bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing trends in medical expenditures and measuring the impact of health-related quality of life on medical expenditures for U.S. adults with diabetes associated chronic kidney disease using 2002–2016 medical expenditure panel survey data
Authors: Kharat Aditi A , Muzumdar Jagannath , Hwang Monica , Wu Wenchen
Published: August 2020

Background

Chronic Kidney Disease (CKD) is one of the most expensive comorbidities of diabetes. The changes in medical expenditures over the years and the latest economic burden of CKD among diabetes are unknown.

Objectives

(1) To examine the trend and estimate the differences in medical expenditures between adults with diabetes-associated CKD and diabetes-no CKD from 2002 to 2016 using Medical Expenditure Panel Survey data (2) To study the impact of health-related quality of life (HRQOL) on medical expenditure for adults with diabetes-associated CKD.

Methods

This is a retrospective cross-sectional study. Descriptive statistics were used for studying the trend in medical expenditures from 2002 to 2016. HRQOL was measured using physical and mental component summary (PCS, MCS). Two-part model was utilized for estimating the incremental medical expenditure for diabetes patients by CKD status.

Key findings

A total of 35,112 diabetic adults were identified in the Medical Expenditure Panel Survey dataset. Among these, 3,489 individuals had CKD. The pooled mean expenditure for diabetes-associated CKD was $25,953 which was almost double of $12,170 for patients with diabetes and no CKD. Individuals with diabetes CKD had $12,109 higher adjusted direct incremental medical expenditure as compared to diabetes-no CKD. With respect to HRQOL, individuals in the highest quartile of PCS and MCS spent $18,076 and $10,307 lesser than those in the lowest quartile respectively.

Conclusions

Medical expenditures associated with CKD are a significant contributor to the financial burden among diabetes adults. Improvements in HRQOL also lead to lower healthcare costs in diabetes-associated CKD patients.
Symptomatic atrioventricular block during biventricular pacing: Facing a double trouble
Authors: Bera Debabrata , Majumder Suchit , Khetan Anup , Sarkar Rakesh , Mukherjee Sanjeev S.
Published: August 2020

Far‐field R wave (FFRW) oversensing in atrial channel is known to cause inappropriate automatic mode switch. We describe a case of 63‐year‐old lady with dual‐chamber permanent pacemaker implanted 2 years back for symptomatic infra‐hisian complete heart block and normal biventricular function. After 6 months, she underwent upgradation to cardiac resynchronization therapy (CRT‐P, Boston Scientific) for right ventricular pacing induced cardiomyopathy. Her LV function normalized after CRT. Later on, FFRW oversensing caused false triggering of an atrial tachycardia, which subsequently opened up an "atrial flutter response" window leading to symptomatic inadvertent atrioventricular block at frequent intervals. Common ways to troubleshoot FFRW oversensing are either by increasing post‐ventricular atrial blanking or reducing atrial channel sensitivity. In her case, concomitant P wave under‐sensing made the situation more challenging to manage.
Coerced Consent with an Unknown Future*
Authors: Dougherty Tom
Published: August 2020

It is hard enough giving an account of how coercion undermines the consent of someone who knows full well the consequences of her choices. But in the wild, coerced consent is even more ethically complex because people are often unsure or misled about what will happen if they refuse to consent. In this essay, I discuss how coercion can invalidate consent under conditions of imperfect information. To explain how consent is invalidated in this way, I argue for the “Subjective Principle.” According to this principle, a sufficient condition for the invalidity of consent is that the consent‐giver either believes or has a credence that they would suffer a penalty for refusing to consent, this penalty is illegitimate, and this belief or credence causes them to consent.
The Effects of Amplification and Dilution Agent in Transmitting Sin Nombre Virus (SNV) in Deer Mouse Population
Authors: Lee Lloyd Wen Feng , Mohd Mohd Hafiz
Published: August 2020

Numerous studies have linked biodiversity with zoonotic disease control. However, researchers have warned against simply believing that the increase in biodiversity can reduce the infection disease in the community. They proposed that amplification effect (increase in biodiversity accompanied by an increase in disease prevalence) might sometimes occur. Thus, we formulated a deterministic model to consider the impact of an amplification or dilution agent on the SNV transmission in the deer mouse population. Bifurcation analysis was carried out to examine the combined influences of the environmental carrying capacity, the interspecific competition strength and the impact of amplification or dilution agent on the deer mouse population. Our results showed that the system with amplification agent required a higher carrying capacity or stronger interspecific strength to compensate for its amplification effect in suppressing the SNV prevalence; this situation explains the lack of reduction in SNV prevalence despite the presence of high biodiversity in some empirical studies. In this study, we highlight the importance of investigating the roles of the additional species in an assemblage to better understand their relationship with the SNV prevalence in deer mouse population.
Predicting the Permeability of Tight Sandstone Utilizing Experimental and Mathematical Modeling Approaches
Authors: Yu Chunsheng , Jiang Qi , Su Na , Chang Lin
Published: August 2020

