bluuebunny/crossref_metadata_2025 huggingface dataset:
Narratives of patient participation in haemodialysis
Authors: Andersen‐Hollekim Tone , Solbjør Marit , Kvangarsnes Marit , Hole Torstein , Landstad Bodil J.
Published: March 2020

Aim and objective

To explore how working‐age adults experience patient participation in hospital haemodialysis.

Background

End‐stage kidney disease is a progressive, chronic condition imposing patients with high treatment burdens and low health‐related quality of life. Patients face multiple medical decisions related to living with kidney failure. Given their frequent interaction with health services, patient participation may be of special value.

Design

Qualitative design with a narrative approach.

Methods

In 2018, eleven patients aged 35–64 years undergoing hospital haemodialysis participated in individual interviews. All interviews were analysed using a narrative approach. Reporting followed the Consolidated criteria for Reporting Qualitative Research guidelines.

Findings

The patients’ narratives of participation comprised three themes following their healthcare trajectory: Informed, but not involved in treatment choices; Duality of care and control; and Frail trust reflecting collaborative deficiencies. The patients received good information about dialysis, but were not involved in choice of treatment modality. Professional work, as well as the nature of treatment, contributed to restricted patient autonomy. Patients’ trust suffered from collaborative deficiency generating delays in their treatment trajectories, and patients extended their responsibility into the coordination of transitions as a way of coping with these issues.

Conclusions

The study identified challenges related to patient involvement and interdisciplinary collaboration. Involving patients through dialogue and acknowledging their experiences, preferences and lifestyles may strengthen the mutual patient–professional understanding of treatment. Despite increased focus on seamless trajectories, patients face obstacles regarding interdisciplinary collaboration and coordination of health services.

Relevance to clinical practice

The findings indicate a want of individually customised care for people requiring dialysis. Patients need to be involved in the choice of treatment modality as well as decisions related to the current treatment. Information must include potential consequences of the different treatment modalities. Health services need to strengthen collaboration in order to secure treatment continuity and patient involvement.
Everyday life experiences of close relatives of people with amyotrophic lateral sclerosis receiving home mechanical ventilation—A qualitative study
Authors: Winther Dorte , Kirkegaard Lorenzen Charlotte , Dreyer Pia
Published: March 2020

Aims and objectives

To explore everyday life experience of relatives of people with amytrophic lateral sclerosis (ALS) living at home with mechanical ventilation and formal caregivers.

Background

ALS is a rapidly progressive disease affecting not only the patient but also close relatives. A burden is placed on relatives affecting their mental and physical health in settings where they provide care. Few studies have examined the everyday life challenges of close relatives with formal caregivers at home and home mechanical ventilation, which often prolongs survival.

Design

We undertook a qualitative study with a phenomenological‐hermeneutic approach inspired by Ricoeur. Eleven close relatives were interviewed, and the three‐level analysis method developed by Dreyer and Pedersen was conducted. The Consolidated Criteria for Reporting Qualitative Research checklist was used.

Results

Four themes were derived from the data during analysis: Vulnerable relatives fighting to keep track of everything, Formal caregivers—a distressing relief, A prison without personal space and We are in this together until the end.

Conclusions

Close relatives of persons with ALS are burdened with everyday life challenges despite having formal caregivers at home, and they feel imprisoned. Despite these challenges and concerns about the end of life of their relative, they stay until the end.

Relevance to clinical practice

There is clearly a need to investigate interventions in clinical practice supporting close relatives to prepare them for what to expect during a prolonged disease course.
Increasing dietary sodium chloride promotes urine dilution and decreases struvite and calcium oxalate relative supersaturation in healthy dogs and cats
Authors: Queau Yann , Bijsmans Esther S. , Feugier Alexandre , Biourge Vincent C.
Published: March 2020

Urolithiasis is highly prevalent in dogs and cats, with struvite and calcium oxalate being most commonly diagnosed. Some commercial diets aimed at reducing the risk of urolithiasis are based on inclusion of sodium chloride (NaCl) in an attempt to dilute the urine and the risk of crystallization, but more information on the effect of differing levels of sodium inclusion is needed. The objective of this study was to compare the short‐term effect of four diets differing only in NaCl content (base diet with 0.3% sodium and diets with added NaCl to achieve 0.7, 1.0 and 1.3% sodium as fed) on urinary ion concentrations and relative supersaturation (RSS) of struvite and calcium oxalate in dogs and cats. In both species, there was a significant increase in water intake and urine volume as dietary NaCl increased. Urine sodium concentration increased with increasing dietary NaCl. The highest sodium diet increased urinary calcium excretion in dogs only, while decreasing urinary calcium concentration. Calcium oxalate RSS and struvite RSS both significantly decreased, with the lowest RSS values reported on the highest sodium diet in both dogs and cats (p < .001). These results suggest that an increase in dietary NaCl decreases RSS values in both dogs and cats. Despite an increase in urinary calcium excretion in dogs, urinary calcium concentration and calcium oxalate RSS were lower on high sodium diets due to urine dilution. Long‐term studies are needed to confirm the relationship between RSS and stone occurrence and recurrence.
Re‐imagining supply chain challenges through critical engaged research
Authors: Touboulic Anne , McCarthy Lucy , Matthews Lee
Published: March 2020

