bluuebunny/crossref_metadata_2025_split huggingface dataset:
Universal versus targeted approaches to prevent early education gaps. The Netherlands as case in point
Authors: Leseman Paul P. M. , Slot Pauline L. 
Published: May 2020

AbstractThere is strong evidence that high quality early childhood programs targeting disadvantaged groups can have lasting benefits and high returns on investment. The evidence for universal programs, however, is less conclusive. The present paper examines the claims of universal and targeted approaches to preventing early education gaps. First, recent findings on the universal unitary early education and care systems in Denmark and Norway are reviewed regarding the educational quality and compensating effects on disadvantaged children. Second, the advantages and disadvantages of targeted approaches are discussed, focusing in particular on the trade-off between cost-effectiveness and aggregated impact on society. Third, the Dutch educational equity policy will be analyzed as a case in point to illustrate the dilemmas, contradictions and paradoxes of equity policy pertaining to targeted and universal approaches. Finally, as a synthesis of the findings, two complementary approaches are outlined: a universal within targetedand a targeted within universalapproach.
Short-term impact of PM2.5, PM10, and PMc on mortality and morbidity in the agglomeration of Warsaw, Poland
Authors: Maciejewska Katarzyna 
Published: May 2020

AbstractThe work presents the results of short-term health effects assessment of particulate matter (PM) in Warsaw, the capital of Poland. The influence of three PM fractions, PM10 (particles of aerodynamic diameter < 10 μm), PM2.5 (particles of aerodynamic diameter < 2.5 μm), and PMc (coarse fraction of diameter between 2.5 and 10 μm), modeled by the CALMET/CALPUFF system, has been studied in the period of 2013–2014. Six population health endpoints; daily counts of all-cause (ALL), cardiovascular (CV), and respiratory (RS) death cases; and ALL, CV, and RS hospital admissions were investigated with the use of statistical time series analysis via nonparametric generalized additive model (GAM) approach. The results show that PM2.5 increases the relative risk (RR) of ALL premature deaths by 0.7% per 10 μg/m3, as well as of CV mortality by 0.9%. PM10 exposures reveal the largest influence on mortality in a 2-day lag: 0.3% for all causes and 0.4% for CV causes, while for RS causes only in the elderly group (above 65 years, 1.4%) and for males (2.1%). The risk of hospitalizations increases with elevated PMc levels by 2.5%, 2.1%, and 4.6% for ALL, CV, and RS hospital admissions, respectively. The results suggest that the research on PM impact on health should concentrate more on attempts to assign specific health outcomes to PM originating from different types of sources, characterized by different granulation, as well as physical and chemical properties of emitted particles.
Systemic therapy for metastatic salivary gland tumors—challenges and novel concepts
Authors: Minichsdorfer Christoph 
Published: May 2020

SummarySalivary gland cancers (SGC) are a rare and heterogeneous group of malignancies. Most frequently tumors arise in the parotid gland. The most common histologic subtypes are adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC). Rare subtypes include salivary ductal carcinoma (SDC), mammary analogue secretory carcinoma (MASC) and adenocarcinoma not other specified (AC NOS). For locally advanced or metastatic disease, chemotherapy has been the mainstay of therapy. The course of disease differs markedly between the subtypes, especially ACC usually presents as slowly progressing disease. Due to the rarity of these tumors only small phase I/II studies exist, which report efficacy of cytotoxic regimens in advanced SGC. However, due to advances in the understanding of tumor biology and molecular testing, drugable genetic changes like androgen receptor (AR) status, HER2/neu overexpression and neurotrophic tyrosine receptor kinase (NTRK) gene fusion have evolved as potential therapy targets in subsets of SGC. Consequently therapy with androgen receptor blockade (ARB) can be offered to patients with AR expressing tumors. Anti-HER2 therapy with trastzumab is an option for the treatment of tumors with overexpression of HER2/neu and finally NTRAK inhibitors can be used for tumors harboring a NTRK gene fusion. Taken together, due to the small number of patients, data from large phase III studies for the treatment of SGC are missing. However, promising targeted therapy approaches have been recently undertaken.
Elastic Moduli of Nanoglasses and Melt-Spun Metallic Glasses by Ultrasonic Time-of-Flight Measurements
Authors: Arnold W. , Birringer R. , Braun C. , Gleiter H. , Hahn H. , Nandam S. H. , Singh S. P. 
Published: May 2020

