bluuebunny/crossref_metadata_2025 huggingface dataset:
Empathy maps in communication skills training
Authors: Cairns Patrick , Pinker India , Ward Andrew , Watson Evelyn , Laidlaw Anita
Published: October 2020

Background

Empathy is a cornerstone of patient‐centred care. However, empathy levels among health care professionals and medical students are currently suboptimal. An empathy map is a tool which aids in understanding another person’s perspective. Empathy maps have up until now not been used in a medical education setting.

Objective

To assess the attitudes towards, applicability and usefulness of empathy maps as part of medical student’s communication skills training.

Methods

Empathy map training was introduced to first‐year medical student communication skills training at two UK‐based medical schools. Twenty‐eight participants in total agreed to be interviewed about their experiences using the empathy map, including sixteen students and twelve patient partners who assisted with communication skills training.

Results

Medical students and patient partners perceive value in empathy map training. Medical students stated that the empathy map training impacted on their views of empathy and patient‐centredness by highlighting the importance of patient‐centred care. Medical students and patient partners enjoyed the experience of completing the empathy map and had suggestions for how it could be improved in the future.

Conclusions

Empathy maps could provide a cost‐effective way to encourage empathic and patient‐centred care in medical education. Furthermore, there is no reason why empathy maps would not aid in any caring profession. Further research is needed to confirm that empathy maps do increase empathy.
Acceptance of open source geospatial software: Assessing QGIS in South Africa with the UTAUT2 model
Authors: Henrico Susan , Coetzee Serena , Cooper Antony , Rautenbach Victoria
Published: October 2020

Geospatial information and technologies are widely used in South Africa, initially mostly with proprietary software but today, mature, open source alternatives such as QGIS are available. We wanted to find out if and why South African users accepted QGIS, globally the most widely used free and open source GIS. We adapted the extended unified theory of acceptance and use of technology model to test several hypotheses regarding the acceptance and use of QGIS in South Africa. 205 registered members of the Geo‐Information Society of South Africa completed a structured questionnaire. Results show that habit has the most significant influence on behavioural intention to use QGIS, followed by facilitating conditions, price value and social influence. Performance expectancy, effort expectancy, hedonic motivation and access to source code played no significant role. The findings show that adoption of QGIS in South Africa is not primarily influenced by benefits attributed to open source software, such as cost benefits, customizability, improved reliability, quality and security. The results are useful for developers of any GIS product and for choosing a GIS product for an organization, because they provide insight into the behavioural intentions of users.
Use of MRI increases interobserver agreement on gross tumor volume for imaging‐diagnosed canine intracranial meningioma
Authors: Morimoto Celina Y. , Waldner Cheryl L. , Fan Vivian , Sidhu Narinder , Matthews Quinn , Randall Elissa , Griffin Lynn , Keyerleber Michele , Rancilio Nicholas , Vanhaezebrouck Isabelle , Zwueste Danielle , Mayer Monique N.
Published: October 2020

There is a lack of information regarding interobserver agreement on canine meningioma gross tumor volume (GTV) delineation, and on the impact of MRI on this agreement. The objectives of this retrospective, secondary analysis, observer agreement study were to describe agreement between veterinary radiation oncologists on GTV for canine intracranial meningioma, and to compare interobserver agreement between delineation based on CT alone and delineation based on fused CT‐MRI. Eighteen radiation oncologists delineated GTV for 13 dogs with an imaging diagnosis of meningioma on pre‐ and postcontrast CT, pre‐ and postcontrast T1‐weighted magnetic resonance, and T2‐weighted magnetic resonance images. Dice similarity coefficient (DSC), concordance index (CI), and center of volume (COV) were used to quantify interobserver agreement. Multilevel mixed models were used to examine the difference in volume, DSC, CI and COV 3D distance between CT and CT‐MR imaging. The mean volume for GTV contours delineated using fused CT‐MRI was larger than when CT alone was used for delineation (mean difference CT‐MR ‐ CT = 0.89 cm3, 95% CI 0.66 to 1.12, P < .001). Interobserver agreement on GTV was improved when MRI was used; the mean DSC and CI were higher, and the mean COV 3D distance was lower, when fused CT‐MRI was used than when CT alone was used (P < .001 for all differences). Based on our results, fused CT‐MRI is recommended for radiation therapy planning of canine intracranial meningioma.
Sol-gel synthesized indium tin oxide as a transparent conducting oxide with solution-processed black phosphorus for its integration into solar-cells
Authors: Mehta Ravindra , Min Misook , Kaul Anupama B.
Published: October 2020

