bluuebunny/crossref_metadata_2025 huggingface dataset:
Extreme data compression while searching for new physics
Authors: Heavens Alan F , Sellentin Elena , Jaffe Andrew H
Published: August 2020

Bringing a high-dimensional data set into science-ready shape is a formidable challenge that often necessitates data compression. Compression has accordingly become a key consideration for contemporary cosmology, affecting public data releases, and reanalyses searching for new physics. However, data compression optimized for a particular model can suppress signs of new physics, or even remove them altogether. We therefore provide a solution for exploring new physics during data compression. In particular, we store additional agnostic compressed data points, selected to enable precise constraints of non-standard physics at a later date. Our procedure is based on the maximal compression of the MOPED algorithm, which optimally filters the data with respect to a baseline model. We select additional filters, based on a generalized principal component analysis, which are carefully constructed to scout for new physics at high precision and speed. We refer to the augmented set of filters as MOPED-PC. They enable an analytic computation of Bayesian Evidence that may indicate the presence of new physics, and fast analytic estimates of best-fitting parameters when adopting a specific non-standard theory, without further expensive MCMC analysis. As there may be large numbers of non-standard theories, the speed of the method becomes essential. Should no new physics be found, then our approach preserves the precision of the standard parameters. As a result, we achieve very rapid and maximally precise constraints of standard and non-standard physics, with a technique that scales well to large dimensional data sets.
Contribution of DNA adenine methylation to gene expression heterogeneity inSalmonella enterica
Authors: Sánchez-Romero María A , Olivenza David R , Gutiérrez Gabriel , Casadesús Josep
Published: August 2020

Expression of Salmonella enterica loci harboring undermethylated GATC sites at promoters or regulatory regions was monitored by single cell analysis. Cell-to-cell differences in expression were detected in ten such loci (carA, dgoR, holA, nanA, ssaN, STM1290, STM3276, STM5308, gtr and opvAB), with concomitant formation of ON and OFF subpopulations. The ON and OFF subpopulation sizes varied depending on the growth conditions, suggesting that the population structure can be modulated by environmental control. All the loci under study except STM5308 displayed altered patterns of expression in strains lacking or overproducing Dam methylase, thereby confirming control by Dam methylation. Bioinformatic analysis identified potential binding sites for transcription factors OxyR, CRP and Fur, and analysis of expression in mutant backgrounds confirmed transcriptional control by one or more of such factors. Surveys of gene expression in pairwise combinations of Dam methylation-dependent loci revealed independent switching, thus predicting the formation of a high number of cell variants. This study expands the list of S. enterica loci under transcriptional control by Dam methylation, and underscores the relevance of the DNA adenine methylome as a source of phenotypic heterogeneity.
Ocular Fundus Abnormalities in Acute Subarachnoid Hemorrhage: The FOTO-ICU Study
Authors: Sharma Rahul A , Garza Philip S , Biousse Valérie , Samuels Owen B , Newman Nancy J , Bruce Beau Benjamin
Published: August 2020

BACKGROUND

Ocular fundus abnormalities, especially intraocular hemorrhage, may represent a clinically useful prognostic marker in patients with acute subarachnoid hemorrhage (SAH).

OBJECTIVE

To evaluate associations between ocular fundus abnormalities and clinical outcomes in acute SAH.

METHODS

Prospective evaluation of acute SAH patients with ocular fundus photography at bedside. Multivariable logistic models were used to evaluate associations between fundus abnormalities and poor outcome (inpatient death, care withdrawal, or discharge Glasgow Outcome Score <4) and intensive care unit (ICU) and hospital lengths-of-stay, controlling for APACHE II score, respiratory failure at ICU admission, Hunt & Hess score, aneurysmal etiology, age, and sex.

RESULTS

Fundus abnormalities were present in 29/79 patients with acute SAH (35.4%), and 20/79 (25.3%) had intraocular hemorrhage. In univariate analyses, poor outcomes were more likely among patients with fundus abnormalities vs without (15/28 [53.6%] vs 15/51 [29.4%], P = .03); median length of ICU stay was longer in patients with intraocular hemorrhage than without (18 d [interquartile range (IQR) 12-25] vs 11 [IQR 7-17], P = .03). Logistic regression with fundus abnormality as predictor of interest showed that male sex (odds ratio [OR] 5.33 [95% CI 1.09-26.0], P = .045), higher APACHE II (OR, per 1-point increase, 1.35 [95% CI 1.08-1.78], P = .01), and aneurysmal etiology (OR 4.35 [95% CI 1.01-22.9], P = .048), but not fundus abnormalities (OR 1.56 [95% CI 0.43-5.65], P = .49) or intraocular hemorrhage (OR 1.28 [95% CI 0.26-5.59], P = .75) were associated with poor outcome.

CONCLUSION

Although ocular fundus abnormalities are associated with disease severity in SAH, they do not add value to patients’ acute management beyond other risk factors already in use.
Impact of Pharmacist-Driven Antiretroviral Stewardship and Transitions of Care Interventions on Persons With Human Immunodeficiency Virus
Authors: Brizzi Marisa B , Burgos Rodrigo M , Chiampas Thomas D , Michienzi Sarah M , Smith Renata , Yanful Paa Kwesi , Badowski Melissa E
Published: August 2020

Background

Persons with human immunodeficiency virus (HIV) experience high rates of medication-related errors when admitted to the inpatient setting. Data are lacking on the impact of a combined antiretroviral (ARV) stewardship and transitions of care (TOC) program. We investigated the impact of a pharmacist-driven ARV stewardship and TOC program in persons with HIV.

