bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxygenation-Controlled Collective Dynamics in Aquatic Worm Blobs
Authors: Tuazon Harry , Kaufman Emily , Goldman Daniel I , Bhamla M Saad
Published: June 2022

Many organisms utilize group aggregation as a method for survival. The freshwater oligochaete, Lumbriculus variegatus (California blackworms) form tightly entangled structures, or worm “blobs”, that have adapted to survive in extremely low levels of dissolved oxygen (DO). Individual blackworms adapt to hypoxic environments through respiration via their mucous body wall and posterior ciliated hindgut, which they wave above them. However, the change in collective behavior at different levels of DO is not known. Using a closed-loop respirometer with flow, we discover that the relative tail reaching activity flux in low DO is ∼75x higher than in the high-DO condition. Additionally, when flow rate is increased to suspend the worm blobs upward, we find that the average exposed surface area of a blob in low DO is ∼1.4x higher than in high DO. Furthermore, we observe emergent properties that arise when a worm blob is exposed to extreme DO levels. We demonstrate that internal mechanical stress is generated when worm blobs are exposed to high DO levels, allowing them to be physically lifted off from the bottom of a conical container using a serrated endpiece. Our results demonstrate how both collective behavior and the emergent generation of internal mechanical stress in worm blobs change to accommodate differing levels of oxygen. From an engineering perspective, this could be used to model and simulate swarm robots, self-assembly structures, or soft material entanglements.
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach
Authors: Corby Sky , Ash Joan S , Whittaker Keaton , Mohan Vishnu , Solberg Nicholas , Becton James , Bergstrom Robby , Orwoll Benjamin , Hoekstra Christopher , Gold Jeffrey A
Published: June 2022

Objective

While the use of medical scribes is rapidly increasing, there are not widely accepted standards for their training and duties. Because they use electronic health record systems to support providers, inadequately trained scribes can increase patient safety related risks. This paper describes the development of desired core knowledge, skills, and attitudes (KSAs) for scribes that provide the curricular framework for standardized scribe training.

Materials and Methods

A research team used a sequential mixed qualitative methods approach. First, a rapid ethnographic study of scribe activities was performed at 5 varied health care organizations in the United States to gather qualitative data about knowledge, skills, and attitudes. The team’s analysis generated preliminary KSA related themes, which were further refined during a consensus conference of subject-matter experts. This was followed by a modified Delphi study to finalize the KSA lists.

Results

The team identified 90 descriptions of scribe-related KSAs and subsequently refined, categorized, and prioritized them for training development purposes. Three lists were ultimately defined as: (1) Hands-On Learning KSA list with 47 items amenable to simulation training, (2) Didactic KSA list consisting of 32 items appropriate for didactic lecture teaching, and (3) Prerequisite KSA list consisting of 11 items centered around items scribes should learn prior to being hired or soon after being hired.

Conclusion

We utilized a sequential mixed qualitative methodology to successfully develop lists of core medical scribe KSAs, which can be incorporated into scribe training programs.
Different Approaches in Manipulating Ratio Spectra for Analyzing Amlodipine Besylate and Irbesartan Combination
Authors: El Mously Dina A , Mostafa Nadia M , Hassan Nagiba Y , El-Sayed Ghada M
Published: June 2022

Background

Hypertension is a key risk factor for ischemic heart disease and atherosclerosis. Most patients require a combination of antihypertensive medications to accomplish their therapeutic goals. Antihypertensive medicines such as calcium channel blockers and angiotensin receptor blockers are indicated for patients whose high blood pressure cannot be controlled with monotherapy. The combination of amlodipine besylate (AML) with irbesartan (IRB) is an example of this synergistic activity in lowering blood pressure.

Objective

In this regard, the goal of the research is to develop sensitive spectrophotometric methods for the simultaneous determination of amlodipine besylate and irbesartan.

Methods

Three simple ratio spectra-manipulating spectrophotometric methods namely, ratio difference, mean centering of ratio spectra, and derivative ratio, were developed for the simultaneous assay of the cited mixture.

Results

Linear correlations were attained over the concentration range of 1–35 μg/mL and 2–35 μg/mL for amlodipine besylate and irbesartan, respectively. The methods were validated according to the International Conference on Harmonization guidelines with good results.

Conclusion

The methods developed were successfully applied for the assay of the cited drugs in their marketed formulation. They could be efficiently used for routine analysis of the mentioned drugs in QC laboratories.

Highlights

The proposed approaches do not require expensive solvents or complex instruments. They could be used in routine laboratory tests where time and cost are crucial.
The strain characteristics of cracked anchored soft rock under short-term creep
Authors: Sun Xiaoming , Cui Li , Hu Jiangchun , Zhang Yong
Published: June 2022

