bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensive photobiont sharing in a rapidly radiating cyanolichen clade
Authors: Dal Forno Manuela , Lawrey James D. , Sikaroodi Masoumeh , Gillevet Patrick M. , Schuettpelz Eric , Lücking Robert
Published: October 2020

Recent studies have uncovered remarkable diversity in Dictyonema s.lat. basidiolichens, here recognized as subtribe Dictyonemateae. This group includes five genera and 148 species, but hundreds more await description. The photobionts of these lichens belong to Rhizonema, a recently resurrected cyanobacterial genus known by a single species. To further investigate photobiont diversity within Dictyonemateae, we generated 765 new cyanobacterial sequences from 635 specimens collected from 18 countries. The ITS barcoding locus supported the recognition of 200 mycobiont (fungal) species among these samples, but the photobiont diversity was comparatively low. Our analyses revealed three main divisions of Rhizonema, with two repeatedly recovered as monophyletic (proposed as new species), and the third mostly paraphyletic. The paraphyletic lineage corresponds to R. interruptum and partnered with mycobionts from all five genera in Dictyonemateae. There was no evidence of photobiont‐mycobiont co‐speciation, but one of the monophyletic lineages of Rhizonema appears to partner predominantly with one of the two major clades of Cora (mycobiont) with samples collected largely from the northern Andes. Molecular clock estimations indicate the Rhizonema species are much older than the fungal species in the Dictyonemateae, suggesting that these basidiolichens obtained their photobionts from older ascolichen lineages and the photobiont variation in extant lineages of Dictyonemateae is the result of multiple photobiont switches. These results support the hypothesis of lichens representing "fungal farmers," in which diverse mycobiont lineages associate with a substantially lower diversity of photobionts by sharing those photobionts best suited for the lichen symbiosis among multiple and often unrelated mycobiont lineages.
Role of serum amylase and salivary cytokines in oral complications during chemoradiotherapy
Authors: Kawahara Kenta , Hiraki Akimitsu , Arita Hidetaka , Takeshita Hisashi , Hirosue Akiyuki , Matsuoka Yuichiro , Sakata Junki , Obayashi Yuko , Nakashima Hikaru , Hirayama Mayumi , Nagata Masashi , Yoshida Ryoji , Shinohara Masanori , Nakayama Hideki
Published: October 2020

Objectives

To investigate whether serum amylase can predict the recovery of salivary volume and determine the correlation of the level of cytokines, including epidermal growth factor, hepatocyte growth factor and keratinocyte growth factor, with oral mucositis during chemoradiotherapy for oral cancer.

Subjects and Methods

This study included 84 patients treated with preoperative chemoradiotherapy followed by curative surgery, following a phase II study protocol. We measured and analysed the correlation of the stimulated saliva volume, serum amylase and cytokines in resting saliva at baseline and 1 month after chemoradiotherapy with oral mucositis levels.

Results

We observed a negative correlation between the serum amylase level at the beginning of chemoradiotherapy and the stimulated saliva volume at 1 month after chemoradiotherapy (p = .03). Epidermal growth factor in resting saliva was significantly reduced after chemoradiotherapy (p < .01). The incidence of severe oral mucositis during chemoradiotherapy was significantly higher and negatively associated with the epidermal growth factor and keratinocyte growth factor levels (p = .04, p = .05).

Conclusions

The serum amylase level at the beginning of chemoradiotherapy may be a predictor of the recovery of the saliva volume. Furthermore, cytokines such as epidermal growth factor and keratinocyte growth factor in resting saliva affect the development of oral mucositis during chemoradiotherapy.
Synchrotron x‐ray fluorescence analysis reveals diagenetic alteration of fossil melanosome trace metal chemistry
Authors: Rogers Christopher S. , Webb Samuel M. , McNamara Maria E.
Published: October 2020

A key feature of the pigment melanin is its high binding affinity for trace metal ions. In modern vertebrates trace metals associated with melanosomes, melanin‐rich organelles, can show tissue‐specific and taxon‐specific distribution patterns. Such signals preserve in fossil melanosomes, informing on the anatomy and phylogenetic affinities of fossil vertebrates. Fossil and modern melanosomes, however, often differ in trace metal chemistry; in particular, melanosomes from fossil vertebrate eyes are depleted in Zn and enriched in Cu relative to their extant counterparts. Whether these chemical differences are biological or taphonomic in origin is unknown, limiting our ability to use melanosome trace metal chemistry to test palaeobiological hypotheses. Here, we use maturation experiments on eye melanosomes from extant vertebrates and synchrotron rapid scan‐x‐ray fluorescence analysis to show that thermal maturation can dramatically alter melanosome trace element chemistry. In particular, maturation of melanosomes in Cu‐rich solutions results in significant depletion of Zn, probably due to low pH and competition effects with Cu. These results confirm fossil melanosome chemistry is susceptible to alteration due to variations in local chemical conditions during diagenesis. Maturation experiments can provide essential data on melanosome chemical taphonomy required for accurate interpretations of preserved chemical signatures in fossils.
Outcomes from wake up safe, the pediatric anesthesia quality improvement initiative
Authors: Haché Manon , Sun Lena S. , Gadi Ghadah , Busse Jennifer , Lee Angela C. , Lorinc Amanda , Rampersad Sally
Published: October 2020

Background

Wake Up Safe, a Patient Safety Organization founded by the Society for Pediatric Anesthesia, collects data on serious adverse events along with demographic data from all pediatric patients receiving anesthesia care at participating institutions. This report reviews all events occurring between 2010 and 2015 and focuses on common adverse events that are anesthesia‐related.