In this manuscript, we explore how engaged research can support the development of the theory and practice of supply chain management (SCM) and present critical engaged research as an extended form of engaged research. The article’s main purpose is to examine more closely the relationship between critical engaged research and the process of theorizing. This essay presents an expanded model of knowledge production for the field of SCM and explores the opportunities for the production and co‐production of new knowledge types, with an emphasis on knowledge produced through a critical engagement with practice. We offer a discussion on how critical engaged research may be applied in SCM research to build, elaborate and test theory.
Debridement, Antibiotics, and Implant Retention for Acute Periprosthetic Joint Infection
Authors: Zhang Chao‐fan , He Long , Fang Xin‐yu , Huang Zi‐da , Bai Guo‐chang , Li Wen‐bo , Zhang Wen‐ming
Published: March 2020

Objective

To report on our clinical outcomes and on the experience of managing acute periprosthetic joint infection (PJI) with debridement, antibiotics, and implant retention (DAIR).

Methods

We performed a retrospective review of all patients who were diagnosed with acute PJI after primary hip or knee replacement surgeries and who were managed with DAIR in our prospective joint replacement registry from 2008 to 2019. The diagnosis of PJI was made according to the 2011 Musculoskeletal Infection Society (MSIS) criteria. The symptom onset duration, inflammatory marker levels (i.e. C‐reactive protein [CRP], erythrocyte sedimentation rate [ESR], white cell count [WBC], and synovial WBC count), functional scores including the Knee Society Score (KSS), the KSS functional score and the Harris Hip Score (HHS), bacteriology, and surgical outcomes of the patients were tracked and recorded. A paired sample of joint fluid and tissues was also sent for a metagenomic next‐generation sequencing (mNGS) test. A paired‐samples t‐test was used to compare the differences in the inflammatory markers and functional scores before and after surgery.

Results

A total of 24 patients with 7 infections after hip replacements and 17 infections after knee replacements were included. A total of 21 patients exhibited early postoperative infections, and 3 exhibited late acute hematogenous infections. During a mean follow‐up time of 29.2 ± 15.1 months, 22 patients were successfully treated, whereas 2 patients were unsuccessfully treated and required repeated DAIR. The overall success rate of DAIR was 91.7%. For staphylococcal infections, DAIR had a 100% success rate. Five patients who presented with symptoms between 4 and 8 weeks also achieved a 100% success rate. At the last follow‐up, the mean CRP level decreased from 52.6 ± 34.0 to 5.4 ± 3.5 (P < 0.001), and the mean ESR level decreased from 72.3 ± 34.3 to 20.2 ± 12.1 (P < 0.001). The mean KSS score increased from 44.8 ± 12.2 to 81.4 ± 9.2 (P < 0.001), and the mean KSS functional score increased from 38.1 ± 3.5 to 73.9 ± 23.0 (P < 0.001), and the mean HHS score increased from 34.4 ± 6.9 to 84.1 ± 15.1 (P < 0.001). The overall pathogen identification rate was 91.7% (22/24 cases). The success rates for Staphylococcus, Streptococcus, and the other pathogens were 100% (9/9 cases), 71.4% (5/7 cases), and 100% (6/6 cases), respectively.

Conclusion

Debridement, antibiotics, and implant retention has a high success rate for the treatment of acute PJI and may be performed in selected patients whose symptoms have been sustained for over 4 weeks. A high rate of success for staphylococcal infections was reported with the use of DAIR.
Hypophosphatemic rickets: A rare complication of congenital melanocytic nevus syndrome
Authors: Welfringer‐Morin Anne , Pinto Graziella , Baujat Geneviève , Vial Yoann , Hadj‐Rabia Smail , Bodemer Christine , Boccara Olivia
Published: March 2020

We report the case of a child who presented with a giant melanocytic nevus with numerous satellite nevi at birth and developed hypophosphatemic rickets due to excessive secretion of the FGF23 hormone. A NRAS c.182A>G (Q61R) mutation was identified in the lesional skin. The functional outcome was favorable with medical treatment.
“Live Sun Smart!” Testing the effectiveness of a sun safety program for middle schoolers
Authors: Steele Chelsea , Burkhart Craig , Tolleson‐Rinehart Sue
Published: March 2020

Background

Skin cancer is a well‐recognized public health issue, and primary prevention is the most effective strategy for reducing skin cancer risk. The current recommendations are that behavioral counseling for sun safety measures is most beneficial and effective for children and adolescents and that targeting this population at primary and middle schools is the ideal intervention strategy to increase sun‐protective behaviors and reduce UV exposure, sunburn incidence, and formation of new moles. Numerous studies on the effectiveness of school‐based sun safety interventions among elementary and middle school students have shown an increase in sun safety knowledge, attitudes, and behaviors following the intervention.

Objective

To conduct a pilot feasibility study of “Live Sun Smart!,” (LSS) a school‐based, multicomponent, interactive sun safety presentation, at changing sun safety knowledge, attitudes, and behaviors among middle school students.