AbstractThe elastic moduli of the metallic nanoglasses Fe86Sc14,Fe90Sc10, Cu58Zr42, and Cu60Zr40were determined by measuring their longitudinal and shear wave velocities together with their densities. The data were compared to the elastic moduli of the conventional melt-spun metallic glass counterparts of the same chemical composition. The elastic moduli for the nanoglasses were significantly smaller than those of the metallic glass counterparts. Finally, a comparison was made between the data for nanoglasses and metallic glasses from the literature.
Organic seeds of the future: simple material?
Authors: Desclaux Dominique 
Published: May 2020

AbstractThe day where seeds were considered “material” in legal text was a decisive moment. At the European level, that was December 1, 1961, when the international convention for the protection of new varieties of plants (UPOV) was adopted by the diplomatic conference. This paper relates the semantic evolution in French and European regulations concerning seeds. Using the term “material” to define a seed sounds as an oxymoron and especially for the organic sector that highlights the concept of life integrity of plants. Semantic drifts and technical drifts are close. To consider seeds as simple material allows everybody to manipulate them, to modify them, to degrade them, to repair them, to edit them, to market them, and to patent them. The drift in regulatory texts is not insignificant; it reflects the thought of a society but can also have a sustainable impact on this thought. Therefore, it seems urgent to raise the question: What seeds do we want in the future? Patented seeds, edited seeds, certified seeds, farm seeds, peasant seeds, participatory seeds? It’s time to decide! And time to precise the words in legal texts.
‘I’m sorry to hear that’—Empathy and Empathic Dissonance: the Perspectives of PA Students
Authors: Laughey William F. , Brown Megan E. L. , Finn Gabrielle M. 
Published: May 2020

AbstractContextOur understanding of clinical empathy could be enhanced through qualitative research—research currently under-represented in the field. Physician associates within the UK undergo an intensive 2-year postgraduate medical education. As a new group of health professionals, they represent a fresh pair of eyes through which to examine clinical empathy, its nature and teaching.MethodsWorking with a constructivist paradigm, utilising grounded theory methodology, researchers studied 19 purposively sampled physician associate students in two UK medical schools. One-to-one semi-structured interviews were transcribed verbatim. Data were analysed using a grounded theory approach.ResultsThe global themes werethe pathways to empathy,empathy modifiersandempathic dissonancea novel term to describe the discomfort students experience when pressurised into making empathic statements they don’t sincerely feel. Students preferred using non-verbal over verbal expressions of empathy. A conceptual model is proposed. The more substantial empathic pathway, affective empathy, involves input from the heart. An alternative empathy, more constrained, comes from the head: cognitive empathy was considered a solution to time pressure and emotional burden. Formal teaching establishes empathic dissonance, a problem which stems from over-reliance on the empathic statement as the means to deliver clinical empathy.ConclusionsThis study furthers our understanding of the construct and teaching of empathy. It identifies empathic barriers, especially time pressure. It proposes a novel concept—empathic dissonance—a concept that challenges medical educationalists to reframe future empathy teaching.
High-Performance Aqueous Zinc–Manganese Battery with Reversible Mn2+/Mn4+ Double Redox Achieved by Carbon Coated MnOx Nanoparticles
Authors: Huang Jingdong , Zeng Jing , Zhu Kunjie , Zhang Ruizhi , Liu Jun 
Published: May 2020

AbstractThere is an urgent need for low-cost, high-energy-density, environmentally friendly energy storage devices to fulfill the rapidly increasing need for electrical energy storage. Multi-electron redox is considerably crucial for the development of high-energy-density cathodes. Here we present high-performance aqueous zinc–manganese batteries with reversible Mn2+/Mn4+ double redox. The active Mn4+ is generated in situ from the Mn2+-containing MnOx nanoparticles and electrolyte. Benefitting from the low crystallinity of the birnessite-type MnO2 as well as the electrolyte with Mn2+ additive, the MnOx cathode achieves an ultrahigh energy density with a peak of 845.1 Wh kg−1 and an ultralong lifespan of 1500 cycles. The combination of electrochemical measurements and material characterization reveals the reversible Mn2+/Mn4+ double redox (birnessite-type MnO2 ↔ monoclinic MnOOH and spinel ZnMn2O4 ↔ Mn2+ ions). The reversible Mn2+/Mn4+ double redox electrode reaction mechanism offers new opportunities for the design of low-cost, high-energy-density cathodes for advanced rechargeable aqueous batteries.
A Review: Does Complement or the Contact System Have a Role in Protection or Pathogenesis of COVID-19?
Authors: Maglakelidze Natella , Manto Kristen M. , Craig Timothy J. 
Published: May 2020

