bluuebunny/crossref_metadata_2025 huggingface dataset:
Visceral Metastasis: A Prognostic Factor of Survival in Patients with Spinal Metastases
Authors: Lun Deng‐xing , Chen Nai‐Wang , Feng Jiang‐tao , Yang Xion‐gang , Xu Zhao‐wan , Li Feng , Hu Yong‐cheng
Published: March 2020

Objective

To characterize the visceral metastasis as a predictive tool for the survival of patients with spinal metastases through an exploratory meta‐analysis.

Methods

Two investigators independently searched PubMed and Embase databases for eligible studies from 2000–2016. The effect estimates for the hazard ratio (HR) or risk ratio (RR) and 95% confidence interval (CI) were collected and pooled with a random‐ or fixed‐effect model.

Results

In total, 18 eligible studies were retrieved with 5468 participants from nine countries. The overall pooled effect size for HR and RR was 1.50 and 3.79, respectively, which was proved to be statistically significant. In the subgroup of prostate cancer (PCa) and non‐small cell lung cancer (NSCLC), statistical significance and marginal statistical significance was presented for the pooled HR (HR = 1.76, 95% CI 1.35–2.29) and (RR = 1.56, 95% CI 0.99–2.48), respectively. However, in the subgroup of thyroid cancer, breast cancer, and renal cancer, statistical significance was not achieved (HR = 1.17, 95% CI 0.75–1.83,Z= 0.70,P= 0.486). The results did not show any evidence of publication bias.

Conclusions

This study demonstrated that visceral metastasis was a significant prognostic factor in patients with spinal metastases as a whole. Interestingly, the onset of visceral metastases differentially impacted the survival in different primary tumors. Therefore, the prognostic value of visceral metastasis might be related to the type of primary tumor.
Risk of Dislocation After Total Hip Arthroplasty in Patients with Crowe Type IV Developmental Dysplasia of the Hip
Authors: Ding Zi‐chuan , Zeng Wei‐nan , Mou Ping , Liang Zhi‐min , Wang Duan , Zhou Zong‐ke
Published: March 2020

Objective

To investigate whether the risk of dislocation after total hip arthroplasty (THA) in patients with Crowe type IV developmental dysplasia of the hip (DDH) is high and to further identify the risk factors for postoperative dislocation in these patients.

Methods

This retrospective cohort study reviewed Crowe type IV DDH patients undergoing THA between January 2009 and December 2017 in our institution. Each Crowe type IV DDH patient was matched with three Crowe type I, II, or III DDH patients according to gender, side and date of operation. The primary outcome of this study was postoperative dislocation after THA. Occurrence, rate, classification, treatment and outcome of dislocation were documented in detail for all patients. The dislocation rates were compared between Crowe type IV DDH patients and Crowe type I, II, or III DDH patients. Demographic data, implant factors, and surgical factors were compared between the dislocation and no dislocation groups. Multiple logistic regression analysis was used to determine the independent risk factors for dislocation in Crowe type IV hips.

Results

A total of 131 Crowe type IV hips were followed up for a mean of 76.5 ± 28.1 months. Three hundred and ninety‐three Crowe type I, II and III hips, including 261 type I hips, 94 type II hips, and 38 type III hips, were identified as controls and followed up for a mean of 76.4 ± 28.2 months. No significant difference was observed in follow‐up time between two groups (P = 0.804). One or more dislocations occurred in 22 of the 524 dysplasia hips (4.20%). Of the 22 dislocated hips, 20 hips (90.9%) were successfully managed with non‐operative treatment. Two patients (9.1%, one Crowe type I and one Crowe type IV) experienced recurrent dislocation and required revision surgery. Crowe type IV hips had a significantly higher postoperative dislocation rate than type I, II, and III hips (11.45% vs 1.78%, P < 0.001). The use of a 22‐mm femoral head (odds ratio [OR] = 23.55, 95% confidence interval [CI] = 1.901–291.788, P = 0.014), older age (OR = 1.128, 95% CI = 1.037–1.275, P = 0.031), and absence of false acetabulum (OR = 12.425, 95% CI = 1.982–77.879, P = 0.007) were identified as independent risk factors for dislocation in Crowe type IV hips.

Conclusions

Crowe type IV DDH patients were at a high risk of dislocation after THA, and using large femoral heads and improving abductor muscle strength may help decrease the rate of postoperative dislocation in such patients.
Combining focused identification of germplasm and core collection strategies to identify genebank accessions for central European soybean breeding
Authors: Haupt Max , Schmid Karl
Published: March 2020