Methods

A non‐randomized, single‐group pretest‐posttest interventional pilot study of the LSS program among children enrolled in grade 6.

Results

After exposure to LSS, participants were more likely to give correct answers to knowledge‐based sun safety questions and to report negative attitudes toward tanning. Minimal and not significant changes were found in self‐reported sun safety behaviors, though students did report an intention to change behaviors following the intervention. Participants were satisfied with the program and believed it increased their sun safety knowledge.

Conclusion

Live Sun Smart! appears to be an effective school‐based, multicomponent sun safety program for improving sun safety knowledge and attitudes toward tanning among middle school students in this initial test of it. The strengths and weaknesses of this pilot study have implications for future research.
Effect of phosphorus efficiency on elemental stoichiometry of two shrubs
Authors: Hu X. , Zhang L. , Zhang D. , Niu D. , Fu H.
Published: March 2020

Phosphorus (P) is an important nutrient that can restrict plant growth. However, the influence of P deficiency on elemental homeostasis and application of the growth rate hypothesis in higher plants remain to be assessed.

Two shrubs, Zygophyllum xanthoxylum and Nitraria tangutorum, were used as experiment material and subjected to five P addition treatments: 0, 17.5, 35.0, 52.5 and 70.0 mg P·kg−1 soil.

The biomass and relative growth rate of Z. xanthoxylum did not change with altered P supply. There was no significant difference in P concentration among the treatments for Z. xanthoxylum, but N. tangutorum showed an upward trend. The P stoichiometric homeostasis of Z. xanthoxylum was higher than that of N. tangutorum. For Z. xanthoxylum, available P in the rhizosphere improved significantly under extreme P deficiency conditions, and P concentrations in all treatments were lower than in N. tangutorum, showing that Z. xanthoxylum had stronger P absorption and P utilization capacity.

No relationships between growth rate and C:N:P ratios were found in Z. xanthoxylum. The strong P efficiency, and high and stable dry matter accumulation, are likely contributors in maintaining stoichiometric homeostasis. In addition, the relatively high biomass accumulation and high P utilization efficiency for Z. xanthoxylum does not support the growth rate hypothesis for this species.
Study of general practitioner consultations for tick bites at high, medium and low incidence areas for Lyme borreliosis in England and Wales
Authors: Gillingham Emma L. , Hall Jessica L. , Birtles Richard J. , Bown Kevin J. , Medlock Jolyon M. , Smith Robert , Hansford Kayleigh M. , Warner Jenny C. , Dryden Matthew , Pietzsch Maaike E.
Published: March 2020

Lyme borreliosis (LB) is a tick‐borne disease caused by Borrelia burgdorferi sensu lato complex. In Europe, it is predominately transmitted by the sheep tick, Ixodes ricinus. Compared with other European countries, the United Kingdom (UK) is considered to have a low incidence of LB, although this varies regionally. To determine whether an association exists between tick bite consultations and LB incidence in the UK, retrospective questionnaires were sent to general practitioners (GPs) in high (Wiltshire), medium (Cumbria) and low (Wales) incidence areas. During 2011, the greatest incidence of consultations for tick bites was reported by GPs in Cumbria (204 consultations per 100,000 inhabitants), followed by Wiltshire (160 per 100,000 population) and Wales (54 per 100,000 population). In Wiltshire and Cumbria, GPs predominantly provided advice on tick removal, whilst Welsh GPs mostly advised patients on tick bite prevention. Focusing on Cumbria during 2011–2013, 72.5% of GPs removed ticks from patients (incidence of 101 consultations per 100,000 population), and more GPs diagnosed LB based on clinical features than laboratory‐confirmed diagnoses. To date, this is the first study to investigate the incidence of tick bite consultations and LB in England and Wales.
Investigations on Strain Hardening During Cutting of Heat-Resistant Austenitic Stainless Steel
Authors: Arif Rabiae , Fromentin Guillaume , Rossi Frédéric , Marcon Bertrand
Published: March 2020

This study presents a novel analysis of the machined subsurface layer formation dealing with strain hardening phenomenon which results from complex mechanisms due to cutting edge multiple passes in drilling. On the one hand, the hardened layer during drilling is characterized in relation with the local cutting geometry and thanks to a quick-stop device (QSD) to suddenly interrupt the operation. Micro hardness is used to determine the hardened thickness of the machined subsurface layers along the local cutting edge geometry. On the other hand, orthogonal cutting performed with a complex self-designed planing experiment is used to investigate in details the hardening accumulation aspects. Then, dedicated methodologies are proposed to quantify the strain hardening as well as the incremental plastic strain generated by consecutive tool passes. In addition to the subsurface hardness evolution, the work material strain is observed during the steady-state cutting process thanks to the high-speed camera. The digital image correlation technique is exploited to analyze not only the plastic strain remaining on the workpiece after the cut but also the effect of the incremental plastic strain generated by the consecutive planing passes as the cutting edges in drilling do. One of the outcomes is that the hardened layer thickness can reach from two to three times the cut thickness in drilling or in planing. As a consequence, this work demonstrates that the cutting process affects itself by hardening. Thus, the studied austenitic stainless steel in such a way that this last is never cut in its initial state.
Experimental Investigation on Thermal Performance in Three-Sided Solar Air Heaters Having an Alignment of Multi-v and Transverse Wire Roughness on the Absorber Plate
Authors: Kumar Dhananjay , Prasad Laljee
Published: March 2020

