bluuebunny/crossref_metadata_2025 huggingface dataset:
Adopting the Model Minority Myth: Korean Adoption as a Racial Project
Authors: Laybourn SunAh M
Published: December 2019

Drawing upon racial formation theory, this paper argues that Korean adoption was part of a racial project that advanced the model minority myth, helping shape what it means to be Asian in America. This focus on Korean adoption as part of the foundation of the model minority myth departs from traditional renderings that concentrate exclusively on Japanese and Chinese Americans. It also addresses the exclusion of Korean adoptees from Asian immigration history. In making this argument, I incorporate historical context and draw upon Korean adoptee adults’ online survey responses (N=107) and in-depth interviews (N=37) to examine the multiple domains that enacted this racial project, including policy, family socialization, and interpersonal interactions, and the effect on Korean adoptees. Implications of this racial project are discussed in relation to contemporary adoptee deportations and citizenship rights advocacy.
The Racial Politics of Place in Faith-Based Social Service Provision
Authors: Bolger Daniel
Published: December 2019

Prior research indicates that faith-based social service providers are overrepresented in disadvantaged neighborhoods, which has led some to advocate for their increased involvement in the U.S. social safety net. Yet, we have little understanding of how they and other social service organizations understand the significance of place in their work. Here I explore how conceptions of place matter for social service provision by drawing on 12 months of ethnographic observation and interviews with 24 key informants in two faith-based social service organizations in Houston, Texas. I find that faith-based organizations attach significance to their geographic location based not only on their proximity (or lack thereof) to their target service recipients, but also through relationships with key stakeholders. Agencies label places as safe or unsafe to recruit donors and volunteers, but in doing so they channel resources unequally between communities in ways that perpetuate racial disparities in social service access. The results have implications for understanding the importance of place within social service organizations, particularly faith-based agencies, which are increasingly relied upon to serve the urban poor.
How the West Was Fun: Children’s Literature and Frontier Mythmaking toward the Turn of the Twentieth Century
Authors: Rouleau Brian
Published: December 2019

This article discusses the important role that juvenile literature played in creating America’s frontier mythos. It argues that children were a crucial audience for adult authors seeking to justify and normalize settler colonial policies. But, more importantly, young people themselves were active participants in the perpetuation of a popular culture that glorified westward expansion and the eradication of Indigenous peoples. In acknowledging as much, we arrive at a richer understanding of the important intersections between western history and the history of childhood in the United States.
Predictors of Opioid and Alcohol Pharmacotherapy Initiation at Hospital Discharge Among Patients Seen by an Inpatient Addiction Consult Service
Authors: Englander Honora , King Caroline , Nicolaidis Christina , Collins Devin , Patten Alisa , Gregg Jessica , Korthuis P. Todd
Published: December 2019

Background:

Medications for opioid use disorder (MOUD) and alcohol use disorder (MAUD) are effective and under-prescribed. Hospital-based addiction consult services can engage out-of-treatment adults in addictions care. Understanding which patients are most likely to initiate MOUD and MAUD can inform interventions and deepen understanding of hospitals’ role in addressing substance use disorders (SUD).

Objective:

Determine patient- and consult-service level characteristics associated with MOUD/MAUD initiation during hospitalization.

Methods:

We analyzed data from a study of the Improving Addiction Care Team (IMPACT), an interprofessional hospital-based addiction consult service at an academic medical center. Researchers collected patient surveys and clinical data from September 2015 to May 2018. We used logistic regression to identify characteristics associated with medication initiation among participants with OUD, AUD, or both. Candidate variables included patient demographics, social determinants, and treatment-related factors.

Results:

Three hundred thirty-nine participants had moderate to severe OUD, AUD, or both and were not engaged in MOUD/MAUD care at admission. Past methadone maintenance treatment (aOR 2.07, 95%CI (1.17, 3.66)), homelessness (aOR 2.63, 95%CI (1.52, 4.53)), and partner substance use (aOR 2.05, 95%CI (1.12, 3.76) were associated with MOUD/MAUD initiation. Concurrent methamphetamine use disorder (aOR 0.32, 95%CI (0.18, 0.56)) was negatively associated with MOUD/MAUD initiation.

Conclusions:

The association of MOUD/MAUD initiation with homelessness and partner substance use suggests that hospitalization may be an opportunity to reach highly-vulnerable people, further underscoring the need to provide hospital-based addictions care as a health-system strategy. Methamphetamine's negative association with MOUD/MAUD warrants further study.
Cardiac electrical and mechanical synchrony of super-responders to cardiac resynchronization therapy
Authors: Li Ke-Bei , Qian Zhi-Yong , Qian Xue-Song , Zhou Yong , Zhu Di-Di , Qiu Yuan-Hao , Wang Yao , Hou Xiao-Feng , Zou Jian-Gang , Sheng Yu-Feng
Published: December 2019

Background

Super-responders (SRs) to cardiac resynchronization therapy (CRT) regain near-normal or normal cardiac function. The extent of cardiac synchrony of SRs and whether continuous biventricular (BIV) pacing is needed remain unknown. The aim of this study was to evaluate the cardiac electrical and mechanical synchrony of SRs.