In this research, experimental and mathematical modeling were carried out to estimate the permeability of tight sandstones. The pore structure parameters such as the number of pores, pore cross-sectional area, and pore radius were obtained by microcomputed tomography (micro-CT) scanning and image processing. A mathematical model was developed to predict the permeability of tight sandstones using the pore structure parameters. In the model, hydraulic radius was used to estimate the pore hydraulic conductance, where the pore diameter variation in a sinusoidal manner was observed. The stereological correction factor was used to characterize the arbitrary angle between the pore axis and the cross-sectional area. The tortuosity model was applied to characterize the behavior of non-Darcy flow inside the tight formations. Finally, the permeability prediction model was developed based on the effective medium theory. The proposed model was validated by 21 tight sandstone samples, with the relative errors within ±20%. In addition, due to the presence of small pores in tight sandstone with little contribution to overall permeability, the permeability shows inversely proportional behavior against the number of small pores.
Process Optimization Under Uncertainty for Improving the Bond Quality of Polymer Filaments in Fused Filament Fabrication
Authors: Kapusuzoglu Berkcan , Sato Matthew , Mahadevan Sankaran , Witherell Paul
Published: August 2020

This paper develops a computational framework to optimize the process parameters such that the bond quality between extruded polymer filaments is maximized in fused filament fabrication (FFF). A transient heat transfer analysis providing an estimate of the temperature profile of the filaments is coupled with a sintering neck growth model to assess the bond quality that occurs at the interfaces between adjacent filaments. Predicting the variability in the FFF process is essential for achieving proactive quality control of the manufactured part; however, the models used to predict the variability are affected by assumptions and approximations. This paper systematically quantifies the uncertainty in the bond quality model prediction due to various sources of uncertainty, both aleatory and epistemic, and includes the uncertainty and the model discrepancy in the process parameter optimization. Variance-based sensitivity analysis based on Sobol’ indices is used to quantify the relative contributions of the different uncertainty sources to the uncertainty in the bond quality. A Gaussian process (GP) surrogate model is constructed to compute and include the model discrepancy within the optimization. Physical experiments are conducted for calibration and validation of the physics model and also for validation of the optimum solution. The results show that the proposed formulation for process parameter optimization under uncertainty results in high bond quality between adjoining filaments of the FFF product.
A Computational Fluid Dynamics Investigation on the Axial Induction Factor of a Small Horizontal Axis Wind Turbine
Authors: Mendes Rafael C. F. , Macias Marianela M. , Oliveira Taygoara F. , Brasil Antonio C. P.
Published: August 2020

The evolution of wind and hydrokinetic turbines stimulated the development of several tools to evaluate and to predict horizontal axis rotor behavior. From this perspective, the blade element momentum methods stand out as one of the most common approaches due to its reliability and computing speed. In the classical blade element momentum, the axial induction factor is a crucial variable to compute correctly the turbine parameters. Usually, the axial induction is determined by an interactive process that balances the forces at blade sections with momentum equations. The forces are computed based on the airfoil polars evaluated at each blade section with local inlet velocity. This procedure assumes that the swirl terms are linearized, where the lateral pressure forces is neglected. In order to evaluate these tri-dimensional effects on the blade element momentum method, the present work introduces a different methodology to determine the axial induction factor employing computational fluid dynamics simulations. The method was applied for a full-scale horizontal axis rotor with three blades and 1 m of diameter, with wind tunnel experiments for validation. The axial induction factor obtained with the new technique was compared to the classical blade element momentum method. The results show axial induction factor variations along the radial and axial coordinates. An analogy with Glauert power coefficient limit was made, finding a specific limit curve for the tested turbine, and, moreover, a correlation between turbine firing speed and induction factor.
A Generalized Stress Inversion Approach With Application to Residual Stress Estimation
Authors: Chen Mark J. , Aquino Wilkins , Walsh Timothy F. , Reu Phillip L. , Johnson Kyle L. , Rouse Jerry W. , Jared Bradley H. , Bishop Joseph E.
Published: August 2020

We develop a generalized stress inversion technique (or the generalized inversion method) capable of recovering stresses in linear elastic bodies subjected to arbitrary cuts. Specifically, given a set of displacement measurements found experimentally from digital image correlation (DIC), we formulate a stress estimation inverse problem as a partial differential equation-constrained optimization problem. We use gradient-based optimization methods, and we accordingly derive the necessary gradient and Hessian information in a matrix-free form to allow for parallel, large-scale operations. By using a combination of finite elements, DIC, and a matrix-free optimization framework, the generalized inversion method can be used on any arbitrary geometry, provided that the DIC camera can view a sufficient part of the surface. We present numerical simulations and experiments, and we demonstrate that the generalized inversion method can be applied to estimate residual stress.
Adhesion and Interface Properties of Polydopamine and Polytetrafluoroethylene Thin Films
Authors: Brownell Matthew , Nair Arun K.
Published: August 2020