The use of artificial roughness is an efficient and commercial way to appreciate the thermal performance from the collector to the air in solar air heater ducts, for numerous applications such as space-heating, crop-drying, and seasoning of timber industrial purpose. In this paper, the tentative inquiry on thermal enactment using new-fangled of three-sided roughened quadrilateral duct solar air heater having an alignment of multiple-v and transverse wire is performed and compared the outcomes with smooth duct air heater under similar operational circumstances. The modification of an arrangement and operational constraints is inspected within the restrictions, the moral of four-sided duct aspect ratio (W/H) = 8, the Reynolds number occupied from 3000 to 12,000, fraction of pitch to roughness height, P/e in the range of 10–25; ratio of roughness height to hydraulic diameter, e/D in the range of 0.018–0.042; at flow attack angle, α = 60 deg for constant moral of relative roughness width, (W/w) = 6. The augmentation on thermal efficiency in three-sided rugged duct is found to be 23–86% when compared to smooth duct, and the maximum thermal efficiency can occur at P/e = 10 and e/D = 0.042. The enhancement in air temperature flowing under three-sided roughened duct is found to be 49.27% more than that of a smooth duct. The instant innovative form of three-sided roughened solar air warmer would be preferable to those of a smooth solar air heater with respect to heat assignment.
Dynamics of Flexoelectric Materials: Subsonic, Intersonic, and Supersonic Ruptures and Mach Cone Formation
Authors: Giannakopoulos Antonios E. , Rosakis Ares J.
Published: March 2020

Motivated by recent, unexpected, experimental observations of “intersonic” rupture growth in which both shear and dilatational Mach fronts were observed at the tips of dynamic frictional ruptures propagating at rupture speeds below the dilatational wave speed of the surrounding solid, and we formulate the general dynamic flexoelectric problem and we investigate its plane strain/plane polarization specialization. The coupling of the mechanical problem is analogous to a problem of Toupin–Mindlin gradient elasticity, where two micromechanical characteristic lengths and two microinertial lengths emerge as a combination of the mechanical, dielectric, and flexoelectric constants. The solution of the rupture growth problem allows us to provide an explanation of the experimental results. This becomes possible since flexoelectricity predicts a new aspect that was not observed in the classical analysis: subsonic super shear and supersonic crack tip (or rupture) motions are not related exclusively with the problem being elliptic or hyperbolic, respectively. This is due to the influence of the microinertial lengths, which, in addition to the ratios of the rupture to the wave speeds, also affect the slopes of the Mach cones. Moreover, we are able to explain the experimental paradox of the observation of double Mach cone pairs at the tips of supershear, but subsonic, frictional, ruptures in poly-methyl-methacrtylate (PMMA) by demonstrating that both dilatational and shear Mach cones could appear in flexoelectric solids at rupture speeds below the material dilatation wave speed, something that is impossible from the classical elasticity analysis and is due to the dispersive nature of the present problem. Our analysis is of relevance to the dynamic deformation and fracture of both synthetic and naturally occurring flexoelectric materials and systems, with implications to both engineering and earthquake source mechanics.
Sequential Radial Basis Function-Based Optimization Method Using Virtual Sample Generation
Authors: Tang Yifan , Long Teng , Shi Renhe , Wu Yufei , Gary Wang G.
Published: March 2020

To further reduce the computational expense of metamodel-based design optimization (MBDO), a novel sequential radial basis function (RBF)-based optimization method using virtual sample generation (SRBF-VSG) is proposed. Different from the conventional MBDO methods with pure expensive samples, SRBF-VSG employs the virtual sample generation mechanism to improve the optimization efficiency. In the proposed method, a least squares support vector machine (LS-SVM) classifier is trained based on expensive real samples considering the objective and constraint violation. The classifier is used to determine virtual points without evaluating any expensive simulations. The virtual samples are then generated by combining these virtual points and their Kriging responses. Expensive real samples and cheap virtual samples are used to refine the objective RBF metamodel for efficient space exploration. Several numerical benchmarks are tested to demonstrate the optimization capability of SRBF-VSG. The comparison results indicate that SRBF-VSG generally outperforms the competitive MBDO methods in terms of global convergence, efficiency, and robustness, which illustrates the effectiveness of virtual sample generation. Finally, SRBF-VSG is applied to an airfoil aerodynamic optimization problem and a small Earth observation satellite multidisciplinary design optimization problem to demonstrate its practicality for solving real-world optimization problems.
Optimizing the Torque Distribution of a Redundantly Actuated Parallel Robot to Study the Temporomandibular Reaction Forces During Food Chewing
Authors: Mostashiri Naser , Dhupia Jaspreet , Verl Alexander , Bronlund John , Xu Weiliang
Published: March 2020