Environmental adaptation of crops is essential for reliable agricultural production and an important breeding objective. Genebanks provide genetic variation for the improvement of modern varieties, but the selection of suitable germplasm is frequently impeded by incomplete phenotypic data. We address this bottleneck by combining a Focused Identification of Germplasm Strategy (FIGS) with core collection methodology to select soybean (Glycine max) germplasm for Central European breeding from a collection of >17,000 accessions. By focussing on adaptation to high‐latitude cold regions, we selected an “environmental precore” of 3,663 accessions using environmental data and compared the Donor opulation of Environments (DPE) in Asia and the Target Population of Environments (TPE) in Central Europe in the present and 2070. Using single nucleotide polymorphisms, we reduced the precore into two diverse core collections of 183 and 366 accessions to serve as diversity panels for evaluation in the TPE. Genetic differentiation between precore and non‐precore accessions revealed genomic regions that control maturity, and novel candidate loci for environmental adaptation, demonstrating the potential of diversity panels for studying adaptation. Objective‐driven core collections have the potential to increase germplasm utilization for abiotic adaptation by breeding for a rapidly changing climate, or de novo adaptation of crops to expand cultivation ranges.
A precise visual localisation method for the Chinese Chang’e‐4 Yutu‐2 rover
Authors: Ma YouQing , Liu ShaoChuang , Sima Bing , Wen Bo , Peng Song , Jia Yang
Published: March 2020

Precise localisation of the Yutu‐2 moon rover plays an important role in path planning, obstacle avoidance and navigating to target features. To provide high‐precision localisation information, a stereo bundle adjustment method using the theory of the unit quaternions is presented for the first time. To improve the precision and robustness of the proposed method, the rover's pose, from a visual odometry technique assisted by an inertial measurement unit and the rotation angles of the mast mechanism, is viewed as a pseudo‐observation. A reasonable weighting strategy and a rational geometric constraint condition of the stereo cameras is also invoked. Experimental results demonstrate that the proposed method provides more accurate localisation results than either a bundle adjustment alone or a weighted total least‐squares method. The proposed method has been successfully used in Chang'e‐4 mission operations.
Mineralization events in the Xiaokele porphyry Cu (–Mo) deposit, NE China: Evidence from zircon U–Pb and K‐feldspar Ar–Ar geochronology and petrochemistry
Authors: Sun Yonggang , Li Bile , Sun Fengyue , Ding Qingfeng , Wang Baiyi , Li Yujin , Wang Kun
Published: March 2020

The Great Xing'an Range (GXR), Northeast (NE) China, is a major polymetallic metallogenic belt in the eastern segment of the Central Asian Orogenic Belt. The newly discovered Xiaokele porphyry Cu (–Mo) deposit lies in the northern GXR. Field geological and geochronological studies have revealed two mineralization events in this deposit: early porphyry‐type Cu (–Mo) mineralization, and later vein‐type Cu mineralization. Previous geochronological studies yielded an age of ca. 147 Ma for the early Cu (–Mo) mineralization. Our 40Ar/39Ar dating yielded 40Ar/39Ar plateau ages of 124.8 ± 0.4 to 124.3 ± 0.4 Ma on K‐feldspar in altered Cu‐mineralized diorite porphyrite dikes that represent the overprinting vein‐type Cu mineralization, consistent with zircon U–Pb ages of the diorite porphyrite (126.4 ± 0.5 to 125.0 ± 0.5 Ma). The Cr and Ni contents and Mg# of the Xiaokele diorite porphyrites are high. The diorite porphyrites at Xiaokele are enriched in light rare‐earth elements (REEs), and large‐ion lithophile elements (e.g., Rb, Ba, and K), are depleted in heavy REEs and high‐field‐strength elements (e.g., Nb, Ta, and Ti), and have weak negative εHf(t) values (+0.29 to +5.27) with two‐stage model ages (TDM2) of 1,164–845 Ma. Given the regional tectonic setting in Early Cretaceous, the ore‐bearing diorite porphyrites were likely formed in an extensional environment related to lithospheric delamination and asthenospheric upwelling induced by subduction of the Paleo‐Pacific Plate. These tectonic events caused large‐scale magmatic activity, ore mineralization, and lithospheric thinning in NE China.
Gastrocnemius Medialis and Vastus Lateralis in vivo muscle‐tendon behavior during running at increasing speeds
Authors: Monte Andrea , Baltzopoulos Vasilios , Maganaris Constantinos N. , Zamparo Paola
Published: March 2020

This study combines in vivo ultrasound measurements of the Vastus Lateralis (VL) and Gastrocnemius Medialis (GM) muscles with electromyographic, kinematic, and kinetic measurements during treadmill running at different speeds (10, 13, and 16 km/h) to better understand the role of muscle and tendon behavior in two functionally different muscle‐tendon units. In addition, the force‐length and force‐velocity relationships of VL and GM were experimentally assessed by combining dynamometry and EMG data with ultrasound measurements. With increasing running speed, the operating length of the fascicles in the stance phase shifted toward smaller lengths in the GM (P < .05; moving down the ascending limb of the F‐L relationship) and longer lengths in the VL (P < .05; moving down the descending limb) at all speeds; however, both muscles contracted close to their optimal length L0, where isometric force is maximal. Whereas the length of VL SEE did not change as a function of speed, GM SEE lengthened and shortened more at higher speeds. With increasing running speed, the contribution of elastic strain energy to the positive power generated by the MTU increased more for GM (from 0.75 to 1.56 W/kg) than for VL (from 0.62 to 1.02 W/kg). Notwithstanding these differences, these results indicate that, at increasing running speeds, both the VL and GM muscles produce high forces at low contraction velocities, and that the primary function of both muscle‐tendon units is to enhance the storage and recovery of elastic strain energy.
Performance Evaluation of Alternating Current Square Waveform Submerged Arc Welding as a Candidate for Fabrication of Thick Welds in 2.25Cr-1Mo Heat-Resistant Steel
Authors: Mohanty Uttam Kumar , Abe Yohei , Fujimoto Takahiro , Nakatani Mitsuyoshi , Kitagawa Akikazu , Tanaka Manabu , Suga Tetsuo , Sharma Abhay
Published: March 2020