Polytetrafluoroethylene (PTFE) has been studied as a low friction surface coating since its discovery. The high wear-rate of PTFE reduces the usefulness of the polymer for mechanical purposes; however, combining PTFE with polydopamine (PDA) has been shown to greatly reduce the film wear-rate. During rubbing tests involving PDA/PTFE thin films, a tenacious layer of PTFE remains intact after substantial testing even though pure PTFE film layers are destroyed quickly. Understanding the interface mechanics that allow PTFE and PDA to adhere so well during experimental rubbing tests is necessary to improve the wear-rate of PDA/PTFE thin films. In this study, we use density functional theory (DFT) and molecular dynamics (MD) simulations to investigate the adhesive properties and interface deformation mechanisms between PDA and PTFE molecules. Steered molecular dynamics (SMD) is then performed on isolated pairs of PDA and PTFE molecules to investigate different modes of deformation from equilibrium. PDA trimer oligomers were identified as the most adhesive to PTFE and selected to use in a PDA/PTFE thin film, where nano-indentation and scratch tests are performed. Our results indicate that a combination of the unique deformation mechanisms of PDA molecules and the penetration of PTFE molecules into the PDA substrate provide the PTFE/PDA interface with its wear resistance.
The Effects of Stiffness, Fluid Viscosity, and Geometry of Microenvironment in Homeostasis, Aging, and Diseases: A Brief Review
Authors: Park Seungman , Jung Wei-Hung , Pittman Matthew , Chen Junjie , Chen Yun
Published: August 2020

Cells sense biophysical cues in the micro-environment and respond to the cues biochemically and biophysically. Proper responses from cells are critical to maintain the homeostasis in the body. Abnormal biophysical cues will cause pathological development in the cells; pathological or aging cells, on the other hand, can alter their micro-environment to become abnormal. In this minireview, we discuss four important biophysical cues of the micro-environment—stiffness, curvature, extracellular matrix (ECM) architecture and viscosity—in terms of their roles in health, aging, and diseases.
Analysis on Critical Factors of Marine Organism Impacts on Water Intake Safety at Nuclear Power Plants
Authors: Fu Xiaocheng , Du Fenglei , Pu Xiang , Wang Xuan , Han Fengze
Published: August 2020

The safety of cooling water intake in nuclear power plants (NPPs) has gradually become an important factor affecting the safety of NPPs. Marine flora and fauna outbreaks are one of the main types affecting the safety of cooling water intake in NPPs, and the driving mechanism is more complicated and difficult to predict. This paper mainly analyzes the main types and typical cases of marine organisms that cause cooling water intake blockage in NPPs, and analyzes the key factors such as hydrodynamic conditions, timing of organism's outbreak, characteristics of species, and design of the screen systems. The results show that strong hydrodynamic conditions or strong tides caused by special meteorological conditions are important factors. Considering the time of organism's outbreak, spring and summer (May–August, may change slightly according to different latitude) is key period because of the reproduction and growth of most marine organisms, according to the growth law of marine organisms. In terms of biological characteristics, it is sensible to focus on those species with fast growth, strong reproductive capacity, short life cycle, weak swimming ability, and cluster distribution. As to the design of screen systems, the blockage mainly occurs in revolving filter screens. The grid spacing of normal mechanical grille is too large to block the small marine organisms. It is necessary to add trash interception nets according to the type and size of the marine species. Finally, a case is used to confirm the factors needed to pay more attention.
Prediction of Potential Offsite TEDE, Excess Cancer Risk, Dominant Exposure Pathways, and Activity Concentration for Hypothetical Onsite Soil Contamination at the Proposed Rooppur Nuclear Power Plant
Authors: Ashraful Islam Md. , Hossain Sahadath Md.
Published: August 2020

This study evaluates the potential offsite radiological hazards by calculating total effective dose equivalent (TEDE) and excess cancer risk if onsite soil contamination occurs at the proposed Rooppur Nuclear Power Plant (RNPP) site, Bangladesh. The assessment has been performed assuming a hypothetical soil contamination associated with Fukushima Nuclear disaster with the help of the RESRAD (residual radioactivity) OFFSITE computer program developed by Argonne National Laboratory, U.S. Six radionuclides, namely, Cs-134, Cs-136, Cs-137, La-140, Sr-90, and Te-129m have been considered. The maximum TEDE has been found approximately 2.8 mSv/yr whereas the maximum total excess cancer risk shows a value of 3.25×10−3. The number of dominant exposure pathways, maximum contributor pathways, and duration of dominance of different nuclides have been identified. Ingestion of fish is identified as the principal pathway to both TEDE and excess cancer risk. Time variation of activity concentration and dose/source ratio have also been studied.
Silver film etching using halogen gas plasma
Authors: Sasaki Toshiyuki , Yoshikawa Kenichi , Furumoto Kazuhito , Sakai Itsuko , Hayashi Hisataka , Sekine Makoto , Hori Masaru
Published: August 2020

Silver (Ag) film etching was studied with a focus on suppressing the surface roughness induced by Cl2 and CF4 plasmas. After Cl2 plasma etching, roughening of the Ag surface was observed. From in situ x-ray photoelectron spectroscopy and atomic force microscopy analyses using a plasma beam system, the Ag surface was roughened with AgCl formation after Cl2 plasma treatment before exposure to air. In capacitively coupled Cl2 plasma, it seemed that many voids were formed on the Ag surface at a high bias power and cathode temperature. This was considered to be characteristic of agglomeration. In contrast, severe surface roughness was not observed after CF4 plasma etching, even at a high bias power and cathode temperature. Secondary ion mass spectrometry analysis showed high chlorine accumulation near the Ag film surface after Cl2 plasma etching. Possible agglomeration of the Ag film during Cl2 plasma etching was volume expansion caused by chlorine accumulation assumed to enhance the compressive stress of the Ag film, and this resulted in increased boundary grooving and, finally, agglomeration. In contrast, fluorine accumulation was unlikely during CF4 plasma etching, resulting in less Ag film stress, which suppressed grain boundary grooving and agglomeration.
MnO2 nanomaterials functionalized with Ag and SnO2: An XPS study
Authors: Bigiani Lorenzo , Maccato Chiara , Barreca Davide , Gasparotto Alberto
Published: August 2020

