bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system
Authors: Fabiani Massimo , Mateo-Urdiales Alberto , Andrianou Xanthi , Bella Antonino , Del Manso Martina , Bellino Stefania , Rota Maria C , Boros Stefano , Vescio Maria F , D'Ancona Fortunato P , Siddu Andrea , Punzo Ornella , Filia Antonietta , Brusaferro Silvio , Rezza Giovanni , Dente Maria G , Declich Silvia , Pezzotti Patrizio , Riccardo Flavia ,   for the COVID-19 Working Group
Published: December 2020

Background

International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees.

Methods

We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis.

Results

We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33–1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07–1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01–1.75).

Conclusions

A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.
A Multimedia Jesuit Event: The Celebration for St Ignatius and St Francis Xavier (Milan, 1622)
Authors: Ardissino Erminia
Published: December 2020

The events organized in April 1622 in Milan to celebrate the canonization of St Ignatius and St Francis Xavier clearly show how the Catholic Church of the time, the Jesuits especially, used a combination of different sensory elements to reinforce Christian belief in the congregation. The deeds of the two Saints were represented in large pictures, displayed in the Jesuit area of Milan, and were recounted by choirs singing hymns and prayers. Moreover, there was a procession of allegorical carts representing the arts taught at the local Jesuit college of Brera. The event was recorded in a Breve relatione (1622) which allows us not only to reconstruct what happened, but also to understand why the Jesuits placed such great confidence in the efficacy of this multimedial communication strategy.
Overcorrection of the acetabular roof angle or anterior center–edge angle may cause decrease of range of motion after curved periacetabular osteotomy
Authors: Hayashi Shinya , Hashimoto Shingo , Matsumoto Tomoyuki , Takayama Koji , Kamenaga Tomoyuki , Niikura Takahiro , Kuroda Ryosuke
Published: December 2020

The aim of this study was to evaluate the relationship between the correction of radiographic parameters and clinical range of motion (ROM) after periacetabular osteotomy (PAO). Sixty-nine patients with hip dysplasia were enrolled and underwent curved PAO. The pre- and post-operative 3D center–edge (CE) angles, total anteversion (acetabular and femoral anteversion), and radiographic acetabular roof angle were measured and compared with the post-operative ROM. The aim of surgery was to rotate the central acetabular fragment laterally without anterior or posterior rotation. Multiple linear regression analysis demonstrated that post-operative internal rotation at 90° flexion was significantly associated with the post-operative Tönnis sourcil angle (rr = 0.31, P = 0.02) and that the post-operative ROM of flexion and internal rotation at 90° flexion were significantly associated with the anterior CE (flex; rr = −0.44, P = 0.001, internal rotation at 90° flexion; rr = −0.44, P < 0.001). However, we found no association between the lateral CE, femoral anteversion, or total anteversion and the post-operative ROM. We demonstrated that the overcorrection of the acetabular roof angle or anterior CE angle may cause a decrease in the range of motion after curved PAO. Therefore, surgeons need to be careful during surgery to prevent the overcorrection of the weight-bearing area and anterior acetabular coverage of the acetabular fragment to avoid femoroacetabular impingement after PAO.
Reconstructing vegetation and climate in the Nihewan Basin, North China, during the middle Pleistocene (~603–587 ka) to trace the evolution of human environments
Authors: Zhu Yun , Yao Yi-Feng , Wei Qi , Ferguson David K , Wang Yu-Fei
Published: December 2020

Aims

The Nihewan Basin of North China, considered the cradle of Eastern civilization, contains a set of late Cenozoic strata and artifacts used by Homo erectus in the early Pleistocene (~1.66 Ma to 780 ka) and the cranial bones and teeth of early H. sapiens from the late middle Pleistocene (~370 to 260 ka). Palynological studies provide an opportunity to explore the living environment of early humans.

Methods

Palynological samples from the Hutouliang Section (~603–587 ka) of the Xiaodukou Formation of the Nihewan Basin were treated by heavy liquid flotation. Based on the palynological assemblages from the section, vegetation and climate in the Nihewan Basin were reconstructed.

Important Findings

The dynamic vegetation changed from temperate needle- and broad-leaved mixed forest-steppe (mainly Picea, Abies, Betula, Juglans, Artemisia and Chenopodiaceae) to conifer forest (mainly Pinus, Picea and Abies), which saw the replacement of H. erectus by early H. sapiens. The comparison of the Nihewan Basin with other human sites around the world during the same period reveals that early humans preferred to live in caves, accompanied by relatively open steppe or forest-steppe environments, inhabited by numerous mammals. Therefore, it is inferred that the emergence of dense conifer forest and the disappearance of open steppe environments in the Nihewan Basin at approximately 603–587 ka provide new evidence that early humans followed most mammals to steppe or forest-steppe environments and thus left the Nihewan Basin. These new findings not only enrich our knowledge of early human behavior, such as their diet, migration and settlement, but also fill in gaps in paleovegetation and paleoenvironmental research in the Nihewan Basin during the middle Pleistocene (780–400 ka).
A Rodent Model of Sulfur Mustard Hematologic Toxicity for the Efficacy Evaluation of Candidate Medical Countermeasures
Authors: Beske Phillip H , Wilhelm Christina M , Harvilchuck Jill A , Platoff Jr. Gennady E , Yeung David T
Published: December 2020

