bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation dynamics and evolutionary rescue under sulfide selection in cyanobacteria: a comparative study between Microcystis aeruginosa and Oscillatoria sp. (cyanobacteria)
Authors: Martín‐Clemente Elena , Melero‐Jiménez Ignacio J. , Bañares‐España Elena , Flores‐Moya Antonio , García‐Sánchez María J.
Published: August 2019

Experimental evolution studies using cyanobacteria as model organisms are scarce despite the role of cyanobacteria in the evolution of photosynthesis. Three different experimental evolution approaches have been applied to shed light on the sulfide adaptation process, which played a key role in the evolution of this group. We used a Microcystis aeruginosa sulfide‐sensitive strain, unable to grow above ~0.1 mM, and an Oscillatoria sp. strain, isolated from a sulfureous spa (~0.2 mM total sulfide). First, performing a fluctuation analysis design using the spa waters as selective agent, we proved that M. aeruginosa was able to adapt to this sulfide level by rare spontaneous mutations. Second, applying a ratchet protocol, we tested if the limit of adaptation to sulfide of the two taxa was dependent on their initial sulfide tolerance, finding that M. aeruginosa adapted to 0.4 mM sulfide, and Oscillatoria sp. to ~2 mM sulfide, twice it highest tolerance level. Third, using an evolutionary rescue approach, we observed that both speed of exposure to increasing sulfide concentrations (deterioration rate) and populations’ genetic variation determined the survival of M. aeruginosa at lethal sulfide levels, with a higher dependence on genetic diversity. In conclusion, sulfide adaptation of sensitive cyanobacterial strains is possible by rare spontaneous mutations and the adaptation limits depend on the sulfide level present in strain’s original habitat. The high genetic diversity of a sulfide‐sensitive strain, even at fast environmental deterioration rates, could increase its possibility of survival even to a severe sulfide stress.
Documentation of shock features in impactites from the Dhala impact structure, India
Authors: Pati Jayanta Kumar , Poelchau Michael H. , Reimold Wolf Uwe , Nakamura Norihiro , Kuriyama Yutaro , Singh Anuj Kumar
Published: August 2019

The fundamental approach for the confirmation of any terrestrial meteorite impact structure is the identification of diagnostic shock metamorphic features, together with the physical and chemical characterization of impactites and target lithologies. However, for many of the approximately 200 confirmed impact structures known on Earth to date, multiple scale‐independent tell‐tale impact signatures have not been recorded. Especially some of the pre‐Paleozoic impact structures reported so far have yielded limited shock diagnostic evidence. The rocks of the Dhala structure in India, a deeply eroded Paleoproterozoic impact structure, exhibit a range of diagnostic shock features, and there is even evidence for traces of the impactor. This study provides a detailed look at shocked samples from the Dhala structure, and the shock metamorphic evidence recorded within them. It also includes a first report of shatter cones that form in the shock pressure range from ~2 to 30 GPa, data on feather features (FFs), crystallographic indexing of planar deformation features, first‐ever electron backscatter diffraction data for ballen quartz, and further analysis of shocked zircon. The discovery of FFs in quartz from a sample of the MCB‐10 drill core (497.50 m depth) provides a comparatively lower estimate of shock pressure (~7–10 GPa), whereas melting of a basement granitoid infers at least 50–60 GPa shock pressure. Thus, the Dhala impactites register a strongly heterogeneous shock pressure distribution between <2 and >60 GPa. The present comprehensive review of impact effects should lay to rest the nonimpact genesis of the Dhala structure proposed by some earlier workers from India.
Northwest Africa 10414, a pigeonite cumulate shergottite
Authors: Hewins R.H. , Zanda B. , Pont S. , Zanetta P.‐M.
Published: August 2019

Northwest Africa (NWA) 10414 is an unusual shergottite with a cumulate texture. It contains 73% coarse prismatic pigeonite, plus 18% interstitial maskelynite, 2% Si‐rich mesostasis, 2% merrillite, and minor chromite‐ulvöspinel. It contains no olivine, and only ~3% augite. Phase compositions are pigeonite (En68‐43Fs27‐48Wo5‐15) and maskelynite An~54‐36, more sodic than most maskelynite in shergottites. Chromite‐ulvöspinel composition plots between the earliest and most fractionated spinel‐group minerals in olivine‐phyric shergottites. NWA 10414 mineralogically resembles the contact facies between Elephant Moraine 79001 lithologic units A and B, with abundant pigeonite phenocrysts, though it is coarser grained. Its most Mg‐rich pigeonite also has a similar composition to the earliest crystallized pyroxenes in several other shergottites, including Shergotty. The Shergotty intercumulus liquid composition crystallizes pigeonite with a similar composition range to NWA 10414 pigeonite, using PETROLOG. Olivine‐phyric shergottite NWA 6234, with a pure magma composition, produces an even better match to this pigeonite composition range, after olivine crystallization. These observations suggest that after the accumulation of olivine from an olivine‐phyric shergottite magma, the daughter liquid could precipitate pigeonite locally to form this pigeonite cumulate, before the crystallization of overlying liquid as a normal basaltic shergottite.
Learning through the senses
Authors: van der Schaaf Marieke
Published: August 2019

van der Schaaf comments on Kelly et al.'s study to further explain how the concept of embodied cognition can impact health professionals' learning and learning environments.
A spatially explicit model of postdisaster housing recovery
Authors: Nejat Ali , Javid Roxana J. , Ghosh Souparno , Moradi Saeed
Published: August 2019

