bluuebunny/crossref_metadata_2025 huggingface dataset:
Weed or not a weed? Density, perceptions and management of Chromolaena odorata (Asteraceae) in West Africa: Voices from Ghana
Authors: Aigbedion‐Atalor Pascal O.
Published: September 2020

The status (weed or beneficial shrub) of Chromolaena odorata in West Africa has been a major subject of debate since its introduction in the 1930s. Its negative impacts on agriculture and biodiversity are clear. However, indigenous people have harnessed several benefits of the plant, making management strategies less straightforward. Using indigenous voices in Ghana, the current perceptions of C. odorata in West Africa were assessed. Here, 90 respondents in three regions of Ghana were interviewed, using questionnaires, on aspects relating to the abundance, perceptions and management of C. odorata in their communities. Overall, results showed that the density of C. odorata had declined. The majority of the respondents considered C. odorata as a fallow shrub, a medicinal plant or both. However, impacts on crop production and injuries incurred during physical control were also highlighted. The local uses of the plant in Ghana included treating fevers and injuries, and as a fallow shrub for soil nutrient replenishment. Although most of the respondents classified C. odorata as a useful shrub in Ghana, they also highlighted the use of local farming tools such as cutlasses for the slash of the plant. The use of herbicides for the control of C. odorata was rare and not applied specifically for C. odorata. In conclusion, local awareness programmes on the deleterious impacts of C. odorata on ecosystem functioning and livelihoods are required for its effective management in West Africa.
ONTOLOGY VALIDATION ALGORITHM ON DATA DRIVEN APPROACH AND VOCABULARY ASPECT
Authors: Mohamad Radziah , Mohd-Hamka Nurhamizah
Published: September 2020

Ontology evaluation is required before using the ontology within applications. Similar with software practice, the purpose of ontology evaluation is to identify the achievement of requirement criteria.  Users who require coverage criteria often seeking ontology that contain the terms related to their focused domain knowledge. Users encounter the difficulty to select a suitable ontology from variety of ontology evaluation approaches. Conceptualization of information related to ontology evaluation helps to identify the important component within ontology that helps towards coverage criteria achievement. This work proposes an algorithm to extract ontology documents gained from public ontology repositories like Falcons into its vocabulary parts focused on classes and literals. The algorithm then processes the extracted ontology components with similarity algorithm and later displays the result on the coverage match of ontology with provided terms and the terms that are synonym expanded using WordNet.
Acute activation of bronchopulmonary vagal nociceptors by type I interferons
Authors: Patil Mayur J. , Ru Fei , Sun Hui , Wang Jingya , Kolbeck Roland R. , Dong Xinzhong , Kollarik Marian , Canning Brendan J. , Undem Bradley J.
Published: September 2020

Key points

Type I interferon receptors are expressed by the majority of vagal C‐fibre neurons innervating the respiratory tract

Interferon alpha and beta acutely and directly activate vagal C‐fibers in the airways.

The interferon‐induced activation of C‐fibers occurs secondary to stimulation of type 1 interferon receptors

Type 1 interferons may contribute to the symptoms as well as the spread of respiratory viral infections by causing coughing and other defensive reflexes associated with vagal C‐fibre activation

We evaluated the ability of type I interferons to acutely activate airway vagal afferent nerve terminals in mouse lungs. Using single cell RT‐PCR of lung‐specific vagal neurons we found that IFNAR1 and IFNAR2 were expressed in 70% of the TRPV1‐positive neurons (a marker for vagal C‐fibre neurons) and 44% of TRPV1‐negative neurons. We employed an ex vivo vagal innervated mouse trachea‐lung preparation to evaluate the effect of interferons in directly activating airway nerves. Utilizing 2‐photon microscopy of the nodose ganglion neurons from Pirt‐Cre;R26‐GCaMP6s mice we found that applying IFNα or IFNβ to the lungs acutely activated the majority of vagal afferent nerve terminals. When the type 1 interferon receptor, IFNAR1, was blocked with a blocking antibody the response to IFNβ was largely inhibited. The type 2 interferon, IFNγ, also activated airway nerves and this was not inhibited by the IFNAR1 blocking antibody. The Janus kinase inhibitor GLPG0634 (1 μm) virtually abolished the nerve activation caused by IFNβ. Consistent with the activation of vagal afferent C‐fibers, infusing IFNβ into the mouse trachea led to defensive breathing reflexes including apneas and gasping. These reflexes were prevented by pretreatment with an IFN type‐1 receptor blocking antibody. Finally, using whole cell patch‐clamp electrophysiology of lung‐specific neurons we found that IFNβ (1000 U ml−1) directly depolarized the membrane potential of isolated nodose neurons, in some cases beyond to action potential threshold. This acute non‐genomic activation of vagal sensory nerve terminals by interferons may contribute to the incessant coughing that is a hallmark of respiratory viral infections.
Blood Flow Manipulation in the Aorta With Coarctation and Arch Narrowing for Pediatric Subjects
Authors: Jia Yuxi , Punithakumar Kumaradevan , Noga Michelle , Hemmati Arman
Published: September 2020

