bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular modelling of sorption processes of a range of diverse small organic molecules in Leonardite humic acid
Authors: Petrov Drazen , Tunega Daniel , Gerzabek Martin H. , Oostenbrink Chris
Published: July 2019

Soil organic matter (SOM) is abundant in the environment and plays an important role in several biogeochemical processes, including microbial activity, soil aggregation, plant growth and carbon storage. One of its key functions is the retention and release of various chemical compounds, primarily governed by the sorption process, which strongly affects the environmental fate of nutrients and pollutants. Sorption largely depends on the composition of SOM, as well as its structure, dynamics and the thermodynamic conditions. Although several approaches are available, experimental characterization of sorption mechanisms is not easy. Computational models for predicting sorption coefficients often require a wealth of experimental data for training and are only applicable to compounds and conditions related to the training dataset. Here, we use molecular dynamics (MD) simulations to study the sorption of a range of small organic compounds. As a model SOM system we use the standard Leonardite humic acid (LHA) sample, which physicochemical properties have recently been characterized computationally in detail. This model allowed us to estimate sorption propensities of the systems at two different hydration levels (water activities close to 0 and 1), showing a remarkable correlation with experimental data. Importantly, this molecular modelling approach based on perturbation free‐energy calculations is rigorously derived from statistical thermodynamics and requires no experimental sorption data for training. It is therefore in principle applicable to any SOM model or thermodynamic condition. Moreover, the power of MD simulations to provide high‐resolution insight into atomistic and molecular interactions was employed to explore how sorbate molecules associate with the LHA matrix and which contacts they form. The heteroatoms of both sorbate and sorbent play an important role and water molecules are identified as further key players in facilitating the sorption process.

Highlights

Modelling of the sorption processes in soil organic matter at atomistic level.

Rigorous, physics‐based approach applicable to a range of SOM systems and conditions.

Remarkable level of matching with experimental data with additional insight into the molecular mechanism.

Interactions between the sorbate and local environment strongly affects the sorption process.
Identification of most damaging nsSNPs in human CCR6 gene: In silico analyses
Authors: Akhtar Mehran , Jamal Tazkira , Jamal Hina , Din Jalal Ud , Jamal Muhsin , Arif Muhammad , Arshad Maria , Jalil Fazal
Published: July 2019

Single nucleotide polymorphisms in CCR6 (C–C chemokine receptor type 6) gene have been found to be the possible cause of many diseases like rheumatoid arthritis, psoriasis, lupus nephritis and systemic sclerosis and other autoimmune diseases. Therefore, identification of structurally and functionally important polymorphisms in CCR6 is important in order to study its potential malfunctioning and discovering therapeutic targets. Several bioinformatics tools were used to identify most damaging nsSNPs that might be vital for CCR6 structure and function. The in silico tools included PROVEAN, SIFT, SNP&GO and PolyPhen2 followed by I‐Mutant MutPred and ConSurf. Phyre2 and I‐TASSER were used for protein 3‐D Modelling while gene–gene interaction was predicted by STRING and GeneMANIA. Our study suggested that three nsSNPs rs1376162684, rs751102128 and rs1185426631 are the most damaging in CCR6 gene while 7 missense SNPs rs1438637216, rs139697820, rs768420505, rs1282264186, rs1394647982, rs769360638 and rs1263402382 are found to revert into stop codons. Prediction of post‐transcriptional modifications highlighted the significance of rs1376162684 because it effected potential phosphorylation site. Gene–gene interactions showed relation of CCR6 with other genes depicting its importance in several pathways and co‐expressions. In future, studying diseases related to CCR6 should include investigation of these 10 nsSNPs. Being the first of its type, this study also proposes future perspectives that will help in precision medicines. For such purposes, CCR6 proteins from patients of autoimmune diseases should be explored. Animal models can also be of significance find out the effects of CCR6 in diseases.
Low‐ and lower middle‐income countries advanced practice nurses: an integrative review
Authors: Scanlon A. , Murphy M. , Smolowitz J. , Lewis V.
Published: July 2019

Aim

To review published literature descriptions of advanced practice nurses’ roles in low‐ and lower middle‐income countries.

Background

Advanced practice nurse roles have the potential to address insufficient healthcare resources in low‐ and lower middle‐income countries.

Introduction

This integrative review highlights advanced practice nurses’ roles in the delivery of healthcare services in low‐ and lower middle‐income countries.

Methods

Three electronic databases PubMed, CINAHL complete and ProQuest Health & Medicine were searched. No limits by year or language were set. The names for low‐ and lower middle‐income countries and combinations ‘related to advanced practice nurses’ titles were used to identify papers. In addition, a review of publication type was performed. Themes found within the publications were assessed against the advanced practice nurses’ International Council of Nurses’ characteristics. An integrative review facilitated an appraisal of the papers identified.

Results

The initial search identified 5778 publications in 16 languages. This number was reduced to 23, from 18 low‐ and lower middle‐income once exclusion criteria were applied. Six publications were from 1977 to 1999, and six between 2000 and 2010, with the remaining 11 from 2011 to 2018. Zambia had the most publications. Notably, 63 countries were not represented. Of those meeting inclusion criteria, the majority addressed education with a lesser extent focusing on practice and regulation of advanced practice nurse’s roles. The majority were published during the last decade.

Discussion

This review of the published literature identified advanced practice nurses’ roles and function within some healthcare systems. However, not all components were reported. Examination of the grey literature could provide additional information about the actual and potential benefits of advanced practice nurses’ in low‐ and lower middle‐income countries.