Although postdisaster housing recovery is an important player in community recovery, its modeling is still in its infancy. This research aims to provide a spatial regression model for predicting households’ recovery decisions based on publicly available data. For this purpose, a hierarchical Bayesian geostatistical model with random spatial effects was developed. To calibrate the model, households’ data that were collected from Staten Island, New York, in the aftermath of Hurricane Sandy were used. The model revealed that on the scale of census tract, residents with higher income or larger household size were significantly less likely to reconstruct. In contrast, odds of reconstruction rose with increase of long‐term residents. The model outputs were also employed to develop a reconstruction propensity score for each census tract. The score predicts probability of reconstruction/repair in each tract versus others. The model was validated through comparison of the propensity scores with the distribution of Community Development Block Grant Disaster Recovery assistance and its resultant reconstruction. The validation indicated capability of the model to predict the potential hotspots of reconstruction. Accordingly, the propensity score can serve as a decision‐support tool to tailor recovery policies.
Effect of a gum‐based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia
Authors: Bolivar‐Prados Mireia , Rofes Laia , Arreola Viridiana , Guida Sonia , Nascimento Weslania V. , Martin Alberto , Vilardell Natàlia , Ortega Fernández Omar , Ripken Dina , Lansink Mirian , Clavé Pere
Published: August 2019

Background

Increasing viscosity with thickening agents is a valid therapeutic strategy for oropharyngeal dysphagia (OD). To assess the therapeutic effect of a xanthan gum‐based thickener (Nutilis Clear®) at six viscosities compared with thin liquid in poststroke OD (PSOD) patients.

Methods

A total of 120 patients with PSOD were studied in this controlled, multiple‐dose, fixed‐order, and single‐blind study using videofluoroscopy (VFSS). A series of boluses of 10 mL thin liquid and 2000, 1400, 800, 450, 250, and 150 mPa s viscosities were given in duplicate, interrupted in case of aspiration. We assessed the safety and efficacy of swallow and the kinematics of the swallow response.

Key Results

A total of 41.2% patients had safe swallow at thin liquid which significantly increased for all viscosities from 71.9% at 150 mPa s to 95.6% at 1400 mPa s (P < .001). PAS score (3.7 ± 2.3) at thin liquid was also reduced by increasing bolus viscosity (P < .001). The prevalence of patients with aspiration at thin liquid was 17.5% and decreased at all viscosities (P < .01), except at 150 mPa s. Increasing viscosity shortened time to laryngeal vestibule closure (LVC) at all viscosities (P < .01) and reduced bolus velocity at ≥450 mPa s (P < .05). The prevalence of patients with pharyngeal residue at each viscosity 37.7%‐44.7% was similar to that at thin liquid (41.2%).

Conclusions and Inferences

The prevalence of unsafe swallow with thin liquids is very high in PSOD. Increasing shear bolus viscosity with this xanthan gum‐based thickener significantly increased the safety of swallow in patients with PSOD in a viscosity‐dependent manner without increasing the prevalence of pharyngeal residue.
Biochemical pH clamp: the forgotten resource in membrane bioenergetics
Authors: Wegner Lars H. , Shabala Sergey
Published: August 2019

Solute uptake and release by plant cells are frequently energized by coupling to H+ influx supported by the proton motive force (pmf). The pmf results from a stable pH difference between the apoplast and the cytosol, with bulk values ranging from 4.9 to 5.8 and from 7.1 to 7.5, respectively, in combination with a negative electrical membrane potential. The P‐type H+ ATPases pumping H+ from the cytosol into the apoplast at the expense of ATP hydrolysis are generally viewed as the only pmf source, exclusively linking membrane transport to energy metabolism. However, recent evidence suggests that pump activity may be insufficient to energize transport, particularly under stress conditions. Indeed, cytosolic H+ scavenging and apoplastic H+ generation by metabolism (denoted as ‘active’ buffering in contrast to the readily exhausted ‘passive’ matrix buffering) also stabilize the pH gradient. In the cytosol, H+ scavenging is mainly associated with malate decarboxylation catalyzed by malic enzyme, and via the GABA shunt of the tricarboxylic acid (TCA) cycle involving glutamate decarboxylation. In the apoplast, formation of bicarbonate from CO2, the end‐product of respiration, generates H+ at pH ≥ 6. Membrane potential is stabilized by K+ release and/or by anion uptake via ion channels. Finally, thermodynamic aspects of active buffering are discussed.
Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress‐coping model among African American women
Authors: Allen Amani M. , Wang Yijie , Chae David H. , Price Melisa M. , Powell Wizdom , Steed Teneka C. , Rose Black Angela , Dhabhar Firdaus S. , Marquez‐Magaña Leticia , Woods‐Giscombe Cheryl L.
Published: August 2019

