bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventing dispensing errors through the utilization of lean six sigma and failure model and effect analysis: A prospective exploratory study in China
Authors: Chen Xue , Li Xinyu , Liu Yu , Yao Gaoqiong , Yang Jiadan , Li Juan , Qiu Feng 
Published: December 2020

AbstractAimsTo utilize lean six sigma (LSS) and failure model and effect analysis (FMEA) to prevent dispensing errors in a Chinese teaching hospital.MethodsMedication errors (MEs) reported to the China Core Group of the international network for the rational use of drugs (INRUD) by pharmacists at the hospital were collected. Following LSS methodology, the data analysis was structured according to define, measure, analyse, improve, and control (DMAIC) phases, and typical LSS tools (Pareto diagrams, brainstorming sessions) were used to determine the risk factors leading to dispensing errors. FMEA was applied to generate the risk priority numbers (RPNs) of MEs events, and key medications targeted for error prevention strategies were identified through quantitative analysis of the impacts of failure. Finally, corrective measures to prevent MEs were implemented and monitored for efficacy.ResultsBefore the implementation of this programme, a total of 603 cases of dispensing errors were reported from the Year 1 to Year 6, reaching an average rate of incidence of 0.33 cases per 10 000 medication orders delivered, and no difference was found between these years (P = .9424). There was also no difference as location, error type, contributing factors, cause classification were considered. We then determined the real cause behind dispensing errors, and a total of 67 medications were targeted for specific error prevention strategies. One year after intervention, progress had been achieved in the following aspects: the incidence rate of dispensing errors was significantly decreased compared with the previous years (0.19, P = .007). Simultaneously, the incidence rate of dispensing errors occurred in outpatient pharmacy (0.04, P = .0008), with junior pharmacists (0.15, P = .0258), with LASA medications (0.06, P = .0319), as well as with memory‐based errors were significantly decreased (0.03, P = .0191).ConclusionThe combination of LSS and the FMEA tool can be an efficient approach for helping reduce MEs in pharmacy dispensing.
The growth and age structure of Chilean jack mackerel (Trachurus murphyi) following its influx to New Zealand waters
Authors: Horn Peter L. , Ó Maolagáin Caoimhghin 
Published: December 2020

AbstractThe Chilean jack mackerel (Trachurus murphyi) is a predominantly Southeast Pacific Ocean species. It is relatively difficult to determine its age, and multiple studies of its growth off South America have produced markedly different sets of von Bertalanffy parameters. T. murphyi was first identified from New Zealand waters in the mid‐1980s and has comprised part of the commercial landings of Trachurus species (along with Trachurus declivis and Trachurus novaezelandiae) since then. Results from 13 years of age determination of New Zealand samples using sectioned otoliths indicate that a partially validated age determination method has been developed, with a precision level (average percentage error) of 4.6%. The best available von Bertalanffy growth parameters for the New Zealand population (sexes combined) are as follows: L∞, 51.9 cm fork length; K, 0.223 per year; t0, −0.5 year. Analyses by sex showed that males have a significantly larger L∞ than females. Estimated annual catch‐at‐length and catch‐at‐age distributions from the fishery are presented for 2007–2019. There have been at least two episodes of immigration of T. murphyi from international waters, but little evidence of spawning success to maintain the New Zealand population.
Intersectionality within family sciences and family therapy journals from 2010 to 2020
Authors: Curtis M. S. Michael G. , Ellis Émilie M. , Ann Sorita , Dai YiYi , Bermúdez J. Maria 
Published: December 2020

AbstractContemporary scholars have applied intersectionality as a means of capturing the complex ways in which identity, inequality, and social justice converge to manifest unique sources of strength and vulnerability. Given the increase in the use of this term, the aim of this study was to systematically and comprehensively examine the application of intersectionality in the fields of family science and family therapy from 2010 to 2020. Through the use of content and thematic analysis, we examined trends and variations in how scholars operationalized and applied the principles of intersectionality. Findings suggest that intersectionality remains underutilized and underdefined. Moreover, intersectionality was primarily concentrated in theoretically driven articles and was least prevalent in articles focused on addressing a specific clinical topic or need or research methods. These findings suggest that, although the use of intersectionality is expanding, its applicability in empirical, and especially clinically focused, scholarship remains an area of growth and opportunity.
The calcium‐dependent protein kinase ZmCDPK7 functions in heat‐stress tolerance in maize
Authors: Zhao Yulong , Du Hanwei , Wang Yankai , Wang Huali , Yang Shaoyu , Li Chaohai , Chen Ning , Yang Hao , Zhang Yihao , Zhu Yulin , Yang Luyao , Hu Xiuli 
Published: December 2020