Conclusion

The published literature that referred to advanced practice nurses’ identified their contribution to positive impacts on health care over the last 40 years. However, with only 11 publications identified in the last 7 years, further review is required to understand the advanced practice nurses’ roles in these countries.

Implications for nursing and/or health policy

Further development of advanced practice nurses’ in low‐ and lower middle‐income countries is supported by the lack of published literature.
Polyvinylalcohol Membranes for Plasma Separation
Authors: Sueoka Akinori , Wojcicki Jan , Malchesky Paul S. , Nosé Yukihiko
Published: July 2019

Guest Editor's Introduction: This paper was presented at the first plasmapheresis symposium organized by the International Society for Artificial Organs and the International Center for Artificial Organs and Transplantation on April 3,1982, Cleveland, Ohio. This paper was published in the proceedings of this symposium, Plasmapheresis: Therapeutic Applications and New Technologies, edited by Y. Nosé, P.S. Malchesky, J.W. Smith, and R.S. Krakauer, Raven Press, New York, 1983, p. 149‐160. This paper describes the first technical information on the polyvinylalcohol (PVA) plasma separator manufactured by Kuraray Co. (Osaka, Japan). This hollow fiber membrane had a high heat resistency and mechanical strength with high hydrophilicity. They are autoclavable and contain no additives. Its in vitro and ex vivo performances as a plasma separator are described.
Comparison of the different supports used in veterinary medicine for pressure sore prevention
Authors: Caraty J. , De Vreught L. , Cachon T. , Moissonnier P. , Bongartz A. , Viguier E. , Carozzo C.
Published: July 2019

Objectives

To compare the pressure‐relieving capacity of different supports used in veterinary medicine and to find the more common pressure sore locations in laterally recumbent dogs, so as to recommend protocols for decubitus ulcer prevention.

Materials and Methods

We compared the support properties of: (1) blankets on the floor, (2) a standard mattress, (3) a veterinary memory foam mattress and (4) a human medicine memory foam mattress. Three cadaver dogs with different body condition scores but similar sizes were positioned on the different supports in lateral recumbency. Pressures were measured in each dog and at each support contact point over a 4‐hour period using a TexiSense pressure mat.

Results

Regardless of the body condition score and the support used, the skin overlying the scapula‐humeral articulation, the greater trochanter and the thirteenth rib were the recurrent risk zones. In these risk zones, pressure‐relieving mats led to lower pressures than did the standard mats or the blanket placed on the floor. The contact pressures appeared to depend on body condition score, with maximal pressures observed in thin dogs.

Clinical Significance

It is important to use a pressure‐relieving mat to reduce the risk of pressure sores, but static pressure‐relieving mats are generally insufficient to maintain safe pressures in risk zones (<60 mmHg), particularly in thin patients, and so frequent changes in position are recommended.
Vital and enchanted: Jane Bennett and new materialism for nursing philosophy and practice
Authors: Neff Ian
Published: July 2019

Nursing theories are typically anthropocentric and emphasize caring for a person as a unitary whole. They maintain the dualisms of human–nonhuman, natural–social and material–ideal. Recent developments in nonhuman ontology question the utility of that approach. One important philosopher in this new materialism is political theorist Jane Bennett. In this paper, I explore Bennett's vital materialism and enchantment as two concepts arising from the nonhuman turn that should inform nursing philosophy. Vital materialism considers the lively power of matter to affect the world and be affected in relations. Enchantment refers to a sense of wonder and captivation with matter. While summarizing her important contributions, I also describe common criticisms and responses. I consider the human as an assemblage of matter as well as the agency or “thing power” of matter external to humans. This has implications for nursing thought and practice, and it can inform a more capacious research methodology. I also discuss how compassion fatigue or burnout and other professional issues may be seen as a form of disenchantment with the material world. I argue that embracing these and other elements of Bennett's new materialist philosophy can help nurses and other health professionals enrich their theories and practice to advance their disciplines and improve care for persons and populations.
JAK2‐STAT3 signaling pathway is involved in rat periapical lesions induced by Enterococcus faecalis
Authors: Wang Lina , Jin Haiwei , Ao Xiang , Dong Ming , Liu Shuo , Lu Ying , Niu Weidong
Published: July 2019

Objectives

This study aimed to investigate the role of JAK2‐STAT3 (Janus kinase 2/signal transducer and activator of transcription 3) in periapical disease caused by Enterococcus faecalis, as well as the correlation between lipoteichoic acid (LTA) in E. faecalis and the activity of the JAK2‐STAT3 signaling pathway and osteoclast formation.

Materials and Methods

A rat model of periapical periodontitis induced by E. faecalis was established. Periapical bone resorption was confirmed by HE staining. The expression of JAK2, p‐JAK2, STAT3, and p‐STAT3 was assessed with immunohistochemical staining. Osteoclasts were observed through enzyme histochemical staining. LTA acted on mouse osteoclast precursor cells (RAW264.7 cells); a JAK2 inhibitor (AG490) was used to inhibit the JAK2‐STAT3 pathway in RAW264.7 cells. The expression of proteins in the JAK2‐STAT3 pathway and TRAP (tartrate resistant acid phosphatase) in RAW264.7 cells was also detected.

Results

Rat periapical periodontitis was successfully established and bone resorption peaked at day 21. The expression of critical components in the JAK2‐STAT3 pathway increased with the progression of inflammation. LTA promoted the differentiation of RAW264.7 cells into osteoclasts. NFATc1 was highly expressed and was inhibited by AG490.

