bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon starvation reduces carbohydrate and anthocyanin accumulation in red‐fleshed fruit via trehalose 6‐phosphate and MYB27
Authors: Nardozza Simona , Boldingh Helen L. , Kashuba M. Peggy , Feil Regina , Jones Dan , Thrimawithana Amali H. , Ireland Hilary S. , Philippe Marine , Wohlers Mark W. , McGhie Tony K. , Montefiori Mirco , Lunn John E. , Allan Andrew C. , Richardson Annette C.
Published: December 2019

Kiwifruit (Actinidia spp.) is a recently domesticated fruit crop with several novel‐coloured cultivars being developed. Achieving uniform fruit flesh pigmentation in red genotypes is challenging. To investigate the cause of colour variation between fruits, we focused on a red‐fleshed Actinidia chinensis var. chinensis genotype. It was hypothesized that carbohydrate supply could be responsible for this variation. Early in fruit development, we imposed high or low (carbon starvation) carbohydrate supplies treatments; carbohydrate import or redistribution was controlled by applying a girdle at the shoot base. Carbon starvation affected fruit development as well as anthocyanin and carbohydrate metabolite concentrations, including the signalling molecule trehalose 6‐phosphate. RNA‐Seq analysis showed down‐regulation of both gene‐encoding enzymes in the anthocyanin and carbohydrate biosynthetic pathways. The catalytic trehalose 6‐phosphate synthase gene TPS1.1a was down‐regulated, whereas putative regulatory TPS7 and TPS11 were strongly up‐regulated. Unexpectedly, under carbon starvation MYB10, the anthocyanin pathway regulatory activator was slightly up‐regulated, whereas MYB27 was also up‐regulated and acts as a repressor. To link these two metabolic pathways, we propose a model where trehalose 6‐phosphate and the active repressor MYB27 are involved in sensing the carbon starvation status. This signals the plant to save resources and reduce the production of anthocyanin in fruits.
Debunking arguments
Authors: Korman Daniel Z.
Published: December 2019

Debunking arguments—also known as etiological arguments, genealogical arguments, access problems, isolation objections, and reliability challenges—arise in philosophical debates about a diverse range of topics, including causation, chance, color, consciousness, epistemic reasons, free will, grounding, laws of nature, logic, mathematics, modality, morality, natural kinds, ordinary objects, religion, and time. What unifies the arguments is the transition from a premise about what does or doesn't explain why we have certain mental states to a negative assessment of their epistemic status. I examine the common, underlying structure of the arguments and the different strategies for motivating and resisting the premises of debunking arguments.
A multivariate investigation of visual word, face, and ensemble processing: Perspectives from EEG‐based decoding and feature selection
Authors: Nemrodov Dan , Ling Shouyu , Nudnou Ilya , Roberts Tyler , Cant Jonathan S. , Lee Andy C. H. , Nestor Adrian
Published: December 2019

Recent investigations have focused on the spatiotemporal dynamics of visual recognition by appealing to pattern analysis of EEG signals. While this work has established the ability to decode identity‐level information (such as the identity of a face or of a word) from neural signals, much less is known about the precise nature of the signals that support such feats, their robustness across visual categories, or their consistency across human participants. Here, we address these questions through the use of EEG‐based decoding and multivariate feature selection as applied to three visual categories: words, faces and face ensembles (i.e., crowds of faces). Specifically, we use recursive feature elimination to estimate the diagnosticity of time and frequency‐based EEG features for identity‐level decoding across three datasets targeting each of the three categories. We then relate feature diagnosticity across categories and across participants while, also, aiming to increase decoding performance and reliability. Our investigation shows that word and face processing are similar in their reliance on spatiotemporal information provided by occipitotemporal channels. In contrast, ensemble processing appears to also rely on central channels and exhibits a similar profile with word processing in the frequency domain. Further, we find that feature diagnosticity is stable across participants and is even capable of supporting cross‐participant feature selection, as demonstrated by systematic boosts in decoding accuracy and feature reduction. Thus, our investigation sheds new light on the nature and the structure of the information underlying identity‐level visual processing as well as on its generality across categories and participants.
Why Does Workplace Gender Diversity Matter? Justice, Organizational Benefits, and Policy
Authors: Fine Cordelia , Sojo Victor , Lawford‐Smith Holly
Published: December 2019

Why does workplace gender diversity matter? Here, we provide a review of the literature on both justice‐based and organizational benefits of workplace gender diversity that, importantly, is informed by evidence regarding sex differences and their relationship with vocational behavior and outcomes. This review indicates that the sexes are neither distinctly different, nor so similar as to be fungible. Justice‐based gains of workplace gender diversity include that it may cause less sex discrimination and may combat androcentrism in products and services. We then consider potential instrumental benefits of workplace gender diversity to organizations, including for team and firm performance, innovation, occupational well‐being, and corporate governance. The evidence of positive association is currently strongest for occupational well‐being and governance. We recommend that policy makers ground gender diversity initiatives in this comprehensive and evidence‐based understanding of the benefits of workplace gender diversity.
Twenty four‐hour activity cycle in older adults using wrist‐worn accelerometers: The seniors‐ENRICA‐2 study
Authors: Cabanas‐Sánchez Verónica , Esteban‐Cornejo Irene , Migueles Jairo H. , Banegas José Ramón , Graciani Auxiliadora , Rodríguez‐Artalejo Fernando , Martínez‐Gómez David
Published: December 2019

Objectives

This study aimed: (a) to provide a detailed description of sleep, sedentary behavior (SED), light physical activity (LPA), and moderate‐to‐vigorous physical activity (MVPA) over the complete 24‐hours period using raw acceleration data in older adults; and (b) to examine the differences in the 24‐hours activity cycle by sex, age, education, and body mass index (BMI).

