bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characterization of interstitial cystitis/bladder pain syndrome in women based on the presence or absence of Hunner lesions and glomerulations
Authors: Watanabe Daiji , Akiyama Yoshiyuki , Niimi Aya , Nomiya Akira , Yamada Yuta , Sato Yusuke , Nakamura Masaki , Kawai Taketo , Yamada Daisuke , Suzuki Motofumi , Igawa Yasuhiko , Kume Haruki , Homma Yukio
Published: August 2020

Objectives

To compare the clinical characteristics of three groups of female patients with interstitial cystitis/bladder pain syndrome (IC/BPS) classified according to the presence or absence of Hunner lesions (HL) and glomerulations.

Methods

The clinical records of 100 female patients with IC/BPS who underwent their first bladder hydrodistension at our institution were retrospectively reviewed. They were divided into patients having (HL–IC; n = 57) or lacking (BPS; n = 43) HL. BPS patients were further classified as those with (29) and without (14) glomerulations. Among these three subtypes, demographics, comorbidities, symptom parameters including a visual analog scale for pain scores, O'Leary and Sant Symptom and Problem (OSSI/OSPI) Indices, frequency volume chart variables, and bladder capacity at hydrodistension were compared.

Results

HL–IC patients were older and had higher OSSI/OSPI scores, greater daytime frequency and nocturia, reduced maximum and average voided volumes, and smaller bladder capacity at hydrodistension compared with BPS patients. Pain intensity and illness duration were comparable among the three groups. HL–IC patients had autoimmune disorders as comorbidities more often, but had psychiatric disorders and irritable bowel syndrome less often compared with BPS patients. No discernible differences in clinical characteristics of symptom severity and comorbid disorders were evident between BPS patients with and without glomerulations.

Conclusions

The presence of HL is associated with distinctive clinical characteristics, while glomerulations are not in female patients with IC/BPS. The presence of HL, but not glomerulations, is a robust phenotypic feature of IC/BPS in women.
Anthropogenic injuries disrupt social associations of common bottlenose dolphins (Tursiops truncatus) in Sarasota Bay, Florida
Authors: Greenfield Michelle R. , McHugh Katherine A. , Wells Randall S. , Rubenstein Daniel I.
Published: August 2020

Social connectivity is important for measuring the fitness of common bottlenose dolphins (Tursiops truncatus). While interactions in fission‐fusion societies vary between individuals, studies show that repeated interactions enhance reproduction and foraging success. Injuries that potentially remove an individual from its association network may disrupt these interactions. Using data from the long‐term resident dolphin community in Sarasota Bay, Florida, we investigated how anthropogenic injuries affect the dolphins' social associations by examining the differences before and after injury to individuals. We examined group size, strength, eigenvector centrality, clustering coefficient, and number of triangles and analyzed whether the animal's sex, age class, type of injury, or human intervention affected these values. We found that while group size did not change, injured dolphins had fewer preferred associates (HWI > 0.14) and were found in more fluid groups immediately after injury, but started returning to normal association levels after 2 years. This initial decrease in connectivity was not related to the age, sex, type of injury, or intervention. Despite the fluidity in individual associations, the strongest bonds remained stable, those between mothers and calves and those between male alliance partners. These findings provide some of the first information relating injuries and social networks for animals.
Post‐Keynesian Public Budgeting & Finance: Assessing Contributions From Modern Monetary Theory
Authors: Kravchuk Robert S.
Published: August 2020

While Modern Monetary Theory (MMT) offers contributions that are worthy of serious consideration, some additional theory‐building and synthesis with existing theory may be in order to tie MMT into the established budgeting literature. MMT focuses primarily on monetarily sovereign governments. These are governments that face extremely “soft” budget constraints insofar as they: issue and regulate the value of their own currencies, possess central banks that function as the fiscal agents of their government treasuries, are able to issue sovereign debt denominated in their domestic currency, and operate in a system of freely‐floating currency exchange rates, with a minimum of currency and capital controls. National governments that are sovereign according to these criteria are able to make all debt service payments as they come due, virtually without regard to their level of outstanding debt; they cannot be forced to default against their will. They are also macroeconomically‐autonomous. It is the collective position of the symposium papers that these conditions describe, in precise terms, the fiscal position of the U.S. federal government. As such, the existence of an ultra‐soft U.S. government budget constraint is grounded in the extremely favorable conditions of money and credit that the federal government is subject to, and which in fact it has created and nurtured for itself since the Second World War. An important implication is that the federal level budgeting literature cannot ignore the macroeconomics and the administration of a sovereign currency regime, nor the monetary economics that ungirds it, without sustaining charges of unrealism.
Classification approaches for sorting maize (Zea mays subsp. mays) haploids using single‐kernel near‐infrared spectroscopy
Authors: Gustin Jeffery L. , Frei Ursula K. , Baier John , Armstrong Paul , Lübberstedt Thomas , Settles A. Mark
Published: August 2020