AbstractGlobal warming poses a serious threat to crops. Calcium‐dependent protein kinases (CDPKs)/CPKs play vital roles in plant stress responses, but their exact roles in plant thermotolerance remains elusive. Here, we explored the roles of heat‐induced ZmCDPK7 in thermotolerance in maize. ZmCDPK7‐overexpressing maize plants displayed higher thermotolerance, photosynthetic rates, and antioxidant enzyme activity but lower H2O2 and malondialdehyde (MDA) contents than wild‐type plants under heat stress. ZmCDPK7‐knockdown plants displayed the opposite patterns. ZmCDPK7 is attached to the plasma membrane but can translocate to the cytosol under heat stress. ZmCDPK7 interacts with the small heat shock protein sHSP17.4, phosphorylates sHSP17.4 at Ser‐44 and the respiratory burst oxidase homolog RBOHB at Ser‐99, and upregulates their expression. Site‐directed mutagenesis of sHSP17.4 to generate a Ser‐44‐Ala substitution reduced ZmCDPK7's enhancement of catalase activity but enhanced ZmCDPK7's suppression of MDA accumulation in heat‐stressed maize protoplasts. sHSP17.4, ZmCDPK7, and RBOHB were less strongly upregulated in response to heat stress in the abscisic acid‐deficient mutant vp5 versus the wild type. Pretreatment with an RBOH inhibitor suppressed sHSP17.4 and ZmCDPK7 expression. Therefore, abscisic acid‐induced ZmCDPK7 functions both upstream and downstream of RBOH and participates in thermotolerance in maize by mediating the phosphorylation of sHSP17.4, which might be essential for its chaperone function.
Placenta Accreta Spectrum
Authors: Brown Leslie A. , Menendez‐Bobseine Margarita 
Published: December 2020

AbstractPlacenta accreta spectrum is a term used to describe abnormal adherence and abnormal invasion of the placenta into the uterine wall during pregnancy. The incidence of placenta accreta spectrum has steadily increased over the last 40 years and is most notably linked to rising cesarean birth rates. This condition is associated with increased maternal morbidity and mortality because of the high risk of severe hemorrhage and likely need for hysterectomy at the time of birth. Early diagnosis of abnormal placentation is preferable in order to coordinate birth planning with a interprofessional collaborative team within a high‐level perinatal care center. This article describes the case of a woman diagnosed with placenta accreta spectrum and the clinical course of her pregnancy and birth.
Minimizing abdominal incision for transverse uterine fundal incision by aspiration of amniotic fluid and reduction of uterine size
Authors: Nakago Satoshi , Kato Hiroki , Shibata Takashi , Nishijima Koji , Kotsuji Fumikazu 
Published: December 2020

AbstractAimTransverse uterine fundal incision (TUFI) was developed to avoid catastrophic hemorrhage associated with cesarean section of the placenta previa–accreta. Abdominal incisions extend as far as the upper abdomen in patients in the third trimester of pregnancy and require general anesthesia. Instead, we tried to aspirate amniotic fluid (AF) to reduce the uterine size.MethodsTUFI was performed in 19 of our patients in the third trimester in whom placenta previa accreta could not be ruled out between June 2012 and August 2016. After the lower abdominal vertical incision, we attempted to exteriorize the uterine fundus. If this was impossible, we inserted an 18‐gauge spinal needle into the amniotic space. We aspirated AF until the uterine fundus could be exteriorized.ResultsWe exteriorized the uterine fundus without extending the incision to the upper abdomen by aspirating 250–670 mL of AF in 12 patients who were between the 33rd and 37th week of pregnancy, and TUFI was performed under spinal anesthesia. AF aspiration was not required in four patients who were in the 30th or 31st week of pregnancy and in two patients with oligohydramnios in the 35th week of pregnancy. In one case, the trial was canceled due to hemorrhagic AF aspiration. No serious complications were observed in mothers or neonates.ConclusionTUFI could be made by abdominal incision to the left of the umbilicus under spinal anesthesia without anesthesia by reducing the uterine size through AF aspiration, even for patients in the third trimester of pregnancy.
Treating peritoneal dialysis catheter exit‐site granulomas with chlorhexidine swabstick: A pilot study
Authors: Hui Yun‐Ho , So Winnie K.‐W. , Ng Marques S.‐N. , Leung Janet T.‐W. , Ho Elaine T.‐L. , Wong Sunny S.‐H. 
Published: December 2020

