bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence of Occurrence of Barley Crown Rust Caused by Puccinia coronata var. hordei and Sexual Reproduction of the Pathogen Under Field Conditions in China
Authors: Tian Xiaxia , Yao Qiang , Zhang Zedong , Cheng Xiangrui , Qin Jianfeng , Kang Zhensheng , Zhao Jie
Published: March 2021

Crown rust of barley, caused by Puccinia coronata var. hordei, was first reported by Jin and Steffenson in 1992, and the fungus has been reported only in the United States and Hungary. In China, stripe, stem, and leaf rusts have been reported on barley, but not for crown rust. Recently, a sample (HZJ0004) of rust collected from barley in Qilian county in Qinghai, China, appeared different from the three rusts based on color, size, arrangements of uredinia and/or telia. Teliospores had crown-shaped appendages on the top. Based on the disease symptoms and morphology of urediniospores and teliospores, the fungus was identified as P. coronata var. hordei. Using the internal transcribed spacer sequences, the isolates HZJ0004 from barley and POR3 from buckthorn (Rhamnus sp.) were clustered in one clade with P. coronata var. hordei isolates from barley and Elymus repens but in a different clade from the isolate POC8 from wild oat and the varieties of P. coronata from oats and grasses. At the seedling stage, most of the tested cultivars of barley and rye were susceptible to P. coronata var. hordei isolates HZJ0004 and POR3, but the cultivars of oats, triticale, wheat, and most grasses of genera Aegilops, Brachypodium, Bromus, Calamagrostis, Deschampsia, Elymus, Festuca, and Phleum were resistant, indicating their host specialization on barley. To our knowledge, this is the first report of crown rust on barley in China.
Draft Genome Resource of a Novel Virulent Fusarium oxysporum f. sp. cubense Race 1 Strain (VCG 0124) Infecting Cavendish (AAA) Group of Banana in India
Authors: Thangavelu Raman , Edwin Raj Esack , P Pushpakanth , Muthukathan Gopi , Murugan Loganathan , Uma Subbaraya
Published: March 2021

Fusarium oxysporum f. sp. cubense is one of the most destructive soilborne fungi causing Fusarium wilt disease in banana. Generally, F. oxysporum f. sp. cubense race 1 (R1) severely affects most of the banana varieties, except Cavendish banana (AAA). Here, we present the draft genome of an isolate of VCG 0124, a novel virulent R1 strain that severely affects the Cavendish group of banana isolated from the Theni district of Tamil Nadu, India. The genome assembly of R1 comprises 61,471,473 bp with 88 contigs and 18,377 protein-coding regions. The genome contains homologs of F. oxysporum f. sp. cubense race-specific secreted-in-xylem (SIX) genes SIX1, SIX5, SIX9, and SIX13. The absence of SIX4 and SIX6 and deletion of a peptide in SIX1 virulence factor genes in the R1 (VCG 0124) strain might be the contributing factor for strains infecting Cavendish banana in India.
Genetic Variability of Haplaxius crudus, Based on the 5′ Region of the Cytochrome c Oxidase Subunit I Gene, Sheds Light on Epidemiology of Palm Lethal Decline Phytoplasmas
Authors: Humphries Alessandra R. , Ascunce Marina S. , Goss Erica M. , Helmick Ericka E. , Bartlett Charles R. , Myrie Wayne , Barrantes Edwin A. , Zumbado Marco A. , Bustillo Alex E. , Bahder Brian W.
Published: March 2021