Introduction

While exposure to sulfur mustard (SM) is commonly associated with the production of vesicating dermal, ocular, and respiratory injuries, systemic damage to bone marrow and lymphatic tissue can decrease critical immune cell populations leading to higher susceptibility to life-threatening infection and septicemia. There are currently no approved medical countermeasures for SM-induced myelosuppression. An intravenous SM challenge model was developed in adult rats as a preliminary proof-of-principle platform to evaluate the efficacy of candidate immunostimulants.

Materials and Methods

Adult male and female Sprague Dawley rats were exposed to SM through tail vein injection. Toxicity progression was monitored through clinical observations, body weights, body temperatures, hematology, serum clinical chemistry, and flow cytometry of blood and bone marrow samples.

Results

Following SM exposure, overt toxicity progression was characterized by weight loss, changes in body temperature, and manifestation of toxic clinical signs (diarrhea, lethargy, hunched posture, rough hair coat, respiratory distress, and death). Drastic alterations in complete blood cell profiles included an early-onset lymphopenia followed by a delayed-onset neutropenia and thrombocytopenia. Only transient changes in serum clinical chemistry parameters were observed. Flow cytometry analysis of circulating blood revealed that B-cells were more predominantly affected by SM exposure than T-cells. Challenge with SM resulted in loss of hematopoietic and mesenchymal stem cell populations in the bone marrow.

Conclusions

The small animal model developed in this study replicates many key aspects of human SM exposures and should serve as a relevant, rapid, and cost-effective platform to screen candidate medical countermeasures for SM-induced hematologic toxicity.
Complicity and Normative Control
Authors: Bennett Christopher
Published: December 2020

A distinctive nonconsequentialist argument for criminalisation and punishment claims that the citizens of a state that did not criminalise serious mala in se perpetrated in its jurisdiction would be complicit in their commission. However, one objection to such an argument is that such citizens cannot be complicit because they play no causal role in the commission of the offence. Against this objection, I argue that causal contribution is unnecessary, and that one way in which a secondary agent can become complicit in a principal’s wrongdoing is if they allow that wrongdoing to be carried out in a domain over which they have authority, and with their permission. As a result of giving permission, the agent shares in the principal’s blameworthiness.
Developing an end-to-end simulation framework of supernova neutrino detection
Authors: Mori Masamitsu , Suwa Yudai , Nakazato Ken’ichiro , Sumiyoshi Kohsuke , Harada Masayuki , Harada Akira , Koshio Yusuke , Wendell Roger A.
Published: December 2020

Massive stars can explode as supernovae at the end of their life cycle, releasing neutrinos whose total energy reaches $10^{53}{\rm\, erg}$. Moreover, neutrinos play key roles in supernovae, heating and reviving the shock wave as well as cooling the resulting proto-neutron star. Therefore, neutrino detectors are waiting to observe the next galactic supernova, and several theoretical simulations of supernova neutrinos are underway. While these simulations concentrate mainly on only the first second after the supernova bounce, the only observation of a supernova with neutrinos, SN 1987A, revealed that neutrino emission lasts for more than 10 seconds. For this reason, long-time simulation and analysis tools are needed to compare theories with the next observation. Our study develops an integrated supernova analysis framework to prepare an analysis pipeline for treating galactic supernovae observations in the near future. This framework deals with the core-collapse, bounce, and proto-neutron star cooling processes, as well as with neutrino detection on Earth in a consistent manner. We have developed a new long-time supernova simulation in one dimension that explodes successfully and computes the neutrino emission for up to 20 seconds. Using this model we estimate the resulting neutrino signal at the Super-Kamiokande detector to be about 1800 events for an explosion at 10 kpc, and we discuss the implications of this. We compare this result with the SN 1987A observation to test its reliability.
Similarities in Cortical Transcriptome Alterations Between Schizophrenia and Bipolar Disorder Are Related to the Presence of Psychosis
Authors: Enwright John F , Lewis David A
Published: December 2020