Aims

Determine which adverse events were most common from 2010 to 2015 among participating Wake Up Safe institutions. Determine how many anesthesia‐related events were deemed to be preventable.

Methods

This is a descriptive report. The Wake Up Safe registry data were queried on September 29, 2017. Institutions were included if they had complete demographic data and at least 5 adverse events per year reported. At that time, 19 out of 29 institutions had complete demographic data for events from 2010 to 2015. This study describes demographic data and adverse events from these nineteen institutions. Descriptive data were extracted, and event rate was calculated for each adverse event category. In events that were assessed as primarily related to anesthesia, further detailed analysis was performed.

Results

Of all reported adverse events (2544 events), the most common were cardiac arrests (646, 31.6%), respiratory complications (598, 29.2%), and medication events (345, 16.9%). Of all anesthesia‐related events (612 events), medication events were the most common (239, 31.9%), followed by respiratory complications (181, 24.1%), and cardiac arrests (139, 18.5%). Overall, 85% of anesthesia‐related serious adverse events were deemed somewhat or almost certainly preventable.

Conclusions

The majority of anesthesia‐related serious adverse events reported to the Wake Up Safe database are preventable. Medication events are the most common anesthesia‐related adverse events. Innovations aimed at decreasing medication events may be the most impactful.
Online Abortion Drug Sales in Indonesia: A Quality of Care Assessment
Authors: Moore Ann M. , Philbin Jesse , Ariawan Iwan , Budiharsana Meiwita , Murro Rachel , Aryanty Riznawaty Imma , Bankole Akinrinola
Published: October 2020

This study sought to understand the experience of buying misoprostol online for pregnancy termination in Indonesia. We conducted a mystery client study August through October, 2019. Interactions were analyzed quantitatively and qualitatively, along with the contents of the packages. One hundred ten sellers were contacted, from whom mystery clients made 76 purchases and received 64 drug packages. Almost all sellers sold “packets” containing multiple drugs; 73 percent of packets contained misoprostol, and 47 percent contained at least 800 mcg of misoprostol. Thirty‐four packets contained insufficient drugs to complete an abortion. When compared to WHO standards, 87 percent of sellers imparted incomplete information about potential physical effects; no seller provided information about possible complications. Women buying misoprostol from informal online drugs sellers will be underprepared for understanding potential side effects and complications. Educational activities are needed to increase women's access to information about safe use of misoprostol as a harm reduction strategy.
Age and training volume influence joint kinetics during running
Authors: Paquette Max R. , Powell Douglas W. , DeVita Paul
Published: October 2020

Recently, we proposed the hypothesis that weekly running volume and preferred running pace may play a role in preserving ankle joint kinetics in middle‐age runners as ankle joint kinetics were generally similar in young and middle‐aged runners with similar running volume and preferred pace. To further address this hypothesis, we compared lower extremity joint kinetics between high and low training volume runners in both young and middle‐aged groups. Joint kinetics calculated from 3D kinematic and ground reaction force data during over‐ground running at 2.7 m·s−1 from young and middle‐aged runners who ran low or high weekly volume were analyzed. A two‐factor analysis of variance was used to compare joint kinetics between age and running volume groups. Positive hip work was greater in middle‐aged compared to young runners (P = .005). Plantarflexor torque (P = .009) and positive ankle work (P = .042) were greater in young compared to middle‐aged runners. Positive ankle work was also greater in the high compared to the low volume group (P = .021). Finally, age by volume interactions were found for knee extensor torque (P = .024), negative knee work (P = .018), and positive knee work (P = .019) but not for ankle and hip joint kinetics. These findings suggest less distal‐to‐proximal difference in positive joint work with high running volume in both young and middle‐aged runners as a result of greater power generation at the ankle. Given the age main effects, our findings are also the first to suggest the age‐related distal‐to‐proximal shift in joint kinetics appears in middle‐aged runners.
Evaluating the appropriateness of platelet transfusions compared with evidence‐based platelet guidelines: An audit of platelet transfusions at 57 hospitals
Authors: Hill‐Strathy MaryJane , Pinkerton Peter H. , Thompson Troy A. , Wendt Alison , Collins Allison , Cohen Robert , BComm Wendy Owens , Cameron Tracy , Lin Yulia , Lau Wendy , Lieberman Lani , Callum Jeannie
Published: October 2020

Background

Platelet transfusions are used to prevent or control bleeding in patients with thrombocytopenia or platelet dysfunction. The pretransfusion platelet count threshold has been studied extensively in multiple patient settings yielding high‐quality evidence that has been summarized in several comprehensive evidence‐based platelet guidelines.

Study Design and Methods

A prospective 12‐week audit of consecutive platelet transfusions using validated and evidence‐based adjudication criteria was conducted. Patient demographic, laboratory, and transfusion details were collected with an electronic audit tool. Each order was adjudicated either electronically or independently by two transfusion medicine physicians. The aim was to determine platelet transfusion appropriateness and common scenarios with deviations from guidelines.