The short-term creep properties of cracked soft rock are the basis for analyzing and predicting the long-term deformation characteristics of engineering rock mass. Based on orthogonal test design and by means of physical testing and theoretical analysis, this paper systematically studies the short-term creep strain properties of soft rock mass with a vertical anchor form under different combinations of crack number, crack discontinuity degree and crack inclination. The results show the following: (i) as the stress increases, the growth rate of the instantaneous strain of the anchored soft rock slows down, the growth rate of the creep strain increases and the growth rate of the total strain decreases at first and before it then increases. Based on this, the idea is proposed that the stress corresponding to the turning stress of the total strain change rate, from small to large, is the turning stress of the strain rate. This stress value is approximately 50% of its uniaxial compressive strength (UCS). (ii) Statistical analysis shows that for the same cracked rock mass, the three characteristics of cracks have different effects on the instantaneous strain, creep strain and total strain of anchored soft rock, and a certain number of cracks under specific geometric conditions are beneficial to the long-term deformation control of anchored soft rock. (iii) A relative creep model based on mutation is proposed. Considering the effects of the test instrument, the model can be divided into the power function model, the logarithmic function model and the exponential function model, according to goodness of fit. All three models can describe the initial and stable creep stage of anchored soft rock with cracks.
The Tyranny of Distance: The Treatment and Prevention of Diphtheria in Middle Canada, 1894-1920
Authors: Rushton Alan R
Published: June 2022

Before 1900, diphtheria was a deadly infection in Canadian children. Clinical trials in Europe demonstrated that “antitoxin” decreased mortality of the disease. Canadian physicians first utilized the new medication in 1894 and found it most efficacious when administered early in the illness. Two factors hindered the widespread application of the new medication. Imported antitoxin was expensive, and physicians frequently purchased it themselves rather than let their patients expire. In 1916, Connaught Laboratories in Toronto began domestic production of antitoxin, and provincial governments eventually provided access to the life-saving medication for all citizens.

The vast distances between families and physicians in rural districts also made it impossible to access the antitoxin before sick children were beyond hope. During the 1920s, a public health program began to actually prevent diphtheria. Ten years of experience in many regions demonstrated the efficacy of immunization as mortality from diphtheria declined to almost zero.
Alzheimer Type I Astrocytes: Still Mysterious Cells
Authors: Goldman James E
Published: June 2022

Over 100 years ago, von Hösslein and Alzheimer described enlarged and multinucleated astrocytes in the brains of patients with Wilson disease. These odd astrocytes, now well known to neuropathologists, are present in a large variety of neurological disorders, and yet the mechanisms underlying their generation and their functional attributes are still not well understood. They undergo abnormal mitoses and fail to accomplish cytokinesis, resulting in multinucleation. Oxidative stress, hypoxia, and inflammation may be contributing pathologies to generate these astrocytes. The abnormal mitoses occur from changes in cell shape, the accumulation of cytoplasmic proteins, and the mislocalization of many of the important molecules whose coordination is necessary for proper mitotic spindle formation. Modern technologies will be able to characterize their abnormalities and solve century old questions of their form and function.
Risk of deaths due to injuries in travellers: a systematic review
Authors: Wyler Benjamin A , Young Hannah M , Hargarten Stephen W , Cahill John D
Published: June 2022

Background

Annual global travel reached an all-time high of 1.4 billion international tourist visits in 2019. It is estimated that injury accounts for close to 25% of deaths in travellers, most of which are theoretically preventable. However, there are limited data available on injury occurrence and outcomes in travellers. Our objective was to better understand the relative risk of dying from injury that arises from the novel environments and behavioural changes associated with foreign travel.

Methods

A systematic literature review was conducted (PubMed, Embase and Scopus) according to PRISMA guidelines that included studies published in English since 1990 that reported injury deaths in tourists per 100 000-person years or as a proportion of total tourist deaths in comparison to a non-traveller population. We also included studies that reported data allowing calculation of these rates. Relative rates or proportions of overall injury mortality, mortality due to traffic accidents, drowning and homicide were summarized.

Results

In total, 1847 articles were identified, 105 underwent full-text review, and 10 articles were suitable for data extraction. There was great variability of relative risk reported, but overall, travellers appear to have a higher risk of injury mortality than domestic populations, with relative rates of injury death ranging from 1.04 to 16.7 and proportionate mortality ratios ranging from 1.43 to 3.

Conclusions

Tourists should be aware of the increased risk of dying from road traffic hazards, drowning and homicide while traveling abroad. Specific geographies and activities associated with higher risk should be emphasized. Travel medicine practitioners and organizations that send people abroad should counsel travellers regarding these risks and seek ways to reduce them, including encouraging potential risk-mitigating behaviours. There is a need to improve systems of data collection and reporting on injury deaths in travellers and to study the impact of pre-travel and institutional interventions aimed at reducing this risk.
Characterizing atmospheres of cloudy temperate mini-neptunes with JWST
Authors: Constantinou Savvas , Madhusudhan Nikku
Published: June 2022