Schizophrenia (SCZ) and bipolar disorder (BP) share a number of features. For example, multiple transcriptome analyses have reported molecular alterations common to both diagnoses, findings supported by the considerable overlap in the genetic risk for each disorder. These molecular similarities may underlie certain clinical features that are frequently present in both disorders. Indeed, many individuals with BP exhibit psychosis, and some individuals with SCZ have prominent mood symptoms that warrant the diagnosis of schizoaffective disorder (SA). To explore the potential relationships between molecular alterations and certain clinical features among subjects with these diagnoses, we analyzed RNA sequencing data from the dorsolateral prefrontal and anterior cingulate cortices, provided by the CommonMind Consortium, in subjects from the University of Pittsburgh Brain Tissue Donation Program. Relative to unaffected comparison subjects, in each brain region, robust differential gene expression was present only in SCZ, including a lower expression of genes involved in mitochondrial function and an elevated expression of immune-related genes. However, correlation analyses showed that BP subjects had similar, although less pronounced, gene expression alterations. Comparisons across subgroups of subjects revealed that the similarities between SCZ and BP subjects were principally due to the BP subjects with psychosis. Moreover, the gene expression profile in BP subjects with psychosis was more similar to “pure” SCZ and SA subjects than to BP subjects without psychosis. Together, these analyses suggest that similarities in gene expression between SCZ and BP are at least partially related to the presence of psychosis in some BP subjects.
Implementing a Hospital-Based Safe Sleep Program for Newborns and Infants
Authors: Patrick Patricia A. , Canter Jennifer F. , Brumberg Heather L. , Dozor Donna , Aboudi David , Smith Marichu , Sandhu Sumeet , Trinidad Nathalie , LaGamma Edmund , Altman Robin L.
Published: December 2020

Background:

An unsafe sleep environment remains the leading contributor to unexpected infant death.

Purpose:

To determine the effectiveness of a quality improvement initiative developed to create a hospital-based safe sleep environment for all newborns and infants.

Methods:

A multidisciplinary team from the well-baby nursery (WBN) and neonatal intensive care unit (NICU) of a 149-bed academic, quaternary care, regional referral center developed and implemented safe sleep environments within the hospital for all prior to discharge. To monitor compliance, the following were tracked monthly: documentation of parent education, caregiver surveys, and hospital crib check audits. On the inpatient general pediatric units, only hospital crib check audits were tracked. Investigators used Plan-Do-Study-Act (PDSA) cycles to evaluate the impact of the initiative from October 2015 through February 2018.

Results:

Safe sleep education was documented for all randomly checked records (n = 440). A survey (n = 348) revealed that almost all caregivers (95.4%) reported receiving information on safe infant sleep. Initial compliance with all criteria in WBN (n = 281), NICU (n = 285), and general pediatric inpatient units (n = 121) was 0%, 0%, and 8.3%, respectively. At 29 months, WBN and NICU compliance with all criteria was 90% and 100%, respectively. At 7 months, general pediatric inpatient units' compliance with all criteria was 20%.

Implications for Practice:

WBN, NICU and general pediatric inpatient unit collaboration with content experts led to unit-specific strategies that improved safe sleep practices.

Implications for Research:

Future studies on the impact of such an initiative at other hospitals are needed.
The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy
Authors: Bayraktar Sema , Balcı Serap , Ince Zeynep
Published: December 2020

Background:

The use of heated and humidified gas during mechanical ventilation is routine care in neonatal intensive care units. Giving gas at inadequate heat and humidity levels can affect neonatal morbidity and mortality.

Purpose:

To compare the effects of 2 humidifier temperature settings on the temperature and humidity of the inspired gas and the physiologic parameters in preterm newborns receiving mechanical ventilation.

Methods:

The research was conducted in a single-group quasi-experimental design. Proximal temperature was measured using a humidity heat transmitter. The humidifier temperature was set at 38°C (temperature I) and then at 39°C (temperature II).

Results:

The mean proximal temperatures were significantly lower than the values set in the humidifier (33.8 ± 1.20°C at temperature I, and 34.06 ± 1.30°C at temperature II, P < .001). However, the difference between the 2 proximal temperatures was not significant (P = .162). The incubator temperature was found to be effective on the proximal gas temperature (P < .05). It was found that only preterm infants in the temperature II group had a higher mean heart rate (P < .05).

Implications for Practice:

Incubator temperatures may have an effect on inspired gas temperature in preterm infants who are mechanically ventilated and caregivers should be aware of these potentially negative effects.

Implications for Research:

Future studies should focus on how to measure the temperature and humidity of gas reaching infants in order to prevent heat and humidity losses.
Recovering Together
Authors: McGlothen-Bell Kelly , Recto Pamela , McGrath Jacqueline M. , Brownell Elizabeth , Cleveland Lisa M.
Published: December 2020

Background:

Over the past 2 decades, the prevalence of neonatal abstinence syndrome (NAS) has increased almost 5-fold. Skin-to-skin care (SSC), a method of parent–infant holding, is a recommended nonpharmacologic intervention for managing NAS symptoms. SSC has the potential to reduce withdrawal symptoms while positively influencing parent–infant attachment. Yet, little is known about the SSC experiences of mothers of infants with NAS.

Purpose:

The purpose of this study was to explore the SSC experiences of mothers of infants with NAS, including perceived barriers to SSC in the hospital and following discharge home.