Results

Fifty‐seven (38%) of 150 hospitals provided data on 1903 platelet orders, representing 90% of platelet usage in the region during the time period. Overall, 702 of 1693 adult (41.5%) and 133 of 210 pediatric orders (63.3%) were deemed inappropriate. The most common inappropriate platelet order was for prophylaxis in the absence of bleeding or planned procedure in patients with hypoproliferative thrombocytopenia and a platelet count over 10 x 109/L (53% of inappropriate orders in adults and 45% in pediatrics). Platelet transfusions ordered with either a preprinted transfusion order set (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.44‐2.73) or technologist prospective screening (OR, 1.40; 95% CI, 1.10‐1.78) were more likely to be appropriate.

Conclusion

There is a discrepancy between clinical practice and evidence‐based platelet guidelines. Broad educational and system changes will be needed to align platelet transfusion practice with guideline recommendations.
Innovative R&D offshoring in North–South trade: Theory and evidence
Authors: Cohle Zachary
Published: October 2020

This study proposes a general equilibrium model to describe innovative R&D location decisions by multinational firms. Using two countries, a developed North and a developing South, the model examines Northern firms employing researchers in the South in order to produce new varieties of a good. The Northern firms risk their product being imitated when offshoring research. Southern researchers may take information learned while employed by the Northern firm and start their own competing firm. The model's main predictions are supported empirically by a data set constructed with U.S. patent data. For high‐tech industries, stronger IPR protection in the South increases both industry‐level and firm‐level offshoring at a rate faster than low‐tech industries. Southern import tariffs do not affect firm‐level innovative R&D offshoring.
Analysis of Friction-Saturated Flutter Vibrations With a Fully Coupled Frequency Domain Method
Authors: Berthold Christian , Gross Johann , Frey Christian , Krack Malte
Published: October 2020

Flutter stability is a dominant design constraint of modern turbines. Thus, flutter-tolerant designs are currently explored, where the resulting vibrations remain within acceptable bounds. In particular, friction damping has the potential to yield limit cycle oscillations (LCOs) in the presence of a flutter instability. To predict such LCOs, it is the current practice to model the aerodynamic forces in terms of aerodynamic influence coefficients for a linearized structural model with fixed oscillation frequency. This approach neglects that both the nonlinear contact interactions and the aerodynamic stiffness cause a change in the deflection shape and the frequency of the LCO. This, in turn, may have a substantial effect on the aerodynamic damping. The goal of this paper is to assess the importance of these neglected interactions. To this end, a state-of-the-art aero-elastic model of a low pressure turbine blade row is considered, undergoing nonlinear frictional contact interactions in the tip shroud interfaces. The LCOs are computed with a fully coupled harmonic balance method, which iteratively computes the Fourier coefficients of structural deformation and conservative flow variables, as well as the a priori unknown frequency. The coupled algorithm was found to provide excellent computational robustness and efficiency. Moreover, a refinement of the conventional energy method is developed and assessed, which accounts for both the nonlinear contact boundary conditions and the linearized aerodynamic influence. It is found that the conventional energy method may not predict a limit cycle oscillation at all while the novel approach presented here can.
A Theoretical Study on the Transient Morphing of Linear Poroelastic Plates
Authors: Andrini Dario , Lucantonio Alessandro , Noselli Giovanni
Published: October 2020

Based on their shape-shifting capabilities, soft active materials have enabled new possibilities for the engineering of sensing and actuation devices. While the relation between active strains and emergent equilibrium shapes has been fully characterized, the transient morphing of thin structures is a rather unexplored topic. Here, we focus on polymer gel plates and derive a reduced linear model to study their time-dependent response to changes in the fluid environment. We show that independent control of stretching and bending deformations in stress-free conditions allows to realize spherical shapes with prescribed geometry of the mid-plane. Furthermore, we demonstrate that tensile (compressive) membrane stresses delay (accelerate) swelling-induced shape transitions compared to the stress-free evolution. We believe that these effects should be considered for the accurate design of smart systems and may contribute to explain the complexity of natural shapes.
Electric Vehicle Battery Thermal and Cabin Climate Management Based on Model Predictive Control
Authors: Liu Yuanzhi , Zhang Jie
Published: October 2020

Energy management plays a critical role in electric vehicle (EV) operations. To improve EV energy efficiency, this paper proposes an effective model predictive control (MPC)-based energy management strategy to simultaneously control the battery thermal management system (BTMS) and the cabin air conditioning (AC) system. We aim to improve the overall energy efficiency and battery cycle-life, while retaining soft constraints from both BTMS and AC systems. The MPC-based strategy is implemented by optimizing the battery operations and discharging schedules to avoid a peak load and by directly utilizing the regenerative power instead of recharging the battery. Compared with the benchmark system without any control coordination between BTMS and AC, the proposed MPC-based energy management has shown a 4.3% reduction in the recharging energy and a 6.5% improvement for the overall energy consumption. Overall, the MPC-based energy management is a promising solution to enhance the battery efficiency for EVs.
An Optimal Architectural Design for Unconventional Modular Reconfigurable Manipulation System
Authors: Dogra Anubhav , Sekhar Padhee Srikant , Singla Ekta
Published: October 2020