Methods

We retrospectively analyzed CRT recipients between 2008 and 2016 in 2 centers to identify SRs, whose left ventricular (LV) ejection fraction was increased to ≥50% at follow-up. Cardiac synchrony was evaluated in intrinsic and BIV-paced rhythms. Electrical synchrony was estimated by QRS duration and LV mechanical synchrony by single-photon emission computed tomography myocardial perfusion imaging.

Results

Seventeen SRs were included with LV ejection fraction increased from 33.0 ± 4.6% to 59.3 ± 6.3%. The intrinsic QRS duration after super-response was 148.8 ± 30.0 ms, significantly shorter than baseline (174.8 ± 11.9 ms,P = 0.004,t = −3.379) but longer than BIV-paced level (135.5 ± 16.7 ms,P = 0.042,t = 2.211). Intrinsic LV mechanical synchrony significantly improved after super-response (phase standard deviation [PSD], 51.1 ± 16.5°vs.19.8 ± 8.1°,P < 0.001,t = 5.726; phase histogram bandwidth (PHB), 171.7 ± 64.2°vs.60.5 ± 22.9°,P < 0.001,t = 5.376) but was inferior to BIV-paced synchrony (PSD, 19.8 ± 8.1°vs.15.2 ± 6.4°,P = 0.005,t = 3.414; PHB, 60.5 ± 22.9°vs.46.0 ± 16.3°,P = 0.009,t = 3.136).

Conclusions

SRs had significant improvements in cardiac electrical and LV mechanical synchrony. Since intrinsic synchrony of SRs was still inferior to BIV-paced rhythm, continued BIV pacing is needed to maintain longstanding and synchronized contraction.
Cardiac Rehabilitation for Adults and Adolescents With Congenital Heart Disease
Authors: Sarno Lauren A. , Misra Amrit , Siddeek Hani , Kheiwa Ahmed , Kobayashi Daisuke
Published: December 2019

Purpose:

Cardiac rehabilitation (CR) effectively decreases morbidity and mortality in adults after cardiovascular events. Cardiac rehabilitation has been underutilized for patients with congenital heart disease (CHD). The primary objective was to evaluate the inclusion of adolescents and adults with CHD in a CR program by analyzing data from our single-center CR program. The secondary objectives were to evaluate the efficacy and safety of CR as well as referral barriers.

Methods:

This was a retrospective study of patients aged ≥15 yr who were referred to regional CR centers. Data on efficacy and safety were collected.

Results:

Over a 4-yr period, 36 patients were referred to 23 regional centers: 23 patients completed CR, 12 are currently enrolled or in the referral process, and 1 died before initiation. The median age was 22 yr (range: 15-55). The primary indication was post-surgical (61%), followed by chronic heart failure (30%), and post-transplant (9%). After CR, metabolic equivalent tasks increased by 1.6 (P < .001), maximal heart rate increased by 13 beats/min (P = .026), exercise time increased by 1.35 min (P = .047), and treadmill speed increased by 0.7 mph (P = .007). There were no serious adverse events. All patients who completed CR remain alive at a median follow-up of 17 mo (range: 5-45). Common barriers to CR included accessibility, social circumstances, and cost for phase III CR.

Conclusion:

In our cohort, CR was effective and safe for adolescents and adults with CHD.
The Journal of Cardiopulmonary Rehabilitation and Prevention at 40 Years and Its Role in the Evolution of Cardiac Rehabilitation
Authors: Ades Philip A. , Balady Gary J. , Berra Kathy , Franklin Barry A. , Froelicher Victor , Hamm Larry F. , Kaminsky Leonard A. , Williams Mark A.
Published: December 2019

The maturing of a clinical discipline necessitates the ability to document scientific advancements and state-of-the-art reviews with a focus on clinical practice. Such was the case for the field of cardiac rehabilitation in 1981. Whereas a growing body of literature was demonstrating benefits of exercise in cardiac patients with regard to clinical, psychologic, and quality-of-life outcomes,1
,
2 there were still concerns about the safety of exercise and whether it could be widely adapted in clinical care. Since this was a time period when searches of online databases such as PubMed had not yet been established (began in 1996), there was a great value of concentrating much of the cardiac rehabilitation literature in a single journal.

This commentary describes the conceptualization and implementation of the Journal of Cardiopulmonary Rehabilitation and Prevention from 1981 to the present and its acceptance as the official journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and later the Canadian Association of Cardiac Rehabilitation. The commentary also highlights the journal's inclusion in Index Medicus in 1995, its receipt of an impact factor from International Scientific Indexing in 2007, and its publication of many important scientific statements, often in collaboration with major scientific organizations such as the American Heart Association and the American College of Cardiology.
An Analysis of YouTube Videos as Educational Resources for Patients About Refractive Surgery
Authors: Kuçuk Bekir , Sirakaya Ender
Published: December 2019

Purpose:

The aim of the study was to assess the quality of videos on YouTube as educational resources about refractive surgery.

Methods:

This is a retrospective, cross-sectional, register-based study. A search of YouTube was performed for the term “refractive surgery” without any changes to the Web site's standard search preferences. The first 160 videos were recorded. Additional videos from the search engine were also searched for the other common terms “LASIK,” “PRK,” and “laser eye surgery.” The first 50 videos for each additional term were evaluated. A total of 310 videos were evaluated regarding DISCERN score (min–max: 16–75), Journal of the American Medical Association score (min–max: 0–4), and Global Quality score (min–max: 0–5).

