bluuebunny/crossref_metadata_2025 huggingface dataset:
Exertional heat stroke: an evidence based approach to clinical assessment and management
Authors: DeGroot David W. , O'Connor Francis G. , Roberts William O.
Published: June 2022

New Findings

What is the topic of this review?

The treatment of exertional heat stress, from initial field care through the return‐to‐activity decision.

What advances does it highlight?

Clinical assessment during field care using AVPU and vital signs to gauge recovery, approaches to field cooling and end of active cooling, and shared clinical decision making for return to activity recommendations.

Exertional heat stroke (EHS) is a potentially fatal condition characterized by central nervous system (CNS) dysfunction and body temperature often but not always >40°C that occurs in the context of physical work in warm or hot environments. In this paper, we review the continuum of care, from initial recognition and field care to transport and hospital care, and finally return‐to‐duty considerations. Morbidity and mortality can be greatly reduced if not eliminated with prompt recognition and aggressive cooling. If medical personnel are not present at point of collapse during or immediately following exercise, EHS should be the presumptive diagnosis until a formal diagnosis can be determined by qualified medical staff. EHS is a rare medical situation where initial treatment (cooling) takes precedence over transport to a medical facility, where advanced medical care may be required for severe EHS casualties. Recovery from EHS and return to activity is usually straightforward and unremarkable provided the casualty is rapidly cooled at time of collapse and adequate time is allowed for body healing. However, evidence‐based data to guide return to activity following EHS are limited. Current research suggests that most individuals recover completely within a few weeks though some individuals may suffer prolonged sequalae and additional evaluation may be warranted, including heat tolerance testing (HTT). Several aspects of the care of the EHS casualty are based on best practices derived from personal experience and continued research is necessary to optimize evaluation and management.
Correlation networks of spinal motor neurons that innervate lower limb muscles during a multi‐joint isometric task
Authors: Hug François , Avrillon Simon , Sarcher Aurélie , Del Vecchio Alessandro , Farina Dario
Published: June 2022

Movements are reportedly controlled through the combination of synergies that generate specific motor outputs by imposing an activation pattern on a group of muscles. To date, the smallest unit of analysis of these synergies has been the muscle through the measurement of its activation. However, the muscle is not the lowest neural level of movement control. In this human study (n = 10), we used a purely data‐driven method grounded on graph theory to extract networks of motor neurons based on their correlated activity during an isometric multi‐joint task. Specifically, high‐density surface electromyography recordings from six lower limb muscles were decomposed into motor neurons spiking activity. We analysed these activities by identifying their common low‐frequency components, from which networks of correlated activity to the motor neurons were derived and interpreted as networks of common synaptic inputs. The vast majority of the identified motor neurons shared common inputs with other motor neuron(s). In addition, groups of motor neurons were partly decoupled from their innervated muscle, such that motor neurons innervating the same muscle did not necessarily receive common inputs. Conversely, some motor neurons from different muscles‐including distant muscles‐received common inputs. The study supports the theory that movements are produced through the control of small numbers of groups of motor neurons via common inputs and that there is a partial mismatch between these groups of motor neurons and muscle anatomy. We provide a new neural framework for a deeper understanding of the structure of common inputs to motor neurons.

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Key points

A central and unresolved question is how spinal motor neurons are controlled to generate movement.

We decoded the spiking activities of dozens of spinal motor neurons innervating six muscles during a multi‐joint task, and we used a purely data‐driven method grounded on graph theory to extract networks of motor neurons based on their correlated activity (considered as common input).

The vast majority of the identified motor neurons shared common inputs with other motor neuron(s).

Groups of motor neurons were partly decoupled from their innervated muscle, such that motor neurons innervating the same muscle did not necessarily receive common inputs. Conversely, some motor neurons from different muscles, including distant muscles, received common inputs.

The study supports the theory that movement is produced through the control of groups of motor neurons via common inputs and that there is a partial mismatch between these groups of motor neurons and muscle anatomy.
CKAMP44 controls synaptic function and strength of relay neurons during early development of the dorsal lateral geniculate nucleus
Authors: Hetsch Florian , Wang Danni , Chen Xufeng , Zhang Jiong , Aslam Muhammad , Kegel Marcel , Tonner Henrik , Grus Franz , von Engelhardt Jakob
Published: June 2022

Relay neurons of the dorsal lateral geniculate nucleus (dLGN) receive inputs from retinal ganglion cells via retinogeniculate synapses. These connections undergo pruning in the first 2 weeks after eye opening. The remaining connections are strengthened several‐fold by the insertion of AMPA receptors (AMPARs) into weak or silent synapses. In this study, we found that the AMPAR auxiliary subunit CKAMP44 is required for receptor insertion and function of retinogeniculate synapses during development. Genetic deletion of CKAMP44 resulted in decreased synaptic strength and a higher number of silent synapses in young (P9–11) mice. Recovery from desensitisation of AMPARs was faster in CKAMP44 knockout (CKAMP44–/–) than in wild‐type mice. Moreover, loss of CKAMP44 increased the probability of inducing plateau potentials, which are known to be important for eye‐specific input segregation and retinogeniculate synapse maturation. The anatomy of relay neurons in the dLGN was changed in young CKAMP44–/– mice showing a transient increase in dendritic branching that normalised during later development (P26–33). Interestingly, input segregation in young CKAMP44–/– mice was not affected when compared to wild‐type mice. These results demonstrate that CKAMP44 promotes maturation and modulates function of retinogeniculate synapses during early development of the visual system without affecting input segregation.