The paper evaluates the performance of alternating current (AC) square waveform submerged arc welding (SAW) as a candidate technology for manufacturing thick welds for high-pressure vessels. A new mathematical formulation for calculating melting efficiency in square waveform arc welding is presented. The melting efficiency and the heat consumption are presented as a mathematical model of welding parameters, namely welding current, welding speed, current frequency, and electrode negativity (EN) ratio. The proposed approach is demonstrated through the welding of 2.25Cr-1Mo heat-resistant steel performed over a wide range of welding parameters. The investigation provides deeper insights into the interplay between process parameter, total heat consumption, and melting efficiency. The effect on flux consumption is also explained. The melting efficiency is inversely proportional to flux consumption. The welding heat does not necessarily promote the plate melting. Improper use of welding heat may lead to decreased melting efficiency and increased unwanted melting and consumption of welding flux. Compared to the conventional direct current (DC) power sources, the AC square waveform welding achieves almost the same order of melting efficiency with added advantages of better weld bead shape and flux consumption in a desirable range. The two additional parameters (frequency and EN ratio) of the AC square waveform power source provide more freedom to fine-tune the process and thereby efficiently use welding heat. The results of this investigation will be advantageous to the designers and fabricators of high-pressure vessels using AC square waveform welding.
Human plasma protein adsorption to elastin-like polypeptide nanoparticles
Authors: Bahniuk Markian S. , Alshememry Abdullah K. , Unsworth Larry D.
Published: March 2020

Elastin-like polypeptides (ELPs) are being developed for numerous biomedical applications. There is a limited understanding of ELP biocompatibility, with conflicting results in the literature. Protein adsorption is the fate determining event for blood-contacting biomaterials. The aim of this study is to elucidate the biocompatibility of ELP-based nanoparticles by examining the adsorbed proteome from platelet poor human plasma as a function of the physicochemical properties of these nanoparticles: diameter, amino acid hydrophobicity, and chain length. It was found that all ELP constructs had adsorbed an extremely large amount of albumin and high levels of immunoglobulin G and activated complement factor 3. Variations in the compositions of the proteomes across the eight nanoparticle systems studied were observed for plasminogen, fibronectin, activated fibrinogen, and coagulation modulating antithrombin and alpha2 macroglobulin. Plasma clotting experiments showed that ELP-based nanoparticles slightly inhibited normal blood clotting, with shorter and/or more hydrophilic constructs showing a greater difference from the control than longer or more hydrophobic constructs. These results indicate that ELP nanoparticles, regardless of chain length, particle diameter, or amino acid hydrophobicity, may have the potential to stimulate a humoral immune response via immunoglobulin G and activated complement factor 3 despite the large amounts of albumin adsorbed at the blood-material interface.
“The Stories That Will Make a Difference Aren’t the Easy Ones”: Outdoor Recreation, the Wilderness Ideal, and Complicating Settler Mobility
Authors: Laurendeau Jason
Published: March 2020

In this autoethnography, I read my history of and connection to outdoor culture, with an eye toward interrogating my complicity in historical and ongoing settler-colonial violence that has rendered my love of “the mountains” both possible and ostensibly unproblematic. In so doing, I unsettle (my) understandings of the connections between land, embodiment, masculinities, and able-bodiedness, exploring how settler attachment to the mountains ispredicated onand serves to perpetuate, a(n ongoing) history of land dispossession. I also, however, consider a “different temporal horizon” through a discussion of settler futurity as it relates to outdoor recreation, complicating settler mobility in the process.
Antimicrobial Resistance in Clinical
Ureaplasma
spp. and Mycoplasma hominis and Structural Mechanisms Underlying Quinolone Resistance
Authors: Yang Ting , Pan Lianlian , Wu Ningning , Wang Lin , Liu Zhen , Kong Yingying , Ruan Zhi , Xie Xinyou , Zhang Jun
Published: March 2020

Antibiotic resistance is a global concern; however, data on antibiotic-resistant
Ureaplasma
spp. and
Mycoplasma hominis
are limited in comparison to similar data on other microbes. A total of 492
Ureaplasma
spp. and 13
M. hominis
strains obtained in Hangzhou, China, in 2018 were subjected to antimicrobial susceptibility testing for levofloxacin, moxifloxacin, erythromycin, clindamycin, and doxycycline using the broth microdilution method.
A Nonlive Preparation of
Chromobacterium
sp. Panama (Csp_P) Is a Highly Effective Larval Mosquito Biopesticide
Authors: Caragata Eric P. , Otero Luisa M. , Carlson Jenny S. , Borhani Dizaji Nahid , Dimopoulos George
Published: March 2020