In this work, indium tin oxide (ITO) thin films were synthesized using solgel processing with a mixture of InCl3, methanol, and SnCl2, where the solutions were spin coated onto glass substrates. The maximum transmittance of the ITO thin film in the visible region was found to be ∼75% for films annealed at 650 °C, where plasma treatment of the substrate was found to aid in the large-area continuity and homogeneity over the glass substrates compared to films annealed at lower temperatures. Two-dimensional (2D), semiconducting black phosphorus (BP) dispersions were then prepared by liquid exfoliation, where the black phosphorus bulk crystals were finely ground inside a glove box and dissolved in N-cyclohexyl-2-pyrrolidone. Following further treatment, the BP solution dispersions were drop cast onto the transparent ITO thin films to form heterostructures toward transparent electronics and future solar cell applications. Direct electrical probing of the black phosphorus revealed that it was electrically conducting and the currents measured were large on the order of a few microampere at ∼20 V. Raman and photoluminescence measurements on the black phosphorus revealed that the flakes ranged in thickness from few-layers up to bulk. Few-layer black phosphorus can be distinguished from the bulk through the red-shift of the Ag1, Bg2, and Ag2 peaks for bulk black phosphorus flakes compared to the few-layers’ black phosphorus flakes. Electrical measurements made in the heterostructure interfaces showed a higher magnitude of currents at the black phosphorus interface compared to the bare ITO film. The combined architecture of black phosphorus on ITO thin films shows promise in its use for transparent electronics, which can also serve as a stepping stone for future solar cell platforms.
The circadian dynamics of the hippocampal transcriptome and proteome is altered in experimental temporal lobe epilepsy
Authors: Debski K. J. , Ceglia N. , Ghestem A. , Ivanov A. I. , Brancati G. E. , Bröer S. , Bot A. M. , Müller J. A. , Schoch S. , Becker A. , Löscher W. , Guye M. , Sassone-Corsi P. , Lukasiuk K. , Baldi P. , Bernard C.
Published: October 2020

The cycling of hippocampal genes during the night and day cycle is altered in epilepsy.
A 3D atlas of the dynamic and regional variation of pancreatic innervation in diabetes
Authors: Alvarsson Alexandra , Jimenez-Gonzalez Maria , Li Rosemary , Rosselot Carolina , Tzavaras Nikolaos , Wu Zhuhao , Stewart Andrew F. , Garcia-Ocaña Adolfo , Stanley Sarah A.
Published: October 2020

Three-dimensional mapping of pancreatic innervation shows rapid remodeling of islet innervation in mouse and human diabetes.
Untangling impacts of global warming and Interdecadal Pacific Oscillation on long-term variability of North Pacific tropical cyclone track density
Authors: Zhao Jiuwei , Zhan Ruifen , Wang Yuqing , Xie Shang-Ping , Wu Qiong
Published: October 2020

Untangle the impacts of global warming and Interdecadal Pacific Oscillation on tropical cyclone track over the North Pacific.
Acceptor plane expansion enhances horizontal orientation of thermally activated delayed fluorescence emitters
Authors: Xiang Yepeng , Li Pan , Gong Shaolong , Huang Yu-Hsin , Wang Chun-Yu , Zhong Cheng , Zeng Weixuan , Chen Zhanxiang , Lee Wei-Kai , Yin Xiaojun , Wu Chung-Chih , Yang Chuluo
Published: October 2020

An acceptor plane expansion approach is demonstrated to selectively improve horizontal dipole orientation of TADF emitters.
Solar irradiance and ENSO affect food security in Lake Tanganyika, a major African inland fishery
Authors: McGlue M. M. , Ivory S. J. , Stone J. R. , Cohen A. S. , Kamulali T. M. , Latimer J. C. , Brannon M. A. , Kimirei I. A. , Soreghan M. J.
Published: October 2020

Geochemical and paleoecological data reveal that solar irradiance and La Niña control Lake Tanganyika’s pelagic food web.
Rare earth element mobility in and around carbonatites controlled by sodium, potassium, and silica
Authors: Anenburg Michael , Mavrogenes John A. , Frigo Corinne , Wall Frances
Published: October 2020

Rare earths concentrate by complexing with alkalis in carbonatite-derived hydrothermal fluids.
Harnessing the topotactic transition in oxide heterostructures for fast and high-efficiency electrochromic applications
Authors: Lim Ji Soo , Lee Jounghee , Lee Byeoung Ju , Kim Yong-Jin , Park Heung-Sik , Suh Jeonghun , Nahm Ho-Hyun , Kim Sang-Woo , Cho Byeong-Gwan , Koo Tae Yeong , Choi Eunjip , Kim Yong-Hyun , Yang Chan-Ho
Published: October 2020

High-speed, high-performance electrochromic devices can be designed using unique solid-solid phase changes induced by oxygen flow.
NAD
+
-mediated rescue of prenatal forebrain angiogenesis restores postnatal behavior
Authors: Subburaju Sivan , Kaye Sarah , Choi Yong Kee , Baruah Jugajyoti , Datta Debkanya , Ren Jun , Kumar Ashwin Srinivasan , Szabo Gabor , Fukumura Dai , Jain Rakesh K. , Elkhal Abdallah , Vasudevan Anju
Published: October 2020

Prenatal NAD
+
treatment can rescue abnormal brain development and prevent the origin of mental illness.
Injectable, photoresponsive hydrogels for delivering neuroprotective proteins enabled by metal-directed protein assembly
Authors: Jiang Bojing , Liu Xiaotian , Yang Chao , Yang Zhongguang , Luo Jiren , Kou Songzi , Liu Kai , Sun Fei
Published: October 2020

Injectable, photoresponsive protein hydrogels engender neuroprotection and neuroregeneration in optic nerves.
Blood-brain barrier–penetrating siRNA nanomedicine for Alzheimer’s disease therapy
Authors: Zhou Yutong , Zhu Feiyan , Liu Yang , Zheng Meng , Wang Yibin , Zhang Dongya , Anraku Yasutaka , Zou Yan , Li Jia , Wu Haigang , Pang Xiaobin , Tao Wei , Shimoni Olga , Bush Ashley I. , Xue Xue , Shi Bingyang
Published: October 2020