The characteristics of blood flow in an abnormal pediatric aorta with an aortic coarctation and aortic arch narrowing are examined using direct numerical simulations and patient-specific boundary conditions. The blood flow simulations of a normal pediatric aorta are used for comparison to identify unique flow features resulting from the aorta geometrical anomalies. Despite flow similarities compared to the flow in normal aortic arch, the flow velocity decreases with an increase in pressure, wall shear stress, and vorticity around both anomalies. The presence of wall shear stresses in the trailing indentation region and aorta coarctation opposing the primary flow direction suggests that there exist recirculation zones in the aorta. The discrepancy in relative flowrates through the top and bottom of the aorta outlets, and the pressure drop across the coarctation, implies a high blood pressure in the upper body and a low blood pressure in the lower body. We propose using flow manipulators prior to the aortic arch and coarctation to lower the wall shear stress, while making the recirculation regions both smaller and weaker. The flow manipulators form a guide to divert and correct blood flow in critical regions of the aorta with anomalies.
Adding a Detrital Actor to Increase System of System Resilience: A Case Study Test of a Biologically Inspired Design Heuristic to Guide Sociotechnical Network Evolution
Authors: Watson Bryan C. , Malone Stephen , Weissburg Marc , Bras Bert
Published: September 2020

Networking complex sociotechnical systems into larger Systems of Systems (SoS) typically results in improved performance characteristics including sustainability, efficiency, and productivity. The response, or lack thereof, of many SoS to unexpected constituent system failures undermines their effectiveness in many cases. SoS performance after faults can be improved by improving the SoS’s hard (physical design) or soft (human intervention) resilience. The current approaches to increase resilience are limited due to the cost and necessary of human response increasing non-linearly with SoS scale. The limitations of current approaches require a novel design approach to improve SoS network resilience. We hypothesize that biologically inspired network design can improve SoS resilience. To illustrate this, a systems dynamics model of a Forestry Industry is presented and an optimization search over potential hard and soft resilience approaches is compared to a biologically inspired network improvement. SoS network resilience is measured through the newly developed System of System Resilience Measurement (SoSRM). Our first result provides evidence that biologically inspired network design provides an approach to increase SoS resilience beyond hard and soft resilience improvements alone. Second, this work provides evidence that having a SoS constituent fulfill the ecosystem role of detrital actor increases resilience. Third, this paper documents the first case study using the new SoSRM metric to justify a design decision. Finally, this case study provides a counter-example to the theory that increased sustainability always results in increased resilience. By comparing biologically inspired network redesign and optimized traditional resilience improvements, this paper provides evidence that biologically inspired intervention may be the needed strategy to increase sociotechnical SoS network resilience, improve SoS performance, and overcome the limitations of traditional resilience improvement approaches.
An impedance-based formulation of frequency-domain nonlinearity indicators in finite-amplitude sound propagation
Authors: Ohm Won-Suk , Gee Kent L. , Park Taeyoung
Published: September 2020

Since the Morfey-Howell Q/S was introduced as a single-point frequency-domain nonlinearity indicator for propagation of intense broadband noise [AIAA J. 19, 986–992 (1981)], there has been debate about its validity, utility, and interpretation. In this Letter, the generalized Burgers equation is recast in terms of specific acoustic impedance along with linear absorption and dispersion coefficients, normalized quadspectral density (Q/S), and newly proposed normalized cospectral density (C/S). The formulation leads to a rather straightforward interpretation in which Q/S and C/S, respectively, represent the additional absorption and dispersion at a locale, produced by the passage of a finite-amplitude wave.
MAIT cell activation and dynamics associated with COVID-19 disease severity
Authors: Parrot Tiphaine , Gorin Jean-Baptiste , Ponzetta Andrea , Maleki Kimia T. , Kammann Tobias , Emgård Johanna , Perez-Potti André , Sekine Takuya , Rivera-Ballesteros Olga ,   the Karolinska COVID-19 Study Group, Gredmark-Russ Sara , Rooyackers Olav , Folkesson Elin , Eriksson Lars I. , Norrby-Teglund Anna , Ljunggren Hans-Gustaf , Björkström Niklas K. , Aleman Soo , Buggert Marcus , Klingström Jonas , Strålin Kristoffer , Sandberg Johan K. , Sandberg John Tyler , Bergsten Helena , Björkström Niklas K , Brighenti Susanna , Buggert Marcus , Butrym Marta , Chambers Benedict J. , Chen Puran , Cornillet Martin , Cuapio Angelica , Diaz Lozano Isabel , Dzidic Majda , Emgård Johanna , Flodström-Tullberg Malin , Gorin Jean-Baptiste , Gredmark-Russ Sara , Haroun-Izquierdo Alvaro , Hertwig Laura , Kalsum Sadaf , Klingström Jonas , Kokkinou Efthymia , Kvedaraite Egle , Ljunggren Hans-Gustaf , Lourda Magdalini , Maleki Kimia T , Malmberg Karl-Johan , Michaëlsson Jakob , Mjösberg Jenny , Moll Kirsten , Muvva Jagadeeswara Rao , Norrby-Teglund Anna , Palma Medina Laura M. , Parrot Tiphaine , Radler Lena , Ringqvist Emma , Sandberg Johan K. , Sekine Takuya , Soini Tea , Svensson Mattias , Tynell Janne , Von Kries Andreas , Wullimann David , Perez-Potti André , Rivera-Ballesteros Olga , Maucourant Christopher , Varnaite Renata , Akber Mira , Berglin Lena , Brownlie Demi , Loreti Marco Giulio , Sohlberg Ebba , Kammann Tobias , Henriksson Elisabeth , Marquardt Nicole , Strålin Kristoffer , Aleman Soo , Sönnerborg Anders , Dillner Lena , Färnert Anna , Glans Hedvig , Nauclér Pontus , Rooyackers Olav , Mårtensson Johan , Eriksson Lars I. , Persson Björn P. , Grip Jonathan , Unge Christian
Published: September 2020

