2.3) for childhood liver cancers, 2.8 (95% CI 1.8, 3.8) for hepatoblastoma and −3.0 (95% CI −11.0, 4.9) for hepatocellular carcinoma. Sub‐group analysis by region indicated increasing trends for childhood liver cancers in North America/Europe/Australia (APC 1.7, 95% CI 0.7, 2.8) whereas corresponding trends were stable in Asia (APC 1.4, 95%CI −0.3, 2.7). Publication bias was not detected for any of these analyses. The I2 statistic indicated that the heterogeneity among included studies was low for combined liver cancers, moderate for hepatoblastoma and high for hepatocellular carcinoma.

Conclusions

Incidence is increasing for childhood liver cancers and the most commonly diagnosed subgroup hepatoblastoma. Lack of knowledge of the etiology of childhood liver cancers limited the ability to understand the reasons for observed incidence trends. This review highlighted the need for ongoing monitoring of incidence trends and etiological studies.
Gamers on Gaming: A Research Note Comparing Behaviors and Beliefs of Gamers, Video Game Players, and Non‐Players
Authors: Kort‐Butler Lisa A.
Published: April 2020

Research often conflates video game players and “gamers,” defining gamers by time spent playing or by type of game played. Such operationalization may be a matter of convention or, more problematically, based on stereotypical beliefs about gamers. With a survey of nearly 900 young adults, this study compared self‐identified gamers to other video game players and people who do not play video games. There were behavioral differences in terms of time played, but few attitudinal differences across the groups with regards perceptions of media violence. Non‐players, compared to players and gamers, tended to hold more negative attitudes about video games and their effects. Non‐players also tended to be more socially engaged and have more social support, but gamers were not socially isolated. Notably, hours played did not consistently correlate with beliefs and behaviors. Results demonstrate the importance of recognizing the theoretical, empirical, and practical distinctions among hours played, gamer stereotypes, and gamer identity.
Characterization of the novel HLA‐DRB1*15:170 allele in a French hematopoietic stem cell donor
Authors: Dard Céline , Senoussi Ornella , Elsermans Vincent , Bardy Béatrice , Masson Dominique
Published: April 2020

HLA‐DRB1*15:170 differs from HLA‐DRB1*15:01:01:03 by one nucleotide substitution at codon 85 in exon 2.
Inhibition of legume nodulation by Pi deficiency is dependent on the autoregulation of nodulation (AON) pathway
Authors: Isidra‐Arellano Mariel C. , Pozas‐Rodríguez Eithan A. , del Rocío Reyero‐Saavedra María , Arroyo‐Canales Jazmin , Ferrer‐Orgaz Susana , del Socorro Sánchez‐Correa María , Cardenas Luis , Covarrubias Alejandra A. , Valdés‐López Oswaldo
Published: April 2020

Inhibition of nodule development is one of the main adverse effects of phosphate (Pi) deficiency in legumes. Despite all of the efforts made over the last decades to understand how root nodules cope with Pi deficiency, the molecular mechanisms leading to the reduction in nodule number under Pi deficiency remain elusive. In the present study, we provide experimental evidence indicating that Pi deficiency activates the autoregulation of nodulation (AON) pathway, leading to a reduction in nodule numbers in both common bean and soybean. A transcriptional profile analysis revealed that the expression of the AON‐related genes PvNIN, PvRIC1, PvRIC2, and PvTML is upregulated under Pi deficiency conditions. The downregulation of the MYB transcription factor PvPHR1 in common bean roots significantly reduced the expression of these four AON‐related genes. Physiological analyses indicated that Pi deficiency does not affect the establishment of the root nodule symbiosis in the supernodulation mutant lines Pvnark and Gmnark. Reciprocal grafting and split‐roots analyses determined that the activation of the AON pathway was required for the inhibitory effect of Pi deficiency. Altogether, these data improve our understanding of the genetic mechanisms controlling the establishment of the root nodule symbiosis under Pi deficiency.
Impact of taurine on red blood cell metabolism and implications for blood storage
Authors: Bertolone Lorenzo , Roy Micaela Kalani , Hay Ariel M. , Morrison Evan J. , Stefanoni Davide , Fu Xiaoyun , Kanias Tamir , Kleinman Steve , Dumont Larry J. , Stone Mars , Nemkov Travis , Busch Michael P. , Zimring James C. , D'Alessandro Angelo
Published: April 2020

BACKGROUND

Taurine is an antioxidant that is abundant in some common energy drinks. Here we hypothesized that the antioxidant activity of taurine in red blood cells (RBCs) could be leveraged to counteract storage‐induced oxidant stress.