The present study is devoted to the characterization of MnO2-Ag and MnO2-SnO2 nanocomposites of technological interest as gas sensors for food quality control and security applications. In particular, MnO2 nanomaterials were deposited on polycrystalline alumina substrates by plasma enhanced-chemical vapor deposition and functionalized with either Ag or SnO2 nanoparticles by means of radio frequency-sputtering. The target materials were investigated by a multitechnique approach, evidencing the successful formation of nanocomposites with tailored morphology, featuring an intimate contact of their components. Herein, the attention is dedicated to the characterization of system surface composition by x-ray photoelectron spectroscopy. Besides wide scan spectra, data obtained by the analysis of the C 1s, O 1s, Mn 2p, Mn 3s, Ag 3d, Sn 3d, and silver Auger signal spectral features are presented and critically discussed. The results highlight the occurrence of phase-pure MnO2 and SnO2 free from other Mn and Sn oxidation states and of appreciable silver surface oxidation in the target nanomaterials.
The Effects of Lifting Lighter and Heavier Loads on Subjective Measures
Authors: Emanuel Aviv , Rozen Smukas Isaac Isur , Halperin Israel
Published: August 2020

Background: Despite the progress made in the study of subjective measures in resistance training, some questions remain unanswered. Here the authors investigated if ratings of perceived exertion (RPE) can predict task failure and bar velocity across exercises and loads as a primary outcome and whether a battery of subjective measures differ as a function of the lifted loads as a secondary outcome. Methods: In this preregistered study, 20 resistance-trained subjects (50% female) first completed a 1-repetition-maximum test of the barbell squat and bench press. In the second and third sessions, they completed 2 sets of squats followed by 2 sets of bench press to task failure, using 70% or 83% of 1-repetition maximum, while bar velocity was recorded. RPE scores were recorded after every repetition. In addition to RPE, rating of fatigue, affective valence, enjoyment, and load preferences were collected after set and session completion. Results: Across conditions, RPE was strongly correlated with reaching task failure (r = .86) and moderately correlated with bar velocity (r = −.58). The model indicates that an increase in 1 RPE unit is associated with an 11% shift toward task failure and a 4% reduction in bar velocity, with steeper slopes observed in the heavier condition. Negligible differences were observed between the load conditions in rating of fatigue, affective valence, enjoyment, and load preference. Conclusion: RPE scores, collected on a repetition-by-repetition basis, accurately reflected reaching task failure across loads and conditions. Hence, RPE can be used to prescribe repetition numbers during ongoing sets. The negligible differences between load conditions in rating of fatigue, affective valence, enjoyment, and load preference indicate that when sets are taken to task failure, loads can be selected based on individual preferences.
Unifying the synthesis of nucleoside analogs
Authors: Miller Gavin J.
Published: August 2020

A short, versatile synthetic pathway transforms achiral reactants into nucleoside analogs
Specificity in legume nodule symbiosis
Authors: Bisseling Ton , Geurts Rene
Published: August 2020

Structural variation in recognition molecules shapes symbiotic partnerships
Productivity in a pandemic
Authors: Collins Caitlyn
Published: August 2020

Almost overnight, coronavirus disease 2019 (COVID-19) has upended daily life, including the work of scientific research. But scientists have not experienced these new disruptions equally. You may have heard that women scientists seem to be submitting fewer papers for publication (including preprints), whereas men are submitting more. If this imbalance is correct, then the effects could include fewer women being granted tenure and promotion, a larger gender pay gap, and even some women being pushed out of science.
Optimal Dosing of Ceftriaxone in Infants Based on a Developmental Population Pharmacokinetic-Pharmacodynamic Analysis
Authors: Wang Ya-Kun , Wu Yue-E , Li Xue , Tian Li-Yuan , Khan Muhammad Wasim , Tang Bo-Hao , Shi Hai-Yan , Zheng Yi , Hao Guo-Xiang , van den Anker John , You Dian-Ping , Zhao Wei
Published: August 2020

Ceftriaxone is a third-generation cephalosporin used to treat infants with community-acquired pneumonia. Currently, there is a large variability in the amount of ceftriaxone used for this purpose in this particular age group, and an evidence-based optimal dose is still unavailable. Therefore, we investigated the population pharmacokinetics of ceftriaxone in infants and performed a developmental pharmacokinetic-pharmacodynamic analysis to determine the optimal dose of ceftriaxone for the treatment of infants with community-acquired pneumonia.
Biosynthesis Gene Cluster and Oxazole Ring Formation Enzyme for Inthomycins in
Streptomyces
sp. Strain SYP-A7193
Authors: Hou Shao-Yang , Zhang Meng-Yue , Wang Hong-Da , Zhang Yi-Xuan
Published: August 2020