Inverse dynamics solution of redundantly actuated parallel robots (RAPRs) requires redundancy resolution methods. In this paper, the Lagrange’s equations of the second kind are used to derive governing equations of a chewing RAPR. Jacobian analysis of the RAPR is presented. As redundancy resolutions, two different optimization cost functions corresponding to specific neuromuscular objectives, which are minimization of effort of the muscles of mastication and temporomandibular joints (TMJs) loads, are used to find the RAPR’s optimized actuation torque distributions. The actuation torques under the influence of experimentally determined dynamic chewing forces on molar teeth reproduced from a separate chewing experiment are calculated for realistic in vitro simulation of typical human chewing. These actuation torques are applied to the RAPR with a distributed-computed-torque proportional-derivative control scheme, allowing the RAPR’s mandible to follow a human subject’s chewing trajectory. TMJs loads are measured by force sensors, which are comparable with the computed loads from theoretical formulation. The TMJs loads for the two optimization cost functions are measured while the RAPR is chewing 3 g of peanuts on its left molars. Maximum and mean of the recorded loads on the left TMJ were higher in both cases. Moreover, the maximum and mean of the recorded loads on both TMJs were smaller for the cost function minimizing the TMJs loads. These results demonstrate validity of the model, suggesting the RAPR as a potential TMJ loads measurement tool to study the chewing characteristics of patients suffering from pain in TMJs.
Controlling Mechanism of Temperature Dependence of Kinetic Friction of Ice
Authors: Hong Jialin , Talalay Pavel , Zhang Nan , Fan Xiaopeng
Published: March 2020

Ice friction is one of the major technical issues in almost every application involving ice as one of the moving parts. Very few studies have placed emphasis on the effects of temperature on ice friction at low velocities, although this is important in the transportation of heavy loads in cold regions using sleds, particularly at the onset of sled movement. In this study, a linear tribometer was designed to move a surface of ice over the test surfaces under constant sliding velocity and load. We present new experimental results of the kinetic friction of ice on stainless steel and polytetrafluoroethylene (PTFE) substrates at low velocities and a wide range of temperatures to a minimum of −60 °C. The results show a strong reduction in friction with increase in temperature. Low friction at low velocities and high temperatures may be owing to the thicker quasi-liquid water from pre-melting at the points of sliding contact, while high friction at low velocities and low temperatures can be caused by the low mobility of the surface molecules. The huge difference between the thermal conductivities of stainless steel and PTFE as well as the relatively high glass transition temperature of PTFE most likely account for the divergence of their coefficient of kinetic friction (COF) curves.
In situ monitoring of GaSb1 − xBix growth using desorption mass spectrometry
Authors: McCoy Jedidiah , Lu Chunte , Kaspi Ron
Published: March 2020

Incorporation of bismuth into GaSb is of interest because the alloy bandgap can be substantially reduced while avoiding strain relaxation. Thus, the GaSb1 − xBix alloy is potentially useful in extending the wavelength in optoelectronic devices. However, the epitaxial growth of this alloy via molecular beam epitaxy is challenging because the parameter space is relatively small. Additionally, a precise relationship between Bi incorporation and growth parameters is not well understood. In this study, the authors have utilized the in situ desorption mass spectrometry (DMS) technique to make relative measurements of Sb and Bi desorption during GaSb1 − xBix growth. Employed in this material system for the first time, the authors were able to identify critical growth parameters and correlate these parameters with Bi incorporation as well as accumulation at the growth surface. Specifically, the authors used the ability of DMS to precisely adjust the Sb/Ga flux ratio in order to determine the sensitivity of Bi incorporation to this flux ratio, in particular, as it approaches unity. Additionally, the authors used DMS to provide information on the surface accumulation of Bi and how this population can be purged from the surface using an incident Sb flux. The authors found that DMS can be very useful in rapidly locating the appropriate growth parameter window for this alloy as well as identifying relationships between Bi incorporation and other parameters such as substrate temperature and incident fluxes within that window.
Multiplexed single-molecule enzyme activity analysis for counting disease-related proteins in biological samples
Authors: Sakamoto Shingo , Komatsu Toru , Watanabe Rikiya , Zhang Yi , Inoue Taiki , Kawaguchi Mitsuyasu , Nakagawa Hidehiko , Ueno Takaaki , Okusaka Takuji , Honda Kazufumi , Noji Hiroyuki , Urano Yasuteru
Published: March 2020

We established an ultrasensitive method for identifying enzymes in biological samples by multiplexed single-molecule enzymatic assay.
Do us a favor
Authors: Thorp H. Holden
Published: March 2020