Methods:

A qualitative descriptive design was used to obtain new knowledge regarding the experience of SSC of mothers of infants with NAS. Purposive sampling was used to recruit participants eligible for the study. We conducted semistructured individual interviews with postpartum mothers of infants with NAS. Data were analyzed using thematic analysis.

Findings/Results:

Thirteen mothers participated in the study. Four themes emerged from the data analysis: “a little nerve racking”; “she needed me, and I needed her”; dealing with the “hard times”; and “a piece of my puzzle is missing.” SSC was described as a conduit for healing and bonding; in addition, several barriers to SSC were reported.

Implications for Practice and Research:

These findings highlight the inherent benefits of SSC for infants with NAS and demonstrate the unique challenges of these mother–infant dyads. Critical changes in hospital practices are needed to create an environment supportive of SSC for this patient population. In addition, research regarding implementation of interventions to increase SSC usage in this population is warranted.
BRAIN HEALTH ASSESSMENT IN MACULAR DEGENERATION PATIENTS UNDERGOING INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS (THE BHAM STUDY)
Authors: Ray Subhransu K. , Manz Sarah N.
Published: December 2020

Purpose:

After intravitreal injection, anti–vascular endothelial growth factor (VEGF) agents are found in the systemic circulation and can suppress systemic VEGF levels. Neuronal health and cognitive function in the central nervous system have been associated with normal physiological levels of VEGF expression. We wished to determine whether there was an association between cumulative anti-VEGF exposure and cognitive function.

Methods:

One hundred and seventy-five patients aged 65 to 85 with vision of at least 20/50 or better in one eye and a diagnosis of age-related macular degeneration took an iPad-based brain health assessment to determine their risk of mild cognitive impairment. The result for each patient was compared with the total number of anti-VEGF injections per individual patient. Patients were then stratified into groups with 0 injections (control), 1 to 9 injections, 10 to 20 injections, or greater than 20 injections.

Results:

The group of patients with more than 20 injections had a higher likelihood of mild cognitive impairment compared with the control group, with statistically significant worse mean Z-scores (P = 0.04).

Conclusion:

Our study is the first to associate worsening cognitive health with higher cumulative anti-VEGF injections. This study was not designed to show a causal link, but does suggest that additional investigation is warranted.
Therapy Dog Effects on Nursing Student Stress
Authors: Hall Deborah , Duke Gloria
Published: December 2020

Background

Nursing students experience stress levels that may interfere with success in rigorous nursing programs. While evidence indicates therapy dogs can decrease stress, no intervention standards exist, and outcomes are usually measured with questionnaires.

Purpose

The purpose of this research was to enhance empirical evidence supporting a campus therapy dog by explaining the therapy dog's effect on nursing student stress.

Methods

The research used an embedded mixed-methods design. Introductory-level students interacted with a therapy dog on designated days. They measured stress using a smartphone application and Cohen's Perceived Stress Scale. Focus group discussion and program graduate surveys provided qualitative data explaining quantitative results.

Results

Results supported use of a campus therapy dog to decrease nursing student stress.

Conclusions

The therapy dog's regular presence on campus may have improved student outcomes by decreasing stress and improving focus.
The integration between and common prosperity of government and market: China's experience of economic development
Authors: Hu Leming
Published: December 2020

Purpose

The relationship between government and market is the key to the economic development performance of market economy countries. Due to the limits such as the state/market dichotomy, the focus on static allocation efficiency and the ignorance of the diversity of the market economy and the relationship between government and market, economic liberalism and state interventionism can hardly position and explain the role and evolution of government and market in the real world accurately.

Design/methodology/approach

China’s economic transition has always adhered to the reform direction of the socialist market economy and the development goal of a modern socialist country as well as the symbiosis and positive and progressive evolution of government and market, blazing a “third way” in handling the relationship between government and market.

Findings

The “China’s experience” shows that the key for emerging market economies to achieve good economic development performance lies in whether they can build a new relationship of the mutual integration between and common prosperity of government and market regarding target selection, production organisation, technological innovation, institutional change and regulatory adjustment.

Originality/value

The second part of this paper analyses the inherent defects of economic liberalism and state interventionism as well as the reasons why they can hardly be adopted as the theoretical guidance for emerging market economies to handle the relationship between government and market. The third part analyses how China has transcended the inherent thinking of liberalism and interventionism and shaped the new relationship between government and market through goal-oriented, active and progressive, two-way interactive exploration and practice to ensure the success of China's economic transition.
A randomised controlled trial of motivational interview for relapse prevention after release from smoke-free prisons in Australia
Authors: Jin Xingzhong , Kinner Stuart Alistair , Hopkins Robyn , Stockings Emily , Courtney Ryan James , Shakeshaft Anthony , Petrie Dennis , Dobbins Timothy , Puljevic Cheneal , Chang Shuai , Dolan Kate
Published: December 2020

Purpose

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.

