bluuebunny/crossref_metadata_2025 huggingface dataset:
Gaze behaviour during multiple object tracking is dependent on binocular vision integrity
Authors: Zwierko Teresa , Redondo Beatríz , Jedziniak Wojciech , Molina Ruben , Jiménez Raimundo , Vera Jesús
Published: August 2023

Introduction

Despite the critical importance of binocular vision integrity in daily activities, there exists limited understanding of how alterations in binocular vision integrity impact gaze behaviour during dynamic, complex psychomotor skills. This study aimed to measure how alterations in binocular vision integrity, created by Bangerter filters (BF), affect gaze behaviour during multiple object tracking (MOT).

Methods

During the experiment, 22 volunteers completed the MOT task under three different visual conditions. The first condition involved natural binocular viewing, while the second and third conditions used 0.4 and 0.2 neutral density BF, respectively, resulting in monocular blur in the sensorially dominant eye. During the MOT task, participants were instructed to track three of eight balls for 10 s, and the speed was adjusted using a staircase procedure. Throughout the task, the following gaze parameters were recorded: fixation duration, saccade duration, amplitude and frequency as well as blink rate.

Results

During MOT execution, participants employed three gaze strategies regardless of viewing conditions: saccadic movements were predominant, followed by maintaining fixation on a central location throughout the trial and to a lesser extent, smooth pursuit eye movements. There was a significant effect of manipulating viewing conditions on the MOT scores (p = 0.046, η2 = 0.09). As the viewing conditions became more difficult, we observed a decrease in fixation duration (p = 0.004, η2 = 0.16) and blink rate (p < 0.001, η2 = 0.20) and an increase in saccadic amplitude (p < 0.001, η2 = 0.29).

Conclusions

The results support the notion that perceptual‐cognitive skills depend on the integrity of binocular vision, underscoring the sensitivity of gaze behaviours to any impairment of binocular function.
Proteomics analysis to investigate the potential mechanism of theacrine against UV‐induced skin photodamage
Authors: He Yong , Zheng Xinkai , Hu Yunfeng , Deng Liehua , Xu Jin , Wu Shi
Published: August 2023

Aim

This study aimed to explore the underlying mechanism of theacrine treatment of UV‐induced skin photodamage.

Materials and Methods

Tandem Mass Tag (TMT) relative quantitative proteomics analysis was used to characterize the proteins and pathways associated with the ability of theacrine to combat photodamage in mouse skin by modeling UV irradiation of the backs of ICR mice.

Results

Apoptosis‐related proteins and signaling pathways play a key role in the ability of theacrine to protect against skin photodamage, according to proteomic and bioinformatics analysis; molecular docking and Western blotting further revealed that theacrine was associated with apoptosis‐related proteins (p53, Bcl‐2, Bax, caspase‐3, and cleaved‐caspase‐3) with strong binding affinity, which can significantly reduce skin cell apoptosis induced by UV exposure.

Conclusion

The findings revealed that theacrine can reduce UVB‐induced epidermal damage by controlling the apoptosis signaling pathway, implying that theacrine could be a useful anti‐UVB damage agent.
Intergovernmental cooperation and joint purchasing agreements: Do governments free‐ride?
Authors: Madsen Morten Skov
Published: August 2023

Public management scholars argue that collective action problems (e.g., incentives to free‐ride on the efforts of others or shirk agreements) threaten the feasibility of intergovernmental cooperation. Drawing on collective action theory, this article examines factors associated with overcoming free‐riding incentives and provides evidence challenging the idea that governments are prone to such strategic behavior. The empirical analysis of a national Danish purchasing group demonstrates how coercion is not necessary to induce subnational governments to incur private costs to join the group and, despite opportunity and incentive to free‐ride, contribute to its production of joint purchasing agreements—collective goods whose quality depends on the staff resources and expertise the participating governments contribute to their production. Further, multivariate analyses find that governments are more likely to help produce these collective goods when they receive more of their benefits, face lower contribution costs, and receive stronger social norm pressures from peers.
Effect of red light on epidermal proliferation and mitochondrial activity
Authors: Umino Yuki , Denda Mitsuhiro
Published: August 2023

Background/Purpose

We previously demonstrated that irradiation with red light accelerates recovery of the epidermal water‐impermeable barrier, whereas blue light delays it, and white and green light have no effect. Here, we aimed to examine in detail the effects of red and blue light in a human epidermal‐equivalent model and in human skin.

Methods

We used light‐emitting diodes (red light, 630 nm, 6.2 mW/cm2; blue light, 463 nm, 6.2 mW/cm2) for irradiation of an epidermal‐equivalent model and human skin. Cell proliferation was evaluated by means of BrdU and Ki‐67 staining, and mitochondrial activity was quantified with an extracellular flux analyzer.

Results

Irradiation of the epidermal‐equivalent model with red light for 2 h (44.64 J/cm2) increased both epidermal proliferation in the basal layer and mitochondrial activity. Blue light had no effect on epidermal proliferation. Furthermore, irradiation with red light for 2 h on three consecutive days increased epidermal proliferation in human skin tissue in culture.