Methods

Population‐based cohort comprising 3273 community‐dwelling individuals (1739 women), aged 71.8 ± 4.5 years, participating in the Seniors‐ENRICA‐2 study. Participants wore a wrist‐worn ActiGraph GT9X accelerometer for 7 consecutive days, and the raw signal was processed using the R‐package GGIR.

Results

Participants reached 21.5 mg as mean acceleration over the whole day; 32.3% (7.7 h/d) of time was classified as sleep, 53.2% (12.7 h/d) as SED, 10.4% (148.6 min/d) as LPA, and 4.1% (59.0 min/d) as MVPA. No marked differences were found in sleep‐related variables between socio‐demographic and BMI groups. However, women showed higher LPA but lower SED and MVPA than men. Moreover, SED increased whereas LPA and MVPA decreased with age. Participants with obesity (BMI ≥ 30 kg/m2) accumulated more SED and less LPA and MVPA than those without obesity. As expected, adherence to physical activity recommendations varied widely (9.2%‐76.6%) depending on the criterion of MVPA accumulation.

Conclusion

Objective assessment of the 24‐hour activity cycle provides extensive characterization of daily activities distribution in older adults and may inform health‐promotion interventions in this population. Women, the oldest old, and those with obesity offer relevant targets of strategies to improve lifestyle patterns.
Mean squared error of ridge estimators in logistic regression
Authors: Blagus Rok , Goeman Jelle J.
Published: December 2019

It is well known that the maximum likelihood estimator (MLE) is inadmissible when estimating the multidimensional Gaussian location parameter. We show that the verdict is much more subtle for the binary location parameter. We consider this problem in a regression framework by considering a ridge logistic regression (RR) with three alternative ways of shrinking the estimates of the event probabilities. While it is shown that all three variants reduce the mean squared error (MSE) of the MLE, there is at the same time, for every amount of shrinkage, a true value of the location parameter for which we are overshrinking, thus implying the minimaxity of the MLE in this family of estimators. Little shrinkage also always reduces the MSE of individual predictions for all three RR estimators; however, only the naive estimator that shrinks toward 1/2 retains this property for any generalized MSE (GMSE). In contrast, for the two RR estimators that shrink toward the common mean probability, there is always a GMSE for which even a minute amount of shrinkage increases the error. These theoretical results are illustrated on a numerical example. The estimators are also applied to a real data set, and practical implications of our results are discussed.
Role of salt supplementation on vasovagal reactions in young whole blood donors
Authors: Kumar Karan , Sachdev Suchet , Marwaha Neelam , Sharma Ratti Ram
Published: December 2019

Background

The physiologic interventions to prevent vasovagal reactions (VVRs) have been published evaluating water loading, applied muscle tension and salt loading on immediate VVRs (IVVRs), but the effect of salt on delayed VVRs (DVVRs) has not been evaluated.

Materials and Methods

Randomized controlled study was conducted enrolling 3060 donors in age group 18–25 years. Control group (CG) donors were given 300 ml of sweetened lime water, with additional 2·5 g salt added in the test group (TG).

Results

There were 90 VVRs in 3060 (2·94%, 1 in 34) young college‐going whole blood donors in the present study. This included 57 IVVRs (1·86%, 1 in 54) and 33 DVVRs (1·08%, 1 in 93). There were 53 VVRs (3·49%, 1 in 29) in the CG and 37 VVRs (2·39%, 1 in 57) in the TG, with absolute risk reduction (ARR) of 1·1%. There were 30 IVVRs (1·98%, 1 in 51) in CG and 27 IVVRs (1·74%, 1 in 57) in TG, with ARR of 0·2%%. Significantly, there were 23 DVVRs (1·51%, 1 in 67) in CG and only 10 DVVRs (0·65%, 1 in 154) in the TG, with ARR of 0·9%. One thousand (1000), five hundred (500) and one hundred and eleven (111) young whole donors need to be given 2·5 g of salt supplementation in fluid medium to prevent one VVR, IVVR and DVVR, respectively. The odds and the adjusted odds (AOR) of occurrence of DVVRs were 2·36, 95% CI (1·12–4·98) and 2·40, 95% CI (1·13–5·07) in the CG as against in the TG, on binary and multivariable logistic regression, respectively.

Conclusion

There is an overall trend of decrease in VVRs with salt loading in young college‐going whole blood donors, which is statistically evident in the case of DVVRs.
Regional respiratory movement of the tongue is coordinated during wakefulness and is larger in severe obstructive sleep apnoea
Authors: Jugé Lauriane , Knapman Fiona L. , Burke Peter G.R. , Brown Elizabeth , Bosquillon de Frescheville Anne France , Gandevia Simon C. , Eckert Danny J. , Butler Jane E. , Bilston Lynne E.
Published: December 2019

Key points

Coordination of the neuromuscular compartments of the tongue is critical to maintain airway patency. Currently, little is known about the extent to which regional tongue dilatory motion is coordinated in heathy people and if this coordination is altered in people with obstructive sleep apnoea (OSA).

