bluuebunny/crossref_metadata_2025 huggingface dataset:
Bi-allelic GAD1 variants cause a neonatal onset syndromic developmental and epileptic encephalopathy
Authors: Chatron Nicolas , Becker Felicitas , Morsy Heba , Schmidts Miriam , Hardies Katia , Tuysuz Beyhan , Roselli Sandra , Najafi Maryam , Alkaya Dilek Uludag , Ashrafzadeh Farah , Nabil Amira , Omar Tarek , Maroofian Reza , Karimiani Ehsan Ghayoor , Hussien Haytham , Kok Fernando , Ramos Luiza , Gunes Nilay , Bilguvar Kaya , Labalme Audrey , Alix Eudeline , Sanlaville Damien , de Bellescize Julitta , Poulat Anne-Lise ,   EuroEpinomics-RES consortium AR working group, Helbig Ingo , von Spiczak Sarah , Baulac Stephanie , Barisic Nina , Balling Rudi , Caglayan Hande , Craiu Dana , Guerrini Renzo , Klein Karl Martin , Marini Carla , Muhle Hiltrud , Rosenow Felix , Serratosa Jose M , Sterbova Katalin , Weber Yvonne , Moslemi Ali-Reza , Lerche Holger , May Patrick , Lesca Gaetan , Weckhuysen Sarah , Tajsharghi Homa
Published: March 2020

Developmental and epileptic encephalopathies are a heterogeneous group of early-onset epilepsy syndromes dramatically impairing neurodevelopment. Modern genomic technologies have revealed a number of monogenic origins and opened the door to therapeutic hopes. Here we describe a new syndromic developmental and epileptic encephalopathy caused by bi-allelic loss-of-function variants in GAD1, as presented by 11 patients from six independent consanguineous families. Seizure onset occurred in the first 2 months of life in all patients. All 10 patients, from whom early disease history was available, presented with seizure onset in the first month of life, mainly consisting of epileptic spasms or myoclonic seizures. Early EEG showed suppression-burst or pattern of burst attenuation or hypsarrhythmia if only recorded in the post-neonatal period. Eight patients had joint contractures and/or pes equinovarus. Seven patients presented a cleft palate and two also had an omphalocele, reproducing the phenotype of the knockout Gad1−/− mouse model. Four patients died before 4 years of age. GAD1 encodes the glutamate decarboxylase enzyme GAD67, a critical actor of the γ-aminobutyric acid (GABA) metabolism as it catalyses the decarboxylation of glutamic acid to form GABA. Our findings evoke a novel syndrome related to GAD67 deficiency, characterized by the unique association of developmental and epileptic encephalopathies, cleft palate, joint contractures and/or omphalocele.
Quantitative Analysis of Taste Bud Cell Numbers in the Circumvallate and Foliate Taste Buds of Mice
Authors: Ogata Takahiro , Ohtubo Yoshitaka
Published: March 2020

A mouse single taste bud contains 10–100 taste bud cells (TBCs) in which the elongated TBCs are classified into 3 cell types (types I–III) equipped with different taste receptors. Accordingly, differences in the cell numbers and ratios of respective cell types per taste bud may affect taste-nerve responsiveness. Here, we examined the numbers of each immunoreactive cell for the type II (sweet, bitter, or umami receptor cells) and type III (sour and/or salt receptor cells) markers per taste bud in the circumvallate and foliate papillae and compared these numerical features of TBCs per taste bud to those in fungiform papilla and soft palate, which we previously reported. In circumvallate and foliate taste buds, the numbers of TBCs and immunoreactive cells per taste bud increased as a linear function of the maximal cross-sectional taste bud area. Type II cells made up approximately 25% of TBCs irrespective of the regions from which the TBCs arose. In contrast, type III cells in circumvallate and foliate taste buds made up approximately 11% of TBCs, which represented almost 2 times higher than what was observed in the fungiform and soft palate taste buds. The densities (number of immunoreactive cells per taste bud divided by the maximal cross-sectional area of the taste bud) of types II and III cells per taste bud are significantly higher in the circumvallate papillae than in the other regions. The effects of these region-dependent differences on the taste response of the taste bud are discussed.
Impact of an Antibiotic Side-Chain–Based Cross-reactivity Chart Combined With Enhanced Allergy Assessment Processes for Surgical Prophylaxis Antimicrobials in Patients With β-Lactam Allergies
Authors: Collins Curtis D , Scheidel Caleb , Anam Kishore , Polega Shikha , Malani Anurag N , Hayward Alexandra , Leo Harvey L , Shankar Tara , Morrin Cheryl , Brockhaus Kara
Published: March 2020

Background

β-Lactam antibiotics are first-line therapy for perioperative prophylaxis; however, patient-reported allergies often lead to increased prescribing of alternative antibiotics that may increase the incidence of surgical site infections. The R-group side chain of the β-lactam ring is responsible for allergic cross-reactivity and experts recommend the use of β-lactams that are structurally dissimilar.

Methods

An internally developed, antibiotic side-chain–based cross-reactivity chart was developed and implemented alongside enhanced allergy assessment processes. This single-center, quasi-experimental study analyzed antibiotic prescribing in all adult patients with a documented β-lactam allergy undergoing an inpatient surgical procedure between quartile (Q) 1 (2012)–Q3 (2014) (historical group) and Q3 (2016)–Q3 (2018) (intervention group). Propensity-weighted scoring analyses compared categorical and continuous outcomes. Interrupted time-series analysis further analyzed key outcomes.