Streptomyces
species produce numerous secondary metabolites with diverse structures and pharmacological activities that are beneficial for human health and have several applications in agriculture. In this study, hybrid nonribosomal peptide synthetase/polyketide synthase metabolites inthomycins A and B were isolated from after fermenting
Streptomyces
sp. SYP-A7193. Genome sequencing, gene disruption, gene complementation, heterologous expression, and activity assay revealed that the biosynthesis gene assembly line of inthomycins A and B was a 95.3-kb
trans
-AT type I PKS system in the strain SYP-A7193. More importantly, Itm15, a cyclodehydratase, was identified to be an oxazole ring formation enzyme required for the biosynthesis of inthomycins A and B; it is significant to discover this catalyzation reaction in the PKS/NRPS system in the field of microbiology. Our findings could provide further insights into the diversity of
trans
-AT type I PKS systems and the mechanism of oxazole cyclization involved in the biosynthesis of natural products.
A Compass To Boost Navigation: Cell Biology of Bacterial Magnetotaxis
Authors: Müller Frank D. , Schüler Dirk , Pfeiffer Daniel
Published: August 2020

Magnetotactic bacteria are aquatic or sediment-dwelling microorganisms able to take advantage of the Earth’s magnetic field for directed motility. The source of this amazing trait is magnetosomes, unique organelles used to synthesize single nanometer-sized crystals of magnetic iron minerals that are queued up to build an intracellular compass. Most of these microorganisms cannot be cultivated under controlled conditions, much less genetically engineered, with only few exceptions. However, two of the genetically amenable Magnetospirillum species have emerged as tractable model organisms to study magnetosome formation and magnetotaxis. Recently, much has been revealed about the process of magnetosome biogenesis and dedicated structures for magnetosome dynamics and positioning, which suggest an unexpected cellular intricacy of these organisms. In this minireview, we summarize new insights and place the molecular mechanisms of magnetosome formation in the context of the complex cell biology of Magnetospirillum spp. First, we provide an overview on magnetosome vesicle synthesis and magnetite biomineralization, followed by a discussion of the perceptions of dynamic organelle positioning and its biological implications, which highlight that magnetotactic bacteria have evolved sophisticated mechanisms to construct, incorporate, and inherit a unique navigational device. Finally, we discuss the impact of magnetotaxis on motility and its interconnection with chemotaxis, showing that magnetotactic bacteria are outstandingly adapted to lifestyle and habitat.
Orsay Virus CP-δ Adopts a Novel β-Bracelet Structural Fold and Incorporates into Virions as a Head Fiber
Authors: Guo Yusong R. , Fan Yanlin , Zhou Ying , Jin Miao , Zhang Jim L. , Jiang Hongbing , Holt Matthew V. , Wang Tao , Young Nicolas L. , Wang David , Zhong Weiwei , Tao Yizhi J.
Published: August 2020

Viruses often have extended fibers to mediate host cell recognition and entry, serving as promising targets for antiviral drug development. Unlike other known viral fibers, the δ proteins from the three recently discovered nematode viruses are incorporated into infectious particles as protruding fibers covalently linked to the capsid. Crystal structures of δ revealed novel pentameric folding repeats, which we term β-bracelets, in the intermediate shaft region. Based on sequence analysis, the β-bracelet motif of δ is conserved in all three nematode viruses and could account for ∼60% of the total length of the fiber. Our study indicated that δ plays important roles in cell attachment for this group of nematode viruses. In addition, the tightly knitted β-bracelet fold, which presumably allows δ to survive harsh environments in the worm gut, could be applicable to bioengineering applications given its potentially high stability.
Differential Alphavirus Defective RNA Diversity between Intracellular and Extracellular Compartments Is Driven by Subgenomic Recombination Events
Authors: Langsjoen R. M. , Muruato A. E. , Kunkel S. R. , Jaworski E. , Routh A.
Published: August 2020

Our understanding of viral defective RNAs (D-RNAs), or truncated viral genomes, comes largely from passaging studies in tissue culture under artificial conditions and/or packaged viral RNAs. Here, we show that specific populations of alphavirus D-RNAs arise
de novo
and that they are not packaged into virions, thus imposing a transmission bottleneck and impeding their prior detection. This raises important questions about the roles of D-RNAs, both in nature and in tissue culture, during viral infection and whether their influence is constrained by packaging requirements. Further, during the course of these studies, we found a novel type of alphavirus D-RNA that is enriched intracellularly; dubbed subgenomic D-RNAs (sgD-RNAs), they are defined by deletion boundaries between the capsid-E3 region and the E1-3′ untranslated region (UTR) and are common to chikungunya, Mayaro, Sindbis, and Aura viruses. These sgD-RNAs are enriched intracellularly and do not appear to be selectively packaged, and additionally, they may exist as subgenome-derived transcripts.
A Plant Virus Ensures Viral Stability in the Hemolymph of Vector Insects through Suppressing Prophenoloxidase Activation
Authors: Chen Xiaofang , Yu Jinting , Wang Wei , Lu Hong , Kang Le , Cui Feng
Published: August 2020