We show that regional tongue muscle coordination in people with and without OSA during wakefulness is associated with effective airway dilatation during inspiration, using dynamic tagged magnetic resonance imaging. The maximal movement of four compartments of the tongue were correlated and occurred concurrently towards the end of inspiration.

If tongue movement was observed, people with more severe OSA had larger movement and moved more compartments (up to four) to maintain airway patency, while people without OSA moved only one compartment.

These results suggest that airway patency is preserved during wakefulness in people with OSA via active dilatory movement of the genioglossus.

Maintaining airway patency when supine requires neural drive to the genioglossus horizontal and oblique neuromuscular compartments (superior fan‐like and inferior horizontal genioglossus, regions that are innervated by different branches of the hypoglossal nerve) to be coordinated during breathing, but it is unknown if this coordination is altered in obstructive sleep apnoea (OSA). This study aimed to assess coordination of airway dilatory motion across four mid‐sagittal tongue compartments during inspiration (i.e. anterior and posterior of the horizontal and oblique compartments), and compare it in controls and OSA patients. Fifty‐four participants (12 women, aged 20–73 years) underwent dynamic ‘tagged’ magnetic resonance imaging during wakefulness. Ten participants had no OSA [apnoea hypopnoea index (AHI) < 5 events h–1], 14 had mild OSA (5 < AHI ≤ 15 events h–1), 12 had moderate OSA (15 < AHI ≤ 30 events h–1) and 18 had severe OSA (AHI > 30 events h–1). A higher AHI was associated with a greater anterior movement of the anterior and posterior horizontal compartments (Spearman, r = −0.32, P = 0.02 for both), but not in the oblique compartments. If movement was observed, higher OSA severity was associated with an anterior movement of a greater number of compartments. Controls only moved the posterior horizontal compartment while the anterior horizontal compartment also moved in OSA participants. Oblique compartments moved only in people with severe OSA. The maximal anterior inspiratory movement of the four compartments was highly correlated (Spearman, P < 0.001) and occurred concurrently. The posterior horizontal compartment had the greatest anterior motion. These results suggest that airway patency is preserved during wakefulness in people with OSA via active dilatory movement of the genioglossus.
La evolución del discurso de la gestión empresarial a través de la literatura gerencial. Hacia la constitución del sujeto neoliberal
Authors: Medina - Vicent María
Published: December 2019

En el presente artículo se pretende reflexionar en torno a los principales rasgos de la literatura gerencial, poniendo especial énfasis en su capacidad de adaptarse a los cambios históricos que se dan en el sistema económico para amoldar las subjetividades contemporáneas a las necesidades de dicho sistema. Con el fin de conseguir este objetivo, se explorará el potencial del storytelling de estas obras a la hora de establecer prescripciones de comportamiento a sus lectores/as, y nos enfocaremos en las argumentaciones morales que priman en el discurso gerencial actual, y en el proceso de mercantilización y formación del nuevo sujeto neoliberal al que contribuyen.
CFD Simulation of Semi-Submersible Floating Offshore Wind Turbine Under Pitch Decay Motion
Authors: Wang Yu , Chen Hamn-Ching , Vaz Guilherme , Burmester Simon
Published: December 2019

The application of a computational fluid dynamics (CFD) code to simulate the response of a semi-submersible floating wind turbine under pitch decay motion was investigated in this study. Estimation of the natural period, the hydrodynamic damping and the flow characteristics were the main focus of this study. An extensive verification study of the simulation results was conducted to improve the confidence and reliability of the numerical simulation by the estimation of the numerical errors and uncertainties. The time series of pitch motion was plotted against model test data. In addition, the pitch period and hydrodynamic damping were calculated and compared to experimental data. Detailed flow characteristics as vorticity field and hydrodynamic pressure field on the floater surface were illustrated after post processing of the computational data. The results of the flow characteristics suggest that the heave damping plates were a major contributor to the hydrodynamic damping of this floater in pitch decay.
Optimization of the Dynamic Response of Semi-Submersibles: Influence of the Mooring System
Authors: Zhou Shengtao , Lemmer Frank , Yu Wei , Cheng Po Wen , Li Chao , Xiao Yiqing
Published: December 2019

The design and manufacturing cost of substructures is a major component of the total expenditure for a floating wind project. Applying optimization techniques to hull shape designs has become an effective way to reduce the life-cycle cost of a floating wind system. The mooring system is regarded as the component with the highest risk, mainly due to the poor accessibility. This paper extends the previous work by investigating the influences of the mooring design on the optimization process of a semisubmersible substructure. Two optimization loops are set up. In the first loop, only the main dimensions of a semi-submersible platform are parameterized without considering mooring lines (keep a constant mooring design). Nevertheless, the second loop introduces additional variables of the mooring lines. The objective is to minimize the tower-top displacement, fairlead fatigue damage, which are calculated by the in-house nonlinear dynamic simulation code SLOW, and the manufacturing cost of platform and mooring lines. The multi-objective optimization algorithm NSGA-II is employed to search for the optimal designs within the defined design space. The design space and the Pareto fronts are compared between the two optimizations. It is found that, although the mooring design does not have a significant impact on the platform design space, one obtains a different optimal set (Pareto front) if the mooring design and mooring loads are introduced into the platform optimization process. The results of this study are expected to give a better understanding in the relationship between platform and mooring design and serve as a basis for the optimization process of semi-submersible floating wind turbines.
Physical Model Testing of the TetraSpar Demo Floating Wind Turbine Prototype
Authors: Borg Michael , Viselli Anthony , Allen Christopher K. , Fowler Matthew , Sigshøj Christoffer , Grech La Rosa Andrea , Andersen Morten Thøtt , Stiesdal Henrik
Published: December 2019

