bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using patient‐reported outcomes (PROs) and patient‐reported outcome measures (PROMs) in routine head and neck cancer care: What do health professionals perceive as barriers and facilitators?
Authors: Nguyen Hanh , Butow Phyllis , Dhillon Haryana , Morris Lucinda , Brown Alison , West Katrina , Sundaresan Puma 
Published: May 2020

AbstractIntroductionPatient‐reported outcomes (PROs) are direct reports from patients about their health status. Patient‐reported outcome measures (PROMs) are validated tools assessing PROs and completed by patients. Though commonly used in research, implementing PROMs into routine clinical care has been challenging. We aimed to examine health professionals’ (HPs’) perceptions of barriers and facilitators to PRO and PROM use in the routine care of head and neck cancer (HNC) patients.MethodsA custom survey was created, pilot‐tested and disseminated to all HPs involved in the care of HNC patients in Western Sydney Local Health District, Australia. Participants were asked to rate the degree to which they believed the survey items were barriers or facilitators to routine PRO use by answering ‘not at all’, ‘very little’, ‘quite a bit’ and ‘very much’.ResultsOf 129 HPs, 86% had never routinely used PROs. Key barriers perceived were low workplace awareness of PROs (73%), HPs’ lack of knowledge on PRO use (63%) and lack of PROMs in patient preferred languages (63%). Insufficient time, staff and infrastructure to support routine PRO collection and non‐integrated PROMs in patient electronic medical records were also highlighted. Top facilitators were time for PRO administration and interpretation (86%), clear definition of staff roles (84%) and automatic scoring and interpretation of PROMs (81%).ConclusionsThis study highlighted key barriers and facilitators to PRO use in routine HNC patient care as perceived by HPs. The findings will be useful in guiding the successful and sustainable implementation of routine PRO collection in clinical settings.
Symptom Criteria for COVID‐19 Testing of Heath Care Workers
Authors: Clemency Brian M. , Varughese Renoj , Scheafer Danielle K. , Ludwig Brian , Welch Jacob V. , McCormack Robert F. , Ma Changxing , Nan Nan , Giambra Theresa , Raab Thomas 
Published: May 2020

AbstractBackgroundSymptom criteria for COVID‐19 testing of heath care workers (HCWs) limitations on testing availability have been challenging during the COVID‐19 pandemic. An evidence‐based symptom criteria for identifying HCWs for testing, based on the probability of positive COVID‐19 test results, would allow for a more appropriate use of testing resources.MethodsThis was an observational study of outpatient COVID‐19 testing of HCWs. Prior to testing, HCWs were asked about the presence of 10 symptoms. Their responses were then compared to their subsequent pharyngeal swab COVID‐19 polymerase chain reaction test results. These data were used to derive and evaluate a symptom‐based testing criteria.ResultsA total of 961 HCWs were included in the analysis, of whom 225 (23%) had positive test results. Loss of taste or smell was the symptom with the largest positive likelihood ratio (3.33). Dry cough, regardless of the presence or absence of other symptoms, was the most sensitive (74%) and the least specific (32%) symptom. The existing testing criteria consisting of any combination of one or more of three symptoms (fever, shortness of breath, dry cough) was 93% sensitive and 9% specific (area unce the curve [AUC] = 0.63, 95% confidence interval [CI] = 0.59 to 0.67). The derived testing criteria consisting of any combination of one or more of two symptoms (fever, loss of taste or smell) was 89% sensitive and 48% specific (AUC = 0.75, 95% CI = 0.71 to 0.78). The hybrid testing criteria consisting of any combination of one or more of four symptoms (fever, shortness of breath, dry cough, loss of taste or smell) was 98% sensitive and 8% specific (AUC = 0.77, 95% CI = 0.73 to 0.80).ConclusionAn evidence‐based approach to COVID‐19 testing that at least includes fever and loss of taste or smell should be utilized when determining which HCWs should be tested.
Habitat requirements of Tetanocera elata (Diptera: Sciomyzidae): case study of a dry meadow in western Ireland
Authors: Bistline‐East Allison , Burke Daniel , Williams Christopher D. , Gormally Michael J. 
Published: May 2020