Modular and reconfigurable manipulators have gained popularity especially in the service sector, where the use of customized configurations has increased. Adaptable modular designs have come into advances in achieving required configuration of a robotic manipulator. As reported in literature, various designs of the modules mainly with conventional configurations are presented and a few are reported with unconventional adjustments. To cater the non-repetitive applications, this paper presents an optimal architectural design for unconventional parameters for customized reconfigurability. This lighter and easier-to-connect version is also applicable to n-DoF and unconventional robotic parameters. Architecture Prominent Sectioning (APS) strategy is proposed which assumes an architecture as a set of point masses and optimally relocate components with respect to the minimization of the joint torques. Modules are considered to be 3D printable using poly-lactic acid (PLA), a thermoplastic material, and thus light in weight. The new modular architecture design is validated through the assemblage of conventional/unconventional configurations using two types of modules namely Heavy (H) and Light (L). Along with that, worst torque analyses for the different configurations have been done in order to provide a strategy for assembly combinations. A comparative study is presented based upon the payload-to-weight ratio, involving other reported architectures.
Spectral Absorption Coefficient of Additive Manufacturing Materials
Authors: Wallace Nicholas J. , Jones Matthew R. , Crane Nathan B.
Published: October 2020

Active thermography techniques are of interest for quality assurance of additive manufacturing processes. However, accurate measurements of thermophysical properties of materials are required to successfully implement active thermography. In particular, the spectral absorption coefficient of materials commonly used in additive manufacturing must be known to accurately predict the spatial distribution of thermal energy generated from absorption of power emitted by a laser or pulsed flash lamp. Accurate measurements of these optical properties are also needed to develop greater understanding of additive manufacturing processes that rely on radiative heat transfer to fuse powders. This paper presents spectral absorption coefficient measurements and uncertainty estimates of fully and partially dense ABS, PLA, and Polyamide 12 samples.
Microstructural Evolution and Fracture Mechanism for Scar Defect Formation on Advanced High Strength Steel During a Shearing Process
Authors: Diewwanit O. , Keawcha-um P. , Keawcha-um T. , Petchhan W. , Thipprakmas S.
Published: October 2020

To form the required shapes from advanced high strength steels sheets, such as dual-phase (DP) steel, shearing processes are commonly used. In general, although good cut-edge characteristics can be often achieved by setting a small shearing clearance, a scar still remains a major defect on the cut-edge. Therefore, in the present study, the mechanism of scar formation of a DP steel sheet, grade SPFC980Y (JIS) subject to a shearing process was investigated and clarified based on the microstructural evolution, fracture mechanism, and a stress distribution analysis. The microstructural evolution in both tensile test specimens and sheared workpieces were observed to identify the fracture mechanism. The angle between the shear band and the elongated grain flow direction during tensile testing was examined and used to predict the angle of initial fracture and its propagation during the shearing process. With the stress distribution analysis of the shearing zone during the shearing process, the fracture could not propagate into the shearing zone and be directed to the die tip, resulting in the formation of a smooth region again. This feature occurred as a cyclic loop as the punch stroke proceeds and resulted in scar defects in the case of SPFC980Y. However, when the fracture propagation remained in the shearing zone, the fracture was not delayed and fracture was completely generated on the cut-edge in the case of a baseline SPCC steel.
A Novel Planetary Thread Roller Bearing: Design and Analysis of Load Characteristic
Authors: Zheng Shicheng , Fu Yongling , Wang Deyi , Pan Junlin , Li Linjie , Wang Jianbo
Published: October 2020

A novel planetary thread roller bearing (PTRB) was proposed in this paper based on the Hertz theory combined with multiple principles (e.g., equivalent steel ball, multi-point meshing, and power dividing). A significant improvement in load-carrying capacity, compared with existing bearings, was achieved and thus providing a new option for the advanced equipment with high thrust-to-weight ratio requirement. The newly proposed PTRB exhibited a 83% increase in dynamic axial load rating while a comparable static axial load rating comparing with the thrust ball bearing with a comparable size. Furthermore, the working efficiency of the new PTRB was constantly higher than 97%. A self-degradation operation was achieved by the system when some thread rollers were stuck, which improved the system fault tolerance. Finally, friction torque tests were performed on the self-developed test instrument. The results showed a good agreement with the theoretical analysis.
Electromigration simulation and design considerations for integrated circuit power grids
Authors: Najm Farid N. , Sukharev Valeriy
Published: October 2020

Due to continued technology scaling, electromigration has become a serious reliability concern in modern integrated circuits. This is further aggravated by the pervasive use of inaccurate models for electromigration based on traditional empirical black-box models. We will review the modern approach to electromigration verification, with emphasis on recent physical models, then summarize our work on a finite-difference based approach for power grid electromigration checking using these models. The method simulates the electromigration damage across the power grid, much like simulating for voltage or current. The lifetimes found using this physics-based approach are on average about twice or more than those based on the traditional empirical approaches. Because this approach is computationally efficient, one is able to handle large grids with millions of branches. We then present detailed analysis of the steady-state stress and its relation to voltages and currents in the grid, along with a number of design considerations that follow from this analysis.
Two-dimensional exterior sound field reproduction using two rigid circular loudspeaker arrays
Authors: Ren Yi , Haneda Yoichi
Published: October 2020