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Key points

Expression of CKAMP44 starts early during development of the dorsal lateral geniculate nucleus (dLGN) and remains stable in relay neurons and interneurons.

Genetic deletion of CKAMP44 decreases synaptic strength and increases silent synapse number in dLGN relay neurons; increases the rate of recovery from desensitisation of AMPA receptors in dLGN relay neurons; and reduces synaptic short‐term depression in retinogeniculate synapses.

The probability of inducing plateau potentials is elevated in relay neurons of CKAMP44–/– mice.

Eye‐specific input segregation is unaffected in the dLGN of CKAMP44–/– mice.

Deletion of CKAMP44 mildly affects dendritic arborisation of relay neurons in the dLGN.
Heksor: the central nervous system substrate of an adaptive behaviour
Authors: Wolpaw Jonathan R. , Kamesar Adam
Published: June 2022

Over the past half‐century, the largely hardwired central nervous system (CNS) of 1970 has become the ubiquitously plastic CNS of today, in which change is the rule not the exception. This transformation complicates a central question in neuroscience: how are adaptive behaviours – behaviours that serve the needs of the individual – acquired and maintained through life? It poses a more basic question: how do many adaptive behaviours share the ubiquitously plastic CNS? This question compels neuroscience to adopt a new paradigm. The core of this paradigm is a CNS entity with unique properties, here given the nameheksorfrom the Greekhexis. A heksor is a distributed network of neurons and synapses that changes itself as needed to maintain the key features of an adaptive behaviour, the features that make the behaviour satisfactory. Through their concurrent changes, the numerous heksors that share the CNS negotiate the properties of the neurons and synapses that they all use. Heksors keep the CNS in a state ofnegotiated equilibriumthat enables each heksor to maintain the key features of its behaviour. The new paradigm based on heksors and the negotiated equilibrium they create is supported by animal and human studies of interactions among new and old adaptive behaviours, explains otherwise inexplicable results, and underlies promising new approaches to restoring behaviours impaired by injury or disease. Furthermore, the paradigm offers new and potentially important answers to extant questions, such as the generation and function of spontaneous neuronal activity, the aetiology of muscle synergies, and the control of homeostatic plasticity.

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A Mechanical Model for Elastic Wave Propagation in Nacre-Like Materials With Brick-and-Mortar Microstructures
Authors: Lu Yang , Huang Gan-Yun , Wang Yan-Feng , Wang Yue-Sheng
Published: June 2022

Many biological materials have outstanding properties unparalleled by artificial materials because of their periodic and/or hierarchical structures. In this paper, the longitudinal elastic wave propagation in nacre-like materials with brick-and-mortar microstructures has been studied theoretically by taking the different deformation mechanisms into account. A viscoelastic model in relation to the sacrificial bond behavior for the organic matrix has been developed. The shear-lag model is adopted to simulate the deformation of the brick-mortar structure. Complex band structures have been analyzed and the mechanical model has been validated by finite element method. Results have shown that bandgaps with lower edge close to vanishing frequency may arise in such bio-inspired periodic structures and attenuated propagation of elastic waves may be dominant in the range of higher frequencies. It may cast light on the dynamic strengthening mechanisms in nacre-like materials and provide a scientific basis for the design of bio-inspired metamaterials with low-frequency bandgaps.
Digital Twin-Driven Sheet Metal Forming: Modeling and Application for Stamping Considering Mold Wear
Authors: Gan Lei , Li Lei , Huang Haihong
Published: June 2022

Existing various constructed models of stamping provide great support to develop the forming quality improvement and energy-saving strategies. However, the immutable model cannot reflect the actual states of the process as the wear of the mold goes, and the inaccuracy model will lead to the failure of the strategies. To solve this problem, a Digital Twin-driven modeling method considering mold wear for stamping was proposed in this paper. The model of punch force and forming quality considering the coefficients that will vary with the states of mold wear was first built in the virtual space. The real-time punch force was acquired and inputted to the virtual space, and it was then compared with the punch force obtained by the Digital Twin model for monitoring the mold wear. If the difference of punch force is greater than the threshold, the friction coefficients update starts via the Particle Swarm Optimization with Differential Evolution (PSO-DE) algorithm. To validate the effectiveness, the method was applied in the process to form a clutch shell, and the results show that the maximum deviation of the punch force between the updated Digital Twin model and the measured value does not exceed 5%. Optimization results in the application show a 14.35% reduction in the maximum thinning ratio of the stamping part and an 8.9% reduction in the process energy. The Digital Twin-driven modeling assists in quality improvement and energy consumption reduction in sheet metal forming.
Design of Digital Twin Sensing Strategies Via Predictive Modeling and Interpretable Machine Learning
Authors: Kapteyn Michael G. , Willcox Karen E.
Published: June 2022