Racial discrimination has been linked to allostatic load (i.e., cumulative biological stress) among African American women. However, limited attention has been given to psychosocial processes involved in the stress response—critical for understanding biological pathways to health—in studies examining racial discrimination as a social determinant of health. We examined whether the superwoman schema (SWS), a multidimensional culture‐specific framework characterizing psychosocial responses to stress among African American women, modifies the association between racial discrimination and allostatic load. We used purposive sampling to recruit a community sample of African American women ages 30–50 from five San Francisco Bay Area counties (n= 208). Path analysis was used to test for interactions while accounting for the covariance among SWS subscales using both linear and quadratic models. Significant interactions were observed between racial discrimination and four of the five SWS subscales. Feeling obligated to present an image of strength and an obligation to suppress emotions were each protective whereas feeling an intense motivation to succeed and feeling an obligation to help others exacerbated the independent health risk associated with experiencing racial discrimination. Our findings affirm the need to consider individual variability in coping and potentially other psychosocial processes involved in the stress response process, and offer several insights that may help elucidate the mechanisms by which racial discrimination gets “under the skin.”
Postglacial stratigraphic evolution of a current‐influenced sandy shelf: offshore Kujukuri strandplain, central Japan
Authors: Nishida Naohisa , Ajioka Taku , Ikehara Ken , Nakashima Rei , Katayama Hajime , Sato Tomoyuki , Furuyama Seishiro , Tamura Toru
Published: August 2019

Sandy shelf sediments are important elements of clastic sedimentary systems because of their wide distribution in the geological record and their significance as hydrocarbon reservoirs. Although many studies have investigated shelf sediments influenced by waves or tidal currents, little is known about shelf sediments influenced by oceanic currents, particularly their lithofacies characteristics and stratigraphic evolution. This study investigated the stratigraphic evolution of shelf sediments off the Kujukuri strandplain facing the Pacific Ocean, which is influenced by the strong Kuroshio Current. Sediment cores were obtained from six locations on the Kujukuri shelf (34 to 124 m water depth) using a vibrocorer. The dominant lithofacies is mud‐free sand with low‐angle cross‐lamination associated with alternating beds of finer and coarser sand with cross‐lamination. These display depositional processes influenced by storm waves and the Kuroshio Current, respectively. This finding is consistent with the previously presented modern and historical observations of the Kuroshio Current and estimates of the storm‐wave base. Radiocarbon dates show that the sediment succession formed during the last transgressive and highstand stages after 13·1 ka. The depositional processes during the stages represent a transition from storm waves with abundant sediment supply to both storm waves and the Kuroshio Current with sediment starvation mainly due to its trapping in the strandplain. Comparison to other Holocene–Modern shelf systems suggests that the sandy shelf successions are strongly influenced by oceanic currents under conditions of limited riverine input and open coastal geometry. The resultant sand‐dominated succession is characterized by reversal of the proximal to distal grain‐size trend compared to the fining for most other recognized wave/storm‐dominated shelf successions. This is because of seaward increase in the influence of the Kuroshio Current. Thus, shelf deposits are naturally complex, and these may be further complicated by the additional influence of oceanic currents above the usual wave‐dominated and tide‐dominated end members.
Motivational Interviewing to Address Suicidal Ideation: A Randomized Controlled Trial in Veterans
Authors: Britton Peter C. , Conner Kenneth R. , Chapman Benjamin P. , Maisto Stephen A.
Published: August 2019

Objective

Although the months following discharge from psychiatric hospitalization are a period of acute risk for veterans, there is a dearth of empirically supported treatments tailored to veterans in acute psychiatric hospitalization.

Method

We conducted a randomized controlled trial to test the efficacy of Motivational Interviewing to Address Suicidal Ideation (MI‐SI) that explored and resolved ambivalence, and a revised MI‐SI (MI‐SI‐R) that resolved ambivalence, on suicidal ideation (SI) in hospitalized veterans who scored > 2 on the Scale for Suicidal Ideation. Participants were randomized to receive MI‐SI plus treatment as usual (TAU), MI‐SI‐R+TAU, or TAU alone. MI‐SI+TAU and MI‐SI‐R+TAU included two in‐hospital therapy sessions and one telephone booster session. Participants completed follow‐up assessments over 6 months.

Results

Participants in all groups experienced reductions in the presence and severity of SI, but there were no significant differences among the groups. For the presence of SI, results were in the hypothesized direction for both MI‐SI+TAU conditions.