Conclusion

These results suggest that red light accelerates epidermal proliferation in both an epidermal‐equivalent model and human skin, and may promote epidermal homeostasis.
The novel HLA‐B*27:267 allele, identified by Sanger dideoxy nucleotide sequencing in a Chinese individual
Authors: Shen Mei‐xiao , An Lin , Ding Pei‐Pei , Hu Xiao‐zhuang , Lei Mei‐qing
Published: August 2023

HLA‐B*27:267 differs from HLA‐B*27:04:01 by one nucleotide in exon 2.
Characterization of the novel HLA‐B*15:269 allele by sequencing‐based typing
Authors: Li Xiao‐Feng , Zhang Xu , Lin Feng‐Qiu , Li Jian‐Ping
Published: August 2023

HLA‐B*15:269 differs from HLA‐B*15:63 by two nucleotide substitutions in exon 3.
How do we… direct a transfusion service/blood bank with limited laboratory staff
Authors: Lu Wen , Bakhtary Sara , Oliver Louige , Stephens Laura , Tanhehco Yvette , O'Brien Kerry
Published: August 2023

Background

Transfusion services and blood banks in the United States have struggled with staffing shortages for decades. Unfortunately, the COVID‐19 pandemic and other factors have exacerbated these challenges to the point of crisis for many. Meanwhile, providing quality patient care continues to demand accurate test results and safe blood products delivered in a timely fashion.

Materials and Methods

A group of academic Transfusion Medicine Physicians and a Medical Laboratory Scientist from five academic medical centers in the United States met and discussed the steps we explored and took during the staffing crisis that hit during the pandemic. Our goal was to assist our colleagues and the community by detailing the strategies that helped keep us operational during the most extreme staffing shortage we have experienced to date.

Results and Conclusions

We provide both short‐term solutions to include hiring temporary and per diem technologists, consolidating testing, and sending out non–time‐sensitive testing; and long‐term strategies such as recruiting and hiring laboratory assistants, providing retention and referral bonuses, and increasing compensation. The objective is to address the staffing shortage on multiple fronts (e.g., personnel management, testing, and organization) with the objective of not compromising safety, quality, or patient care. The ultimate long‐term goal is to advocate for and build a stronger laboratory workforce for tomorrow.
HIV risk behavior profiles among men who have sex with men interested in donating blood: Findings from the Assessing Donor Variability and New Concepts in Eligibility study
Authors: Custer Brian , Whitaker Barbee I. , Pollack Lance M. , Buccheri Renata , Bruhn Roberta L. , Crowder Lauren A. , Stramer Susan L. , Reik Rita A. , Pandey Suchitra , Stone Mars , Di Germanio Clara , Buchacz Kate , Eder Anne F. , Lu Yun , Forshee Richard A. , Anderson Steven A. , Marks Peter W.
Published: August 2023

Background

Individual risk assessment allows donors to be evaluated based on their own behaviors. Study objectives were to assess human immunodeficiency virus (HIV) risk behaviors in men who have sex with men (MSM) and estimate the proportion of the study population who would not be deferred for higher risk HIV sexual behaviors.

Study Design and Methods

Cross‐sectional survey and biomarker assessment were conducted in eight U.S. cities. Participants were sexually active MSM interested in blood donation aged 18–39 years, assigned male sex at birth. Participants completed surveys during two study visits to define eligibility, and self‐reported sexual and HIV prevention behaviors. Blood was drawn at study visit 1 and tested for HIV and the presence of tenofovir, one of the drugs in oral HIV pre‐exposure prophylaxis (PrEP). Associations were assessed between HIV infection status or HIV PrEP use and behaviors, including sex partners, new partners, and anal sex.

Results

A total of 1566 MSM completed the visit 1 questionnaire and blood draw and 1197 completed the visit 2 questionnaire. Among 1562 persons without HIV, 789 (50.4%) were not taking PrEP. Of those not taking PrEP, 66.2% reported one sexual partner or no anal sex and 69% reported no new sexual partners or no anal sex with a new partner in the past 3 months.

Conclusion

The study found that questions were able to identify sexually active, HIV‐negative MSM who report lower risk sexual behaviors. About a quarter of enrolled study participants would be potentially eligible blood donors using individual risk assessment questions.
Conformal blocks for Galois covers of algebraic curves
Authors: Hong Jiuzu , Kumar Shrawan
Published: August 2023

We study the spaces of twisted conformal blocks attached to a $\Gamma$-curve $\Sigma$ with marked $\Gamma$-orbits and an action of $\Gamma$ on a simple Lie algebra $\mathfrak {g}$, where $\Gamma$ is a finite group. We prove that if $\Gamma$ stabilizes a Borel subalgebra of $\mathfrak {g}$, then the propagation theorem and factorization theorem hold. We endow a flat projective connection on the sheaf of twisted conformal blocks attached to a smooth family of pointed $\Gamma$-curves; in particular, it is locally free. We also prove that the sheaf of twisted conformal blocks on the stable compactification of Hurwitz stack is locally free. Let $\mathscr {G}$ be the parahoric Bruhat–Tits group scheme on the quotient curve $\Sigma /\Gamma$ obtained via the $\Gamma$-invariance of Weil restriction associated to $\Sigma$ and the simply connected simple algebraic group $G$ with Lie algebra $\mathfrak {g}$. We prove that the space of twisted conformal blocks can be identified with the space of generalized theta functions on the moduli stack of quasi-parabolic $\mathscr {G}$-torsors on $\Sigma /\Gamma$ when the level $c$ is divisible by $|\Gamma |$ (establishing a conjecture due to Pappas and Rapoport).
Is polycystic ovary syndrome associated with elevated muscle sympathetic nerve activity?
Authors: Duval Alicia , Huckins Will , Berbrier Danielle E. , Usselman Charlotte W.
Published: August 2023