The upcoming James Webb Space Telescope (JWST) promises a generational shift in the study of temperate mini-Neptune atmospheres using transit spectroscopy. High-altitude clouds, however, threaten to impede their atmospheric characterization by muting spectral features. In this study, we systematically investigate JWST instrument configurations for characterizing cloudy mini-Neptune atmospheres, assessing the importance of instrument choice and wavelength coverage, focusing on NIRISS and NIRSpec. We consider two temperate mini-Neptunes orbiting nearby M dwarfs, K2-18 b, and TOI-732 c, with equilibrium temperatures below 400 K, as case studies and assess observations using different instrument configurations with one transit per instrument. We find that their JWST transmission spectra with modest observing time and adequate wavelength coverage can provide precise abundance constraints of key molecules H2O, CH4, and NH3 even in the presence of clouds at significantly high altitudes. The best constraints are obtained by combining all three high-resolution NIRSpec gratings (G140H+G235H+G395H) that together span the ∼1–5 $\mu$m range. Single-transit observations with this three-instrument configuration allow precise abundance constraints for cloud-top pressures as low as 3 and 0.1 mbar for K2-18 b and TOI-732 c, respectively, assuming a nominal 10× solar metallicity. The constraints vary with instrument combinations. We find that NIRSpec G235H+G395H is the optimal two-instrument configuration, while NIRISS or NIRSpec G235H is optimal for single-instrument observations. Absent high-altitude clouds, even single-instrument observations can provide good abundance constraints for these planets. Our findings underscore the promise of JWST transmission spectroscopy for characterizing temperate mini-Neptunes orbiting nearby M dwarfs.
Active longitudes and starspot evolution of the young rapidly rotating star USNO-B1.0 1388−0463685 discovered in the Yunnan–Hong Kong survey
Authors: Luo Xiang , Gu Shenghong , Xiang Yue , Wang Xiaobin , Yeung Bill , Ng Eric , Bai Jinming , Fan Yufeng , Xu Fukun , Cao Dongtao , Sun Leilei , Liu Yisi , Wang Jianhua , Bai Lu , Xu Xiaoyun
Published: June 2022

We have discovered a young, rapidly rotating active star USNO-B1.0 1388−0463685 with a rotational period of 0.508750 ± 0.000153 d in the Yunnan–Hong Kong wide-field photometric survey. Based on the chromospheric activity identified in the dedicated spectroscopic observations, the brightness variation of this star is attributed to cool spots on its photosphere. We derived the spot maps from 14 light curves, which demonstrate that the strong spot tends to appear in the same hemisphere, and the light curve amplitude varies with a period of about 2.4 yr. Low-resolution spectroscopic observations revealed the chromospheric activity of the star through the indicators Hα, Na i D1 and D2, He i D3, and Ca ii H & K lines. Moreover, there was a clear anticorrelation between the equivalent width variation of the Hα, Na i D1 and D2 lines and the simultaneous light curve, implying the photosphere and chromosphere connection. Using the spectral subtraction technique, the spectral type of the star was determined as K0–2V and its projected rotational velocity v sin i is 107.492 ± 7.388 km s−1. Both the lithium equivalent width of 254.0 ± 43.3 mÅ and its location on the Hertzsprung–Russell diagram indicate that this star should be in the stage from late pre-main sequence to zero-age main sequence.
A survey of HDCO and D2CO towards Class 0/I proto-brown dwarfs
Authors: Riaz B , Thi W-F
Published: June 2022

Deuterium fractionation can constrain the physical and chemical conditions at the early stage of brown dwarf formation. We present IRAM 30-m observations over a wide frequency range of 213–279 GHz of singly and doubly deuterated species of formaldehyde (HDCO and D2CO) towards Class 0/I proto-brown dwarfs (proto-BDs). Multiple low-excitation HDCO and D2CO transition lines with upper energy level ≤40 K are detected. The D2CO/HDCO, HDCO/H2CO, and D2CO/H2CO abundance ratios range between 0.01 and 2.5 for the proto-BDs, similar to the range seen in low-mass protostars. The highest ratios of D2CO/HDCO ∼1.3–2.5 are measured for two Stage 0 proto-BDs. These objects could possess a warm corino, similar to the few hot corino cases reported among Class 0 protostars. The mean D2CO/HDCO, D2CO/H2CO, and HDCO/H2CO ratios for the proto-BDs are comparatively higher than the range predicted by the current gas-grain chemical models, indicating that HDCO and D2CO are formed via grain surface reactions in the dense and cold interiors of the proto-BDs at an early formation stage.
A simple data-driven method to optimize the penalty strengths of penalized models and its application to non-parametric smoothing
Authors: Thomas Jens , Lipka Mathias
Published: June 2022

Information of interest can often only be extracted from data by model fitting. When the functional form of such a model cannot be deduced from first principles, one has to make a choice between different possible models. A common approach in such cases is to minimize the information loss in the model by trying to reduce the number of fit variables (or the model flexibility, respectively) as much as possible while still yielding an acceptable fit to the data. Model selection via the Akaike information criterion (AIC) provides such an implementation of Occam’s razor. We argue that the same principles can be applied to optimize the penalty strength of a penalized maximum-likelihood model. However, while in typical applications AIC is used to choose from a finite, discrete set of maximum-likelihood models, the penalty optimization requires to select out of a continuum of candidate models and these models violate the maximum-likelihood condition. We derive a generalized information criterion AICp that encompasses this case. It naturally involves the concept of effective free parameters, which is very flexible and can be applied to any model, be it linear or non-linear, parametric or non-parametric, and with or without constraint equations on the parameters. We show that the generalized AICp allows an optimization of any penalty strength without the need of separate Monte Carlo simulations. As an example application, we discuss the optimization of the smoothing in non-parametric models, which has many applications in astrophysics, like in dynamical modelling, spectral fitting, or gravitational lensing.
Using HITRAN to model opacities for planetary atmospheres: test case of microwave spectra of NH3, SO2, and PH3
Authors: Skinner Frances M , Hargreaves Robert J , Gordon Iouli E
Published: June 2022