Results

A total of 1119 and 1089 patients were included in the historical and intervention cohorts, respectively. There was a significant difference in patients receiving a β-lactam alternative antibiotic between cohorts (84.9% vs 15.1%; P < .001). There was a decrease in 30-day readmissions in the intervention cohort (7.9% vs 6.3%; P = .035); however, there was no difference in the incidence of SSIs in patients readmitted (14.8% vs 13%; P = .765). No significant differences were observed in allergic reactions (0.5% vs 0.3%; P = .323), surgical site infections, in-hospital and 30-day mortality, healthcare facility–onset Clostridiodes difficile infection, acute kidney injury, or hospital costs.

Conclusions

Implementation of an antibiotic cross-reactivity chart combined with enhanced allergy assessment processes significantly improved the prescribing of β-lactam antibiotics for surgical prophylaxis.
Doxycycline for Prevention of Spirochetal Infections: Status Report
Authors: Wormser Gary P
Published: March 2020

Important human infections caused by spirochetal microorganisms include Lyme disease, syphilis, leptospirosis, and tick-borne relapsing fever. Doxycycline prophylactic regimens have been shown to significantly reduce the risk for developing all of these infections in potentially exposed individuals, which is highly clinically relevant as no vaccines to prevent these infections in humans are currently available. Additional data, however, are needed to define more precisely the level of efficacy of the doxycycline prophylactic regimens, especially for Lyme disease and syphilis, infections that can be potentially prevented by a single 200-mg dose of doxycycline given within 72 hours postexposure.
Improved protein-binding radioassay for plasma cortisol.
Authors: Novacenko H , Halpern F , Sachar E J
Published: March 2020

We describe an improved competitive protein-binding radioassay for total plasma cortisol, which permits rapid analysis of many samples. Plasma, 0.1 mL, is directly applied to a Whatman 3MM filter-paper strip, which is extracted once with dichloromethane. The extract is evaporated and the residue is assayed directly by the micro-method of Murphy (J. Clin. Endocrinol. Metab. 27: 973, 1967). Comparison with the original Murphy method (ethanol extraction) yielded excellent agreement (r = 0.988). One hundred samples, in duplicate, can easily be assayed at a time.
Agricultural land in the Amazon basin supports low bird diversity and is a poor replacement for primary forest
Authors: Neate-Clegg Montague H C , Şekercioğlu Çağan H
Published: March 2020

The Amazon has a long history of disturbance under subsistence agriculture, but slash-and-burn agriculture is small in scale and has relatively low impact on resident avifauna. More recently, the Amazon has suffered extensive deforestation in favor of cattle ranching and other modern systems of agriculture. Cattle pastures, mechanized agriculture, and even tree plantations have detrimental effects on bird communities, greatly lowering diversity, especially that of primary forest interior specialists. A rising threat to the Amazon is the spread of oil palm plantations that retain few bird species and are not viable alternatives to forest. Embedded within the expanding agropastoral mosaic are forest fragments that have experienced a well-documented loss of diversity. Yet, the matrix can mitigate the recovery of fragmented bird communities depending on the type of secondary regrowth. Connectivity via matrix habitats or forest corridors is critical for the maintenance of forest avifauna. With so many types of land use developing across the Amazon, the “tropical countryside” has potential value for bird diversity. However, evidence suggests that the agropastoral mosaic harbors a small, more homogenized avifauna with few forest species, especially when primary forest is absent from the landscape. For the Amazon Basin’s bird life to be conserved into the future, preservation of large tracts of well-connected primary forest is vital. Tropical countryside dominated by agriculture simply cannot sustain sufficient levels of biodiversity.
Relevant issues in tumor regression grading of histopathological response to neoadjuvant treatment in adenocarcinomas of the esophagus and gastroesophageal junction
Authors: Klevebro F , Tsekrekos A , Low D , Lundell L , Vieth M , Detlefsen S
Published: March 2020

Multimodality treatment combining surgery and oncologic treatment has become widely applied in curative treatment of esophageal and gastroesophageal junction adenocarcinoma. There is a need for a standardized tumor regression grade scoring system for clinically relevant effects of neoadjuvant treatment effects. There are numerous tumor regression grading systems in use and there is no international standardization. This review has found nine different international systems currently in use. These systems all differ in detail, which inhibits valid comparisons of results between studies. Tumor regression grading in esophageal and gastroesophageal junction adenocarcinoma needs to be improved and standardized. To achieve this goal, we have invited a significant group of international esophageal and gastroesophageal junction adenocarcinoma pathology experts to perform a structured review in the form of a Delphi process. The aims of the Delphi include specifying the details for the disposal of the surgical specimen and defining the details of, and the reporting from, the agreed histological tumor regression grade system including resected lymph nodes. The second step will be to perform a validation study of the agreed tumor regression grading system to ensure a scientifically robust inter- and intra-observer variability and to incorporate the consented tumor regression grading system in clinical studies to assess its predictive and prognostic role in treatment of esophageal and gastroesophageal junction adenocarcinomas. The ultimate aim of the project is to improve survival in esophageal and gastroesophageal adenocarcinoma by increasing the quality of tumor regression grading, which is a key component in treatment evaluation and future studies of individualized treatment of esophageal cancer.
The relation between cardiac 123I-mIBG scintigraphy and functional response 1 year after CRT implantation
Authors: Verschure D O , Poel E , De Vincentis G , Frantellizzi V , Nakajima K , Gheysens O , de Groot J R , Verberne H J
Published: March 2020