Polycystic ovary syndrome (PCOS) is a complex disorder characterized by reproductive abnormalities, cardiometabolic disturbances and a heightened risk of cardiovascular disease. A small but compelling body of research demonstrates that females with PCOS present with elevated muscle sympathetic nerve activity (MSNA) at rest. Heightened MSNA is present in lean, overweight and obese females with PCOS, but limited evidence suggests that androgens may be more strongly linked to elevated MSNA in lean females with PCOS than in obese females with PCOS. Although the specific mechanisms underlying elevated MSNA in PCOS remain elusive, sympathetic activation is implicated in the progression of several cardiovascular diseases and may contribute to the cardiovascular pathophysiology of PCOS. Encouragingly, MSNA appears responsive to non‐pharmacological intervention, making the sympathetic nervous system a promising therapeutic target to mitigate cardiovascular risk in PCOS. This brief review summarizes the existing evidence regarding elevated MSNA, cardiovascular risk profile and vascular function, as well as the potential for clinical intervention and future research directions in females with PCOS.
Gestational intermittent hypoxia increases FosB‐immunoreactive perikaryas in the paraventricular nucleus of the hypothalamus of adult male (but not female) rats
Authors: Ambrozio‐Marques Danuzia , Gagnon Marianne , Radcliff Abigail B. , Meza Armand L. , Baker Tracy L. , Watters Jyoti J. , Kinkead Richard
Published: August 2023

Sleep‐disordered breathing is a respiratory disorder commonly experienced by pregnant women. The recurrent hypoxaemic events associated with sleep‐disordered breathing have deleterious consequences for the mother and fetus. Adult male (but not female) rats born to dams subjected to gestational intermittent hypoxia (GIH) have a higher resting blood pressure than control animals and show behavioural/neurodevelopmental disorders. The origin of this persistent, sex‐specific effect of GIH in offspring is unknown, but disruption of the neuroendocrine stress pathways is a key mechanism by which gestational stress increases disease risk in progeny. Using FosB immunolabelling as a chronic marker of neuronal activation, we determined whether GIH augments basal expression of FosB in the perikaryas of cells in the paraventricular nucleus of the hypothalamus (PVN), a key structure in the regulation of the stress response and blood pressure. From gestational day 10, female rats were subjected to GIH for 8 h/day (light phase) until the day before delivery (gestational day 21); GIH consisted of 2 min hypoxic bouts (10.5% O2) alternating with normoxia. Control rats were exposed to intermittent normoxia over the same period (GNX). At adulthood (10–15 weeks), the brains of male and female rats were harvested for FosB immunohistochemistry. In males, GIH augmented PVN FosB labelling density by 30%. Conversely, PVN FosB density in GIH females was 28% lower than that of GNX females. We conclude that GIH has persistent and sex‐specific impacts on the development of stress pathways, thereby offering a plausible mechanism by which GIH can disturb neural development and blood pressure homeostasis in adulthood.
Tuberculosis genitourinaria, una causa poco frecuente y olvidada
Authors: Nieto González Manuel Alejandro , Rodríguez Sánchez Martha Patricia , Guarín Navas Erika Geraldine , Ríos Valbuena Juan José
Published: August 2023

El artículo presenta el caso de un hombre de 66 años con antecedente de enfermedad renal crónica y uropatía obstructiva con requerimiento de hemodiálisis de forma transitoria durante cinco meses. Estuvo hospitalizado en un contexto de sepsis de origen urinario, por una complicada infección de las vías urinarias altas, lesión renal aguda KDIGO 3 y requerimiento de terapia de soporte renal hasta lograr su recuperación. El paciente recibió cubrimiento antibiótico empírico sin respuesta completa y persistencia de piuria estéril, pues no se lograba el aislamiento microbiológico en policultivos de gérmenes comunes. Requirió manejo con nefrostomía percutánea izquierda, y por una fuerte sospecha de tuberculosis renal, se solicitó una prueba de PCR para detectar tuberculosis por el método Genexpert, el cual confirmó el diagnóstico. El caso exhibe la relación entre complicaciones renales de tipo funcional y estructural, secundarias a un proceso infeccioso, cuya sospecha clínica es poco frecuente, a pesar de que el paciente se ubicaba en una zona endémica para su presentación.
A Novel Diagnostic Tool for Human-Centric Quality Monitoring in Human–Robot Collaboration Manufacturing
Authors: Verna Elisa , Puttero Stefano , Genta Gianfranco , Galetto Maurizio
Published: August 2023