AbstractBackgroundSilver nitrate cauterisation is the conventional treatment for peritoneal dialysis catheter exit‐site granulomas. However, it requires to be performed by nurses, patients often experience pain and chemical burns. Therefore, the appropriateness and applicability of using 2% aqueous chlorhexidine swabstick as an alternative was explored in two nephrology centres in Hong Kong.ObjectiveTo examine possibility of conducting full trial using chlorhexidine swabstick compared with silver nitrate.DesignA pilot study.ParticipantsFort‐four patients with exit‐site granulomas were equally, randomly allocated to receive chlorhexidine swabstick or silver nitrate.MeasurementsBoth groups were followed for 6 weeks to evaluate the time of granuloma subsidence and adverse effects. Pain and treatment satisfaction were assessed using numerical rating scale and self‐developed questionnaire, respectively.ResultsHealing rates were 94.4% (17 of 18) using chlorhexidine swabstick,100% (21 of 21) using silver nitrate (p = 0.46). The mean time of granuloma subsidence was significantly longer when using chlorhexidine swabstick (32.8 days) than silver nitrate (12.3 days, p=0.02). The chlorhexidine swabstick group reported significantly fewer adverse effects (11.1%, 2 of 18, p = 0.01) compared with the silver nitrate group (52.4%, 11 of 21). The chlorhexidine swabstick group had lower mean pain score (0.5 of 11) than the silver nitrate group (2.4 of 11, p < 0.01). The satisfaction scores between the two groups had no substantial difference.ConclusionChlorhexidine swabstick took long time to remove granulomas but had similar success rate, less pain, fewer adverse effects than silver nitrate. Additional research is warranted to examine the applicability of chlorhexidine swabstick.
σE controlled regulation of porin OmpU in Vibrio cholerae
Authors: Pennetzdorfer Nina , Höfler Thomas , Wölflingseder Martina , Tutz Sarah , Schild Stefan , Reidl Joachim 
Published: December 2020

AbstractBile resistance is essential for enteric pathogens, as exemplified by Vibrio cholerae, the causative agent of cholera. The outer membrane porin OmpU confers bacterial survival and colonization advantages in the presence of host‐derived antimicrobial peptides as well as bile. Expression of ompU is controlled by the virulence regulator ToxR. rpoE knockouts are accompanied by suppressor mutations causing ompU downregulation. Therefore, OmpU constitutes an intersection of the ToxR regulon and the σE‐pathway in V. cholerae. To understand the mechanism by which the sigma factor σE regulates OmpU synthesis, we performed transcription studies using ompU reporter fusions and immunoblot analysis. Our data revealed an increase in ompU promoter activity in ΔrpoE strains, as well as in a ΔompU background, indicating a negative feedback regulation circuit of ompU expression. This regulation seems necessary, since elevated lethality rates of ΔrpoE strains occur upon ompU overexpression. Manipulation of OmpU’s C‐terminal portion revealed its relevance for protein stability and potency of σE release. Furthermore, ΔrpoE strains are still capable of elevating OmpU levels under membrane stress conditions triggered by the bile salt sodium deoxycholate. This study provides new details about the impact of σE on ompU regulation, which is critical to the pathogen’s intestinal survival.
Gesture–speech physics in fluent speech and rhythmic upper limb movements
Authors: Pouw Wim , de Jonge‐Hoekstra Lisette , Harrison Steven J. , Paxton Alexandra , Dixon James A. 
Published: December 2020