Doubled haploids (DHs) are an important breeding tool for creating maize inbred lines. One bottleneck in the DH process is the manual separation of haploids from among the much larger pool of hybrid siblings in a haploid induction cross. Here, we demonstrate the ability of single‐kernel near‐infrared reflectance spectroscopy (skNIR) to identify haploid kernels. The skNIR is a high‐throughput device that acquires an NIR spectrum to predict individual kernel traits. We collected skNIR data from haploid and hybrid kernels in 15 haploid induction crosses and found significant differences in multiple traits such as percent oil, seed weight, or volume, within each cross. The two kernel classes were separated by their NIR profile using Partial Least Squares Linear Discriminant Analysis (PLS‐LDA). A general classification model, in which all induction crosses were used in the discrimination model, and a specific model, in which only kernels within a specific induction cross, were compared. Specific models outperformed the general model and were able to enrich a haploid selection pool to above 50% haploids. Applications for the instrument are discussed.
Development of multiple cutaneous and follicular neoplasms associated with canine papillomavirus type 3 in a dog
Authors: Orbell Helen L. , Munday John S. , Orbell Geoffrey M. B. , Griffin Craig E.
Published: August 2020

A 12‐year‐old spayed English pointer dog developed multiple skin lesions including pigmented viral plaques, basal cell carcinomas, squamous cell carcinomas and trichoblastomas. Canine papillomavirus type 3 was detected in multiple lesions suggesting common aetiology.

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Different Bayesian Methods for Updating the Fatigue Crack Size Distribution in a Tubular Joint
Authors: Khalili H. , Oterkus S. , Barltrop N. , Bharadwaj U.
Published: August 2020

Offshore platforms are prone to fatigue damage. To evaluate the fatigue damage, these platforms are periodically inspected during the in-service lifetime. Inspection activities provide additional information, which includes detection and measurement of crack size. A Bayesian framework can be used to update the probability distribution of the uncertain parameters such as crack size. After updating the distribution of the crack size, it is possible to improve the estimation of joint reliability. The main purpose of this study is to present different methods of Bayesian inference to update the probability distribution of the crack size using the inspection results and to demonstrate how the results are different. Two different methods are presented: analytical (conjugate) and numerical methods. The advantages and shortcomings of each method are discussed. To compare the results of the analytical and numerical methods, two different situations are considered; updating the crack size distribution for a particular joint and updating the crack size distribution for several joints that have almost the same conditions. Although the proposed methodology can be applied to different kinds of structures, an example of tubular joints in a specific jacket platform is presented to demonstrate the proposed approach and to compare the results of two methods.
A Hybrid Method for Predicting Ship Maneuverability in Regular Waves
Authors: Mei Tianlong , Liu Yi , Ruiz Manasés Tello , Lataire Evert , Vantorre Marc , Chen Changyuan , Zou Zaojian
Published: August 2020

Traditionally, ship maneuvering is analyzed under calm water condition. In a more realistic scenario, such as a ship sailing in waves, the importance of taking the wave effects into account should be stressed. In this context, this paper proposes a hybrid method for predicting ship maneuverability in regular waves by combining a potential flow theory based panel method and a Reynolds-averaged Navier–Stokes (RANS)-based computational fluid dynamics method. The mean wave drift forces are evaluated by applying a three-dimensional time-domain higher-order Rankine panel method, which takes the effects of ship's forward speed and lateral speed into consideration. The hull-related hydrodynamic derivatives in the equations of ship maneuvering motion are determined by using a RANS solver based on the double-body model. Then, the two-time scale method is applied to predict ship maneuvering in regular waves by integrating the seakeeping model in a three degrees-of-freedom MMG model for ship maneuvering motion. The numerical results of a laterally drifting S175 container ship, including the wave-induced motions, wave drift forces, and turning trajectories in regular waves, are presented and compared with the available experimental data in literature. The results show that the proposed hybrid method can be used for qualitatively predicting ship maneuvering behavior in regular waves.
Can the prey species Raoiella indica Hirst (Acari: Tenuipalpidae) support the development and reproduction of Neoseiulus barkeri Hughes (Acari: Phytoseiidae)?

Authors: Filgueiras Rosenya Michely Cintra , Da Silva Bruna Weida Rabelo , De Sousa Neto Eduardo Pereira , Mendes Jairo De Almeida , Melo José Wagner Da Silva
Published: August 2020