Methods

This was a retrospective, quasi-experimental analysis evaluating the impact of an HIV-trained clinical pharmacist on hospitalized persons with HIV. Patients included in the study were adults following up, or planning to follow up, at the University of Illinois (UI) outpatient clinics for HIV care and admitted to the University of Illinois Hospital. Data were collected between July 1, 2017 and December 31, 2017 for the preimplementation phase and between July 1, 2018 and December 31, 2018 for the postimplementation phase. Primary and secondary endpoints included medication error rates related to antiretroviral therapy (ART) and opportunistic infection (OI) medications, all-cause readmission rates, medication access at time of hospital discharge, and linkage to care rates.

Results

A total of 128 patients were included in the study: 60 in the preimplementation phase and 68 in the postimplementation phase. After the implementation of this program, medication error rates associated with ART and OI medications decreased from 17% (10 of 60) to 6% (4 of 68) (P = .051), 30-day all-cause readmission rates decreased significantly from 27% (16 of 60) to 12% (8 of 68) (P = .03), and linkage to care rates increased significantly from 78% (46 of 59) to 92% (61 of 66) (P = .02).

Conclusions

A pharmacist-led ARV stewardship and TOC program improved overall care of persons with HIV through reduction in medication error rates, all-cause readmission rates, and an improvement in linkage to care rates.
Fever Patterns, Cytokine Profiles, and Outcomes in COVID-19
Authors: Ng Deborah H L , Choy Chiaw Yee , Chan Yi-Hao , Young Barnaby E , Fong Siew-Wai , Ng Lisa F P , Renia Laurent , Lye David C , Chia Po Ying ,   National Centre for Infectious Diseases COVID-19 Outbreak Research Team, Ping Angela Chow Li , Ang Brenda Sze Peng , Wong Chen Seong , Lee Cheng Chuan , Ying Ding , Tay Jun-Yang , Marimuthu Kalisvar , Lee Lawrence Soon U , Leo Yee-Sin , Ling Li Min , Ang Li Wei , Cui Lin , Chen Mark I-Cheng , Chan Monica , Sadasiv Mucheli Sharavan , Ng Oon-Tek , Lee Pei Hua , Lim Poh Lian , Sadarangani Sapna Pradip , Vasoo Shawn , Sutjipto Stephanie , Yeo Tsin Wen , Mak Tze Minn
Published: August 2020

Background

Prolonged fever is associated with adverse outcomes in dengue viral infection. Similar fever patterns are observed in COVID-19 with unclear significance.

Methods

We conducted a hospital-based case–control study of patients admitted for COVID-19 with prolonged fever (fever >7 days) and saddleback fever (recurrence of fever, lasting <24 hours, after defervescence beyond day 7 of illness). Fever was defined as a temperature of ≥38.0°C. Cytokines were determined with multiplex microbead-based immunoassay for a subgroup of patients. Adverse outcomes were hypoxia, intensive care unit (ICU) admission, mechanical ventilation, and mortality.

Results

A total of 142 patients were included in the study; 12.7% (18/142) of cases had prolonged fever, and 9.9% (14/142) had saddleback fever. Those with prolonged fever had a median duration of fever (interquartile range [IQR]) of 10 (9–11) days for prolonged fever cases, while fever recurred at a median (IQR) of 10 (8–12) days for those with saddleback fever. Both prolonged (27.8% vs 0.9%; P < .01) and saddleback fever (14.3% vs 0.9%; P = .03) were associated with hypoxia compared with controls. Cases with prolonged fever were also more likely to require ICU admission compared with controls (11.1% vs 0.9%; P = .05). Patients with prolonged fever had higher induced protein–10 and lower interleukin-1α levels compared with those with saddleback fever at the early acute phase of disease.

Conclusions

Prolonged fever beyond 7 days from onset of illness can identify patients who may be at risk of adverse outcomes from COVID-19. Patients with saddleback fever appeared to have good outcomes regardless of the fever.
Refugee women’s well-being, needs and challenges: implications for health policymakers
Authors: Qutranji L , Silahlı N Y , Baris H E , Boran P
Published: August 2020

Background

Refugees face circumstances where their health and well-being are compromised. In this qualitative study, the aim was to understand Syrian refugee women’s needs for care and the predisposing and enabling factors to healthcare access and utilisation.

Methods

Out of 945 Syrian mothers who gave birth in our university hospital between 2014 and 2018, 195 were reached; out of which, 47 women were included. Semi-structured in-depth interviews were conducted and were later analysed using a qualitative content analysis approach. Depression was assessed by the Patient Health Questionnaire-9 at the end of the interview.

Results

Social isolation and maternal depression, language barrier and challenges while navigating the healthcare system emerged as the main themes of the study. Low educational and occupational status of the women, poor social resources, limited Turkish proficiency and unfamiliarity with the host healthcare system were identified as the predisposing factors for poor healthcare services utilisation.