Results:

Once 135 videos that did not meet the inclusion criteria were excluded from the sample, the remaining 175 videos were analyzed. The mean DISCERN, Journal of the American Medical Association, and Global Quality scores were 33.25 ± 15.34 (poor quality), 0.74 ± 0.82 (lowest quality), and 1.74 ± 0.81 (poor quality), respectively. Of the 175 videos, 77 (42%) had been uploaded by physicians, 67 (38.2%) by health channels, 16 (9.1%) by patients, and another 15 (8.5%) by medical organizations.

Conclusions:

Although some of the analyzed online videos contain beneficial information, YouTube videos do not generally seem to be useful as educational resources for patients about refractive surgery. Nevertheless, health care professionals should continue to assess the reliability and usefulness of medical information provided by online resources from the viewpoint of patients.
Flushing Versus Pushing Technique for Graft Implantation in Descemet Membrane Endothelial Keratoplasty
Authors: Siebelmann Sebastian , Janetzko Mona , König Peter , Scholz Paula , Matthaei Mario , Händel Alexander , Cursiefen Claus , Bachmann Björn
Published: December 2019

Purpose:

Descemet membrane endothelial keratoplasty (DMEK) has developed into a safe procedure for the replacement of diseased corneal endothelium. However, DMEK still results in a significant donor endothelial cell loss. Here, we compare 2 different graft implantation techniques.

Methods:

Twenty patients undergoing DMEK, where a DMEK injection cartridge was used to flush the graft into the anterior chamber (G-38635 single-use DMEK-Cartridge; Geuder AG, Heidelberg, Germany; group A), were retrospectively compared with 20 patients, where a standard lens injection cartridge (AT.Smart Cartridge; Carl Zeiss Meditec AG, Jena, Germany; group B) was used to push the graft with a plunger. Outcome parameters were intraoperative orientation of the graft, insertion-to-attachment time, rebubbling rates, and postoperative best spectacle-corrected visual acuity, endothelial cell count, and central corneal thickness after 12 months. The surfaces of both cartridges were evaluated by scanning electron microscopy.

Results:

In group A, the insertion-to-attachment time was significantly higher (P = 0.003). Initially, the graft was oriented correctly in 40% of the patients in group A compared with 90% in group B (P = 0.001). No differences were obtained between both groups regarding central corneal thickness, endothelial cell count or best spectacle-corrected visual acuity, and rebubbling rates after 12 months. Scanning electron microscopy analysis demonstrated a rougher and sharper surface of the shooter of group B.

Conclusions:

This study shows significant differences between both insertion techniques regarding correct graft orientation directly after graft implantation leading to prolonged insertion-to-attachment time when the graft is flushed instead of pushed into the anterior chamber.
Eccrine Porocarcinoma: A Rare Tumor of the Eyelid With a Novel Histopathological Finding of Free Tumor Cells in the Tear Film
Authors: Conger Jordan R. , Palileo Bea M. , Grob Seanna R. , Tao Jeremiah , Minckler Don S.
Published: December 2019

The authors present a case of an eyelid eccrine porocarcinoma, a very rare malignant sweat gland tumor characterized histopathologically by nests of atypical poromatous cells and the presence of duct-like lumina. Histopathologic analysis of this case also exhibited numerous loose tumor cells in the adjacent tear film, a finding that has not been previously described.
On-call simulation for adult gerontology acute care nurse practitioner students: A comparative descriptive study
Authors: Griffith Patricia B. , Kelly Michelle M. , Becker Deborah
Published: December 2019

Background:

It is now commonplace for acute care nurse practitioners (ACNPs) to work in positions that include an on-call component or management of emergent concerns through telephone. There are no published reports on the inclusion of an on-call component in ACNP clinical preparation of students; novice ACNPs feel unprepared to competently and confidently manage emergent patient situations and on-call responsibilities.

Purpose:

To examine ACNP student perception of stress, necessary skills, confidence, and benefit of participating in a simulated on-call experience.

Methods:

Using simulated faculty callers as nurses, ACNP students participated in a simulated on-call experience that included receiving two calls, eliciting key information from the nurse, diagnosing and managing the patient, and submitting documentation of the encounter. Students completed preparticipation and postparticipation perception surveys, and they were evaluated by the simulated nurse (faculty) using standardized evaluation tools.

Results:

Acute care nurse practitioner students rated the simulated on-call experience as educationally valuable. High levels of anxiety before participation were notably improved after participation. Students identified critical thinking, clear communication, and knowledge with the specific disease as the most important skills needed to manage nurse calls successfully. Students reported marked improvement in their confidence and were receptive to accepting an nurse practitioner position with call/triage responsibilities after their on-call experience.

Implications for practice:

Inclusion of a simulated on-call experience in the final semester of an ACNP program is both feasible and relevant to ACNP student development. On-call exposure within the clinical practicum is inconsistent and, therefore, should be added through simulation.
Comorbid Cupulolithiasis Is Rare in Patients With Horizontal Semicircular Canal Canalolithiasis
Authors: Choi BoYoon , Nahm HyunJoo , Shin Jung Eun , Kim Chang-Hee
Published: December 2019

Objectives:

Considering that otolith particles pass through the canal until attaching to the cupula in the canal-side horizontal semicircular canal (HSCC) cupulolithiasis, comorbidity of HSCC canalolithiasis and cupulolithiasis may occur. We aimed to investigate the incidence of comorbidity of cupulolithiasis in patients with HSCC canalolithiasis and to improve treatment efficacy.