Conclusions

JAK2‐STAT3 signaling pathway plays an important role in the process of periapical bone resorption and osteoclastogenesis.
Is Nation ‘One of the Most Puzzling and Tendentious Items in the Political Lexicon’?
Authors: Jayet Cyril
Published: July 2019

The aim of this paper is to clarify the meaning of the concept of nation, which has often been described as a puzzling concept. I propose first to analyse various definitions of nation, focusing on whether they imply that nations exist and what this means if so, or in what sense they exist. I distinguish four ways of approaching this. I evidence the shortcomings of each approach, and argue that the best one is that proposed by Brubaker: to focus on nationalization as a process and on nationness as a variable, rather than on ‘nations’ as discrete groups. Second, I show how this approach can benefit from Rosch's theory of categorization, Gellner's definition of nationalism, and Mann's theory of the centralization of the state. Finally, I argue that what Gellner called the ‘weakness of nationalism’ explains the puzzle of ‘nations’: although nationalization contributes to shaping society according to the principle of nationalism, it only succeeds to a certain degree, leaving nations always unfinished and impossible to identify clearly.
Phylogenomics of Auchenorrhyncha (Insecta: Hemiptera) using transcriptomes: examining controversial relationships via degeneracy coding and interrogation of gene conflict
Authors: Skinner Rachel K. , Dietrich Christopher H. , Walden Kimberly K. O. , Gordon Eric , Sweet Andrew D. , Podsiadlowski Lars , Petersen Malte , Simon Chris , Takiya Daniela M. , Johnson Kevin P.
Published: July 2019

The hemipteran suborder Auchenorrhyncha is a highly diverse, ecologically and agriculturally important group of primarily phytophagous insects which has been a source of phylogenetic contention for many years. Here, we have used transcriptome sequencing to assemble 2139 orthologues from 84 auchenorrhynchan species representing 27 families; this is the largest and most taxonomically comprehensive phylogenetic dataset for this group to date. We used both maximum likelihood and multispecies coalescent analyses to reconstruct the evolutionary history in this group using amino acid, nucleotide, and degeneracy‐coded nucleotide orthologue data. Although many relationships at the superfamily level were consistent between analyses, several differing, highly supported topologies were recovered using different datasets and reconstruction methods, most notably the differential placement of Cercopoidea as sister to either Cicadoidea or Membracoidea. To further interrogate the recovered topologies, we explored the contribution of genes as partitioned by third‐codon‐position guanine‐cytosine (GC) content and heterogeneity. We found consistent support for several relationships, including Cercopoidea + Cicadoidea, most often in genes that would be expected to be enriched for the true species tree if recombination‐based dynamics in GC content have contributed to the observed GC heterogeneity. Our results provide a generally well‐supported framework for future studies of auchenorrhynchan phylogeny and suggest that transcriptome sequencing is likely to be a fruitful source of phylogenetic data for resolving its clades. However, we caution that future work should account for the potential effects of GC content heterogeneity on relationships recovered in this group.
Phosphorylated KIT as a predictor of outcome in canine mast cell tumours treated with toceranib phosphate or vinblastine
Authors: Thamm Douglas H. , Weishaar Kristen M. , Charles Joseph B. , Ehrhart E. J.
Published: July 2019

Canine cutaneous mast cell tumour (MCT) is the most common malignant skin tumour in dogs and can exhibit variable biologic behaviour. Dysregulated signalling through the receptor tyrosine kinase (RTK) KIT can promote cell proliferation and survival, and assessment of its dysregulation via detection of activating c‐kit gene mutations or assessment of KIT protein localization is associated with multiple features of malignancy. The aim of the current study was to use a previously validated immunohistochemical (IHC) assay to directly measure phosphorylated KIT (pKIT) in order to investigate its association with other established prognostic markers, response to therapy, progression free interval (PFI) and overall survival time (OST) in dogs treated medically for measurable MCT. Tumour tissue from 74 dogs enrolled in a prospective study comparing toceranib and vinblastine for MCT treatment were evaluated for pKIT immunoreactivity. pKIT was variably expressed, with some degree of positivity observed in 49/74 cases (66%). pKIT immunoreactivity was significantly associated with aberrant KIT localization, high mitotic index and high histologic grade. On univariate analysis, pKIT immunoreactivity predicted shorter PFI and OST in the entire patient population as well as shorter PFI in the toceranib treated group, and was the sole predictive factor for OST upon multivariate analysis, while mitotic index was the sole independent predictive factor for PFI. These results demonstrate that IHC detection of pKIT correlates with several features of aggressive behaviour, and may confer information that is complementary to other prognostic factors. However, the role of pKIT in predicting outcome needs to be studied further before recommendations can be made for its routine use.
Non-symmetric flexural wave scattering and one-way extreme absorption
Authors: Norris Andrew N. , Packo Pawel
Published: July 2019

The possibility of asymmetric absorption and reflection for flexural waves is demonstrated through analytical and numerical examples. The emphasis is on the one-dimensional (1D) case of flexural motion of a beam for which combinations of point scatterers are considered, which together provide asymmetric scattering. The scatterers are attached damped oscillators characterized by effective impedances, analogous to effective configurations in 1D acoustic waveguides. By selecting the impedances of a pair of closely spaced scatterers it is shown that it is possible to obtain almost total absorption for incidence on one side, with almost total reflection if incident from the other side. The one-way absorption is illustrated through numerous examples of impedance pairs that satisfy the necessary conditions for zero reflectivity for incidence from one direction. Examples of almost total and zero reflection for different incidences are examined in detail, showing the distinct wave dynamics of flexural waves as compared with acoustics.
Unified wave field retrieval and imaging method for inhomogeneous non-reciprocal media
Authors: Wapenaar Kees , Reinicke Christian
Published: July 2019