Large ratios of vector-borne plant viruses circulate in the hemolymph of their vector insects before entering the salivary glands to be transmitted to plants. The stability of virions in the hemolymph is vital in this process. Activation of the proteolytic prophenoloxidase (PPO) to produce active phenoloxidase (PO) is one of the major innate immune pathways in insect hemolymph. How a plant virus copes with the PPO immune reaction in its vector insect remains unclear. Here, we report that the PPO affects the stability of rice stripe virus (RSV), a notorious rice virus, in the hemolymph of a vector insect, the small brown planthopper. RSV suppresses PPO activation using viral nonstructural protein. Once the level of PO activity is elevated, RSV is melanized and eliminated from the hemolymph. Our work gives valuable clues for developing novel strategies for controlling the transmission of vector-borne plant viruses.
Chlamydia trachomatis Plasmid Gene Protein 3 Is Essential for the Establishment of Persistent Infection and Associated Immunopathology
Authors: Yang Chunfu , Kari Laszlo , Lei Lei , Carlson John H. , Ma Li , Couch Claire E. , Whitmire William M. , Bock Kevin , Moore Ian , Bonner Christine , McClarty Grant , Caldwell Harlan D.
Published: August 2020

Chlamydia trachomatis
can cause persistent infection that drives damaging inflammatory responses resulting in infertility and blindness. Little is known about chlamydial genes that cause persistence or factors that drive damaging pathology. In this work, we show that the
C. trachomatis
plasmid protein gene 3 (Pgp3) is the essential virulence factor for establishing persistent female genital tract infection and provide supportive evidence that Pgp3 functions similarly in a nonhuman primate trachoma model. We further show that persistent Ppg3-dependent infection drives damaging immunopathology. These results are important advances in understanding the pathophysiology of chlamydial persistence.
Transcriptional Rewiring, Adaptation, and the Role of Gene Duplication in the Metabolism of Ethanol of Saccharomyces cerevisiae
Authors: Sabater-Muñoz Beatriz , Mattenberger Florian , Fares Mario A. , Toft Christina
Published: August 2020

Gene duplication events have been related with increasing biological complexity through the tree of life, but also with illnesses, including cancer. Early evolutionary theories indicated that duplicated genes could explore alternative functions due to relaxation of selective constraints in one of the copies, as the other remains as ancestral-function backup. In unicellular eukaryotes like yeasts, it has been demonstrated that the fate and persistence of duplicates depend on duplication mechanism (whole-genome or small-scale events), shaping their actual genomes. Although it has been shown that small-scale duplicates tend to innovate and whole-genome duplicates specialize in ancestral functions, the implication of duplicates’ transcriptional plasticity and transcriptional divergence on environmental and metabolic responses remains largely obscure. Here, by experimental adaptive evolution, we show that
Saccharomyces cerevisiae
is able to respond to metabolic stress (ethanol as nonfermentative carbon source) due to the persistence of duplicated genes. These duplicates respond by transcriptional rewiring, depending on their transcriptional background. Our results shed light on the mechanisms that determine the role of duplicates, and on their evolvability.
Microbe-Metabolite Associations Linked to the Rebounding Murine Gut Microbiome Postcolonization with Vancomycin-Resistant Enterococcus faecium
Authors: Mu Andre , Carter Glen P. , Li Lucy , Isles Nicole S. , Vrbanac Alison F. , Morton James T. , Jarmusch Alan K. , De Souza David P. , Narayana Vinod K. , Kanojia Komal , Nijagal Brunda , McConville Malcolm J. , Knight Rob , Howden Benjamin P. , Stinear Timothy P.
Published: August 2020

This study demonstrates the importance and power of linking bacterial composition profiling with metabolomics to find the interactions between commensal gut bacteria and a specific pathogen. Knowledge from this research will inform gut microbiome engineering strategies, with the aim of translating observations from animal models to human-relevant therapeutic applications.
Systematic Reconstruction of the Complete Two-Component Sensorial Network in Staphylococcus aureus
Authors: Rapun-Araiz B. , Haag A. F. , De Cesare V. , Gil C. , Dorado-Morales P. , Penades J. R. , Lasa I.
Published: August 2020

Bacteria are able to sense environmental conditions and respond accordingly. Their sensorial system relies on pairs of sensory and regulatory proteins, known as two-component systems (TCSs). The majority of bacteria contain dozens of TCSs, each of them responsible for sensing and responding to a different range of signals. Traditionally, the function of each TCS has been determined by analyzing the changes in gene expression caused by the absence of individual TCSs. Here, we used a bacterial strain deprived of the complete TC sensorial system to introduce, one by one, the active form of every TCS. This gain-of-function strategy allowed us to identify the changes in gene expression conferred by each TCS without interference of other members of the family.
Oscillatory Dynamics in Infectivity and Death Rates of COVID-19
Authors: Pavlíček Tomáš , Rehak Pavel , Král Petr
Published: August 2020

The infectivity and death rates for COVID-19 have been observed in many countries around the world as well as in the collective data of the whole world. These oscillations show distinct circaseptan periodicity, which could be associated with numerous biological reasons as well as with improper reporting of the data collected. Since very different results are observed in different countries and even continents, such as Sweden (very significant oscillations) or India (almost no oscillations), these data provide a very important message about different conditions under which the disease is spread or is reported, which, in turn, could serve as guidance tools in future epidemics. It is necessary that follow-up studies track the observed differences and fully reliably address their origins.
Effectiveness of patient education in acute stroke: a comparison between a customised computer system and a pictorial information booklet
Authors: Chu Yin Man , Choi Kup Sze
Published: August 2020

Background

Patients who develop acute stroke are at high risk for deterioration in the first 48–72 hours after admission. An effective educational intervention is needed.