Abstract
Terrestrial slugs are pervasive pests of agriculture throughout temperate regions and have the potential to disrupt the germination of seedlings, cause damage to fruiting bodies of crops, and vector plant pathogens.
Tetanocera elata Fabricius (Diptera: Sciomyzidae), a widely distributed Palaearctic species, is an obligate mesoparasitoid and predator of pestiferous slugs including Deroceras reticulatum Müller (Stylommatophora: Agriolimacidae). It has the potential to be developed as a native natural enemy in a conservation biological control programme as an alternative to chemical molluscicides.
To better understand the ecological requirements of this species, a detailed observational study was conducted at a site in the west of Ireland possessing naturally occurring T. elata populations.
Comparison of local patches where T. elata were recovered revealed no association with plant community composition.
Taller dead vegetation was associated with T. elata presence throughout the site. Within the area of greatest T. elata aggregation, there was a significantly greater percentage cover of dead vegetation where T. elata occurred. Abundance of T. elata was also significantly correlated to hedgerow proximity. Results of this study are directly applicable for the design of a conservation biological control programme, which effectively satisfies the principal habitat requirements of T. elata populations.
Identification and functional characterization of CYP4V2 genetic variants exhibiting decreased activity of lauric acid metabolism
Authors: Jarrar Yazun Bashir , Shin Jae‐Gook , Lee Su‐Jun 
Published: May 2020

AbstractThe objectives of the present study were to identify CYP4V2 genetic variants and characterize their functional consequences. A total of 26CYP4V2 genetic variants were identified, including seven novel variants in 60 randomly selected healthy subjects. Six protein‐coding variants were studied, including three novel variants (L22V, R287T, and G410C) and three previously reported variants (R36S, Q259K, and H331P). The cDNA sequences encoding each amino acid variant and the wild‐type CYP4V2 protein were cloned into the pcDNA/PDEST40 expression vector and transfected into eukaryotic 293T cells for overexpression of the CYP4V2 coding variants. CYP4V2 H331P and CYP4V2 G410C exhibited significant decreases in activity for lauric acid oxidation (20–30% of wild‐type activity), when compared to the wildtype, which was correlated with low expression of CYP4V2 H331P and G410C substituted proteins. The other four CYP4V2 amino variants were comparable to wild‐type CYP4V2 for lauric acid metabolism. The CYP4V2 H331P and G410C substitutions were predicted to cause a structural change through in silico analysis. In conclusion, the present study provides functional information about CYP4V2 genetic variants. These findings will be valuable for interpreting individual variations in phenotypes associated with CYP4V2 function in the clinical setting.
Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19
Authors: Azkur Ahmet Kursat , Akdis Mübeccel , Azkur Dilek , Sokolowska Milena , van de Veen Willem , Brüggen Marie‐Charlotte , O’Mahony Liam , Gao Yadong , Nadeau Kari , Akdis Cezmi A. 
Published: May 2020

AbstractAs a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID‐19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute‐phase reactants, and serum biochemistry in COVID‐19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1‐week, self‐limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM‐, IgA‐, and IgG‐type virus‐specific antibodies levels are important measurements to predict population immunity against this disease and whether cross‐reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID‐19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine‐secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute‐phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients.
Sustaining better care for patients undergoing emergency laparotomy
Authors: Jordan L. C. , Cook T. M. , Cook S.‐C. , Dalton S. J. , Collins K. , Scott J. , Peden C. J. 
Published: May 2020