Conclusion

Recommendations include bridging language gaps, improving the navigation of the healthcare system by visual support or in-person interpretation, and psychosocial support. Providing hospital-based language courses to mothers and social integration programs for families will improve the mothers’ well-being and indirectly care of the child.
COVID-19 in Italy: An Analysis of Death Registry Data
Authors: Ciminelli Gabriele , Garcia-Mandicó Sílvia
Published: August 2020

Background

There are still many unknowns about COVID-19. We do not know its exact mortality rate nor the speed through which it spreads across communities. This lack of evidence complicates the design of appropriate response policies.

Methods

We source daily death registry data for 4100 municipalities in Italy’s north and match them to Census data. We augment the dataset with municipality-level data on a host of co-factors of COVID-19 mortality, which we exploit in a differences-in-differences regression model to analyze COVID-19-induced mortality.

Results

We find that COVID-19 killed more than 0.15% of the local population during the first wave of the epidemic. We also show that official statistics vastly underreport this death toll, by about 60%. Next, we uncover the dramatic effects of the epidemic on nursing home residents in the outbreak epicenter: in municipalities with a high share of the elderly living in nursing homes, COVID-19 mortality was about twice as high as in those with no nursing home intown.

Conclusions

A pro-active approach in managing the epidemic is key to reduce COVID-19 mortality. Authorities should ramp-up testing capacity and increase contact-tracing abilities. Adequate protective equipment should be provided to nursing home residents and staff.
Co-prescription of gabapentinoids and opioids among adults with and without osteoarthritis in the United Kingdom between 1995 and 2017
Authors: Yu Dahai , Appleyard Tom , Cottrell Elizabeth , Peat George
Published: August 2020

Objectives

To produce national and regional estimates and trends for gabapentinoid–opioid co-prescribing rates in patients with OA, both in absolute terms and relative to matched controls without OA.

Methods

Using the UK Clinical Practice Research Datalink database we first constructed age–sex–practice–date 1:1 matched cohorts of patients aged ≥40 years with and without a new diagnosis of OA between 1995–2017 and estimated the relative incidence of a first gabapentinoid prescription. Incident gabapentinoid users in both cohorts were followed to estimate and compare the event rate of gabapentinoid–opioid co-prescription (prescription from both classes within the same 28-day window).

Results

The incidence of first gabapentinoid prescription was 3-fold higher in patients with OA than in matched controls [n = 215 357; incidence rate ratio (IRR) 2.93; 95% CI: 2.87, 3.00]. Among incident gabapentinoid users with OA (n = 27 374, median follow-up 3.9 years) the event rate of gabapentinoid–opioid co-prescription was 4.03 (4.02–4.05) per person-year. The rate was higher in OA patients classed as long-term gabapentinoid users (6.24; 6.22–6.26). These rates were significantly higher than in incident gabapentinoid users without OA [adjusted-IRR: 1.29 (1.28–1.30)]. This elevated risk was observed across age, sex, geographic regions, and calendar years, when restricted to strong opioids and to long-term gabapentinoid users, and when co-prescription was defined as within 14 days and same-day prescribing.

Conclusions

Patients with OA not only have a higher risk of being prescribed a gabapentinoid but, once prescribed a gabapentinoid, are also at greater risk of opioid co-prescription. Strict restriction of gabapentinoid–opioid co-prescription, and improved access to, and uptake of, effective non-pharmacological and surgical alternatives for OA are required.
Using Natural Language Processing on Electronic Health Records to Enhance Detection and Prediction of Psychosis Risk
Authors: Irving Jessica , Patel Rashmi , Oliver Dominic , Colling Craig , Pritchard Megan , Broadbent Matthew , Baldwin Helen , Stahl Daniel , Stewart Robert , Fusar-Poli Paolo
Published: August 2020

Background

Using novel data mining methods such as natural language processing (NLP) on electronic health records (EHRs) for screening and detecting individuals at risk for psychosis.

Method

The study included all patients receiving a first index diagnosis of nonorganic and nonpsychotic mental disorder within the South London and Maudsley (SLaM) NHS Foundation Trust between January 1, 2008, and July 28, 2018. Least Absolute Shrinkage and Selection Operator (LASSO)-regularized Cox regression was used to refine and externally validate a refined version of a five-item individualized, transdiagnostic, clinically based risk calculator previously developed (Harrell’s C = 0.79) and piloted for implementation. The refined version included 14 additional NLP-predictors: tearfulness, poor appetite, weight loss, insomnia, cannabis, cocaine, guilt, irritability, delusions, hopelessness, disturbed sleep, poor insight, agitation, and paranoia.

Results

A total of 92 151 patients with a first index diagnosis of nonorganic and nonpsychotic mental disorder within the SLaM Trust were included in the derivation (n = 28 297) or external validation (n = 63 854) data sets. Mean age was 33.6 years, 50.7% were women, and 67.0% were of white race/ethnicity. Mean follow-up was 1590 days. The overall 6-year risk of psychosis in secondary mental health care was 3.4 (95% CI, 3.3–3.6). External validation indicated strong performance on unseen data (Harrell’s C 0.85, 95% CI 0.84–0.86), an increase of 0.06 from the original model.