We have developed a novel preparation to kill mosquitoes from an abundant soil bacterium,
Chromobacterium
sp. Panama. This preparation is an air-dried powder containing no live bacteria, and it can be incorporated into an attractive bait and fed directly to mosquito larvae. We demonstrate that the preparation has broad spectrum activity against the larval form of the mosquitoes responsible for the transmission of malaria and the dengue, chikungunya, yellow fever, West Nile, and Zika viruses, as well as mosquito larvae that are already resistant to commonly used mosquitocidal chemicals. Our preparation possesses many favorable traits: it kills at a low dosage, and it does not lose activity when exposed to high temperatures, all of which suggest that this preparation could eventually become an effective new tool for controlling mosquitoes and the diseases they spread.
Synergistic Cues from Diverse Bacteria Enhance Multicellular Development in a Choanoflagellate
Authors: Ireland Ella V. , Woznica Arielle , King Nicole
Published: March 2020

Eukaryotic biology is profoundly influenced by interactions with diverse environmental and host-associated bacteria. However, it is not well understood how eukaryotes interpret multiple bacterial cues encountered simultaneously. This question has been challenging to address because of the complexity of many eukaryotic model systems and their associated bacterial communities. Here, we studied a close relative of animals, the choanoflagellate
Salpingoeca rosetta
, to explore how eukaryotes respond to diverse bacterial cues. We found that a bacterial chondroitinase that induces mating on its own can also synergize with bacterial lipids that induce multicellular “rosette” development. When encountered together, these cues enhance rosette development, resulting in both the formation of larger rosettes and an increase in the number of rosettes compared to rosette development in the absence of the chondroitinase. These findings highlight how synergistic interactions among bacterial cues can influence the biology of eukaryotes.
Cryptococcus neoformansChemotyping by Quantitative Analysis of1H Nuclear Magnetic Resonance Spectra of Glucuronoxylomannans with a Computer-Simulated Artificial Neural Network
Authors: Cherniak Robert , Valafar Homayoun , Morris Laura C. , Valafar Faramarz
Published: March 2020

The complete assignment of the proton chemical shifts obtained by nuclear magnetic resonance (NMR) spectroscopy of de-O-acetylated glucuronoxylomannans (GXMs) fromCryptococcus neoformanspermitted the high-resolution determination of the total structure of any GXM. Six structural motifs based on an α-(1→3)-mannotriose substituted with variable quantities of 2-O-β- and 4-O-β-xylopyranosyl and 2-O-β-glucopyranosyluronic acid were identified. The chemical shifts of only the anomeric protons of the mannosyl residues served as structure reporter groups (SRG) for the identification and quantitation of the six triads present in any GXM. The assigned protons for the mannosyl residues resonated at clearly distinguishable positions in the spectrum and supplied all the information essential for the assignment of the complete GXM structure. This technique for assigning structure is referred to as the SRG concept. The SRG concept was used to analyze the distribution of the six mannosyl triads of GXMs obtained from 106 isolates ofC. neoformans. The six mannosyl triads occurred singularly or in combination with one or more of the other triads. The identification and quantitation of the SRG were simplified by using a computer-simulated artificial neural network (ANN) to automatically analyze the SRG region of the one-dimensional proton NMR spectra. The occurrence and relative distribution of the six mannosyl triads were used to chemotypeC. neoformanson the basis of subtle variations in GXM structure determined by analysis of the SRG region of the proton NMR spectrum by the ANN. The data for the distribution of the six SRGs from GXMs of 106 isolates ofC. neoformansyielded eight chemotypes, Chem1 through Chem8.
Identification of Reptarenaviruses, Hartmaniviruses, and a Novel Chuvirus in Captive Native Brazilian Boa Constrictors with Boid Inclusion Body Disease
Authors: Argenta Fernando Froner , Hepojoki Jussi , Smura Teemu , Szirovicza Leonora , Hammerschmitt Márcia Elisa , Driemeier David , Kipar Anja , Hetzel Udo
Published: March 2020

Boid inclusion body disease (BIBD), caused by reptarenavirus infection, affects captive snake populations worldwide, but the reservoir hosts of reptarenaviruses remain unknown. Here, we report the identification of novel reptarenaviruses, hartmaniviruses, and a chuvirus in captive Brazilian boas with BIBD. Three of the four snakes studied showed coinfection with all three viruses, and one of the snakes harbored three novel reptarenavirus L segments and one novel S segment. The samples originated from collections with Brazilian indigenous snakes only, which could indicate that these viruses circulate in wild snakes. The findings could further indicate that boid snakes are the natural reservoir of reptarena- and hartmaniviruses commonly found in captive snakes. The snakes infected with the novel chuvirus all suffered from BIBD; it is therefore not possible to comment on its potential pathogenicity and contribution to the observed changes in the present case material.
Toxin-Antitoxin Gene Pairs Found in Tn
3
Family Transposons Appear To Be an Integral Part of the Transposition Module
Authors: Lima-Mendez Gipsi , Oliveira Alvarenga Danillo , Ross Karen , Hallet Bernard , Van Melderen Laurence , Varani Alessandro M. , Chandler Michael
Published: March 2020