The latest version of the HITRAN molecular spectroscopic data base, HITRAN2020, has recently been released featuring many updates, including line-by-line broadening parameters (and their temperature dependence) appropriate for the dominant constituents of planetary atmospheres. In this work, line shape codes suitable for calculating microwave spectra have been implemented within the HITRAN Application Programming Interface (HAPI). These new additions allow for spectroscopic calculations of microwave absorbing species pertinent to current and future studies of the atmospheres of Jupiter and Venus, and more generally for the atmospheres of gas giants and rocky planets. The inversion spectrum of the NH3 molecule broadened by H2, He, and H2O dominates the microwave region of Jupiter, whereas for Venus, accurate spectroscopic data of SO2 broadened by CO2 are necessary in order to determine its significance, if any, on the reported detection of PH3 in the Venusian upper cloud deck. Comparisons have been made to available microwave laboratory opacities and the following results illustrate that HITRAN data can be used in conjunction with HAPI to reproduce the existing experimental measurements and provide reliable calculation of planetary opacities. Users should be mindful regarding selection of appropriate parameters in HITRAN and selecting suitable line shape functions in HAPI, depending on the spectral region, target molecular species, as well as ambient chemical and thermodynamic conditions.
Frequency–response relationship between exercise and locomotive syndrome across age groups: Secondary analysis of a nationwide cross-sectional study in Japan
Authors: Yamaguchi Satoshi , Yamada Keiko , Ito Yoichi M , Fuji Takeshi , Sato Kimihito , Ohe Takashi
Published: June 2022

Objectives

This study aimed to clarify the frequency–response relationship between exercise habits and locomotive syndrome (LS) in different age groups.

Methods

We analysed 8681 independent community dwellers who participated in a nationwide cross-sectional LS study. Participants were divided into young (20–39 years), middle (40–64 years), and old (≥ 65 years) groups. The presence of LS was evaluated using the LS risk tests. Exercise habits were assessed by exercise frequency (almost every day/sometimes/occasionally/never). The association between LS and exercise was assessed using the multiple logistic regression analysis adjusted for participant characteristics for each age category.

Results

Overall, 3528 (41%) participants had LS. In the old group, the risk of LS was lower with an increased exercise frequency. However, this dose–response relationship was not found in the young group. The proportion of LS was lower even in participants who occasionally exercised (1–3 days/month) than those who never exercise in the young and middle age groups.

Conclusions

Regular exercise reduced the risk of LS not only in middle and older adults but also in young adults. Moreover, increasing exercise frequency may provide benefits for LS prevention, especially among older adults.
Comparisons between US norm-based two-component and Japanese norm-based three-component SF-36 summary scores in systemic lupus erythematosus patients
Authors: Yamashita Sayuri , Katsumata Yasuhiro , Konda Naoko , Kandane-Rathnayake Rangi , Morand Eric F , Harigai Masayoshi
Published: June 2022

Objectives

We compared the US norm-based two-component vs. Japanese norm-based three-component summary scores of the Medical Outcomes Study Short Form-36 (SF-36) in patients with systemic lupus erythematosus (SLE).

Methods

One hundred fourteen Japanese SLE patients were studied. SF-36 physical component summary (PCS) and mental component summary (MCS) scores were computed by the US norm-based two-component (US2) and Japanese norm-based three-component (JP3) models, respectively, and compared. Their association with demographics and disease characteristics was also analysed.

Results

The US2-PCS scores were significantly higher than the JP3-PCS scores (p < .001); however, the US2-MCS and JP3-MCS scores were not significantly different (p = .16). Bland–Altman analyses demonstrated that the US2-PCS scores were generally higher than the JP3-PCS scores, and their difference was larger in the subjects with lower PCS scores. However, the multiple linear regression analyses for the PCS and MCS scores computed by the different models demonstrated mostly equivalent standardized regression coefficients with the variables.

Conclusions

Although the agreement between the US norm-based two-component and Japanese norm-based three-component models of the SF-36 was insufficient, their scores demonstrated similar associations with other variables. The application of the US original version could be acceptable in certain studies depending on the research question.
The domains of yeast eIF4G, eIF4E and the cap fine-tune eIF4A activities through an intricate network of stimulatory and inhibitory effects
Authors: Krause Linda , Willing Florian , Andreou Alexandra Zoi , Klostermeier Dagmar
Published: June 2022