Conclusions

Results are nondefinitive, but the effect size of both versions of MI‐SI+TAU on the presence of SI was consistent with prior MI findings. Exploratory analyses suggest MI‐SI‐R may be preferable to MI‐SI. More intensive MI‐SI‐R with a greater number of follow‐ups may increase its effectiveness.
Once in Parkland, a Year in Hartford, a Weekend in Chicago: Race and Resistance in the Gun Violence Prevention Movement
Authors: Bernstein Mary , McMillan Jordan , Charash Elizabeth
Published: August 2019

Generally ignoring firearm‐deaths by suicide, “common sense” divides gun violence into two distinct types of phenomena: urban gun violence and mass shootings. At a cursory level, these phenomena seem distinct because of the difference in the number of victims killed during a particular shooting, rather than subtypes co‐creating a master category defined by gun violence. As a result, gunshot deaths of black and brown bodies in urban settings, which constitute the majority of deaths by gun violence after suicide, are viewed as routine whereas gunshot deaths in suburban settings are extraordinary and worthy of outrage. In this article, we draw on ethnographic observation to compare protest vigils in urban communities comprised predominantly of people of color, in suburban areas that are mostly white, and at the national level in order to uncover the racialized processes of symbolic classification by which this “commonsense” view is produced and how it is challenged by activists. We use the framework of cultural pragmatics to analyze these vigils, making visible the racialized forms of domination that structure activism and, we contend, ultimately divide gun violence into two distinct phenomena rather than constituting a master category. We argue that cultural pragmatics provides a way to understand what it means to challenge culture as emphasized by the multi‐institutional politics approach to social movements.
Granulocyte transfusions could benefit patients with severe oral mucositis after allogeneic hematopoietic stem cell transplantation
Authors: Berglund Sofia , Watz Emma , Remberger Mats , Garming Legert Karin , Axdorph‐Nygell Ulla , Sundin Mikael , Uhlin Michael , Mattsson Jonas
Published: August 2019

Background and objectives

Mucositis is a common complication after allogeneic hematopoietic stem cell transplantation (HSCT), and is caused by a combination of conditioning‐induced mucosal damage and severe neutropenia. The symptoms include oral and abdominal pain, inability to swallow food and fluids, and severe diarrhoea. Severe mucositis is associated with increased risk of Graft‐versus‐Host disease and infection. Granulocyte transfusions (GCX) could be a treatment option, and our objective was to study its feasibility and potential benefits.

Material and methods

This retrospective, single‐centre study included 30 patients receiving GCX because of severe oral mucositis after HSCT during 2005–2017. Clinical outcome, response to GCX, change in opiate administration and adverse events were studied.

Results

Twenty‐seven patients received GCX from donors pre‐treated with steroids and G‐CSF, and three from donors pre‐treated with steroids only. Overall response was 83% (24/29 evaluable patients). Fifteen patients reached a complete response. In 14 of 24 responders, a reduction of the administration of opiate pain relief was seen. In eight patients this reduction was ≥50% of the dose. Adverse events (AEs) were reported in 14 cases, and were mild to moderate, and well manageable with symptomatic treatment. No life‐threatening or fatal AEs were recorded.

Conclusions

These results indicate that GCX could be a safe and effective treatment for oral mucositis after HSCT with the potential to reduce the necessity of opiate analgesic treatment in this disorder. No severe AEs were seen in this study, but the risk for severe pulmonary AEs after GCX needs to be considered.
A review of the impact of increased whole blood collections on the blood system
Authors: Beckman Neil , Yazer Mark H.
Published: August 2019

Background and Objectives

It is likely that there will be an increased emphasis on production of whole blood as evidence for efficacy in massively transfused patients increases. Depending on the magnitude of the increase, this has the potential to impact many blood collectors’ practices and to influence the whole supply chain.

Methods

The review uses current knowledge of practices and discusses the impacts on blood collectors, suppliers and the implications for blood donation, manufacturing, inventory and distribution.

Results

Increased whole blood utilisation will influence the production, supply and distribution of blood donation consumables with suppliers further influenced by likely equipment redundancy in the event of a significant increase. New blood components or consumables require regulatory approval and registration, a complex and resource‐consuming area.

Wastage would increase directly as a result of the need to have whole blood constantly available at the right location despite stochastic demand. Efficiency and yield would be influenced due to the reduced number of separated blood components and plasma for fractionation volumes. To ameliorate this, whole blood may need to be returned later in shelf life so that plasma can be recovered. A high uptake of whole blood requires a review of the blood donation and manufacturing infrastructure with the possibility of amendments to fixed assets such as blood processing centres.

Conclusion

The impacts are across the whole supply chain, and whilst the topics discussed are not directly applicable to any specific blood collector, the general principles will apply to many.
The Perception and Level of Digital Citizenship on Pre-Service Classroom Teachers
Authors: Kansu Ceren Çevik , Öksüz Yücel
Published: August 2019