The manufacturing industry is currently facing an increasing demand for customized products, leading to a shift from mass production to mass customization. As a result, operators are required to produce multiple product variants with varying complexity levels while maintaining high-quality standards. Further, in line with the human-centered paradigm of Industry 5.0, ensuring the well-being of workers is equally important as production quality. This paper proposes a novel tool, the “Human–Robot Collaboration Quality and Well-Being Assessment Tool” (HRC-QWAT), which combines the analysis of overall defects generated during product variant manufacturing with the evaluation of human well-being in terms of stress response. The HRC-QWAT enables the evaluation and monitoring of human–robot collaboration systems during product variant production from a broader standpoint. A case study of collaborative human–robot assembly is used to demonstrate the applicability of the proposed approach. The results suggest that the HRC-QWAT can evaluate both production quality and human well-being, providing a useful tool for companies to monitor and improve their manufacturing processes. Overall, this paper contributes to developing a human-centric approach to quality monitoring in the context of human–robot collaborative manufacturing.
Strategic Production Process Design With Additive Manufacturing in a Make-to-Stock Environment
Authors: Chua Ping Chong , Moon Seung Ki , Ng Yen Ting , Lopez Manel
Published: August 2023

With the development and gradual maturity of additive manufacturing (AM) over the years, AM has reached a stage where implementation into a conventional production system becomes possible. With AM suitable for small volumes of highly customized production, there are various ways of implementing AM in a conventional production line. The aim of this paper is to present a strategic design approach to implementing AM with conventional manufacturing in a complementary manner for parallel processing of production orders of large quantities in a make-to-stock environment. By assuming that a single machine in conventional manufacturing can be operated using AM, splitting of production orders is allowed. Therefore, production can be conducted by both conventional and AM processes simultaneously, with the latter being able to produce various make-to-stock parts in a single build. A genetic algorithm with a scheduling and rule-based heuristic for part allocation on the build plate of AM process is used to solve a multi-objective implementation problem of AM with conventional manufacturing, with cost, scheduling, and sustainability being the considered performance measures. By obtaining a knee-point solution using varying numbers of population size and generation number, an experiment involving an industry case study of implementing the fused deposition modeling (FDM) process with injection molding process shows the greatest impact, i.e., increase, in cost. Except for material efficiency, improvements are shown in scheduling and carbon footprint objectives.
Life along the fish lateral line and beyond
Authors: Bleckmann Horst
Published: August 2023

The author came to lateral line research rather by chance, yet this sensory system ended up as the main research focus of my entire scientific career. This paper is not a review article. Instead, it gives an overview of some of the major research topics that the author, collaborators, and students have worked on for more than 4 decades. During the last century, lateral line research was mostly approached by using mono-frequency water motions generated in still water with a stationary vibrating sphere. At the beginning, this approach was necessary and useful. During studies, it became apparent that the fish lateral line can only be fully understood if more natural hydrodynamic stimuli (including natural hydrodynamic noise) were applied. Better methods, like particle image velocimetry, are then needed in the research of lateral line systems. Finally, how a biomimetic approach can be used to investigate lateral line function is discussed. In the final paragraph, some research gaps and hence, opportunities that still exist in the research of the lateral line systems are highlighted.
Intrarater and Interrater Reliability and Agreement of a Method to Quantify Lower-Extremity Kinematics Using Remote Data Collection
Authors: Harrington Margaret S. , Adeyinka Ikeade C. , Burkhart Timothy A.
Published: August 2023

Context: To assess the reliability of a remote 2D markerless motion tracking method (Kinovea) to quantify knee and hip angles during dynamic tasks. Methods: Fourteen healthy adults performed body weight squats and lateral lunges while video recording themselves at home. Knee and hip angles were quantified in the sagittal plane for the squats and in the frontal plane for the lateral lunges. Two students each performed the video analysis procedure twice, 2 weeks apart. Intraclass correlation coefficients were used to calculate the intrarater and interrater reliability for angles at maximum depth. The intrarater and interrater agreement over the joint angle–time signals were quantified using a validation metric; an acceptable agreement threshold was set at a validation metric of 0.803 or higher. Standard error of measurement (SEM) was also calculated. Results: Reliability was good to excellent (intraclass correlation coefficients = .80–.98) for all angle comparisons at maximum depth. The agreement over the entire joint angle–time signal was acceptable for all squat variables except for the interrater hip angle comparison (validation metric = 0.797). None of the lateral lunge variables met the threshold of acceptable agreement. The mean SEM across participants for all joint angle–time signal and for maximum depth was acceptable (<5°) for all measurements (SEM = 1.2°–4.9°). Conclusions: Overall, the reliability, agreement, and SEM quantified in this study support the integration of remote methods to quantify lower-extremity kinematics into research and clinical practice.
A Proposed Three-Stage Postperformance-Routine Framework
Authors: Kostrna Jason , Lebeau Jean-Charles , Sáenz-Moncaleano Camilo , Foster Brian
Published: August 2023

Research has supported the use of preperformance routines to successfully manage the period preceding sport performance. In contrast, little research has been done on the period succeeding skill execution. This article introduces a three-stage model for postperformance routines (PoPR) for novice motor learning and performance including emotion regulation, performance analysis and correction, and continuation to the next performance trial. To test this model, 38 novice golfers completed a putting task after random assignment to either a PoPR or a control condition. Putting performance was measured after each putt, and self-efficacy, arousal, affect, and perceived task difficulty were recorded every 10 putts. Participants in the PoPR group improved their performance from baseline to postintervention (d = −0.55), while performance in the control group remained unchanged (d = −0.01). No significant differences were observed for performance consistency, emotions, self-efficacy, and perceived task difficulty. Thus, practitioners implementing a PoPR in novice athletes may consider the proposed three-stage framework for improvements in motor learning and performance.
Interferon with ovarian cancer
Authors: Baek Amy E.
Published: August 2023