Translation initiation in eukaryotes starts with the recognition of the mRNA 5′-cap by eIF4F, a hetero-trimeric complex of eIF4E, the cap-binding protein, eIF4A, a DEAD-box helicase, and eIF4G, a scaffold protein. eIF4G comprises eIF4E- and eIF4A-binding domains (4E-BD, 4A-BD) and three RNA-binding regions (RNA1–RNA3), and interacts with eIF4A, eIF4E, and with the mRNA. Within the eIF4F complex, the helicase activity of eIF4A is increased. We showed previously that RNA3 of eIF4G is important for the stimulation of the eIF4A conformational cycle and its ATPase and helicase activities. Here, we dissect the interplay between the eIF4G domains and the role of the eIF4E/cap interaction in eIF4A activation. We show that RNA2 leads to an increase in the fraction of eIF4A in the closed state, an increased RNA affinity, and faster RNA unwinding. This stimulatory effect is partially reduced when the 4E-BD is present. eIF4E binding to the 4E-BD then further inhibits the helicase activity and closing of eIF4A, but does not affect the RNA-stimulated ATPase activity of eIF4A. The 5′-cap renders the functional interaction of mRNA with eIF4A less efficient. Overall, the activity of eIF4A at the 5′-cap is thus fine-tuned by a delicately balanced network of stimulatory and inhibitory interactions.
Contrastive learning on protein embeddings enlightens midnight zone
Authors: Heinzinger Michael , Littmann Maria , Sillitoe Ian , Bordin Nicola , Orengo Christine , Rost Burkhard
Published: June 2022

Experimental structures are leveraged through multiple sequence alignments, or more generally through homology-based inference (HBI), facilitating the transfer of information from a protein with known annotation to a query without any annotation. A recent alternative expands the concept of HBI from sequence-distance lookup to embedding-based annotation transfer (EAT). These embeddings are derived from protein Language Models (pLMs). Here, we introduce using single protein representations from pLMs for contrastive learning. This learning procedure creates a new set of embeddings that optimizes constraints captured by hierarchical classifications of protein 3D structures defined by the CATH resource. The approach, dubbed ProtTucker, has an improved ability to recognize distant homologous relationships than more traditional techniques such as threading or fold recognition. Thus, these embeddings have allowed sequence comparison to step into the ‘midnight zone’ of protein similarity, i.e. the region in which distantly related sequences have a seemingly random pairwise sequence similarity. The novelty of this work is in the particular combination of tools and sampling techniques that ascertained good performance comparable or better to existing state-of-the-art sequence comparison methods. Additionally, since this method does not need to generate alignments it is also orders of magnitudes faster. The code is available at https://github.com/Rostlab/EAT.
Association of coronary artery calcium with adverse cardiovascular outcomes and death in patients with chronic kidney disease: results from the KNOW-CKD
Authors: Jung Chan-Young , Yun Hae-Ryong , Park Jung Tak , Joo Young Su , Kim Hyung Woo , Yoo Tae-Hyun , Kang Shin-Wook , Lee Joongyub , Chae Dong-Wan , Chung Wookyung , Kim Yong-Soo , Oh Kook-Hwan , Han Seung Hyeok
Published: June 2022

Background

In East Asian countries, patients with chronic kidney disease (CKD) have lower cardiovascular risk profiles and experience fewer cardiovascular events (CVEs) than those in Western countries. Thus the clinical predictive performance of well-known risk factors warrants further testing in this population.

Methods

The KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD) is a multicenter, prospective observational study. We included 1579 participants with CKD G1–G5 without kidney replacement therapy between 2011 and 2016. The main predictor was the coronary artery calcium score (CACS). The primary outcome was a composite of nonfatal CVEs or all-cause mortality. Secondary outcomes included 3-point major adverse cardiovascular events (MACEs; the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke), all CVEs and all-cause mortality.

Results

During a median follow-up of 5.1 years, a total of 123 primary outcome events occurred (incidence rate 1.6/100 person-years). In the multivariable Cox model, a 1-standard deviation log increase in the CACS was associated with a 1.67-fold [95% confidence interval (CI), 1.37–2.04] higher risk of the primary outcome. Compared with a CACS of 0, the hazard ratio associated with a CACS >400 was 4.89 (95% CI 2.68–8.93) for the primary outcome. This association was consistent for secondary outcomes. Moreover, inclusion of the CACS led to modest improvements in prediction indices of the primary outcome compared with well-known conventional risk factors.

Conclusions

In Korean patients with CKD, the CACS was independently associated with adverse cardiovascular outcomes and all-cause death. The CACS also showed modest improvements in prediction performance over conventional cardiovascular risk factors.
Decisional needs of patients with recurrent high-grade glioma and their families
Authors: Sorensen von Essen Helle , Stacey Dawn , Dahl Steffensen Karina , Guldager Rikke , Rom Poulsen Frantz , Piil Karin
Published: June 2022

Background

High-grade gliomas are aggressive and life-threatening brain tumors. At the time of recurrence, the patients and their families need to decide on future treatment. None of the treatment options are curative, and tradeoffs between benefits and harms must be made. This study aimed to explore the patients’ and family members’ decisional needs when making the decision.

Methods

We performed semi-structured individual interviews with patients and family members to explore their experiences during the decision making. A phenomenological hermeneutical analysis was conducted.

Results

A total of 15 patients and 14 family members aged 22-79 years participated in the study. Most of the family members were partners to the patient. The findings were centered around three interrelated and concurrently occurring themes: (I) A patient- and family-centered decision making, including the subtheme of being a supportive family member; (II) Balanced information and a trustful professional encounter; and (III) The value of hope. We found that both the patients and family members preferred to be involved in the decision making and that a trustful relationship with the surgeon, balanced and tailored information, and sufficient time to make the decision were essential. The experience of hope had a significant influence on patients’ decisions.