This study was aimed to determine of their perceptions and levels of digital citizenship for pre-service classroom teachers. The study was conducted with 76 senior pre-service classroom teachers at Education Faculty of B. U. The study is survey research. In this research, “The Digital Citizenship Scale” developed by Kocadağ (2012) was applied to the pre-service classroom teachers. By using open-ended questions that prepared by researchers, it was interviewed with the same students in order to making in-depth review. To determine digital citizenship levels, the frequencies, percentages, arithmetic means and standard deviations of obtained data were interpreted on the table. The data from the interviews were carried out with content analysis, which is one of the qualitative analysis methods, and had been interpreted. As a result, pre-service classroom teachers had been stated that they had no courses related with digital citizenship and its sub-dimensions during their higher education. Nevertheless, it has been found that they were correctly expressed the concept of digital citizenship. Pre-service classroom teachers have indicated that digital technologies were particularly utilized to aimed for online shopping, entering to social networking and researching of homework assignments in courses. Digital citizenship includes nine sub-dimensions that every individual should have in today’s world. The classroom teachers, that play a key role in the training of the individuals must have been trained themselves by qualified properties before the beginning of their career. It is thought that this study might be leading to further studies by training on knowledge, ability and values about digital citizenship before beginning of their service to classroom teachers.
4-Amino-2-Sulfanylbenzoic Acid as a Potent Subclass B3 Metallo-β-Lactamase-Specific Inhibitor Applicable for Distinguishing Metallo-β-Lactamase Subclasses
Authors: Wachino Jun-ichi , Kanechi Reo , Nishino Erina , Mochizuki Marie , Jin Wanchun , Kimura Kouji , Kurosaki Hiromasa , Arakawa Yoshichika
Published: August 2019

The number of cases of infection with carbapenem-resistant
Enterobacteriaceae
(CRE) has been increasing and has become a major clinical and public health concern. Production of metallo-β-lactamases (MBLs) is one of the principal carbapenem resistance mechanisms in CRE. Therefore, developing MBL inhibitors is a promising strategy to overcome the problems of carbapenem resistance conferred by MBLs.
Attenuation of Equine Lentivirus Alters Mitochondrial Protein Expression Profile from Inflammation to Apoptosis
Authors: Du Cheng , Duan Yingyi , Wang Xue-Feng , Lin Yuezhi , Na Lei , Wang Xinhui , Chen Kewei , Wang Xiaojun
Published: August 2019

Following viral infection, the working pattern and function of the cell can be transformed through the impact on mitochondria. It still unknown how the mitochondrial response changes in cells infected with viruses in the process of virulence attenuation. EIAV
DLV121
is the only effective lentiviral vaccine for large-scale use in the world. EIAV
DLV34
is the parent pathogenic strain. Unlike EIAV
DLV34
-induced inflammation storms, EIAV
DLV121
can induce high levels of apoptosis. For the first time, we found that, after the mitochondrial protein expression profile is altered, EIAV
DLV34
-infected cells are transformed into M1-polarized-type macrophages and cause inflammatory injury and that the intrinsic apoptosis pathway is activated in EIAV
DLV121
-infected cells. These studies shed light on how the mitochondrial protein expression profile changes between cells infected by pathogenic lentivirus strains and cells infected by attenuated lentivirus strains to drive different cellular responses, especially from inflammation to apoptosis.
A CRISPR Screen Identifies the Cell Polarity Determinant Crumbs 3 as an Adeno-associated Virus Restriction Factor in Hepatocytes
Authors: Madigan Victoria J. , Tyson Tyne O. , Yuziuk Julianne A. , Pillai Minakshi , Moller-Tank Sven , Asokan Aravind
Published: August 2019

Adeno-associated viruses (AAVs) have recently emerged at the forefront as gene therapy vectors; however, our understanding of host factors that influence AAV transduction in different cell types is still evolving. In the present study, we perform a genome-scale CRISPR knockout screen to identify cellular host factors that restrict AAV infection in hepatocyte cultures. We discover that Crumbs 3, which determines cellular polarity, also influences the distribution of certain carbohydrate attachment factors on the cell surface. This in turn affects the ability of virions to bind and enter the cells. This study underscores the importance of cell polarity in AAV transduction and provides a potential molecular basis for the differential infectious mechanism(s) in cell culture versus organ systems.
Dual RNA-seq in Streptococcus pneumoniae Infection Reveals Compartmentalized Neutrophil Responses in Lung and Pleural Space
Authors: Ritchie Neil D. , Evans Tom J.
Published: August 2019

The factors that regulate the passage of bacteria between different anatomical compartments are unclear. We have used an experimental model of infection withStreptococcus pneumoniaeto examine the host and bacterial factors involved in the passage of bacteria from the lung to the pleural space. The transcriptional profile of host and bacterial cells within the pleural space and lung was analyzed using deep sequencing of the entire transcriptome using the technique of dual RNA-seq. We found significant differences in the host and bacterial RNA profiles in infection, which shed light on the key factors that allow passage of this bacterium into the pleural space.
Association of high amounts of physical activity with mortality risk: a systematic review and meta-analysis
Authors: Blond Kim , Brinkløv Cecilie Fau , Ried-Larsen Mathias , Crippa Alessio , Grøntved Anders
Published: August 2019

Objectives

To systematically review and analyse studies of high amounts of physical activity and mortality risk in the general population.

Eligibility criteria

Inclusion criteria related to follow-up (minimum 2 years), outcome (mortality from all causes, cancer, cardiovascular disease (CVD) or coronary heart disease), exposure (eg, a category of >1000 metabolic equivalent of task (MET) min/week), study design (prospective cohort, nested case control or case-cohort) and reports of cases and person years of exposure categories.

Information sources

Systematic searches were conducted in Embase and Pubmed from database inception to 2 March 2019.

Risk of bias

The quality of the studies was assessed with the Newcastle–Ottawa scale.