As part of the process of deploying new floating offshore wind turbines, scale model testing is carried out to de-risk and verify the design of novel foundation concepts. This paper describes the testing of a 1:43 Froude-scaled model of the TetraSpar Demo floating wind turbine prototype that shall be installed at the Metcentre test facility, Norway. The TetraSpar floating foundation concept consists of a floater tetrahedral structure comprising of braces connected together through pinned connections, and a triangular keel structure suspended below the floater by six suspension lines. A description of the experimental setup and program at the Alfond W2 Ocean Engineering Lab at University of Maine is given. The objective of the test campaign was to validate the initial design, and contribute to the development of the final demonstrator design and numerical models. The nonlinear hydrodynamic characteristics of the design are illustrated experimentally and the keel suspension system is shown to satisfy design criteria.
Substructure Flexibility and Member-Level Load Capabilities for Floating Offshore Wind Turbines in OpenFAST
Authors: Jonkman Jason M. , Damiani Rick R. , Branlard Emmanuel S. P. , Hall Matthew , Robertson Amy N. , Hayman Greg J.
Published: December 2019

OpenFAST is an open-source, physics-based engineering tool applicable to the load analysis of land-based and offshore wind turbines, including floating offshore wind turbines. The substructure for a floating wind turbine has historically been modeled in OpenFAST as a rigid body with hydrodynamic loads lumped at a point, which enabled the tool to predict the global response of the floating substructure but not the structural loads within its individual members. This limitation is an impediment to designing floating substructures — especially newer designs that are more streamlined, flexible, and cost-effective. This paper presents the development plan of new capabilities in OpenFAST to model floating substructure flexibility and member-level loads, including the functional requirements and modeling approaches needed to understand and apply them correctly.
Effects of Four Moon Pools on a Floating System Installed With Twin-VAWTs
Authors: Ikoma Tomoki , Nakamura Mitsuru , Moritsu Satsuya , Aida Yasuhiro , Masuda Koichi , Eto Hiroaki
Published: December 2019

This paper describes characteristics of motion responses and tether tensions of a floating structure with four moon pools, on which one or two vertical axis wind turbine models are installed. Effects of several moon pools founded in a floating structure on motion characteristics have been unclear.

In this study, the authors proposed a twin-VAWT installed floating system, which was a pontoon based structure. However four moon pools were set on. The study conducted model experiments in a wave tank using regular waves with 0.6 to 2.0 seconds in wave periods and 0.02 and 0.04 m in wave height. The model had four moon pools and was installed with one or two vertical axis turbine models. From it, gyroscopic moment effects were investigated. Besides, the study performed numerical calculations with the linear potential theory based method which were a Green function method.

As a results, responses of the twin-turbine model are not affected by gyroscopic moment. The study discusses motion responses and tether tensions with nonlinear behaviours from mainly the experimental results. Also the effect of moon pools were investigated from the calculations. From comparisons of motion results on calculation models with same displacement but different draft, the results suggested that not only heave motion but also roll motion could be reduced because of the moon pools if the size of the moon pools were optimized.
Compact chip-scale guided cold atom gyrometers for inertial navigation: Enabling technologies and design study
Authors: Garrido Alzar Carlos L.
Published: December 2019

This work reviews the topic of rotation sensing with compact cold atom interferometers. A representative set of compact free-falling cold atom gyroscopes is considered because, in different respects, they establish a rotation-measurement reference for cold guided-atom technologies. This review first discusses enabling technologies relevant to a set of key functional building blocks of an atom chip-based compact inertial sensor with cold guided atoms. These functionalities concern the accurate and reproducible positioning of atoms to initiate a measurement cycle, the coherent momentum transfer to the atom wave packets, the suppression of propagation-induced decoherence due to potential roughness, on-chip detection, and vacuum dynamics because of its impact on sensor stability, which is due to the measurement dead time. Based on the existing enabling technologies, the design of an atom chip gyroscope with guided atoms is formalized using a design case that treats design elements such as guiding, fabrication, scale factor, rotation-rate sensitivity, spectral response, important noise sources, and sensor stability.
Measuring the success of climate change adaptation and mitigation in terrestrial ecosystems
Authors: Morecroft Michael D. , Duffield Simon , Harley Mike , Pearce-Higgins James W. , Stevens Nicola , Watts Olly , Whitaker Jeanette
Published: December 2019

Measuring mitigation and adaptation

As more and more carbon dioxide is emitted into the atmosphere, humans and the natural world are beset by the damaging consequences of a rapidly changing climate. Natural and seminatural ecosystems are likely to be the best starting place for immediate adaptation and mitigation solutions. First, though, many natural environments need restoration to maximize their own resilience to climate change. In reviewing our options, Morecroft
et al.
point out that we can directly observe the success of mitigation strategies by quantifying atmospheric carbon dioxide. Successful adaptation is more challenging because it involves a range of social and biodiversity measures. However, we could make matters worse if we do not constantly monitor the effects of the interventions we devise and react flexibly as changing conditions unfold.