Haplaxius crudus is an economically important species of cixiid planthopper that is widespread and abundant throughout the Caribbean basin. It is the vector of lethal yellowing and putative vector of lethal bronzing, both phytoplasma diseases of palm that cause death in Florida and the Caribbean. The primary objective of this study was to evaluate the genetic diversity of H. crudus in Florida to determine whether divergent populations existed. The 5′ region of the cytochrome c oxidase subunit I gene was used as the molecular marker. DNA sequences were obtained from 236 specimens collected throughout Florida, United States as well as populations from the southeastern United States. Populations from Costa Rica, Colombia, and Jamaica were included to compare differences between isolated populations. In Florida, four haplotypes were discovered, with 97% of individuals belonging to a single haplotype, two smaller haplotypes comprising six and four individuals, and a single haplotype comprising one individual. Populations from Texas and Mississippi represented distinct haplotypes whereas populations from Georgia and South Carolina were identical to the predominant haplotype in Florida. Populations from Costa Rica and Colombia were highly divergent whereas the population from Jamaica was 100% identical to the predominant population in Florida. These findings highlight measurable levels of genetic variability of H. crudus in Florida, and the similarity to populations from Jamaica highlight the need for more robust sampling throughout the Caribbean to better understand movement and invasion potential of this species.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Postoperative Pulmonary Complications’ Association with Sugammadex versus Neostigmine: A Retrospective Registry Analysis
Authors: Li Gen , Freundlich Robert E. , Gupta Rajnish K. , Hayhurst Christina J. , Le Chi H. , Martin Barbara J. , Shotwell Matthew S. , Wanderer Jonathan P.
Published: March 2021

Background

Postoperative residual neuromuscular blockade related to nondepolarizing neuromuscular blocking agents may be associated with pulmonary complications. In this study, the authors sought to determine whether sugammadex was associated with a lower risk of postoperative pulmonary complications in comparison with neostigmine.

Methods

Adult patients from the Vanderbilt University Medical Center National Surgical Quality Improvement Program database who underwent general anesthesia procedures between January 2010 and July 2019 were included in an observational cohort study. In early 2017, a wholesale switch from neostigmine to sugammadex occurred at Vanderbilt University Medical Center. The authors therefore identified all patients receiving nondepolarizing neuromuscular blockades and reversal with neostigmine or sugammadex. An inverse probability of treatment weighting propensity score analysis approach was applied to control for measured confounding. The primary outcome was postoperative pulmonary complications, determined by retrospective chart review and defined as the composite of the three postoperative respiratory occurrences: pneumonia, prolonged mechanical ventilation, and unplanned intubation.

Results

Of 10,491 eligible cases, 7,800 patients received neostigmine, and 2,691 received sugammadex. A total of 575 (5.5%) patients experienced postoperative pulmonary complications (5.9% neostigmine vs. 4.2% sugammadex). Specifically, 306 (2.9%) patients had pneumonia (3.2% vs. 2.1%), 113 (1.1%) prolonged mechanical ventilation (1.1% vs. 1.1%), and 156 (1.5%) unplanned intubation (1.6% vs. 1.0%). After propensity score adjustment, the authors found a lower absolute incidence rate of postoperative pulmonary complications over time (adjusted odds ratio, 0.91 [per year]; 95% CI, 0.87 to 0.96; P < .001). No difference was observed on the odds of postoperative pulmonary complications in patients receiving sugammadex in comparison with neostigmine (adjusted odds ratio, 0.89; 95% CI, 0.65 to 1.22; P = 0.468).

Conclusions

Among 10,491 patients at a single academic tertiary care center, the authors found that switching neuromuscular blockade reversal agents was not associated with the occurrence of postoperative pulmonary complications.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Assessing Competence in Critical Care Echocardiography: Development and Initial Results of an Examination and Certification Processes*
Authors: Panebianco Nova L. , Mayo Paul H. , Arntfield Robert T. , Brown Sam M. , Diaz-Gomez Jose , Hernandez Antonio , Koenig Seth J. , Noble Vicki , Sekiguchi Hiroshi , Subhiyah Raja G. , Mulvagh Sharon , Saric Muhamed , Troianos Christopher A. , Labovitz Arthur J.
Published: March 2021

OBJECTIVES:

To describe the development and initial results of an examination and certification process assessing competence in critical care echocardiography.

DESIGN:

A test writing committee of content experts from eight professional societies invested in critical care echocardiography was convened, with the Executive Director representing the National Board of Echocardiography. Using an examination content outline, the writing committee was assigned topics relevant to their areas of expertise. The examination items underwent extensive review, editing, and discussion in several face-to-face meetings supervised by National Board of Medical Examiners editors and psychometricians. A separate certification committee was tasked with establishing criteria required to achieve National Board of Echocardiography certification in critical care echocardiography through detailed review of required supporting material submitted by candidates seeking to fulfill these criteria.