In exterior sound field reproduction using loudspeaker arrays, such as a single circular array, there is a trade-off between the reproduction accuracy and the filter gain of the loudspeaker array. With the aim of reproducing complex sound fields with a lower filter gain, an asymmetrical array geometry with reflections between two or more rigid arrays is introduced. This paper proposes a sound field reproduction method using two rigid circular loudspeaker arrays in a circular harmonic domain. Transfer functions that consider the multiple scattering between two rigid baffles can be represented in the circular harmonic domain. By repeatedly transforming the expansion coefficient between two coordinate systems, the circular harmonic expansion was applied to the reproduced sound field in a mixed coordinate system. Then, the driving function of the loudspeaker arrays was derived through a mode expansion. Numerical simulations were conducted to verify the accuracy of the reproduced sound field.
Assessing Interlimb Jump Asymmetry in Young Soccer Players: The My Jump 2 App
Authors: Barbalho Matheus , Kleiner Ana Francisca Rozin , Callegari Bianca , de Lima Ramon Costa , da Silva Souza Givago , de Athayde Costa e Silva Anselmo , Coswig Victor Silveira
Published: October 2020

Background:Jumps are important evaluation tools for muscle strength and power and for interlimb asymmetries. Different jump tests are well related to athletic performance, prediction of injury risk, and common motor gestures of several sports such as soccer. Low-cost mobile applications (apps) have gained popularity for this measure. The authors hypothesized that the My Jump 2 app would be a valid tool to assess drop-jump performance and interlimb asymmetry in soccer players.Methods:Eleven male soccer players took part in this study (18.2 [1.3] y, 69.9 [9.5] kg, 174 [6.6] cm). The athletes performed each test twice on a force plate (gold-standard method), while the jumps were recorded through the mobile app. Measures with the My Jump 2 app were applied by 2 evaluators, independently and in duplicate (interrater and intrarater reliability). The agreement analysis between both evaluations was done using an intraclass correlation coefficient and Bland–Altman plots.Results:Compared with the force platform, the app tested showed excellent reliability for the drop jump’s flight time and interlimb asymmetry (intraclass correlation coefficient > .98). For interlimb contact-time asymmetry, the values were 18.4 (9.9) and 19.1 (9.9) milliseconds for the My Jump 2 app and the force platform, respectively (P = .88). For flight-time asymmetries, the values were 389.7 (114.3) and 396.8 (112.5) milliseconds for the My Jump 2 app and the force platform, respectively (P = .88).Conclusion:The My Jump 2 app is a valid tool to assess drop-jump and interlimb asymmetry in soccer players.
Wood, Canvas, Fiberglass, and Whitewater: The Development of Recreational Paddling in Alberta, Canada
Authors: Weller Jon L.
Published: October 2020

In Alberta, Canada during the 1960s and early 1970s the popularity of recreational paddling expanded considerably. The reasons for this were varied, including wider demographic and economic shifts that produced a population that was both able, with time and the means, and eager to engage in these activities. But at the same time there was a notable change in the material reality of the sport brought on by the development of new construction techniques and materials. The goal of this article is to investigate the changing nature of recreational paddling in the 1960s and 70s with a focus on the influence that changing materials and construction methods had on these processes. Developed for other commercial purposes, fiberglass provided paddlers in Alberta with a means of constructing more robust canoes cheaply, quickly, and with a great deal of customization. To facilitate this construction, paddlers came together to share knowledge, materials, designs, and labor. In turn, these boatbuilding workshops became the nucleus of a budding and ultimately vibrant paddling community in the province. Moreover, the increased durability and design adaptability allowed paddlers to push the limits of the sport and successively redesign and further specialize the boats allowing for even greater skill development.
Interclass GPCR heteromerization affects localization and trafficking
Authors: Toneatti Rudy , Shin Jong M. , Shah Urjita H. , Mayer Carl R. , Saunders Justin M. , Fribourg Miguel , Arsenovic Paul T. , Janssen William G. , Sealfon Stuart C. , López-Giménez Juan F. , Benson Deanna L. , Conway Daniel E. , González-Maeso Javier
Published: October 2020

Serotonin 5-HT
2A
receptors heterodimerize with mGluR2 and trigger internalization.
SMAR1
repression by pluripotency factors and consequent chemoresistance in breast cancer stem-like cells is reversed by aspirin
Authors: Bhattacharya Apoorva , Mukherjee Shravanti , Khan Poulami , Banerjee Shruti , Dutta Apratim , Banerjee Nilanjan , Sengupta Debomita , Basak Udit , Chakraborty Sourio , Dutta Abhishek , Chattopadhyay Samit , Jana Kuladip , Sarkar Diptendra K. , Chatterjee Subhrangsu , Das Tanya
Published: October 2020