Science
, this issue p.
eaaw9256
Microglia monitor and protect neuronal function through specialized somatic purinergic junctions
Authors: Cserép Csaba , Pósfai Balázs , Lénárt Nikolett , Fekete Rebeka , László Zsófia I. , Lele Zsolt , Orsolits Barbara , Molnár Gábor , Heindl Steffanie , Schwarcz Anett D. , Ujvári Katinka , Környei Zsuzsanna , Tóth Krisztina , Szabadits Eszter , Sperlágh Beáta , Baranyi Mária , Csiba László , Hortobágyi Tibor , Maglóczky Zsófia , Martinecz Bernadett , Szabó Gábor , Erdélyi Ferenc , Szipőcs Róbert , Tamkun Michael M. , Gesierich Benno , Duering Marco , Katona István , Liesz Arthur , Tamás Gábor , Dénes Ádám
Published: December 2019

Microglia take control

Changes in the activity of microglia, the primary immune cells of the central nervous system, are linked with major human diseases, including stroke, epilepsy, psychiatric disorders, and neurodegeneration. Cserép
et al.
identified a specialized morphofunctional communication site between microglial processes and neuronal cell bodies in the mouse and the human brain (see the Perspective by Nimmerjahn). These junctions are formed at specific areas of the neuronal somatic membranes and possess a distinctive nanoarchitecture and specialized molecular composition linked to mitochondrial signaling. The junctions appear to provide a major site for microglia-neuron communication and may help to mediate the neuroprotective effects of microglia after acute brain injury.

Science
, this issue p.
528
; see also p.
510
Surprising regulation of cell cycle entry
Authors: Sherr Charles J.
Published: December 2019

Structures of heterotrimeric cyclin-dependent kinase 4 complexes reveal the mechanism of drug inhibition
In Vitro
Activity of Ibrexafungerp (SCY-078) against
Candida auris
Isolates as Determined by EUCAST Methodology and Comparison with Activity against
C. albicans
and
C. glabrata
and with the Activities of Six Comparator Agents
Authors: Arendrup Maiken Cavling , Jørgensen Karin Meinike , Hare Rasmus Krøger , Chowdhary Anuradha
Published: December 2019

Ibrexafungerp (SCY-078) is a novel first-in-class antifungal agent targeting glucan synthase.
Candida auris
is an emerging multidrug-resistant species that has caused outbreaks on five continents. We investigated the
in vitro
activity of ibrexafungerp against
C. auris
by applying EUCAST E.Def 7.3.1 methodology.
C. albicans
and
C. glabrata
, as well as anidulafungin, micafungin, amphotericin B, fluconazole, voriconazole, and isavuconazole, were included as comparators.
Nanomolar Responsiveness of an Anaerobic Degradation Specialist to Alkylphenol Pollutants
Authors: Vagts Jannes , Weiten Arne , Scheve Sabine , Kalvelage Kristin , Swirski Sebastian , Wöhlbrand Lars , Neidhardt John , Winklhofer Michael , Rabus Ralf
Published: December 2019

Alkylphenols (like
p
-cresol and
p
-ethylphenol) represent bulk chemicals for industrial syntheses. Besides massive local damage events, large-scale micropollution is likewise of environmental and health concern. Next to understanding how such pollutants can be degraded by microorganisms, it is also relevant to determine the microorganisms’ lower threshold of responsiveness.
Aromatoleum aromaticum
EbN1 is a specialist in anaerobic degradation of aromatic compounds, employing a complex and substrate-specifically regulated catabolic network. The present study aims at verifying the predicted role of the PcrSR system in sensing
p
-cresol and at determining the threshold of responsiveness for alkylphenols. The findings have implications for the enigmatic persistence of dissolved organic matter (escape from biodegradation) and for the lower limits of aromatic compounds required for bacterial growth.
Draft Genome Sequence of an Escherichia coli Sequence Type 410 Isolate Harboring
bla
NDM-5
Genes with
gyrA
and
parE
Mutations, Isolated from Urine Culture in China
Authors: Huang Junwei , Ma Shanshan , Yu Qian , Fu Miao , Shao Lingli
Published: December 2019

Escherichia coli
sequence type 410 (ST410) is now an international high-risk clone and is responsible for a large number of clinical infections. Here, we report the draft genome sequence of an ST410 clinical isolate harboring multiple
bla
NDM-5
genes that was obtained from urine culture in China.
Spatiotemporal patterns of distributed slip in southern Owens Valley indicated by deformation of late Pleistocene shorelines, eastern California
Authors: Bacon Steven N. , Bullard Thomas F. , Keen-Zebert Amanda K. , Jayko Angela S. , Decker David L.
Published: December 2019