The potential of Neoseiulus barkeri Hughes (Acari: Phytoseiidae) as a biological control agent has been widely studied and demonstrated against several pest species, mainly against pest mites. However, its potential has not been assessed with tenuipalpid mites, which emerged as a threat to agriculture, especially in coconut and banana crops. The potential of natural enemies can be predicted through life history tests; thus, we conducted experiments to determine the life history parameters of N. barkeri that fed on tenuipalpid mite Raoiella indica Hirst (Acari: Tenuipalpidae) individuals of different developmental stages. Neoseiulus barkeri successfully completed its development by feeding on R. indica of all developmental stages; there were no differences in survivorship during the entire immature period (always above 95%) irrespective of the developmental stages of the R. indica used. The average oviposition period was 27 days with an average fecundity of 56.2 eggs/female. Positive ri values obtained for all prey developmental stages indicated that R. indica of all developmental stages is suitable to support the population growth of N. barkeri. Additionally, the life table parameters of N. barkeri recorded in this study [net reproductive rate (R0= 37.9 female/female), intrinsic rate of increase (rm = 0.22 female/female/day), finite rate of increase (λ = 1.24 female/female/day), mean generation time (T = 16.67 days), and population doubling time (DT = 3.18 days)] show that N. barkeri performed excellently when feeding on R. indica eggs. Our results show that the prey species R. indica is a suitable food source for the predatory species N. barkeri.
Continuous polymer films deposited on top of porous substrates using plasma-enhanced atomic layer deposition and molecular layer deposition
Authors: Welch Brian C. , McIntee Olivia M. , Ode Anand B. , McKenzie Bonnie B. , Greenberg Alan R. , Bright Victor M. , George Steven M.
Published: August 2020

Molecular layer deposition (MLD) is able to produce ultrathin polymer films with control over thickness, cross-linking, and chemical composition. With these capabilities, MLD should be useful in the fabrication of novel polymer membranes on porous supports. However, confining a continuous MLD film to the surface of porous substrates is difficult because of MLD film growth in the pores. The deposition in the pores lowers the conductance of the porous support. This paper presents a method to deposit continuous polymer films on top of porous substrates. In this method, Al2O3 plasma-enhanced atomic layer deposition (PE-ALD) using trimethylaluminum and oxygen plasma as the reactants was first used to cap the pores of the substrate. Subsequently, a polyamide MLD film was deposited on the Al2O3 PE-ALD capping layer using m-phenylenediamine and trimesoyl chloride as the reactants. The Al2O3 pore caps were then removed from the porous substrate by etching from the backside using a timed exposure to a dilute sodium hydroxide solution. This method was demonstrated using anodic aluminum oxide (AAO) and polyethersulfone (PES) porous substrates. Al2O3 PE-ALD film growth was limited to the top of the porous substrate, resulting in rapid surface recombination or high sticking coefficients for the reactive plasma species within the pores. Gas permeance measurements confirmed the pore capping of the AAO substrates. The reopening of the pores by dissolving the Al2O3 pore caps with a sodium hydroxide solution was monitored using gas permeance versus etch time. The removal of the Al2O3 pore caps from the PES substrates could also dissolve the Al2O3 layer underneath the MLD film. The loss of this Al2O3 layer led to the detachment of the MLD film from the PES substrate. However, the MLD film could be anchored to the PES support at fractures located in the Al2O3 film prior to the MLD. The Al2O3 film fracture allowed the MLD film to anchor firmly to the PES substrate by MLD in the pores of the PES porous substrate. The distance between the anchor points was a function of fracture density. This distance could be controlled by applying a tensile stress to the Al2O3 PE-ALD film to fracture the film through sample bending. This method produced firmly anchored polymer MLD films on top of the PES porous substrates.
Introduction to the special issue on the effects of sound on aquatic life
Authors: Thomsen Frank , Erbe Christine , Hawkins Anthony , Lepper Paul , Popper Arthur N. , Scholik-Schlomer Amy , Sisneros Joseph
Published: August 2020

The effects of anthropogenic (man-made) underwater sound on aquatic life have become an important environmental issue. One of the focal ways to present and to share knowledge on the topic has been the international conference on The Effects of Noise on Aquatic Life (“Aquatic Noise”). The conferences have brought together people from diverse interests and backgrounds to share information and ideas directed at understanding and solving the challenges of the potential effects of sound on aquatic life. The papers published here and in a related special issue of Proceedings of Meetings on Acoustics present a good overview of the many topics and ideas covered at the meeting. Indeed, the growth in studies on anthropogenic sound since the first meeting in 2007 reflects the increasing use of oceans, lakes, rivers, and other waterways by humans. However, there are still very substantial knowledge gaps about the effects of sound on all aquatic animals, and these gaps lead to there being a substantial need for a better understanding of the sounds produced by various sources and how these sounds may affect animals.
A modified Marchenko method to retrieve the wave field inside layered metamaterial from reflection measurements at the surface
Authors: Wapenaar Kees
Published: August 2020

With the Marchenko method, it is possible to retrieve the wave field inside a medium from its reflection response at the surface. To date, this method has predominantly been applied to naturally occurring materials. This study extends the Marchenko method for applications in layered metamaterials with, in the low-frequency limit, effective negative constitutive parameters. It illustrates the method with a numerical example, which confirms that the method properly accounts for multiple scattering. The proposed method has potential applications, for example, in non-destructive testing of layered materials.
Australian Football in America During COVID-19
Authors: Bingaman James
Published: August 2020