Design/methodology/approach

This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.

Findings

From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).

Research limitations/implications

A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.

Originality/value

This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.
A network-based four-phase routing approach of multisource design change propagation on complex products
Authors: Zhang Na , Li Mengze , Ren Haibing , Li Yupeng
Published: December 2020

Purpose

The development of complex products and systems is a continuously iterative process from customer requirements to a mature design. Design changes derived from multisources occur frequently during the design process. Furthermore, change propagation will impose impacts on design costs and lead times. In view of this, how to predict and control the propagation of multisource design change to reduce the changes impact is an urgent issue in the development of complex product.

Design/methodology/approach

In this paper, a new four-phase routing approach based on weighted and directed complex networks is proposed for multisource design change propagation. Phase I: as the foundation of this research, a product network model is established to quantify describe the complex product. Phase II: the hub nodes are identified based on the LeaderRank algorithm, which can be regarded as multisource nodes of design changes. Phase III: a calculation method for change propagation intensity is proposed, which improves the systematicness and accuracy of the evaluation results. In this paper, change propagation intensity is defined by four assessment factors: importance degree of parts, execution time of design tasks, coupling strength between parts and propagation likelihood. Phase IV: a routing method of multisource design change propagation and ant colony optimization algorithm are proposed in this paper, which can solve the coupling conflicts among change propagation paths and improve the search efficiency by using the parallel search strategy.

Findings

The proposed method and another method are used to search the optimal propagation path of multisource design change of a motorcycle engine; the results indicate that this method designed in this study has a positive effect on reducing the change impact, market response time and product design costs when design change occurs in the products design process.

Originality/value

The authors find a new method (a network-based four-phase routing approach) to search the optimal propagation path of multisource design change in complex products design.
Effect of age and comorbidity on the ability of quick‐Sequential Organ Failure Assessment score to predict outcome in emergency department patients with suspected infection
Authors: Williams Alex , Griffies Thomas , Damianopoulos Sophie , Fatovich Daniel , Macdonald Stephen
Published: December 2020

Objective

To determine if a combination of the Charlson Comorbidity Index (CCI) and quick‐Sequential Organ Failure Assessment (qSOFA) score is superior to qSOFA alone for predicting the outcome of ED patients with suspected infection.

Methods

A prospective, observational single‐centre study recruited consecutive adult patients who underwent blood culture collection in the ED and were admitted to hospital. The primary outcome was 28‐day in‐hospital mortality, and the secondary outcome a composite of mortality and/or ICU admission ≥72 h duration. The qSOFA and CCI were combined using logistic regression models, and the resulting area under the receiver operating characteristic curve (AUROC) compared to that for qSOFA alone.

Results

Of 551 patients recruited, 18 (3%) died and 27 (5%) attained the composite outcome. The AUROC for qSOFA/CCI versus qSOFA for the primary outcome is 0.79 versus 0.72 (95% confidence interval 0.71–0.88 vs 0.62–0.82, P = 0.055) and 0.80 versus 0.76 (95% confidence interval 0.73–0.86 vs 0.68–0.84, P = 0.048). Deaths among patients not admitted to ICU (12/495) accounted for most of the overall differences in AUROC.

Conclusions

This generates the hypothesis that age and comorbid disease status augment the qSOFA score for predicting adverse outcome among patients with suspected infection in the ED. The results may reflect the predominance of these factors in determining suitability for admission to ICU. Reported limitations of qSOFA to detect the risk of adverse outcome may reflect the influence of unmeasured patient factors.
PD‐L1+ dendritic cells in the tumor microenvironment correlate with good prognosis and CD8+ T cell infiltration in colon cancer
Authors: Miller Timothy J. , Anyaegbu Chidozie C. , Lee‐Pullen Tracey F. , Spalding Lisa J. , Platell Cameron F. , McCoy Melanie J.
Published: December 2020

Background

The prognostic value of tumor‐associated dendritic cells (DC) in colon cancer remains poorly understood. This may be in part due to the interchangeable expression of immunostimulatory and immunoinhibitory molecules on DC. Here we investigated the prognostic impact of CD11c+ DC co–expressing the immunoinhibitory molecule PD‐L1 and their spatial relationship with CD8+ T‐cells in patients treated for stage III colon cancer.

Methods

Tissue microarrays containing representative cores of central tumor, leading edge, and adjacent normal tissue from 221 patients with stage III colon cancer were immunostained for CD8, CD11c, PD‐L1, and cytokeratin using immunofluorescent probes. Cells were quantified using StrataQuest digital image analysis software, with intratumoral and stromal regions analyzed separately. Kaplan‐Meier estimates and Cox regression were used to assess survival.