MAIT cell activation and decline in blood are associated with COVID-19 severity, features that dynamically recover in convalescence.
Genetic Features Leading to Reduced Susceptibility to Aztreonam-Avibactam among Metallo-β-Lactamase-Producing Escherichia coli Isolates
Authors: Sadek Mustafa , Juhas Mario , Poirel Laurent , Nordmann Patrice
Published: September 2020

Metallo-β-lactamase (MBL)-producing
Escherichia coli
isolates resistant to the newly developed β-lactam/β-lactamase inhibitor drug combination aztreonam-avibactam (ATM-AVI) have been reported. Here, we analyzed a series of 118 clinical MBL-producing
E. coli
isolates of various geographical origins for susceptibility to ATM-AVI. The nature of the PBP3 protein sequence and the occurrence of
bla
CMY
genes for susceptibility to ATM-AVI were investigated.
Expression of an Extracellular Protein (SMU.63) Is Regulated by SprV in Streptococcus mutans
Authors: Pandey Satya Deo , Biswas Indranil
Published: September 2020

We previously identified a pleiotropic regulator, SprV, in
Streptococcus mutans
. This regulator appears to be highly conserved among streptococci. Here, we showed that SprV regulates the expression of a secreted protein encoded by SMU.63 in
S. mutans
. SMU.63 has been known to impact biofilm formation and genetic competence, two important characteristics that help in colonization of the organism. SMU.63 is also unique since it is known to form amyloid fiber. We found that SprV regulates the expression of SMU.63 at both the transcriptional and translational levels. We also found that the expression of SprV is regulated by magnesium ion concentration. Interestingly, both low and high magnesium ion concentrations affected biofilm formation and genetic competence. Since SMU.63 is also highly conserved among streptococci, we hypothesized that SprV will have a similar effect on its expression.
Increased c-di-GMP Levels Lead to the Production of Alginates of High Molecular Mass in Azotobacter vinelandii
Authors: Ahumada-Manuel Carlos L. , Martínez-Ortiz Iliana C. , Hsueh Brian Y. , Guzmán Josefina , Waters Christopher M. , Zamorano-Sánchez David , Espín Guadalupe , Núñez Cinthia
Published: September 2020

c-di-GMP has been widely recognized for its essential role in the production of exopolysaccharides in bacteria, such as alginate produced by
Pseudomonas
and
Azotobacter
spp. This study reveals that the levels of c-di-GMP also affect the physical properties of alginate, favoring the production of high-molecular-mass alginates in response to lower OTRs. This finding opens up new alternatives for the design of tailor-made alginates for biotechnological applications.
Transcriptional Responses of Pseudomonas aeruginosa to Inhibition of Lipoprotein Transport by a Small Molecule Inhibitor
Authors: Lorenz Christian , Dougherty Thomas J. , Lory Stephen
Published: September 2020

A key set of lipoprotein transport components, LolCDE, were inhibited by both a small molecule as well as genetic downregulation of their expression. The data show a unique signature in the
Pseudomonas aeruginosa
transcriptome in response to perturbation of outer membrane biogenesis. In addition, we demonstrate a transcriptional response in key genes with marked specificity compared to several antibiotic classes with different mechanisms of action. As a result of this work, we identified genes that could be of potential use as biomarkers in a cell-based screen for novel antibiotic inhibitors of lipoprotein transport in
P. aeruginosa
.
Klebsiella pneumoniae Reduces SUMOylation To Limit Host Defense Responses
Authors: Sá-Pessoa Joana , Przybyszewska Kornelia , Vasconcelos Filipe Nuno , Dumigan Amy , Frank Christian G. , Hobley Laura , Bengoechea Jose A.
Published: September 2020

Klebsiella pneumoniae
has been singled out as an urgent threat to human health due to the increasing isolation of strains resistant to “last-line” antimicrobials, narrowing the treatment options against
Klebsiella
infections. Unfortunately, at present, we cannot identify candidate compounds in late-stage development for treatment of multidrug-resistant
Klebsiella
infections; this pathogen is exemplary of the mismatch between unmet medical needs and the current antimicrobial research and development pipeline. Furthermore, there is still limited evidence on
K. pneumoniae
pathogenesis at the molecular and cellular levels in the context of the interactions between bacterial pathogens and their hosts. In this research, we have uncovered a sophisticated strategy employed by
Klebsiella
to subvert the activation of immune defenses by controlling the modification of proteins. Our research may open opportunities to develop new therapeutics based on counteracting this
Klebsiella-
controlled immune evasion strategy.
S Protein-Reactive IgG and Memory B Cell Production after Human SARS-CoV-2 Infection Includes Broad Reactivity to the S2 Subunit
Authors: Nguyen-Contant Phuong , Embong A. Karim , Kanagaiah Preshetha , Chaves Francisco A. , Yang Hongmei , Branche Angela R. , Topham David J. , Sangster Mark Y.
Published: September 2020