This work develops a methodology for sensor placement and dynamic sensor scheduling decisions for digital twins. The digital twin data assimilation is posed as a classification problem, and predictive models are used to train optimal classification trees that represent the map from observed data to estimated digital twin states. In addition to providing a rapid digital twin updating capability, the resulting classification trees yield an interpretable mathematical representation that can be queried to inform sensor placement and sensor scheduling decisions. The proposed approach is demonstrated for a structural digital twin of a 12 ft wingspan unmanned aerial vehicle. Offline, training data are generated by simulating scenarios using predictive reduced-order models of the vehicle in a range of structural states. These training data can be further augmented using experimental or other historical data. In operation, the trained classifier is applied to observational data from the physical vehicle, enabling rapid adaptation of the digital twin in response to changes in structural health. Within this context, we study the performance of the optimal tree classifiers and demonstrate how they enable explainable structural assessments from sparse sensor measurements and also inform optimal sensor placement.
Mobility Prediction of Off-Road Ground Vehicles Using a Dynamic Ensemble of NARX Models
Authors: Liu Yixuan , Barthlow Dakota , Mourelatos Zissimos P. , Zeng Jice , Gorsich David , Singh Amandeep , Hu Zhen
Published: June 2022

Mobility prediction of off-road autonomous ground vehicles (AGV) in uncertain environments is essential for their model-based mission planning, especially in the early design stage. While surrogate modeling methods have been developed to overcome the computational challenge in simulation-based mobility prediction, it is very challenging for a single surrogate model to accurately capture the complicated vehicle dynamics. With a focus on vertical acceleration of an AGV under off-road conditions, this article proposes a surrogate modeling approach for AGV mobility prediction using a dynamic ensemble of nonlinear autoregressive models with exogenous inputs (NARX) over time. Synthetic vehicle mobility data of an AGV are first collected using a limited number of high-fidelity simulations. The data are then partitioned into different segments using a variational Gaussian mixture model to represent different vehicle dynamic behaviors. Based on the partitioned data, multiple surrogate models are constructed under the NARX framework with different numbers of lags. The NARX models are then assembled together dynamically over time to predict the mobility of the AGV under new conditions. A case study demonstrates the advantages of the proposed method over the classical NARX models for AGV mobility prediction.
Zero-Free-Length Elastic System for Gravity Compensation of Parallel Mechanisms With Delta and Delta-Like Architectures
Authors: Jin Lixing , Lai Quanbin , Ma Rui , Zhang Weijun , Duan Xingguang , Li Changsheng
Published: June 2022

Passive gravity compensation can effectively reduce the load of actuators, but existing methods are commonly complex in terms of mechanisms and elastic systems with zero-free-length (ZFL) property. A compensation strategy using all joint information is further developed in this paper, as well as the involved elastic system. This approach with considerable compensation effect is simple in principle, and the ZFL property is precisely and completely realized by commercial springs. Compared with the previous method, the process of spring selection is also greatly simplified. Possible arrangements with approximate compensation are also calculated and discussed to achieve a compromise between the compensation effect and the mechanism complexity. The elastic system for Delta-like is implemented and calibrated as an illustration. The results show that the stiffness error rate is reduced from 23.53% to 3.92% and the compensation effect is improved by 63.36% for full compensation and 24.01% for approximate compensation, respectively.
Nonlinear Temperature Gradient Focusing of Deoxyribose Nucleic Acid in a Microfluidic Channel With Patterned Surface Charges: A Numerical Study
Authors: Dutta Amitava , Santra Apurba Kumar , Ganguly Ranjan
Published: June 2022

We present a numerical analysis of electrophoretic transport of a biological sample, such as, deoxyribose nucleic acid (DNA) via nonlinear temperature gradient within a microfluidic channel having patterned surface charges. The transport of the electrolyte is induced by electroosmotic force by imposing an axial electric field, superposed with the wall electric field via electrodes embedded along the wall of the microchannel. We consider the periodic variation of wall zeta potential in electrokinetic motion of an electrolyte wherein the DNA sample exhibits electrophoretic migration. Temperature dependence of the thermophysical properties of the electrolyte and the electrophoretic mobility and diffusivity of the analyte sample is accounted for in the model to improve its accuracy. Nonlinear longitudinal temperature field along the microchannel is induced via Joule heating by suitably shaping the channel geometry, which enhances the concentration of DNA approximately 270 folds by applying just 500 V DC field with constant zeta potential at the walls. The study further reveals that the concentration of DNA reduces drastically when a periodic wall zeta potential is applied. Results of the study lend to the design of novel electrically actuated bio-microfluidic devices with tunable solute separation and dispersion capabilities.
Simulation of Flow Field of Solution Mining Salt Cavities for Underground Gas Storage
Authors: Wang Jinchao , Wang Zhiming , Zeng Quanshu , Ding Guosheng , Li Kang , Wanyan Qiqi , Wang Yanxi
Published: June 2022

Salt cavern solution mining is a complicated process of fluid dynamics and chemical dynamics, including salt boundary dissolution, cavern expansion, brine flow, and species transport. The reaction processes occur simultaneously and interact with each other. In this study, a multiphysical coupled model is established to evaluate the real-time three-dimensional salt cavern shape expansion, the velocity field, and the brine concentration distribution. Then, the predicted results are compared with the field data of a Jintan Gas Storage Well in China. The average relative deviations with the turbulent flow are 5.7% for outlet brine concentration and 4.0% for cavern volume. The results show that salt cavern can be divided into four regions, including the shock region, plume region, reflow region, and suction region. The results also indicate that the turbulent flow will stimulate the formation of the vortex, thus affecting the distribution of brine concentration. And, the brine concentration distribution primarily influences cavern corrosion. The results suggest that adjusting the inject velocity and the tube position can change the cavern construction rate and the cavern shape. Overall, these results have guiding significance for the design and engineering practice of salt cavern construction for energy storage.
Application of the Equivalent Markov Motion Model in Solving Solid Particle Erosion and Droplet Deposition
Authors: Zhang Ri , Wang Yumiao
Published: June 2022