High-resolution elevation surveys of deformed late Pleistocene shorelines and new luminescence dating provide improved constraints on spatiotemporal patterns of distributed slip between normal and strike-slip faulting in southern Owens Valley, eastern California. A complex array of five subparallel faults, including the normal Sierra Nevada frontal fault and the oblique-normal Owens Valley fault, collectively form an active pull-apart basin that has developed within a dextral transtensional shear zone. Spatiotemporal patterns of slip are constrained by post–IR-IRSL (post-infrared–infrared stimulated luminescence) dating of a 40.0 ± 5.8 ka highstand beach ridge that is vertically faulted and tilted up to 9.8 ± 1.8 m and an undeformed suite of 11–16 ka beach ridges. The tectono-geomorphic record of deformed beach ridges and alluvial fans indicates that both normal and dextral faulting occurred between the period of ca. 16 and 40 ka, whereas dextral faulting has been the predominant style of slip since ca. 16 ka. A total extension rate of 0.7 ± 0.2 mm/yr resolved in the N72°E direction across all faults in Owens Lake basin is within error of geodetic estimates, suggesting extension has been constant during intervals of 101–104 yr. A new vertical slip rate of 0.13 ± 0.04 m/k.y. on the southern Owens Valley fault from deformed 160 ± 32 ka shoreline features also suggests constant slip for intervals up to 105 yr when compared to paleoseismic vertical slip rates from the same fault segment. This record supports a deformation mechanism characterized by steady slip and long interseismic periods of 8–10 k.y. where the south-central Owens Valley fault and Sierra Nevada frontal fault form a parallel fault system.
Measurement error, microcephaly prevalence and implications for Zika: an analysis of Uruguay perinatal data
Authors: Harville Emily W , Buekens Pierre M , Cafferata Maria Luisa , Gilboa Suzanne , Tomasso Giselle , Tong Van
Published: December 2019

Background and objective

The Zika virus outbreak has drawn attention to microcephaly, whose definition is based on head circumference measuring below a percentile or number of SDs below the mean. The objective of this analysis was to assess how differences in measurement precision might affect prevalence and trends of microcephaly.

Methods

Data from all births in Uruguay during 2010–2015 were obtained from the Perinatal Information System. The prevalence of births with microcephaly was calculated based on head circumference measurement at birth applying the INTERGROWTH-21st standards for sex and gestational age, and compared by method of ascertaining gestational age.

Results

Rounding and digit preference was observed: 74% of head circumference measurements were reported as a whole centimetre value. The prevalence of births varied substantially by the criterion used to define microcephaly (<3 SD, <2 SD, <3rd percentile for gestational age) and could be halved or doubled based on adding or subtracting a half-centimetre from all reported head circumference measurements. If 4 days were added to gestational age calculations, rather than using completed gestational weeks (without days) for gestational age reporting, the prevalence was 1.7–2 times higher.

Discussion

Rounding in measurement of head circumference and reporting preferences of gestational age may have contributed to a lower prevalence of microcephaly than expected in this population. Differences in head circumference measurement protocols and gestational age dating have the potential to affect the prevalence of babies reported with microcephaly, and this limitation should be acknowledged when interpreting head circumference data collected for surveillance.
Event-based surveillance at health facility and community level in low-income and middle-income countries: a systematic review
Authors: Kuehne Anna , Keating Patrick , Polonsky Jonathan , Haskew Christopher , Schenkel Karl , Le Polain de Waroux Olivier , Ratnayake Ruwan
Published: December 2019

Background

The International Health Regulations require member states to establish “capacity to detect, assess, notify and report events”. Event-based surveillance (EBS) can contribute to rapid detection of acute public health events. This is particularly relevant in low-income and middle-income countries (LMICs) which may have poor public health infrastructure. To identify best practices, we reviewed the literature on the implementation of EBS in LMICs to describe EBS structures and to evaluate EBS systems.

Methods

We conducted a systematic literature search of six databases to identify articles that evaluated EBS in LMICs and additionally searched for grey literature. We used a framework approach to facilitate qualitative data synthesis and exploration of patterns across and within articles.

Results

We identified 778 records, of which we included 15 studies concerning 13 different EBS systems. The 13 EBS systems were set up as community-based surveillance, health facility-based surveillance or open surveillance (ie, notification by non-defined individuals and institutions). Four systems were set up in outbreak settings and nine outside outbreaks. All EBS systems were integrated into existing routine surveillance systems and pre-existing response structures to some extent. EBS was described as useful in detecting a large scope of events, reaching remote areas and guiding outbreak response.

Conclusion

Health facility and community-based EBS provide valuable information that can strengthen the early warning function of national surveillance systems. Integration into existing early warning and response systems was described as key to generate data for action and to facilitate rapid verification and response. Priority in its implementation should be given to settings that would particularly benefit from EBS strengths. This includes areas most prone to outbreaks and where traditional ‘routine’ surveillance is suboptimal.
Diffusion of knowledge and behaviours among trainee doctors in an acute medical unit and implications for quality improvement work: a mixed methods social network analysis
Authors: Sullivan Paul , Saatchi Ghazal , Younis Izaba , Harris Mary Louise
Published: December 2019

Objectives

To describe the social networks that diffuse knowledge, attitudes and behaviours relating to different domains of practice within teams of trainee doctors in an acute hospital medical setting. The domains examined were ‘clinical-technical’, ‘patient centredness’ and ‘organisation of work’.

Design

Sequential mixed methods: (i) sociocentric survey of trainee consisting of questions about which colleagues are emulated or looked to for advice, with construction of social network maps, followed by (ii) semi-structured interviews regarding peer-to-peer influence, analysed using a grounded theory approach. The study took place over 24 months.