Abstract
Introduction
COVID-19 presentation may include a profound increase in cytokines and associated pneumonia, rapidly progressing to acute respiratory distress syndrome (ARDS). This so-called cytokine storm often leads to refractory edema, respiratory arrest, and death. At present, anti-IL-6, antiviral therapy, convalescent plasma, hydroxychloroquine, and azithromycin among others are being investigated as potential treatments for COVID-19. As the disease etiology and precise therapeutic interventions are still not definitively defined, we wanted to review the roles that complement and the contact system may have in either the treatment or pathogenesis of the disease.

Methods
We searched the recent literature (PubMed) on complement and coronavirus; contact system and coronavirus; bradykinin and coronavirus; and angiotensin receptor and coronavirus. The manuscript complies with ethics guidelines and was deemed exempt from institutional review board approval according to Human Subjects Protection Office guidelines.

Results
Mouse models are available for the study of coronavirus and complement. Although complement is effective in protecting against many viruses, it does not seem to be protective against coronavirus. C3 knockout mice infected with SARS-CoV had less lung disease than wild-type mice, suggesting that complement may play a role in coronavirus pathogenesis. Some evidence suggests that the observed pulmonary edema may be bradykinin-induced and could be the reason that corticosteroids, antihistamines, and other traditional interventions for edema are not effective. Angiotensin-converting enzyme 2 (ACE2) is a co-receptor for SARS-CoV-2, and studies thus far have not concluded a benefit or risk associated with the use of either ACE-inhibitors or angiotensin receptor antagonists.

Summary
Activation of complement and the contact system, through generation of bradykinin, may play a role in the SARS-CoV-2-induced pulmonary edema, and our search suggests that further work is necessary to confirm our suspicions.
Viable but nonculturable bacteria and their resuscitation: implications for cultivating uncultured marine microorganisms
Authors: Zhang Xiao-Hua , Ahmad Waqar , Zhu Xiao-Yu , Chen Jixiang , Austin Brian 
Published: May 2020

AbstractCulturing has been the cornerstone of microbiology since Robert Koch first successfully cultured bacteria in the late nineteenth century. However, even today, the majority of microorganisms in the marine environment remain uncultivated. There are various explanations for the inability to culture bacteria in the laboratory, including lack of essential nutrients, osmotic support or incubation conditions, low growth rate, development of micro-colonies, and the presence of senescent or viable but nonculturable (VBNC) cells. In the marine environment, many bacteria have been associated with dormancy, as typified by the VBNC state. VBNC refers to a state where bacteria are metabolically active, but are no longer culturable on routine growth media. It is apparently a unique survival strategy that has been adopted by many microorganisms in response to harsh environmental conditions and the bacterial cells in the VBNC state may regain culturability under favorable conditions. The resuscitation of VBNC cells may well be an important way to cultivate the otherwise uncultured microorganisms in marine environments. Many resuscitation stimuli that promote the restoration of culturability have so far been identified; these include sodium pyruvate, quorum sensing autoinducers, resuscitation-promoting factors Rpfs and YeaZ, and catalase. In this review, we focus on the issues associated with bacterial culturability, the diversity of bacteria entering the VBNC state, mechanisms of induction into the VBNC state, resuscitation factors of VBNC cells and implications of VBNC resuscitation stimuli for cultivating these otherwise uncultured microorganisms. Bringing important microorganisms into culture is still important in the era of high-throughput sequencing as their ecological functions in the marine environment can often only be known through isolation and cultivation.
Management recommendations for patients with chronic kidney disease during the novel coronavirus disease 2019 (COVID‐19) epidemic
Authors: Li Juan , Li Shuang‐Xi , Zhao Li‐Fang , Kong De‐Liang , Guo Zhi‐Yong 
Published: May 2020