SummaryEmergency laparotomy is associated with high mortality. Implementation of an evidence‐based care bundle has been shown to improve patient outcomes. A quality improvement project to implement a six‐component care bundle was undertaken between July 2015 and May 2018. As part of this project, we worked with 27 hospitals in the Emergency Laparotomy Collaborative. Previous pilot implementation of the same bundle in our hospital between December 2012 and July 2013 had shown marked improvement, maintained until April 2014, but then deterioration. Understanding the reasons for this deterioration informed our work to re‐implement the bundle and sustain improvement. A cohort of 930 consecutive patients requiring emergency laparotomy between October 2014 and April 2019 were included. Baseline data were collected between October 2014 and June 2015, and the bundle was re‐implemented in July 2015. Thirty‐day mortality decreased from 11% in the baseline group to 7.3% after bundle implementation. Hospital length of stay decreased from 19.5 to 17.9 days. Full bundle compliance improved from < 60% to > 80% for all patients, with improvement in application of all individual bundle components. This study provides further evidence that outcomes for high‐risk surgical patients can be improved with an evidence‐based care bundle, but attention must be paid to maintaining bundle compliance. Issues around sustaining improvement must be considered from project initiation.
Changes in oxygen saturation and the retinal nerve fibre layer in patients with optic neuritis associated with multiple sclerosis in a 6‐month follow‐up
Authors: Svrčinová Tereza , Hok Pavel , Šínová Irena , Dorňák Tomáš , Král Michal , Hübnerová Petra , Mareš Jan , Kaňovský Petr , Šín Martin 
Published: May 2020

AbstractPurposeOptic neuritis (ON) is an inflammatory demyelinating disorder of the optic nerve, which can be the first manifestation of multiple sclerosis (MS). The main goal was to assess changes in the retinal nerve fibre layer (RNFL) and in retinal oxygen saturation [arterial (AS), venous (VS) and arterio‐venous (A‐V) difference] in the affected and unaffected eye.MethodsFifty patients with ON due to MS within 3 months of onset of symptoms were enrolled (17 males, mean age 35.3). All patients were examined at baseline (V1) and after 6 months (V2) using optical coherence tomography (OCT) to get RNFL values; automatic retinal oximetry to obtain saturation values; and ultrasound to exclude arterial stenosis, and orbital colour Doppler imaging was performed in the ophthalmic artery.ResultsAt V1, AS was significantly increased in affected eye compared to unaffected eye (99.5% versus 98.0%, p = 0.03). Significant decrease in A‐V difference from baseline was detected in both eyes for ON eye: 32.0% versus 29.0%, p = 0.004; for fellow eye: 31.4% versus 30.0%, p = 0.04. We did not observe any changes in retinal vessel diameter. There were no changes observed in blood flow in ophthalmic artery. At V1, there were no significant differences in RNFL, and significant loss of RNFL was confirmed in the affected eye at V2 (95 μm versus 86 μm, p = 0.0002) and in comparison with the fellow eye (86 μm versus 94 μm, p = 0.0002). There were no correlations between RNFL and saturation values at V1, although at V2, there was a negative correlation between the RNFL and AS (Spearman's rho = −0.480, p = 0.003) and between the RNFL and VS (rho = −0.620, p = 0.00007).ConclusionRetinal oximetry is altered in both eyes in MS patients with unilateral ON. During the course of the disease, the retinal oxygen consumption decreases to a different degree in each eye and this change is not completely followed by changes in the RNFL thickness, suggesting either sub‐clinical ON or systemic effects in the clinically unaffected eye. Since this is the first and initial longitudinal evaluation of the saturation changes in MS patients, the clinical value of these findings needs to be deeper evaluated in the future studies.
Learning analytics initiatives in Latin America: Implications for educational researchers, practitioners and decision makers
Authors: Salas‐Pilco Sdenka Zobeida , Yang Yuqin 
Published: May 2020