Study Design:

Retrospective study.

Setting:

Tertiary referral academic center.

Patients:

Ninety-seven consecutive patients with HSCC canalolithiasis between March 2017 and March 2019 were included.

Main Outcome Measures:

Coexistence of HSCC cupulolithiasis was hierarchically investigated. 1) Spontaneous reversal of initial nystagmus is observed bilaterally in a head-roll test (HRT), 2) nystagmus is in the same direction at each of the three times the supine position was tested, and 3) both bowing and leaning nystagmus with opposite direction are observed.

Results:

Of 97 patients with HSCC canalolithiasis, 2 patients (2%) had comorbid HSCC cupulolithiasis.

Conclusions:

Although coexistence of HSCC canalolithiasis and cupulolithiasis should be considered when spontaneous reversal of nystagmus direction is observed without position change during a HRT, the incidence of coexistence is very low. However, canalith repositioning maneuvers for both canalolithiasis and cupulolithiasis should be performed in cases with comorbidity.
Examining Predictors of Fear of Cancer Recurrence Using Leventhal’s Commonsense Model
Authors: Galica Jacqueline , Maheu Christine , Brennenstuhl Sarah , Townsley Carol , Metcalfe Kelly
Published: December 2019

Background

Fear of cancer recurrence (FCR) is a common concern for survivors. Oncology nurses have a unique opportunity to identify survivors at increased risk of heightened FCR. Understanding predictors of FCR would be useful for this purpose; however, results about FCR predictors are inconsistent.

Objective

To examine empirically inconsistent predictors of FCR as guided by Leventhal’s Commonsense Model.

Methods

A cross-sectional survey design was used to assess FCR, sociodemographic and clinical characteristics, and characteristics of the self (self-esteem and generalized expectancies) among cancer survivors. Structural equation modeling was used to examine predictors of FCR.

Results

Among 1001 participants, the mean time since diagnosis was 9.07 years, and most were diagnosed with breast cancer (65.93%). The strongest predictor of higher FCR was belief that knowing someone with a recurrence affects one’s own level of FCR, although knowing someone with a recurrence actually predicted lower FCR. Other significant predictors of higher FCR were having 1 or more symptoms attributed to cancer, lower self-esteem, younger age, female gender, lower pessimism, longer time since diagnosis, and active follow-up at the survivorship clinic.

Conclusion

Cancer survivors’ perceptions are among an important series of variables that may predict higher levels of FCR. Oncology nurses are uniquely situated to identify the subset of cancer survivors with levels of FCR requiring professional intervention.

Implications for Practice

Oncology nurses can use the predictors indicated in this study to identify survivors with greatest need for coping with FCR to facilitate expedient intervention and/or referral to psychosocial providers.
Preventing Postpartum Depression With Mindful Self-Compassion Intervention
Authors: Guo Lu , Zhang Jing , Mu Liping , Ye Zhao
Published: December 2019

Mindfulness and self-compassion are reported to have a preventive effects on depression and anxiety disorders. In the present study, we aimed to assess the effect of mindful self-compassion intervention on preventing postpartum depression in a group of symptomatic pregnant women. Participants were screened and assigned to the intervention and control groups randomly. A 6-week Internet-based Mindful Self-Compassion Program was used to train the participants. Multiple scales were used to assess depressive and anxiety symptoms, mindfulness, self-compassion, and mother and infant well-being. All assessments were performed at three time points: baseline, 3 months, and 1 year postpartum. Compared with the control group, the intervention group showed significant improvement in depressive and anxiety behaviors. In addition, the intervention group became more mindful and self-compassionate at 3 months and 1 year postpartum. More importantly, both mothers and infants experienced substantial improvement in well-being. Our findings indicate that mindful self-compassion intervention is effective in preventing postpartum depression and promoting mother and infant well-being.
A Pilot Quality Improvement Project to Reduce Preoperative Fasting Duration in Pediatric Inpatients
Authors: Nye Allison , Conner Erin , Wang Ellen , Chadwick Whitney , Marquez Juan , Caruso Thomas J.
Published: December 2019

Introduction:

Despite guidelines allowing clear liquids up to 2 hours before anesthesia, preoperative fasting for pediatric inpatients is often unnecessarily prolonged. This delay can lead to prolonged recovery time and increased postoperative pain. Efforts to reduce fasting duration in pediatric surgical patients is an evolving standard in pediatric anesthesiology. The primary aim of this quality improvement project was to reduce the average inpatient fasting duration undergoing anesthesia by 25% within a year of our pilot intervention. Secondary aims included measuring the adoption rate of the intervention and comparing aspiration rates as a balancing measure.

Methods:

At an academic pediatric hospital, we created the preanesthesia diet order, a standardized, clear liquid diet for eligible inpatients undergoing anesthesia to decrease preoperative fasting duration. After implementation in January 2018, a statistical process control chart was used to measure the fasting duration of all eligible inpatients by month, and the Wilcoxon rank-sum test assessed differences. A Poisson test was used to determine differences in aspiration rates.