STUDY DESIGN AND METHODS

Metabolomics analyses were performed on plasma and RBCs from healthy volunteers (n = 4) at baseline and after consumption of a whole can of a common, taurine‐rich (1000 mg/serving) energy drink. Reductionistic studies were also performed by incubating human RBCs with taurine ex vivo (unlabeled or 13C15N‐labeled) at increasing doses (0, 100, 500, and 1000 μmol/L) at 37°C for up to 16 hours, with and without oxidant stress challenge with hydrogen peroxide (0.1% or 0.5%). Finally, we stored human and murine RBCs under blood bank conditions in additives supplemented with 500 μmol/L taurine, before metabolomics and posttransfusion recovery studies.

RESULTS

Consumption of energy drinks increased plasma and RBC levels of taurine, which was paralleled by increases in glycolysis and glutathione (GSH) metabolism in the RBC. These observations were recapitulated ex vivo after incubation with taurine and hydrogen peroxide. Taurine levels in the RBCs from the REDS‐III RBC‐Omics donor biobank were directly proportional to the total levels of GSH and glutathionylated metabolites and inversely correlated to oxidative hemolysis measurements. Storage of human RBCs in the presence of taurine improved energy and redox markers of storage quality and increased posttransfusion recoveries in FVB mice.

CONCLUSION

Taurine modulates RBC antioxidant metabolism in vivo and ex vivo, an observation of potential relevance to transfusion medicine.
Optimization of “Deoxidation Alloying” Batching Scheme
Authors: Ma Tingyu , Wang Tao , Huang Jingwen , Wang Lepan , Liu Xin , Liu Yingxia , Dong Hanjiang , Yan Dongsong
Published: April 2020

In this paper, a mathematical model was established to predict the deoxidation alloying and to optimize the type and quantity of input alloys. Firstly, the GCA method was used to obtain the main factors affecting the alloy yield of carbon and manganese based on the historical data. Secondly, the alloy yield was predicted by the stepwise MRA, the BP neural network and the regression SVM models, respectively. The conclusion is that the regression SVM model has the highest prediction accuracy and the maximum deviation between the test set prediction result and the real value was only 0.0682 and 0.0554. Thirdly, in order to reduce the manufacturer's production cost, the genetic algorithm was used to calculate the production cost mathematical programming model. Finally, sensitivity analysis was performed on the prediction model and the cost optimization model. The unit price of 20% of the alloy raw materials was increased by 20%, and the total cost change rate was 0.7155%, the lowest was -0.4297%, which proved that the mathematical model established presented strong robustness and could be certain reference value for the current production of iron and steel enterprises.
Polyethylene terephthalate by near-ambient pressure XPS
Authors: Avval Tahereh G. , Hodges Grant T. , Wheeler Joshua , Ess Daniel H. , Bahr Stephan , Dietrich Paul , Meyer Michael , Thißen Andreas , Linford Matthew R.
Published: April 2020

Near-ambient pressure x-ray photoelectron spectroscopy (NAP-XPS) is a less traditional form of XPS that allows samples to be analyzed at relatively high pressures, i.e., at greater than 2500 Pa. With NAP-XPS, XPS can probe moderately volatile liquids, biological samples, porous materials, and/or polymeric materials that outgas significantly. In this submission, we show survey, C 1s, and O 1s NAP-XPS spectra of polyethylene terephthalate, a common, widely used thermoplastic. The C 1s envelope was fit with different approaches, i.e., to three, four, and five Gaussian–Lorentzian sum (GLS) functions. Hartree–Fock orbital energy calculations of a model trimer served as a guide to an additional fit of the C 1s envelope. The best fit was obtained by adding an extra component to the four-component fit to compensate for adventitious carbon or additives in the polymer. The O 1s signal was well fit with two GLS peaks with a 1:1 area ratio representing the C—O and C=O moieties in PET.
Psychological and Behavioral Correlates of Early Adolescents’ Physical Literacy
Authors: Blain Dylan O. , Curran Thomas , Standage Martyn
Published: April 2020