Conclusions

Using NLP on EHRs can considerably enhance the prognostic accuracy of psychosis risk calculators. This can help identify patients at risk of psychosis who require assessment and specialized care, facilitating earlier detection and potentially improving patient outcomes.
Risk-seeking attitude in health and safety domain is associated with continuous positive airway pressure discontinuation in patients with obstructive sleep apnea—a multicenter prospective cohort study
Authors: Pelletier-Fleury Nathalie , Le Vaillant Marc , Goupil François , Paris Audrey , Pigeane Thierry , Gagnadoux Frédéric , Meslier Nicole ,   IRSR Sleep Cohort Group, Gagnadoux F , Meslier N , Person C , Priou P , Trzepizur W , Goupil F , Paris A , Molinier O , Bizieux-Thaminy A , Caby Isabelle , Bellier Maël , des Olonnes Pôle santé , Pigeanne T , Corne F , Jaffre S , Leclair-Visonneau Laurene , Humeau M P , de la Tranchade M Normand
Published: August 2020

Study Objectives

Many studies have already looked at factors that may influence adherence to continuous positive airway pressure (CPAP) (severity of obstructive sleep apnea (OSA), patients’ age, technical aspects, socioeconomic factors, living conditions, psychological factors). Although it has been shown that individuals’ preference for risky behaviors in daily life can influence the use of care or adherence to drug therapies in care settings, this has never been tested in OSA. This study aims to analyze the association between risk attitude in the health/safety domain and CPAP discontinuation in a cohort of OSA patients.

Methods

In a prospective multicenter cohort study nested within the IRSR sleep cohort, consecutive patients who were prescribed CPAP were monitored for at least 6 months. In addition to the data usually collected in the IRSR sleep cohort at baseline, patients also completed a risk-taking questionnaire using the Domain-Specific Risk-Taking (DOSPERT) scale. Cox’s proportional hazards regression was used to model the risk of CPAP discontinuation as a function of a linear combination of variables hypothetically related to this risk including health risk attitude.

Results

Of the 489 patients under CPAP, 12.1% (n = 59) were risk-seeking, 87.9% (n = 430) were risk-neutral, and none were risk-averse. Cox’s model indicated that a risk-seeking attitude (p = 0.04) and an AHI <30 (p < 0.01) were significantly associated with CPAP discontinuation.

Conclusions

Patients with risk-seeking behaviors in daily life have been shown to be more likely to discontinue CPAP. The DOSPERT scale can be a useful tool for screening this specific group of patients in clinical practice.
Sleep and screen exposure across the beginning of life: deciphering the links using big-data analytics
Authors: Kahn Michal , Barnett Natalie , Glazer Assaf , Gradisar Michael
Published: August 2020

Study Objectives

Evidence for the association between screen time and insufficient sleep is bourgeoning, and recent findings suggest that these associations may be more pronounced in younger compared to older children, and for portable compared to non-portable devices. However, these effects have yet to be investigated within the beginning of life. Importantly, there are no data for the relationship between screen exposure and objectively measured infant sleep. This study examined the moderating role of age for both touchscreens’ and television’s relationship with sleep, using auto-videosomnography within a big-data sample of infants.

Methods

The sleep of 1074 infants (46% girls) aged 0–18 months was objectively assessed using computer-vision technology in this cross-sectional study. Sleep was additionally reported by parents in an online survey, as was infant exposure to screens.

Results

Age significantly moderated the relationship between daytime touchscreen exposure and sleep with a distinct pattern for younger infants, in which screen exposure was associated with decreased daytime sleep, but with a proposed compensatory increase in nighttime sleep consolidation. Compared to touchscreens, television exposure was less likely to be associated with sleep metrics, and age moderated this relationship only for daytime and 24-hour sleep duration.

Conclusions

In young infants, a daytime-nighttime sleep “trade-off” emerged, suggesting that the displacement of daytime sleep by screens may lead to greater accumulation of sleep homeostatic pressure, which in turn facilitates more consolidated nighttime sleep.
Some aspects of the acute phase immune response to a lipopolysaccharide (LPS) challenge are mitigated by supplementation with a Saccharomyces cerevisiae fermentation product in weaned beef calves1,2
Authors: Burdick Sanchez Nicole C , Carroll Jeff A , Broadway P Rand , Edrington Tom S , Yoon Ilkyu , Belknap Craig R
Published: August 2020