Setting

An acute medical admissions unit, which receives admissions from the emergency department and primary care, in a National Health Service England teaching hospital.

Participants

Trainee medical doctors working in five consecutive rotational teams. Surveys were done by 39 trainee doctors; then 15 different participants from a maximal diversity sample were interviewed.

Results

Clinical-technical behaviours spread in a dense network with rich horizontal peer-to-peer connections. Patient-centred behaviours spread in a sparse network. Approaches to non-patient facing work are seldom copied from colleagues. Highly influential individuals for clinical technical memes were identified; high influencers were not identified for the other domains.

Conclusion

Information and influence relating to different aspects of practice have different patterns of spread within teams of trainee doctors; highly influential individuals were important only for spread of clinical-technical practice. Influencers have particular characteristics, and this knowledge could guide leaders and teachers.
Conceptualising post-stroke fatigue: a cross-sectional survey of UK-based physiotherapists and occupational therapists
Authors: Thomas Karen , Hjalmarsson Clarissa , Mullis Ricky , Mant Jonathan
Published: December 2019

With survival after stroke improving, more people are discharged into the community with multiple and persistent deficits. Fatigue is a common unmet need for stroke survivors, but there are no evidence-based guidelines for its assessment and management. This study explored how UK-based therapists conceptualise post-stroke fatigue (PSF) in current practice.

Objective

To describe current understanding of PSF among physiotherapists (PT) and occupational therapists (OT).

Design

A cross-sectional online survey using Qualtrics software (a survey creation and analysis programme) was sent to therapists working with stroke survivors in 2019. Responses to the open ended question, ‘How would you describe PSF if approached by another healthcare professional?’ were analysed thematically by two independent researchers.

Participants

137 survey respondents (71 PT and 66 OT) from a range of clinical settings (25 acute care, 24 sub-acute rehabilitation care, 3 primary care and 85 community care) with 7 months-36 years of experience working with stroke survivors completed the survey.

Results

Respondents stated that PSF should be regarded as an important medical condition because it is common and can be associated with severe symptoms. Symptoms were perceived to be highly variable and the syndrome was difficult to define objectively. It was felt to have both physical and cognitive components. A variety of different opinions were expressed with regard to causation, conceptualisation and best management.

Conclusion

Therapists working with stroke survivors conceptualise and manage PSF in different ways. Clinical practice is hampered by a lack of a widely adopted definition, and a small evidence base. Research into causes and management of PSF is a priority.
Paediatric palliative care: a systematic review
Authors: Nilsson Stefan , Ohlen Joakim , Hessman Eva , Brännström Margareta
Published: December 2019

Objectives

To review literature relating to evidence, context and facilitation to describe knowledge translation in paediatric palliative care. Paediatric palliative care requires competences including both paediatric specialists as well as services that are developed for this purpose, and there is a need to facilitate paediatric palliative care knowledge translation. Promoting Action on Research Implementation in the Health Services (PARiHS) is a framework for knowledge translation, which highlights the relationships between evidence, context and facilitation. PARiHS framework has been revised and updated in a new version called i-PARiHS.

Methods

The electronic databases AgeLine, CINAHL, The Cochrane Library, PsycINFO, PubMed and Scopus were searched. Papers included were limited to English and Swedish publications and restricted to publications dated between 1993 and August 2019. All types of observational and experimental studies using any research design were included.

Results and conclusions

Thirty-eight articles were included and there was a common vision about how and when palliative care should be offered to children. The i-PARiHS was used as a lens to describe the knowledge translation in paediatric palliative care. Symptom relief was the most commonly described evidence-based strategy, and the hospital environment was the most commonly described context. Different types of education were the most commonly used strategies to facilitate knowledge translation. The results mainly focused on increasing knowledge of palliative care in paediatric care. To sum up, the results report strategies to achieve knowledge translation of paediatric palliative care, and these can be interpreted as a guideline for how this process can be facilitated.

Trial registration number

CRD42018100663.
Non-alcoholic fatty liver disease (NAFLD) in non-obese individuals
Authors: Phipps Meaghan , Wattacheril Julia
Published: December 2019

Individuals with non-alcoholic fatty liver disease (NAFLD) who lack classical risk factors also have the ability to develop nonalcoholic steatohepatitis (NASH) and progression to more advanced liver disease. The pathophysiology and risk factors for the development of NAFLD in non-obese persons are not fully understood but seem to be closely related to insulin resistance, atherogenic dyslipidaemia and alterations in body composition, with some patients harbouring predisposing genetic polymorphisms. In normal-weight individuals, also called ‘lean’, there is limited potential for effective lifestyle change in disease management. Additionally, biological mechanisms underlying the development of NASH in non-obese individuals may reveal novel targets for intervention. In this review, the authors discuss the clinical, histological and genetic features and risk factors for non-obese NAFLD and highlight gaps in knowledge and areas for future research.
Ischaemic colitis: practical challenges and evidence-based recommendations for management
Authors: Hung Alex , Calderbank Tom , Samaan Mark A , Plumb Andrew A , Webster George
Published: December 2019