AbstractCOVID‐19 has become a pandemic and it has already spread to at least 171 countries/regions. Chronic kidney disease (CKD) is a global public health problem with a total of approximately 850 million patients with CKD worldwide and 119.5 million in China. Severe COVID‐19 infection may damage the kidney and cause acute tubular necrosis, leading to proteinuria, hematuria and elevated serum creatinine. Since the SARS‐CoV‐2 enters the cells by binding to the angiotensin‐converting enzyme 2 receptor, some doctors question its ability to increase the risk and severity of developing COVID‐19. Neither clinical data nor basic scientific evidence supports this assumption. Therefore, patients who take angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker are not advised to change their therapy. Patients with CKD are generally the elderly population suffering from multiple comorbidities. Moreover, some patients with CKD might need to take glucocorticoids and immunosuppressants. Dialysis patients are recurrently exposed to a possible contaminated environment because their routine treatment usually requires three dialysis sessions per week. Considering all the above reasons, patients with CKD are more vulnerable to COVID‐19 than the general population. The development of COVID‐19 may worsen the impaired kidney function and further lead to rapid deterioration of kidney function and even death. Strict comprehensive protocols should be followed to prevent the spread of COVID‐19 among patients with CKD. In this review, we provide some practical management recommendations for health care providers, patients with CKD, dialysis patients and dialysis facilities.
LO47: Hematochezia in children with acute gastroenteritis in the emergency department: clinical phenotype, etiologic pathogens, and resource utilization
Authors: Böhrer M. , Fitzpatrick E. , Hurley K. , Xie J. , Lee B. , Pang X. , Chui L. , Tarr P. , Ali S. , Vanderkooi O. , Freedman S. 
Published: May 2020

Introduction: Acute bloody diarrhea obligates rapid and accurate diagnostic evaluation; few studies have described such cohorts of children. Methods: We conducted a planned secondary analysis employing the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) acute gastroenteritis study cohort to describe the characteristics of children with acute bloody diarrhea, compared to a cohort of children without hematochezia. Children <18 years of age presenting to 2 pediatric tertiary care emergency departments (EDs) in Alberta, with ≥3 episodes of diarrhea and/or vomiting in the preceding 24 hours and <7 days of symptoms were consecutively recruited. Stools were tested for 17 viruses, bacteria and parasites. Primary outcomes were clinical characteristics and pathogens identified. Secondary outcomes included interventions and resource utilization. Results: Of 2257 children enrolled between October 2015 and August 2018, hematochezia before or at the index ED visit was reported in 122 (5.4%). Compared to children with nonbloody diarrhea, children with hematochezia had longer illness duration [59.5 vs. 41.5 hrs, difference 10.6, 95% CI 3.5, 19.9], more diarrheal episodes in a 24-hour period [8 vs. 5, difference 3, 95% CI 2, 4], and less vomiting [55.7% vs. 91.1%; difference -35.3%; 95% CI -44.7, -26.3]. They received more intravenous fluids [32.0% vs. 18.3%; difference 13.7%, 95% CI 5.5, 23.0], underwent non-study stool testing [53.7% vs. 4.8%; difference 49.0%, 95% CI 39.6, 58.0], experienced longer ED visits [4.1 vs. 3.3 hours, difference 0.9, 95% CI 0.3, 1.0] and were more likely to have repeat healthcare visits within 14 days [54.8% vs. 34.2%; difference 20.6%, 95% CI 10.8, 30.1]. A bacterial enteric pathogen was found in 31.9% of children with hematochezia versus 6.6% without bloody diarrhea (difference 25.4%, 95% CI 17.2, 34.7). In children with hematochezia, the most commonly detected bacteria were Salmonella spp. (N = 15), Shiga toxin-producing E. coli (N = 9), Campylobacter spp. (N = 7), and Shigella spp. (N = 5). Viruses were detected in 32.8% of children with bloody diarrhea, most commonly adenovirus (N = 15), norovirus (N = 14), sapovirus (N = 8) and rotavirus (N = 7). Conclusion: Children with hematochezia differed clinically from those without hematochezia and required more healthcare resources. While bacterial etiologies are common, several viruses were also detected.
LO49: Digital technology distraction for acute pain in children: a meta-analysis
Authors: Gates M. , Hartling L. , Shulhan-Kilroy J. , MacGregor T. , Guitard S. , Wingert A. , Featherstone R. , Vandermeer B. , Poonai N. , Kircher J. , Perry S. , Graham T. , Scott S. , Ali S. 
Published: May 2020