Despite its relative obscureness in the United States, Australian football has graced American airwaves since the 1990s. The outbreak of COVID-19 in the spring of 2020 paved the way for the Australian Football League to be one of the only professional sports leagues broadcasting games live on American television. Although the Australian Football League would later suspend the season, for at least one weekend, Australian football was the most popular sport in the United States. This short essay pulls from news articles, social media posts, and existing literature to explore this unique time in the American sports landscape by investigating the response to Australian football from fans, the response from media outlets, and the future directions of Australian football in the United States. The increase in exposure could help the Australian Football League become the next big spectator sport in the United States as well as help grow the game at a local, grassroots level.
Everyday Things Change: Australian Athlete Communication During the Coronavirus Lockdown
Authors: Whales Lewis , Frawley Stephen , Cohen Adam , Nikolova Natalia
Published: August 2020

During the coronavirus (COVID-19) pandemic, Australian professional sport leagues were impacted by temporary league shutdowns. One example is the Suncorp Super Netball, the world’s premier netball competition. This commentary paper explores the Suncorp Super Netball league shutdown from the perspective of the players. Our commentary has emerged from an ongoing ethnographic study supported by interviews with two players (a representative on the players association and a club captain) conducted during the league shutdown. Such a shutdown was the first in the history of the league, and it required an unprecedented response, coordinated by interdependent stakeholders. The authors outlined the importance of stakeholder communication in effectively navigating this extraordinary situation. In addition, the authors discussed the usefulness of technology-as-context for teamwork and leadership, given the limitations on physical interaction and geographical separation. In conclusion, the authors proposed recommendations for sport practitioners and potential research directions resulting from the coronavirus-related league shutdown.
Rebooting Content: Broadcasting Sport and Esports to Homes During COVID-19
Authors: Goldman Michael M. , Hedlund David P.
Published: August 2020

Beginning in early March 2020, sport in the United States entered an unprecedented period of hiatus due to the COVID-19 pandemic. The postponement, suspension, and cancellation of live sporting events impacted every professional and amateur sport organization, from the National Basketball Association to the National Association for Stock Car Auto Racing, high school sports to college football, and even esports leagues. Although the abrupt cancellation of live sporting events was disruptive, it did create opportunities for the production of new media and consumption opportunities for sport leagues, teams, and their fans through different types of sport media broadcasts. This commentary examines how the U.S. sport industry developed media content strategies using new, mixed, and rebroadcasted content, across multiple broadcast and streaming platforms, to provide sport consumption opportunities to fans who were largely quarantined at home. This research contributes to the existing scholarship on live and rebroadcasted mediated content, while providing guidance to content owners and rights holders facing uncertainty in the marketplace.
COVID-19 and Soccer Teams on Instagram: The Case of Corporate Social Responsibility
Authors: López-Carril Samuel , Anagnostopoulos Christos
Published: August 2020

COVID-19 has given greater importance to the role of social media in sport, making it an essential way for fans to stay “in touch” with their teams. At the same time, the pandemic triggered additional actions from sport entities with the view to prove their commitment to society in an unprecedented moment of crisis. Professional team sport organizations have indeed initiated corporate social responsibility actions to collaborate in the fight against COVID-19. To explore these actions, the authors analyzed 3,906 posts on the official Instagram profiles of professional team sport organizations of La Liga (soccer, Spain), from March 11 to May 11, 2020, classifying them as philanthropic, sponsorship, or personnel engagement actions. The role of corporate social responsibility in a time of crisis and the potential of social media as a corporate social responsibility communication channel was also discussed.
A Five-in-One First-in-Human Study To Assess Safety, Tolerability, and Pharmacokinetics of RO7049389, an Inhibitor of Hepatitis B Virus Capsid Assembly, after Single and Multiple Ascending Doses in Healthy Participants
Authors: Feng Sheng , Gane Edward , Schwabe Christian , Zhu Mingfen , Triyatni Miriam , Zhou Julian , Bo Qingyan , Jin Yuyan
Published: August 2020

RO7049389, an inhibitor of hepatitis B virus (HBV) capsid assembly, is being developed for the treatment of patients with chronic HBV infection. The objectives of this first-in-human study are to assess the safety, tolerability, pharmacokinetics (PK), food effect, inhibitory effect on CYP3A, and effect on QT of RO7049389 in healthy participants. Five components, single-ascending-dose (SAD) cohorts, multiple-ascending-dose (MAD) cohorts, food effect assessment, drug-drug interaction assessment, and concentration-QT analysis were integrated in one study (five-in-one).
Performance of the Lateral Flow Assay and the Latex Agglutination Serum Cryptococcal Antigen Test in Cryptococcal Disease in Patients with and without HIV
Authors: Hevey Matthew A. , George Ige A. , Rauseo Adriana M. , Larson Lindsey , Powderly William , Spec Andrej
Published: August 2020