Objective

This study aimed to examine the applicability of the customised interactive computer education system (CICS) in patients who had a stroke in the early acute phase in order to determine the efficacy of the education system in (1) information satisfaction and (2) physiological related management compliance.

Methods

The prospective non-blinded randomised controlled study was conducted in an acute stroke unit of a local hospital in Hong Kong from March to August 2019. Chinese participants were selected if they were at least 18 years of age, experienced a minor stroke within 3 days. The exclusion criteria were communication problem and comorbidity with another acute disease. On the first day of admission, participants were allocated to the CICS and booklet groups, with each group comprising 50 participants. On the third day, the primary outcome, Modified Information Satisfaction Questionnaire for Acute Stroke (MISQ-S), was assessed.

Results

There was a significant difference in ‘the need to improve information measures’ of the MISQ-S (p=0.04) between the CICS and booklet groups. The management compliance of these two groups did not have difference, but the CICS group had better clinical outcome, though not significant (p=0.387).

Conclusion

Patient education was needed and feasible in the early acute phase, and the CICS was more efficacious than the booklet. The positive results provided insights into and give a direction to the use of information technology in patient education.
Does smoke-free legislation work for teens too? A logistic regression analysis of smoking prevalence and gender among 16 years old in Ireland, using the 1995–2015 ESPAD school surveys
Authors: Li Shasha , Keogan Sheila , Clancy Luke
Published: August 2020

Objectives

To assess the role of tobacco control legislation (TCL) in youth smoking in Ireland. To examine the effects of smoke-free legislation in youth. To consider whether TCL contributed to the gender equalisation in prevalence in 16 years old seen between 2003 and 2015.

Setting

Data are from the 4 yearly European School Survey Project on Alcohol and Other Drugs from 1995 to 2015. Total sample size was 12.394. A logistic regression model on grouped data was used. Dependent variable is whether a student was a smoker in last 30 days. Independent variables are time, gender and the policy indicators, workplace ban on smoking, point-of-sale (POS) display ban, the introduction of graphical images on packs and the average real price of cigarettes.

Results

Smoking prevalence dropped from 41% in 1995 to 13% in 2015. The effects of policies differed between boys and girls. For girls, estimates for workplace bans, graphical images on packs and a unit real (Consumer Price Index adjusted) price increase reduced prevalence by 7.31% (95% CI 2.94% to 11.68%), 8.80% (95% CI 2.60% to 15.01%) and 5.87 (95% CI 2.96 to 8.79), respectively. The POS ban did not have a significant effect in girls. For boys, estimates for workplace bans and a unit real price increase, reduced prevalence by 8.41% (95% CI 5.16% to 11.66%) and 4.93% (95% CI 0.77% to 9.08%), respectively, POS gave an increase of 7.02% (95% CI 1.96% to 12.40%). The introduction of graphical images had an insignificant effect.

Conclusions

TC legislation helps to explain the out-of-trend reduction in youth smoking prevalence. The estimated differential effects of the workplace ban, POS displays, real price changes and graphical images on packs help to explain the sharper decline in girls than boys. These findings should remind policy-makers to give increased consideration to the possible effects on young people of any legislative changes aimed at adults in TCL.
Study protocol for a mixed methods prospective cohort study to explore experiences of care following a suicidal crisis in the Australian healthcare system
Authors: Rosebrock Hannah , Chen Nicola , Tye Michelle , Mackinnon Andrew , Calear Alison L , Batterham Philip J , Maple Myfanwy , Rasmussen Victoria-Mae , Schroeder Liz , Cutler Henry , Shand Fiona
Published: August 2020

Introduction

For individuals presenting to the emergency department (ED) for a suicide attempt, the period after discharge from hospital is marked by heightened vulnerability for further suicide attempts. Effective care following a suicidal crisis has the potential to significantly decrease this risk. The current study aims to examine the impact of the LifeSpan multilevel suicide prevention model on experiences of care following a suicidal crisis. Perspectives from healthcare consumers (individuals who have presented to the ED following a suicidal crisis), carers, and health professionals will be explored. The LifeSpan model is currently being evaluated as a high-fidelity trial in four geographically defined regions in New South Wales, Australia.

Methods and analysis

This study will use a mixed methods prospective cohort design. Quantitative data collection includes a structured survey, administered to healthcare consumers from LifeSpan sites and control sites. Two cohorts of healthcare consumers will be recruited 12 months apart with baseline assessment occurring within 18 months of the ED presentation, and follow-up 12 months after the initial assessment. Survey participants will be recruited online and through participating EDs, mental health organisations and aftercare services. Qualitative interview data from healthcare consumers, carers who have accompanied a loved one to the ED following a suicidal crisis and health professionals who provide care to people at risk of suicide will be collected concurrently with the recruitment of the first cohort of survey participants. Purposive and convenience sampling techniques will be used for recruitment of interview participants. The primary outcome for this study will be healthcare consumers’ experiences of service provided at the ED. Analysis will be undertaken of the change over time within LifeSpan sites, as well as between LifeSpan sites and control sites, using mixed effects repeated measures models as principal means of data analysis.

Ethics and dissemination

This research has been approved by the Hunter New England Human Research Ethics Committee (HREC/17/HNE/144). Results will be disseminated via conferences and peer-reviewed journals.