Results:

Over the first year of our pilot intervention, 127 inpatients received the preanesthesia diet. The average fasting duration before its implementation was 12.5 and 5.7 hours postimplementation. The average adoption rate for eligible inpatients was 17.6%, and there was no difference in aspiration rates.

Conclusion:

This quality improvement project demonstrated that a standardized, clear liquid diet on the morning of surgery could reduce preoperative fasting times among pediatric inpatients. The adoption of this pilot intervention was limited, highlighting the challenges of implementing a practice change.
Automatic Quantitative Computed Tomography Evaluation of the Lungs in Patients With Systemic Sclerosis Treated With Autologous Stem Cell Transplantation
Authors: Wada Danilo Tadao , de Almeida Fabrício Arantes , de Moraes Daniela Aparecida , Dias Juliana Bernardes Elias , Baddini-Martinez José , Oliveira Maria Carolina , Koenigkam-Santos Marcel
Published: December 2019

Background/Objective

Interstitial lung disease stands among the leading causes of death in systemic sclerosis (SSc) patients. Autologous hematopoietic stem cell transplantation (AHSCT) has been proven superior to conventional immunosuppressive therapy in severe and progressive SSc. Here, pulmonary quantitative measurements were obtained in high-resolution computed tomography (HRCT) scans of patients with SSc before and after AHSCT.

Methods

The medical records of thirthy-three patients who underwent AHSCT between 2011 and 2017 were evaluated for clinical and tomographic features at baseline (pre-AHCST) and 18 months after the procedure. Quantitative analysis of HRCT images by a fully automated program calculated lung volumes, densities, attenuation percentiles, and vascular volume. Patients were divided into 2 groups, according to changes in forced vital capacity (FVC). The “best response” group included patients that had an increased FVC of 10% or greater, and the “stable response” group included those who had a decreased or an increased FVC of less than 10%.

Results

In the best response group (15 patients), there was reduction (p < 0.05) of mean lung density and density percentile values after AHSCT. In the stable response group (18 patients), there were no significant changes in lung volumes and pulmonary densities after AHSCT. Pulmonary HRCT densities showed moderate/strong correlation with function.

Conclusions

Quantitative HRCT analysis identified significant reduction in pulmonary densities in patients with improved pulmonary function after AHSCT. Lung density, as evaluated by the quantitative HRCT analysis tool, has potential to become a biomarker in the evaluation of interstitial lung disease treatment in patients with SSc.
Comparison of Saline Expanders and Air Expanders for Breast Reconstruction
Authors: Porter Brooke E. , Vonu Peter M. , Mast Bruce A.
Published: December 2019

Introduction

Postmastectomy breast reconstruction with saline tissue expanders requires frequent saline injections. Air expanders contain an air canister and patient-operated remote to control expansion. The aim of this study was to evaluate the effectiveness of air expanders, inclusive of cost.

Methods

An international review board-approved retrospective review was performed of women who underwent breast tissue expansion between January 1, 2005 and February 5, 2019. Data collected included demographics, distance from clinic, mastectomy type, breast cancer treatment, expander type, expansion duration, postoperative visits, expansion visits, and postoperative complications. We compared true, unrealized, and overall costs and efficiency measured by time for expansion completion. True cost was calculated by adding expander, saline, and needle prices. Unrealized cost was calculated by multiplying number of visits for expansion by the expense of roundtrip driving. T tests and z scores determined clinical significance.

Results

Postoperative complication rates were not significantly different between groups. The air expansion mean true cost was US $1006.11 more than saline expansion (P < 0.001), whereas the mean unrealized cost was US $551.81 less (P = 0.008). The air expansion mean overall cost was US $461.43 more than saline expansion (P = 0.063). There was no significant difference in time to expander-to-implant exchange.

Conclusions

This study demonstrates that saline and air expanders have no difference in complications or ability to complete expansion. However, there is significantly higher unrealized cost of saline expansion due to needle and saline costs and travel for more frequent doctor visits. However, saline expansion overall cost is less than air expansion, but statistically insignificant. Air expanders are effective in properly selected patients.
Expression of ArfGAP3 in Vaginal Anterior Wall of Patients With Pelvic Floor Organ Prolapse in Pelvic Organ Prolapse and Non–Pelvic Organ Prolapse Patients
Authors: Sun Yu , Li Bingshu , Lu Danhua , Liu Cheng , Hong Shasha , Hong Li
Published: December 2019

Purpose of Investigation

The purpose of this study was to study the expression of adenosine diphosphate ribosylation factor GTPase-activating protein 3 (ArfGAP3) in the anterior vaginal wall of patients with pelvic organ prolapse (POP).

Materials and Methods

From July 2016 to July 2018, the anterior vaginal wall of 31 POP patients (pelvic organ prolapse quantification [POP-Q] II-III [n = 10] and POP-Q IV [n = 21]) with pelvic floor dysfunction-related symptoms who underwent vaginal hysterectomy were enrolled in POP group in the Department of Gynecology of Wuhan University People’s Hospital. The anterior vaginal wall of 28 non-POP patients who underwent vaginal hysterectomy was selected as control group. The expression of 3 groups was determined by immunohistochemical staining, Western blotting, and quantitative real-time fluorescence polymerase chain reaction.