Aims 

Cardiac resynchronization therapy (CRT) is a disease-modifying therapy in patients with chronic heart failure (CHF). Current guidelines ascribe CRT eligibility on three parameters only: left ventricular ejection fraction (LVEF), QRS duration, and New York Heart Association (NYHA) functional class. However, one-third of CHF patients does not benefit from CRT. This study evaluated whether 123I-meta-iodobenzylguanidine (123I-mIBG) assessed cardiac sympathetic activity could optimize CRT patient selection.

Methods and results 

A total of 78 stable CHF subjects (age 66.8 ± 9.6 years, 73% male, LVEF 25.2 ± 6.7%, QRS duration 153 ± 23 ms, NYHA 2.2 ± 0.7) referred for CRT implantation were enrolled. Subjects underwent 123I-mIBG scintigraphy prior to implantation. Early and late heart-to-mediastinum (H/M) ratio and 123I-mIBG washout were calculated. CRT response was defined as either an increase of LVEF to >35%, any improvement in LVEF of >10%, QRS shortening to <150 ms, or improvement in NYHA class of >1 class. In 33 patients LVEF increased to >35%, QRS decreased <150 ms in 36 patients, and NYHA class decreased in 33 patients. Late H/M ratio and hypertension were independent predictors of LVEF improvement to >35% (P = 0.0014 and P = 0.0149, respectively). In addition, early H/M ratio, LVEF, and absence of diabetes mellitus (DM) were independent predictors for LVEF improvement by >10%. No independent predictors were found for QRS shortening to <150 ms or improvement in NYHA class.

Conclusion 

Early and late H/M ratio were independent predictors of CRT response when improvement of LVEF was used as measure of response. Therefore, cardiac 123I-mIBG scintigraphy may be used as a tool to optimize selection of subjects that might benefit from CRT.
Progression of ultrasound plaque attenuation and low echogenicity associates with major adverse cardiovascular events
Authors: Shishikura Daisuke , Kataoka Yu , Di Giovanni Giuseppe , Takata Kohei , Scherer Daniel J , Andrews Jordan , Psaltis Peter J , Puri Rishi , Wolski Kathy , Nissen Steven E , Nicholls Stephen J
Published: March 2020

Aims

Intravascular ultrasound (IVUS) imaging can visualize vulnerable plaque features including attenuation (AP) and echolucency (ELP). While IVUS-derived vulnerable plaque features associate with microvascular obstruction during percutaneous coronary intervention, the relationship between these plaque features and clinical outcomes has not been established. This analysis aimed to evaluate the association of AP/ELP with cardiovascular events.

Methods and results

Serial IVUS imaging was reviewed in 1497 patients, followed for 18–24 months, with coronary artery disease from two clinical trials. Attenuated plaque and ELP were identified to measure each characteristics (AP arc, ELP area, and lengths), which permitted calculation of an AP index (API) and ELP volume. Attenuated plaque/ELP progression was defined as patients with any increase of API or ELP volume on serial imaging. The major cardiovascular events (MACEs) were defined as death, myocardial infarction, stroke, and coronary revascularization. AP or ELP was identified in 282 patients (18.8%) at baseline and 160 (10.7%) patients demonstrated an increase in AP or ELP at follow-up. The incidence of MACE was higher in patients with baseline AP/ELP than those without (8.2% vs. 3.9%, P = 0.002). Patients with AP/ELP progression were more likely to be acute coronary syndrome (41.9 vs. 33.2%, P = 0.03) and have greater baseline percent atheroma volume (40.0% vs. 35.8%, P < 0.001) than those without. On multivariable analysis, AP/ELP progression was more strongly associated with MACE [baseline AP/ELP: hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.05–2.97, AP/ELP progression: HR 2.19, 95% CI 1.24–3.86].

Conclusion

Attenuation/ELP progression was associated with a higher prevalence of cardiovascular events, supporting a potential role for the identification of high-risk vulnerable plaques in patients with coronary artery disease.
Propulsive nanomachines: the convergent evolution of archaella, flagella and cilia
Authors: Beeby Morgan , Ferreira Josie L , Tripp Patrick , Albers Sonja-Verena , Mitchell David R
Published: March 2020