Glycosylated “triple-interaction” stabilized siRNA nanomedicine ameliorated AD neuropathology by targeting BACE1.
Dietary thiamine influences
l
-asparaginase sensitivity in a subset of leukemia cells
Authors: Guarecuco Rohiverth , Williams Robert T. , Baudrier Lou , La Konnor , Passarelli Maria C. , Ekizoglu Naz , Mestanoglu Mert , Alwaseem Hanan , Rostandy Bety , Fidelin Justine , Garcia-Bermudez Javier , Molina Henrik , Birsoy Kıvanç
Published: October 2020

Plasma thiamine concentrations affect
l
-asparaginase sensitivity of leukemia cells deficient for thiamine uptake.
Cross-reactive neutralization of SARS-CoV-2 by serum antibodies from recovered SARS patients and immunized animals
Authors: Zhu Yuanmei , Yu Danwei , Han Yang , Yan Hongxia , Chong Huihui , Ren Lili , Wang Jianwei , Li Taisheng , He Yuxian
Published: October 2020

Cross-neutralization of SARS-CoV-2 by antibodies against SARS-CoV suggests a universal vaccine strategy for emerging coronaviruses.
Unresponsiveness to inhaled antigen is governed by conventional dendritic cells and overridden during infection by monocytes
Authors: Bedford James G. , Heinlein Melanie , Garnham Alexandra L. , Nguyen Thi H. O. , Loudovaris Tom , Ge Chenghao , Mannering Stuart I. , Elliott Michael , Tangye Stuart G. , Kedzierska Katherine , Gray Daniel H. D. , Heath William R. , Wakim Linda M.
Published: October 2020

Immunity to inhaled antigens is governed by inflammatory signals that alter the composition of DC subsets within the NALTs.
Supplemental Material: Recycling of mercury from the atmosphere-ocean system into volcanic-arc–associated epithermal gold systems
Authors: Deng Changzhou , Yin Runsheng , al. et
Published: October 2020

Geological background, samples and methods, and analytical results for hydrothermal Au deposits in northeast China.
Quality assurance systems of pharmaceutical distributors in low-income and middle-income countries: weaknesses and ways forward
Authors: Nebot Giralt Ariadna , Bourasseau Anthony , White Gareth , Pouget Corinne , Tabernero Patricia , Van Assche Kerlijn , Ravinetto Raffaella
Published: October 2020

Introduction

Access to quality-assured medicines is an essential prerequisite for universal health coverage, and pharmaceutical distributors play an important role to assure the quality of medicines along the supply chain.

Methods

We retrospectively assessed the compliance with WHO quality standards, that is, the Model Quality Assurance System for Procurement Agencies (MQAS) or the good distribution practices (GDP), of a convenience sample of 75 public, private-for-profit and non-for-profit distributors, audited by QUAMED in 14 low-income and middle-income countries (LMICs) between 2017 and 2019. We calculated the compliance per quality assurance activity, and we defined the percentage of compliant distributors, that is, the percentage (%) of distributors with MQAS or GDP levels of>2 for each activity.

Results

The distributors in our sample were mainly private for-profit (66/75). Only one MQAS-audited distributor out of 11 was found compliant with all MQAS-activities, while none out of 64 GDP-assessed distributors were found compliant with all GDP activities. The GDP-assessed distributors were generally less compliant with WHO standards than MQAS-audited distributors. Common weaknesses and strengths were observed. The activities with lowest compliance were quality control, and physical storage conditions, while those with highest compliance were warehouse organisation and stock control.

Conclusions

The quality systems of pharmaceutical distributors in LMICs remain weak. For preventing harm caused by poor-quality medicines, a comprehensive and stringent regulatory oversight should be urgently implemented; the WHO MQAS-standards and GDP-standards should be incorporated in national regulations; and reliable information on the quality systems of distributors (and manufacturers from which they buy) should be publicly available.
Media trust and infection mitigating behaviours during the COVID-19 pandemic in the USA
Authors: Zhao Erfei , Wu Qiao , Crimmins Eileen M , Ailshire Jennifer A
Published: October 2020

Introduction

The COVID-19 pandemic is an unprecedented public health crisis. It is becoming increasingly clear that people’s behavioural responses in the USA during this fast-changing pandemic are associated with their preferred media sources. The polarisation of US media has been reflected in politically motivated messaging around the coronavirus by some media outlets, such as Fox News. This resulted in different messaging around the risks of infection and behavioural changes necessary to mitigate that risk. This study determined if COVID-related behaviours differed according to trust in left-leaning or right-leaning media and how differences changed over the first several months of the pandemic.

Methods

Using the nationally representative Understanding America Study COVID-19 panel, we examine preventive and risky behaviours related to infection from COVID-19 over the period from 10 March to 9 June for people with trust in different media sources: one left-leaning, CNN and another right-leaning, Fox News. People’s media preferences are categorised into three groups: (1) those who trust CNN more than Fox News; (2) those who have equal or no preferences and (3) those who trust Fox News more than CNN.