The equivalent Markov motion model (EMMM) is used to improve the probability model for solid particle erosion and droplet deposition. When calculating the solid particle erosion, the probability density distribution of particle velocity developed by EMMM is used to improve the solution of the impact parameters of solid particles. When calculating the droplet deposition rate of annular flow, the conversion coefficient proposed by EMMM is used to correct the variance of the particle displacement. The proportion of the particles deposited is calculated by solving the probability of a single particle reaching the pipe wall or liquid film. The improved model involving the EMMM is well verified by comparison with experimental data. Compared with the previous probability model, the present model can provide more accurate predictions. In addition, the self-compatibility of the EMMM is discussed in detail.
Composite Imagery-Based Non-Uniform Illumination Sensing for System Health Monitoring of Solar Power Plants
Authors: Arosh Sirshendu , Ghosh Kuntal , Dheer Dharmendra Kumar , Prakash Surya
Published: June 2022

Incidence of non-uniform illumination (NUI) degrades the affected solar photovoltaic modules temporarily. However, in worst case, it may also lead to permanent degradation. Thus, non-uniform illumination sensing in terms of encompassed area over solar photovoltaic module becomes important for sustainable power generation. An integrated framework by combining optical and thermal images for non-uniform illumination sensing and classification (static and dynamic) is proposed. The proposed technique detects hotspots along with identification of the nature of shading on the solar photovoltaic modules. Additionally, Hungarian Kalman filter is implemented for estimating the coverage of the non-uniform illumination-affected region including its abrupt shape. The proposed estimation technique also calculates the total loss in the output energy of the solar photovoltaic system due to non-uniform illumination. Overall, the proposed methodology develops a hybrid imagery-dependent advanced early warning system for large-scale solar power plants which are cost-effective and bypass multi-sensor data fusion to attain real-time application.
Cenozoic evolution of deep ocean temperature from clumped isotope thermometry
Authors: Meckler A. N. , Sexton P. F. , Piasecki A. M. , Leutert T. J. , Marquardt J. , Ziegler M. , Agterhuis T. , Lourens L. J. , Rae J. W. B. , Barnet J. , Tripati A. , Bernasconi S. M.
Published: June 2022

Characterizing past climate states is crucial for understanding the future consequences of ongoing greenhouse gas emissions. Here, we revisit the benchmark time series for deep ocean temperature across the past 65 million years using clumped isotope thermometry. Our temperature estimates from the deep Atlantic Ocean are overall much warmer compared with oxygen isotope–based reconstructions, highlighting the likely influence of changes in deep ocean pH and/or seawater oxygen isotope composition on classical oxygen isotope records of the Cenozoic. In addition, our data reveal previously unrecognized large swings in deep ocean temperature during early Eocene acute greenhouse warmth. Our results call for a reassessment of the Cenozoic history of ocean temperatures to achieve a more accurate understanding of the nature of climatic responses to tectonic events and variable greenhouse forcing.
Tectonic degassing drove global temperature trends since 20 Ma
Authors: Herbert Timothy D. , Dalton Colleen A. , Liu Zhonghui , Salazar Andrea , Si Weimin , Wilson Douglas S.
Published: June 2022

The Miocene Climatic Optimum (MCO) from ~17 to 14 million years ago (Ma) represents an enigmatic reversal in Cenozoic cooling. A synthesis of marine paleotemperature records shows that the MCO was a local maximum in global sea surface temperature superimposed on a period from at least 19 Ma to 10 Ma, during which global temperatures were on the order of 10°C warmer than at present. Our high-resolution global reconstruction of ocean crustal production, a proxy for tectonic degassing of carbon, suggests that crustal production rates were ~35% higher than modern rates until ~14 Ma, when production began to decline steeply along with global temperatures. The magnitude and timing of the inferred changes in tectonic degassing can account for the majority of long-term ice sheet and global temperature evolution since 20 Ma.
Soft, bioresorbable coolers for reversible conduction block of peripheral nerves
Authors: Reeder Jonathan T. , Xie Zhaoqian , Yang Quansan , Seo Min-Ho , Yan Ying , Deng Yujun , Jinkins Katherine R. , Krishnan Siddharth R. , Liu Claire , McKay Shannon , Patnaude Emily , Johnson Alexandra , Zhao Zichen , Kim Moon Joo , Xu Yameng , Huang Ivy , Avila Raudel , Felicelli Christopher , Ray Emily , Guo Xu , Ray Wilson Z. , Huang Yonggang , MacEwan Matthew R. , Rogers John A.
Published: June 2022