Interferon-ε has antitumor activity and activates antitumor immunity in ovarian cancer in mice.
Unraveling and characterization of novel T3SS effectors in
Edwardsiella piscicida
Authors: Liao Xiao Jian , He Tian Tian , Liu Lu Yi , Jiang Xiu Long , Sun Shan Shan , Deng Yu Hang , Zhang Li Qiang , Xie Hai Xia , Nie Pin
Published: August 2023

Type III secretion system (T3SS) facilitates survival and replication of
Edwardsiella piscicida in vivo
. Identifying novel T3SS effectors and elucidating their functions are critical in understanding the pathogenesis of
E. piscicida. E. piscicida
T3SS effector EseG and EseJ was highly secreted when T3SS gatekeeper-containing protein complex EsaB-EsaL-EsaM was disrupted by EsaB deficiency. Based on this observation, concentrated secretomes of Δ
esaB
strain and Δ
esaB
Δ
esaN
strain were purified by loading them into SDS-PAGE gel for a short electrophoresis to remove impurities prior to the in-the gel digestion and mass spectrometry. Four reported T3SS effectors and two novel T3SS effector candidates EseQ (ETAE_2009) and Trx2 (ETAE_0559) were unraveled by quantitative comparison of the identified peptides. EseQ and Trx2 were revealed to be secreted and translocated in a T3SS-dependent manner through CyaA-based translocation assay and immunofluorescent staining, demonstrating that EseQ and Trx2 are the novel T3SS effectors of
E. piscicida
. Trx2 was found to suppress macrophage apoptosis as revealed by TUNEL staining and cleaved caspase-3 of infected J774A.1 monolayers. Moreover, Trx2 has been shown to inhibit the p65 phosphorylation and p65 translocation into the nucleus, thus blocking the NF-κB pathway. Furthermore, depletion of Trx2 slightly but significantly attenuates
E. piscicida
virulence in a fish infection model. Taken together, an efficient method was established in unraveling T3SS effectors in
E. piscicida
, and Trx2, one of the novel T3SS effectors identified in this study, was demonstrated to suppress apoptosis and block NF- κB pathway during
E. piscicida
infection.

IMPORTANCE

Edwardsiella piscicida
is an intracellular bacterial pathogen that causes intestinal inflammation and hemorrhagic sepsis in fish and human. Virulence depends on the
Edwardsiella
type III secretion system (T3SS). Identifying the bacterial effector proteins secreted by T3SS and defining their role is key to understanding
Edwardsiella
pathogenesis. EsaB depletion disrupts the T3SS gatekeeper-containing protein complex, resulting in increased secretion of T3SS effectors EseG and EseJ. EseQ and Trx2 were shown to be the novel T3SS effectors of
E. piscicida
by a secretome comparison between ∆
esaB
strain and ∆
esaB
∆
esaN
strain (T3SS mutant), together with CyaA-based translocation assay. In addition, Trx2 has been shown to suppress macrophage apoptosis and block the NF-κB pathway. Together, this work expands the known repertoire of T3SS effectors and sheds light on the pathogenic mechanism of
E. piscicida
.
Flagella-related gene mutations in
Vibrio cholerae
during extended cultivation in nutrient-limited media impair cell motility and prolong culturability
Authors: Okada Kazuhisa , Roobthaisong Amonrattana , Hamada Shigeyuki
Published: August 2023

Understanding the survival strategies of pandemic cholera pathogens in aquatic environments is important for preventing their dissemination. Here, we report a phenomenon wherein long-term cultivation of
Vibrio cholerae
under nutrient-limited condition (M9 minimal medium supplemented with 0.2% glucose) causes mutations in flagella-related genes, thus inhibiting motility. Moreover, the motility defect reduced the transition of the viable but nonculturable state of the organisms. Maintenance of proliferative capability allows for the rapid population growth and prolonged survival in environments with nutrient sources. Diverse flagella-related genes, including
flrA, flrC, flrD, flhA, flhF, fliD, fliF, fliG, fliH, fliI, fliP, fliQ, flgF, flgL, flgK, motX,
and
pomA,
underwent mutations during the cultivation. However, only one gene (site) was mutated in a single
V. cholerae
. Longer cultivation for up to 300 days yielded further mutations in metabolism-related genes and the loss of virulence factors (e.g., CTX phage) and large DNA regions (~35 kb). These mutations were detected in most organisms of
V. cholerae
, accompanying the loss of genomic integrity. Motility-defective variants with mutations in the acetate kinase gene had become predominant in culturable cells after long-term cultivation in independently replicated experiments. These findings shed light on a survival mechanism in which
V. cholerae
adapts to an environmental niche by accumulating mutations.