The recent rapid worldwide spread of SARS-CoV-2 has established a pandemic of potentially serious disease in the highly susceptible human population. Key issues are whether humans have preexisting immune memory that provides some protection against SARS-CoV-2 and whether SARS-CoV-2 infection generates lasting immune protection against reinfection. Our analysis focused on pre- and postinfection IgG and IgG memory B cells (MBCs) reactive to SARS-CoV-2 proteins. Most importantly, we demonstrate that infection generates both IgG and IgG MBCs against the novel receptor binding domain and the conserved S2 subunit of the SARS-CoV-2 spike protein. Thus, even if antibody levels wane, long-lived MBCs remain to mediate rapid antibody production. Our study results also suggest that SARS-CoV-2 infection strengthens preexisting broad coronavirus protection through S2-reactive antibody and MBC formation.
Rescue of SARS-CoV-2 from a Single Bacterial Artificial Chromosome
Authors: Ye Chengjin , Chiem Kevin , Park Jun-Gyu , Oladunni Fatai , Platt Roy Nelson , Anderson Tim , Almazan Fernando , de la Torre Juan Carlos , Martinez-Sobrido Luis
Published: September 2020

The pandemic coronavirus (CoV) disease 2019 (COVID-19) caused by severe acute respiratory syndrome CoV-2 (SARS-CoV-2) is a major threat to global human health. To date, there are no approved prophylactics or therapeutics available for COVID-19. Reverse genetics is a powerful approach to understand factors involved in viral pathogenesis, antiviral screening, and vaccine development. In this study, we describe the feasibility of generating recombinant SARS-CoV-2 (rSARS-CoV-2) by transfection of a single bacterial artificial chromosome (BAC). Importantly, rSARS-CoV-2 possesses the same phenotype as the natural isolate
in vitro
and
in vivo
. This is the first description of a BAC-based reverse genetics system for SARS-CoV-2 and the first time that an rSARS-CoV-2 isolate has been shown to be phenotypically identical to a natural isolate in a validated animal model of SARS-CoV-2 infection. The BAC-based reverse genetics approach will facilitate the study of SARS-CoV-2 and the development of prophylactics and therapeutics for the treatment of COVID-19.
CPSF6-Dependent Targeting of Speckle-Associated Domains Distinguishes Primate from Nonprimate Lentiviral Integration
Authors: Li Wen , Singh Parmit K. , Sowd Gregory A. , Bedwell Gregory J. , Jang Sooin , Achuthan Vasudevan , Oleru Amarachi V. , Wong Doris , Fadel Hind J. , Lee KyeongEun , KewalRamani Vineet N. , Poeschla Eric M. , Herschhorn Alon , Engelman Alan N.
Published: September 2020

Integration is the defining step of the retroviral life cycle and underlies the inability to cure HIV/AIDS through the use of intensified antiviral therapy. The reservoir of latent, replication-competent proviruses that forms early during HIV infection reseeds viremia when patients discontinue medication. HIV cure research is accordingly focused on the factors that guide provirus formation and associated chromatin environments that regulate transcriptional reactivation, and studies of orthologous infectious agents such as nonprimate lentiviruses can inform basic principles of HIV biology. HIV-1 utilizes the integrase-binding protein LEDGF/p75 and the capsid interactor CPSF6 to target speckle-associated domains (SPADs) for integration. However, the extent to which these two host proteins regulate integration of other lentiviruses is largely unknown. Here, we mapped millions of retroviral integration sites in cell lines that were depleted for LEDGF/p75 and/or CPSF6. Our results reveal that primate lentiviruses uniquely target SPADs for integration in a CPSF6-dependent manner.
A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients
Authors: Morrissette Madeleine , Pitt Norman , González Antonio , Strandwitz Philip , Caboni Mariaelena , Rebman Alison W. , Knight Rob , D’Onofrio Anthony , Aucott John N. , Soloski Mark J. , Lewis Kim
Published: September 2020

Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in
Blautia
, a decrease in
Bacteroides
, and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease.
Adaptation of Arginine Synthesis among Uropathogenic Branches of the Escherichia coli Phylogeny Reveals Adjustment to the Urinary Tract Habitat
Authors: Hibbing Michael E. , Dodson Karen W. , Kalas Vasilios , Chen Swaine L. , Hultgren Scott J.
Published: September 2020

Uropathogenic
Escherichia coli
(UPEC) is the most common cause of human urinary tract infection (UTI). Population bottlenecks during early stages of UTI make high-throughput screens impractical for understanding clinically important later stages of UTI, such as persistence and recurrence. As UPEC is hypothesized to be adapted to these later pathogenic stages, we previously identified 29 genes evolving under positive selection in UPEC. Here, we found that 8 of these genes, including
argI
(which is involved in arginine biosynthesis), are important for persistence in a mouse model of UTI. Deletion of
argI
and other arginine synthesis genes resulted in (i) arginine auxotrophy and (ii) defects in persistent UTI. Replacement of a B2 clade
argI
with a non-B2 clade
argI
complemented arginine auxotrophy, but the resulting strain remained attenuated in its ability to cause persistent bacteriuria. Thus,
argI
may have a second function during UTI that is not related to simple arginine synthesis. This study demonstrates how variation in metabolic genes can impact virulence and provides insight into the mechanisms and evolution of bacterial virulence.
A New Subclass of Exoribonuclease-Resistant RNA Found in Multiple Genera of
Flaviviridae
Authors: Szucs Matthew J. , Nichols Parker J. , Jones Rachel A. , Vicens Quentin , Kieft Jeffrey S.
Published: September 2020