Results

Results showed that compared with those who trust CNN more than Fox news, people who trust Fox News more than CNN engaged in fewer preventive behaviours and more risky behaviours related to COVID-19. Out of five preventive and five risky behaviours examined, people who trust Fox News more than CNN practised an average of 3.41 preventive behaviours and 1.25 risky behaviours, while those who trust CNN more than Fox News engaged in an average of 3.85 preventive and 0.94 risky behaviours, from late March to June. The difference between these two groups widened in the month of May (p≤0.01), even after controlling for access to professional information and overall diversity of information sources.

Conclusions

Our findings indicate that behavioural responses were divided along media bias lines. In such a highly partisan environment, false information can be easily disseminated, and health messaging, which is one of the few effective ways to slowdown the spread of the virus in the absence of a vaccine, is being damaged by politically biased and economically focused narratives. During a public health crisis, media should reduce their partisan stance on health information, and the health messaging from neutral and professional sources based on scientific findings should be better promoted.
Improving substance misuse outcomes in contingency management treatment with adjunctive formal psychotherapy: a systematic review and meta-analysis
Authors: Sheridan Rains Luke , Steare Thomas , Mason Oliver , Johnson Sonia
Published: October 2020

Objectives

Contingency management (CM) is a treatment for substance misuse that involves the provision of incentives. This review examines the hypothesis that adding another formal psychotherapy, such as cognitive–behavioural therapy (CBT) or motivational enhancement therapy (MET), to CM improves substance use outcomes at both treatment end and at post-treatment follow-up compared with CM only.

Data sources

Searches were performed in December 2017 and July 2019 of seven electronic bibliographic databases (MEDLINE, PsycINFO, EMBASE, Scopus, Web of Science, CINAHL, PsycEXTRA), as well as online trial registries and EThoS, and were followed by reference list screening.

Eligibility criteria

Included studies were randomised controlled trials of adults (18–65) who were using illicit substances, alcohol or tobacco. Studies featured an experimental arm delivering CM combined with a structured evidence-based psychotherapeutic intervention and a CM-only arm. Studies published up to July 2019 were included.

Data extraction and synthesis

The primary outcome was biometrically verified point prevalent abstinence (PPA) at treatment end. Secondary outcomes included biometrically verified PPA at post-treatment follow-up and self-reported days of use at treatment end and post-treatment follow-up. Pooled risk ratios for PPA outcomes and standardised mean differences for days of use were calculated using random effects models. Risk of bias was assessed using the Grading of Recommendations Assessment, Development and Evaluation.

Results

12 studies (n=1654) were included. The primary analysis found no evidence of a synergistic effect in PPA at treatment end (relative risk (RR) 0.97, 95% CI 0.85 to 1.09; p=0.57). Sensitivity analysis of studies featuring CBT/MET also found no evidence of an effect (RR 0.92; 95% CI 0.79 to 1.08; p=0.32). None of the secondary outcomes showed any evidence of benefit.

Conclusion

The results of the meta-analyses found no evidence that combining CM with another intervention improves the short-term or long-term effects of CM treatment.
Establishment of sex-specific reference intervals for automated haematology analyser-delivered research parameters in healthy Korean adults: a retrospective database review
Authors: Jeon Kibum , Kim Miyoung , Han Junhee , Lee Jiwon , Lee Jee-soo , Kim Han-Sung , Kang Hee Jung , Lee Young Kyung
Published: October 2020

Objectives

Automated haematology analysers measure various parameters of relevance to clinical research along with routine complete blood count (CBC)-related components. We aimed to establish ethnicity-specific and sex-specific reference intervals for 26 research-specific parameters as well as 18 routinely reported components using a large cohort of healthy Korean adults. The necessity of requiring separate sex-specific reference intervals for each parameter was also examined.

Design

A retrospective database review.

Setting

Single tertiary-care hospital of approximately 375 physicians and 530 nurses.

Participants

This study included 1383 reference individuals (840 men and 543 women).

Primary and secondary outcome measures

Following the Clinical and Laboratory Standards Institute guidelines for establishing reference intervals, routine CBCs as well as research parameters were measured using an ADVIA 2120i instrument.

Results

All the routine components except for mean platelet volume and per cent lymphocytes differed significantly between men and women. Most research parameters also differed between the sexes; the exceptions were large platelets, platelet dry mass distribution width, per cent basophil saturation, per cent peroxidase saturation and per cent abnormal peroxidase absorption. Despite these differences, separate reference intervals for men and women were required only for two research-specific parameters: ‘percentage high cellular haemoglobin’ and ‘percentage of hyperchromic red blood cells (RBCs)’.

Conclusion

Even though most parameters showed significant differences between men and women, none of the evaluated parameters except two RBC-related factors required separate reference intervals for each sex.
Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis
Authors: Chen Dandan , Ye Zhihong , Shao Jing , Tang Leiwen , Zhang Hui , Wang Xiyi , Qiu Ruolin , Zhang Qi
Published: October 2020

Objective

We aimed to examine whether eHealth interventions can effectively improve anthropometric and biochemical indicators of patients with metabolic syndrome (MetS).

Design

Systematic review and meta-analysis.

Methods

PubMed, the Web of Science, Embase, Medline, CINAHL, PsycINFO, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang and Weipu databases were comprehensively searched for papers that were published from database inception to May 2019. Articles were included if the participants were metabolic syndrome (MetS) patients, the participants received eHealth interventions, the participants in the control group received usual care or were wait listed, the outcomes included anthropometric and biochemical indicators of MetS, and the study was a randomised controlled trial (RCT) or a controlled clinical trial (CCT). The Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included articles. The meta-analysis was conducted using Review Manager V.5.3 software.