Conclusion

This study found that patient and family involvement, balanced information, and hope were the primary decisional needs of patients and family members at the time of recurrent high-grade glioma. Patients and family members can have different decisional needs, making individual needs assessment essential to decisional support.
Conserved secreted effectors contribute to endophytic growth and multihost plant compatibility in a vascular wilt fungus
Authors: Redkar Amey , Sabale Mugdha , Schudoma Christian , Zechmann Bernd , Gupta Yogesh K , López-Berges Manuel S , Venturini Giovanni , Gimenez-Ibanez Selena , Turrà David , Solano Roberto , Di Pietro Antonio
Published: June 2022

Fungal interactions with plant roots, either beneficial or detrimental, have a crucial impact on agriculture and ecosystems. The cosmopolitan plant pathogen Fusarium oxysporum (Fo) provokes vascular wilts in more than a hundred different crops. Isolates of this fungus exhibit host-specific pathogenicity, which is conferred by lineage-specific Secreted In Xylem (SIX) effectors encoded on accessory genomic regions. However, such isolates also can colonize the roots of other plants asymptomatically as endophytes or even protect them against pathogenic strains. The molecular determinants of endophytic multihost compatibility are largely unknown. Here, we characterized a set of Fo candidate effectors from tomato (Solanum lycopersicum) root apoplastic fluid; these early root colonization (ERC) effectors are secreted during early biotrophic growth on main and alternative plant hosts. In contrast to SIX effectors, ERCs have homologs across the entire Fo species complex as well as in other plant-interacting fungi, suggesting a conserved role in fungus–plant associations. Targeted deletion of ERC genes in a pathogenic Fo isolate resulted in reduced virulence and rapid activation of plant immune responses, while ERC deletion in a nonpathogenic isolate led to impaired root colonization and biocontrol ability. Strikingly, some ERCs contribute to Fo infection on the nonvascular land plant Marchantia polymorpha, revealing an evolutionarily conserved mechanism for multihost colonization by root infecting fungi.
SlVQ15 interacts with jasmonate-ZIM domain proteins and SlWRKY31 to regulate defense response in tomato
Authors: Huang Huang , Zhao Wenchao , Li Chonghua , Qiao Hui , Song Susheng , Yang Rui , Sun Lulu , Ma Jilin , Ma Xuechun , Wang Shaohui
Published: June 2022

Botrytis cinerea is one of the most widely distributed and harmful pathogens worldwide. Both the phytohormone jasmonate (JA) and the VQ motif-containing proteins play crucial roles in plant resistance to B. cinerea. However, their crosstalk in resistance to B. cinerea is unclear, especially in tomato (Solanum lycopersicum). In this study, we found that the tomato VQ15 was highly induced upon B. cinerea infection and localized in the nucleus. Silencing SlVQ15 using virus-induced gene silencing reduced resistance to B. cinerea. Overexpression of SlVQ15 enhanced resistance to B. cinerea, while disruption of SlVQ15 using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein9 (Cas9) technology increased susceptibility to B. cinerea. Furthermore, SlVQ15 formed homodimers. Additionally, SlVQ15 interacted with JA-ZIM domain proteins, repressors of the JA signaling pathway, and SlWRKY31. SlJAZ11 interfered with the interaction between SlVQ15 and SlWRKY31 and repressed the SlVQ15-increased transcriptional activation activity of SlWRKY31. SlVQ15 and SlWRKY31 synergistically regulated tomato resistance to B. cinerea, as silencing SlVQ15 enhanced the sensitivity of slwrky31 to B. cinerea. Taken together, our findings showed that the SlJAZ-interacting protein SlVQ15 physically interacts with SlWRKY31 to cooperatively control JA-mediated plant defense against B. cinerea.
Signatures of muscle disuse in spaceflight and bed rest revealed by single muscle fiber proteomics
Authors: Murgia Marta , Ciciliot Stefano , Nagaraj Nagarjuna , Reggiani Carlo , Schiaffino Stefano , Franchi Martino V , Pišot Rado , Šimunič Boštjan , Toniolo Luana , Blaauw Bert , Sandri Marco , Biolo Gianni , Flück Martin , Narici Marco V , Mann Matthias
Published: June 2022

Astronauts experience dramatic loss of muscle mass, decreased strength, and insulin resistance, despite performing daily intense physical exercise that would lead to muscle growth on Earth. Partially mimicking spaceflight, prolonged bed rest causes muscle atrophy, loss of force, and glucose intolerance. To unravel the underlying mechanisms, we employed highly sensitive single fiber proteomics to detail the molecular remodeling caused by unloading and inactivity during bed rest and changes of the muscle proteome of astronauts before and after a mission on the International Space Station. Muscle focal adhesions, involved in fiber–matrix interaction and insulin receptor stabilization, are prominently downregulated in both bed rest and spaceflight and restored upon reloading. Pathways of antioxidant response increased strongly in slow but not in fast muscle fibers. Unloading alone upregulated markers of neuromuscular damage and the pathway controlling EIF5A hypusination. These proteomic signatures of mechanical unloading in muscle fiber subtypes contribute to disentangle the effect of microgravity from the pleiotropic challenges of spaceflight.
Doctor of Physical Therapy Education in a Hybrid Learning Environment: A Case Report
Authors: Gagnon Kendra , Bachman Teresa , Beuning Brett , Koppenhaver Shane , Unverzagt Casey , Feda Jessica , Gantt Christy , Young Brian
Published: June 2022

Objective

The purpose of this case report is to describe the implementation and report early outcomes of a 2-year (6-trimester), hybrid doctor of physical therapy (DPT) program.