The members of the
Flaviviridae
comprise one of the largest families of positive-sense single-stranded RNA (+ssRNA) and are divided into the
Flavivirus
,
Pestivirus
,
Pegivirus
, and
Hepacivirus
genera. The genus
Flavivirus
contains many medically relevant viruses such as Zika virus, dengue virus, and Powassan virus. In these, a part of the RNA of the virus twists up into a distinct three-dimensional shape called an exoribonuclease-resistant RNA (xrRNA) that blocks the ability of the cell to “chew up” the viral RNA. Hence, part of the RNA of the virus remains intact, and this protected part is important for viral infection. These xrRNAs were known to occur in flaviviruses, but whether they existed in the other members of the family was not known. In this study, we identified a new subclass of xrRNA found not only in flaviviruses but also in the remaining three genera. The fact that these structured viral RNAs exist throughout the
Flaviviridae
family suggests they are important parts of the infection strategy of diverse pathogens, which could lead to new avenues of research.
Diagnosing and Predicting Mixed-Culture Fermentations with Unicellular and Guild-Based Metabolic Models
Authors: Scarborough Matthew J. , Hamilton Joshua J. , Erb Elizabeth A. , Donohue Timothy J. , Noguera Daniel R.
Published: September 2020

Microbiomes are vital to human health, agriculture, and protecting the environment. Predicting behavior of self-assembled or synthetic microbiomes, however, remains a challenge. In this work, we used unicellular and guild-based metabolic models to investigate production of medium-chain fatty acids by a mixed microbial community that is fed multiple organic substrates. Modeling results provided insights into metabolic pathways of three medium-chain fatty acid-producing guilds and identified potential strategies to increase production of medium-chain fatty acids. This work demonstrates the role of metabolic models in augmenting multi-omic studies to gain greater insights into microbiome behavior.
Inter-rater reliability of paediatric emergency assessment: physiological and clinical features
Authors: Heal Calvin , Cotterill Sarah , Rowland Andrew Graeme , Garratt Natalie , Long Tony , Brown Stephen , O'Connor Grainne , Rishton Chloe , Woby Steve , Roland Damian
Published: September 2020

Objective

The Paediatric Admission Guidance in the Emergency Department (PAGE) score is an assessment tool currently in development that helps predict hospital admission using components including patient characteristics, vital signs (heart rate, temperature, respiratory rate and oxygen saturation) and clinical features (eg, breathing, behaviour and nurse judgement). It aims to assist in safe admission and discharge decision making in environments such as emergency departments and urgent care centres. Determining the inter-rater reliability of scoring tools such as PAGE can be difficult. The aim of this study was to determine the inter-rater reliability of seven clinical components of the PAGE Score.

Design

Inter-rater reliability was measured by each patient having their clinical components recorded by two separate raters in succession. The first rater was the assessing nurse, and the second rater was a research nurse.

Setting

Two emergency departments and one urgent care centre in the North West of England. Measurements were recorded over 1 week; data were collected for half a day at each of the three sites.

Patients

A convenience sample of 90 paediatric attendees (aged 0–16 years), 30 from each of the three sites.

Main outcome measures

Two independent measures for each child were compared using kappa or prevalence-adjusted bias-adjusted kappa (PABAK). Bland-Altman plots were also constructed for continuous measurements.

Results

Inter-rater reliability ranged from moderate (0.62 (95% CI 0.48 to 0.74) weighted kappa) to very good (0.98 (95% CI 95 to 0.99) weighted kappa) for all measurements except ‘nurse judgement’ for which agreement was fair (0.30, 95% CI 0.09 to 0.50 PABAK). Complete information from both raters on all the clinical components of the PAGE score were available for 73 children (81%). These total scores showed good’ inter-rater reliability (0.64 (95% CI 0.53 to 0.74) weighted kappa).

Conclusions

Our findings suggest different nurses would demonstrate good inter-rater reliability when collecting acute assessments needed for the PAGE score, reinforcing the applicability of the tool. The importance of determining reliability in scoring systems is highlighted and a suitable methodology was presented.
Incidence of retinopathy of prematurity in Germany: evaluation of current screening criteria
Authors: Larsen Petra P , Müller Andreas , Lagrèze Wolf A , Holz Frank G , Stahl Andreas , Krohne Tim U
Published: September 2020

Objective

To evaluate current screening criteria for retinopathy of prematurity (ROP) by investigating the incidence of ROP requiring treatment in infants with gestational age (GA) ≥30 weeks or postmenstrual age (PMA) <32 weeks in Germany.

Methods

Three patient databases were analysed, that is, the German Quality Assurance Procedure in Neonatology (years 2011–2017; n=52 461 infants screened for ROP, 1505 infants treated for ROP), the German Retina.net ROP Registry (years 2011–2018; n=281 treated infants) and the ROP screening programme of two German university hospitals (years 2012–2016; n=837 screened infants).