Results

In our review, seven RCTs and two CCTs comprising 935 MetS participants met the inclusion criteria. The results of the meta-analysis revealed that eHealth interventions resulted in significant improvements in body mass index (standardised mean difference (SMD)=−0.36, 95% CI (−0.61 to −0.10), p<0.01), waist circumference (SMD=−0.47, 95% CI (−0.84 to −0.09), p=0.01) and systolic blood pressure(SMD=−0.35, 95% CI (−0.66 to −0.04), p=0.03) compared with the respective outcomes associated with the usual care or wait-listed groups. Based on the included studies, we found significant effects of the eHealth interventions on body weight. However, we did not find significant positive effects of the eHealth interventions on other metabolic parameters.

Conclusions

The results indicated that eHealth interventions were beneficial for improving specific anthropometric outcomes, but did not affect biochemical indicators of MetS. Therefore, whether researchers adopt eHealth interventions should be based on the purpose of the study. More rigorous studies are needed to confirm these findings.
Predicting the chance on live birth per cycle at each step of the IVF journey: external validation and update of the van Loendersloot multivariable prognostic model
Authors: Devroe Johanna , Peeraer Karen , Verbeke Geert , Spiessens Carl , Vriens Joris , Dancet Eline
Published: October 2020

Objective

To study the performance of the ‘van Loendersloot’ prognostic model for our clinic’s in vitro fertilisation (IVF) in its original version, the refitted version and in an adapted version replacing previous by current cycle IVF laboratory variables.

Methods

This retrospective cohort study in our academic tertiary fertility clinic analysed 1281 IVF cycles of 591 couples, who completed at least one 2nd–6th IVF cycle with own fresh gametes after a previous IVF cycle with the same partner in our clinic between 2010 and 2018. The outcome of interest was the chance on a live birth after one complete IVF cycle (including all fresh and frozen embryo transfers from the same episode of ovarian stimulation). Model performance was expressed in terms of discrimination (c-statistics) and calibration (calibration model, comparison of prognosis to observed ratios of five disjoint groups formed by the quintiles of the IVF prognoses and a calibration plot).

Results

A total of 344 live births were obtained (26.9%). External validation of the original van Loendersloot model showed a poor c-statistic of 0.64 (95% CI: 0.61 to 0.68) and an underestimation of IVF success. The refitted and the adapted models showed c-statistics of respectively 0.68 (95% CI: 0.65 to 0.71) and 0.74 (95% CI: 0.70 to 0.77). Similar c-statistics were found with cross-validation. Both models showed a good calibration model; refitted model: intercept=0.00 (95% CI: −0.23 to 0.23) and slope=1.00 (95% CI: 0.79 to 1.21); adapted model: intercept=0.00 (95% CI: −0.18 to 0.18) and slope=1.00 (95% CI: 0.83 to 1.17). Prognoses and observed success rates of the disjoint groups matched well for the refitted model and even better for the adapted model.

Conclusion

External validation of the original van Loendersloot model indicated that model updating was recommended. The good performance of the refitted and adapted models allows informing couples about their IVF prognosis prior to an IVF cycle and at the time of embryo transfer. Whether this has an impact on couple’s expected success rates, distress and IVF discontinuation can now be studied.
‘Hobson’s choice’: a qualitative study of consent in acute surgery
Authors: Howard Anthony , Webster Jonathan , Quinton Naomi , Giannoudis Peter V
Published: October 2020

Objectives

The study aimed to understand through qualitative research what patients considered material in their decision to consent to an acute surgical intervention.

Participants, setting and intervention

The patients selected aged between 18 and 90, having been admitted to a major trauma centre to undergo an acute surgical intervention within 14 days of injury, where English was their first language. Data saturation point was reached after 21 patients had been recruited. Data collection and analysis were conducted simultaneously, through interviews undertaken immediately prior to surgery. The data were coded using NVIVO V.12 software.

Results

The key theme that originated from the data analysis was patients were unable to identify any individual risk that would modify their decision-making process around giving consent. The patient’s previous experience and the experience of others around them were a further theme. Patients sensed that there were no non-operative options for their injuries.

Conclusion

This is the first study investigating what patient considered a material risk in the consent process. Patients in this study did attribute significance to past experiences of friends and family as material, prompting us to suggest that the surgeon asks about these experiences as part of the consent process. Concern about functional recovery was important to patients but insufficient to stop them from consenting to surgery, thus could not be classified as material risk.
Patient or family perceived deterioration in functional status and outcome after intensive care admission: a retrospective cohort analysis of routinely collected data
Authors: Gross Jamie L , Borkowski Jacek , Brett Stephen J
Published: October 2020

Objective

To explore the association of patient or family reported functional deterioration (defined by a single question) in the preceding year, with mortality outcome for those admitted to the intensive care unit (ICU).

Design

Retrospective observational analysis of a routinely collected data source.

Participants

Patients that were admitted to the ICU at Northwick Park and St Marks Hospitals, London North West University Healthcare NHS Trust between 01 October 2017 to 15 June 2019 were included. Patients were excluded if they had a prior ICU admission during the existing hospital episode or if information on functional deterioration could not be retrieved from either the patient or their advocate.