Results

Intratumoral CD8+ cell density (HR = .52, 95% confidence interval [CI] .33‐.83, P = .007), stromal CD11c+ cell density (HR = .52, 95% CI .33‐.83, P = .006), intratumoral CD11c+PD‐L1+ cell density (HR = .57, 95% CI .35‐.92, P = .021), and stromal CD11c+PD‐L1+ cell density (HR = .48, 95% CI .30‐.77, P = .003) on leading‐edge cores were all significantly associated with good survival. CD8+ cell density was positively correlated with both CD11c+ cell density and CD11c+PD‐L1+ cell density in tumor epithelium and stromal compartments.

Conclusion

Here we showed that PD‐L1‐expressing DC in the tumor microenvironment are associated with improved survival in stage III colon cancer and likely reflect an immunologically “hot” tumor microenvironment. Further investigation into the expression of immunomodulatory molecules by tumor‐associated DC may help to further elucidate their prognostic value.
Genomic vulnerability to rapid climate warming in a tree species with a long generation time
Authors: Dauphin Benjamin , Rellstab Christian , Schmid Max , Zoller Stefan , Karger Dirk N. , Brodbeck Sabine , Guillaume Frédéric , Gugerli Felix
Published: December 2020

The ongoing increase in global temperature affects biodiversity, especially in mountain regions where climate change is exacerbated. As sessile, long‐lived organisms, trees are especially challenged in terms of adapting to rapid climate change. Here, we show that low rates of allele frequency shifts in Swiss stone pine (Pinus cembra) occurring near the treeline result in high genomic vulnerability to future climate warming, presumably due to the species’ long generation time. Using exome sequencing data from adult and juvenile cohorts in the Swiss Alps, we found an average rate of allele frequency shift of 1.23 × 10−2/generation (i.e. 40 years) at presumably neutral loci, with similar rates for putatively adaptive loci associated with temperature (0.96 × 10−2/generation) and precipitation (0.91 × 10−2/generation). These recent shifts were corroborated by forward‐in‐time simulations at neutral and adaptive loci. Additionally, in juvenile trees at the colonisation front we detected alleles putatively beneficial under a future warmer and drier climate. Notably, the observed past rate of allele frequency shift in temperature‐associated loci was decidedly lower than the estimated average rate of 6.29 × 10−2/generation needed to match a moderate future climate scenario (RCP4.5). Our findings suggest that species with long generation times may have difficulty keeping up with the rapid climate change occurring in high mountain areas and thus are prone to local extinction in their current main elevation range.
B regulatory cells in allergy
Authors: Ma Siyuan , Satitsuksanoa Pattraporn , Jansen Kirstin , Cevhertas Lacin , van de Veen Willem , Akdis Mübeccel
Published: December 2020

B cells have classically been recognized for their unique and indispensable role in the production of antibodies. Their potential as immunoregulatory cells with anti‐inflammatory functions has received increasing attention during the last two decades. Herein, we highlight pioneering studies in the field of regulatory B cell (Breg) research. We will review the literature on Bregs with a particular focus on their role in the regulation of allergic inflammation.
Incidence of adverse cardiovascular events in type 2 diabetes mellitus patients after initiation of glucose‐lowering agents: A population‐based community study from the Shizuoka Kokuho database
Authors: Kohsaka Shun , Kumamaru Hiraku , Nishimura Shiori , Shoji Satoshi , Nakatani Eiji , Ichihara Nao , Yamamoto Hiroyuki , Miyachi Yoshiki , Miyata Hiroaki
Published: December 2020

Aims/Introduction

Increased incidence of hospitalization for heart failure (HHF) among patients with diabetes is increasingly being reported. We investigated the incidence of adverse cardiovascular events including HHF among patients with type 2 diabetes mellitus, and the potential clinical improvement with sodium–glucose cotransporter 2 inhibitors (SGLT2i) using a contemporary administrative claims database from a large governmental district of Japan.

Materials and Methods

We included initiators of any oral glucose‐lowering drugs between 2013 and 2018. We estimated the 5‐year cumulative incidence of hospitalization for HF, myocardial infarction and stroke, treating death as a competing risk. We evaluated the possible impact of introducing SGLT2i to the potential recipients of the drug, using the inclusion criteria from Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA‐REG OUTCOME) and Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (DECLARE‐TIMI 58) trials, assuming the same risk reduction as theirs.

Results

Among 23,340 drug initiators (54.0% men, and 6.4% aged >85 years), the 5‐year cumulative incidence was 5.4% (95% confidence interval 4.9–5.9%) for HHF, 1.9% (95% confidence interval 1.7–2.2%) for myocardial infarction admission and 6.1% (95% confidence interval 5.7–6.6%) for stroke admission. Among 6,192 patients with laboratory test data, 651 (10.5%) and 2,680 (43.3%) patients met the EMPA‐REG‐like and DECLARE‐like criteria, respectively. The 5‐year cumulative incidence among the 2,849 patients meeting either of the criteria was estimated to decrease from 97.1 to 75.6 events through 75% adoption of SGLT2i.