Results

In the analysed cohorts, infants with GA ≥30 weeks represented 33.1%–38.5% of the screening populations but only 1.40%–1.42% of the cases requiring ROP treatment. In a cohort of 281 infants treated for ROP, all 4 infants with GA ≥30 weeks had additional risk factors for ROP including prolonged oxygen supplementation and/or significant comorbidities. Five infants (1.8%) were treated at 32 weeks PMA and none at PMA <32 weeks.

Conclusions

In the investigated cohorts, preterm infants with GA ≥30 weeks carried a very low or no risk for developing treatment-requiring ROP unless additional risk factors were present, and no treatment was performed earlier than 32 weeks PMA. These findings are of relevance for the ongoing re-evaluation of ROP screening criteria.
Supraglottic airway devices for administration of surfactant to newborn infants with respiratory distress syndrome: a narrative review
Authors: Roberts Calum T , Manley Brett James , O'Shea Joyce E , Stark Michael , Andersen Chad , Davis Peter G , Buckmaster Adam
Published: September 2020

Surfactant is an effective treatment for respiratory distress syndrome, being particularly important for infants in whom continuous positive airway pressure (CPAP) provides insufficient support. Supraglottic airway devices present an attractive option for surfactant delivery, particularly as an alternative to methods dependent on direct laryngoscopy, a procedural skill that is both difficult to learn and in which to maintain competence. Published studies provide encouraging data that surfactant administration by supraglottic airway device can be performed with a high rate of success and may reduce the need for subsequent intubation compared with either continued CPAP or surfactant administration via endotracheal tube. However, existing randomised controlled trials (RCTs) are heterogeneous in design and include just over 350 infants in total. To date, all RCT evidence has been generated in tertiary units, whereas the greatest potential for benefit from the use of these devices is likely to be in non-tertiary settings. Future research should investigate choice and utility of device in addition to safety and effectiveness of procedure. Importantly, studies conducted in non-tertiary settings should evaluate feasibility, meaningful clinical outcomes and the impact that this approach might have on infants and their families. Supraglottic airway devices may represent a simple and effective mode of surfactant administration that can be widely used by a variety of clinicians. However, further well-designed RCTs are required to determine their role, safety and effectiveness in both tertiary and non-tertiary settings before introduction into routine clinical practice.
Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial
Authors: Rabusin Chantel L , Menz Hylton B , McClelland Jodie A , Evans Angela M , Malliaras Peter , Docking Sean I , Landorf Karl B , Gerrard James M , Munteanu Shannon E
Published: September 2020

Objective(s)

To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy.

Methods

This was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) heel lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance.

Results

There was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the heel lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the heel lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points.

Conclusion

In adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions.

Trial registration number

ACTRN12617001225303.
Role of resistin, IL-6 and NH2-terminal portion proBNP in the pathogenesis of cardiac disease in type 2 diabetes mellitus
Authors: Ghanem Samar Ebrahim , Abdel-Samiee Mohamed , Torky Mohamed Hamdy , Gaafar Ahmed , Mohamed Somia Mokabel , Salah Eldin Ghada Mohamed Mohamed , Awad Samah Mohammed , Diab Karema A , ELsabaawy Dalia M , Yehia Sania Ali , Abdelaziz Elbasyouni Hany Abdelbary , Elshormilisy Amr Aly
Published: September 2020

Introduction

Epidemiological and genetic studies have recorded the association between proinflammatory cytokines and the development of insulin resistance, diabetes, and cardiovascular disease. The role of interleukin 6 (IL-6), NH2-terminal portion pro-brain natriuretic peptide (NT-proBNP) and resistin in the pathogenesis of heart disease in type 2 diabetes mellitus (T2DM) is still a matter of controversy. The current study aimed to evaluate the role of these biomarkers in the development of left ventricular systolic dysfunction and the ability to use them as non-invasive test in the prediction of left ventricular hypertrophy and systolic dysfunction in T2DM.

Research design and methods

150 participants were included in this case–control study. Patients were divided into two subgroups according to echocardiographic findings: group 1a included 46 patients with type 2 diabetes mellitus and echocardiographic evidence of abnormal systolic function; group 1b included 54 patients with type 2 diabetes mellitus and with normal echocardiogenic study; and group 2 included 50 apparently healthy controls. Routine laboratory investigations such as complete blood count, liver and renal function tests, and lipid profile, serum IL-6, NT-proBNP, and resistin were measured in all participants. Conventional echocardiography was done with special concern on the assessment of left ventricular systolic function (ejection fraction).

Results

There was a significant increase in the level of resistin, NT-proBNP and IL-6 in group 1a patients compared with group 1b and in healthy controls. Echocardiographic parameters showed a significant increase in left ventricular mass index, left ventricle posterior wall thickness, interventricular septum thickness, and left ventricle mass in group 1a compared with group 1b and the control group. The increased left ventricular mass index was associated with higher levels of IL-6, NT-proBNP and resistin.

Conclusions

Proinflammatory cytokines had a clear relation with left ventricular systolic dysfunction and hypertrophy and can be used as early non-invasive markers for detection of left ventricular remodeling and systolic dysfunction in patients with T2DM.
Multicentre, single-blind randomised controlled trial comparing MyndMove neuromodulation therapy with conventional therapy in traumatic spinal cord injury: a protocol study
Authors: Anderson Kim D , Wilson James R , Korupolu Radha , Pierce Jacqueline , Bowen James M , O'Reilly Daria , Kapadia Naaz , Popovic Milos R , Thabane Lehana , Musselman Kristin E
Published: September 2020

Introduction

This protocol is describing a multicentre, single-blind randomised controlled trial. The objective is to compare the efficacy of MyndMove therapy versus conventional therapy (CT) in improving upper extremity function in individuals with C4–C7 traumatic, incomplete spinal cord injury (SCI). It is being conducted in two US and two Canadian SCI rehabilitation centres.