“Do me a favor, speed it up, speed it up.” This is what U.S. President Donald Trump told the National Association of Counties Legislative Conference, recounting what he said to pharmaceutical executives about the progress toward a vaccine for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Anthony Fauci, the long-time leader of the National Institute of Allergy and Infectious Diseases, has been telling the president repeatedly that developing the vaccine will take at least a year and a half—the same message conveyed by pharmaceutical executives. Apparently, Trump thought that simply repeating his request would change the outcome.
Dendritic cells dictate responses to PD-L1 blockade cancer immunotherapy
Authors: Mayoux Maud , Roller Andreas , Pulko Vesna , Sammicheli Stefano , Chen Stanford , Sum Eva , Jost Christian , Fransen Marieke F. , Buser Regula B. , Kowanetz Marcin , Rommel Karolin , Matos Ines , Colombetti Sara , Belousov Anton , Karanikas Vaios , Ossendorp Ferry , Hegde Priti S. , Chen Daniel S. , Umana Pablo , Perro Mario , Klein Christian , Xu Wei
Published: March 2020

DCs are critical cellular targets of PD-L1 blockade in cancer treatment.
New coronavirus outbreak: Framing questions for pandemic prevention
Authors: Layne Scott P. , Hyman James M. , Morens David M. , Taubenberger Jeffery K.
Published: March 2020

We need to understand and quantify the dominant variables that govern the SARS–CoV-2 outbreak, rather than relying exclusively on confirmed cases and their geospatial spread.
Bacterial Defense Systems against the Neutrophilic Oxidant Hypochlorous Acid
Authors: Sultana Sadia , Foti Alessandro , Dahl Jan-Ulrik
Published: March 2020

Neutrophils kill invading microbes and therefore represent the first line of defense of the innate immune response. Activated neutrophils assemble NADPH oxidase to convert substantial amounts of molecular oxygen into superoxide, which, after dismutation into peroxide, serves as the substrate for the generation of the potent antimicrobial hypochlorous acid (HOCl) in the phagosomal space. In this minireview, we explore the most recent insights into physiological consequences of HOCl stress. Not surprisingly, Gram-negative bacteria have evolved diverse posttranslational defense mechanisms to protect their proteins, the main targets of HOCl, from HOCl-mediated damage.
Nup358 and Transportin 1 Cooperate in Adenoviral Genome Import
Authors: Carlon-Andres Irene , Lagadec Floriane , Pied Noémie , Rayne Fabienne , Lafon Marie-Edith , Kehlenbach Ralph H. , Wodrich Harald
Published: March 2020

Nuclear import of viral genomes is an essential step to initiate productive infection for several nuclear replicating DNA viruses. On the other hand, DNA is not a physiological nuclear import substrate; consequently, viruses have to exploit existing physiological transport routes. Here, we show that adenoviruses use the nucleoporin Nup358 to increase the efficiency of adenoviral genome import. In its absence, genome import efficiency is reduced and the transport receptor transportin 1 becomes rate limiting. We show that the N-terminal half of Nup358 is sufficient to drive genome import and identify a transportin 1 binding region. In our model, adenovirus genome import exploits an existing protein import pathway and Nup358 serves as an assembly platform for transport complexes.
Draft Genome Sequence of a Mycobacterium porcinum Strain Isolated from a Pet Cat with Atypical Mycobacterial Panniculitis
Authors: Mannion Anthony , McCollester Tina , Sheh Alexander , Shen Zeli , Holcombe Hilda , Fox James G.
Published: March 2020

A fast-growing
Mycobacterium
species was cultured from draining, purulent lesions on the caudal abdomen of a 12-year-old male domestic long-haired cat. Whole-genome sequencing identified the organism as
Mycobacterium porcinum
.
Complete Genome Sequence of a Precore-Defective Hepatitis B Virus Genotype D2 Strain Isolated in Bangladesh
Authors: Hossain Md Golzar , Mahmud Md Muket , Rahman Md Arifur , Akter Sharmin , Nazir K. H. M. Nazmul Hussain , Saha Sukumar , Wada Masami , Ohsaki Eriko , Honda Tomoyuki , Ueda Keiji
Published: March 2020

Hepatitis B virus (HBV) genomic mutations affect viral replication, disease progression, and diagnostic and vaccination efficiency. There is limited information regarding characterization and mutational analysis of HBV isolated in Bangladesh. Here, we report the complete nucleotide sequence of a precore-defective HBV genotype D2 strain isolated in Bangladesh.
Draft Genome Sequence of Marinobacter hydrocarbonoclasticus NCT7M, Obtained from the Microbiome of a Marine Copepod
Authors: Nuttall Ryan A. , Sharma Gaurav , Moisander Pia H.
Published: March 2020

The gammaproteobacterium
Marinobacter hydrocarbonoclasticus
NCT7M was cultivated from the copepod
Acartia tonsa
, collected from the coastal western North Atlantic Ocean. The genome was assembled into 45 contigs for a total of 4,128,590 bp, a GC content of 57.3%, and 3,890 protein-coding genes. The genome contains the full gene cluster for denitrification.
Genome Sequences of Two F1 Subcluster Bacteriophages, Burwell21 and Nivrat, Isolated Using the Bacterial Host Mycobacterium smegmatis
Authors: Katsanos Joanna , Ngene Chioma , Cook-Easterwood Jennifer
Published: March 2020