Introduction: Digital distraction is being integrated into pediatric pain care, but its efficacy is currently unknown. We conducted a systematic review to determine the effect of digital technology distraction on pain and distress for children experiencing acutely painful conditions or medical procedures. Methods: We searched eight online databases (MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, IEEE Xplore, Ei Compendex, Web of Science), grey literature sources, scanned reference lists, and contacted experts for quantitative studies where digital technologies were used as distraction for acutely painful conditions or procedures in children. Study selection was performed by two independent reviewers with consensus. One reviewer extracted relevant study data and another verified it for accuracy. Appraisal of risk of bias within studies and the certainty of the body of evidence were performed independently in duplicate, with the final appraisal determined by consensus. The primary outcomes of interest were child pain and distress. Results: Of 3247 unique records identified by the search, we included 106 studies (n = 7820) that reported on digital technology distractors (e.g., virtual reality; videogames) used during common procedures (e.g., venipuncture, minor dental procedures, burn treatments). We located no studies reporting on painful conditions. For painful procedures, digital distraction resulted in a modest but clinically important reduction in self-reported pain (SMD -0.48, 95% CI -0.66 to -0.29, 46 RCTs, n = 3200), observer-reported pain (SMD -0.68, 95% CI -0.91 to -0.45, 17 RCTs, n = 1199), behavioural pain (SMD -0.57, 95% CI -0.94 to -0.19, 19 RCTs, n = 1173), self-reported distress (SMD -0.49, 95% CI -0.70 to -0.27, 19 RCTs, n = 1818), observer-reported distress (SMD -0.47, 95% CI -0.77 to -0.17, 10 RCTs, n = 826), and behavioural distress (SMD -0.35, 95% CI -0.59 to -0.12, 17 RCTs, n = 1264) compared to usual care. Few studies directly compared different distractors or provided subgroup data to inform applicability. Conclusion: Digital distraction provides modest pain and distress reduction for children undergoing painful procedures; its superiority over non-digital distractors is not established. Healthcare providers and parents should strongly consider using distractions as a pain-reduction strategy for children and teens during common painful procedures (e.g., needle pokes, dental fillings). Context, child preference, and availability should inform the choice of distractor.
LO54: Emergency department prevalence of intracranial aneurysm on computed tomography angiography (EPIC-ACT)
Authors: Sheppard B. , Beller G. , O'Rielly C. , Wong Charles 
Published: May 2020

Introduction: Evidence is accumulating that a CT plus a CT angiogram (CTA) of the head and neck may be adequate to rule out subarachnoid haemorrhage (SAH) in patients with a thunderclap headache, thus potentially negating the need for lumbar puncture. One of the most widely cited objections to this strategy is the fear of detecting “incidental asymptomatic aneurysms,” lesions seen on angiography that are not in fact the cause of the patient's symptoms. Currently existing data on the background rate of aneurysms are based on cadaveric studies, invasive angiography, or MRI, and thus does not reflect the true rate of incidental aneurysms that would be detected using a CT plus CTA strategy. This study characterizes the rate of incidental aneurysms identified on CTA in an emergency department population. Methods: In this multicentre retrospective cohort study we analyzed the electronic medical records of all emergency department patients ≥ 18 years of age who underwent CTA of the head and neck over a two month period across four urban tertiary care emergency departments. Two independent reviewers evaluated the final radiology reports and extracted relevant data. The primary outcome of interest was the presence of incidental intracranial aneurysm, defined as a newly diagnosed aneurysm not associated with evidence of acute hemorrhage. Secondary outcomes included aneurysm location and size. Results: Of 739 charts meeting inclusion criteria, incidental intracranial aneurysms were detected in 21 cases or 2.85% (95% confidence interval, 1.77 - 4.32). An additional 20 aneurysms were identified but excluded from the analysis as they were previously known (n = 9) or were associated with evidence of acute hemorrhage (n = 11) and thus were not considered incidental. Of 21 patients with identified incidental aneurysms, 7 had multiple aneurysms. The most common aneurysm sites were internal carotid artery (n = 13), middle cerebral artery (n = 6) and anterior cerebral artery (n = 4). The average size of incidental aneurysm was 4.1 mm. Conclusion: The rate of incidental intracranial aneurysm among emergency department patients undergoing CTA of the head and neck is lower than many previously described estimates obtained through invasive angiography and MRI studies. To our knowledge, this is the first study on the prevalence of incidental intracranial aneurysms in an emergency department specific population and may therefore help guide clinicians when considering using a CT plus CTA rule out strategy for patients presenting with acute headache suspicious for SAH.