Methods and analysis

Sixty people aged 18 years or older with a C4–C7 incomplete (AIS B-D) SCI between 4 months and 8 years postinjury are randomised to receive 40 sessions of MyndMove neuromodulation therapy or CT within a 14-week period of time. Therapy sessions are 1 hour in duration with a dose of 3–5 sessions per week. Assessments occur prior to randomisation, after 20 sessions, after 40 sessions and 10 weeks after the last session. The primary outcome measure is the efficacy of MyndMove therapy versus CT in improving upper extremity function as measured by Spinal Cord Independence Measure III: Self-Care subscore after 40 sessions. Secondary outcomes include: (1) improvements in the SCIM mobility subscore; (2) upper limb functions measured by Graded Redefined Assessment of Strength, Sensibility and Prehension and (3) Toronto Rehab Institute Hand Function Test; (4) To assess safety as measured by serious and non-serious adverse events recorded for participants in both groups of the study population over the duration of the study; (5) to compare the change in quality of life as measured by the Spinal Cord Injury-Quality of Life; and (6) to evaluate the impact on healthcare resource utilisation.

Ethics and dissemination

All ethical approvals were obtained prior to enrolling any participants. Dissemination of the results of the study will be made at peer-reviewed academic meetings and through peer-reviewed medical journals

Trial registration number

NCT03439319
Emergency medicine response to the COVID-19 pandemic in England: a phenomenological study
Authors: Walton Henry , Navaratnam Annakan Victor , Ormond Martyn , Gandhi Vanita , Mann Clifford
Published: September 2020

Background

The COVID-19 pandemic has stretched EDs globally, with many regions in England challenged by the number of COVID-19 presentations. In order to rapidly share learning to inform future practice, we undertook a thematic review of ED operational experience within England during the pandemic thus far.

Methods

A rapid phenomenological approach using semistructured telephone interviews with ED clinical leads from across England was undertaken between 16 and 22 April 2020. Participants were recruited through purposeful sampling with sample size determined by data saturation. Departments from a wide range of geographic distribution and COVID-19 experience were included. Themes were identified and included if they met one of three criteria: demonstrating a consistency of experience between EDs, demonstrating a conflict of approach between emergency departments or encapsulating a unique solution to a common barrier.

Results

Seven clinical leads from type 1 EDs were interviewed. Thematic redundancy was achieved by the sixth interview, and one further interview was performed to confirm. Themes emerged in five categories: departmental reconfiguration, clinical pathways, governance and communication, workforce and personal protective equipment.

Conclusion

This paper summarises learning and innovation from a cross-section of EDs during the first UK wave of the COVID-19 pandemic. Common themes centred around the importance of flexibility when reacting to an ever-changing clinical challenge, clear leadership and robust methods of communication. Additionally, experience in managing winter pressures helped inform operational decisions, and ED staff demonstrated incredible resilience in demanding working conditions. Subsequent surges of COVID-19 infections may occur within a more challenging context with no guarantee that there will be an associated reduction in A&E attendance or cessation of elective activity. Future operational planning must therefore take this into consideration.
Prospective cohort study of elderly patients with coronary artery disease: impact of frailty on quality of life and outcome
Authors: Qayyum Shouaib , Rossington Jennifer Ann , Chelliah Raj , John Joseph , Davidson Benjamin J , Oliver Richard M , Ngaage Dumbor , Loubani Mahmoud , Johnson Miriam J , Hoye Angela
Published: September 2020

Background

Elderly, frail patients are often excluded from clinical trials so there is lack of data regarding optimal management when they present with symptomatic coronary artery disease (CAD).

Objective

The aim of this observational study was to evaluate an unselected elderly population with CAD for the occurrence of frailty, and its association with quality of life (QoL) and clinical outcomes.

Methods

Consecutive patients aged ≥80 years presenting with CAD were prospectively assessed for frailty (Fried frailty phenotype (FFP), Edmonton frailty scale (EFS)), QoL (Short form survey (SF-12)) and comorbidity (Charlson Comorbidity Index (CCI)). Patients were re-assessed at 4 months to determine any change in frailty and QoL status as well as the clinical outcome.

Results

One hundred fifty consecutive patients with symptomatic CAD were recruited in the study. The mean age was 83.7±3.2 years, 99 (66.0%) were men. The clinical presentation was stable angina in 68 (45.3%), the remainder admitted with an acute coronary syndrome including 21 (14.0%) with ST-elevation myocardial infarction. Frailty was present in 28% and 26% by FFP and EFS, respectively, and was associated with a significantly higher CCI (7.5±2.4 in frail, 6.2±2.2 in prefrail, 5.9±1.6 in those without frailty, p=0.005). FFP was significantly related to the physical composite score for QoL, while EFS was significantly related to the mental composite score for QoL (p=0.003). Treatment was determined by the cardiologist: percutaneous coronary intervention in 51 (34%), coronary artery bypass graft surgery in 15 (10%) and medical therapy in 84 (56%). At 4 months, 14 (9.3%) had died. Frail participants had the lowest survival. Cardiovascular symptom status and the mental composite score of QoL significantly improved (52.7±11.5 at baseline vs 55.1±10.6 at follow-up, p=0.04). However, overall frailty status did not significantly change, nor the physical health composite score of QoL (37.2±11.0 at baseline vs 38.5±11.3 at follow-up, p=0.27).