Echoing the repeated convergent evolution of flight and vision in large eukaryotes, propulsive swimming motility has evolved independently in microbes in each of the three domains of life. Filamentous appendages – archaella in Archaea, flagella in Bacteria and cilia in Eukaryotes – wave, whip or rotate to propel microbes, overcoming diffusion and enabling colonization of new environments. The implementations of the three propulsive nanomachines are distinct, however: archaella and flagella rotate, while cilia beat or wave; flagella and cilia assemble at their tips, while archaella assemble at their base; archaella and cilia use ATP for motility, while flagella use ion-motive force. These underlying differences reflect the tinkering required to evolve a molecular machine, in which pre-existing machines in the appropriate contexts were iteratively co-opted for new functions and whose origins are reflected in their resultant mechanisms. Contemporary homologies suggest that archaella evolved from a non-rotary pilus, flagella from a non-rotary appendage or secretion system, and cilia from a passive sensory structure. Here, we review the structure, assembly, mechanism and homologies of the three distinct solutions as a foundation to better understand how propulsive nanomachines evolved three times independently and to highlight principles of molecular evolution.
A method of phase identification for seismic data acquired with the controlled accurate seismic source (CASS)
Authors: Wang Xiaolei , Xue Bing , Cui Rensheng , Gu Guoliang , Peng Chaoyong , Zheng Yu , Yang Jiansi
Published: March 2020

With the advantages of the little destruction to the deployment site and high repeatability compared with explosive sources, the controlled accurate seismic source (CASS) has many potential applications with respect to the investigation of the crustal structure and seismic wave velocities. However, the signal generated by the CASS rapidly attenuates with the increasing distance because of its poor signal-to-noise ratio (SNR). Consequently, the difficulties in identifying specific seismic phases from the CASS data limit its application and popularization. The aim of this study is to present a new method to improve the accuracy of traveltime estimation and to identify more seismic phases travelling through the crust. We adopt the global seismic phase scanning algorithms (GSPSA) combined with an optimized narrowband time-varying filter, whose central frequency corresponds to the instantaneous frequency of the linear frequency modulation (LFM) signals produced by the CASS. Using the seismic data from the 40-ton CASS in a field experiment around Xinfengjiang reservoir in southeast China, we attain the seismic phases such as Pg, Sg, PmP and SmS at epicentral distances of more than 200 km with GSPSA. To identify and verify these seismic phases information, we also calculate synthetic waveforms. The results demonstrate that the GSPSA method is an effective tool for seismic phase identification of CASS data.
Migration-based near real-time detection and location of microearthquakes with parallel computing
Authors: Guidarelli Mariangela , Klin Peter , Priolo Enrico
Published: March 2020

Prompt detection and accurate location of microseismic events are of great importance in seismic monitoring at local scale and become essential steps in monitoring underground activities, such as oil and gas production, geothermal exploitation and underground gas storage, for implementing effective control procedures to limit the induced seismicity hazard. In this study, we describe an automatic and robust earthquake detection and location procedure that exploits high-performance computing and allows the analysis of microseismic events in near real-time using the full waveforms recorded by a local seismic network. The implemented technique, called MigraLoc, is based on the space–time migration of continuous waveform data and consists of the following steps: (1) enhancement of P and S arrivals in noisy signals through a characteristic function, by means of the time–frequency analysis of the seismic records; (2) blind event location based on delay-and-sum approach systematically scanning the volume of potential hypocentres; (3) detection notification according to the information content of the hypocentre probability distribution obtained in the previous step. The technique implies that theoretical arrival times are pre-calculated for each station and all potential hypocentres as a solution of the seismic-ray equation in a given 3-D medium. As a test case, we apply MigraLoc to two, low-magnitude, earthquake swarms recorded by the Collalto Seismic Network in the area of the Veneto Alpine foothills (Italy) in 2014 and 2017, respectively. Thanks to MigraLoc, we can increase the number of events reported in the network catalogue by more than 25 per cent. The automatically determined locations prove to be consistent with, and overall more accurate than, those obtained by classical methods using manual time-arrival picks. The proposed method works preferably with dense networks that provide signals with some degree of coherency. It shows the following advantages compared to other classical location methods: it works on the continuous stream of data as well as on selected intervals of waveforms; it detects more microevents owing to the increased signal-to-noise ratio of the stacked signal that feeds the characteristic function; it works with any complex 3-D model with no additional effort; it is completely automatic, once calibrated, and it does not need any manual picking.
Skeletal muscle quality affects patient outcomes in acute type A aortic dissection
Authors: Gomibuchi Toshihito , Seto Tatsuichiro , Chino Shuji , Mikoshiba Toru , Komatsu Masaki , Tanaka Haruki , Ichimura Hajime , Yamamoto Takateru , Ohashi Noburo , Fuke Megumi , Wada Yuko , Okada Kenji
Published: March 2020

OBJECTIVES

Although skeletal muscle quantity is linked to surgical outcomes, quality remains unexamined. In this study, we evaluated whether skeletal muscle quality and quantity could predict surgical outcomes in acute type A aortic dissection (ATAAD).

METHODS

Skeletal muscle quality and quantity were evaluated using computed tomography (CT) values and the psoas muscle mass index, respectively. From May 2004 to December 2017, 324 ATAAD patients underwent aortic replacement after CT scans and psoas muscle mass index measurements. Patients were grouped into intramuscular fat (IMF; n = 55) and non-IMF (n = 269) deposition groups.

RESULTS

The mean ages of the patients were 72.3 ± 9.7 and 66.8 ± 12.1 years (P = 0.002), and hospital mortality rates were 3.6% (2/55) and 7.4% (20/269; P = 0.393) for IMF and non-IMF deposition groups, respectively. IMF deposition was a risk factor for a deterioration in activities of daily living at discharge by multivariable analysis [odds ratio 0.33, 95% confidence interval (CI) 0.16–0.69; P = 0.003]. The mean follow-up was 43.9 ± 36.8 months. The 5-year survival was significantly worse for the IMF deposition group (IMF 73.8% vs non-IMF 88.2%; P = 0.010). The multivariable Cox proportional hazard analysis showed that IMF deposition significantly predicted poor survival (hazard ratio 3.26, 95% CI 1.47–7.24; P = 0.004), unlike psoas muscle mass index and age.