Primary outcomes

Mortality at the point of hospital discharge and 1 year following admission to the ICU.

Results

Of the 1006 patients who were admitted to the ICU during the study period, information on functional deterioration was available for 621 patients who were included in the analysis. From these, 251 (40.4%) patients had patient or family reported functional deterioration in the preceding year, while 370 (59.6%) patients had a perceived stable functional baseline. Comparing the two groups, mortality was significantly higher in those who had functionally deteriorated compared with those with stable baseline function, at the point of hospital discharge (45.4% vs 25.9%; p<0.0001) and at 1 year (59.4% vs 33.0%; p<0.0001).

Conclusion

Patient or family reported functional deterioration was significantly associated with higher mortality at the point of hospital discharge and at 1 year. The concept of functional deterioration in the lead up to ICU admission warrants further exploration.
Stroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study
Authors: Balabanski Anna H , Goldsmith Kendall , Giarola Blake , Buxton David , Castle Sally , McBride Katharine , Brady Stephen , Thrift Amanda G , Katzenellenbogen Judith , Brown Alex , Burrow James , Donnan Geoffrey A , Koblar Simon , Kleinig Timothy J
Published: October 2020

Objectives

We aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia where a high proportion Aboriginal people reside (40% of the population). We hypothesised that the rates of stroke, particularly in younger adults, would be greater in the Aboriginal population, compared with the non-Aboriginal population; we aimed to elucidate causes for any identified disparities.

Design

A retrospective population-based study of patients hospitalised with stroke within a defined region from 1 January 2011 to 31 December 2014.

Setting

Alice Springs Hospital, the only neuroimaging-capable acute hospital in Central Australia, serving a network of 50 healthcare facilities covering 672 000 km2.

Participants

161 residents (63.4% Aboriginal) of the catchment area admitted to hospital with stroke.

Primary and secondary outcome measures

Rates of first-ever stroke, overall (all events) stroke and in-hospital death.

Results

Of 121 residents with first-ever stroke, 61% identified as Aboriginal. Median onset-age (54 years) was 17 years younger in Aboriginal patients (p<0.001), and age-standardised stroke incidence was threefold that of non-Aboriginal patients (153 vs 51 per 100 000, incidence rate ratio 3.0, 95% CI 2 to 4). The rate ratios for the overall rate of stroke (first-ever and recurrent) were similar. In Aboriginal patients aged <55 years, the incidence of ischaemic stroke was 14-fold greater (95% CI 4 to 45), and intracerebral haemorrhage 19-fold greater (95% CI 3 to 142) than in non-Aboriginal patients. Crude prevalence of diabetes mellitus (70.3% vs 34.0%, p<0.001) and hypercholesterolaemia (68.9% vs 51.1%, p=0.049) was greater, and age-standardised in-hospital deaths were fivefold greater (35 vs 7 per 100 000, 95% CI 2 to 11) in Aboriginal patients than in non-Aboriginal patients.

Conclusions

Stroke incidence (both subtypes) and in-hospital deaths for remote Aboriginal Australians are dramatically greater than in non-Aboriginal people, especially in patients aged <55 years.
Prioritising recommendations following analyses of adverse events in healthcare: a systematic review
Authors: Bos Kelly , van der Laan Maarten J , Dongelmans Dave A
Published: October 2020

Purpose

The purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.

Data sources

The electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.

Study selection

Studies were considered eligible when reporting on methods to prioritise recommendations.

Data extraction

Two teams of reviewers performed the data extraction which was defined prior to this phase.

Results of data synthesis

Eleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.

Conclusion

There are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.
Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot
Authors: Giovannetti Erin R , Clair Catherine A , Jennings Lee A , Sandberg Shana F , Bowman Angelia , Reuben David B , Scholle Sarah H
Published: October 2020

Background

Older adults with complex care needs face trade-offs in determining the right course of treatment. The Centers for Medicare and Medicaid Services identified ‘Care is personalized and aligned with patient’s goals’ as a key meaningful measures category, yet existing quality measures typically assess disease-specific care and may not effectively evaluate what is most important to older adults and family members. Measures based on individualised goals and goal-based outcomes have been proposed as an alternative but are not routinely assessed or implemented.

Objectives

We tested two approaches to assessing goal-based outcomes that allow individuals to set goals based on their own priorities and measure progress—(1) goal attainment scaling and (2) existing, validated patient-reported outcome measures (PROM).

Methods

A prospective cohort study of feasibility in seven sites (33 clinicians) of the two approaches with 229 individuals. We calculated performance on a measure of achievement of individually identified goals.

Results

Both approaches were successfully implemented in a non-randomly selected population, and a goal-based outcome could be calculated for 189 (82%) of participants. Most individuals met their goal-based outcome (73%) with no statistical difference between the goal attainment scaling approach (74%) and the patient-reported outcomes approach (70%). Goals were heterogeneous ranging from participating in activities, health management, independence and physical health. Clinicians chose to use goal attainment scaling (n=184, 80%) more often than PROMs (n=49, 20%) and rated the goal attainment scaling approach as useful for providing patient care.