Ischaemic colitis (IC) is a common condition with rising incidence, and in severe cases a high mortality rate. Its presentation, severity and disease behaviour can vary widely, and there exists significant heterogeneity in treatment strategies and resultant outcomes. In this article we explore practical challenges in the management of IC, and where available make evidence-based recommendations for its management based on a comprehensive review of available literature. An optimal approach to initial management requires early recognition of the diagnosis followed by prompt and appropriate investigation. Ideally, this should involve the input of both gastroenterology and surgery. CT with intravenous contrast is the imaging modality of choice. It can support clinical diagnosis, define the severity and distribution of ischaemia, and has prognostic value. In all but fulminant cases, this should be followed (within 48 hours) by lower gastrointestinal endoscopy to reach the distal-most extent of the disease, providing endoscopic (and histological) confirmation. The mainstay of medical management is conservative/supportive treatment, with bowel rest, fluid resuscitation and antibiotics. Specific laboratory, radiological and endoscopic features are recognised to correlate with more severe disease, higher rates of surgical intervention and ultimately worse outcomes. These factors should be carefully considered when deciding on the need for and timing of surgical intervention.
Comparison of medium to long-term outcomes of acute severe ulcerative colitis patients receiving accelerated and standard infliximab induction
Authors: Gibson David J , Doherty Jayne , McNally Mairead , Campion John , Keegan Denise , Keogh Aine , Kennedy Una , Byrne Kathryn , Egan Laurence J , McKiernan Susan , MacCarthy FInbar , Sengupta Subhasish , Sheridan Juliette , Mulcahy Hugh E , Cullen Garret , Slattery Eoin , Kevans David , Doherty Glen A
Published: December 2019

Introduction

Accelerated dose infliximab (IFX) induction is associated with reduced short-term colectomy rate in acute severe ulcerative colitis (ASUC). Data on medium/long-term outcomes of this strategy are limited.

Aims

Evaluate medium/long-term outcomes in patients receiving IFX induction for ASUC, comparing accelerated dose (AD) and standard dose (SD) induction.

Methods

Retrospective study of consecutive patients admitted with corticosteroid-refractory ASUC in four tertiary referral centres within INITIative IBD research network (www.initiativeibd.ie). IFX rescue was given either as SD (weeks 0, 2, 6) or AD (<28 days) from January 2010 to September 2017. AD induction has been utilised in participating centres since 2014. Consequently SD patients were subdivided based on time period of IFX rescue: historical SD group (SD1) (2010–2013) and current SD group (SD2) (2014–2017). Primary endpoint was time to colectomy; secondary endpoint was time to IFX discontinuation if induction was complete.

Results

145 patients received rescue IFX (AD=58, SD1=32, SD2=55). Disease severity at induction was comparable between AD and SD1 groups; however, SD2 group had less severe disease: median C-reactive protein (CRP) 39, 44 and 20 mg/L for AD, SD1 and SD2 groups, respectively (p=0.026, Kruskal-Wallis); median CRP: albumin ratio was 1.4, 1.8 and 0.6 (p=0.016). Median follow-up for AD, SD1 and SD2 groups was 1.6 (IQR 1.1–3.1), 4.9 (IQR 2.6–5.5) and 1.5 (IQR 0.9–2.3) years. Time to colectomy was shorter in SD1 (log rank p=0.0013); no significant difference in time to colectomy was observed comparing AD and SD2 groups (log rank p=0.32). 123 patients (84%) completed IFX induction and received maintenance therapy. Time to IFX discontinuation was shorter in SD1 (log rank p=0.009).

Conclusion

Time to colectomy is significantly prolonged with use of AD IFX in selected ASUC patients with more severe disease. Historical use of standard IFX induction for all ASUC patients is associated with inferior long-term outcomes.
Cardiovascular magnetic resonance: applications and practical considerations for the general cardiologist
Authors: Arnold Jayanth Ranjit , McCann Gerry P
Published: December 2019

Cardiovascular magnetic resonance (CMR) is a rapidly evolving non-invasive imaging modality offering comprehensive, multiparametric assessment of cardiac structure and function in a variety of clinical situations. Cine imaging with CMR is the gold standard non-invasive imaging technique for the quantification of ventricular volumes and systolic function. It also affords superior visualisation of apical and right ventricular morphological abnormalities. In coronary artery disease, CMR stress perfusion imaging identifies functionally significant coronary artery disease with high sensitivity and specificity, and international guidelines recommend CMR perfusion imaging in patients with chest pain at intermediate-high risk of coronary disease. Late gadolinium enhancement (LGE) imaging is the most sensitive imaging technique for identifying infarction/viability. In non-ischaemic cardiomyopathy, LGE imaging plays vital diagnostic and prognostic roles in a number of cardiomyopathies (eg, hypertrophic and dilated cardiomyopathies, and amyloidosis). In vivo tissue characterisation with CMR enables the identification of oedema/inflammation in acute coronary syndromes/myocarditis and the diagnosis of chronic fibrotic conditions (eg, in hypertrophic and dilated cardiomyopathy, aortic stenosis and amyloidosis). CMR T2* imaging uniquely offers non-invasive assessment of iron overload states, facilitating diagnosis and management. A multiparametric CMR approach also enables differentiation of cardiac masses/tumours and is a useful adjunct to echocardiography in the assessment of valve disease. The emergence of automated, inline, quantitative methodologies will expand the scope of CMR and reduce its cost in forthcoming years.