IMPORTANCE

Vibrio cholerae
undergoes a transition to a viable but non-culturable (VNC) state when subjected to various environmental stresses. We showed here that flagellar motility was involved in the development of the VNC state of
V. cholerae
. In this study, motility-defective isolates with mutations in various flagella-related genes, but not motile isolates, were predominantly obtained under the stress of long-term batch culture. Other genomic regions were highly conserved, suggesting that the mutations were selective. During the stationary phase of long-term culture,
V. cholerae
isolates with mutations in the acetate kinase and flagella-related genes were predominant. This study suggests that genes involved in specific functions in
V. cholerae
undergo mutations under certain environmental conditions.
Supplemental Material: Asymmetry and evolution of craton-influenced rifted margins
Authors: Raghuram G. , al. et
Published: August 2023

Additional information on the geological setting of the central South Atlantic, details of numerical model, and model setup.  
Idiopathic CD4+ T-lymphocytopaenia withFLT1mutation complicated by progressive multifocal leucoencephalopathy and EBV+ polymorphic lymphoproliferative disorder
Authors: Rippel Noa , Wong Joshua , Hussein Shafinaz , Kalac Matko
Published: August 2023

We describe a unique case of idiopathic CD4+T cell lymphocytopaenia complicated by viral-associated disorders in a patient with a heterozygousFLT1mutation. A previously healthy woman presented with left-sided neurological deficits. Workup revealed a severe HIV-seronegative CD4+T cell deficiency and white matter brain lesions; brain biopsy confirmed progressive multifocal leucoencephalopathy (PML). Six years later, she represented with a tender mandibular lesion, with pathology diagnostic for EBV+polymorphic post-transplant-like lymphoproliferative disorder. A heterozygousFLT1P1127L mutation was detected on peripheral blood and mandibular lesion next-generation sequencing. Concern for PML reactivation with rituximab-based therapy and the presence of localised disease led us to offer radiotherapy, resulting in significant symptom relief and marked therapeutic response on repeat imaging.
DisseminatedStrongyloides stercoralisinfection in the setting ofEscherichia colimeningitis and bacteraemia in a patient living with HIV on high-dose corticosteroid therapy
Authors: Montreuil Nadine , Sternberg Candice A , Abaribe Obinna , Ayoade Folusakin O
Published: August 2023

Strongyloidiasis, a helminth infection caused byStrongyloides stercoralis, can be complicated by hyperinfection, especially in the setting of immunosuppression; however, many patients go undiagnosed. One clue to diagnosis is unexplained gram-negative bacteraemia or meningitis in patients who are immunosuppressed. Serology can be helpful but may be negative in these patients who are immunocompromised.

We present the case of a white cisgender man from Central America in his 40s, living with HIV, with a CD4 count of 77 cells/µL. He was diagnosed withStrongyloideshyperinfection after an increase in his steroid dose. He also hadEscherichia colimeningitis and bacteraemia. Strongyloidiasis was diagnosed by stool microscopy despite a negative serology test.

This case highlights the challenges in diagnosing strongyloidiasis in the setting of immunosuppression. A high index of clinical suspicion is warranted for patients living with HIV on high-dose corticosteroids. Up to three stool microscopy studies forStrongyloidesshould be sent in addition to serology.
Biceps muscle injury associated with non-invasive automatic blood pressure monitoring
Authors: Nicol Rose , Lin Ian , Prasad Linga
Published: August 2023

This case describes a young, healthy woman who developed a grade 1 biceps muscle strain after the use of automatic non-invasive blood pressure monitoring during an elective surgical procedure. She was treated conservatively with simple analgesia, physiotherapy and a sling for comfort. Follow-up conducted 1 week later revealed occasional soreness, but she had almost returned to her baseline activity. The patient made a full recovery without any residual symptoms by the end of 6 weeks. This case highlights the importance of careful monitoring to ensure that routine use of blood pressure cuffs does not cause any pressure injuries.
Safety and efficacy of Vitamin D3supplementation with Imatinib in Chronic Phase- Chronic Myeloid Leukaemia: an Exploratory Randomized Controlled Trial
Authors: Bandyopadhyay Arkapal , Palepu Sarika , Dhamija Puneet , Nath Uttam Kumar , Chetia Rituparna , Bakliwal Anamika , Vaniyath Sudeep , Chattopadhyay Debranjani , Handu Shailendra
Published: August 2023

Objectives

The study aimed to compare early molecular response (EMR) rates at 3 months of imatinib therapy with and without vitamin D3supplementation in patients newly diagnosed with chronic-phase chronic myeloid leukaemia (CML-CP). The secondary objective was to assess the effects of vitamin D3on complete haematological response (CHR) and its safety.

Design

Double-blind, placebo-controlled, exploratory randomised trial.

Setting

Tertiary care hospital in northern India.

Participants

Treatment-naive patients with chronic phase chronic myeloid leukaemia (n=62) aged >12 years were recruited from January 2020 to January 2021. Patients with progressive disease, pregnancy and hypercalcaemia were excluded.

Intervention

Oral vitamin D3supplementation (60 000 IU) or matched placebo was given once weekly for an initial 8 weeks along with imatinib after randomisation with 1:1 allocation ratio.

Primary and secondary outcome measures

The primary outcome was to compare EMR (defined asBCR-ABL1transcript level ≤10%, international scale) at 3 months. The secondary outcomes were to compare effect of the intervention on CHR, correlation of 25(OH)2D3levels with treatment response and safety according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.

Results

At baseline, 14.5% of the patients had normal vitamin D3levels. EMR at 3 months was attained in 24 patients (82.7%) of the vitamin D3group and 21 (75%) of the placebo group (OR 1.6, 95% CI 0.37 to 7.37, p=0.4). A significant difference in vitamin D3levels from baseline to the end of study was observed. Patients with vitamin D3supplementation did not achieve higher CHR in comparison with placebo (OR 1.3, 95% CI 0.25 to 7.23, p=1.0). Vitamin D3 levels were not significantly correlated withBCR-ABL1levels. No dose-limiting toxicities were observed.