Cryptococcal epidemiology is shifting toward HIV-negative populations who have diverse presentations. Cryptococcal antigen (CrAg) testing is also changing, with development of the lateral flow assay (LFA) having reported increased sensitivity and specificity, but with minimal knowledge in the HIV-negative population. In this study, we evaluate the real-life performance of CrAg testing in patients with cryptococcal disease. We conducted a retrospective review of patients with cryptococcosis from 2002 to 2019 at Barnes-Jewish Hospital.
Functional and Structural Insights into a Vif/PPP2R5 Complex Elucidated Using Patient HIV-1 Isolates and Computational Modeling
Authors: Salamango Daniel J. , McCann Jennifer L. , Demir Özlem , Becker Jordan T. , Wang Jiayi , Lingappa Jairam R. , Temiz Nuri A. , Brown William L. , Amaro Rommie E. , Harris Reuben S.
Published: August 2020

A critical function of HIV-1 Vif is to counteract the family of APOBEC3 innate immune proteins. It is also widely accepted that Vif induces G
2
/M cell cycle arrest in several different cell types. Recently, it has been shown that Vif degrades multiple PPP2R5 phosphoregulators to induce the G
2
/M arrest phenotype. Here, computational approaches are used to test a structural model of the Vif/PPP2R5 complex. In addition, imaging studies are used to show that Vif degrades these PPP2R5 substrates in roughly the same time frame as APOBEC3 degradation and that this activity is prevalent in patient-derived Vif isolates. These studies are important by further defining PPP2R5 proteins as a bona fide substrate of HIV-1 Vif.
A Conditional Protein Degradation System To Study Essential Gene Function in Cryptosporidium parvum
Authors: Choudhary Hadi H. , Nava Maria G. , Gartlan Brina E. , Rose Savannah , Vinayak Sumiti
Published: August 2020

Cryptosporidium parvum
and
Cryptosporidium hominis
are leading pathogens responsible for diarrheal disease (cryptosporidiosis) and deaths in infants and children below 5 years of age. There are no effective treatment options and no vaccine for cryptosporidiosis. Therefore, there is an urgent need to identify essential gene targets and uncover their biological function to accelerate the development of new and effective anticryptosporidial drugs. Current genetic tool allows targeted disruption of gene function but leads to parasite lethality if the gene is essential for survival. In this study, we have developed a genetic tool for conditional degradation of proteins in
Cryptosporidium
spp., thus allowing us to study the function of essential genes. Our conditional system expands the molecular toolbox for
Cryptosporidium
, and it will help us to understand the biology of this important human diarrheal pathogen for the development of new drugs and vaccines.
Acetylation of Surface Carbohydrates in Bacterial Pathogens Requires Coordinated Action of a Two-Domain Membrane-Bound Acyltransferase
Authors: Pearson Caroline R. , Tindall Sarah N. , Herman Reyme , Jenkins Huw T. , Bateman Alex , Thomas Gavin H. , Potts Jennifer R. , Van der Woude Marjan W.
Published: August 2020

Acyltransferase-3 (AT3) domain-containing membrane proteins are involved in
O
-acetylation of a diverse range of carbohydrates across all domains of life. In bacteria they are essential in processes including symbiosis, resistance to antimicrobials, and biosynthesis of antibiotics. Their mechanism of action, however, is poorly characterized. We analyzed two acetyltransferases as models for this important family of membrane proteins, which modify carbohydrates on the surface of the pathogen
Salmonella enterica
, affecting immunogenicity, virulence, and bacteriophage resistance. We show that when these AT3 domains are fused to a periplasmic partner domain, both domains are required for substrate acetylation. The data show conserved elements in the AT3 domain and unique structural features of the periplasmic domain. Our data provide a working model to probe the mechanism and function of the diverse and important members of the widespread AT3 protein family, which are required for biologically significant modifications of cell-surface carbohydrates.
Heterologous Expression of the Unusual Terreazepine Biosynthetic Gene Cluster Reveals a Promising Approach for Identifying New Chemical Scaffolds
Authors: Caesar Lindsay K. , Robey Matthew T. , Swyers Michael , Islam Md N. , Ye Rosa , Vagadia Purav P. , Schiltz Gary E. , Thomas Paul M. , Wu Chengcang C. , Kelleher Neil L. , Keller Nancy P. , Bok Jin Woo
Published: August 2020

Here, we provide evidence that
Aspergillus terreus
encodes a biosynthetic gene cluster containing a repurposed indoleamine 2,3-dioxygenase (IDO) dedicated to secondary metabolite synthesis. The discovery of this neofunctionalized IDO not only enabled discovery of a new compound with an unusual chemical scaffold but also provided insight into the numerous strategies fungi employ for diversifying and protecting themselves against secondary metabolites. The observations in this study set the stage for further in-depth studies into the function of duplicated IDOs present in fungal biosynthetic gene clusters and presents a strategy for accessing the biosynthetic potential of gene clusters containing duplicated primary metabolic genes.
Intraspecies Signaling between Common Variants of Pseudomonas aeruginosa Increases Production of Quorum-Sensing-Controlled Virulence Factors
Authors: Mould Dallas L. , Botelho Nico J. , Hogan Deborah A.
Published: August 2020