Acoustic imaging methods often ignore multiple scattering. This leads to false images in cases where multiple scattering is strong. Marchenko imaging has recently been introduced as a data-driven way to deal with internal multiple scattering. Given the increasing interest in non-reciprocal materials, both for acoustic and electromagnetic applications, a modification to the Marchenko method is proposed for imaging such materials. A unified wave equation is formulated for non-reciprocal materials, exploiting the similarity between acoustic and electromagnetic wave phenomena. This unified wave equation forms the basis for deriving reciprocity theorems that interrelate wave fields in a non-reciprocal medium and its complementary version. Next, these theorems are reformulated for downgoing and upgoing wave fields. From these decomposed reciprocity theorems, representations of the Green's function inside the non-reciprocal medium are derived in terms of the reflection response at the surface and focusing functions inside the medium and its complementary version. These representations form the basis for deriving a modified version of the Marchenko method to retrieve the wave field inside a non-reciprocal medium and to form an image, free from artefacts related to multiple scattering. The proposed method is illustrated at the hand of the numerically modeled reflection response of a horizontally layered medium.
Asymmetric acoustic energy transport in non-Hermitian metamaterials
Authors: Thevamaran Ramathasan , Branscomb Richard Massey , Makri Eleana , Anzel Paul , Christodoulides Demetrios , Kottos Tsampikos , Thomas Edwin L.
Published: July 2019

The ability to control and direct acoustic energy is essential for many engineering applications such as vibration and noise control, invisibility cloaking, acoustic sensing, energy harvesting, and phononic switching and rectification. The realization of acoustic regulators requires overcoming fundamental challenges inherent to the time-reversal nature of wave equations. Typically, this is achieved by utilizing either a parameter that is odd-symmetric under time-reversal or by introducing passive nonlinearities. The former approach is power consuming while the latter has two major deficiencies: it has high insertion losses and the outgoing signal is harvested in a different frequency than that of the incident wave due to harmonic generation. Here, a unique approach is adopted that exploits spatially distributed linear and nonlinear losses in a fork-shaped resonant metamaterials. This compact metamaterial design demonstrates asymmetric acoustic reflectance and transmittance, and acoustic switching. In contrast to previous studies, the non-Hermitian metamaterials exhibit asymmetric transport with high frequency purity of the outgoing signal.
Cryo-EM structure of the activated RET signaling complex reveals the importance of its cysteine-rich domain
Authors: Bigalke Janna M. , Aibara Shintaro , Roth Robert , Dahl Göran , Gordon Euan , Dorbéus Sarah , Amunts A. , Sandmark Jenny
Published: July 2019

We report the first subnanometer resolution structure of the RET extracellular domain in complex with a ligand and co-receptor.
Efficient apoptosis requires feedback amplification of upstream apoptotic signals by effector caspase-3 or -7
Authors: McComb Scott , Chan Pik Ki , Guinot Anna , Hartmannsdottir Holmfridur , Jenni Silvia , Dobay Maria Pamela , Bourquin Jean-Pierre , Bornhauser Beat C.
Published: July 2019

Caspase-3 and -7 are redundantly required to amplify the extrinsic and intrinsic apoptotic cascade in human leukemia.
Fluctuation-induced distributed resonances in oscillatory networks
Authors: Zhang Xiaozhu , Hallerberg Sarah , Matthiae Moritz , Witthaut Dirk , Timme Marc
Published: July 2019

How do networks respond to fluctuating inputs?—Localized? Homogeneous? Resonant?
Intensified vegetation water use under acid deposition
Authors: Lanning Matthew , Wang Lixin , Scanlon Todd M. , Vadeboncoeur Matthew A. , Adams Mary B. , Epstein Howard E. , Druckenbrod Daniel
Published: July 2019

Acid deposition increases vegetation water use by altering soil calcium availability.
Covalent chemistry on nanostructured substrates enables noninvasive quantification of gene rearrangements in circulating tumor cells
Authors: Dong Jiantong , Jan Yu Jen , Cheng Ju , Zhang Ryan Y. , Meng Meng , Smalley Matthew , Chen Pin-Jung , Tang Xinghong , Tseng Patrick , Bao Lirong , Huang Tzu-Yang , Zhou Dongjing , Liu Yupin , Chai Xiaoshu , Zhang Haibo , Zhou Anqi , Agopian Vatche G. , Posadas Edwin M. , Shyue Jing-Jong , Jonas Steven J. , Weiss Paul S. , Li Mengyuan , Zheng Guangjuan , Yu Hsiao-hua , Zhao Meiping , Tseng Hsian-Rong , Zhu Yazhen
Published: July 2019

Dong
et al
. report gene rearrangement detection in circulating tumor cells by using covalent chemistry on nanosubstrates.
A transcriptomic atlas of mammalian olfactory mucosae reveals an evolutionary influence on food odor detection in humans
Authors: Saraiva Luis R. , Riveros-McKay Fernando , Mezzavilla Massimo , Abou-Moussa Eman H. , Arayata Charles J. , Makhlouf Melanie , Trimmer Casey , Ibarra-Soria Ximena , Khan Mona , Van Gerven Laura , Jorissen Mark , Gibbs Matthew , O’Flynn Ciaran , McGrane Scott , Mombaerts Peter , Marioni John C. , Mainland Joel D. , Logan Darren W.
Published: July 2019

