bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘A less unpalatable alternative’: Executive leaders strategically redefining their work in primary MATs
Authors: Spicksley Kathryn 
Published: September 2020

Since the election of the Coalition government in 2010, an increasing number of primary schools in England have converted to academy status. This article explores how executive leaders working in primary academies construct academy freedoms and their attitudes towards their local authorities. Interviews with four executive leaders working in two contrasting Multi-Academy Trusts were analysed using critical discourse analysis. Findings show that in these primary academies, leaders chose to discursively distance themselves from other academy schools, and instead construct themselves as continuing the best traditions of local authority support. The findings indicate that the professional identities of academy leaders, as key policy actors, have an impact on how national policy is interpreted and enacted. The discourse of these academy leaders suggests that primary academisation has led to school leaders appropriating methods of strategic redefinition, to navigate the new post-2010 education landscape and construct new professional identities.
Four Faces of Marginalisation: Variations in Institutional Frameworks of Welfare State Provisions and Social Trust in Europe
Authors: Tamilina Larysa , Tamilina Natalya 
Published: September 2020

By assuming that marginalisation threatens social trust formation, this study introduces a new analytical framework to explain the relationship between a welfare state’s institutional design and trust levels in European societies. A good’s lifecycle view, consisting of production and consumption, is applied to the provision of social benefits to discern four forms of marginalisation in an individual’s experience with the welfare state: (a) marginalisation through attitude, (b) marginalisation through context, (c) marginalisation through poverty and (d) marginalisation through opportunity lack. We argue that universalism in benefit provisions minimises each of the four marginalisation forms whereas selectivity is characterised by higher odds of marginalisation. We further demonstrate that this especially holds true when universal social programmes are generous, and the State dedicates substantial resources to their funding. When the State’s resources are scarce, selectivity becomes a good alternative to universalism and may enhance social trust formation among individuals. We tested our hypotheses using data from the European Social Survey (2010). JEL: D02, D03, Z10, Z1
End-of-Life Nutrition Considerations: Attitudes, Beliefs, and Outcomes
Authors: Loofs Tyler S. , Haubrick Kevin 
Published: September 2020

Objective: To assess the physiological outcomes and interpersonal influences that should be considered when making the decision to provide artificial nutrition and hydration (AN&H) for patients in hospice/palliative programs. Methods: A systematic review was conducted using items from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist. Distinct search strategies were employed to find primary research articles that addressed: General health outcomes of artificial nutrition and hydration interventions and nutrition therapy interventions (n = 16), nutrition-related symptoms in end-of-life care (n = 8), and the attitudes of patients and providers toward artificial nutrition and hydration (n = 21). Results: The effect of AN&H on health outcomes, quality-of-life measures and nutrition-related symptoms is limited and may vary by patient setting and diagnosis. In the absence of consistent evidence for specific health outcomes, decisions regarding AN&H should be made in context of the desires and beliefs of a patient, their family, and their medical providers. These beliefs may not be consistent with likely outcomes or may be inconsistent between individuals involved in the decision-making process, and individuals of different cultures or geographic regions may approach AN&H decisions from different perspectives. To help navigate the intersection of nutrition-related health outcomes and patient/provider beliefs, palliative care teams may employ a variety of strategies for approaching the decision-making process, and may benefit from specific involvement of a Registered Dietitian to help contribute to or lead these discussions.
Efficacy of azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis
Authors: Alemu Birhanu Motbaynor , Worku Teshager 
Published: September 2020