Results

The expression levels of ArfGAP3 of POP-Q II-III and POP-Q IV groups were lower than the control group (P < 0.05), and there were significant differences between POP-Q II-III and POP-Q IV groups (P < 0.05).

Conclusions

The expression of ArfGAP3 in the anterior vaginal wall of POP patients decreased, which was related to the pathogenesis and clinical grading of POP.
Energy-driven computing
Authors: Sliper Sivert T. , Cetinkaya Oktay , Weddell Alex S. , Al-Hashimi Bashir , Merrett Geoff V.
Published: December 2019

For decades, the design of untethered devices has been focused on delivering a fixed quality of service with minimum power consumption, to enable battery-powered devices with reasonably long deployment lifetime. However, to realize the promised tens of billions of connected devices in the Internet of Things, computers must operate autonomously and harvest ambient energy to avoid the cost and maintenance requirements imposed by mains- or battery-powered operation. But harvested power typically fluctuates, often unpredictably, and with large temporal and spatial variability. Energy-driven computers are designed to treat energy-availability as a first-class citizen, in order to gracefully adapt to the dynamics of energy harvesting. They may sleep through periods of no energy, endure periods of scarce energy, and capitalize on periods of ample energy. In this paper, we describe the promise and limitations of energy-driven computing, with an emphasis on intermittent operation.

This article is part of the theme issue ‘Harmonizing energy-autonomous computing and intelligence’.
Markov blankets, information geometry and stochastic thermodynamics
Authors: Parr Thomas , Da Costa Lancelot , Friston Karl
Published: December 2019

This paper considers the relationship between thermodynamics, information and inference. In particular, it explores the thermodynamic concomitants of belief updating, under a variational (free energy) principle for self-organization. In brief, any (weakly mixing) random dynamical system that possesses a Markov blanket—i.e. a separation of internal and external states—is equipped with an information geometry. This means that internal states parametrize a probability density over external states. Furthermore, at non-equilibrium steady-state, the flow of internal states can be construed as a gradient flow on a quantity known in statistics as Bayesian model evidence. In short, there is a natural Bayesian mechanics for any system that possesses a Markov blanket. Crucially, this means that there is an explicit link between the inference performed by internal states and their energetics—as characterized by their stochastic thermodynamics.

This article is part of the theme issue ‘Harmonizing energy-autonomous computing and intelligence’.
Real-time cortical simulation on neuromorphic hardware
Authors: Rhodes Oliver , Peres Luca , Rowley Andrew G. D. , Gait Andrew , Plana Luis A. , Brenninkmeijer Christian , Furber Steve B.
Published: December 2019

Real-time simulation of a large-scale biologically representative spiking neural network is presented, through the use of a heterogeneous parallelization scheme and SpiNNaker neuromorphic hardware. A published cortical microcircuit model is used as a benchmark test case, representing ≈1 mm
2
of early sensory cortex, containing 77 k neurons and 0.3 billion synapses. This is the first hard real-time simulation of this model, with 10 s of biological simulation time executed in 10 s wall-clock time. This surpasses best-published efforts on HPC neural simulators (3 × slowdown) and GPUs running optimized spiking neural network (SNN) libraries (2 × slowdown). Furthermore, the presented approach indicates that real-time processing can be maintained with increasing SNN size, breaking the communication barrier incurred by traditional computing machinery. Model results are compared to an established HPC simulator baseline to verify simulation correctness, comparing well across a range of statistical measures. Energy to solution and energy per synaptic event are also reported, demonstrating that the relatively low-tech SpiNNaker processors achieve a 10 × reduction in energy relative to modern HPC systems, and comparable energy consumption to modern GPUs. Finally, system robustness is demonstrated through multiple 12 h simulations of the cortical microcircuit, each simulating 12 h of biological time, and demonstrating the potential of neuromorphic hardware as a neuroscience research tool for studying complex spiking neural networks over extended time periods.

This article is part of the theme issue ‘Harmonizing energy-autonomous computing and intelligence’.
An energy efficient time-mode digit classification neural network implementation
Authors: Akgun O. C. , Mei J.
Published: December 2019

This paper presents the design of an ultra-low energy neural network that uses time-mode signal processing). Handwritten digit classification using a single-layer artificial neural network (ANN) with a Softmin-based activation function is described as an implementation example. To realize time-mode operation, the presented design makes use of monostable multivibrator-based multiplying analogue-to-time converters, fixed-width pulse generators and basic digital gates. The time-mode digit classification ANN was designed in a standard CMOS 0.18 μm IC process and operates from a supply voltage of 0.6 V. The system operates on the MNIST database of handwritten digits with quantized neuron weights and has a classification accuracy of 88%, which is typical for single-layer ANNs, while dissipating 65.74 pJ per classification with a speed of 2.37 k classifications per second.

This article is part of the theme issue ‘Harmonizing energy-autonomous computing and intelligence’.
SalvageDNN: salvaging deep neural network accelerators with permanent faults through saliency-driven fault-aware mapping
Authors: Abdullah Hanif Muhammad , Shafique Muhammad
Published: December 2019

Deep neural networks (DNNs) have proliferated in most of the application domains that involve data processing, predictive analysis and knowledge inference. Alongside the need for developing highly performance-efficient DNN accelerators, there is an utmost need to improve the yield of the manufacturing process in order to reduce the per unit cost of the DNN accelerators. To this end, we present ‘SalvageDNN’, a methodology to enable reliable execution of DNNs on the hardware accelerators with permanent faults (typically due to imperfect manufacturing processes). It employs a fault-aware mapping of different parts of a given DNN on the hardware accelerator (subjected to faults) by leveraging the saliency of the DNN parameters and the fault map of the underlying processing hardware. We also present novel modifications in a systolic array design to further improve the yield of the accelerators while ensuring reliable DNN execution using ‘SalvageDNN’ and negligible overheads in terms of area, power/energy and performance.