Transposable elements (TEs) are important in genetic diversification due to their recombination properties and their ability to promote horizontal gene transfer. Over the last decades, much effort has been made to understand TE transposition mechanisms and their impact on prokaryotic genomes. For example, the Tn
3
family is ubiquitous in bacteria, molding their host genomes by the paste-and-copy mechanism. In addition to the transposition module, Tn
3
members often carry additional passenger genes (e.g., conferring antibiotic or heavy metal resistance and virulence), and three were previously known to carry a toxin-antitoxin (TA) system often associated with plasmid maintenance; however, the role of TA systems within the Tn
3
family is unknown. The genetic context of TA systems in Tn
3
members suggests that they may play a regulatory role in ensuring stable invasion of these Tns during transposition.
Spatial variations of incoming sediments at the northeastern Japan arc and their implications for megathrust earthquakes
Authors: Fujie Gou , Kodaira Shuichi , Nakamura Yasuyuki , Morgan Jason P. , Dannowski Anke , Thorwart Martin , Grevemeyer Ingo , Miura Seiichi
Published: March 2020

The nature of incoming sediments is a key controlling factor for the occurrence of megathrust earthquakes in subduction zones. In the 2011 Mw 9 Tohoku earthquake (offshore Japan), smectite-rich clay minerals transported by the subducting oceanic plate played a critical role in the development of giant interplate coseismic slip near the trench. Recently, we conducted intensive controlled-source seismic surveys at the northwestern part of the Pacific plate to investigate the nature of the incoming oceanic plate. Our seismic reflection data reveal that the thickness of the sediment layer between the seafloor and the acoustic basement is a few hundred meters in most areas, but there are a few areas where the sediments appear to be extremely thin. Our wide-angle seismic data suggest that the acoustic basement in these thin-sediment areas is not the top of the oceanic crust, but instead a magmatic intrusion within the sediments associated with recent volcanic activity. This means that the lower part of the sediments, including the smectite-rich pelagic red-brown clay layer, has been heavily disturbed and thermally metamorphosed in these places. The giant coseismic slip of the 2011 Tohoku earthquake stopped in the vicinity of a thin-sediment area that is just beginning to subduct. Based on these observations, we propose that post-spreading volcanic activity on the oceanic plate prior to subduction is a factor that can shape the size and distribution of interplate earthquakes after subduction through its disturbance and thermal metamorphism of the local sediment layer.
Epidemiology of multimorbidity in conditions of extreme poverty: a population-based study of older adults in rural Burkina Faso
Authors: Odland Maria Lisa , Payne Collin , Witham Miles D , Siedner Mark J , Bärnighausen Till , Bountogo Mamadou , Coulibaly Boubacar , Geldsetzer Pascal , Harling Guy , Manne-Goehler Jennifer , Ouermi Lucienne , Sie Ali , Davies Justine I
Published: March 2020

Introduction

Multimorbidity is a health issue of increasing importance worldwide, and is likely to become particularly problematic in low-income countries (LICs) as they undergo economic, demographic and epidemiological transitions. Knowledge of the burden and consequences of multimorbidity in LICs is needed to inform appropriate interventions.

Methods

A cross-sectional household survey collected data on morbidities and frailty, disability, quality of life and physical performance on individuals aged over 40 years of age living in the Nouna Health and Demographic Surveillance System area in northwestern Burkina Faso. We defined multimorbidity as the occurrence of two or more conditions, and evaluated the prevalence of and whether this was concordant (conditions in the same morbidity domain of communicable, non-communicable diseases (NCDs) or mental health (MH)) or discordant (conditions in different morbidity domains) multimorbidity. Finally, we fitted multivariable regression models to determine associated factors and consequences of multimorbidity.

Results

Multimorbidity was present in 22.8 (95% CI, 21.4 to 24.2) of the study population; it was more common in females, those who are older, single, more educated, and wealthier. We found a similar prevalence of discordant 11.1 (95% CI, 10.1 to 12.2) and concordant multimorbidity 11.7 (95% CI, 10.6 to 12.8). After controlling for age, sex, marital status, education, and wealth, an increasing number of conditions was strongly associated with frailty, disability, low quality of life, and poor physical performance. We found no difference in the association between concordant and discordant multimorbidity and outcomes, however people who were multimorbid with NCDs alone had better outcomes than those with multimorbidity with NCDs and MH disorders or MH multimorbidity alone.

Conclusions

Multimorbidity is prevalent in this poor, rural population and is associated with markers of decreased physical performance and quality of life. Preventative and management interventions are needed to ensure that health systems can deal with increasing multimorbidity and its downstream consequences.
Protocol for a randomised trial of an interprofessional team-delivered intervention to support surrogate decision-makers in ICUs
Authors: Lincoln Taylor , Shields Anne-Marie , Buddadhumaruk Praewpannarai , Chang Chung-Chou H , Pike Francis , Chen Hsiangyu , Brown Elke , Kozar Veronica , Pidro Caroline , Kahn Jeremy M , Darby Joseph M , Martin Susan , Angus Derek C , Arnold Robert M , White Douglas B
Published: March 2020

Introduction

Although shortcomings in clinician–family communication and decision making for incapacitated, critically ill patients are common, there are few rigorously tested interventions to improve outcomes. In this manuscript, we present our methodology for the Pairing Re-engineered Intensive Care Unit Teams with Nurse-Driven Emotional support and Relationship Building (PARTNER 2) trial, and discuss design challenges and their resolution.