Conclusion

Goal-based outcomes have the potential to both improve the way healthcare is provided and fill a critical gap in value-based payment.
KALRNmutations promote antitumor immunity and immunotherapy response in cancer
Authors: Li Mengyuan , Ma Yuxiang , Zhong You , Liu Qian , Chen Canping , Qiang Lei , Wang Xiaosheng
Published: October 2020

Background

kalirin RhoGEF kinase (KALRN) is mutated in a wide range of cancers. Nevertheless, the association betweenKALRNmutations and the pathogenesis of cancer remains unexplored. Identification of biomarkers for cancer immunotherapy response is crucial because immunotherapies only show beneficial effects in a subset of patients with cancer.

Methods

We explored the correlation betweenKALRNmutations and antitumor immunity in 10 cancer cohorts from The Cancer Genome Atlas program by the bioinformatics approach. Moreover, we verified the findings from the bioinformatics analysis with in vitro and in vivo experiments. We explored the correlation betweenKALRNmutations and immunotherapy response in five cancer cohorts receiving immune checkpoint blockade therapy.

Results

Antitumor immune signatures were more enriched inKALRN-mutated thanKALRN-wildtype cancers. Moreover,KALRNmutations displayed significant correlations with increased tumor mutation burden and the microsatellite instability or DNA damage repair deficiency genomic properties, which may explain the high antitumor immunity inKALRN-mutated cancers. Also, programmed cell death 1 ligand (PD-L1) expression was markedly upregulated inKALRN-mutated versusKALRN-wildtype cancers. The increased antitumor immune signatures and PD-L1 expression inKALRN-mutated cancers may favor the response to immune checkpoint blockade therapy in this cancer subtype, as evidenced in five cancer cohorts receiving antiprogrammed cell death protein 1 (PD-1)/PD-L1/cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) immunotherapy. Furthermore, the significant association betweenKALRNmutations and increased antitumor immunity was associated with the fact thatKALRNmutations compromised the function of KALRN in targeting Rho GTPases for the regulation of DNA damage repair pathways. In vitro and in vivo experiments validated the association of KALRN deficiency with antitumor immunity and the response to immune checkpoint inhibitors.

Conclusions

TheKALRNmutation is a useful biomarker for predicting the response to immunotherapy in patients with cancer.
Adherent cell depletion promotes the expansion of renal cell carcinoma infiltrating T cells with optimal characteristics for adoptive transfer
Authors: Braun Mitchell W , Abdelhakim Haitham , Li Meizhang , Hyter Stephen , Pessetto Ziyan , Koestler Devin C , Pathak Harsh B , Dunavin Neil , Godwin Andrew K
Published: October 2020

Background

Tumor-infiltrating lymphocyte (TIL) therapy is a personalized cancer treatment which involves generating ex vivo cultures of tumor-reactive T cells from surgically resected tumors and administering the expanded TILs as a therapeutic infusion. Phase 1 of many TIL production protocols use aldesleukin (IL-2) alone to establish TIL cultures (termed “PreREP” (Pre-Rapid Expansion Protocol)); however, this fails to consistently produce TIL cultures from renal cell carcinoma (RCC) in a timely manner. Adding mitogenic stimulation via anti-CD3/anti-CD28 beads along with IL-2 to the fresh tumor digest (FTD) during TIL generation (termed “FTD+ beads”) increases successful TIL culture rates; however, T cells produced by this method may be suboptimal for adoptive transfer. We hypothesize that adherent cell depletion (ACD) before TIL expansion will produce a superior TIL product by removing the immunosuppressive signals originating from adherent tumor and stromal cells. Here we investigate if “panning,” a technique for ACD prior to TIL expansion, will impact the phenotype, functionality and/or clonality of ex vivo expanded RCC TILs.

Methods

Tumor specimens from 55 patients who underwent radical or partial nephrectomy at the University of Kansas Medical Center (KUMC) were used to develop the panning method and an additional 19 specimens were used to validate the protocol. Next-generation sequencing, immunohistochemistry/immunocytochemistry and flow cytometry were used during method development. The phenotype, functionality and clonality of autologous TILs generated in parallel by panning, PreREP, and FTD+ beads were assessed by flow cytometry, in vitro co-culture assays, and TCRB CDR3 sequencing.

Results

TIL cultures were successfully generated using the panning protocol from 15/16 clear cell, 0/1 chromophobe, and 0/2 papillary RCC samples. Significantly fewer regulatory (CD4+/CD25+/FOXP3+) (p=0.049, p=0.005), tissue-resident memory (CD8+/CD103+) (p=0.027, p=0.009), PD-1+/TIM-3+ double-positive (p=0.009, p=0.011) and TIGIT+ T cells (p=0.049, p=0.026) are generated by panning relative to PreREP and FTD+ beads respectively. Critically, a subset of TILs generated by panning were able to degranulate and/or produce interferon gamma in response to autologous tumor cells and the average tumor-reactive TIL yield was greatest when using the panning protocol.

Conclusions

Removing immunosuppressive adherent cells within an RCC digest prior to TIL expansion allow for the rapid production of tumor-reactive T cells with optimal characteristics for adoptive transfer.
Lupus serum induces inflammatory interaction with neutrophils in human glomerular endothelial cells
Authors: Russell Dayvia A , Markiewicz Margaret , Oates Jim C
Published: October 2020

Objectives

SLE is associated with endothelial cell dysfunction (ECD). Understanding how ECD leads to neutrophil infiltration into glomeruli is essential to finding therapeutic targets for SLE. The aim of this study is to determine the effect of SLE serum from patients with active disease to induce neutrophil adhesion to and chemotaxis towards glomerular endothelial cells and factors induced by serum that associate with neutrophil chemotaxis.