Aspirin represses drug efflux pump expression and enhances chemotherapy efficacy in stem-like breast cells.
Identification and Characterization of a Novel FosA7 Member from Fosfomycin-Resistant Escherichia coli Clinical Isolates from Canadian Hospitals
Authors: Milner Kieran A. , Bay Denice C. , Alexander David , Walkty Andrew , Karlowsky James A. , Mulvey Michael R. , Sharma Meenu K. , Zhanel George G.
Published: October 2020

Here, we characterize the
fosA
genes from three
Escherichia coli
clinical isolates recovered from Canadian patients. Each
fosA
sequence was individually overexpressed in
E. coli
BW25113, and antimicrobial susceptibility testing was performed to assess their role in fosfomycin resistance. The findings from this study identify and functionally characterize FosA3, FosA8, and novel FosA7 members and highlight the importance of phenotypic characterization of
fosA
genes.
High-Level Antibiotic Tolerance of a Clinically Isolated Enterococcus faecalis Strain
Authors: Gu Huan , Roy Sweta , Zheng Xiaohui , Gao Tian , Ma Huilin , Soultan Zafer , Fortner Christopher , Nangia Shikha , Ren Dacheng
Published: October 2020

Enterococcus faecalis
represents a major group of pathogens causing nosocomial infections that are resistant to multiple classes of antibiotics. An important challenge associated with
E. faecalis
infection is the emergence of multidrug-tolerant strains, which have normal MICs but do not respond to antibiotic treatment. Here, we report a strain of
E. faecalis
that was isolated from a cystic fibrosis patient and demonstrated high-level tolerance to ampicillin, vancomycin, and tetracycline. Whole-genome sequencing revealed critical substitutions in one of the tetracycline efflux pump repressors that are consistent with the increased tolerance of
E. faecalis
UM001B to tetracycline. These findings provide new information about bacterial antibiotic tolerance and may help develop more effective therapeutics.
Fragment Exchange Plasmid Tools for CRISPR/Cas9-Mediated Gene Integration and Protease Production in Bacillus subtilis
Authors: García-Moyano Antonio , Larsen Øivind , Gaykawad Sushil , Christakou Eleni , Boccadoro Catherine , Puntervoll Pål , Bjerga Gro Elin Kjæreng
Published: October 2020

We complemented a cloning platform with new editing plasmids that allow a quick transition from high-throughput cloning and the expression of new enzymes to the stable integration of genes for the production of enzymes through
B. subtilis
fermentation. We present two systems for the effective assembly cloning of any genome-editing cassette that shortens the engineering procedure to obtain the final editing constructs. The utility of the customized tools is demonstrated by disrupting
Bacillus
’ capacity to sporulate and by introducing the stable expression of subtilisin. The tools should be useful to engineer
B. subtilis
strains by a variety of recombination events to ultimately improve the application range of this industry-relevant host.
Molecular Microbiological and Immune Characterization of a Cohort of Patients Diagnosed with Early Lyme Disease
Authors: Mosel Michael R. , Rebman Alison W. , Carolan Heather E. , Montenegro Tristan , Lovari Robert , Schutzer Steven E. , Ecker David J. , Yang Ting , Ramadoss Nitya S. , Robinson William H. , Soloski Mark J. , Eshoo Mark W. , Aucott John N.
Published: October 2020

Lyme disease is a tick-borne infection caused by the bacteria
Borrelia burgdorferi
. Current diagnosis of early Lyme disease relies heavily on clinical criteria, including the presence of an erythema migrans rash. The sensitivity of current gold-standard diagnostic tests relies upon antibody formation, which is typically delayed and thus of limited utility in early infection. We conducted a study of blood and skin biopsy specimens from 57 patients with a clinical diagnosis of erythema migrans.
Tuberculous Meningitis: Pathogenesis, Immune Responses, Diagnostic Challenges, and the Potential of Biomarker-Based Approaches
Authors: Manyelo Charles M. , Solomons Regan S. , Walzl Gerhard , Chegou Novel N.
Published: October 2020

Tuberculous meningitis (TBM) is the most devastating form of tuberculosis (TB), causing high mortality or disability. Clinical management of the disease is challenging due to limitations of the existing diagnostic approaches. Our knowledge on the immunology and pathogenesis of the disease is currently limited. More research is urgently needed to enhance our understanding of the immunopathogenesis of the disease and guide us toward the identification of targets that may be useful for vaccines or host-directed therapeutics.
Global Epidemiology and Evolutionary History of Staphylococcus aureus ST45
Authors: Effelsberg N. , Stegger M. , Peitzmann L. , Altinok O. , Coombs G. W. , Pichon B. , Kearns A. , Randad P. R. , Heaney C. D. , Bletz S. , Schaumburg F. , Mellmann A.
Published: October 2020

Staphylococcus aureus
ST45 is a major global MRSA lineage with huge strain diversity and a high clinical impact. It is one of the most prevalent carrier lineages but also frequently causes severe invasive disease, such as bacteremia. Little is known about its evolutionary history. In this study, we used whole-genome sequencing to analyze a large collection of 451 diverse ST45 isolates from 6 continents and 26 countries.
De novo
-assembled genomes were used to understand genomic plasticity and to perform coalescent analyses.
Genetic Markers of Adaptation of Plasmodium falciparum to Transmission by American Vectors Identified in the Genomes of Parasites from Haiti and South America
Authors: Tagliamonte Massimiliano S. , Yowell Charles A. , Elbadry Maha A. , Boncy Jacques , Raccurt Christian P. , Okech Bernard A. , Goss Erica M. , Salemi Marco , Dame John B.
Published: October 2020