Purpose: Physical literacy is understood to be important for adolescents’ behavioral and psychological wellness. Yet, to date, limited empirical data exist to support such reasoning. Addressing this gap, the present study examined relationships between physical literacy and early adolescents’ physical education engagement, leisure-time exercise behavior, and psychological well-being. Methods: The physical literacy level of 187 early adolescents (Mage = 12.84, SD = 0.55, girls = 99) was measured using the Canadian Assessment for Physical Literacy. One week later, data pertaining to standardized measures of engagement in physical education, leisure-time exercise behavior, and psychological well-being were collected. Results: Structural equation modeling revealed that physical literacy was positively correlated with physical education engagement, leisure-time exercise, positive affect, and vitality, whereas it was negatively correlated with negative affect. Conclusion: The findings from this work substantiate the contention that physical literacy has manifold benefits for early adolescents’ behavioral and psychological wellness.
Commensal Oral Rothia mucilaginosa Produces Enterobactin, a Metal-Chelating Siderophore
Authors: Uranga Carla C. , Arroyo Pablo , Duggan Brendan M. , Gerwick William H. , Edlund Anna
Published: April 2020

The communication language of the human oral microbiota is vastly underexplored. However, a few studies have shown that specialized small molecules encoded by BGCs have critical roles such as in colonization resistance against pathogens and quorum sensing. Here, by using a genome mining approach in combination with compound screening of growth cultures, we identified that the commensal oral community memberR. mucilaginosaharbors a catecholate-siderophore BGC, which is responsible for the biosynthesis of enterobactin. The iron-scavenging role of enterobactin is known to have positive effects on the host’s iron pool and negative effects on host immune function; however, its role in oral health remains unexplored.R. mucilaginosawas previously identified as an abundant community member in cystic fibrosis, where bacterial iron cycling plays a major role in virulence development. With respect to iron’s broad biological importance, iron-chelating enterobactin may explainR. mucilaginosa’s colonization success in both health and disease.
Hazards from lava–river interactions during the 1783–1784 Laki fissure eruption
Authors: Boreham Frances , Cashman Katharine , Rust Alison
Published: April 2020

Interactions between lava flows and surface water are not always considered in hazard assessments, despite abundant historical and geological evidence that they can create significant secondary hazards (e.g., floods and steam explosions). We combine contemporary accounts of the 1783–1784 Laki fissure eruption in southern Iceland with morphological analysis of the geological deposits to reconstruct the lava–water interactions and assess their impact on residents. We find that lava disrupted the local river systems, impounded water that flooded farms and impeded travel, and drove steam explosions that created at least 2979 rootless cones on the lava flow.

Using aerial photographs and satellite-derived digital terrain models, we mapped and measured 12 of the 15 rootless cone groups on the Laki lava field. We have identified one new rootless cone group and provide data that suggest another cone group previously attributed to the 939–940 CE Eldgjá eruption was created by the Laki eruption. We then use contemporary accounts to estimate formation dates and environments for each cone group, which formed in wetland/lake areas, on riverbeds, and near areas of impounded water. Furthermore, comparison with previous field studies shows that assessments using remote sensing can be used to identify and map meter-scale and larger features on a lava flow, although remote mapping lacks the detail of field observations.

Our findings highlight the different ways in which lava can interact with surface water, threatening people, property, water supplies, and infrastructure. For these reasons, anticipation of such interactions is important in lava flow hazard assessment in regions with abundant surface water; we further demonstrate that remote sensing can be an effective tool for identifying lava–water interactions in past lava flows.
Influence of metabolic profiles on the safety of drug therapy in routine care in Germany: protocol of the cohort study EMPAR
Authors: Huebner Tatjana , Steffens Michael , Linder Roland , Fracowiak Jochen , Langner Daria , Garling Marco , Falkenberg Felix , Roethlein Christoph , Gomm Willy , Haenisch Britta , Stingl Julia
Published: April 2020

Introduction

Pre-emptive testing of pharmacogenetically relevant single-nucleotide polymorphisms can be an effective tool in the prevention of adverse drug reactions and therapy resistance. However, most of the tests are not used as standard in routine care in Germany because of lacking evidence for the clinical and economical benefit and their impact on the usage of healthcare services. We address this issue by investigating the influence of pharmacogenetic profiles on the use of healthcare services over an extended period of several years using routine care data from a statutory health insurance company. The goal is to provide clinical evidence whether pre-emptive pharmacogenetic testing of metabolic profiles in routine care in Germany is beneficial and cost-effective.