CONCLUSIONS

Skeletal muscle quality, defined by IMF deposition, was an independent predictor of overall survival and postoperative activities of daily living dependence risk in patients undergoing surgery for ATAAD. Thus, IMF deposition may be an additional risk factor for estimating late outcomes of ATAAD surgery.
An inverse optimal approach to ship course-keeping control
Authors: Wang Chuanrui , Yan Chuanxu , Liu Zhenchong , Cao Feng
Published: March 2020

This paper deals with the ship course tracking control problem in a novel inverse optimal control approach. The inverse optimal stabilization problem and inverse optimal gain assignment problem are firstly extended to general systems affine in the control with unknown control gain. It is shown that a sufficient condition to solve the inverse optimal control problem is the existence of a stabilization control law in a special form for a corresponding auxiliary system. Then, by employing backstepping technique, control laws are designed which solve the inverse optimal stabilization, inverse optimal adaptive stabilization and inverse optimal adaptive gain assignment problem of ship course control system, respectively. Simulations are included to illustrate the effectiveness of the proposed control algorithms.
Elliptic Curves with Long Arithmetic Progressions Have Large Rank
Authors: Garcia-Fritz Natalia , Pasten Hector
Published: March 2020

For any family of elliptic curves over the rational numbers with fixed $j$-invariant, we prove that the existence of a long sequence of rational points whose $x$-coordinates form a nontrivial arithmetic progression implies that the Mordell–Weil rank is large, and similarly for $y$-coordinates. We give applications related to uniform boundedness of ranks, conjectures by Bremner and Mohanty, and arithmetic statistics on elliptic curves. Our approach involves Nevanlinna theory as well as Rémond’s quantitative extension of results of Faltings.
Functions of Bounded Variation on Complete and Connected One-Dimensional Metric Spaces
Authors: Lahti Panu , Zhou Xiaodan
Published: March 2020

In this paper, we study functions of bounded variation on a complete and connected metric space with finite one-dimensional Hausdorff measure. The definition of BV functions on a compact interval based on pointwise variation is extended to this general setting. We show this definition of BV functions is equivalent to the BV functions introduced by Miranda [18]. Furthermore, we study the necessity of conditions on the underlying space in Federer’s characterization of sets of finite perimeter on metric measure spaces. In particular, our examples show that the doubling and Poincaré inequality conditions are essential in showing that a set has finite perimeter if the codimension one Hausdorff measure of the measure-theoretic boundary is finite.
Has Human Papillomavirus (HPV) Vaccination Prevented Adverse Pregnancy Outcomes? Population-Level Analysis After 8 Years of a National HPV Vaccination Program in Australia
Authors: Yuill Susan , Egger Sam , Smith Megan , Velentzis Louiza , Wrede C David , Bateson Deborah , Canfell Karen
Published: March 2020

Background

Human papillomavirus (HPV) infection, and its sequelae of precancerous cervical lesions and their subsequent treatment, have been linked with an increased risk of adverse pregnancy outcomes. Publicly funded HPV vaccination of female adolescents began in Australia in 2007 with initial catch-up to age 26 years.

Methods

Using data from the National Perinatal Data Collection we compared rates of preterm births and small-for-gestational-age infants born in Australia 2000–2015. We used generalized linear models, assuming a Poisson distribution and log link function, with single-year categories of infant birth year, maternal age, and age-specific HPV vaccination coverage as independent variables.

Results

In maternal cohorts with 60%–80% HPV vaccination coverage as achieved in Australia, there was a relative rate reduction of 3.2% (95% confidence interval, 1.1%–5.3%) in preterm births and 9.8% (8.2% to 11.4%) in small-for-gestational-age infants, after adjustment for infant’s birth year and maternal age.

Conclusion

This analysis provides provisional population-level evidence of a reduction in adverse pregnancy outcomes in cohorts of women offered HPV vaccination. Confounding by smoking or other variables and/or ecological analysis limitations, however, cannot be excluded. These findings indicate potential broader benefits of HPV vaccination than have been documented to date.
A systematic review of factors that enable psychological safety in healthcare teams
Authors: O’donovan Róisín , Mcauliffe Eilish
Published: March 2020

Purpose

The current systematic review will identify enablers of psychological safety within the literature in order to produce a comprehensive list of factors that enable psychological safety specific to healthcare teams.

Data sources

A keyword search strategy was developed and used to search the following electronic databases PsycINFO, ABI/INFORM, Academic search complete and PubMed and grey literature databases OpenGrey, OCLC WorldCAT and Espace.

Study selection

Peer-reviewed studies relevant to enablers of psychological safety in healthcare setting that were published between 1999 and 2019 were eligible for inclusion. Covidence, an online specialized systematic review website, was used to screen records. Data extraction, quality appraisal and narrative synthesis were conducted on identified papers.