Historical data suggest that millions of
P. falciparum
parasite lineages were introduced into the Americas during the trans-Atlantic slave trade, which would suggest a paraphyletic origin of the extant isolates in the Western Hemisphere. Our analyses of whole-genome variants show that the American parasites belong to a well-supported monophyletic clade. We hypothesize that the required adaptation to American vectors created a severe bottleneck, reducing the effective introduction to a few lineages. In support of this hypothesis, we discovered genes expressed in the mosquito stages of the life cycle that have alleles with multiple, high-frequency or fixed, nonsynonymous mutations in the American populations which are rarely found in African isolates. These alleles appear to be in gene products critical for transmission through the anopheline vector. Thus, these results may inform efforts to develop novel transmission-blocking vaccines by identifying parasite proteins functionally interacting with the vector that are important for successful transmission. Further, to the best of our knowledge, these are the first whole-genome data available from Haitian
P. falciparum
isolates. Defining the genome of these parasites provides genetic markers useful for mapping parasite populations and monitoring parasite movements/introductions.
Electric Breakdown in Long Discharge Tubes at Low Pressure (Review)
Authors: Ionikh Yu. Z.
Published: October 2020

The review is devoted to studies of the processes and mechanisms of ignition of a glow discharge in tubes whose length significantly exceeds their diameter (long discharge tubes) at low pressures (~10 Torr and lower) and moderate voltage rise rates (~1 kV/μs and lower). The electric field in such tubes before a breakdown is substantially nonuniform. Therefore, a breakdown occurs after an ionization wave (or waves) passes through the discharge gap at a speed of ~105–107cm/s. This makes the characteristics of the breakdown in long tubes significantly different from the breakdown between large and closely spaced electrodes, where the electric field is uniform before the breakdown and where the Townsend or, under strong overvoltage, streamer mechanism is realized. On the other hand, the nature of these processes is very different from those occurring in nanosecond discharges, which arise at voltages with a steepness of ~1 kV/ns and higher and are associated with high-speed (~109cm/s) ionization waves. The review is based on the materials of experimental and computational works published from 1938 to 2020. Breakdown processes, optical and electrical characteristics of the discharge gap during breakdown, and the influence of the external circuit parameters and external actions (shielding and illumination by external sources of visible radiation) are analyzed.
What are important consequences in children with non-specific spinal pain? A qualitative study of Danish children aged 9–12 years
Authors: Lauridsen Henrik Hein , Stolpe Anna Bjellekjær , Myburgh Cornelius , Hestbæk Lise
Published: October 2020

Objectives

It is currently unknown whether children, adolescents and adults experiencing non-specific spinal pain are affected by their pain in a similar manner. It is also unclear whether questionnaires developed for adults can simply be transferred to paediatric populations. The objective of this study was to explore the physical, psychological and social consequences of a life with non-specific spinal pain among Danish children and to compare these consequences with the content of common adult questionnaires.

Design and setting

A qualitative study based on individual interviews and focus group discussions with participants recruited from two public schools in Denmark.

Participants

Thirty-six children aged 9–12 years with spinal pain were invited to an interview using a purposive sampling strategy with age, pain intensity and frequency, and general well-being status as inclusion criteria. Nineteen (9 girls, 10 boys) accepted to participate.

Methods

Data were transcribed verbatim and coded by following a thematic approach to elicit key concepts relevant to spinal pain. Subsequently, focus group interviews were conducted, and all codes were assigned categories corresponding to the International Classification of Function, Disability and Health (ICF) for comparison to adult questionnaires.

Results

Nineteen interviews were included, and 21 individual codes identified. Across the codes, five themes emerged in relation to children’s experiences of living with spinal pain: ‘Sports and play’, ‘Axial loading’, ‘Coping strategies’, ‘Mood changes’ and ‘Pain anxiety’. Codes and themes were elaborated on by the focus groups. Only approximately 40% of the identified ICF categories were covered by adult spinal questionnaires.

Conclusions

The negative impact of non-specific spinal pain on children aged 9–12 years pivots around codes which are considerably different to adults. Psychological and social factors were more prominent and pain anxiety was dominant in the lived lives of children. New questionnaires should be age specific and include the identified codes within each theme.
Protocol for a scoping review to understand what is known about how GPs make decisions with, for and on behalf of patients who lack capacity
Authors: Ogden Simon Jack , Huxtable Richard , Ives Jonathan
Published: October 2020

Introduction

General Practitioners (GPs) and allied healthcare professionals working in primary care are regularly required to make decisions with, for and on behalf of patients who lack capacity. In England and Wales, these decisions are made for incapacitated adult patients under the Mental Capacity Act 2005, which primarily requires that decisions are made in the patient’s ‘best interests’. Regarding children, decisions are also made in their best interests but are done so under the Children Act 1989, which places paramount importance on the welfare of the child. Decisions for children are usually made by parents, but a GP may become involved if he or she feels a parent is not acting in the best interests of the child. Internationally, including elsewhere in the UK, different approaches are taken. We hypothesise that, despite the legislation and professional guidelines, there are many different approaches taken by GPs and allied healthcare professionals in England and Wales when making these complex decisions with, for and on behalf of patients who lack capacity. To better understand what is known about how these decisions are made, we plan to undertake a scoping review and directed content analysis of the literature. While the majority of decisions made in primary care are made by GPs, for completeness, this review will include all allied healthcare professionals working in primary care.