Coculture interactions between
lasR
loss-of-function and LasR+
Pseudomonas aeruginosa
strains may explain the worse outcomes associated with the presence of LasR− strains. More broadly, this report illustrates how interactions within a genotypically diverse population, similar to those that frequently develop in natural settings, can promote unpredictably high virulence factor production.
Rotavirus Infection and Cytopathogenesis in Human Biliary Organoids Potentially Recapitulate Biliary Atresia Development
Authors: Chen Sunrui , Li Pengfei , Wang Yining , Yin Yuebang , de Ruiter Petra E. , Verstegen Monique M. A. , Peppelenbosch Maikel P. , van der Laan Luc J. W. , Pan Qiuwei
Published: August 2020

There is substantial evidence indicating the possible involvement of rotavirus in biliary atresia (BA) development, at least in a subset of patients, but concrete proof remains lacking. In a mouse model, it has been well demonstrated that rotavirus can infect the biliary epithelium to cause biliary inflammation and obstruction, representing the pathogenesis of BA in humans. By using recently developed organoids technology, we now have demonstrated that human biliary organoids are susceptible to rotavirus infection, and this provokes active virus-host interactions and causes severe cytopathogenesis. Thus, our model recapitulates some essential aspects of BA development. Furthermore, we have demonstrated that antiviral drugs and neutralizing antibodies are capable of counteracting the infection and BA-like morphological changes, suggesting their potential for mitigating BA in patients.
Press Disturbance Alters Community Structure and Assembly Mechanisms of Bacterial Taxa and Functional Genes in Mesocosm-Scale Bioreactors
Authors: Santillan Ezequiel , Constancias Florentin , Wuertz Stefan
Published: August 2020

Ecosystem management must be viewed in the context of increasing frequencies and magnitudes of various disturbances that occur at different scales. This work provides a glimpse of the changes in assembly mechanisms found in microbial communities exposed to sustained changes in their environment. These mechanisms, deterministic or stochastic, can cause communities to reach a similar or variable composition and function. For a comprehensive view, we use a joint evaluation of temporal dynamics in assembly mechanisms and community structure for both bacterial taxa and their functional genes at different abundance levels, in both disturbed and undisturbed states. We further reverted the disturbance state to contrast recovery of function with community structure. Our findings are relevant, as very few studies have employed such an approach, while there is a need to assess the relative importance of assembly mechanisms for microbial communities across different spatial and temporal scales, environmental gradients, and types of disturbance.
Barriers and facilitators influencing facility-based childbirth in rural Haiti: a mixed method study with a convergent design
Authors: Raymondville Maxi , Rodriguez Carly A , Richterman Aaron , Jerome Gregory , Katz Arlene , Gilbert Hannah , Anderson Gregory , Joseph Jean Paul , Franke Molly F , Ivers Louise C
Published: August 2020

Introduction

Haiti has the highest maternal mortality rate in the Western Hemisphere. Facility-based childbirth is promoted as the standard of care for reducing maternal and neonatal mortality. We conducted a convergent, mixed methods study to assess barriers and facilitators to facility-based childbirth at Hôpital Universitaire de Mirebalais (HUM) in Mirebalais, Haiti.

Methods

We conducted secondary analyses of a prospective cohort of pregnant women seeking antenatal care at HUM and quantitatively assessed predictors of not having a facility-based childbirth at HUM. We prospectively enrolled 30 pregnant women and interviewed them about their experiences delivering at home or at HUM.

Results

Of 1105 pregnant women seeking antenatal care at the hospital between May and December 2017, 773 (70%) returned to the hospital for facility-based childbirth. In multivariable analyses, living farther from the hospital (adjusted OR (AOR)=0.73; 95% CI 0.56 to 0.96), poverty (AOR=0.93; 95% CI 0.88 to 0.99) and household hunger (AOR=0.45; 95% CI 0.26 to 0.79) were associated with not having a facility-based childbirth. Primigravid women were more likely to have a facility-based childbirth (AOR=1.34, 95% CI 1.02 to 1.76). Qualitative data provided insight into the value women place on traditional birth attendants (‘matrons’) during home-based childbirths. While women perceived facility-based childbirths as better equipped to handle birth complications, barriers such as distance, costs of transportation and supplies, discomfort of facility birthing practices and mistreatment by medical staff resulted in negative perceptions of facility-based childbirths.