AbstractThis study presents several Latin American research initiatives in the field of learning analytics (LA). The study’s purpose is to enhance awareness and understanding of LA among researchers, practitioners and decision makers, and to highlight the importance of supporting research on LA. We analyzed case studies of LA research conducted at four levels of the educational system (the national, institutional, classroom and student levels), which were implemented in four countries (Brazil, Ecuador, Mexico and Uruguay). Diversified cases were selected to demonstrate the use of LA in primary, secondary and higher education, and to allow the inclusion of different types of datasets. These cases also showed the development of legal frameworks for handling ethical issues, and they met the requirements for data privacy protection in Latin America. The study concludes with a discussion of the findings and their implications for further research and practice in the field of LA for teaching and learning.
Mean platelet counts are relatively decreased with malaria but relatively increased with endemic Burkitt Lymphoma in Uganda, Tanzania, and Kenya
Authors: Peprah Sally , Ogwang Martin D. , Kerchan Patrick , Reynolds Steven J. , Tenge Constance N. , Were Pamela A. , Kuremu Robert T. , Wekesa Walter N , Masalu Nestory , Kawira Esther , Kinyera Tobias , Otim Isaac , Legason Ismail D. , Nabalende Hadijah , Dhudha Herry , Mumia Mediatrix , Ayers Leona W. , Biggar Robert J. , Bhatia Kishor , Goedert James J. , Mbulaiteye Sam M. 
Published: May 2020

SummaryPlatelet counts are decreased in Plasmodium falciparum malaria, which is aetiologically linked with endemic Burkitt lymphoma (eBL). However, the pattern of platelet counts in eBL cases is unknown. We studied platelet counts in 582 eBL cases and 2 248 controls enrolled in a case‐control study in Uganda, Tanzania and Kenya (2010–2016). Mean platelet counts in controls or eBL cases with or without malaria‐infection in controls versus eBLcases were compared using Student’s t‐test. Odds ratios (ORs) and two‐sided 95% confidence intervals (95% CIs) were estimated using multiple logistic regression, controlling for age, sex, haemoglobin and white blood cell counts. Platelets were decreased with malaria infection in the controls [263 vs. 339 × 109 platelets/l, P < 0·0001; adjusted OR (aOR) = 3·42, 95% CI: 2·79–4·18] and eBL cases (314 vs. 367 × 109 platelets/l, P‐value = 0·002; aOR = 2·36, 95% CI: 1·49–3·73). Unexpectedly, platelets were elevated in eBL cases versus controls in overall analyses (mean: 353 vs. 307 × 109 platelets/l, P < 0·0001; aOR = 1·41; 95% CI: 1·12–1·77), and when restricted to malaria‐positive (mean 314 vs. 263 × 109 platelets/l, P < 0·0001; OR = 2·26; 95% CI: 1·56–3·27) or malaria‐negative (mean 367 vs. 339 × 109 platelets/l, P < 0·001; OR = 1·46; 95% CI: 1·17–1·83) subjects. Platelets were decreased with malaria infection in controls and eBL cases but elevated with eBL.
Acute illness in patients with concomitant Addison's disease and type 1 diabetes mellitus: Increased incidence of hypoglycaemia and adrenal crises
Authors: Mortimer Brienna , Naganur Vaidehi Dhirendra , Satouris Paul , Greenfield Jerry R. , Torpy David J. , Rushworth Rosemary Louise 
Published: May 2020