This study was conducted to determine if feeding a Saccharomyces cerevisiae fermentation product (SCFP) to calves would alter the acute phase response to a lipopolysaccharide (LPS) challenge. Crossbred steer calves [n = 32; 274 ± 1.9 kg body weight (BW)] were randomly allotted to two treatment diets for 21 d: 1) control, fed RAMP (Cargill, Dalhart, TX) and 2) SCFP, fed the control ration supplemented with NaturSafe at 12 g/hd/d mixed into the TMR (NaturSafe, Diamond V, Cedar Rapids, IA). On day 22, steers were fitted with indwelling jugular catheters and rectal temperature monitoring devices and placed in individual bleeding stalls. On day 23, steers were challenged i.v. with 0.25 µg/kg BW LPS. Blood samples were collected at 0.5-h (serum) or 2-h (complete blood counts) intervals from −2 to 8 h and again at 24 h relative to the LPS challenge at 0 h. Sickness behavior scores (SBS) were recorded after the collection of each blood sample. Rectal temperatures were greater in SCFP steers from 6 to 11 h, at 13 h, from 15 to 20 h, and from 22 to 24 h following the LPS challenge compared to Control steers (treatment × time: P = 0.01). Additionally, SCFP-supplemented steers had reduced (P < 0.01) SBS compared to Control steers. Platelet concentrations remained greater in SCFP-supplemented steers compared to Control steers throughout the study (P = 0.05), while there was a tendency (P = 0.09) for SCFP steers to have greater white blood cells and eosinophils concentrations than Control steers. There was a treatment × time interaction for serum cortisol and glucose (P < 0.01). Specifically, cortisol was greater at 0.5 and 2 h postchallenge but was reduced at 3 h for SCFP steers compared to Control steers. Glucose was greater in SCFP steers at −0.5, 2, and 7.5 h compared to Control steers. Serum amyloid A was reduced in SCFP steers at 0.5 h, yet greater at 1 and 7.5 h postchallenge compared to Control steers (treatment × time: P < 0.01). Fibrinogen concentrations were greater (P < 0.01) in SCFP compared to Control steers. There was a treatment × time interaction (P < 0.01) for tumor necrosis factor-α (TNF-α) such that concentrations were reduced in SCFP steers from 1 to 2 h postchallenge compared to Control steers. Overall, these data suggest that supplementing calves with SCFP may have primed the innate immune response prior to the challenge, particularly platelets, which resulted in an attenuated sickness behavior and TNF-α response to LPS.
I English Language
Authors: Kostadinova Viktorija , Yáñez-Bouza Nuria , Wiemann Marco , Dreschler Gea , Gregersen Sune , Gyuris Beáta , Allan Kathryn , Scott Maggie , Anderwald Lieselotte , Leuckert Sven , Kraš Tihana , Cogo Alessia , Gan Tian , Parise Ida , Ting Shawnea Sum Pok , Da Silva Juliana Souza , Hansen Beke , Cushing Ian
Published: August 2020

This chapter has fourteen sections: 1. General; 2. History of English Linguistics; 3. Phonetics and Phonology; 4. Morphology; 5. Syntax; 6. Semantics; 7. Lexicography, Lexicology, and Lexical Semantics; 8. Onomastics; 9. Dialectology and Sociolinguistics; 10. New Englishes and Creolistics; 11. Second Language Acquisition; 12. English as a Lingua Franca; 13. Pragmatics and Discourse; 14. Stylistics. Section 1 is by Viktorija Kostadinova; section 2 is by Nuria Yáñez-Bouza; section 3 is by Marco Wiemann; sections 4 and 5 are by Gea Dreschler and Sune Gregersen; section 6 is by Beáta Gyuris; section 7 is by Kathryn Allan; section 8 is by Maggie Scott; section 9 is by Lieselotte Anderwald; section 10 is by Sven Leuckert; section 11 is by Tihana Kraš; section 12 is by Shawnea Sum Pok Ting, Tian Gan, Ida Parise, Juliana Souza da Silva, and Alessia Cogo; section 13 is by Beke Hansen; section 14 is by Ian Cushing.
Challenges With Managing Disease Complexes During Application of Different Measures Against Foliar Diseases of Field Pea
Authors: Barbetti Martin J. , Khan Tanveer N. , Pritchard Ian , Lamichhane Jay Ram , Aubertot Jean-Noël , Corrales David Camilo , You Ming Pei
Published: August 2020

Studies were undertaken across five field locations in Western Australia to determine the relative changes in disease severity and subsequent field pea yield from up to four foliar pathogens associated with a field pea foliar disease complex (viz. genera Didymella, Phoma, Peronospora, and Septoria) across four different pea varieties sown at three different times and at three different densities. Delaying sowing of field pea significantly (P < 0.05) reduced the severity of Ascochyta blight (all five locations) and Septoria blight (one location), increased the severity of downy mildew (four locations), but had no effect on seed yield. In relation to Ascochyta blight severity at 80 days after sowing, at all locations the early time of sowing had significantly (P < 0.05) more severe Ascochyta blight than the mid and late times of sowing. Increasing actual plant density from 20 to 25 plants m−2 to 58 to 78 plants m−2 significantly (P < 0.05) increased the severity of the Ascochyta blight (four locations) and downy mildew (one location), and it increased seed yield at four locations irrespective of sowing date and three locations irrespective of variety. Compared with varieties Dundale, Wirrega, and Pennant, variety Alma showed significantly (P < 0.05) less severe Ascochyta blight, downy mildew, and Septoria blight (one location each). Grain yield was highest for the early time of sowing at three locations. Varieties Alma, Dundale, and Wirrega significantly (P < 0.05) outyielded Pennant at four locations. The percentage of isolations of individual Ascochyta blight pathogens at 80 days after the first time of sowing varied greatly, with genus Didymella ranging from 25 to 93% and genus Phoma ranging from 6 to 23% across the five field locations. This fluctuating nature of individual pathogen types and proportions within the Ascochyta blight complex, along with variation in the occurrence of pathogens Peronospora and Septoria, highlights the challenges to understand and manage the complexities of co-occurring different foliar pathogens of field pea. While the search for more effective host resistance continues, there is a need for and opportunities from further exploring and exploiting cultural management approaches focusing on crop sequence diversification, intercropping, manipulating time of sowing and stand density, and application of improved seed sanitation and residue/inoculum management practices. We discuss the constraints and opportunities toward overcoming the challenges associated with managing foliar disease complexes in field pea.
Hymenoptera allergy and anaphylaxis: are warmer temperatures changing the impact?
Authors: Demain Jeffrey G.
Published: August 2020

Purpose of review

Climate change has brought about many changes in our ecosystem. Prolongation of pollen seasons has been reported, related to earlier frost off in the spring and later onset of frost on in the fall. This review considers recent global evidence that stinging insects are redistributing toward the poles, thereby potentially increasing human exposure and risk of sting events.