AbstractIt is commonly understood that hand gesture and speech coordination in humans is culturally and cognitively acquired, rather than having a biological basis. Recently, however, the biomechanical physical coupling of arm movements to speech vocalization has been studied in steady‐state vocalization and monosyllabic utterances, where forces produced during gesturing are transferred onto the tensioned body, leading to changes in respiratory‐related activity and thereby affecting vocalization F0 and intensity. In the current experiment (n = 37), we extend this previous line of work to show that gesture–speech physics also impacts fluent speech. Compared with nonmovement, participants who are producing fluent self‐formulated speech while rhythmically moving their limbs demonstrate heightened F0 and amplitude envelope, and such effects are more pronounced for higher‐impulse arm versus lower‐impulse wrist movement. We replicate that acoustic peaks arise especially during moments of peak impulse (i.e., the beat) of the movement, namely around deceleration phases of the movement. Finally, higher deceleration rates of higher‐mass arm movements were related to higher peaks in acoustics. These results confirm a role for physical impulses of gesture affecting the speech system. We discuss the implications of gesture–speech physics for understanding of the emergence of communicative gesture, both ontogenetically and phylogenetically.
Emergence of pollen food allergy syndrome in asthmatic children in Paris
Authors: Loraud Christine , de Ménonville Charlotte Thibaut , Bourgoin‐Heck Mélisande , Cottel Nathalie , Wanin Stéphanie , Just Jocelyne 
Published: December 2020

AbstractBackgroundOver the last few decades, the level of pollen from birch and homologous trees has increased in parts of Europe. Sensitization to birch pollen allergens (principally Bet v 1) has been associated with food cross‐reactivity called pollen food allergy syndrome (PFAS).ObjectiveTo evaluate changes in allergic diseases due to IgE sensitization over 25 years in asthmatic children.MethodsThis was a cross‐sectional retrospective study conducted in Paris. We analyzed two cohorts of asthmatic children with similar characteristics explored between 1993‐1999 (old cohort = OC) and 2012‐2018 (recent cohort = RC).Results121 children were in the OC and 120 in the RC. An increase in sensitization to tree pollens was found especially for birch pollen, which was 11.6% in the OC and 31% in the RC (P = .0002). Allergic rhinitis prevalence was significantly higher in the RC than in the OC (96% vs 52%, respectively, P < .0001). IgE‐mediated food allergy increased from 6% to 16% in the OC and RC, respectively, (P = .01) mainly due to PFAS. In the RC, a higher mean Bet v 1‐specific IgE level was observed in children with PFAS compared to children without (105.7 KU/L ± 17.8 and 48.9 kU/L ± 15.7, respectively, P < .05).ConclusionAllergic rhinitis and food allergy with tree pollen sensitization have increased in Paris over 25 years mainly due to PFAS. Environmental factors could be responsible for these modifications as described in the literature.
Evaluation of emergency department utilization for dermatologic conditions in the pediatric population within the United States from 2009‐2015
Authors: Collier Erin K. , Yang Jason J. , Sangar Sophia , Chen Steven T. , Huang Jennifer T. , Bach Daniel Q. 
Published: December 2020

AbstractBackgroundDermatologic conditions comprise a significant number of emergency department visits in the pediatric population in the United States. Understanding key predictors of emergency department utilization for dermatologic conditions is important to reduce inappropriate use.MethodsA total of 44 554 sampled patient emergency department visits, consisting of patients less than 18 years of age, were collected from the National Hospital Ambulatory Medical Care Survey between 2009 to 2015. ICD‐9 codes were used to define dermatologic conditions versus non‐dermatologic conditions with univariate and multivariate analyses used to identify factors significantly correlated with dermatologic emergency department utilization.ResultsA total of 13 681 691 pediatric dermatologic emergency department visits (weighted) were evaluated over the seven‐year period, representing 6.4% of total pediatric emergency department visits. The most common dermatologic diagnosis was cellulitis (25.6% of visits). The majority of patients were five years old or younger (54.4%). Patients with primary dermatologic conditions were more likely to be triaged as non‐urgent (16.7%) or semi‐urgent (45.8%) than patients without dermatologic conditions. Only 2.1% of patients with dermatologic conditions required further observation or admission. On further regression modeling, age ≤ 5, semi‐urgent or non‐urgent acuity, Medicaid insurance, and residence in the Northeastern or Midwestern United States were significantly associated with presentation to the emergency department with a dermatologic condition when compared to non‐dermatologic condition.ConclusionsDermatologic conditions continue to comprise a significant number of ED visits in the pediatric population. Increased ED utilization by vulnerable pediatric populations highlights the need to better direct or provide access to outpatient dermatologic care.
Primary pediatric live‐donor‐kidney transplant‐recipients' outcomes by immunosuppression induction received in the United States
Authors: Riad Samy , Jackson Scott , Chinnakotla Srinath , Verghese Priya 
Published: December 2020