Methods and analysis

This is a pragmatic, stepped-wedge, cluster randomised controlled trial comparing the PARTNER 2 intervention to usual care among 690 incapacitated, critically ill patients and their surrogates in five ICUs in Pennsylvania. Eligible subjects will include critically ill patients at high risk of death and/or severe long-term functional impairment, their main surrogate decision-maker and their clinicians. The PARTNER intervention is delivered by the interprofessional ICU team and overseen by 4–6 nurses from each ICU. It involves: (1) advanced communication skills training for nurses to deliver support to surrogates throughout the ICU stay; (2) deploying a structured family support pathway; (3) enacting strategies to foster collaboration between ICU and palliative care services and (4) providing intensive implementation support to each ICU to incorporate the family support pathway into clinicians’ workflow. The primary outcome is surrogates’ ratings of the quality of communication during the ICU stay as assessed by telephone at 6-month follow-up. Prespecified secondary outcomes include surrogates’ scores on the Hospital Anxiety and Depression Scale, the Impact of Event Scale, the modified Patient Perception of Patient Centredness scale, the Decision Regret Scale, nurses’ scores on the Maslach Burnout Inventory, and length of stay during and costs of the index hospitalisation.

We also discuss key methodological challenges, including determining the optimal level of randomisation, using existing staff to deploy the intervention and maximising long-term follow-up of participants.

Ethics and dissemination

We obtained ethics approval through the University of Pittsburgh, Human Research Protection Office. The findings will be published in peer-reviewed journals.

Trial registration number

NCT02445937
Accelerated partner therapy (APT) partner notification for people withChlamydia trachomatis: protocol for the Limiting Undetected Sexually Transmitted infections to RedUce Morbidity (LUSTRUM) APT cross-over cluster randomised controlled trial
Authors: Estcourt Claudia S , Howarth Alison R , Copas Andrew , Low Nicola , Mapp Fiona , Woode Owusu Melvina , Flowers Paul , Roberts Tracy , Mercer Catherine H , Wayal Sonali , Symonds Merle , Nandwani Rak , Saunders John , Johnson Anne M , Pothoulaki Maria , Althaus Christian , Pickering Karen , McKinnon Tamsin , Brice Susannah , Comer Alex , Tostevin Anna , Ogwulu Chidubem (Duby) , Vojt Gabriele , Cassell Jackie A
Published: March 2020

Introduction

Partner notification (PN) is a process aiming to identify, test and treat the sex partners of people (index patients) with sexually transmitted infections (STIs). Accelerated partner therapy (APT) is a PN method whereby healthcare professionals assess sex partners, by telephone consultation, before giving the index patient antibiotics and STI self-sampling kits to deliver to their sex partner(s). The Limiting Undetected Sexually Transmitted infections to RedUce Morbidity programme aims to determine the effectiveness of APT in heterosexual women and men with chlamydia and determine whether APT could affectChlamydia trachomatistransmission at population level.

Methods and analysis

This protocol describes a cross-over cluster randomised controlled trial of APT, offered as an additional PN method, compared with standard PN. The trial is accompanied by an economic evaluation, transmission dynamic modelling and a qualitative process evaluation involving patients, partners and healthcare professionals. Clusters are 17 sexual health clinics in areas of England and Scotland with contrasting patient demographics. We will recruit 5440 heterosexual women and men with chlamydia, aged ≥16 years.

The primary outcome is the proportion of index patients testing positive forC. trachomatis12-16 weeks after the PN consultation. Secondary outcomes include: proportion of sex partners treated; cost effectiveness; model-predicted chlamydia prevalence; experiences of APT.

The primary outcome analysis will be by intention-to-treat, fitting random effects logistic regression models that account for clustering of index patients within clinics and trial periods. The transmission dynamic model will be used to predict change in chlamydia prevalence following APT. The economic evaluation will use mathematical modelling outputs, taking a health service perspective. Qualitative data will be analysed using interpretative phenomenological analysis and framework analysis.

Ethics and dissemination

This protocol received ethical approval from London—Chelsea Research Ethics Committee (18/LO/0773). Findings will be published with open access licences.

Trial registration number

ISRCTN15996256.
Assessing the European impact of alcohol misuse and illicit drug dependence research: clinical practice guidelines and evidence-base policy
Authors: Pallari Elena , Soukup Tayana , Kyriacou Andri , Lewison Grant
Published: March 2020

Background

Despite alcohol and illicit drug dependence being one of the most common diagnoses in Europe, there is heterogeneity of research evidence used in policy and practice.

Objective

We sought to (1) evaluate European research outputs on alcohol misuse and drug addiction in 2002–2018 in the Web of Science, (2) compare these with their burden of disease and (3) determine their impact in several ways.

Methods

A bibliometric research was undertaken including an assessment of the citation counts, the influence of research on members of national health advisory committees, and their contribution to the evidence base of clinical practice guidelines (CPGs).

Findings

There were 3201 analysed references cited in 28 CPGs across 11 European Countries on alcohol misuse and illicit drug abuse. Research conducted in the USA dominated both sets of CPGs, while many European countries were overcited relative to their research presence. The illicit drug research appeared to be adequate relative to the evidence of harm in Europe. However, alcohol misuse research appeared grossly inadequate to the harm it causes by a factor of 20.