Comparative transcriptomics of olfactory mucosae offers clues into the putative functions of highly abundant ORs in mammals.
Insect-scale fast moving and ultrarobust soft robot
Authors: Wu Yichuan , Yim Justin K. , Liang Jiaming , Shao Zhichun , Qi Mingjing , Zhong Junwen , Luo Zihao , Yan Xiaojun , Zhang Min , Wang Xiaohao , Fearing Ronald S. , Full Robert J. , Lin Liwei
Published: July 2019

An insect-scale soft robot has fast relative speed of motion, high load-carrying capability, and exceptional robustness.
Early life stress: It’s all in the timing
Authors: Gee Dylan G.
Published: July 2019

The effects of childhood maltreatment on adult amygdala function depend on when the maltreatment occurs.
Whole-Genome Sequences of Four Indian Isolates of Azospirillum brasilense
Authors: Singh Chhaya , Pandey Parul , Singh Durgesh Narain , Pandey Rachna , Shasany Ajit Kumar , Tripathi Anil Kumar
Published: July 2019

Azospirillum brasilense
is used worldwide as a plant growth-promoting inoculant for agricultural crops. To understand how the genomes of Indian strains of
A. brasilense
compare with their South American counterparts, we determined the whole-genome sequences of four strains of
A. brasilense
isolated from the rhizosphere of grasses from India.
Metagenome-Assembled Genome Sequence of
Phormidium
sp. Strain SL48-SHIP, Isolated from the Microbial Mat of Salt Lake Number 48 (Novosibirsk Region, Russia)
Authors: Rozanov Aleksey S. , Shipova Aleksandra A. , Bryanskaya Alla V. , Peltek Sergey E.
Published: July 2019

The
Phormidium
sp. strain SL48-SHIP genome was obtained from metagenomics sequencing of the microbial mat of Salt Lake No. 48 (54.201806 N, 78.179194 E; Novosibirsk Region, Russia). The sequenced and annotated genome is 4,384,607 bp and encodes 3,807 genes.
Complete Genome Sequences of Thermus thermophilus Strains AA2-20 and AA2-29, Isolated from Arima Onsen in Japan
Authors: Miyazaki Kentaro , Tomariguchi Natsuki
Published: July 2019

We isolated halophilic and thermophilic
Thermus thermophilus
strains AA2-20 and AA2-29 from nonvolcanic, oceanic Arima Onsen (hot spring) in Japan. Here, we report the complete genome sequences of these organisms to gain insights into halophilicity.
Bi-directional drones to strengthen healthcare provision: experiences and lessons from Madagascar, Malawi and Senegal
Authors: Knoblauch Astrid M , de la Rosa Sara , Sherman Judith , Blauvelt Carla , Matemba Charles , Maxim Luciana , Defawe Olivier D , Gueye Abdoulaye , Robertson Joanie , McKinney Jesse , Brew Joe , Paz Enrique , Small Peter M , Tanner Marcel , Rakotosamimanana Niaina , Grandjean Lapierre Simon
Published: July 2019

Drones are increasingly being used globally for the support of healthcare programmes. Madagascar, Malawi and Senegal are among a group of early adopters piloting the use of bi-directional transport drones for health systems in sub-Saharan Africa. This article presents the experiences as well as the strengths, weaknesses, opportunities and threats (SWOT analysis) of these country projects. Methods for addressing regulatory, feasibility, acceptability, and monitoring and evaluation issues are presented to guide future implementations. Main recommendations for governments, implementers, drone providers and funders include (1) developing more reliable technologies, (2) thorough vetting of drone providers’ capabilities during the selection process, (3) using and strengthening local capacity, (4) building in-country markets and businesses to maintain drone operations locally, (5) coordinating efforts among all stakeholders under government leadership, (6) implementing and identifying funding for long-term projects beyond pilots, and (7) evaluating impacts via standardised indicators. Sharing experiences and evidence from ongoing projects is needed to advance the use of drones for healthcare.
Triaging the triage: reducing waiting time to triage in the emergency department at a tertiary care hospital in New Delhi, India
Authors: Kumar Akshay , Lakshminarayanan Dheeneshbabu , Joshi Nitesh , Vaid Sonali , Bhoi Sanjeev , Deorari Ashok
Published: July 2019

Background

Prolonged wait times prior to triage outside the emergency department (ED) were a major problem at our institution, compromising patient safety. Patients often waited for hours outside the ED in hot weather leading to exhaustion and clinical deterioration. The aim was to decrease the median waiting time to triage from 50 min outside ED for patients to <30 min over a 4-month period.

Methods

A quality improvement (QI) team was formed. Data on waiting time to triage were collected between 12 pm and 1 pm. Data were collected by hospital attendants and recorded manually. T1 was noted as a time of arrival outside the ED, and T2 was noted as the time of first medical contact. The QI team used plan–do–study–act cycles to test solutions. Change ideas to address these gaps were tested during May and June 2018. Change ideas were focused on improving the knowledge and skills of staff posted in triage and reducing turnover of triage staff. Data were analysed using run chart rules.

Results

Within 6 weeks, the waiting time to triage reduced to <30 min (median, 12 min; IQR, 11 min) and this improvement was sustained for the next 8 weeks despite an increase in patient load.