Methods

The case report describes management of (1) academic affairs, (2) student affairs, (3) faculty affairs, and (4) institutional affairs for an accredited, fully hybrid, 2-year DPT program. In the hybrid program, students from across the country participate in synchronous and asynchronous online learning and travel to campus twice per trimester for immersive blocks of in-person laboratory instruction. The case report describes how the program structures the hybrid learning environment and reports outcomes from the first 2 graduated cohorts.

Results

Program outcomes assessment revealed that 97% to 98% of students/graduates reported being somewhat or very satisfied with the 2-year hybrid DPT program at the end of DPT year 1, at graduation, and at 1 year after graduation. Clinical instructors reported that 84% of students were prepared or well-prepared for clinical education. At 1 year after graduation, 20% of graduates were enrolled in or had completed residency, National Physical Therapy Examination (NPTE) pass rate was 97%, and employment rate was 99%.

Conclusion

Hybrid DPT education is feasible and may provide opportunities for more flexible and accessible delivery of DPT education. Outcomes of this case report suggest high student satisfaction, increased student/graduate diversity, and graduate outcomes comparable with national averages as reported in the Commission on Accreditation in Physical Therapy Education aggregate data.

Impact

This case report provides early evidence that hybrid DPT education—a type of blended learning that uses both face-to-face and online instructional strategies—is feasible, with student satisfaction and student/graduate outcomes comparable with national averages. Hybrid education may provide educators, programs, and institutions the flexibility to innovate in ways that address some of the immediate and long-term challenges facing physical therapist professional education while maintaining standards of excellence.
Combining Cognitive Behavioral Therapy for Insomnia and Chronic Spinal Pain Within Physical Therapy: A Practical Guide for the Implementation of an Integrated Approach
Authors: Van Looveren Eveline , Meeus Mira , Cagnie Barbara , Ickmans Kelly , Bilterys Thomas , Malfliet Anneleen , Goubert Dorien , Nijs Jo , Danneels Lieven , Moens Maarten , Mairesse Oliver
Published: June 2022

Most people who have nonspecific chronic spinal pain (nCSP) report comorbid insomnia. However, in current treatment strategies for nCSP, insomnia is usually not addressed. Considering the bidirectional interaction between pain and sleep and its underlying psychophysiological mechanisms, insomnia may increase the risk of developing adverse physical and psychological health outcomes and should thus no longer be left untreated. As suggested by previous pilot studies, adding cognitive behavioral therapy for insomnia to the contemporary evidence-based biopsychosocial physical therapy approach may also improve pain outcomes in nCSP. This manuscript aims to provide practical guidelines on hybrid physical therapy, including the combination of the following components: (1) pain neuroscience education (eg, to reconceptualize pain) and cognition-targeted exercise therapy (eg, graded exposure to functional daily life movements), and (2) cognitive behavioral therapy for insomnia (sleep psychoeducation, behavioral and cognitive therapy, correction of sleep hygiene, and relaxation therapy) can be deployed for the management of patients who have chronic spinal pain.

Impact. Due to the major impact sleep disturbances have on pain and disability, insomnia as a comorbidity should no longer be ignored when treating patients with chronic spinal pain.
Sex Differences in Functional Capacity in Older Adults With Stroke: An Analysis of Data From the National Health and Aging Trends Study
Authors: Wiley Elise , Noguchi Kenneth S , Moncion Kevin , Stratford Paul W , Tang Ada
Published: June 2022

Objective

Women experience greater disability following stroke, but biological sex differences in both overall and specific domains of functional capacity are not well understood. The primary objective of this study was to examine sex differences in overall functional capacity (Short Physical Performance Battery [SPPB] score) cross-sectionally and longitudinally over a 3-year follow-up period. The secondary objective was to determine whether sex differences exist in specific domains of functional capacity of walking speed and lower extremity functional strength.

Methods

This study was a secondary analysis of data of individuals with stroke from the National Health and Aging Trends Study. For the cross-sectional analyses, general linear models were used to examine differences between 293 men and 427 women in SPPB, walking speed, and the 5-Times Sit-to-Stand Test (5XSST). For the longitudinal analysis, survey-weighted, multivariable-adjusted generalized linear mixed models were used to compare 3-year trajectories in SPPB scores between the sexes (87 men, 153 women).

Results

Women had lower SPPB scores at baseline (difference = 0.9, linearized SE = 0.3) and over 3 years. SPPB scores declined similarly between men and women. Women had lower walking speed (difference = 0.08 m/s, SE = 0.02) as compared with men, but men and women had similar 5XSST scores (difference = 0.6 seconds, SE = 0.5).

Conclusion

Older women with stroke have clinically meaningfully lower overall functional capacity as compared with older men but decline at a similar rate over time. Walking speed was lower in older women with stroke, but similar between sexes in 5XSST.

Impact

Women with stroke have poorer functional capacity compared with men, which reinforces the importance of targeted stroke rehabilitation strategies to address these sex-specific disparities.