Conclusion

Vitamin D3levels were low among patients with CML-CP in this study. Vitamin D3supplementation with imatinib therapy did not have significant effect on EMR or CHR. Further clinical trials could be undertaken to assess the effective dosage and duration of vitamin D3supplementation in these patients.

Trial registration number

CTRI/2019/09/021164.
Effect modification in network meta-analyses for relapsed/refractory multiple myeloma: systematic review and meta-analysis
Authors: Rose Christopher James , Ohm Ingrid Kristine , Giske Liv , Næss Gunn Eva , Fretheim Atle
Published: August 2023

Objectives

To systematically review and meta-analyse the evidence for effect modification by refractory status and number of treatment lines in relapsed/refractory multiple myeloma (RRMM); and to assess whether effect modification is likely to invalidate network meta-analyses (NMA) that assume negligible modification.

Design

Systematic review, meta-analysis and simulation.

Data sources

We systematically searched the literature (e.g., OVID Medline) to identify eligible publications in February 2020 and regularly updated the search until January 2022. We also contacted project stakeholders (including industry)

Eligibility criteria

Phase 2 and 3 randomised controlled trials reporting stratified estimates for comparisons with at least one of a prespecified set of treatments relevant for use in Norwegian RRMM patients.

Outcomes

We used meta-analysis to estimate relative HRs (RHRs) for overall survival (OS) and progression-free survival (PFS) with respect to refractory status and number of treatment lines. We used the estimated RHRs in simulations to estimate the percentage of NMA results expected to differ significantly in the presence versus absence of effect modification.

Results

Among the 42 included publications, stratified estimates were published by and extracted from up to 18 (43%) publications and on as many as 8364 patients. Within-study evidence for effect modification is very weak (p>0.05 for 47 of 49 sets of stratified estimates). The largest RHR estimated was 1.32 (95% CI 1.18 to 1.49) for the modifying effect of refractory status on HR for PFS. Simulations suggest that, in the worst case, this would result in only 4.48% (95% CI 4.42% to 4.54%) of NMA estimates differing statistically significantly in the presence versus absence of effect modification.

Conclusions

Based on the available evidence, effect modification appears to be sufficiently small that it can be neglected in adequately performed NMAs. NMAs can probably be relied on to provide estimates of HRs for OS and PFS in RRMM, subject to caveats discussed herein.
Scoping review on Physical Health Conditions in Irish Travellers (Mincéiri)
Authors: Kennedy Fiona , Ward Amy , Mockler David , Villani Jacopo , Broderick Julie
Published: August 2023

Objective

The objective of this scoping review was to collate physical health conditions in Mincéiri—Irish Travellers.

Design

Scoping review.

Search strategy and charting method

MEDLINE/PubMed, EMBASE, PEDro, AMED, CINAHL, PsycINFO, SCOPUS as well as reports and grey literature were searched for primary data reporting physical health conditions of Irish Travellers up to 4 April 2023. Data was extracted, described and organised meaningfully into tables according to reported physical health conditions.

Eligibility criteria

The population was Travellers. The concept referred to physical health conditions. The context was Irish Travellers based in any location or setting. Exclusion criteria was data/research other than primary data relating to physical health conditions of Irish Travellers.

Results

From 198 citations generated from the database search, 11 unique studies (20 reports) were included in this scoping review, including n=7397 participants. Driven by the data, physical health conditions were categorised into cardiovascular diseases, respiratory diseases, injuries/musculoskeletal/arthritic disorders, genetic disorders and gut/bowel conditions. This review showed that the metabolic syndrome, asthma, bronchitis, tuberculosis and intentional injuries were 2–3 times more prevalent in Irish Travellers compared with the background population. Genetic conditions were also described in a proportion of Travellers.

Conclusions

Overall, Irish Travellers experience a disproportionate burden of physical health conditions compared with background populations. Healthcare providers need to be aware of the unique physical health burden experienced by many Irish Travellers. Multifaceted strategies are needed to improve the health profile of this vulnerable and marginalised group.
Improving primary care referral to specialist services: a protocol for a 10-year global systematic review in the Australian context
Authors: Ekanayake Siyaguna Kosgamage Dilum Manthinda , Ward Aletha E , Heart Diane , Valery Patricia , Soar Jeffrey
Published: August 2023

Introduction

Barriers to accessing specialist services impart a significant burden on patient outcomes and experience as well as a cost and administrative burden on health systems due to healthcare wastage and inefficiencies. This paper outlines the planned protocol for a systematic review relating to how health systems perform with regard to patient access to specialist care, and the efficacy of interventions aimed at improving this.