Conclusion

Pregnant women in rural Haiti must overcome substantial structural barriers and forfeit valued support from traditional birth attendants when they pursue facility-based childbirths. If traditional birth attendants could be involved in care alongside midwives at facilities, women may be more inclined to deliver there. While complex structural barriers remain, the inclusion of matrons at facilities may increase uptake of facility-based childbirths, and ultimately improve maternal and neonatal outcomes.
A vulnerability index for COVID-19: spatial analysis at the subnational level in Kenya
Authors: Macharia Peter M , Joseph Noel K , Okiro Emelda A
Published: August 2020

Background

Response to the coronavirus disease 2019 (COVID-19) pandemic calls for precision public health reflecting our improved understanding of who is the most vulnerable and their geographical location. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya.

Methods

Geospatial indicators were assembled to create three vulnerability indices; Social VulnerabilityIndex (SVI), Epidemiological Vulnerability Index (EVI) and a composite of the two, that is, Social Epidemiological Vulnerability Index (SEVI) resolved at 295 subcounties in Kenya. SVI included 19 indicators that affect the spread of disease; socioeconomic deprivation, access to services and population dynamics, whereas EVI comprised 5 indicators describing comorbidities associated with COVID-19 severe disease progression. The indicators were scaled to a common measurement scale, spatially overlaid via arithmetic mean and equally weighted. The indices were classified into seven classes, 1–2 denoted low vulnerability and 6–7, high vulnerability. The population within vulnerabilities classes was quantified.

Results

The spatial variation of each index was heterogeneous across Kenya. Forty-nine northwestern and partly eastern subcounties (6.9 million people) were highly vulnerable, whereas 58 subcounties (9.7 million people) in western and central Kenya were the least vulnerable for SVI. For EVI, 48 subcounties (7.2 million people) in central and the adjacent areas and 81 subcounties (13.2 million people) in northern Kenya were the most and least vulnerable, respectively. Overall (SEVI), 46 subcounties (7.0 million people) around central and southeastern were more vulnerable, whereas 81 subcounties (14.4 million people) were least vulnerable.

Conclusion

The vulnerability indices created are tools relevant to the county, national government and stakeholders for prioritisation and improved planning. The heterogeneous nature of the vulnerability indices underpins the need for targeted and prioritised actions based on the needs across the subcounties.
Time to listen: a mixed-method study examining community-based views of mobile technology for interventions to promote physical activity
Authors: Claudel Sophie E , Ceasar Joniqua N , Andrews Marcus R , El-Toukhy Sherine , Farmer Nicole , Middleton Kimberly R , Sabado-Liwag Melanie , Mitchell Valerie M , Tamura Kosuke , Brooks Alyssa T , Wallen Gwenyth R , Powell-Wiley Tiffany M.
Published: August 2020

Introduction

A mixed-method, co-design approach to studying the adoption of mobile health (mHealth) technology among African-American (AA) women has not been fully explored. Qualitative data may contextualise existing knowledge surrounding perceptions of mHealth among AA women as part of formative work for designing a physical activity application (app).

Methods

A convenience sample of 16 AA women completed an informatics survey prior to participating in focus groups exploring their use of mobile technology and health apps. Survey responses provided frequency data, while iterative transcript analysis of focus groups identified themes.

Results

The majority of participants (mean age=62.1 years, SD=6.6) felt comfortable using a tablet/smartphone (75.0%). Most (68.8%) reported using health-related apps, primarily focused on physical activity and nutrition. Focus groups revealed four overarching concepts, including (1) user attachment, (2) technology adoption, (3) potential facilitators and (4) potential barriers. Important features which may serve as facilitators or barriers to future adoption of a mobile app for an mHealth intervention include individual app tailoring and software concerns, respectively.

Discussion

Thematic analysis revealed high user attachment to smartphones and described participants’ process for adopting new mHealth technology.

Conclusion

Early engagement of target end users as a part of a broader co-design and community-based participatory research process for developing mHealth technologies may be useful for sustained adoption of these tools in future mHealth behavioural interventions.
Primary care EMR and administrative data linkage in Alberta, Canada: describing the suitability for hypertension surveillance
Authors: Garies Stephanie , Youngson Erik , Soos Boglarka , Forst Brian , Duerksen Kimberley , Manca Donna , McBrien Kerry , Drummond Neil , Quan Hude , Williamson Tyler
Published: August 2020

Objective

To describe the process for linking electronic medical record (EMR) and administrative data in Alberta and examine the advantages and limitations of utilising linked data for hypertension surveillance.

Methods

De-identified EMR data from 323 primary care providers contributing to the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) in Alberta were used. Mapping files from each contributing provider were generated from their EMR to facilitate linkage to administrative data within the provincial health data warehouse. Deterministic linkage was conducted using valid personal healthcare number (PHN) with age and/or sex. Characteristics of patients and providers in the linked cohort were compared with population-level sources. Criteria used to define hypertension in both sources were examined.