Data extraction

Thirty-six relevant studies were identified for full review and data extraction. A data extraction template was developed and included sections for the study methodology and the specific enablers identified within each study.

Results of data synthesis

Identified studies were reviewed using a narrative synthesis. Within the 36 articles reviewed, 13 enablers from across organizational, team and individual levels were identified. These enablers were grouped according to five broader themes: priority for patient safety, improvement or learning orientation, support, familiarity with colleagues, status, hierarchy and inclusiveness and individual differences.

Conclusion

This systematic review of psychological safety literature identifies a list of enablers of psychological safety within healthcare teams. This list can be used as a first step in developing observational measures and interventions to improve psychological safety in healthcare teams.
Comparing outcome measures of persons with severe mental illness in vocational rehabilitation programs: a dual perspective of consumers and providers
Authors: Gal Gilad , Shadmi Efrat , Hoter-Ishay Gili , Gelkopf Marc , Roe David
Published: March 2020

Objective

Vocational rehabilitation for people with severe mental illness (SMI) has many benefits. Among the existing models, supported employment has consistently shown to have better impact on vocational outcomes while the findings on non-vocational outcomes are inconsistent. One source of variation with regard to non-vocational outcomes could be related to differences between consumers’ self-reports and the providers’ point of view.

Design

A cross-sectional study of people with SMI consuming three different vocational services and their service providers.

Setting

Data were collected as part of the Israeli Psychiatric Rehabilitation Patient Reported Outcome Measurement project.

Participants

The current data is based on 3666 pairs of people with SMI consuming vocational services and their service providers.

Interventions

Vocational services included supported employment, sheltered workshops and vocational support centers.

Main Outcome Measures

The consumers-filled self-report questionnaires, which consisted of the following patient-reported outcome measurements (PROMs): quality of life, functioning and illness management. Primary professional providers were given instruments that mirrored the ones designed for self-report.

Results

According to providers’ ratings, supported employment was associated with higher functioning (F = 78.6, P < 0.001) and illness management (F = 33.0, P < 0.001) compared to other vocational services. PROMs revealed that supported employment was associated with higher functioning only (F = 31.5, P < 0.001). Consumers rated themselves higher compared to providers on all measures.

Conclusions

This study provides a deeper insight into non-vocational outcomes of people with SMI participating in vocational services and suggests differences in perspectives between consumers and providers with regard to outcome measures.
Aztreonam for Neisseria gonorrhoeae: a systematic review and meta-analysis
Authors: Barbee Lindley A , Golden Matthew R
Published: March 2020

Background

Ceftriaxone is the only consistently active antimicrobial agent recommended for the treatment of Neisseria gonorrhoeae. Although some new antimicrobials are in development, the necessity to expand treatment options in the near term may require using older drugs that have not been widely used to treat gonorrhoea.

Methods

We conducted a literature review of clinical trials and case series, published from 1983 to 2017, reporting treatment efficacy results following administration of 1 g aztreonam intramuscularly or IV for uncomplicated gonococcal infections. We summed trial data, stratified by anatomical site of infection, and calculated summary efficacy estimates and 95% CI for each site of infection.

Results

The 10 identified clinical trials enrolled 678, 38 and 16 individuals with urogenital, rectal and pharyngeal gonorrhoea, respectively. Aztreonam had an efficacy of 98.6% (95% CI: 97.5%–99.4%) for urogenital, 94.7% (95% CI: 82.3%–99.4%) for rectal and 81.3% (95% CI: 54.4%–96.0%) for pharyngeal gonococcal infections.

Conclusions

Although most clinical trials included in this meta-analysis were conducted >30 years ago, aztreonam appears to have excellent efficacy for urogenital gonorrhoea; its efficacy at extragenital sites remains uncertain.
COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression
Authors: Zhou Dan , Dai Sheng-Ming , Tong Qiang
Published: March 2020

A novel coronavirus disease (COVID-19), caused by infection with SARS-CoV-2, has swept across 31 provinces in China and over 40 countries worldwide. The transition from first symptoms to acute respiratory distress syndrome (ARDS) is highly likely to be due to uncontrolled cytokine release. There is an urgent need to identify safe and effective drugs for treatment. Chloroquine (CQ) exhibits a promising inhibitory effect. However, the clinical use of CQ can cause severe side effects. We propose that hydroxychloroquine (HCQ), which exhibits an antiviral effect highly similar to that of CQ, could serve as a better therapeutic approach. HCQ is likely to attenuate the severe progression of COVID-19, inhibiting the cytokine storm by suppressing T cell activation. It has a safer clinical profile and is suitable for those who are pregnant. It is cheaper and more readily available in China. We herein strongly urge that clinical trials are performed to assess the preventive effects of HCQ in both disease infection and progression.
Validation of the HAPPI Kids Continuous Age-Specific Pediatric Reference Intervals
Authors: Hoq Monsurul , Matthews Susan , Karlaftis Vicky , Burgess Janet , Donath Susan , Carlin John , Ignjatovic Vera , Monagle Paul
Published: March 2020

Introduction

To facilitate best possible patient care, reference intervals (RIs) adopted by a laboratory must be appropriate for the population demographics and, where applicable, the analytical principle and/or the analytical instrument used. While guidelines from the Clinical and Laboratory Standard Institute (CLSI) recommend a validation process for discrete RIs, there are no current recommendations for the validation process for continuous RIs. This study aimed to validate recently published, HAPPI Kids continuous RIs, in a routine laboratory.