Implantable devices capable of targeted and reversible blocking of peripheral nerve activity may provide alternatives to opioids for treating pain. Local cooling represents an attractive means for on-demand elimination of pain signals, but traditional technologies are limited by rigid, bulky form factors; imprecise cooling; and requirements for extraction surgeries. Here, we introduce soft, bioresorbable, microfluidic devices that enable delivery of focused, minimally invasive cooling power at arbitrary depths in living tissues with real-time temperature feedback control. Construction with water-soluble, biocompatible materials leads to dissolution and bioresorption as a mechanism to eliminate unnecessary device load and risk to the patient without additional surgeries. Multiweek in vivo trials demonstrate the ability to rapidly and precisely cool peripheral nerves to provide local, on-demand analgesia in rat models for neuropathic pain.
Conservation and divergence of cortical cell organization in human and mouse revealed by MERFISH
Authors: Fang Rongxin , Xia Chenglong , Close Jennie L. , Zhang Meng , He Jiang , Huang Zhengkai , Halpern Aaron R. , Long Brian , Miller Jeremy A. , Lein Ed S. , Zhuang Xiaowei
Published: June 2022

The human cerebral cortex has tremendous cellular diversity. How different cell types are organized in the human cortex and how cellular organization varies across species remain unclear. In this study, we performed spatially resolved single-cell profiling of 4000 genes using multiplexed error-robust fluorescence in situ hybridization (MERFISH), identified more than 100 transcriptionally distinct cell populations, and generated a molecularly defined and spatially resolved cell atlas of the human middle and superior temporal gyrus. We further explored cell-cell interactions arising from soma contact or proximity in a cell type–specific manner. Comparison of the human and mouse cortices showed conservation in the laminar organization of cells and differences in somatic interactions across species. Our data revealed human-specific cell-cell proximity patterns and a markedly increased enrichment for interactions between neurons and non-neuronal cells in the human cortex.
Ancient DNA reveals five streams of migration into Micronesia and matrilocality in early Pacific seafarers
Authors: Liu Yue-Chen , Hunter-Anderson Rosalind , Cheronet Olivia , Eakin Joanne , Camacho Frank , Pietrusewsky Michael , Rohland Nadin , Ioannidis Alexander , Athens J. Stephen , Douglas Michele Toomay , Ikehara-Quebral Rona Michi , Bernardos Rebecca , Culleton Brendan J. , Mah Matthew , Adamski Nicole , Broomandkhoshbacht Nasreen , Callan Kimberly , Lawson Ann Marie , Mandl Kirsten , Michel Megan , Oppenheimer Jonas , Stewardson Kristin , Zalzala Fatma , Kidd Kenneth , Kidd Judith , Schurr Theodore G. , Auckland Kathryn , Hill Adrian V. S. , Mentzer Alexander J. , Quinto-Cortés Consuelo D. , Robson Kathryn , Kennett Douglas J. , Patterson Nick , Bustamante Carlos D. , Moreno-Estrada Andrés , Spriggs Matthew , Vilar Miguel , Lipson Mark , Pinhasi Ron , Reich David
Published: June 2022

Micronesia began to be peopled earlier than other parts of Remote Oceania, but the origins of its inhabitants remain unclear. We generated genome-wide data from 164 ancient and 112 modern individuals. Analysis reveals five migratory streams into Micronesia. Three are East Asian related, one is Polynesian, and a fifth is a Papuan source related to mainland New Guineans that is different from the New Britain–related Papuan source for southwest Pacific populations but is similarly derived from male migrants ~2500 to 2000 years ago. People of the Mariana Archipelago may derive all of their precolonial ancestry from East Asian sources, making them the only Remote Oceanians without Papuan ancestry. Female-inherited mitochondrial DNA was highly differentiated across early Remote Oceanian communities but homogeneous within, implying matrilocal practices whereby women almost never raised their children in communities different from the ones in which they grew up.
The microbiome and gut homeostasis
Authors: Lee Jee-Yon , Tsolis Renée M. , Bäumler Andreas J.
Published: June 2022

Changes in the composition of the gut microbiota are associated with many human diseases. So far, however, we have failed to define homeostasis or dysbiosis by the presence or absence of specific microbial species. The composition and function of the adult gut microbiota is governed by diet and host factors that regulate and direct microbial growth. The host delivers oxygen and nitrate to the lumen of the small intestine, which selects for bacteria that use respiration for energy production. In the colon, by contrast, the host limits the availability of oxygen and nitrate, which results in a bacterial community that specializes in fermentation for growth. Although diet influences microbiota composition, a poor diet weakens host control mechanisms that regulate the microbiota. Hence, quantifying host parameters that control microbial growth could help define homeostasis or dysbiosis and could offer alternative strategies to remediate dysbiosis.
United Kingdom set to abandon EU funding and go it alone
Authors: O’Grady Cathleen
Published: June 2022

Horizon Europe grants held hostage over Brexit dispute
Foodmaking microbes bear marks of domestication
Authors: Pennisi Elizabeth
Published: June 2022

Bacteria and fungi behind cheese, soy, and more share genomic traits wth domesticated plants and animals
Candida auris Pan-Drug-Resistant to Four Classes of Antifungal Agents
Authors: Jacobs Samantha E. , Jacobs Jonathan L. , Dennis Emily K. , Taimur Sarah , Rana Meenakshi , Patel Dhruv , Gitman Melissa , Patel Gopi , Schaefer Sarah , Iyer Kishore , Moon Jang , Adams Victoria , Lerner Polina , Walsh Thomas J. , Zhu YanChun , Anower Mohammed Rokebul , Vaidya Mayuri M. , Chaturvedi Sudha , Chaturvedi Vishnu
Published: June 2022