Recent findings

With changing climate, particularly climate warming, range expansion of insects is occurring in both the Northern and Southern Hemispheres. Likewise, stinging insects, such as Hymenoptera and Lepidoptera, are also expanding range. Though there is scant data on associated increase of insect-related anaphylaxis, increased insect–human interaction is certain.

It is likely that climate change will continue to alter the distribution and population of Hymenoptera and other insects. As temperatures warm and regions become suitable for nesting and establishment of colonies, many insects will expand their territory. As already reported in Alaska, one would anticipate expansion of range, especially toward the poles, thereby increasing the probability of human encounters and likewise anaphylaxis.
Can patients with oral allergy syndrome be at risk of anaphylaxis?
Authors: Skypala Isabel J.
Published: August 2020

Purpose of review

Oral allergy syndrome, also known as pollen-food syndrome (PFS), is a condition usually associated with adults and characterized by mild transient oropharyngeal symptoms. The purpose of this review is to determine whether systemic or anaphylactic reactions do occur and if so, who is affected and what are the triggers.

Recent findings

An increasing number of studies demonstrate that PFS occurs all age groups, and a significant number of affected adults do experience systemic and anaphylactic reactions. The upsurge in the adoption of vegan lifestyles, increase in consumption of fruits and vegetables including smoothies and juices, and use of plant foods in nutritional or body-building supplements, could exacerbate this. Changes in pollen and pollution levels, cofactors and sensitization to other plant food allergens may also be involved.

While the majority of those with PFS will continue to experience mild symptoms, all individuals should be properly advised regarding the dangers of concentrated or unusual forms of plant food allergens such as smoothies, juices, soy/nut milks and nutritional supplements. Further well characterized studies are needed to determine risk factors for severe reactions, and sensitization patterns to pollens and plant food allergens.
TNF-a Is a Potent Stimulator of Tc9-Cell Differentiation
Authors: Yang Siyu , Chen Jintong , Zhang Hong , Jiang Yuxue , Qin Tianxue , Gao Sujun , Yue Ying , Wang Siqing
Published: August 2020

Tumor-specific Tc9 cells exhibit an excellent antitumor potential in tumor immunotherapy. Identification of factors that contribute to Tc9-cell differentiation may have important clinical significance. In this study, we found that tumor necrosis factor (TNF)-α promotes Tc9 differentiation in vitro, and the TNF-α-induced Tc9 cells display enhanced cell survival and cell proliferation. More importantly, the TNF-α-induced tumor-specific Tc9 cells have increased antitumor capabilities in vivo. TNF-α activates its downstream signaling through 2 cell surface receptors, TNFR1 and TNFR2. In this study, we found that TNF-α promotes Tc9-cell differentiation through TNFR2, but not TNFR1. Furthermore, we found that TNF-α-TNFR2 activates STAT5 and nuclear factor-κB signaling during Tc9-cell differentiation. Blocking STAT5 or nuclear factor-κB by their specific inhibitors partially abrogates TNF-α-induced promotion of Tc9-cell differentiation. Thus, our study demonstrated TNF-α as a potent stimulator of Tc9-cell differentiation and may have important clinical implications.
Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis
Authors: Lopes Susana , Afreixo Vera , Teixeira Manuel , Garcia Catarina , Leitão Cátia , Gouveia Marisol , Figueiredo Daniela , Alves Alberto J. , Polonia Jorge , Oliveira José , Mesquita-Bastos José , Ribeiro Fernando
Published: August 2020

Objective:

Arterial stiffness, namely pulse wave velocity (PWV), is an emerging biomarker in the assessment of vascular health. This meta-analysis aims to determine the effects of exercise training on PWV in patients with hypertension, and to identify the possible moderator variables (e.g. type of exercise) of the effect of exercise on PWV.

Methods:

MEDLINE, EMBASE, Cochrane and Web of Science were searched up until July 2019 for randomized controlled trials assessing the effect of exercise interventions lasting 4 or more weeks on PWV in adults with hypertension. Random-effects modelling was used to compare changes from pre to postintervention in PWV between exercise and control groups. Data were reported as weighted mean difference (WMD) and 95% confidence interval (95% CI). Protocol registration: PROSPERO registration number CRD42019138658.

Results:

We included 14 trials (15 interventions), involving five aerobic, two dynamic resistance, six combined and two isometric resistance groups, totalling 642 participants with hypertension. PWV was significantly reduced by exercise training [(WMD (95% CI) = −0.76 m/s (−1.05 to −0.47)]. Analysis of moderator variables showed that aerobic exercise [WMD (95% CI) = −0.70 m/s (−1.20 to −0.19)], combined exercise [WMD (95% CI) = −0.74 m/s (−1.41 to −0.08)] and isometric resistance exercise [WMD (95% CI) = −0.98 m/s (−1.24 to −0.73)] reduced PWV. There was no significant reduction in PWV in participants undertaking dynamic resistance training [WMD (95% CI) = −0.58 (−1.58 to 0.42)]

Conclusion:

This meta-analysis supports that exercise interventions based on aerobic, combined or isometric exercise are suitable to improve PWV in adults with hypertension.
Developing a Screening Tool for Young Children Using an Ecological Framework
Authors: DeCandia Carmela J. , Volk Katherine T. , Unick George J. , Donegan Laura Rose W.
Published: August 2020

Young children from impoverished backgrounds experience high levels of family and environmental stress, adversely impacting developmental functioning. Early identification provides a pathway to solutions, but many children are never evaluated. In addition, the child-serving workforce lacks resources and expertise to use traditional measures. Furthermore, existing measures do not account for the substantial influence of a child's ecology. To bridge these gaps, we developed the Neurodevelopmental Ecological Screening Tool (NEST) and conducted a pilot study (n = 60) to test its feasibility for use with caregivers of children 3–5 years of age in low-resource settings. We developed an item pool across 3 domains (child, caregiver, and environment), vetted it with experts, and conducted cognitive interviewing with parents (n = 15) and case managers (n = 10). Simultaneously, we built an online, user-friendly delivery platform. We used a one-parameter Item Response Model and a Rasch-based Rating Scale Model and fit confirmatory factor analytical models to test for unidimensional and construct validity. The results support the feasibility of screening children from low socioeconomic status populations within low-resource settings using an ecological perspective and support the work of child-serving paraprofessionals in identifying and addressing risks in the lives of young children.
Evaluation of a Brief Teacher Coaching Program for Delivering an Early Intervention Program to Preschoolers With Autism Spectrum Disorder
Authors: Tupou Jessica , Waddington Hannah , Sigafoos Jeff
Published: August 2020

There is a need for research that evaluates the effectiveness of early intervention when delivered in inclusive preschools. In this study, 3 regular preschool teachers were trained to use the Early Start Denver Model with a child with autism spectrum disorder who attended an inclusive preschool. Each teacher worked with 1 child. Teachers received eleven 60-min coaching sessions based on an adapted version of the Early Start Denver Model's parent coaching program. A multiple baseline across participants design was used to evaluate effectiveness in terms of teachers' use of the early intervention techniques and children's levels of participation, imitation, and communication. Data were collected via weekly 10-min video recordings, with 3 follow-up probes conducted 11 weeks following intervention. Teachers improved in their use of early intervention techniques, and children demonstrated improved levels of active participation, but results for child imitation and communication were mixed. Positive results were generally maintained at follow-up. This study provides preliminary support for the effectiveness and feasibility of using a modified coaching program to train preschool teachers to use early intervention techniques from the Early Start Denver Model.
Supporting Early Communication Skills of Children With Developmental Disorders in South Africa
Authors: Bornman Juan , Romski MaryAnn , King Marika , Madima Vuledzani , Sevcik Rose A.
Published: August 2020

Using a mobile health application (i.e., app) to empower primary caregivers of young children with developmental disorders in low- and middle-income countries is opening up new avenues for early childhood intervention. Thirteen caregivers and 10 speech–language pathologists participated in 3 focus groups to explore their perspectives about the potential benefits and suitability of a mobile health app as part of intervention, its features, the likelihood of using and recommending it, as well as potential pitfalls to be avoided. Both participant groups were generally positive, although there was little overlap between their responses. Caregivers generally focused on increased knowledge and skills (of all family members), as well as on empowerment and reduced costs. Speech–language pathologists, on the other hand, focused on how current service delivery would be enriched by increasing the dosage of therapy and enhancing parental cooperation. They also expected that the reach of service delivery would be expanded as more children and caregivers could potentially benefit. Although technology (i.e., mobile apps) could open up new possibilities for service delivery in this population, the perspectives of all stakeholder groups should be considered to ensure successful adoption of such technologies.
Qualitative Analysis of Health Systems Utilizing Non-Face-to-Face Chronic Care Management for Medicare-Insured Patients With Diabetes
Authors: Wharton Mary Kristina , Shi Lizheng , Eragoda Shalini , Monnette Alisha M. , Nauman Elizabeth , Price-Haywood Eboni G. , Hu Gang , Bazzano Alessandra N.
Published: August 2020

Chronic diseases impact 117 million adults in the United States and account for $3.3 trillion in health care spending. This qualitative study investigated experiences with reimbursement structure for non-face-to-face (NFF) chronic care management (CCM) through diverse health system approaches in primary care settings in Southeastern Louisiana. In-depth interviews were conducted with 16 purposively selected key informants, and reflexive thematic analysis was utilized to explore findings. Variation in health system approaches for implementing and quality of NFF CCM programs were identified. Results included differences in health system motivation and methods for financial structuring and quality of third-party vendor and alternative models.
Insights on COVID-19 From Community Health Worker State Leaders
Authors: Mayfield-Johnson Susan , Smith Denise O. , Crosby Sara A. , Haywood Catherine G. , Castillo Joelisa , Bryant-Williams Dolontria , Jay Kim , Seguinot Milagrosa , Smith Treva , Moore Nicole , Wennerstrom Ashley
Published: August 2020

Community health workers (CHWs) leverage their trusting relationships with underresourced populations to promote health equity and social justice in their communities. Little is known about CHWs roles in addressing COVID-19 or how the pandemic may have affected CHWs' ability to interact with and support communities experiencing disparities. A focus group with CHW leaders from 7 states revealed 8 major themes: CHW identity, CHW resiliency, self-care, unintended positives outcomes of COVID-19, technology, resources, stressors, and consequences of COVID-19. Understanding the pandemic's impact on CHWs has implications for workforce development, training, and health policies.
Current methods of measuring platelet activity: pros and cons
Authors: Mansouritorghabeh Hassan , de Laat Bas , Roest Mark
Published: August 2020