AbstractBackgroundPatients with Addison's disease (AD) and comorbid type 1 diabetes mellitus (T1DM) are at increased risk of certain acute metabolic disorders relative to patients with one of these conditions only. The reasons for this are unknown.MethodsAll attendances for acute illness by AD patients at the emergency department of a Sydney hospital between 2000 and 2017 were reviewed. Physiological parameters and illness management strategies were compared between AD patients, those with T1DM and AD combined, and a control group of patients with T1DM.ResultsThere were 39 presentations for an acute medical illness by 20 nondiabetic AD (28 attendances) and 5 diabetic AD patients (11 presentations) and 40 attendances by 10 T1DM controls. In AD patients, 17 (43.6%) attendances were medically diagnosed adrenal crises (AC) (63.6% [n = 7] in diabetic AD and 35.7% [n = 10] in nondiabetic AD). This corresponded to an estimated incidence of 12.5 AC/100 patient‐years (PY) for diabetic AD patients compared to 4.7 AC/100PY for nondiabetic AD patients (P < .05). Glucocorticoid stress doses preceded 61.5% (n = 24) of all attendances. Patients who used stress doses had more presentations than those who did not (2.0 ± 1.3 vs 1.2 ± 0.5, P = .01). Diabetic AD patients had a lower mean blood glucose level on presentation (5.6 ± 3.9 mmol/L) than the T1DM control sample (11.6 ± 6.2 mmol/L) P < .001. No T1DM patients had hypoglycaemia in the 3.0‐3.9 mmol/L range but 2 (18.2%) of the diabetic AD patients had presenting blood glucose levels in this category (P < .05). Hyperglycaemia was more common among T1DM control patients (62.5%, n = 26) than diabetic AD patients (18.2%, n = 2), P < .01.ConclusionAddison's disease patients with T1DM have a higher incidence of adrenal crisis (AC) and hypoglycaemia than nondiabetic AD patients and a lower incidence of hyperglycaemia than those with T1DM alone. This information may be of value in counselling patients with T1DM and AD about AC and hypoglycaemia prevention.
Hypertrophic lichenoid dermatitis immune‐related adverse event during combined immune checkpoint and exportin inhibitor therapy: A diagnostic pitfall for superficially invasive squamous cell carcinoma
Authors: Marques‐Piubelli Mario L. , Tetzlaff Michael T. , Nagarajan Priyadharsini , Duke Taylor C. , Glitza Oliva Isabella C. , Ledesma Debora A. , Aung Phyu P. , Torres‐Cabala Carlos A. , Wistuba Ignacio I. , Prieto Victor G. , Nelson Kelly C. , Curry Jonathan L. 
Published: May 2020

AbstractImmune checkpoint inhibitors (ICIs) for cancer treatment have revolutionized the field of medicine. However, an unintended but frequent consequence of ICI therapy is the development of cutaneous immune‐related adverse events (irAEs), such as lichenoid dermatitis irAEs (LD‐irAEs). The hypertrophic variant of LD‐irAE may be a diagnostic challenge since it can mimic superficially invasive squamous cell carcinoma (SCC). A 79‐year‐old woman with metastatic melanoma who began treatment with an ICI—pembrolizumab—plus exportin‐1 (XPO1) inhibitor presented after 1 month of therapy with symmetrical violaceous papules coalescing into plaques and with two nodules of the bilateral dorsal hands. Biopsy of the nodules revealed an actinic keratosis and atypical epidermal proliferation concerning for SCC. However, in the ensuing 3 weeks, the patient developed multiple new erythematous, violaceous, and scaly macules and papules, some coalescing into plaques on the extremities. Biopsies of these lesions revealed exuberant irregular epidermal hyperplasia with hypermaturation and lichenoid infiltrate concentrated at the base of the elongated, broadened rete ridges, consistent with hypertrophic LD‐irAE. Treatment included topical fluocinonide ointment, intralesional triamcinolone injections and oral acitretin. Distinguishing hypertrophic LD‐irAE and SCC can be challenging since both entities share histopathologic features; thus, correlation with clinical presentation is essential for diagnosis and optimal patient management.
Microbes in Helicoverpa armigera oral secretions contribute to increased senescence around plant wounds
Authors: Waterman Jamie M. , Mann Timothy J. , Cazzonelli Christopher I. , Hartley Susan E. , Johnson Scott N. 
Published: May 2020

1. Plants have long been exposed to insect herbivore attack. Crucial to the plant's ability to defend itself is its ability to identify specific signals associated with attacking insects. Distinctive chemical cues, such as those associated with chewing insect oral secretions (OS), activate targeted defence responses to chewing insect herbivores.2. Herbivore‐associated cues can be complicated by the fact that many herbivores form associations with microbes that produce their own specific signals, which may induce alternative defence processes.3. Here we report that OS of the global pest, the cotton bollworm (Helicoverpa armigera), induce senescence around wounds in Brachypodium distachyon leaves. Crude OS activate greater levels of senescence than OS with reduced microbial abundance or mechanical wounding alone. Nonetheless, plants closed mechanical wounds more rapidly when treated with H. armigera OS regardless of the microbial component.4. This study concludes that H. armigera OS can activate senescence and wound closure in plant tissues and that microbes within OS have an important role in shaping plant‐herbivore interactions through additional increases in senescence.