Conclusions

The volume of research on illicit drug addiction is commensurate to the European burden, whereas alcohol misuse is far below what is needed to curb a significant source of harm.

Clinical implications

The research asymmetries call for attention to the causes of the problem. Development of research-based solutions to a serious social harm is needed, including minimum pricing and collaborative work to harmonise efforts on disease management and treatment practices across European countries.
Estimating the burden of road traffic crashes in Uganda using police and health sector data sources
Authors: Muni Kennedy Maring , Ningwa Albert , Osuret Jimmy , Zziwa Esther Bayiga , Namatovu Stellah , Biribawa Claire , Nakafeero Mary , Mutto Milton , Guwatudde David , Kyamanywa Patrick , Kobusingye Olive
Published: March 2020

Background

In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this cross-sectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries).

Methods

A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations.

Results

We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%).

Conclusions

Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
Interferon gamma replacement as salvage therapy in chronic pulmonary aspergillosis: effects on frequency of acute exacerbation and all-cause hospital admission
Authors: Monk Edward J M , Harris Chris , Döffinger Rainer , Hayes Gemma , Denning David W , Kosmidis Chris
Published: March 2020

Chronic pulmonary aspergillosis (CPA) is often poorly responsive to antifungal treatment; secondary infections increase morbidity/mortality, particularly in progressive cases. Interferon gamma (IFNγ) has been implicated in not onlyAspergilluscontrol but also bacterial clearance. Clinical notes of patients with CPA treated with IFNγ (2011–2018) were retrospectively hand-searched. In patients treated for >12 months (n=20), the frequency of acute exacerbation reduced from 3.1 to 1.4 episodes/year (p=0.006) in the 12 months after treatment initiation compared with the 12 months before. A significant reduction in the frequency of hospital admissions/year was also observed (0.8 to 0.3, p=0.04). These findings support further prospective studies.
Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial
Authors: Hansen Henrik , Bieler Theresa , Beyer Nina , Kallemose Thomas , Wilcke Jon Torgny , Østergaard Lisbeth Marie , Frost Andeassen Helle , Martinez Gerd , Lavesen Marie , Frølich Anne , Godtfredsen Nina Skavlan
Published: March 2020

Rationale

Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR).

Objective

To investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV1<50% eligible for routine hospital-based, outpatient PR.

Methods

In this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks’ follow-up from baseline. The primary analysis was based on the intention-to-treat principle.

Measurements and main results

The primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV133%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: −6.6 to 24.9)) or at 22 weeks’ follow-up (−5.3 metres (95% CI: −28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ2test p<0.01).

Conclusion

PTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design.

Trial registration number

ClinicalTrials.gov (NCT02667171), 28 January 2016.
Jasmonic acid–induced inhibition of root growth and leaf senescence is reduced by GmbHLH3, a soybean bHLH transcription factor
Authors: Wang Tianliang , Wang Shuo , Wang Ying , Li Jingwen , Yan Fan , Liu Yajing , Zhao Lei , Wang Qingyu
Published: March 2020

Basic helix-loop-helix (bHLH) transcription factors (TFs) are known to play significant roles in plant growth and development, secondary metabolite synthesis, and stress responses. However, the functions of soybean [Glycine max (L.) Merr.] bHLH TFs have been less widely explored. The main purpose of this study was to explore the function of a bHLH TF subfamily gene, GmbHLH3, by overexpression in wild type Arabidopsis thaliana (L.) Heynh. GmbHLH3 is a homolog of Arabidopsis bHLH3 (AtbHLH3) that participates in the regulation of jasmonic acid (JA) signaling. Several cis-regulatory elements responding to methyl-jasmonate (MeJA), including G-Box CGTCA and TGACG motifs, were found in the promoter of GmbHLH3. GmbHLH3 is located in the nucleus. It can form dimers with AtbHLH3, AtbHLH13, and GmbHLH3a, respectively, by yeast two-hybrid and bimolecular fluorescence complementation assay. GmbHLH3 induced root growth by suppressing expression of AtPDF1.2, AtVSPP1, AtLOX2, and AtTAT1 under MeJA treatment. GmbHLH3 inhibited JA-induced leaf senescence by limiting transcription levels of the senescence-related genes AtSAG29, AtAZF2, AtWRKY22, and AtMKP2, and the chlorophyll degradation genes AtSGR, AtNYC1, AtCLH1, AtPPH, and AtPAO. Under long day conditions, in the absence of JA treatment the GmbHLH3-overexpression lines tended to have a reduced time to flowering. Moreover, GmbHLH3 transcript expression pattern analysis revealed that MeJA treatment could induce GmbHLH3 transcript in soybean. This study provides evidence that JA treatment alters the effects of GmbHLH3 on the regulation of plant growth and gene expression. It contributes to future research on the functions of bHLH TFs in soybean.
Yield losses in canola in response to blackleg disease
Authors: Wang Yixiao , Strelkov Stephen E. , Hwang Sheau-Fang
Published: March 2020