Conclusion

The authors demonstrated that people new to QI could use improvement methods to address a specific problem. It was the commitment of the frontline staff, with the active support of senior leadership in the department that helped this effort succeed.
Stroke mechanisms and outcomes of isolated symptomatic basilar artery stenosis
Authors: Samaniego Edgar A , Shaban Amir , Ortega-Gutierrez Santiago , Roa Jorge A , Hasan David M , Derdeyn Colin , Dai Biyue , Adams Harold , Leira Enrique
Published: July 2019

Background

While diffuse atherosclerotic disease affecting the posterior circulation has been described extensively, the prevalence, natural history and angiographic characteristics ofisolatedsymptomatic basilar artery stenosis (ISBAS) remain unknown.

Methods

We reviewed our prospective institutional database to identify patients with ≥50% symptomatic basilar artery (BA) stenosis without significant atherosclerotic burden in the vertebral or posterior cerebral arteries. Stroke mechanism, collateral circulation, and degree and length of stenosis were analysed. The primary outcome was time from index event to new transient ischaemic attack (TIA), acute ischaemic stroke (AIS) or death. Other outcome variables included modified Rankin Scale (mRS) score on discharge and last follow-up.

Results

Of 6369 patients with AIS/TIA, 91 (1.43%) had ISBAS. Seventy-three (80.2%) patients presented with AIS and 18 (19.8%) with TIA. Twenty-nine (31.9%) were women and the median age was 66.8±13.6 years. The mean follow-up time was 2.7 years. The most common stroke mechanism was artery-to-artery thromboembolism (45.2%), followed by perforator occlusion (28.7%) and flow-dependent/hypoperfusion (15.1%). The percentage of stenosis was lower in patients who had favourable outcome compared with those with mRS 3–6 on discharge (78.3±14.3 vs 86.9±14.5, p=0.007). Kaplan-Meier curves showed higher recurrence/death rates in patients with ≥80% stenosis, mid-basilar location and poor collateral circulation. Approximately 13% of patients with ISBAS presented with complete BA occlusion.

Conclusion

ISBAS is an uncommon (1.43%) cause of TIA and AIS. Men in their 60s are mostly affected, and artery-to-artery embolism is the most common stroke mechanism. Mid-basilar location, ≥80% stenosis and poor collateral circulation are important factors associated with worse prognosis.
Fusion of halo nucleus 6He on 238U : Evidence for tennis-ball (bubble) structure of the core of the halo (even the giant-halo) nucleus
Authors: Abbas Syed Afsar
Published: July 2019

In a decade-and-a-half old experiment, Raabe et al. [Nature 431, 823 (2004)], had studied fusion of an incoming beam of halo nucleus 6He with the target nucleus [Formula: see text]. We extract a new interpretation of the experiment, different from the one that has been inferred so far. We show that their experiment is actually able to discriminate between the structures of the target nucleus (behaving as standard nucleus with density distribution described with canonical RMS radius [Formula: see text] with [Formula: see text] fm), and the “core” of the halo nucleus, which surprisingly, does not follow the standard density distribution with the above RMS radius. In fact, the core has the structure of a tennis-ball (bubble)-like nucleus, with a “hole” at the center of the density distribution. This novel interpretation of the fusion experiment provides an unambiguous support to an almost two decades old model [A. Abbas, Mod. Phys. Lett. A 16, 755 (2001)], of the halo nuclei. This Quantum Chromodynamics based model succeeds in identifying all known halo nuclei and makes clear-cut and unique predictions for new and heavier halo nuclei. This model supports the existence of tennis-ball (bubble)-like core, of even the giant-neutron halo nuclei. This should prove beneficial to the experimentalists, to go forward more confidently, in their study of exotic nuclei.
Fidelity-based unitary operation-induced quantum correlation for continuous-variable systems
Authors: Liu Liang , Qi Xiaofei , Hou Jinchuan
Published: July 2019

We propose a measure of nonclassical correlation [Formula: see text] in terms of local Gaussian unitary operations based on square of the fidelity [Formula: see text] for bipartite continuous-variable systems. This quantity is easier to be calculated or estimated and is a remedy for the local ancilla problem associated with the geometric measurement-induced nonlocality. A simple computation formula of [Formula: see text] for any [Formula: see text]-mode Gaussian states is presented and an estimation of [Formula: see text] for any [Formula: see text]-mode Gaussian states is given. For any [Formula: see text]-mode Gaussian states, [Formula: see text] does not increase after performing a local Gaussian channel on the unmeasured subsystem. Comparing [Formula: see text] in scale with other quantum correlations such as Gaussian geometric discord for two-mode symmetric squeezed thermal states reveals that [Formula: see text] is much better in detecting quantum correlations of Gaussian states.
Single-motor-unit discharge characteristics in lumbar multifidus muscle of acute low back pain patients
Authors: Lothe Lise R. , Raven Tim J. L. , Sandbæk Gunnar , Eken Torsten
Published: July 2019

Acute low back pain (ALBP) causes rapid deterioration of paraspinal muscle function. The underlying neurophysiology is poorly understood. We therefore carried out this observational study in patients with ALBP to characterize motor unit (MU) activity in deep lumbar multifidus (LM) muscle and compare with our previous findings from pain-free subjects. Nine subjects (1 woman; age 26–59 yr) with ALBP duration of 1–21 days were recruited from outpatient clinics. Fine wire electromyography (EMG) electrodes were implanted bilaterally at the painful spinal level under computer tomography guidance. EMG was recorded during spontaneous sitting and standing, and during voluntary force production. Linear mixed models were utilized to test or control for the effects of a number of predefined variables. Compared with sitting, standing increased total duration of EMG activity, median MU discharge rate, interspike interval variability, and common drive measured as common drive coefficients (CDC) derived from concurrently active MU pairs. Median discharge rate in 73 MUs was 5.5 and 6.6 pulses per second (pps) during spontaneous sitting and standing, and 7.2 pps during voluntary force production. Interspike interval variability was lower during voluntary tasks than during spontaneous force production. Common drive was less pronounced in bilateral vs. unilateral unit pairs, also in spontaneous standing. This difference was not seen in our previous pain-free subjects, suggesting altered bilateral control of the spine in ALBP. The distribution of CDC values was not a homogeneous continuum but could be seen as two partially overlapping populations of CDC distributions.