Methods

Initially, the difference in test results between the primary study laboratory that contributed to previous RIs development and a routine laboratory was assessed using specimens from 77 children tested in both laboratories using the Siemens ADVIA 1800 or Centaur/XP/XPT. Later, validation of the HAPPI Kids RIs was undertaken using 279 pediatric samples tested on the same analyzer type in the routine laboratory. The previously published RIs were validated if more than 90% of results in the routine laboratory were within the RIs.

Results

There was minimal evidence of clinically significant differences in test results between the primary and routine laboratories. The continuous RIs were validated after initial analysis for 16 of the 18 biochemistry analytes tested, and after secondary analysis for the remaining 2 analytes.

Conclusion

This study validates the HAPPI Kids RIs in a routine laboratory, satisfying the laboratory accreditation requirements for evaluation, implementation, and sourcing of RIs. In addition, this study presents a modification of the current CLSI method for validation of continuous RIs that will benefit routine laboratories in general.
A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension
Authors: Choi Wonchan , Wang Shengang , Lee Yura , Oh Hyunkyoung , Zheng Zhi
Published: March 2020

Objective

This article reports results from a systematic literature review of the current state of mobile health (mHealth) technologies that have the potential to support self-management for people with diabetes and hypertension. The review aims to (a) characterize mHealth technologies used or described in the mHealth literature and (b) summarize their effects on self-management for people with diabetes and hypertension from the clinical and technical standpoints.

Materials and Methods

A systematic literature review was conducted following PRISMA guidelines. Online databases were searched in September 2018 to identify eligible studies for review that had been published since 2007, the start of the smartphone era. Data were extracted from included studies based on the PICOS framework.

Results

Of the 11 studies included for in-depth review, 5 were clinical research examining patient health outcomes and 6 were technology-focused studies examining users’ experiences with mHealth technologies under development. The most frequently used mHealth technology features involved self-management support (n = 11) followed by decision support (n = 6) and shared decision-making (n = 6). Most clinical studies reported benefits associated with mHealth interventions. These included reported improvements in objectively measured patient health outcomes (n = 3) and perceptual or behavioral outcomes (n = 4).

Discussion

Although most studies reported promising results in terms of the effects of mHealth interventions on patient health outcomes and experience, the strength of evidence was limited by the study designs.

Conclusion

More randomized clinical trials are needed to examine the promise and limitations of mHealth technologies as assistive tools to facilitate the self-management of highly prevalent comorbidity of chronic conditions, such as diabetes and hypertension.
Efficient goal attainment and engagement in a care manager system using unstructured notes
Authors: Rosenthal Sara , Das Subhro , Hsueh Pei-Yun Sabrina , Barker Ken , Chen Ching-Hua
Published: March 2020

Objective

To improve efficient goal attainment of patients by analyzing the unstructured text in care manager (CM) notes (CMNs). Our task is to determine whether the goal assigned by the CM can be achieved in a timely manner.

Materials and Methods

Our data consists of CM structured and unstructured records from a private firm in Orlando, FL. The CM data is based on phone interactions between the CM and the patient. A portion of the data has been manually annotated to indicate engagement. We present 2 machine learning classifiers: an engagement model and a goal attainment model.

Results

We can successfully distinguish automatically between engagement and lack of engagement. Subsequently, incorporating engagement and features from textual information from the unstructured notes significantly improves goal attainment classification.

Discussion

Two key challenges in this task were the time-consuming annotation effort for engagement classification and the limited amount of data for the more difficult goal attainment class (specifically, for people who take a long time to achieve their goals). We successfully explore domain adaptation and transfer learning techniques to improve performance on the under-represented classes. We also explore the value of using features from unstructured notes to improve the model and interpretability.

Conclusions

Unstructured CMNs can be used to improve accuracy of our classification models for predicting patient self-management goal attainment. This work can be used to help identify patients who may require special attention from CMs to improve engagement in self-management.
Listening and question-asking behaviors in resident and nurse handoff conversations: a prospective observational study
Authors: Kannampallil Thomas , Abraham Joanna
Published: March 2020

Objective

To characterize interactivity during resident and nurse handoffs by investigating listening and question-asking behaviors during conversations.

Materials and Methods

Resident (n = 149) and nurse (n = 126) handoffs in an inpatient medicine unit were audio-recorded. Handoffs were coded based on listening behaviors (active and passive), question types (patient status, coordination of care, clinical reasoning, and framing and alignment), and question responses. Comparisons between residents and nurses for listening and question-asking behaviors were performed using the Wilcoxon rank-sum tests. A Poisson regression model was used to investigate differences in the question-asking behaviors between residents and nurses, and the association between listening and question-asking behaviors.

Results

There were no significant differences between residents and nurses in their active (18% resident vs 39% nurse handoffs) or passive (88% resident vs 81% nurse handoffs) listening behaviors. Question-asking was common in resident and nurse handoffs (87% vs 98%) and focused primarily on patient status, co-ordination, and framing and alignment. Nurses asked significantly more questions than residents (Mresident = 2.06 and Mnurse = 5.52) by a factor of 1.76 (P < 0.001). Unit increase in listening behaviors was associated with an increase in the number of questions during resident and nurse handoffs by 7% and 12%, respectively.