Candida auris
is an urgent antimicrobial resistance threat due to its global emergence, high mortality, and persistent transmissions. Nearly half of
C. auris
clinical and surveillance cases in the United States are from the New York and New Jersey Metropolitan area.
Effects of Milk Replacer-Based
Lactobacillus
on Growth and Gut Development of Yaks’ Calves: a Gut Microbiome and Metabolic Study
Authors: Wang Yaping , An Miao , Zhang Zhao , Zhang Wenqian , Kulyar Muhammad Fakhar-e-Alam , Iqbal Mudassar , He Yuanyuan , Li Feiran , An Tianwu , Li Huade , Luo Xiaolin , Yang Shan , Li Jiakui
Published: June 2022

The host microbiome is a composite of the trillion microorganisms colonizing host bodies. It can be impacted by various factors, including diet, environmental conditions, and physical activities.
Multimodal imaging analysis for the impact of retinal peripheral lesions on central neurovascular structure and retinal function in type 2 diabetes with diabetic retinopathy
Authors: Zhuang Xuenan , Chen Ruoyu , Liang Anyi , Yao Jie , Wang Zicheng , Chen Yesheng , Zheng Kangyan , Lu Peiyao , Zhang Liang , Cao Dan
Published: June 2022

Objectives

To explore the possible role of peripheral lesions (PLs) detected by ultrawide field (UWF) imaging system on central neurovascular structure and retinal function.

Methods

Ninety-seven diabetic patients were included in this cross-sectional study using UWF pseudocolour colour imaging with Optos Daytona (Optos, PLC). UWF images were graded as with predominantly peripheral lesions (PPLs) and without PPL. Macular neurovascular alterations and retinal function were measured by optical coherence tomography angiography (OCTA) and RETeval device, respectively. Central microcirculation and retinal function were compared between eyes with and without PPL.

Results

The study evaluated 186 eyes (97 patients; 43 females (44.3%)), including 92 eyes without PPL and 94 eyes with PPL. Central retinal vessel density was comparable between eyes with and without PPL. Delayed implicit time and decreased pupil area ratio were found in the PPL group compared with eyes without PPL, and this difference remained unchanged after adjusting for systemic factors (all p＜0.01).

Conclusions

Our study suggests that retinal function is worse in diabetic eyes with PPL. These findings challenged the conventional ETDRS protocols which ignored peripheral retina in determining DR severity. Furthermore, combining UWF imaging with RETeval system to detect more retinal abnormalities may be helpful in DR management.
Perspectives on the production, and use, of rapid evidence in decision making during the COVID-19 pandemic: a qualitative study
Authors: Clyne Barbara , Hynes Lisa , Kirwan Colette , McGeehan Máire , Byrne Paula , Killilea Martha , Smith Susan M. , Ryan Máirín , Collins Claire , O’Neill Michelle , Wallace Emma , Murphy Andrew W , Kelly Maureen E
Published: June 2022

Objectives

To describe perceptions of providing, and using rapid evidence, to support decision making by two national bodies (one public health policy and one front-line clinical practice) during the COVID-19 pandemic.

Design

Descriptive qualitative study (March–August 2020): 25 semistructured interviews were conducted, transcribed verbatim and thematically analysed.

Setting

Data were obtained as part of an evaluation of two Irish national projects; the Irish COVID-19 Evidence for General Practitioners project (General Practice (GP) project) which provided relevant evidence to address clinical questions posed by GPs; and the COVID-19 Evidence Synthesis Team (Health Policy project) which produced rapid evidence products at the request of the National Public Health Emergency Team.

Participants

Purposive sample of 14 evidence providers (EPs: generated and disseminated rapid evidence) and 11 service ssers (SUs: GPs and policy-makers, who used the evidence).

Main outcome measures

Participant perceptions.

Results

The Policy Project comprised 27 EPs, producing 30 reports across 1432 person-work-days. The GP project comprised 10 members from 3 organisations, meeting 49 times and posting evidence-based answers to 126 questions. Four unique themes were generated. ‘The Work’ highlighted that a structured but flexible organisational approach to producing evidence was essential. Ensuring quality of evidence products was challenging, particularly in the context of absent or poor-quality evidence. ‘The Use’ highlighted that rapid evidence products were considered invaluable to decision making. Trust and credibility of EPs were key, however, communication difficulties were highlighted by SUs (eg, website functionality). ‘The Team’ emphasised that a highly skilled team, working collaboratively, is essential to meeting the substantial workload demands and tight turnaround time. ‘The Future’ highlighted that investing in resources, planning and embedding evidence synthesis support, is crucial to national emergency preparedness.

Conclusions

Rapid evidence products were considered invaluable to decision making. The credibility of EPs, a close relationship with SUs and having a highly skilled and adaptable team to meet the workload demands were identified as key strengths that optimised the utilisation of rapid evidence.

Ethics approval

Ethical approval was obtained from the National Research Ethics Committee for COVID-19-related Research, Ireland.
Investing in the health workforce: fiscal space analysis of 20 countries in East and Southern Africa, 2021–2026
Authors: Asamani James Avoka , Kigozi Jesse , Sikapande Brivine , Christmals Christmal Dela , Okoroafor Sunny C , Ismaila Hamza , Ahmat Adam , Nyoni Jennifer , Nabyonga-Orem Juliet , Mwinga Kasonde
Published: June 2022

Background and objectives

The health workforce (HWF) is at the core of ensuring an efficient, effective and functional health system, but it faces chronic underinvestment. This paper presents a fiscal space analysis of 20 countries in East and Southern Africa to generate sustained evidence-based advocacy for significant and smarter investment in the HWF.