NEW & NOTEWORTHY We implanted fine-wire electrodes in the deepest part of axial postural muscles in patients with acute low back pain and characterized their motor unit activity. We found less pronounced common drive to the two sides of the spine compared with pain-free subjects, suggesting a different postural control strategy in patients with acute low back pain. An unexpected finding was that common drive coefficient values appeared to consist of two partially overlapping populations of normal distributions.
Persons with essential tremor can adapt to new walking patterns
Authors: Roper Jaimie A. , Brinkerhoff Sarah A. , Harrison Benjamin R. , Schmitt Abigail C. , Roemmich Ryan T. , Hass Chris J.
Published: July 2019

Essential tremor (ET) is a common movement disorder that causes motor deficits similar to those seen in cerebellar disorders. These include kinetic tremor, gait ataxia, and impaired motor adaptation. Previous studies of motor adaptation in ET have focused on reaching while the effects of ET on gait adaptation are currently unknown. The purpose of this study was to contrast locomotor adaptation in persons with and without ET. We hypothesized that persons with ET would show impaired gait adaptation. In a cross-sectional study, persons with ET ( n = 14) and healthy matched controls ( n = 12) walked on a split-belt treadmill. Participants walked with the belts moving at a 2:1 ratio, followed by overground walking to test transfer, followed by a readaptation period and finally a deadaptation period. Step length asymmetry was measured to assess the rate of adaptation, amount of transfer, and rates of readaptation and deadaptation. Spatial, temporal, and velocity contributions to step length asymmetry were analyzed during adaptation. There were no group by condition interactions in step length asymmetry or contributions to step length asymmetry. Regardless of condition, persons with ET walked slower and exhibited lower temporal ( P < 0.001) and velocity ( P = 0.001) contributions to step length asymmetry than controls. Persons with ET demonstrated a preserved ability to adapt to, store, and transfer a new walking pattern. Despite probable cerebellar involvement in ET, locomotor adaptation is an available mechanism to teach persons with ET new gait patterns.

NEW & NOTEWORTHY This study is the first to investigate walking adaptation abilities of people with essential tremor. Despite evidence of cerebellar impairment in this population, people with essential tremor can adapt their walking patterns. However, people with essential tremor do not modulate the timing of their footsteps to meet walking demands. Therefore, this study is the first to report impairments in the temporal aspects of walking in people with essential tremor during both typical and locomotor learning.
Comprehensive Biomechanism of Impact Resistance in the Cat’s Paw Pad
Authors: Wu Xueqing , Pei Baoqing , Pei Yuyang , Hao Yan , Zhou Kaiyuan , Wang Wei
Published: July 2019

Cats are able to jump from a high-rise without any sign of injury, which is attributed in large part to their impact-resistant paw pads. The biomechanical study of paw pads may therefore contribute to improving the impact resistance of specific biomimetic materials. The present study is aimed at investigating the mechanics of the paw pads, revealing their impact-resistant biomechanism from macro- and microscopic perspectives. Histological and micro-CT scanning methods were exploited to analyze the microstructure of the pads, and mechanical testing was conducted to observe the macroscopic mechanical properties at different loading frequencies. Numerical micromodels of the ellipsoidal and cylindrical adipose compartments were developed to evaluate the mechanical functionality as compressive actions. The results show that the stiffness of the pad increases roughly in proportion to strain and mechanical properties are almost impervious to strain rate. Furthermore, the adipose compartment, which comprises adipose tissue enclosed within collagen septa, in the subcutaneous tissue presents an ellipsoid-like structure, with a decreasing area from the middle to the two ends. Additionally, the finite element results show that the ellipsoidal structure has larger displacement in the early stage of impact, which can absorb more energy and prevent instability at touchdown, while the cylindrical structure is more resistant to deformation. Moreover, the Von Mises of the ellipsoidal compartment decrease gradually from both ends to the middle, making it change to a cylindrical shape, and this may be the reason why the macroscopic stiffness increases with increasing time after contact. This preliminary investigation represents the basis for biomechanical interpretation and can accordingly provide new inspirations of shock-absorbing composite materials in engineering.
Skin/Muscle Incision and Retraction Induces Evoked and Spontaneous Pain in Mice
Authors: Yang Juan , Yuan Fei , Ye Gang , Wang Yong-Jie , Wu Cheng , Wang Jinghua , Li Xiang-Yao , Feng Zhiying
Published: July 2019