Blackleg, caused by Leptosphaeria maculans (Desm.) Ces. & De Not., is an important disease of canola (Brassica napus L.) worldwide. In Canada, blackleg is managed mainly by the cultivation of resistant or moderately resistant canola hybrids. Field experiments were conducted in Edmonton, AB, Canada, in 2017 and 2018 to determine the relationship between blackleg disease severity and yield in the moderately resistant canola hybrids ‘73-15RR’ and ‘1950RR’. Blackleg severity was rated on a 0–5 scale, where 0 = no disease and 5 = plant death. Regression analysis showed that relationships between disease severity and pod number and seed yield were best explained by second-degree quadratic equations in all site-years for both cultivars. Percentage yield loss increased by 18%–99% and 26%–86% in plants of ‘73-15RR’ and ‘1950RR’, respectively, with disease severities of 2–5 compared with plants with severities of 0–1. An improved knowledge of the relationship between blackleg severity and yield losses is important for a more accurate evaluation of the agronomic efficacy and economic benefits of control measures.
Dynamical systems methods and statender diagnostic of interacting vacuum energy models
Authors: Panotopoulos Grigoris , Rincón Ángel , Otalora Giovanni , Videla Nelson
Published: March 2020

We study three interacting dark energy models within the framework of four-dimensional General Relativity and a spatially flat Universe. In particular, we first consider two vacuum models where dark energy interacts with dark matter, while relativistic matter as well as baryons are treated as non-interacting fluid components. Secondly, we investigate a third model where the gravitational coupling is assumed to be a slowly-varying function of the Hubble rate and dark energy and dark matter interact as well. We compute the statefinders parameters versus red-shift as well as the critical points and their nature applying dynamical systems methods. In the case of only an interaction term, our main findings indicate that (i) significant differences between the models are observed as we increase the strength of the interaction term, and (ii) all the models present an unique attractor corresponding to acceleration. On the other hand, when we allow for a variable gravitational coupling, we find that (i) the deviation from the concordance model depends of both the strength of gravitational coupling parameter and the interaction term, and (ii) there is an unique attractor corresponding to acceleration.
Preduals and complementation of spaces of bounded linear operators
Authors: Gardella Eusebio , Thiel Hannes
Published: March 2020

For Banach spaces [Formula: see text] and [Formula: see text], we establish a natural bijection between preduals of [Formula: see text] and preduals of [Formula: see text] that respect the right [Formula: see text]-module structure. If [Formula: see text] is reflexive, it follows that there is a unique predual making [Formula: see text] into a dual Banach algebra. This removes the condition that [Formula: see text] have the approximation property in a result of Daws. We further establish a natural bijection between projections that complement [Formula: see text] in its bidual and [Formula: see text]-linear projections that complement [Formula: see text] in its bidual. It follows that [Formula: see text] is complemented in its bidual if and only if [Formula: see text] is (either as a module or as a Banach space). Our results are new even in the well-studied case of isometric preduals.
On kernel bundles over reducible curves with a node
Authors: Brivio Sonia , Favale Filippo F.
Published: March 2020

Given a vector bundle [Formula: see text] on a complex reduced curve [Formula: see text] and a subspace [Formula: see text] of [Formula: see text] which generates [Formula: see text], one can consider the kernel of the evaluation map [Formula: see text], i.e. the kernel bundle [Formula: see text] associated to the pair [Formula: see text]. Motivated by a well-known conjecture of Butler about the semistability of [Formula: see text] and by the results obtained by several authors when the ambient space is a smooth curve, we investigate the case of a reducible curve with one node. Unexpectedly, we are able to prove results which goes in the opposite direction with respect to what is known in the smooth case. For example, [Formula: see text] is actually quite never [Formula: see text]-semistable. Conditions which gives the [Formula: see text]-semistability of [Formula: see text] when [Formula: see text] or when [Formula: see text] is a line bundle are then given.
Effects of multiplicative noise on the Duffing oscillator with variable coefficients and its integral of motion
Authors: Urenda-Cázares E. , Gallegos A. , Jaimes-Reátegui R.
Published: March 2020

In this work, we implement multiplicative noise to the Duffing oscillator with variable coefficients. The stochastic differential equations are solved using the fourth-order Runge–Kutta method with the Box-Müller algorithm and the corresponding integral of motion is obtained. Some numerical experiments are performed and the results show that the integral of motion is highly unaffected by the multiplicative noise.
Predicting missing links in directed networks based on local network structure and investment theory
Authors: Li Jinsong , Peng Jianhua , Liu Shuxin , Ji Xinsheng
Published: March 2020

As an elementary task in statistical physics and network science, link prediction has attracted great attention of researchers from many fields. While numerous similarity-based indices have been designed for undirected networks, link prediction in directed networks has not been thoroughly studied yet. Among several representative works, motif predictors such as “feed-forward-loop” and Bi-fan predictor perform well in both accuracy and efficiency. Nevertheless, they fail to explicitly explain the linkage motivation of nodes, nor do they consider the unequal contributions of different neighbors between node pairs. In this paper, motivated by the investment theory in economics, we propose a universal and explicable model to quantify the contributions of nodes on driving link formation. Based on the analysis on two typical investment relationships, namely “follow-up” and “co-follow”, an investment-profit index is designed for link prediction in directed networks. Empirical studies on 12 static networks and four temporal networks show that the proposed method outperforms eight mainstream baselines under three standard metrics. As a quasi-local index, it is also suitable for large-scale networks.