This article is part of the theme issue ‘Harmonizing energy-autonomous computing and intelligence’.
Developing high through put screening strategies to identify the next generation of antimicrobials
Authors: Booth Peter , McCarthy Ronan
Published: December 2019

Area of expertise: My research interests focus on identifying novel compounds that can disrupt key phenotypes associated with antibiotic resistance such as biofilm formation and motility in the pathogens Acinetobacter baumannii and Pseudomonas aeruginosa. To this end we have developed a range of screens and assays to facilitate compound identification and mechanism of action profiling in these pathogens. These include: Antibiotic Resistance Inhibitor Screens, Biofilm Inhibition Screens, Biofilm Disruption Screens, Signalling Pathway Specific Biosensor Screens , Mechanism of Action Assays, Resistance Development Screens, Antibiotic Resistance Inhibitor Screens, In vivo biofilm and pathogenicity models to validate lead compounds and perform toxicity profiling.

Future goals: Future goals include being part of a collaborative multidisciplinary drug discovery network that has access to diverse and bespoke extract/compound collections and the expertise to identify the bioactive leads, characterise their mechanism of action and ultimately take them forward to clinical trials. Further to this the goal is to target national and international funding opportunities that will facilitate taking active compounds right through the drug discovery pipeline from the bench to the bedside. I am hoping to identify collaborators across all aspects of drugs discovery, particularly collaborators with: Access to compound or extract collections, Expertise in compound identification ,Clinical trial expertise.
Budding induces symmetry defects in flavivirus virions
Authors: Kuhn Richard , Therkelsen Matthew , Klose Thomas , Rossmann Michael
Published: December 2019

Flaviviruses assemble at the endoplasmic reticulum in an immature, non-infectious state that is designed to inhibit premature fusion with the host. Maturation of the particle occurs when it enters the trans-Golgi network, where low pH induces a conformational rearrangement of the virus glycoproteins. This transition causes 60 prM-E glycoprotein trimers in the immature virus to rearrange into 90 M-E dimers in the mature virus. We hypothesize that flaviviruses do not have exact icosahedral symmetry, thus providing flexibility for the large conformational rearrangements that are required during the virus life cycle. When icosahedral symmetry constraints were excluded in calculating the cryo-EM reconstruction of immature Kunjin virus (KUNV), a low virulent strain of West Nile virus, the nucleocapsid core touched the inside of the viral lipid membrane at the “proximal pole” and was asymmetrically positioned within the lipid bilayer envelope. The outer glycoprotein spikes on the “distal pole” were either distorted or missing. In the asymmetric reconstruction of mature KUNV, the core was re-positioned, as expected, concentric with the glycoprotein shell and there remained a distortion of the glycoproteins on one pole of the virion. This suggests that the interactions between the core and glycoproteins are altered during viral assembly and budding from the ER. In addition, it implies that the glycoproteins have a geometric defect that perhaps facilitates the transitions that occur during maturation. This defect in number and arrangement of the glycoproteins may reflect the consequence of membrane budding.
Host genome depletion to determine the evolution, genetic diversity and transmission patterns of full genome sequences of African swine fever genotype IX from Uganda
Authors: Filipe Ana Da Silva , Vattipally Sreenu B. , Mair Daniel , Ogweng Peter , Mayega Johnson , Muwanika Vincent , Palmarini Massimo , Biek Roman , Masembe Charles
Published: December 2019

African swine fever (ASF) is a highly contagious viral haemorrhagic disease of domestic pigs, wild boar and feral swine. It is caused by the only DNA arbovirus, African swine fever virus (ASFV), which is the only member of the family Asfarviridae and is transmitted by the soft ticks in the genus Ornithodoros. ASF results in mortalities of up to 100% and exhibits different epidemiological patterns in Africa, Europe and Asia. This ASFV has recently spread to other countries in Europe and is also now present in Asia where it has spread like wildfire, resulting into high economic losses. The lack of a treatment or vaccine against this disease makes its control and prevention extremely difficult. This is partly due to the large size of the ASFV genome (170-190 kbp) and the many genes (187–190) that it encodes. There are currently 24 genotypes, with genotype IX predominating in Uganda and Kenya. Understanding the genetic characteristics of ASFV have focused mainly on partial fragments of selected genes, thus missing the opportunity to investigate the evolution, genetic diversity and patterns of transmission at the whole genomic level. Using the host-genome depletion approach we show an increase in the amount of ASFV DNA recovered directly from clinical material and generate genotype IX complete genomes on an NGS platform. We further show the inter-epidemic relationships of ASFV outbreaks in Uganda. The data contribute towards understanding the patterns and dynamics of transmission and maintenance of ASFV in a country in which ASF is endemic.
Mapping the virome in lab-reared and wild-caught Aedes albopictus mosquitoes
Authors: Zhao Lu , Atoni Evans , Shi Chenyan , Yuan Zhiming , Xia Han
Published: December 2019