Lay Summary

Women with stroke have poorer outcomes in terms of their ability to move around the community when compared with men. However, both men and women with stroke have similar physical functioning over time.
Systemic Discrimination Among Large U.S. Employers
Authors: Kline Patrick , Rose Evan K , Walters Christopher R
Published: June 2022

We study the results of a massive nationwide correspondence experiment sending more than 83,000 fictitious applications with randomized characteristics to geographically dispersed jobs posted by 108 of the largest U.S. employers. Distinctively Black names reduce the probability of employer contact by 2.1 percentage points relative to distinctively white names. The magnitude of this racial gap in contact rates differs substantially across firms, exhibiting a between-company standard deviation of 1.9 percentage points. Despite an insignificant average gap in contact rates between male and female applicants, we find a between-company standard deviation in gender contact gaps of 2.7 percentage points, revealing that some firms favor male applicants and others favor women. Company-specific racial contact gaps are temporally and spatially persistent, and negatively correlated with firm profitability, federal contractor status, and a measure of recruiting centralization. Discrimination exhibits little geographical dispersion, but two-digit industry explains roughly half of the cross-firm variation in both racial and gender contact gaps. Contact gaps are highly concentrated in particular companies, with firms in the top quintile of racial discrimination responsible for nearly half of lost contacts to Black applicants in the experiment. Controlling false discovery rates to the 5% level, 23 companies are found to discriminate against Black applicants. Our findings establish that discrimination against distinctively Black names is concentrated among a select set of large employers, many of which can be identified with high confidence using large-scale inference methods.
Combined plasma metabolomic and transcriptomic analysis identify histidine as a biomarker and potential contributor in SLE pathogenesis
Authors: Iwasaki Yukiko , Takeshima Yusuke , Nakano Masahiro , Okubo Mai , Ota Mineto , Suzuki Akari , Kochi Yuta , Okamura Tomohisa , Endo Takaho , Miki Ichiro , Sakurada Kazuhiro , Yamamoto Kazuhiko , Fujio Keishi
Published: June 2022

Objectives

To investigate metabolite alterations in the plasma of SLE patients to identify novel biomarkers and provide insight into SLE pathogenesis.

Methods

Patients with SLE (n = 41, discovery cohort and n = 37, replication cohort), healthy controls (n = 30 and n = 29) and patients with RA (n = 19, disease control) were recruited. Metabolic profiles of the plasma samples were analysed using liquid chromatography-time-of-flight mass spectrometry and capillary electrophoresis-time-of-flight mass spectrometry. Transcriptome data was analysed using RNA-sequencing for 18 immune cell subsets. The importance of histidine (His) in plasmablast differentiation was investigated by using mouse splenic B cells.

Results

We demonstrate that a specific amino acid combination including His can effectively distinguish between SLE patients and healthy controls. Random forest and partial least squares-discriminant analysis identified His as an effective classifier for SLE patients. A decrease in His plasma levels correlated with damage accrual independent of prednisolone dosage and type I IFN signature. The oxidative phosphorylation signature in plasmablasts negatively correlated with His levels. We also showed that plasmablast differentiation induced by innate immune signals was dependent on His.

Conclusions

Plasma His levels are a potential biomarker for SLE patients and are associated with damage accrual. Our data suggest the importance of His as a pathogenic metabolite in SLE pathogenesis.
Dynamic Patterns of Symptoms and Functioning in Predicting Deliberate Self-harm in Patients with First-Episode Schizophrenia-Spectrum Disorders Over 3 Years
Authors: Wong Ting Yat , Chan Sherry Kit Wa , Cheung Charlton , Lai Ming Hui Christy , Suen Yi Nam , Chang Wing Chung , Lee Edwin Ho Ming , Chen Eric Yu Hai
Published: June 2022

Objectives

Patients with schizophrenia have a significant risk of self-harm. We aimed to explore the dynamic relationship between symptomatology, functioning and deliberate self-harm (DSH) and evaluate the feasibility of developing a self-harm risk prediction tool for patients with first-episode schizophrenia (FES).

Methods

Patients with FES (n = 1234) were followed up for 36 months. Symptomatology, functioning, treatment adherence and self-harm information were obtained monthly over the follow-up period. A time-varying vector autoregressive (VAR) model was used to study the contribution of clinical variables to self-harm over the 36th month. Random forest models for self-harm were established to classify the individuals with self-harm and predict future self-harm events.

Results

Over a 36-month period, 187 patients with FES had one or more self-harm events. The depressive symptoms contributed the most to self-harm prediction during the first year, while the importance of positive psychotic symptoms increased from the second year onwards. The random forest model with all static information and symptom instability achieved a good area under the receiver operating characteristic curve (AUROC = 0.77 ± 0.023) for identifying patients with DSH. With a sliding window analysis, the averaged AUROC of predicting a self-event was 0.65 ± 0.102 (ranging from 0.54 to 0.78) with the best model being 6-month predicted future 6-month self-harm for month 11–23 (AUROC = 0.7).

Conclusions

Results highlight the importance of the dynamic relationship of depressive and positive psychotic symptoms with self-harm and the possibility of self-harm prediction in FES with longitudinal clinical data.