Conclusions

The incidence of HHF was similar to that of stroke. A significant portion of our cohort met the inclusion criteria for major randomized clinical trials for SGLT2i, and estimated reduction in the HHF events was substantial.
Anatomy, ontogeny, and evolution of the archosaurian respiratory system: A case study on Alligator mississippiensis and Struthio camelus
Authors: Schachner Emma R. , Hedrick Brandon P. , Richbourg Heather A. , Hutchinson John R. , Farmer CG
Published: December 2020

The avian lung is highly specialized and is both functionally and morphologically distinct from that of their closest extant relatives, the crocodilians. It is highly partitioned, with a unidirectionally ventilated and immobilized gas‐exchanging lung, and functionally decoupled, compliant, poorly vascularized ventilatory air‐sacs. To understand the evolutionary history of the archosaurian respiratory system, it is essential to determine which anatomical characteristics are shared between birds and crocodilians and the role these shared traits play in their respective respiratory biology. To begin to address this larger question, we examined the anatomy of the lung and bronchial tree of 10 American alligators (Alligator mississippiensis) and 11 ostriches (Struthio camelus) across an ontogenetic series using traditional and micro‐computed tomography (µCT), three‐dimensional (3D) digital models, and morphometry. Intraspecific variation and left to right asymmetry were present in certain aspects of the bronchial tree of both taxa but was particularly evident in the cardiac (medial) region of the lungs of alligators and the caudal aspect of the bronchial tree in both species. The cross‐sectional area of the primary bronchus at the level of the major secondary airways and cross‐sectional area of ostia scaled either isometrically or negatively allometrically in alligators and isometrically or positively allometrically in ostriches with respect to body mass. Of 15 lung metrics, five were significantly different between the alligator and ostrich, suggesting that these aspects of the lung are more interspecifically plastic in archosaurs. One metric, the distances between the carina and each of the major secondary airways, had minimal intraspecific or ontogenetic variation in both alligators and ostriches, and thus may be a conserved trait in both taxa. In contrast to previous descriptions, the 3D digital models and CT scan data demonstrate that the pulmonary diverticula pneumatize the axial skeleton of the ostrich directly from the gas‐exchanging pulmonary tissues instead of the air sacs. Global and specific comparisons between the bronchial topography of the alligator and ostrich reveal multiple possible homologies, suggesting that certain structural aspects of the bronchial tree are likely conserved across Archosauria, and may have been present in the ancestral archosaurian lung.
Influence of salinity on survival, growth, hemolymph osmolality, gill sodium potassium ATPase activity, and sodium potassium chloride co‐transporter expression in the redclaw crayfish Cherax quadricarinatus
Authors: Rida Reem , Zein‐Eddine Razan , Kreydiyyeh Sawsan , Garza de Yta Antonio , Saoud Imad Patrick
Published: December 2020

The Australian redclaw crayfish Cherax quadricarinatus is a freshwater crustacean aquacultured in many countries. Redclaw crayfish are often exposed to saline waters in attempts to improve flavor, to relieve stress during transport, and to prevent or treat parasitic infestations. However, the effect of salinity on the crayfish osmoregulatory process is not well studied. In the present work, we assessed the effect of various salinities on survival, growth, and osmoregulation in redclaw crayfish. Adult crayfish were maintained at seven salinities (0, 2, 4, 6, 8, 10, and 12 ppt) for 4 weeks, and hemolymph osmolality, gill sodium potassium ATPase activity, and sodium potassium chloride cotransporter expression were assessed. In another experiment, juvenile crayfish were size sorted to similar weights and stocked at four salinities (0, 2, 4, and 6 ppt) for 8 weeks. The animals were group weighed every 2 weeks and individually weighed at the end of the eighth week. Hemolymph osmolality was constant as salinity increased from 0 to 10 ppt then a significant increase was observed at 12 ppt. Redclaw growth rate decreased with an increase in salinity from 0 to 6 ppt. Sodium potassium ATPase activity and sodium potassium chloride cotransporter expression increased with salinity increase. Although salinity might help treat ectoparasites, improve taste, and reduce transportation stress, long‐term exposure increases osmoregulatory metabolic costs and affects growth and energy consumption.
Compras públicas sustentáveis: Uma análise dos editais de licitação de cidades brasileiras participantes do Programa Cidades Sustentáveis
Authors: Vilar Lemos Livia , Nonato Rodrigues Raimundo , Cravo Teixeira Lagioia Umbelina , Libonati Jeronymo José
Published: December 2020