Mosquitoes are known vectors that can harbor a wide array of viruses that range from classical arboviruses that can infect vertebrates to insect-specific viruses that are restricted only in mosquito. Recent advances in the field of metagenomics and bioinformatics have strongly supported studies on mosquito-associated viruses. However, the study for mosquito virome profile is still inadequate. In the present study, we aimed to investigate and compare the virome structure and profile between laboratory reared and wild-caught Aedes albopictus mosquito. Four mosquito samples (egg, larvae, pupae, adult) of laboratory rearedand two (larvae and adult)of field collected from Guangzhou of China were prepared for next generation sequencing (NGS) and analyzed. The results indicated that the common viruses presented in all samples were High Island virus, Aedes flavivirus, and Guato virus, whereas the Wenzhou sobemo-like virus 4 and Hubei mosquito virus 2 were the most dominant virus and presented only in wild mosquito samples. Additionally, unclassified Papillomaviridae viruses was the most dominant vertebrate virus, which was significantly detected only in wild adult mosquitoes. Important to note, the viral composition of larvae obtained from the wild was the most diverse group with many viruses belonging to virus families including Flaviviridae, Totiviridae, Tymoviridae, Rhabdoviridae, Orthomyxoviridae, Iflaviridae and unclassified viruses. This observed diverse nature can be attributed to influence of environment substrates and water in which the mosquito larvae inhabit. In conclusion, our findings provide essential information necessary in understanding the structure and diversity of Aedes virome.

Keywords: mosquito, virome, Aedes albopictus, next generation sequencing.
DENV-captured plasmin enhances mosquito midgut infection and is inhibited by an endogenous Kazal-type inhibitor AaTI
Authors: Mok Yu Keung , Ramesh Karthik , Wong Benjamin , Sayed Ahmed , Misse Dorothee , Manjanatha Kini , Pompoon Julien
Published: December 2019

Deciphering how dengue pathogenesis influences vector transmission will improve our understanding on virulence evolution, epidemiology and design of transmission-blocking tools. Here, we demonstrate that addition to blood meal of plasmin, the human fibrinolytic factor, increased permeability and DENV infectivity in mosquito midgut, resulting in higher infection rate and dissemination in whole mosquitoes. Further, we show that a plasmin-selective mosquito Kazal-type protease inhibitor, AaTI reverted this enhanced infection by inhibiting proteolysis. We also determined that DENV or E-protein, plasmin (not plasminogen) and AaTI can interact to form a tripartite complex using biolayer interferometry, suggesting physical interaction between DENV E-protein and kringle domain of plasmin. Our study suggests that (a) DENV recruit plasmin in solution to increase local proteolytic activity in midgut, thus enhancing DENV infection and (b) AaTI can act as a transmission-blocking agent, which could also alleviate hemorrhagic patients. By discovering that dengue pathogenesis can enhance DENV fitness by increasing mosquito infectivity, our results provide the first evidence of mosquito-based evolutionary pressures on dengue virulence in human. We are currently determining the effect of plasmin and AaTI on DENV infection in cellular and mouse models. H/D exchange mass spectrometry is being employed to identify which kringle domain of plasmin is interacting with DENV E-protein. The structure of the complex formed between the kringle domain of plasmin and DENV E-protein and between the catalytic domain of plasmin and AaTI are in progress.
Biotyping of TBEV-infected IRE/CTVM19 tick cell line
Authors: Loginov Dmitry , Böttinger Katharina , Loginova Yana , Dycka Filip , Sterba Jan
Published: December 2019

Background. Ticks have developed defense mechanisms and pathways against transmitted infections, including tick-borne encephalitis virus (TBEV). An important issue is to reveal mechanisms allowing them to control the virus at a level which does not hinder ticks’ fitness and development.

Methods. Biotyping was performed on an Autoflex Speed MALDI-TOF/TOF (Bruker Daltonik). Protein digests were analyzed using Synapt G2-Si High Definition mass spectrometer (Waters).

Results. MS profiles of TBEV-infected and non-infected IRE/CTVM19 cells were analyzed using principal component analysis. Obtained spectra were clustered based on the cultivation time, but not the infection status. Nevertheless, analysis of loading plots revealed different factors to be important for clustering of infected and non-infected cells. Out of them, nine were assigned with proteins: five and four for non-infected and infected cells, respectively. Peak with m/z 8565 was found to be of interest from viewpoint of tick-virus interaction and assigned to proteasome subunit alpha type (B7QE67).

Conclusion. MALDI-TOF MS was shown to be useful for characterization of tick cell lines and studying tick-virus interactions. Signals in MS profiles discriminating cell aging and those affected by TBEV were revealed, and matched with proteins.

We thank Dr Lesley Bell-Sakyi and the Tick Cell Biobank for provision of IRE/CTVM19 cells.

This study was supported by the MŠMT ČR INTER-ACTION project (LTARF 18021); GAČR (18-27204S), European Regional Development Fund Project (CZ.02.1.01/0.0/0.0/15_003/0000441), and MSHE RF (#14.616.21.0094, RFMEFI61618X0094). Access to instruments and other facilities was supported by the Czech research infrastructure for systems biology C4SYS (LM2015055).