Background: Azithromycin 1% and 1.5% ophthalmic preparations are used widely in clinical practice for the treatment of signs and symptoms of eye diseases. The aim of this study was to render conclusive evidence by comparing the efficacy of azithromycin 1% and 1.5% over tobramycin 0.3% ophthalmic solutions for the treatment of eye diseases in a short duration in terms of bacterial resolution, the cure rate, and resolving clinical sign and symptoms. Methods: Systematic searches were performed in the electronic database (MEDLINE, Embase, Emcare, CINAHL, Scopus, PubMed, ProQuest, and Web of Science) and other sources. Multicenter randomized controlled trial studies conducted in English were identified and screened. Analysis of individual studies was conducted using the OpenMeta-analyst and Review Manager Version 5.3 software. Results: Eleven studies were included in the systematic review and meta-analysis. In clinical cure rate, azithromycin 1% and 1.5% eye drops were more effective than tobramycin 0.3% eye drops in short duration dosing (⩽5 days) with a twice-a-day regimen (relative risk = 1.13; 95% confidence interval: 1.008, 1.28), whereas on increased duration (>5 days), azithromycin is almost similarly as effective as tobramycin (relative risk = 1.007; 95% confidence interval: 0.96, 1.05). There was no significant difference in efficacy of bacterial resolution of azithromycin (1%, 1.5%) eye drops compared to tobramycin (0.3%) eye drops (relative risk = 0.99; 95% confidence interval: 0.96, 1.018). Azithromycin eye drops are effective in improving the signs and symptoms of eye disease. Conclusion: Azithromycin 1% or 1.5% is more effective in the clinical cure rate of eye disease than tobramycin 0.3% eye drops in ⩽5 days of treatment. It is also the best choice of treatment for improving the signs and symptoms of eye disease. So that we recommend clinicians to use azithromycin 1% or 1.5% eye drops. Systematic Review Registration: PROSPERO 2019 CRD42019139911
Anatomic Characteristics of Tissues Attached to the Fifth Metatarsal Bone
Authors: Kaneko Fumiya , Edama Mutsuaki , Ikezu Masahiro , Matsuzawa Kanta , Hirabayashi Ryo , Kageyama Ikuo 
Published: September 2020

Background: Two types of stress, bending stress and traction stress, have been reported to be involved in the mechanism of Jones fracture. However, little is known about the risk factors for traction stress. Purpose: To classify the attachment position of the peroneus brevis muscle (PB), peroneus tertius (PT), lateral band of the plantar aponeurosis (LB), and the long plantar ligament (LPL), focusing on the zone where a Jones fracture occurs (zone 2), and to compare the footprint area of each tissue type. Study Design: Descriptive laboratory study. Methods: This study examined 102 legs from 55 Japanese cadavers. Type classification was performed by focusing on the positional relationship between each tissue attachment and the zone where Jones fracture occurs (zone 2). The classifications were as follows: type I, attached proximal to the border between zones 1 and 2; type IIa, attached to the border between zones 1 and 2 with one attached part; and type IIb, attached across the border between zones 1 and 2 with two or more attached parts. The footprint areas of the PB, PT, LB, and LPL were compared between tissue types and within each attachment classification. Results: The PB was recorded as type I in 41 feet (40.2%), type IIa in 56 feet (54.9%), and type IIb in 5 feet (4.9%); the PT was recorded as type IIa in 54 feet (60.0%) and type IIb in 36 feet (40.0%); and the LB was recorded as type I in 27 feet (26.5%) and type IIa in 75 feet (73.5%). The LPL did not attach to the fifth metatarsal bone. No significant difference was found in the footprint area between type I PB and type I LB. Conclusion: The results indicate that type I, which attaches proximal to zone 2, occurs with PB and LB, and there was no significant difference in the footprint area between them. These findings suggest that type I is involved in traction stress. In the future, biomechanical research based on the results of this study will be necessary. Clinical Relevance: The results of this study provide basic research for investigating the mechanism of Jones fracture and the cause of delayed healing.
The HIV and SARS-CoV-2 Parallel in Dentistry from the Perspectives of the Oral Health Care Team
Authors: Brondani M. , Donnelly L. 
Published: September 2020