Included studies

From 31 368 studies identified, 48 were included. Two authors independently extracted outcome estimates and assessed study quality.

Synthesis of results

We estimated hazard ratios (HRs) using random effect restricted cubic spline dose–response meta-analyses. Compared with the recommended level of physical activity (750 MET min/week), mortality risk was lower at physical activity levels exceeding the recommendations, at least until 5000 MET min/week for all cause mortality (HR=0.86, 95% CI 0.78 to 0.94) and for CVD mortality (HR=0.73, 95% CI 0.56 to 0.95).

Strengths and limitations of evidence

The strengths of this study include the detailed dose–response analyses, inclusion of 48 studies and examination of sources of heterogeneity. The limitations include the observational nature of the included studies and the inaccurate estimations of amount of physical activity.

Interpretation

Compared with the recommended level, mortality risk was lower at physical activity levels well above the recommended target range. Further, there was no threshold beyond which lifespan was compromised.

Registration

PROSPERO CRD42017055727.
Missing female patients: an observational analysis of sex ratio among outpatients in a referral tertiary care public hospital in India
Authors: Kapoor Mudit , Agrawal Deepak , Ravi Shamika , Roy Ambuj , Subramanian S V , Guleria Randeep
Published: August 2019

Objective

To investigate gender discrimination in access to healthcare and its relationship with the patient’s age and distance from the healthcare facility.

Design and setting

An observational study based on outpatient data from a large referral public hospital in Delhi, India.

Participants

Confirmed clinical appointments.

Primary and secondary outcome measures

Estimates from the logistic regression are used to compute sex ratios (male/female) of patient visits with respect to distance from the hospital and age. Missing female patients for each state—a measure of the extent of gender discrimination—is computed as the difference in the actual number of female patients who came from each state and the number of female patients that should have visited the hospital had male and female patients come in the same proportion as the sex ratio of the overall population from the 2011 census.

Results

Of 2377028 outpatient visits, excluding obstetrics and gynaecology patients, the overall sex ratio was 1.69 male to one female visit. Sex ratios, adjusted for age and hospital department, increased with distance. The ratio was 1.41 for Delhi, where the facility is located; 1.70 for Haryana, an adjoining state; 1.98 for Uttar Pradesh, a state further away; and 2.37 for Bihar, the state furthest from Delhi. The sex ratios had a U-shaped relationship with age: 1.93 for 0–18 years, 2.01 for 19–30 years, and 1.75 for 60 years or over compared with 1.43 and 1.40 for the age groups 31–44 and 45–59 years, respectively. We estimate there were 402 722 missing female outpatient visits from these four states, which is 49% of the total female outpatient visits for these four states.

Conclusion

We found gender discrimination in access to healthcare, which was worse for female patients who were in the younger and older age groups, and for those who lived at increasing distances from the hospital.
Framing of clinical information affects physicians’ diagnostic accuracy
Authors: Popovich Ivor , Szecket Nicolas , Nahill Art
Published: August 2019

Background

Framing bias occurs when people make a decision based on the way the information is presented, as opposed to just on the facts themselves. How the diagnostician sees a problem may be strongly influenced by the way it is framed. Does framing bias result in clinically meaningful diagnostic error?

Methods

We created three hypothetical cases and asked consultants and registrars in Emergency Medicine and Internal Medicine to provide their differential diagnoses and investigations list. Two of the presentations were written two ways to frame the case towards or away from a particular diagnosis (Presentation 2 – pulmonary embolus (PE) and Presentation 3 – interstitial lung disease (ILD)) and these were randomly assigned to the participants. Both versions were however entirely identical in terms of the objective facts. Physician impressions and diagnostic plan were compared. A third presentation was identical for all and served as a control for clinician baseline ‘risk-averseness’.

Results

There were significant differences in the differential diagnoses generated depending on the presentation’s framing. PE and ILD were considered and investigated for the majority of the time when the presentation was framed towards these diagnoses, and the minority of the time when it was not. This finding was most striking in Presentation 2, where 100%versus50% of clinicians considered PE in their diagnosis when the presentation was framed towards PE. This result remained robust when undertaking stratified analysis and logistic regression to account for differences in seniority and baseline risk-averseness— neither of the latter variables had any effect on the result.

Conclusion

We demonstrate a clinically meaningful effect of framing bias on diagnostic error. The strength of our study is focus on clinically meaningful outcomes: investigations ordered. This finding has implications for the way we conduct handovers and teach juniors to communicate clinical information.
Molecular pathology of neurodegenerative diseases: principles and practice
Authors: Kovacs Gabor G
Published: August 2019