Methods and analysis

Systematic review of the literature will be carried out on publications retrieved by searching the following electronic literature databases: EBSCOhost Megafile Ultimate (Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Ultimate, APA Psychological Abstracts (PsycINFO), HealthSource), PubMed (Medical Literature Analysis and Retrieval System Online (MEDLINE)), Elsevier Bibliographic Database (Scopus), Excerpta Medica Database (EMBASE), Web of Science and The Cochrane Library. Articles published over a 10-year period (2012–2022) will be analysed to determine; current accessibility and availability problems faced by primary care services when referring patients to specialist care, and the effectiveness of interventions to improve primary care access to specialist services. Grey literature publications (ie, government reports, policy statements and issues papers, conference proceedings) will not be analysed in this review. Articles not published in English, Spanish or Portuguese will not be included. Two independent reviewers will conduct the initial screening, disagreements will be resolved by a third independent reviewer, following which data extraction and selection of eligible sources will be carried out. Selected articles will be categorised on study design, setting and participants. Methodological quality and heterogeneity will subsequently be assessed using the Mixed Methods Appraisal Tool. A descriptive approach will be used to review and synthesise the findings.

Ethics and dissemination

This study does not require ethics committee review as it solely focuses on analysing published literature. Findings will be published and disseminated through a peer-reviewed journal.

PROSPERO registration number

CRD42022354890.
Comparative study on risk prediction model of type 2 diabetes based on machine learning theory: a cross-sectional study
Authors: Wang Shu , Chen Rong , Wang Shuang , Kong Danli , Cao Rudai , Lin Chunwen , Luo Ling , Huang Jialu , Zhang Qiaoli , Yu Haibing , Ding Yuan Lin
Published: August 2023

Objectives

To compare the prediction effects of six models based on machine learning theories, which can provide a methodological reference for predicting the risk of type 2 diabetes mellitus (T2DM).

Setting and participants

This study was based on the monitoring data of chronic disease risk factors in Dongguan residents from 2016 to 2018. The multistage cluster random sampling method was adopted at each monitoring site, and 4157 people were finally selected. In the initial population, we excluded individuals with more than 20% missing data and eventually included 4106 subjects.

Design

K nearest neighbour algorithm and synthetic minority oversampling technique were used to process the data. Single factor analysis was used for preliminary selection of variables. The 10-fold cross-validation was used to optimise the parameters of some models. The accuracy, precision, recall and area under receiver operating characteristic curve (AUC) were used to evaluate the prediction effect of models, and Delong test was used to analyse the differences of AUC values of each model.

Results

After balancing data, the sample size increased to 8013, of which 4023 are patients with T2DM and 3990 in control group. The comparison results of the six models showed that back propagation neural network model has the best prediction effect with 93.7% accuracy, 94.6% accuracy, 92.8% recall and the AUC value of 0.977, followed by logistic model, support vector machine model, CART decision tree model and C4.5 decision tree model. Deep neural network has the worst prediction performance, with 84.5% accuracy, 86.1% precision, 82.9% recall and the AUC value of 0.845.

Conclusions

In this study, six types of risk prediction models for T2DM were constructed, and the predictive effects of these models were compared based on various indicators. The results showed that back propagation neural network based on the selected data set had the best prediction effect.
Early and Intensive Motor Training for people with spinal cord injuries (the SCI-MT Trial): protocol of the process evaluation
Authors: Chu Jackie , Glinsky Joanne V , Liu Hueiming , Ben Marsha , Spooren Annemie I , Roberts Sharon , Chen Lydia W , Di Natal Fernanda , Tamburella Federica , Jørgensen Vivien , Gollan Emilie J , Agostinello Jacqui , van Laake-Geelen Charlotte , Lincoln Claire , van der Lede Jessica , Stolwijk Janneke M , Bell Chris , Paddison Sue , Rainey Donna , Scivoletto Giorgio , Oostra Kristine M , Jan Stephen , Sherrington Catherine , Harvey Lisa A
Published: August 2023

Introduction

People with spinal cord injury receive physical rehabilitation to promote neurological recovery. Physical rehabilitation commences as soon as possible when a person is medically stable. One key component of physical rehabilitation is motor training. There is initial evidence to suggest that motor training can enhance neurological recovery if it is provided soon after injury and in a high dosage. The Early and Intensive Motor Training Trial is a pragmatic randomised controlled trial to determine whether 10 weeks of intensive motor training enhances neurological recovery for people with spinal cord injury. This pragmatic randomised controlled trial will recruit 220 participants from 15 spinal injury units in Australia, Scotland, Italy, Norway, England, Belgium and the Netherlands. This protocol paper describes the process evaluation that will run alongside the Early and Intensive Motor Training Trial. This process evaluation will help to explain the trial results and explore the potential facilitators and barriers to the possible future rollout of the trial intervention.

Methods and analysis

The UK Medical Research Council process evaluation framework and the Implementation Research Logic Model will be used to explain the trial outcomes and inform future implementation. Key components of the context, implementation and mechanism of impact, as well as the essential elements of the intervention and outcomes, will be identified and analysed. Qualitative and quantitative data will be collected and triangulated with the results of the Early and Intensive Motor Training Trial to strengthen the findings of this process evaluation.

Ethics and dissemination

Ethical approval for the Early and Intensive Motor Training Trial and process evaluation has been obtained from the Human Research Ethics Committee at the Northern Sydney Local Health District (New South Wales) in Australia (project identifier: 2020/ETH02540). All participants are required to provide written consent after being informed about the trial and the process evaluation. The results of this process evaluation will be published in peer-reviewed journals.

Trial registration number

Australian New Zealand Clinical Trial Registry (ACTRN12621000091808); Universal Trial Number (U1111-1264-1689).