Objectives: The aim of this study was to unravel the professional and social consequences of COVID-19 as compared with the AIDS pandemic according to oral health care providers, staff, and administrators. Methods: An exploratory qualitative inquiry via at-a-distance, semistructured interviews engaged a purposefully recruited sample of oral health care team workers in British Columbia. Interviews took place between April 20 and May 15, 2020; they were audio recorded, transcribed verbatim, and deidentified for interactive thematic analysis. An inductive process of coding was used to identify themes, subthemes, and categories of information. Results: Forty-five interviews were conducted with 18 dentists, 12 dental hygienists, 6 certified dental assistants, and 9 administrators; 22 were females. Interviews each lasted an average of 48 min. After the transcripts were coded, 3 subthemes emerged: 1) personal protective equipment and universal precautions as commonsense approaches to care during both pandemics; 2) an (un)collapsed world in terms of global lockdowns; and 3) social unrest in terms of the potential for stigma and discrimination caused by both pandemics. These subthemes made up the COVID-19–AIDS parallel theme. Conclusion: This study explored the extent to which the current COVID-19 pandemic is leading to professional and social consequences when a parallel is drawn with the AIDS pandemic. This is the first qualitative study that identifies the potential social unrest of the pandemic from the perspective of oral health care providers and administrators. Future studies should include other providers across Canada, as well the patients receiving oral health care during this pandemic. Knowledge Transfer Statement: The COVID-19 pandemic has unraveled potential societal implications in a parallel to the HIV/AIDS era from the perspectives of oral health care providers and their staff. Such implications are changing the way that oral health care is delivered; it may also be leading to social unrest in the form of stigma and discrimination. This study discusses some of these implications from the perspective of oral health care providers and administrators.
A framework for the management of donated medical devices based on perspectives of frontline public health care staff in Ghana
Authors: Williams Dinsie B , Kohler Jillian C , Howard Andrew , Austin Zubin , Cheng Yu-Ling 
Published: September 2020

Background: Transnational funders provide up to 80% of funds for medical devices in resource-limited settings, yet sustained access to medical devices remains unachievable. The primary goal of this study was to identify what factors hinder access to medical devices through the perspectives of frontline public hospital staff in Ghana involved in the implementation of transnational funding initiatives. Methods: A case study was developed that involved an analysis of semi-structured interviews of 57 frontline technical, clinical and administrative public health care staff at 23 sites in Ghana between March and April 2017; a review of the national guidelines for donations; and images of abandoned medical devices. Results: Six key themes emerged, demonstrating how policy, collaboration, quality, lifetime operating costs, attitudes of health care workers and representational leadership influence access to medical devices. An in-depth assessment of these themes has led to the development of an enterprise-wide comprehensive acquisition and management framework for medical devices in the context of transnational funding initiatives. Conclusion: The findings in this study underscore the importance of incorporating frontline health care staff in developing solutions that are targeted at improving delivery of care. Sustained access to medical devices may be achieved in Ghana through the adoption of a rigorous and comprehensive approach to acquisition, management and technical leadership. Funders and public health policy makers may use the study’s findings to inform policy reform and to ensure that the efforts of transnational funders truly help to facilitate sustainable access to medical devices in Ghana.
Successful management of zinc phosphide poisoning—a Hungarian case
Authors: Bilics Gergely , Héger Júlia , Pozsgai Éva , Bajzik Gábor , Nagy Csaba , Somoskövi Csilla , Varga Csaba 
Published: September 2020

Abstract
Background
Zinc phosphide (ZnP) is the basic component of several insecticides easily accessible worldwide. Intentional or accidental intoxication may lead to severe complications and multiple organ failure, resulting in high mortality. No known antidote is currently available. The iron-chelation and the antioxidative effects are well-known features of alpha-lipoic acid (ALA), although its use in the treatment of ZnP poisoning has not been documented previously. We describe the case of a patient with serious ZnP poisoning with multiple organ failure, where ALA was also included in the patient’s supportive therapy.