Discussion and Conclusion

As suggested by the Joint Commission, question-asking behaviors were common across resident and nurse handoffs, playing a critical role in supporting resilience in communication and collaborative cross-checks during conversations. The role of listening in initiating question-asking behaviors is discussed.
Combined signature of rumen microbiome and metabolome in dairy cows with different feed intake levels
Authors: Li Yeqing Q , Xi Yumeng M , Wang Zedong D , Zeng Hanfang F , Han Zhaoyu
Published: March 2020

Feed intake is a major factor in maintaining the balance between ruminal fermentation and the microbial community of dairy cows. To explore the relationship among feed intake, microbial metabolism, and ruminal fermentation, we examined the combined signatures of the microbiome and metabolome in dairy cows with different feed intake levels. Eighteen dairy cows were allocated to high feed intake (HFI), medium feed intake (MFI), and low feed intake (LFI) groups according to their average daily feed intake. 16S rDNA sequencing results revealed that the relative abundance of Firmicutes in the HFI group was significantly higher than that in the MFI and LFI groups (P < 0.05). The ratio of Bacteroidetes to Firmicutes was significantly lower in the HFI group than in the MFI and LFI groups (P < 0.05). The relative abundance of Lachnospiraceae_unclassified, Veillonellaceae_unclassified, and Saccharofermentants was significantly higher in the HFI group than in the LFI and MFI groups (P < 0.05). The relative abundance of Erysipelotrichaceae_unclassified and Butyrivibrio was significantly higher in the HFI group than in the MFI and LFI groups (P < 0.05). Ultra high performance liquid chromatography-mass spectrometry revealed five key pathways, including the linoleic acid metabolism pathway, alpha-linolenic acid metabolism, arginine and proline metabolism, glutathione metabolism, and valine, leucine, and isoleucine biosynthesis, which are closely related to energy and amino acid metabolism. Linoleic acid, glutamate, alpha-linolenic acid, l-methionine, and l-valine levels were significantly lower in the HFI group than in the MFI and LFI groups (q < 0.05), while the relative content of glutamate was significantly lower in the MFI group than in the LFI group (q < 0.05). Stearic acid content was significantly higher in the HFI group than in the LFI group (q < 0.05). Our findings provide insight into the rumen microbiome of dairy cows with different feed intake and the metabolic pathways closely associated with feed intake in early-lactating cows. The candidates involved in these metabolic pathways may be useful for identifying variations in feed intake. The signatures of the rumen microbiome and metabolome in dairy cows may help make decisions regarding feeding.
Systematic analysis of needs and requirements for the design of smart manufacturing systems in SMEs☆
Authors: Rauch Erwin , Vickery Andrew R
Published: March 2020

With the increasing trend of the Fourth Industrial Revolution, also known as Industry 4.0 or smart manufacturing, many companies are now facing the challenge of implementing Industry 4.0 methods and technologies. This is a challenge especially for small and medium-sized enterprises, as they have neither sufficient human nor financial resources to deal with the topic sufficiently. However, since small and medium-sized enterprises form the backbone of the economy, it is particularly important to support these companies in the introduction of Industry 4.0 and to develop appropriate tools. This work is intended to fill this gap and to enhance research on Industry 4.0 for small and medium-sized enterprises by presenting an exploratory study that has been used to systematically analyze and evaluate the needs and translate them into a final list of (functional) requirements and constraints using axiomatic design as scientific approach.
Plant Preferences of Z-Pheromone Race Ostrinia nubilalis (Lepidoptera: Crambidae) Based on Leaf Tissue Consumption Rates
Authors: Fisher Kelsey E , Flexner J Lindsey , Mason Charles E
Published: March 2020

European corn borer, Ostrinia nubilalis Hübner (Lepidoptera: Crambidae), has been present in the United States for over 100 yr and documented on >200 plant species, including economically valuable crops. The reported preferred host of O. nubilalis is corn, Zea mays L. (Cyperales: Poaceae), although it is considered to be a generalist agricultural pest. Life cycles of the two pheromone races, E and Z, align with the seasonality of different agricultural plants. Since the introduction of Bt corn in 1996, overall O. nubilalis presence has declined and suggests that alternative crop plants might not be suitable hosts. We investigated plant vegetation preference of third-instar Z-race O. nubilalis for leaf disks of corn and a variety of other crops using 48 h no-choice and choice tests. Z-race larvae gained more mass on V6 non-Bt field corn leaf disks in comparison to other plant species options. Additionally, a preference for non-Bt field corn leaf disks was observed in most comparisons. Higher consumption of cucumber, Cucumis sativus L. (Cucurbitales: Cucurbitaceae), leaf disks as compared to non-Bt field corn leaf disks suggested an ability to feed on excised leaf tissues of a plant species that does not induce defenses to herbivory.
Why the Axiom of Choice Sometimes Fails
Authors: Victoria Pallares-Vega Ivonne
Published: March 2020

The early controversies surrounding the axiom of choice are well known, as are the many results that followed concerning its (in)dependence from, and equivalence to, other mathematical propositions. This paper focuses not on the logical status of the axiom but rather on showing why it fails in certain categories.