Results

Data were successfully linked for 6307 hypertensive patients (96.2% of eligible patients) from 49 contributing providers. Non-linkages from invalid PHN (n=246) occurred more for deceased patients and those with fewer primary care encounters, with differences due to type of EMR and patient EMR status. The linked cohort had more patients who were female, >60 years and residing in rural areas compared to the provincial healthcare registry. Family physicians were more often female and medically trained in Canada compared to all physicians in Alberta. Most patients (>97%) had ≥1 record in the registry, pharmacy, emergency/ambulatory care and claims databases; 44.3% had ≥1 record in the hospital discharge database.

Conclusion

EMR-administrative data linkage has the potential to enhance hypertension surveillance. The current linkage process in Alberta is limited and subject to selection bias. Processes to address these deficiencies are under way.
Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study
Authors: Cunningham-Myrie Colette Andrea , Younger Novie O , Theall Katherine P , Greene Lisa-Gaye , Lyew-Ayee Parris , Wilks Rainford
Published: August 2020

Objective

To derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.

Design

Cross-sectional study.

Setting

Data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.

Participants

A subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.

Primary outcome measure

Mean BMI, calculated as weight divided by height squared (kg/m2).

Results

There was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.

Conclusions

Higher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.
Why are epilepsy mortality rates rising in the United States? A population-based multiple cause-of-death study
Authors: DeGiorgio Christopher M , Curtis Ashley , Carapetian Armen , Hovsepian Dominic , Krishnadasan Anusha , Markovic Daniela
Published: August 2020

Introduction

Epilepsy mortality rates are rising. It is unknown whether rates are rising due to an increase in epilepsy prevalence, changes in epilepsy causes of death, increase in the lethality or epilepsy or failures of treatment. To address these questions, we compare epilepsy mortality rates in the USA with all-cause and all-neurological mortality for the years 1999 to 2017.

Objectives

To determine changes in US epilepsy mortality rates versus all-cause mortality, and to evaluate changes in the leading causes of death in people with epilepsy.

Design

Retrospective population-based multiple cause-of-death study.

Primary outcome

Change in age-adjusted epilepsy mortality rates compared with mortality rates for all-cause and all-neurological mortality.

Secondary outcome

Changes in the leading causes of death in epilepsy.

Results

From 1999 to 2017, epilepsy mortality rates in the USA increased 98.8%, from 5.83 per million in 1999 to 11.59 per million (95% CI 88.2%–110.0%), while all-cause mortality declined 16.4% from 8756.34 per million to 7319.17 per million (95% CI 16.3% to 16.6%). For the same period, all-neurological mortality increased 80.8% from 309.21 to 558.97 per million (95% CI 79.4%–82.1%). The proportion of people with epilepsy who died due to neoplasms, vascular dementia and Alzheimer’s increased by 52.3%, 210.1% and 216.8%, respectively. During the same period, the proportion who died due to epilepsy declined 27.1%, while ischaemic heart disease as a cause of death fell 42.6% (p<0.001).

Conclusions

Epilepsy mortality rates in the USA increased significantly from 1999 to 2017. Likely causes include increases in all-neurological mortality, increased epilepsy prevalence and changes in the underlying causes of death in epilepsy, led by increases in vascular dementia and Alzheimer’s. An important finding is that ischaemic heart disease and epilepsy itself are declining as underlying causes of death in people with epilepsy.
Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis
Authors: Sharma Sweekriti , Traeger Adrian C , Reed Ben , Hamilton Melanie , O’Connor Denise A , Hoffmann Tammy C , Bonner Carissa , Buchbinder Rachelle , Maher Chris G
Published: August 2020

Objective

Overuse of diagnostic imaging for patients with low back pain remains common. The underlying beliefs about diagnostic imaging that could drive overuse remain unclear. We synthesised qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain.

Design

A qualitative evidence synthesis using a thematic analysis.

Methods

We searched MEDLINE, EMBASE, CINAHL, AMED and PsycINFO from inception to 17 June 2019. Qualitative studies that interviewed clinicians, patients and/or general public exploring beliefs about diagnostic imaging for low back pain were included. Four review authors independently extracted data and organised these according to themes and subthemes. We used the Critical Appraisal Skills Programme tool to critically appraise included studies. To assess confidence in review findings, we used the GRADE-Confidence in the Evidence from Reviews of Qualitative Research method.

Results

We included 69 qualitative studies with 1747 participants. Key findings included: Patients and clinicians believe diagnostic imaging is an important test to locate the source of low back pain (33 studies, high confidence); patients with chronic low back pain believe pathological findings on diagnostic imaging provide evidence that pain is real (12 studies, moderate confidence); and clinicians ordered diagnostic imaging to reduce the risk of a missed diagnosis that could lead to litigation, and to manage patients’ expectations (12 studies, moderate confidence).

Conclusion

Clinicians and patients can believe that diagnostic imaging is an important tool for locating the source of non-specific low back pain. Patients may underestimate the harms of unnecessary imaging tests. These beliefs could be important targets for intervention.

PROSPERO registration number

CRD42017076047.