The mycobacteriophages Burwell21 and Nivrat are two F1 cluster bacteriophages isolated from different soil samples in Charlotte, NC. Burwell21 has a 58,098-base-pair double-stranded DNA genome, with 99 protein-coding genes predicted, whereas Nivrat has a 58,009-base-pair genome, with 102 protein-coding genes predicted.
Fifteen-minute consultation: Keeping young school children safe online using the ‘SOCKS’ workshop
Authors: Opstad Hannah , Williams Carrie
Published: March 2020

This paper aims to raise awareness of cyberbullying and online safety among health practitioners and provide some useful advice and key messages to help facilitate conversations with children and young people about internet use. The paper also discusses the role of ‘SOCKS’ (Stamp Out Cyberbullying & Keep Safe), a novel teaching workshop aimed at primary school children, which aims to generate awareness and understanding before they become regularly exposed to the dangers of the online world.
Tranexamic acid is safe to use following mild-to-moderate traumatic brain injury
Authors: Cook Rob , Lyon-Maris Johnny , Martin Rosie
Published: March 2020

The study

The CRASH-3 Trial Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial.Lancet 2019;394:1713-23.

This trial was funded by NIHR Health Technology Assessment Programme (project number 14/190/01), JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and the Wellcome Trust (Joint Global Health Trials scheme).

To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000870/tranexamic-acid-following-mild-to-moderate-traumatic-brain-injury-is-safe-and-reduces-deaths
Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study
Authors: Zhao Mao Xiang , Zhao Quanhui , Zheng Mengyi , Liu Tong , Li Yao , Wang Miao , Yao Siyu , Wang Chi , Chen Yan-Ming , Xue Hao , Wu Shouling
Published: March 2020

Objective

Previous studies have shown that an elevated heart rate is associated with a higher risk of cardiovascular events. This study aimed to prospectively examine the relationship between resting heart rate (RHR) and all-cause mortality in Chinese patients with hypertension.

Design

An observational, prospective and population-based cohort study.

Setting

The Kailuan cohort study was conducted in Tangshan City in northern China.

Participants

We enrolled 46 561 patients who did not receive beta-blocker treatment and were diagnosed with hypertension for the first time during an employee health examination in Kailuan Group in 2006 and 2008.

Outcome

The primary outcome of this study was all-cause mortality.

Methods

The patients in this study were followed for 9.25±1.63 years. All patients were followed up face to face every 2 years. According to the distribution of RHR in the study population, RHR was categorised into five groups on the basis of quintiles: Q1: RHR ≤68 beats per minute (bpm); Q2: RHR >68 and ≤72 bpm; Q3: RHR >72 and ≤76 bpm; Q4: RHR >76 and ≤82 bpm; Q5: RHR >82 bpm. Cox proportional hazards model, which was adjusted for traditional risk factors, was used.

Results

During follow-up, 4751 deaths occurred. After adjustment for potential confounders, restricted cubic spline regression showed that the risk of all-cause mortality increased with heart rate. In multivariate Cox regression analyses adjusted for age, sex and major covariates, the HR for all-cause mortality was 1.31 (95% CI 1.27 to 1.33) in the highest quintile group (Q5) compared with the lowest quintile group (Q1).

Conclusion

An increase in RHR is a long-term risk factor of all-cause mortality in Chinese patients with hypertension.

Trial registration number

ChiCTR-TNC-11001489.
Continuing professional development requirements for UK health professionals: a scoping review
Authors: Karas Marek , Sheen Nik J L , North Rachel V , Ryan Barbara , Bullock Alison
Published: March 2020

Objectives

This paper sets out to establish the numbers and titles of regulated healthcare professionals in the UK and uses a review of how continuing professional development (CPD) for health professionals is described internationally to characterise the postqualification training required of UK professions by their regulators. It compares these standards across the professions and considers them against the best practice evidence and current definitions of CPD.

Design

A scoping review.

Search strategy

We conducted a search of UK health and social care regulators’ websites to establish a list of regulated professional titles, obtain numbers of registrants and identify documents detailing CPD policy. We searched Applied Social Sciences Index and Abstracs (ASSIA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, EMCare and Scopus Life Sciences, Health Sciences, Physical Sciences and Social Sciences & Humanities databases to identify a list of common features used to describe CPD systems internationally and these were used to organise the review of CPD requirements for each profession.

Results

CPD is now mandatory for the approximately 1.5 million individuals registered to work under 32 regulated titles in the UK. Eight of the nine regulators do not mandate modes of CPD and there is little requirement to conduct interprofessional CPD. Overall 81% of those registered are required to engage in some form of reflection on their learning but only 35% are required to use a personal development plan while 26% have no requirement to engage in peer-to-peer learning.

Conclusions

Our review highlights the wide variation in the required characteristics of CPD being undertaken by UK health professionals and raises the possibility that CPD schemes are not fully incorporating the best practice.
Supporting the emotional needs of young people in care: a qualitative study of foster carer perspectives
Authors: Hiller Rachel M , Halligan Sarah L , Meiser-Stedman Richard , Elliott Elizabeth , Rutter-Eley Emily
Published: March 2020

Objectives

Young people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer–child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.