Methods and analysis

To ensure a wide breadth of literature is captured, a scoping review will be undertaken as described by Arksey and O’Malley (2005). A five-stage approach will be taken when conducting this review: (1) identifying the research question; (2) identifying relevant papers; (3) study selection; (4) data extraction and (5) summarising and synthesis. The final stage will include a directed content analysis of the data to help establish the cross-cutting themes.

Ethics and dissemination

The scoping review will be disseminated through conferences and peer-reviewed publications. This scoping review is the first (mapping) phase in a proposed larger study to explore how GPs make decisions with, for and on behalf of those who lack capacity. Qualitative research with GPs, patients and their families will follow, before all the results are synthesised using an ‘empirical bioethics’ methodology.
SUFE and the internet: are healthcare information websites accessible to parents?
Authors: Mc Carthy Andrea , Taylor Colm
Published: October 2020

Background

Slipped upper femoral epiphysis is an adolescent hip disorder requiring rapid surgical intervention. Faced with the prospect of their child undergoing surgery, many fearful parents will turn to the internet to provide information and reassurance. Previous studies have shown the orthopaedic information can be difficult to comprehend.

Objective

Assess the readability of healthcare websites regarding slipped upper femoral epiphysis.

Methods

The term Slipped Upper Femoral Epiphysis was searched in Google, Bing and Yahoo. The websites were evaluated using readability software with seven specialised readability tests including the Flesch-Kincaid Reading Grade Level, the Flesch Reading Ease Score, the Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index and the Gunning Fog Index. The reading grade level (RGL) was also calculated.

A Flesich Read Ease Score (FRES) score above 65 and an RGL of sixth grade and under was considered acceptable. Websites were also assessed for translation services.

Results

21 unique websites were assessed. The average FRES was 52.5±15.4. Only 3 websites scored 65 or higher (14%). There was a statistically significant difference between website scores based on affiliation, with physician websites having the overall highest mean(p=0.004).

The average RGL was 8.67±1.8. Only two websites met the accepted RGL criteria (9.5%) while five websites were marked as extremely difficult to understand (23.8%). Only five websites offered translations (23.8%). There was no statistically significant difference in readability scores between websites which offered translation and those which did not.

One-sample t-tests showed that both the RGL (p<0.001; CI 1.83 to 3.49) and the FRES (p<0.001, CI −19.4 to −5.4) scores were significantly different from the accepted standard.

Conclusion

Most websites reviewed were above the recommended RGL, making content inaccessible. Improving readability and translation services would enhance the internet’s usability as a healthcare tool for parents.
Income level and outcomes in patients with heart failure with universal health coverage
Authors: Hung Chung-Lieh , Chao Tze-Fan , Su Cheng-Huang , Liao Jo-Nan , Sung Kuo-Tzu , Yeh Hung-I , Chiang Chern-En
Published: October 2020

Objective

We aimed to investigate the influence of income level on guideline-directed medical therapy (GDMT) prescription rates and prognosis of patients with heart failure (HF) following implementation of a nationwide health insurance programme.

Methods

A total of 633 098 hospitalised patients with HF from 1996 to 2013 were identified from Taiwan National Health Insurance Research Database. Participants were classified into low-income, median-income and high-income groups. GDMT utilisation, in-hospital mortality and postdischarge HF readmission, and mortality rates were compared.

Results

The low-income group had a higher comorbidity burden and was less likely to receive GDMT than the other two groups. The in-hospital mortality rate in the low-income group (5.07%) was higher than in the median-income (2.47%) and high-income (2.51%) groups. Compared with the high-income group, the low-income group had a significantly higher risk of postdischarge HF readmission (adjusted HR (aHR): 1.29, 95% CI 1.27 to 1.31), all-cause mortality (aHR: 1.98, 95% CI 1.95 to 2.02) and composite HF readmission/all-cause mortality (aHR: 1.54, 95% CI 1.52 to 1.56). These results were generally consistent among the population after propensity matching (low vs high: HR=2.08 for mortality and 1.36 for HF readmission; median vs high: HR=1.23 for mortality and 1.12 for HF readmission; all p<0.001) and after inverse probability of treatment weighting (low-income vs high-income group: HR: 2.19 for mortality and 1.16 for HF readmission; median-income vs high-income group: HR: 1.53 for mortality and 1.09 for HF readmission; all p<0.001). Lower utilisation of GDMT and poorer prognosis in lower-income hospitalised patients with HF appeared to mitigate over time.

Conclusions

Low-income patients with HF had nearly a twofold increase in the risk of in-hospital mortality and postdischarge events compared with the high-income group, partly due to lower GDMT utilisation. The differences between postdischarge HF outcomes among various income groups appeared to mitigate over time following the implementation of nationwide universal health coverage.