Conclusions

In patients referred to hospital with CAD, frailty is associated with impaired QoL and a high coexistence of comorbidities. Following cardiac treatment, patients had improvement in cardiovascular symptoms and mental component of QoL.
Power law plateau inflation potential in the RS II braneworld evading swampland conjecture
Authors: Adhikari Rathin , Gangopadhyay Mayukh R. , Yogesh
Published: September 2020

In the recent time, inflationary cosmology is facing an existential crisis due to the proposed Swampland criterion which aims to evade any (meta-)stable de Sitter construction within the String landscape. It is been realised that a single field slow roll inflation is inconsistent with the Swampland criterion unless the inflationary model is realised in some non-standard scenario such as Warm inflation or the Braneworld scenario. Dimopoulos and Owen (Phys Rev D 94(6): 063518, 2016) introduced a new class of model of inflation dubbed as the power law plateau inflation in the standard cold inflationary scenario. But to realise this model in the standard scenario consistent with observation, they had to introduce a phase of thermal inflation. In this paper we have analysed this model in the braneworld scenario to show that for some choice of the parameters defining the model class, one can have an observationally consistent power law plateau without any phase of thermal inflation. We have also shown that, for the correct choice of model parameters, one can easily satisfy the Swampland criterion. Besides, for correct choice of equation of states ($$w_{re}$$

w

re

), one can also satisfy the recently proposed Trans–Planckian Censorship Conjecture (TCC).
BIOMECHANICAL EFFECTS OF DIFFERENT LENGTHS OF CROSS-PINS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A FINITE ELEMENT ANALYSIS
Authors: ABIDIN NUR AFIKAH ZAINAL , KADIR MOHAMMED RAFIQ ABDUL , RAMLEE MUHAMMAD HANIF
Published: September 2020

Complication rates of anterior cruciate ligament reconstruction (ACL-R) were reported to be around 15%. Although it is a very common arthroscopic surgery with good outcomes, breakage and migration of fixators are still possible to occur due to stability issue. One of the factors that affects the mechanical stability of fixators is its length. Therefore, the aim of this paper is to analyze the biomechanical effects of different lengths of fixators (cross-pin technique) towards the stabilities of the knee joint after ACL-R. Finite element analyses of knee joint with DST grafts and fixators were carried out. Mimics and 3-Matic were used in the development of knee joint models, while the grafts and fixators were designed by using SolidWorks software. All models were remeshed in the 3-Matic and numerical analysis was performed via MSC.Marc Mentat software. A 100 N anterior tibial load was applied onto the tibia to simulate the anterior drawer test after the surgery and proximal femur was fixed at all degrees of freedom. Based on the findings, cross-pin with 40[Formula: see text]mm in length provided the most favorable option for better treatment of ACL-R, where it could promote osseointegration and preventing fracture.
MAGNETOPHORETIC CIRCUIT BIOCOMPATIBILITY
Authors: ABEDINI-NASSAB ROOZBEH
Published: September 2020

Recently, we introduced magnetophoretic circuits, composed of overlaid magnetic and metallic layers, as a novel single-cell analysis (SCA) tool. We showed the ability of these circuits in organizing large single-particle and particle-pair arrays. Assembling the cells in microarrays is performed with the ultimate goal of running temporal phenotypic analyses. However, for long-term studies, a suitable microenvironment for the cells to normally grow and differentiate is needed. Towards this goal, in this study, we run required biocompatibility tests, based on which we make the magnetophoretic-based microchip a suitable home for the cells to grow. The results confirm the ability of these chips in cell handling and show no unwanted cell behavior alteration due to the applied shear stress on them, the magnetic labeling, or the microenvironment. After this achievement, this tool would be ready for running important single-cell studies in oncology, virology, and medicine.
Quantum Key Distribution
Authors: Mehic Miralem , Niemiec Marcin , Rass Stefan , Ma Jiajun , Peev Momtchil , Aguado Alejandro , Martin Vicente , Schauer Stefan , Poppe Andreas , Pacher Christoph , Voznak Miroslav
Published: September 2020

The convergence of quantum cryptography with applications used in everyday life is a topic drawing attention from the industrial and academic worlds. The development of quantum electronics has led to the practical achievement of quantum devices that are already available on the market and waiting for their first application on a broader scale. A major aspect of quantum cryptography is the methodology of Quantum Key Distribution (QKD), which is used to generate and distribute symmetric cryptographic keys between two geographically separate users using the principles of quantum physics. In previous years, several successful QKD networks have been created to test the implementation and interoperability of different practical solutions. This article surveys previously applied methods, showing techniques for deploying QKD networks and current challenges of QKD networking. Unlike studies focusing on optical channels and optical equipment, this survey focuses on the network aspect by considering network organization, routing and signaling protocols, simulation techniques, and a software-defined QKD networking approach.