Case presentation
A 65-year-old man ingested 125 g of Arvalin® (containing 5 g ZnP) and presented to the Emergency Department, with respiratory insufficiency and decreased consciousness. He developed hypokalemia, hypocalcemia, low white blood cell count, elevated C-reactive protein level, mixed acidosis, hepatic and kidney damage, thickening of the jejunal wall, and lung atelectasis, which served as a basis for the ensuing bacterial pneumonia. Antibiotics and adequate supportive therapy were provided. Laboratory tests indicated liver damage (slightly increased liver enzymes, low pseudocholinesterase levels; 706 U/L on day 2), possibly caused by the patient’s chronic alcoholism or the ZnP poison itself, therefore, hepatoprotective agents, ALA (Thiogamma Turbo-Set®) with N-acetylcysteine were administered for six consecutive days. Pseudocholinesterase values increased sixfold until the end of the second week of care. Fifteen days after admission, the patient was relocated to the department of psychiatry with stable vital functions, clear consciousness, declining inflammatory markers, and improved liver function. He was discharged 1 month later, fully recovered.

Conclusions
Our case is the first documented voluntary and severe ZnP poisoning in Hungary. Our patient developed multiple organ failure and atelectasis, possibly resulting in the observed respiratory infection. The development of bacterial pneumonia highlighted the dangers of phosphine-induced atelectasis. The use of ALA in our patient’s case, as an antioxidant and agent for metal chelation, suggested that this agent could be a promising tool in the prevention and treatment of ZnP-induced hepatic damage.
Genome-wide identification and expression patterns analysis of the RPD3/HDA1 gene family in cotton
Authors: Zhang Jingjing , Wu Aimin , Wei Hengling , Hao Pengbo , Zhang Qi , Tian Miaomiao , Yang Xu , Cheng Shuaishuai , Fu Xiaokang , Ma Liang , Wang Hantao , Yu Shuxun 
Published: September 2020

Abstract
Background
Histone deacetylases (HDACs) catalyze histone deacetylation and suppress gene transcription during various cellular processes. Within the superfamily of HDACs, RPD3/HDA1-type HDACs are the most studied, and it is reported that RPD3 genes play crucial roles in plant growth and physiological processes. However, there is a lack of systematic research on the RPD3/HDA1 gene family in cotton.

Results
In this study, genome-wide analysis identified 9, 9, 18, and 18 RPD3 genes in Gossypium raimondii, G. arboreum, G. hirsutum, and G. barbadense, respectively. This gene family was divided into 4 subfamilies through phylogenetic analysis. The exon-intron structure and conserved motif analysis revealed high conservation in each branch of the cotton RPD3 genes. Collinearity analysis indicated that segmental duplication was the primary driving force during the expansion of the RPD3 gene family in cotton. There was at least one presumed cis-element related to plant hormones in the promoter regions of all GhRPD3 genes, especially MeJA- and ABA-responsive elements, which have more members than other hormone-relevant elements. The expression patterns showed that most GhRPD3 genes had relatively high expression levels in floral organs and performed higher expression in early-maturity cotton compared with late-maturity cotton during flower bud differentiation. In addition, the expression of GhRPD3 genes could be significantly induced by one or more abiotic stresses as well as exogenous application of MeJA or ABA.

Conclusions
Our findings reveal that GhRPD3 genes may be involved in flower bud differentiation and resistance to abiotic stresses, which provides a basis for further functional verification of GhRPD3 genes in cotton development and a foundation for breeding better early-maturity cotton cultivars in the future.
Interaction of zinc and IAA alleviate aluminum-induced damage on photosystems via promoting proton motive force and reducing proton gradient in alfalfa
Authors: Su Liantai , Xie Jianping , Wen Wuwu , Li Jiaojiao , Zhou Peng , An Yuan 
Published: September 2020

Abstract
Background
In acidic soils, aluminum (Al) competing with Zn results in Zn deficiency in plants. Zn is essential for auxin biosynthesis. Zn-mediated alleviation of Al toxicity has been rarely studied, the mechanism of Zn alleviation on Al-induced photoinhibition in photosystems remains unclear. The objective of this study was to investigate the effects of Zn and IAA on photosystems of Al-stressed alfalfa. Alfalfa seedlings with or without apical buds were exposed to 0 or100 μM AlCl3 combined with 0 or 50 μM ZnCl2, and then foliar spray with water or 6 mg L− 1 IAA.