Methods

Patients with SLE had serum collected during paired longitudinal visits with lower and higher activity. 13 patients with SLE (5 SLE, 5 SLE with hypertension (HTN) and 3 SLE lupus nephritis (LN) and HTN), and 10 healthy controls (5 with and 5 without HTN) were examined. The adhesion of neutrophils to serum-treated human renal glomerular endothelial cells (HRGECs) or chemotaxis of neutrophils towards conditioned media from serum-treated HRGECs was determined, and levels of cytokines in this conditioned medium were quantified. Pathway analysis of cytokines induced by SLE and LN serum that associated with neutrophil migration was performed.

Results

HRGECs treated with SLE serum induced significantly greater neutrophil chemotaxis and adhesion compared with control serum. When examining specific cohorts, SLE HTN and LN HTN promoted greater neutrophil chemotaxis than control serum, while SLE HTN and LN HTN promoted greater chemotaxis than SLE serum. Serum from active disease visits promoted neutrophil chemotaxis and adhesion over paired inactive visits. Levels of platelet-derived growth factor-BB, interleukin (IL)-15 and IL-8 secreted by SLE serum-treated HRGECs positively correlated with neutrophil chemotaxis. Pathway analysis suggested that LN serum induced pathways important in endoplasmic reticulum and oxidative stress.

Conclusions

SLE serum induces expression of mediators by HRGECs that promote neutrophil chemotaxis and adhesion, which increases during disease activity, and associates with factors common to pathways of endoplasmic reticulum and oxidative stress. These findings highlight the potential importance of serum factor-induced ECD in SLE and LN.
Development of performance limit states for concrete bridge piers with high strength concrete and high strength steel reinforcement
Authors: Billah A.H.M. Muntasir , Kabir Md Asif Bin
Published: October 2020

Current design codes and guidelines do not permit reinforcing the plastic hinge region of bridge piers using high strength steel (HSS) rebars. This is due to the lack of adequate research on the seismic response of HSS reinforced bridge piers. The objective of this study is to develop analytical expressions for predicting the drift at the onset of different performance limit states for high strength concrete (HSC) bridge pier reinforced with HSS reinforcement. Utilizing damage data obtained from incremental dynamic analysis of HSC circular bridge piers reinforced with HSS, this study developed drift ratio relationship accounting for the aspect ratio, concrete and steel material properties, axial load ratio, and reinforcement ratio, using validated finite element models. Analytical equations are developed for estimating the drift at the inception of rebar yielding, concrete spalling, and bar buckling using multivariate regression analysis. The proposed equations showed reasonable precision when corroborated against experimental results.
Light clusters in dilute heavy-baryon admixed nuclear matter
Authors: Sedrakian Armen
Published: October 2020

We study the composition of nuclear matter at sub-saturation densities, non-zero temperatures, and isospin asymmetry, under the conditions characteristic of binary neutron star mergers, stellar collapse, and low-energy heavy-ion collisions. The composition includes light clusters with mass number $$A\le 4$$

A
≤
4

, a heavy nucleus ($$^{56}{Fe}$$

56

Fe

), the $$\varDelta $$
Δ
-resonances, the isotriplet of pions, as well as the $$\Lambda $$
Λ
hyperon. The nucleonic mean-fields are computed from a zero-range density functional, whereas the pion-nucleon interactions are treated to leading order in chiral perturbation theory. We show that with increasing temperature and/or density the composition of matter shifts from light-cluster to heavy baryon dominated one, the transition taking place nearly independent of the magnitude of the isospin. Our findings highlight the importance of simultaneous treatment of light clusters and heavy baryons in the astrophysical and heavy-ion physics contexts.
Analysis of entropy corrected holographic and new agegraphic dark energy models in generalized Rastall gravity
Authors: Maity Sayani , Biswas Mahasweta , Debnath Ujjal
Published: October 2020

This work deals with two fluid system in the framework of generalized Rastall gravity theory. One component represents dark energy whereas the other is dark matter. For the dark energy component, entropy corrected holographic and entropy corrected new agegraphic dark energy models in power-law and logarithmic versions are taken into account. For this study, we assume two classes of scale factors in which one corresponds to the future singularity and another corresponds to the initial singularity. For each of the entropy corrected dark energy models, the cosmological parameters such as Hubble parameter, deceleration parameter and equation of state parameter are calculated and their implications are established. Furthermore, to describe the stability analysis of the models, the behaviors of the squared speed of sound are analyzed graphically for each of these models. From the graphical analysis of [Formula: see text] plane, the thawing or freezing regions of all the models are determined.
Path integral approach to theD-dimensional quantum mechanics of the nonrelativistic Snyder–de Sitter model
Authors: Benzair H. , Boudjedaa T. , Merad M.
Published: October 2020

In the context of Snyder–de Sitter (SdS) algebra, we formulate the D-dimensional momentum space path integral transition amplitude for harmonic oscillator and free particle. The exact energy spectrum and the corresponding normalized radial momentum space eigenfunctions are obtained through the different quantum corrections rule.