Methods and analysis

The EMPAR (Einfluss metabolischer Profile auf die Arzneimitteltherapiesicherheit in der Routineversorgung) study is a non-interventional cohort study conducted to analyse pharmacogenetic risk factors that are important for drug therapy by means of endpoints relevant for healthcare. The analysis is based on pharmacogenetic profiles and statutory health insurance data. We perform pharmacogenetic, pharmacoepidemiological and pharmacoeconomic analyses using health care utilisation scores and machine learning techniques. Therefore, we aim to include about 10 000 patients (≥18 years) insured by the health insurance provider Techniker Krankenkasse. The study focuses on patients with prescriptions of anticoagulants and prescriptions of cholesterol-lowering drugs. Also, a screening for special pharmacogenetic characteristics will be performed in patients with at least one Y57.9! diagnosis (Complication of medical and surgical care: drug or medicament, unspecified). Outcomes include the utilisation of health insurance services, the incidence of incapacity for work and costs for drugs and treatment.

Ethics and dissemination

The protocol was approved by the Ethics Committee of the Medical Faculty, University of Bonn (Lfd. Nr. 339/17). The results of this research project will be published in scientific open access journals and at conferences.

Trial registration number

German Clinical Trials Register, DRKS00013909.
Domain-specific physical activity patterns and cardiorespiratory fitness among the working population: Findings from the cross-sectional German Health Interview and Examination Survey
Authors: Zeiher Johannes , Duch Maurice , Kroll Lars E , Mensink Gert B M , Finger Jonas D , Keil Thomas
Published: April 2020

Objectives

This study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population.

Design

Population-based cross-sectional study.

Setting

Two-stage cluster-randomised general population sample selected from population registries of 180 nationally distributed sample points. Information was collected from 2008 to 2011.

Participants

1296 women and 1199 men aged 18–64 from the resident working population.

Outcome measure

Estimated low maximal oxygen consumption (V˙O2max), defined as first and second sex-specific quintile, assessed by a standardised, submaximal cycle ergometer test.

Results

Low estimatedV˙O2maxwas strongly linked to low leisure time physical activity, but not occupational physical activity. The association of domain-specific physical activity patterns with lowV˙O2maxvaried by sex: women doing no leisure time physical activity with high occupational physical activity levels were more likely to have lowV˙O2max(OR 6.54; 95% CI 2.98 to 14.3) compared with women with ≥2 hours of leisure time physical activity and high occupational physical activity. Men with no leisure time physical activity and low occupational physical activity had the highest odds of lowV˙O2max(OR 4.37; 95% CI 2.02 to 9.47).

Conclusion

There was a strong association between patterns of leisure time and occupational physical activity and cardiorespiratory fitness within the adult working population in Germany. Women doing no leisure time physical activity were likely to have poor cardiorespiratory fitness, especially if they worked in physically demanding jobs. However, further investigation is needed to understand the relationships between activity and fitness in different domains. Current guidelines do not distinguish between activity during work and leisure time, so specifying leisure time recommendations by occupational physical activity level should be considered.
(Cost-)effectiveness of lower extremity nerve decompression surgery in subjects with diabetes: the DeCompression (DECO) trial—study protocol for a randomised controlled trial
Authors: Rinkel Willem D , Fakkel Tirzah M , Castro Cabezas Manuel , Birnie Erwin , Coert J Henk
Published: April 2020

Introduction

The peripheral nerves of patients with diabetes are often pathologically swollen, which results in entrapment at places of anatomical narrowing. This results in nerve dysfunction. Surgical treatment of compression neuropathies in the lower extremities (lower extremity nerve decompression (LEND)) results in relief of symptoms and gain in peripheral nerve function, which may lead to less sensory loss (short term) and less associated detrimental effects including foot ulceration and amputations, and lower costs (long term). The aim of the DeCompression trial is to evaluate the effectiveness and (cost-)effectiveness of surgical decompression of compressed lower extremity nerves (LEND surgery) compared with patients treated with conventional (non-surgical) care.

Methods and analysis

A stratified randomised (1 to 1) controlled trial comparing LEND surgery (intervention) with conventional non-surgical care (control strategy) in subjects with diabetes with problems of neuropathy due to compression neuropathies in the lower extremity. Randomisation is stratified for participating hospital (n=11) and gender. Patients and controls have the same follow-up at 1.5, 3, 6, 9, 12, 18, 24 and 48 months. Participants (n=344) will be recruited in 12 months and enrolled in all affiliated hospitals in which they receive both the intervention or conventional non-surgical care and follow-up. Outcome assessors are blinded to group assignment. Primary outcome: disease-specific quality of life (Norfolk Quality of Life Questionnaire—Diabetic Neuropathy). Secondary outcomes: health-related quality of life (EuroQoL 5-dimension 5-level (EQ-5D5L), 36-item Short Form (SF-36)), plantar sensation (Rotterdam Diabetic Foot Test Battery), incidence of ulcerations/amputations, resource use and productivity loss (Medical Cost Questionnaire, Productivity Cost Questionnaire) during follow-up. The incremental cost-effectiveness ratio will be estimated on the basis of the collected empirical data and a cost-utility model.