Neurodegenerative diseases are characterised by selective dysfunction and progressive loss of synapses and neurons associated with pathologically altered proteins that deposit primarily in the human brain and spinal cord. Recent discoveries have identified a spectrum of distinct immunohistochemically and biochemically detectable proteins, which serve as a basis for protein-based disease classification. Diagnostic criteria have been updated and disease staging procedures have been proposed. These are based on novel concepts which recognise that (1) most of these proteins follow a sequential distribution pattern in the brain suggesting a seeding mechanism and cell-to-cell propagation; (2) some of the neurodegeneration-associated proteins can be detected in peripheral organs; and (3) concomitant presence of neurodegeneration-associated proteins is more the rule than the exception. These concepts, together with the fact that the clinical symptoms do not unequivocally reflect the molecular pathological background, place the neuropathological examination at the centre of requirements for an accurate diagnosis. The need for quality control in biomarker development, clinical and neuroimaging studies, and evaluation of therapy trials, as well as an increasing demand for the general public to better understand human brain disorders, underlines the importance for a renaissance of postmortem neuropathological studies at this time. This review summarises recent advances in neuropathological diagnosis and reports novel aspects of relevance for general pathological practice.
Associations between adult height and type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies
Authors: Shrestha Sarita , Rasmussen Sara H , Pottegård Anton , Ängquist Lars H , Jess Tine , Allin Kristine H , Bjerregaard Lise G , Baker Jennifer L
Published: August 2019

Background

Although short adult height is generally associated with increased risks of type 2 diabetes mellitus (T2DM), there are large inconsistencies across studies. The aims of this study were to describe and quantify currently available evidence on the association between adult height and T2DM, to examine whether the reported associations differ by sex, and to examine the shapes of the height and T2DM associations.

Methods

Relevant literature was identified using PubMed (1966–May 2018), EMBASE (1947–May 2018) and Google Scholar (May 2018). We identified cross-sectional and cohort studies with original publications on human subjects, which were included in a random-effects meta-analysis.

Results

From 15 971 identified sources, 25 studies met the inclusion criteria for the systematic review (N=401 562 individuals). From these 25 studies, 16 (9 cross-sectional studies and 7 cohort studies) were included in the meta-analysis (n=261 496 individuals). The overall random-effects meta-analysis indicated an inverse association between adult height and T2DM (effect estimate=0.88, 95% CI 0.81 to 0.95). No sex differences in the associations between adult height and T2DM were found (effect estimate for men: 0.86, 95% CI 0.75 to 0.99; effect estimate for women: 0.90; 95% CI 0.80 to 1.01; p value for sex interaction=0.80). Due to lack of data, results on the shape of the association between height and T2DM were inconclusive.

Conclusions

Shorter height is associated with an increased risk of T2DM and the association does not significantly differ by sex. The currently available data are insufficient to support conclusions regarding the shape of the association between height and T2DM.

Trial registration number

CRD42017062446.
Modelling outer- and inner-crown profiles based on tree status and cardinal directions in relation to competition for Larix kaempferi plantations in northeastern China
Authors: Gao Huilin , Chen Dongsheng , Sun Xiaomei , Zhang Shougong
Published: August 2019

Using the branch data from 90 sample trees, we developed novel models of outer- and inner-crown profiles for the northern, eastern, southern, and western sides of planted Larix kaempferi (Lam.) Carrière trees in northeastern China via the integration of competition indices (CIs) based on nonlinear marginal regression (NMR). We also used nonparametric boundary regression (NBR) to model the crown-profile boundary. The largest crown radius and inflection points of sample trees were calculated using NBR and NMR. We determined that the CIs of the ratio of the diameter of the subject tree to the quadratic mean diameter (CI3) and ratio of the basal area of the subject tree to the mean basal area of the stand (CI5) were the best distance-independent CIs for incorporation into the models of outer- and inner-crown profiles, respectively. The CIs showed a significant effect on the outer-crown profile in all four directions for dominant, intermediate, and suppressed trees but did not show a significant effect on inner-crown profile. The outer-crown radius increased and inner-crown radius decreased with increasing CI3 and CI5, respectively. The crown profile on the northern side was the largest, which conformed to the regularity in the mean current increment of the sampled branches.
AvDR-Based Wireless Secure Key Generation with Colored Noise for IoT
Authors: Soni Ankit , Upadhyay Raksha , Kumar Abhay
Published: August 2019

Physical layer key generation exploiting inherent channel randomness is an open research area in securing the networks with resource constraint nodes; therefore reduction of numerical computation is desirable to save battery power. However, the correlated components due to colored noise also affect the system performance. In this work, we consider the correlated colored noise components along with the additive white Gaussian noise (AWGN) in the wireless channel and analyze the effect of these correlated components on the system performance. We further propose a hybrid averaging and dimensionality reduction (AvDR), based received signal strength (RSS) preprocessing which is the combination of moving window averaging (Av) and principal component analysis (PCA) as dimensionality reduction technique (DR) to improve the system performance. Further, the system performance was evaluated by numerical simulations, and it is observed that the same improvement in system performance is achieved by generating keys from a fewer number of points selected after PCA as compared to processing all the points. Picking a few of the points in the data sequence instead of all reduces the total number of numerical calculations and saves system power, which is the primary requirement of resource constraint networks like the IoT.
Low Temperature Synthesis of Mesoporous SiC in Dual-Confined Spaces via Magnesiothermic Reduction
Authors: Wang Zeng-Rong , Liu Long , Zhang Xue , Xu Jia-Lin , Sun Qiang
Published: August 2019