Trial registration number

ACTRN12617000457347.
Efficacy of deep learning methods for predicting under-five mortality in 34 low-income and middle-income countries
Authors: Adegbosin Adeyinka Emmanuel , Stantic Bela , Sun Jing
Published: August 2020

Objectives

To explore the efficacy of machine learning (ML) techniques in predicting under-five mortality (U5M) in low-income and middle-income countries (LMICs) and to identify significant predictors of U5M.

Design

This is a cross-sectional, proof-of-concept study.

Settings and participants

We analysed data from the Demographic and Health Survey. The data were drawn from 34 LMICs, comprising a total of n=1 520 018 children drawn from 956 995 unique households.

Primary and secondary outcome measures

The primary outcome measure was U5M; secondary outcome was comparing the efficacy of deep learning algorithms: deep neural network (DNN); convolution neural network (CNN); hybrid CNN-DNN with logistic regression (LR) for the prediction of child’s survival.

Results

We found that duration of breast feeding, number of antenatal visits, household wealth index, postnatal care and the level of maternal education are some of the most important predictors of U5M. We found that deep learning techniques are superior to LR for the classification of child survival: LR sensitivity=0.47, specificity=0.53; DNN sensitivity=0.69, specificity=0.83; CNN sensitivity=0.68, specificity=0.83; CNN-DNN sensitivity=0.71, specificity=0.83.

Conclusion

Our findings provide an understanding of determinants of U5M in LMICs. It also demonstrates that deep learning models are more efficacious than traditional analytical approach.
Objectively assessed physical activity patterns and physical function in community-dwelling older adults: a cross-sectional study in Taiwan
Authors: Hsueh Ming-Chun , Rutherford Ru , Chou Chien-Chih , Park Jong-Hwan , Park Hyun-Tae , Liao Yung
Published: August 2020

Objectives

To objectively assess light physical activity (PA), moderate-to-vigorous PA (MVPA), step counts and number of 10 min MVPA bouts and their association with physical function among older adults.

Design

Cross-sectional design.

Setting

Urban community setting in Taiwan.

Participants

127 Taiwanese older adults aged over 65 years (mean age=70.8±5.3 years; 72% women).

Primary and secondary outcome measures

Triaxial accelerometers were used to measure PA variables for 10 hours/day for seven consecutive days. Then, five physical function components (handgrip strength, single-leg stance, 5-metre walk speed, timed up and go and sit-to-stand test) were measured. Multiple linear regressions were used to perform separate analyses for older men and women.

Results

For older women, daily MVPA time (β: 0.39, 95% CI: 0.12, 0.64; p=0.004), daily step counts (β: 0.46, 95% CI: 0.12, 0.78; p=0.009) and number of 10 min MVPA bouts (β: 0.27, 95% CI: 0.001, 0.53; p=0.049) were positively associated with handgrip strength after adjusting for accelerometer wear time, sedentary time and other confounders. Furthermore, daily MVPA time was positively associated with a single-leg stance (β: 0.25, 95% CI: 0.02, 0.49; p=0.036) and higher daily step counts were associated with shorter walking speed performance (β: −0.31, 95% CI: −0.57, −0.001; p=0.049). None of the variables of the objectively assessed PA patterns was associated with physical function outcomes among older men due to their small sample size.

Conclusions

Daily MVPA, MVPA bouts of at least 10 min and accumulated daily steps are important for improving physical function among older women. Future prospective research should establish causal associations between PA patterns and functional ability among older adults.
How do healthcare professionals perceive physical activity prescription for community-dwelling people with COPD in Australia? A qualitative study
Authors: Lahham Aroub , Burge Angela T , McDonald Christine F , Holland Anne E
Published: August 2020

Objectives

Clinical practice guidelines recommend that people with chronic obstructive pulmonary disease (COPD) should be encouraged to increase their physical activity levels. However, it is not clear how these guidelines are applied in clinical practice. This study aimed to understand the perspectives of respiratory healthcare professionals on the provision of physical activity advice to people with COPD. These perspectives may shed light on the translation of physical activity recommendations into clinical practice.

Design

A qualitative study using thematic analysis.

Setting

Healthcare professionals who provided care for people with COPD at two major tertiary referral hospitals in Victoria, Australia.

Participants

30 respiratory healthcare professionals including 12 physicians, 10 physical therapists, 4 nurses and 4 exercise physiologists.

Interventions

Semistructured voice-recorded interviews were conducted, transcribed verbatim and analysed by two independent researchers using an inductive thematic analysis approach.

Results

Healthcare professionals acknowledged the importance of physical activity for people with COPD. They were conscious of low physical activity levels among such patients; however, few specifically addressed this in consultations. Physicians described limitations including time constraints, treatment prioritisation and perceived lack of expertise; they often preferred that physical therapists provide more comprehensive assessment and advice regarding physical activity. Healthcare professionals perceived that there were few evidence-based strategies to enhance physical activity. Physical activity was poorly differentiated from the prescription of structured exercise training. Although healthcare professionals were aware of physical activity guidelines, few were able to recall specific recommendations for people with COPD.

Conclusion

Practical strategies to enhance physical activity prescription may be required to encourage physical activity promotion in COPD care.