Design and participants

Participants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42–65 years old and ranged from those who were relatively new to the profession (<12 months’ experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children’s emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.

Results

Only half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.

Conclusions

Findings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.
Multimodality imaging in patients with post-cardiac injury syndrome
Authors: Verma Beni R , Chetrit Michael , Gentry III James L , Noll Andrew , Bafadel Ahmed , Khayata Mohamed , Harb Serge C , Xu Bo , Kontzias Apostolos , Kwon Deborah H , Jellis Christine , Klein Allan L
Published: March 2020

This review article is focused on the role of echocardiography, cardiac CT and cardiac magnetic resonance (CMR) imaging in diagnosing and managing patients with post-cardiac injury syndrome (PCIS). Clinically, the spectrum of pericardial diseases under PCIS varies not only in form and severity of presentation but also in the timing varying from weeks to months, thus making it difficult to diagnose. Pericarditis developing after recent or remote myocardial infarction, cardiac surgery or ablation if left untreated or under-treated could worsen into complicated pericarditis which can lead to decreased quality of life and increased morbidity. Colchicine in combination with other anti-inflammatory agents (non-steroidal anti-inflammatory drugs) is proven to prevent and treat acute pericarditis as well as its relapses under various scenarios. Imaging modalities such as echocardiography, CT and CMR play a pivotal role in diagnosing PCIS especially in difficult cases or when clinical suspicion is low. Echocardiography is the tool of choice for emergent bedside evaluation for cardiac tamponade and to electively study the haemodynamics impact of constrictive pericarditis. CT can provide information on pericardial thickening, calcification, effusions and lead perforations. CMR can provide pericardial tissue characterisation, haemodynamics changes and guide long-term treatment course with anti-inflammatory agents. It is important to be familiar with the indications as well as findings from these multimodality imaging tools for clinical decision-making.
Gene of the month: BCOR
Authors: Aldera Alessandro Pietro , Govender Dhirendra
Published: March 2020

BCL-6 transcriptional corepressor (BCOR) gene is located at Xp11.4 and encodes a protein which is involved in transcriptional repression in association with BCL-6 and epigenetic silencing through polycomb repressive complex 1 (PRC1).BCORmutations are being identified in an increasing number of tumours which are diverse in their anatomical location and clinical setting. Interestingly, these tumours share similar and overlapping histological features, namely small round blue cell morphology and a myxoid background with delicate capillary channels. Clear cell sarcoma of the kidney, primitive myxoid mesenchymal tumour of infancy and central nervous system high-grade neuroepithelial tumour withBCORalteration all share similar internal tandem duplications in the polycomb-group really interesting new gene (RING) finger homolog ubiquitin-likefold discriminator domain ofBCOR. Translocations resulting inBCORfusion withCCNB3,MAML3andZC3H7Bhave been identified in undifferentiated round cell sarcoma. Subsets of high-grade endometrial stromal sarcoma and ossifying fibromyxoid tumour which have a more aggressive clinical course have been shown to harbourZC3H7B-BCORfusions. BCOR immunohistochemistry is an established marker with diagnostic utility.
Hyper-realistic and immersive surgical simulation training environment will improve team performance
Authors: Hoang Tuan N , LaPorta Anthony J , Malone John D , Champagne Roland , Lavell Kit , De La Rosa Gabriel M , Gaul Lawrence , Dukovich Mitchell
Published: March 2020

Background

Surgical trauma care requires excellent multidisciplinary team skills and communication to ensure the highest patient survival rate. This study investigated the effects of Hyper-realistic immersive surgical team training to improve individual and team performance. A Hyper-realistic surgical training environment is defined as having a high degree of fidelity in the replication of battlefield conditions in a training environment, so participants willingly suspend disbelief that they become totally immersed and eventually stress inoculated in a way that can be measured physiologically.

Methods

Six multispecialty member US Navy Fleet Surgical/US Army Forward Surgical Teams (total n=99 evaluations) underwent a 6-day surgical training simulation using movie industry special effects and role players wearing the Human Worn Surgical Simulator (Cut Suit). The teams were immersed in trauma care scenarios requiring multiple complex interventions and decision making in a realistic, fast-paced, intensive combat trauma environment.

Results

Hyper-realistic immersive simulation training enhanced performance between multidisciplinary healthcare team members. Key efficacy quantitative measurements for the same simulation presented on day 1 compared with day 6 showed a reduction in resuscitation time from 24 minutes to 14 minutes and critical error decrease from 5 to 1. Written test scores improved an average of 21% (Medical Doctors 11%, Registered Nurses 25%, and Corpsman/Medics 26%). Longitudinal psychometric survey results showed statistically significant increases in unit readiness (17%), combat readiness (12%), leadership quality (7%), vertical cohesion (7%), unit cohesion (5%), and team communication (3%). An analysis of salivary cortisol and amylase physiologic biomarkers indicated an adaptive response to the realistic environment and a reduction in overall team stress during performance evaluations.

Conclusions

Hyper-realistic immersive simulation training scenarios can be a basis for improved military and civilian trauma training.

Level of evidence

Level III.