Silicon carbide (SiC), especially mesoporous SiC has been in immense vogue for more than a decade because of its intriguing properties and wide applications. However, it is still challenging to synthesize mesoporous SiC with good structural integrality, large specific surface area and desirable porosity at a low temperature. In this study, we reported a “dual-confined spaces”-assisted synthesis of mesoporous SiC using well-assembled SiO2/carbon composite as precursor via a magnesiothermic reduction process. The well-crystallinity mesoporous SiC presented a mesopore structure with high specific surface area of 267.3 m2 g[Formula: see text] and large mesopore size of ca. 10[Formula: see text]nm can be directly fabricated at a temperature of at least 550∘C and the optimum synthesis temperature is 650∘C. During the synthesis, mesoporous carbon matrix and a pressure-tight stainless steel reactor were served as “dual-confined spaces” to avoid the aggregation of silica and the silicon residue left in the final SiC sample. Furthermore, the as-prepared mesoporous SiC showed prominent performance as catalyst support for the reduction of 4-nitrophenol to 4-aminophenol.
Medial gastrocnemius muscle remodeling correlates with reduced plantarflexor kinetics 14 weeks following Achilles tendon rupture
Authors: Hullfish Todd J. , O’Connor Kathryn M. , Baxter Josh R.
Published: August 2019

Deficits in plantarflexor kinetics are associated with poor outcomes in patients following Achilles tendon rupture. In this longitudinal study, we analyzed the fascicle length and pennation angle of the medial gastrocnemius muscle and the length of the Achilles tendon using ultrasound imaging. To determine the relationship between muscle remodeling and deficits in plantarflexor kinetics measured at 14 wk after injury, we correlated the reduction in fascicle length and increase in pennation angle with peak torque measured during isometric and isokinetic plantarflexor contractions. We found that the medial gastrocnemius underwent an immediate change in structure, characterized by decreased length and increased pennation of the muscle fascicles. This decrease in fascicle length was coupled with an increase in tendon length. These changes in muscle-tendon structure persisted throughout the first 14 wk following rupture. Deficits in peak plantarflexor torque were moderately correlated with decreased fascicle length at 120 degrees per second ( R2 = 0.424, P = 0.057) and strongly correlated with decreased fascicle length at 210 degrees per second ( R2 = 0.737, P = 0.003). However, increases in pennation angle did not explain functional deficits. These findings suggest that muscle-tendon structure is detrimentally affected following Achilles tendon rupture. Plantarflexor power deficits are positively correlated with the magnitude of reductions in fascicle length. Preserving muscle structure following Achilles tendon rupture should be a clinical priority to maintain plantarflexor kinetics.

NEW & NOTEWORTHY In our study, we found that when the Achilles tendon ruptures due to excessive biomechanical loading, the neighboring skeletal muscle undergoes rapid changes in its configuration. The magnitude of this muscle remodeling explains the amount of ankle power loss demonstrated by these patients once their Achilles tendons are fully healed. These findings highlight the interconnected relationship between muscle and tendon. Isolated injuries to the tendon stimulate detrimental changes to the muscle, thereby limiting joint-level function.
Parkinson’s Disease in Central Asian and Transcaucasian Countries: A Review of Epidemiology, Genetics, Clinical Characteristics, and Access to Care
Authors: Kaiyrzhanov Rauan , Rizig Mie , Aitkulova Akbota , Zharkinbekova Nazira , Shashkin Chingiz , Kaishibayeva Gulnaz , Karimova Altynay , Khaibullin Talgat , Sadykova Dinara , Ganieva Manizha , Rasulova Khurshidakhon , Houlden Henry
Published: August 2019

Our understanding of Parkinson’s disease (PD) has significantly accelerated over the last few years, but predominant advances have been made in developed, Western countries. Little is known about PD in the Central Asian (CA) and Transcaucasian (TC) countries. Here, we review the clinical characteristics, treatments used, epidemiology, and genetics of PD in CA and TC countries via a methodological search in MEDLINE, EMBASE, Scopus, Web of Science, and Google Scholar databases. For the acquisition of PD care-related data, the search was extended to the local web resources. Our findings showed that PD prevalence in the region is averaging 62 per 100,000 population. The mean age of onset is 56.4 ± 2.8 in females and 63.3 ± 3.5 in males. Large-scale national studies on PD prevalence from the region are currently lacking. A limited number of genetic studies with small cohorts and inconclusive results were identified. The G2019S LRRK2 mutation, the commonest mutation in PD worldwide, was found in 5.7% of patients with idiopathic PD and 17.6% of familial cases in 153 Uzbek patients. Our review highlighted systematic deficiencies in PD health care in the region including lacks of neurologists specializing in PD, delays in PD diagnosis, absence of specialized PD nurses and PD rehab services, limited access to PD medications and surgery, and the unavailability of PD infusion therapies. Overall, this article demonstrated the paucity of data on this common neurological disorder in CA and TC countries and identified a number of healthcare areas that require an urgent consideration. We conclude that well-designed large-scale epidemiological, genetic, and clinical studies are desperately needed in this region. Healthcare professionals, local and national institutions, and stakeholders must come together to address deficiencies in PD healthcare systems in CA and TC countries.