O objetivo dessa pesquisa é identificar critérios de sustentabilidade (ambiental e social) presentes nos editais de licitação de três municípios brasileiros de pequeno porte das regiões Sudeste e Sul, participantes voluntários do Projeto Cidades Sustentáveis (PCS). O parâmetro de seleção desses municípios, além da participação do PCS, é ter adotado o indicador Compras Públicas Sustentáveis (CPS) como parte do seu plano de metas do projeto. O período de elaboração da pesquisa foi de 2018 a 2019. Foram coletados e analisados 43 editais publicados em 2018. A coleta de dados nos editais de licitação foi realizada por Análise de Conteúdo (AC). Foi executada uma pesquisa bibliográfica para a construção do sistema de critérios e categorias da AC, que possibilitou a coleta e ordenação das informações obtidas. Ao realizar a análise dos dados baseada na quantidade de critérios sustentáveis identificados, verificou-se que esses editais contemplam critérios sociais e ambientais de sustentabilidade, sendo os sociais mais presentes e a maior parte deles em decorrência de prerrogativa legal de apoio as microempresas e empresas de pequeno porte.
Dominio y percepción de las NIIF por los contadores públicos en Barranquilla, Colombia
Authors: Perez Grau Samuel Leonidas
Published: December 2020

Este artículo explica el impacto que han producido los cambios del modelo contable colombiano sobre las prácticas de los contadores públicos en Barranquilla. Estos cambios se resumen en el paso de un modelo netamente fiscalista a otro que privilegia el aspecto financiero. El objetivo es describir el dominio de las NIIF sobre las prácticas del contador barranquillero, así como la percepción de sus efectos. Esta investigación combina la encuesta y la entrevista en profundidad, trianguladas mediante documentos soportes de estudios similares. Los resultados señalan que los contadores no se sienten adecuadamente capacitados en las NIIF ni en la regulación profesional. Igualmente, los participantes cuestionan la conveniencia de estas normas, que ven como el paso a otro sistema extraño, de tradiciones foráneas y más complejo. Se concluye que el estilo sustantivista débil del marco conceptual de las NIIF relega a los contadores solamente a la deliberación técnico contable de su práctica, sin poder discutir nacionalmente posiciones de justicia, moral y sociedad.
Development of a Loss Method for Energy and Exergy Audit of Condensing Hot Water Boilers
Authors: Banifateme Mohsen , Behbahaninia Ali , Sayadi Saeed
Published: December 2020

Condensing boilers are used in commercial and residential buildings extensively. In this article, a loss method is proposed to estimate the energy and exergy efficiencies of condensing hot water boilers. The presented method is based on the development of the method presented in ASME PTC 4.1. Energy loss terms consist of exhaust flue gas, carbon monoxide formation, radiation, and condensate outflow sensible heat. Exergy loss terms also include radiation losses, physical exergy of the exhaust flue gas, chemical exergy of the exhaust flue gas, increase in the chemical exergy of the flue gas due to carbon monoxide formation, condensate outflow exergy, boiler exergy destruction, and economizer exergy destruction. Energy and exergy efficiencies are calculated by estimation of these loss terms. To depict the method’s capability and compare results with the direct method, an experimental setup was designed and constructed. Results of energy and exergy audition of the boiler by applying the loss method are compared with the direct method. The results show that, although the condensing economizer improves energy efficiency, it does not improve the exergy efficiency significantly. The energy and exergy efficiencies were 98.65% and 5.14%, respectively.
Novel physics-based tool-prototype for electromigration assessment in commercial-grade power delivery networks
Authors: Torosyan Sofya , Kteyan Armen , Sukharev Valeriy , Choy Jun-Ho , Najm Farid N.
Published: December 2020

A recently developed novel methodology for electromigration (EM) failure assessment in power/ground grids of integrated circuits is employed in the electronic design automation tool prototype. The tool performs the analysis of stress evolution in interconnect trees for detecting EM-induced voiding locations and tracks resistance increase in the voided wires based on a physics-based model of voiding kinetics. Increased resistances of the branches of power/ground networks lead to a voltage drop increase in grid nodes. The instance in time when a designer-specified voltage-drop threshold is reached defines the EM-induced time-to-failure. Monte-Carlo simulation, performed around the core engine that simulates the stress over time using randomly generated atomic diffusivities and critical stress values, leads to the mean-time-to-failure of the grid, along with voiding probabilities of the interconnect branches.
“They May Be a Level One Student, But I Love Them All”: Preservice Teachers Negotiating Inclusion and Diversity in Their Classes
Authors: van Doodewaard Corina
Published: December 2020

Teachers are continually pressured to professionalize and to adopt measures that enhance inclusion and diversity. Professionalism can, however, have various meanings; each meaning has its own conceptualization of and approach to inclusion. The purpose of this paper is to explore how preservice teachers in physical education negotiate discourses about professionalism and how they attempt to use them to practice inclusion. Eleven Dutch preservice teachers participated in video-stimulated interviews and elaborated on their understandings of inclusion and diversity in physical education. By applying a Foucauldian lens to their understandings, the author reveals some of the complexities they encountered while being subjected to and/or positioned as agents in competing discursive practices of professionalism. The paper concludes by addressing the challenges generated from this work for future schooling practices and research in physical education teacher education.