Background. Surgery is a frequent cause of persistent pain. Unrelieved chronic postsurgical pain causes unnecessary patient suffering and discomfort and usually leads to psychological complications. The rat model of skin/muscle incision and retraction (SMIR) with decreased paw withdrawal thresholds developed by Flatters was usually used to investigate the underlying mechanism of chronic postsurgical pain. Objectives. The aim of our study was to develop a new mice model of SMIR for further investigation with transgenic mice and so on and to evaluate the analgesic effects of clonidine and gabapentin on pain behavior with this new mice model. Methods. Male C57BL/6 mice were anesthetized, and a 1.0–1.3 cm incision was made in the skin of the medial thigh approximately 3 mm medial to the saphenous vein to reveal the muscle of the thigh. The paw withdrawal threshold (PWT) to mechanical stimuli and the paw withdrawal latency to heat stimuli were measured before and after SMIR. Furthermore, the PWT to mechanical stimuli and conditioned place preference (CPP) was measured before and after the systemic injection of clonidine and gabapentin. Results. SMIR-evoked mechanical hypersensitivity in mice began on day 1 after the procedure, prominent between days 1 and 10 after the procedure, persisted at least until day 14, and disappeared on day 18 after the procedure. However, the mice model of SMIR did not evoke significant heat hypersensitivity. Systemic injection of clonidine and gabapentin raised the PWT in the SMIR mice dose-dependently. Compared with the mice that underwent the sham operation, mice of SMIR spent a longer time in the clonidine-paired chamber than those of NS, while the gabapentin-paired chamber has no difference with that of NS in the CPP paradigm. Conclusion. These data suggested that the mice model of SMIR demonstrated a persistent pain syndrome, including evoked pain and spontaneous pain. Clonidine and gabapentin could relieve mechanical hypersensitivity dose-dependently simultaneously. However, clonidine but not gabapentin could alleviate the spontaneous pain of SMIR in the mice model.
MicroRNA Signatures in Malignant Pleural Mesothelioma Effusions
Authors: Birnie Kimberly A. , Prêle Cecilia M. , Musk Arthur W. (Bill) , de Klerk Nicholas , Lee Y. C. Gary , Fitzgerald Deirdre , Allcock Richard J. N. , Thompson Philip J. , Creaney Jenette , Badrian Bahareh , Mutsaers Steven E.
Published: July 2019

Malignant pleural mesothelioma (MPM) is an incurable cancer of the pleura that can be difficult to diagnose. Biomarkers for an easier and/or earlier diagnosis are needed. Approximately 90% of MPM patients develop a pleural effusion (PE). PEs are ideal sources of biomarkers as the fluid would almost always require drainage for diagnostic and/or therapeutic reasons. However, differentiating MPM PE from PE caused by other diseases can be challenging. MicroRNAs are popular biomarkers given their stable expression in tissue and fluid. MicroRNAs have been analysed in PE cytology samples for the diagnosis of MPM but have not been measured in frozen/fresh PE. We hypothesise that microRNAs expressed in PE are biomarkers for MPM. TaqMan OpenArray was used to analyse over 700 microRNAs in PE cells and supernatants from 26 MPMs and 21 other PE-causing diseases. In PE cells, combining miR-143, miR-210, and miR-200c could differentiate MPM with an area under the curve (AUC) of 0.92. The three-microRNA signature could also discriminate MPM from a further 40 adenocarcinomas with an AUC of 0.9887. These results suggest that the expression of miR-143, miR-210, and miR-200c in PE cells might provide a signature for diagnosing MPM.
A Tumor-Localized Approach to Bypass Anti-4-1BB Immuno-Toxicity
Authors: Su Tina Tianjiao , Gao Xiaobin , Wang Jun
Published: July 2019

4-1BB (CD137) is an important costimulatory molecule upregulated on antigen-experienced T cells, however, clinical development of 4-1BB agonists has stalled because of significant liver immuno-toxicity. Using rational protein engineering, a next-generation anticalin-antibody–based therapy achieved localized 4-1BB activation triggered by tumor-expressed antigen, helping to revitalize this pathway in immuno-oncology.

See related article by Hinner et al., p. 5878
Expression of Normally Repressed Myosin Heavy Chain 7b in the Mammalian Heart Induces Dilated Cardiomyopathy
Authors: Peter Angela K. , Rossi Alberto C. , Buvoli Massimo , Ozeroff Christopher D. , Crocini Claudia , Perry Amy R. , Buvoli Ada E. , Lee Lindsey A. , Leinwand Leslie A.
Published: July 2019

Background

In mammals, muscle contraction is controlled by a family of 10 sarcomeric myosin motors. The expression of one of its members,
MYH
7b, is regulated by alternative splicing, and while the protein is restricted to specialized muscles such as extraocular muscles or muscle spindles,
RNA
that cannot encode protein is expressed in most skeletal muscles and in the heart. Remarkably, birds and snakes express
MYH
7b protein in both heart and skeletal muscles. This observation suggests that in the mammalian heart, the motor activity of
MYH
7b may only be needed during development since its expression is prevented in adult tissue, possibly because it could promote disease by unbalancing myocardial contractility.

Methods and Results

We have analyzed
MYH
7b null mice to determine the potential role of
MYH
7b during cardiac development and also generated transgenic mice with cardiac myocyte expression of
MYH
7b protein to measure its impact on cardiomyocyte function and contractility. We found that
MYH
7b null mice are born at expected Mendelian ratios and do not have a baseline cardiac phenotype as adults. In contrast, transgenic cardiac
MYH
7b protein expression induced early cardiac dilation in males with significantly increased left ventricular mass in both sexes. Cardiac dilation is progressive, leading to early cardiac dysfunction in males, but later dysfunction in females.

Conclusions

The data presented show that the expression of
MYH
7b protein in the mammalian heart has been inhibited during the evolution of mammals most likely to prevent the development of a severe cardiomyopathy that is sexually dimorphic.