AbstractObjectiveWe examined the association between induction type and outcomes of live‐donor pediatric kidney recipients on tacrolimus and mycophenolate maintenance.Material and MethodsWe analyzed the SRTR standard analysis file to evaluate primary live‐donor pediatric kidney recipients between 2000 and 2018. Recipients were grouped by induction type into three groups: alemtuzumab n = 289, anti‐thymocyte n = 1197, and IL‐2RA n = 1625. Kaplan‐Meier curves were generated for recipient and death‐censored graft survival. Predictors of recipient and allograft survival were examined using Cox proportional hazards models. Models were adjusted for age, sex, ethnicity, renal failure etiology, HLA‐mismatches, transplant year, steroid maintenance, preemptive transplantation, payor type, and donor factors such as age, sex, and donor‐recipient relationship. The transplant center was included as a random effect to account for inter‐center variability.ResultsRejection rates at 6 months (Alemtuzumab 9.5% vs. r‐ATG 5.7% vs. IL2‐RA 5.3%; P: .023) and 12 months (Alemtuzumab 14.5% vs. r‐ATG 10.8% vs. IL2‐RA 9%; P: .028) were significantly higher in the alemtuzumab group. PTLD rate (Alemtuzumab 0.8% vs. r‐ATG 2.2% vs. IL2‐RA 1%; P: .028) was significantly higher in the anti‐thymocyte group. In the multivariable models, induction type did not influence patient or death‐censored graft survival within ten years post‐transplant.ConclusionIn this large cohort of standard immunological risk primary pediatric live‐donor kidney recipients, as compared to IL‐2RA, neither alemtuzumab nor anti‐thymocyte globulin was associated with improved long‐term graft or recipient survival. In the first year post‐transplant, recipients of alemtuzumab induction had a higher rejection rate, while PTLD was more frequently observed in the anti‐thymocyte recipients.
Combined experimental drought and nitrogen loading: the role of species‐dependent leaf level control of carbon and water exchange in a temperate grassland
Authors: Kübert A. , Kuester E. , Götz M. , Dubbert D. , Eiblmeier M. , Werner C. , Rothfuss Y. , Dubbert M. 
Published: December 2020

Abstract

Nitrogen (N) loading and extreme drought strongly alter biomass production, species composition and carbon and water fluxes of temperate grasslands. Such changes at the community level are often attributed to species‐ and functional group‐specific responses in phenology and/or physiology.

In a multifactorial field experiment, we studied the responses of three abundant grassland species (forb Centaurea jacea, grasses Arrhenatherum elatius and Dactylis glomerata) to N loading and extreme drought, focusing on responses of carbon and water relations at the leaf level. We analysed (1) changes in bulk leaf N (uptake efficiency of additional N), (2) adaptation of plant water status (leaf water potential) and (3) impact on leaf carbon and water fluxes.

We observed more efficient N utilization in the two grasses compared to C. jacea. Naturally occurring summer drought significantly impacted the plant water status of all species, while extreme drought treatment only further affected water status during and after summer drought. C. jacea was able to maintain much lower leaf water potentials compared to the grasses during drought. Despite these clear species‐specific responses to N loading and drought, the species were able to maintain homeostasis of leaf carbon and water fluxes.

Thus, strong declines in the (community) carbon sequestration observed at this site during the (natural) summer drought were not related to leaf physiological responses in assimilation, but were driven by phenological adaptions of the species community: the drought‐sensitive grasses, even though exhibiting higher N uptake efficiency, responded with a shortened life cycle to severe summer drought.