Methods

We adapted an established empirical framework for fiscal space analysis and applied it to the HWF. Country-specific data were curated and triangulated from publicly available datasets and government reports to model the fiscal space for the HWF for each country. Based on the current knowledge, three scenarios (business as-usual, optimistic and very optimistic) were modelled and compared.

Findings

A business-as-usual scenario shows that the cumulative fiscal space across the 20 countries is US$12.179 billion, which would likely increase by 28% to US$15.612 billion by 2026 but varies across countries—the highest proportional increases expected in Seychelles (117%) and Mozambique (69%) but lowest in Zambia (15%). Under optimistic assumptions, allocating an additional 1.5% of gross domestic product (GDP) to health even without further prioritising the proportional allocation to the wage bill could boost the cumulative fiscal space for HWF by US$4.639 billion. In a very optimistic scenario of a 1.5% increase in health expenditure as a proportion of GDP and further prioritisation of HWF within the health expenditure, the cumulative fiscal space for HWF could improve by some 105%—ranging from 24% in Zambia to 330% in Lesotho.

Conclusion

Small increments in government health expenditure and increased prioritisation of HWF in funding in tandem with the 57% global average could potentially increase the fiscal space for HWF by at least 32% in 11 countries. Unless the HWF is sufficiently prioritised within the health expenditures, only increasing the overall health expenditure to even recommended levels would still portend severe underinvestment in HWF amid unabating shortages to deliver health services. Thus, HWF strategies and investment plans should include fiscal space analysis to deepen advocacy for sustainable investment in the HWF.
Review of enteral nutrition practices in critically ill adults in resource-limited environments
Authors: Carter Chris , Notter Joy
Published: June 2022

Enteral nutrition in critical care is a complex area of practice. A resource-limited environment includes countries that are identified as low income and low/middle income. This review describes three themes for its successful implementation of enteral nutrition in a resource-limited environment. These include identification of patients at risk of malnutrition, using non-commercial feeds and the urgent need to develop practice. Malnutrition is a serious complication of critical illness and remains a crucial aspect of patient care in order to prevent complications. Further evidence to develop sustainable enteral nutrition strategies for critically ill patients is urgently required. This is a paper commissioned as part of the Humanitarian and Disaster Relief Operations special issue ofBMJ Military Health.
Selective internal radiation therapy (SIRT) for hepatocellular carcinoma (HCC): informing clinical practice for multidisciplinary teams in England
Authors: Reeves Helen L , Reicher John , Priona Georgia , Manas Derek M , Littler Peter
Published: June 2022

Objective

Hepatocellular carcinoma (HCC) deaths are rising alarmingly. Many patients are unsuitable for available therapies. Poor response rates further hamper outcomes for those that are. Selective internal radiation therapy (SIRT) offers hope, although which patients benefit over standard approaches remains unclear.

Design/method

As a quality/service improvement, we audited consecutive patients treated with SIRT (2015-2020) by the Newcastle upon Tyne Hospitals National Health Service Foundation Trust HCC multidisciplinary team . Indications, Barcelona clinic liver cancer (BCLC) stage, treatment response, subsequent therapies and survival at 30 September 2021 were assessed

Results

Fifty-one patients received SIRT. Thirty-day mortality was zero. Three months partial response, stable disease and progressive disease on imaging were 50%, 22% and 28%, respectively. Overall median survival was 21 months. There were four subgroups: (1) BCLC-B: HCC>7 cm too large for transarterial chemoembolisation (TACE) alone (n=21); (2) BCLC-B: HCC progressed post TACE (n=7); (3) BCLC-C: HCC with any combination of large tumour burden, branch portal vein thrombosis, non-hepatitis C virus aetiology (n=16); (4) BCLC-C: sorafenib inappropriate (n=7). In group 1, 5/21 (23.8%) of patients were downstaged to resection, 33% received subsequent medical therapies and median survival was >40 months. In BCLC-B patients treated second line (group 2), median survival was 14.2 months. In BCLC–C, median survival was 20.2 months for group 3 and 4.2 months for group 4.

Conclusion

SIRT outcomes for advanced HCC, often bridging patients with adverse predictive factors to subsequent surgery or medical therapies, were encouraging. A role after TACE or for BCLC-C patients requires further assessment.
Prediction models of diabetes complications: a scoping review
Authors: Ndjaboue Ruth , Ngueta Gérard , Rochefort-Brihay Charlotte , Delorme Sasha , Guay Daniel , Ivers Noah , Shah Baiju R , Straus Sharon E , Yu Catherine , Comeau Sandrine , Farhat Imen , Racine Charles , Drescher Olivia , Witteman Holly O
Published: June 2022

Background

Diabetes often places a large burden on people with diabetes (hereafter ‘patients’) and the society, that is, in part attributable to its complications. However, evidence from models predicting diabetes complications in patients remains unclear. With the collaboration of patient partners, we aimed to describe existing prediction models of physical and mental health complications of diabetes.