Platelets play a pivotal role in controlling hemorrhaging from vessels of the human body. The impairment of platelets may lead to the development of bleeding manifestations. Unraveling the precise defects of platelets by means of suitable laboratory methods paves the way for the effective control and management of platelet disorders. Choosing the most appropriate approach for the detection of platelet disorders may be difficult for a researcher or clinical internist when faced with ordering a platelet-function test. The aim of the current study was to provide a user-friendly overview of the advantages and disadvantages of the available detection systems. To reach this goal, 11 commonly used methods of studying platelet activity were evaluated and compared in detail. A literature search, with no time or language limitations, was conducted in Google Scholar and Medline. All publications published before June 2019 were analyzed. The following laboratory methods were compared: number and size of platelets, bleeding time, clot retraction time, platelet function assay 100 & 200, Rapid platelet function assay, flow cytometry, light transmission aggregometry, multiple electrode aggregometry, 96-well plate aggregometry, cone and plate(let) analyzer (Impact-R), and Plateletworks (single platelet counting system). This article provides the reader with a rapid comparison of the different systems used to study platelets activities.
Bone conduction implants
Authors: Richards John P. , Symms John T. , Beasley Kerry , Coffman Heather M.S.
Published: August 2020

Purpose of review

To discuss the different types of bone conduction implants available today and describe the types of hearing loss that could benefit from bone conduction implants.

Recent findings

Bone conduction implants have been used successfully for over two decades. However, there have been barriers to their use because of skin complications and limited high-frequency hearing gains. Recently developed technologies, such as active bone conduction implants may overcome some of these limitations, potentially opening the door for improved aided benefit and increased patient satisfaction from bone conduction amplification.

A variety of bone conduction implants currently exist, with suitable amplification options available for many different types and severities of hearing loss and patient preferences.
Maternal History of Adverse Childhood Experiences and Ambulatory Blood Pressure in Pregnancy
Authors: Bublitz Margaret H. , Ward Laura G. , Simoes Meera , Stroud Laura R. , Salameh Myriam , Bourjeily Ghada
Published: August 2020

Objective

This study aimed to study the association between maternal history of childhood adversity and blood pressure in pregnancy.

Methods

A total of 127 pregnant women completed measures of adverse childhood experiences (ACE) and prenatal stress between June 2015 and April 2019. At 11 weeks’ gestation (range, 6–17 weeks), we measured 24-hour ambulatory blood pressure. All women were considered to be at risk for pregnancy complications due to elevated body mass index and self-reporting snoring in pregnancy.

Results

Women were, on average, 30 years old (range, 19–40 years), and average (standard deviation) body mass index in this sample was 34 (7) kg/m2 (range, 27–55 kg/m2). Higher ACE scores were associated with higher nighttime blood pressure (systolic blood pressure: β = 0.23, p = .013; diastolic blood pressure: β = 0.22, p = .028). There were no significant associations between the ACE score and daytime blood pressure. Women with four or more ACEs were more likely to display nocturnal blood pressure nondipping (odds ratio = 3.97, 95% confidence interval = 1.38–11.40). Associations between ACE and nocturnal blood pressure remained significant after adjusting for symptoms of prenatal stress.

Conclusions

Results indicate that experiences of childhood adversity are associated with elevated nocturnal blood pressure and loss of a typical decline in blood pressure between day and night.
Optimism and Cardiovascular Health: Longitudinal Findings From the Coronary Artery Risk Development in Young Adults Study
Authors: Boehm Julia K. , Qureshi Farah , Chen Ying , Soo Jackie , Umukoro Peter , Hernandez Rosalba , Lloyd-Jones Donald , Kubzansky Laura D.
Published: August 2020

Objective

Favorable cardiovascular health is associated with greater longevity free of cardiovascular disease. Although the prevalence of cardiovascular health decreases with age, less is known about protective factors that promote and preserve it over time. We investigated whether optimism was associated with better cardiovascular health over a 10-year period.

Methods

Participants included 3188 Black and White men and women from the Coronary Artery Risk Development in Young Adults study. Self-reported optimism was assessed in 2000 (this study’s baseline) with the revised Life Orientation Test. Favorable cardiovascular health was defined by healthy status on five components of cardiovascular functioning that were repeatedly assessed through 2010 either clinically or via self-report (blood pressure, lipids, body mass index, diabetes, and smoking status). Linear mixed-effects models examined whether optimism predicted cardiovascular health over time, adjusting for covariates such as sociodemographic characteristics, health behaviors, health status, and depression diagnosis.

Results

In models adjusting for sociodemographic characteristics, optimism was associated with better cardiovascular health across all time points (β = 0.08, 95% confidence interval = 0.04–0.11, p ≤ .001) but not with rate of change in cardiovascular health. Findings were similar when adjusting for additional covariates. Optimism did not interact significantly with race (p = .85) but did with sex, such that associations seemed stronger for women than for men (p = .03).

Conclusions

Optimism may contribute to establishing future patterns of cardiovascular health in adulthood, but other factors may be more strongly related to how slowly or quickly cardiovascular health deteriorates over time.