Ethics and dissemination

Ethics approval has been granted by the Medical Research Ethics Committee of Utrecht University Medical Center (reference: NL68312.041.19v5, protocol number: 19-335/M). Dissemination of results will be via journal articles and presentations at national and international conferences.

Trial registration number

NetherlandsTrial Registry NL7664.
Assessment of: self-management skills towards transition readiness and patient portal use among Hispanic adolescent and young adult patients
Authors: Allende-Richter Sophie , Ramirez Melanie , Khoury Zana , Bourgeois Fabienne , Epee-Bounya Alexandra , O"Hare Kitty
Published: April 2020

We conducted a 15-item self-answered survey to assess self-management skills and explore interest in a patient portal among publicly insured Hispanic youths ages 12–25. Out of 61 participants, 33% did not know how to schedule an appointment, 50% how to refill prescriptions, 58% how to access their personal health information, 84% were unaware of the portal and 92% never used it. Referring to the portal as an online application increased participants interest by 39%. Although study participants exhibit low self-management skills and awareness of a patient portal, most welcome using it to manage their health. Further research is needed to validate whether a patient portal can promote self-management skills towards transition readiness among Hispanic youths.
Diagnostic accuracy of clinical tests for cam or pincer morphology in individuals with suspected FAI syndrome: a systematic review
Authors: Caliesch Rahel , Sattelmayer Martin , Reichenbach Stephan , Zwahlen Marcel , Hilfiker Roger
Published: April 2020

Objectives

To determine the diagnostic accuracy of clinical tests for cam or pincer morphology in individuals with suspected femoroacetabular impingement (FAI) syndrome and to evaluate their clinical utility.

Design

A systematic review of studies investigating the diagnostic accuracy of clinical tests for cam and pincer morphology.

Data sources

PubMed, Embase, CINAHL and SPORTDiscus.

Eligibility criteria for selecting studies

Studies investigating the diagnostic accuracy of clinical tests for cam, pincer or mixed morphology in symptomatic patients. Patients had to undergo an index test and a reference test able to identify cam or pincer morphology. Study results have to allow the calculation of true or false positives and/or negatives to calculate sensitivity, specificity, likelihood ratios (LR) and post-test probabilities.

Results

Eight studies were included, investigating 17 tests and two test combinations. The studies reported a low specificity for all tests, ranging from 0.11 to 0.56. Sensitivity ranged from 0.11 to 1.00, with high sensitivities for the flexion-adduction-internal rotation (FADIR), foot progression angle walking (FPAW) and maximal squat tests. We estimated that negative test results on all of these three tests would result in a negative LR of 0.15. However, we judged the studies to provide low-quality evidence.

Conclusion

There is low-quality evidence that negative test results reduce the post-test probability of cam or mixed morphologies and that consecutive testing with the FADIR, FPAW and maximal squat tests might be used as a clinical test combination. We would not recommend their use to confirm the diagnosis of FAI syndrome.

PROSPERO registration number

CRD42018079116.
Cancer immunotherapy and toxic epidermal necrolysis
Authors: Zhang Liyan , Shen Lin , Lu Yuhan , Xue Jing
Published: April 2020

Objectives

Immunotherapy has come to play an increasingly important role in cancer treatment. Accordingly, immune-related adverse events (irAEs) have drawn considerable attention. In this case, a young female patient developed immune-related toxic epidermal necrolysis (TEN). The same irAEs have been rarely reported in previous studies. In this study, we describe the treatment and care methods used in this case in detail in order to provide a reference for clinical practice.

Methods

After being diagnosed with TEN, the patient accepted systemic glucocorticoid therapy, timely care of skin and mucous membranes, nutrition support, antiacid therapy, anti-inflammatory, analgesics and other supportive measures.

Results

The patient’s skin recovered completely, and no serious adverse outcomes, such as secondary infection or multiple organ failure, occurred during treatment.

Conclusion

Medical staff should be able to identify the performance of rare irAEs such as TENs and actively explore comprehensive treatments to ensure patient safety and avoid adverse outcomes.