Results
Our results showed that Al stress significantly decreased plant growth rate, net photosynthetic rate (Pn), quantum yields and electron transfer rates of PSI and PSII. Exogenous application of Zn and IAA significantly alleviated the Al-induced negative effects on photosynthetic machinery, and an interaction of Zn and IAA played an important role in the alleviative effects. After removing apical buds of Al-stressed alfalfa seedlings, the values of pmf, gH+ and Y(II) under exogenous spraying IAA were significantly higher, and ΔpHpmf was significantly lower in Zn addition than Al treatment alone, but the changes did not occur under none spraying IAA. The interaction of Zn and IAA directly increased Y(I), Y(II), ETRI and ETRII, and decreased O2− content of Al-stressed seedlings. In addition, the transcriptome analysis showed that fourteen functionally noted genes classified into functional category of energy production and conversion were differentially expressed in leaves of alfalfa seedlings with and without apical buds.

Conclusion
Our results suggest that the interaction of zinc and IAA alleviate aluminum-induced damage on photosystems via increasing pmf and decreasing ΔpHpmf between lumen and stroma.
“Black box warning” rash with entecavir - case report
Authors: Cheong Xiong Khee , Wong Zhiqin , Nor Norazirah Md , Lee Bang Rom 
Published: September 2020

Abstract
Background
Hepatitis B infection is a significant worldwide health issue, predispose to the development of liver cirrhosis and hepatocellular carcinoma. Entecavir is a potent oral antiviral agent of high genetic barrier for the treatment of chronic hepatitis B infection. Cutaneous adverse reaction associated with entecavir has rarely been reported in literature. As our knowledge, this case was the first case reported on entecavir induced lichenoid drug eruption.

Case presentation
55 year old gentlemen presented with generalised pruritic erythematous rash on trunk and extremities. Six weeks prior to his consultation, antiviral agent entecavir was commenced for his chronic hepatitis B infection. Skin biopsy revealed acanthosis and focal lymphocytes with moderate perivascular lymphocyte infiltration. Skin condition recovered completely after caesation of offending drug and short course of oral corticosteroids.

Conclusion
This case highlight the awareness of clinicians on the spectrum of cutaneous drug reaction related to entecavir therapy.
Sex differences in the prevalence and determinants of HPV-related external genital lesions in young adults: a national cross-sectional survey in Brazil
Authors: Comerlato Juliana , Kops Natália Luiza , Bessel Marina , Horvath Jaqueline Driemeyer , Fernandes Bruna Vieira , Villa Luisa Lina , de Souza Flavia Moreno Alves , Pereira Gerson Fernando Mendes , Wendland Eliana Márcia 
Published: September 2020

Abstract
Background
External genital lesions (EGL) are the most common sexually transmitted infections (STIs). We aimed to evaluate the prevalence, determinants and sex differences in EGL among young adults from Brazil.

Methods
Overall, 7694 participants (aged 16 to 25 years) underwent an interview, genital examination and sampling for HPV genotyping.

Results
The prevalence of EGL was 4.08% (234) and is more frequent in men (5.72%) than women (2.31%) (p <  0.001). Genital lesions were significantly associated with male sex, infection by high-risk and multiple HPV types, having more than two sexual partners in the last year, smoking status and the presence of other STI. While alcohol use was associated with a higher prevalence of EGL in women, same-sex sexual relationship increase the prevalence in men. In the EGL group, 67.79% (p = 0.032) were positive for HPV infection and the types HPV6 and HPV11 were the most prevalent ones.

Conclusion
The prevalence of EGL in young adults was consistently high, and most cases were associated with genital HPV infection and STIs. Although men have a higher prevalence, both sexes share most genital lesion determinants. The promotion of sexual education and vaccination especially focus in young men, who are usually outside the targets of primary health care programmes, can prevent EGL in Brazilian young adults.