Methods

Building on existing frameworks, we systematically searched for studies in Ovid-Medline and Embase. We included studies describing prognostic prediction models that used data from patients with pre-diabetes or any type of diabetes, published between 2000 and 2020. Independent reviewers screened articles, extracted data and narratively synthesised findings using established reporting standards.

Results

Overall, 78 studies reported 260 risk prediction models of cardiovascular complications (n=42 studies), mortality (n=16), kidney complications (n=14), eye complications (n=10), hypoglycaemia (n=8), nerve complications (n=3), cancer (n=2), fracture (n=2) and dementia (n=1). Prevalent complications deemed important by patients such as amputation and mental health were poorly or not at all represented. Studies primarily analysed data from older people with type 2 diabetes (n=54), with little focus on pre-diabetes (n=0), type 1 diabetes (n=8), younger (n=1) and racialised people (n=10). Per complication, predictors vary substantially between models. Studies with details of calibration and discrimination mostly exhibited good model performance.

Conclusion

This rigorous knowledge synthesis provides evidence of gaps in the landscape of diabetes complication prediction models. Future studies should address unmet needs for analyses of complications n> and among patient groups currently under-represented in the literature and should consistently report relevant statistics.

Scoping review registration

https://osf.io/fjubt/
Patterns and seasonality in pediatric referrals for functional somatic symptoms
Authors: den Braber Pepijn , van Driel Joris , Broekhuijsen Dorien , Wienen Bert , Bekhof Jolita
Published: June 2022

Functional somatic symptoms (FSS), or medically unexplained physical symptoms, are common in children and it has been suggested that the incidence is increasing. To determine the incidence and pattern of referrals for FSS to pediatricians, we performed a retrospective analysis including newly referred pediatric patients to our secondary pediatric practice in Zwolle, The Netherlands, ultimately diagnosed with FSS between 2013 and 2018. FSS was defined as functional abdominal pain, chronic fatigue, chronic musculoskeletal pain and chronic headache without an underlying medical diagnosis. In the 6-year period, 10.4% of elective referrals were related to FSS without a significant upward trend. We found clear seasonal variation with peaks in incidences in March (+31%) and November (+21%) and a nadir around August (−48%). In conclusion, FSS account for 1 in 10 non-acute pediatric referrals, without an increase in incidence in the past 6 years. The seasonal pattern is remarkable and warrants further analysis.
Semi-analytical solution for undrained cylindrical cavity expansion in variably saturated soils
Authors: Liu Geng-Yun , Li Jing-Pei , Zhou Pan
Published: June 2022

The effect of different initial degrees of saturation on the behaviour of variably saturated soils around an expanding cavity has not been adequately studied thus far. Therefore, this study aimed to fill this gap. Moreover, it sought to theoretically explain the cylindrical cavity expansion response in unsaturated three-phase media, particularly focusing on its effect on the cavity wall during the transition from an unsaturated to a saturated state. To this end, a semi-analytical solution based on a hydro-mechanically coupled Sheng–Fredlund–Gens model was proposed for the undrained cavity expansion problem in variably saturated soils in which unsaturated and fully saturated regions coexisted around the cavity. The cylindrical cavity expansion and expansion pressure response in initially unsaturated soils (considering different initial degrees of saturation) and initially fully saturated soils were explored. The proposed solution further extends the cavity expansion theory to unsaturated soils. Furthermore, this work could serve as a theoretical framework for modelling of the cavity expansion problem in the variably saturated soils considering the effect of hydraulic state transition.
Low-dose spironolactone abates cardio-renal disorder by reduction of BAX/inflammasome expression in experimentally induced polycystic ovarian syndrome rat model
Authors: Peter Mmenyene U. , Areloegbe Stephanie E. , Akintayo Christopher O. , Oniyide Adesola A. , Aturamu Ayodeji , Olaniyi Kehinde S.
Published: June 2022

The impact of low-dose spironolactone (LSPL) on polycystic ovarian syndrome (PCOS)-associated cardio-renal disorder is unknown. Therefore, the present study hypothesized that LSPL would ameliorate cardio-renal disorders in experimental PCOS animals. Eight-week-old female Wistar rats were allotted into three groups. The control group received vehicle (distilled water; per os (p.o.)), the letrozole (LET)-treated group designated as PCOS group received LET (1 mg/kg; p.o.), and PCOS+LSPL received LET and LSPL (0.25 mg/kg, p.o.). The treatment was done once daily for 21 days uninterrupted. The experimental PCOS rats were characterized with insulin resistance, as well as elevated testosterone and luteinizing hormone/follicle-stimulating hormone, with a significant increase in cardiac and renal lipid profile, oxidative stress, inflammatory biomarkers (nuclear factor-κB and tumor necrosis factor-α), lactate dehydrogenase and lactate content and decrease in cardiac and renal antioxidant system (glutathione peroxidase and reduced glutathione) compared with the control rats. In addition, immunohistochemical assessment of cardiac and renal tissue showed significant expression of inflammasome and B-cell lymphoma-2 associated X-protein (BAX) in animals with PCOS. Nevertheless, these perturbations were attenuated following the administration of LSPL. Collectively, the present results suggest that LSPL attenuates PCOS-associated cardio-renal disorders by reduction of oxidative stress and BAX/inflammasome expression.