SETTING:

The writing committee met twice a year in person at the National Board of Medical Examiner office in Philadelphia, PA.

SUBJECTS:

Physicians enrolled in the examination of Special Competence in Critical Care Electrocardiography (CCEeXAM).

MEASUREMENTS AND MAIN RESULTS:

A total of 524 physicians sat for the examination, and 426 (81.3%) achieved a passing score. Of the examinees, 41% were anesthesiology trained, 33.2% had pulmonary/critical care background, and the majority had graduated training within the 10 years (91.6%). Most candidates work full-time at an academic hospital (46.9%).

CONCLUSIONS:

The CCEeXAM is designed to assess a knowledge base that is shared with echocardiologists in addition to that which is unique to critical care. The National Board of Echocardiography certification establishes that the physician has achieved the ability to independently perform and interpret critical care echocardiography at a standard recognized by critical care professional societies encompassing a wide spectrum of backgrounds. The interest shown and the success achieved on the CCEeXAM by practitioners of critical care echocardiography support the standards set by the National Board of Echocardiography for testamur status and certification in this imaging specialty area.
Developing consensus on core outcome domains for assessing effectiveness in perioperative pain management: results of the PROMPT/IMI-PainCare Delphi Meeting
Authors: Pogatzki-Zahn Esther M. , Liedgens Hiltrud , Hummelshoj Lone , Meissner Winfried , Weinmann Claudia , Treede Rolf-Detlef , Vincent Katy , Zahn Peter ,   the IMI-PainCare PROMPT consensus panel, Kaiser Ulrike
Published: March 2021

Postoperative pain management is still insufficient, leading to major deficits, including patient suffering, impaired surgical recovery, long-term opioid intake, and postsurgical chronic pain. Yet, identifying the best treatment options refers to a heterogeneous outcome assessment in clinical trials, not always reflecting relevant pain-related aspects after surgery and therefore hamper evidence synthesis. Establishing a core outcome set for perioperative pain management of acute pain after surgery may overcome such limitations. An international, stepwise consensus process on outcome domains (“what to measure”) for pain management after surgery, eg, after total knee arthroplasty, sternotomy, breast surgery, and surgery related to endometriosis, was performed. The process, guided by a steering committee, involved 9 international stakeholder groups and patient representatives. The face-to-face meeting was prepared by systematic literature searches identifying common outcome domains for each of the 4 surgical procedures and included breakout group sessions, world-café formats, plenary panel discussions, and final voting. The panel finally suggested an overall core outcome set for perioperative pain management with 5 core outcome domains: physical function (for a condition-specific measurement), pain intensity at rest, pain intensity during activity, adverse events, and self-efficacy. Innovative aspects of this work were inclusion of the psychological domain self-efficacy, as well as the specific assessment of pain intensity during activity and physical function recommended to be assessed in a condition-specific manner. The IMI-PROMPT core outcome set seeks to improve assessing efficacy and effectiveness of perioperative pain management in any clinical and observational studies as well as in clinical practice.
Up-regulation of long non-coding RNA BLACAT1 predicts aggressive clinicopathologic characteristics and poor prognosis of glioma
Authors: Zhang Xiaojue , Wei Xiuchuan , Liu Jie , Yang Jiaying , Jin Peng
Published: March 2021

Bladder cancer-associated transcript 1 (BLACAT1) is one of the most common cancer-associated long non-coding RNAs (lncRNAs), which has been reported as a tumor promotor in several malignancies. Previously, BLACAT1 was found to be overexpressed in glioma tissues and cell lines. Functional assays determined that BLACAT1 promoted glioma cell proliferation, migration, invasion and epithelial-mesenchymal transition, suggesting that BLACAT1 might serve as an oncogene in glioma. In the present study, we aimed to investigate its clinical significance and prognostic value in glioma patients.

A total of 137 paired glioma tissue samples and adjacent normal brain tissue samples were collected from 137 glioma patients who underwent surgery from May 2014 to February 2019. The Student t test was applied to determine the statistical significance of the observed differences between 2 groups. Survival curves were constructed and differences among groups were calculated using the Kaplan–Meier method.

The relative expression of BLACAT1 in glioma samples was significantly higher than that of matched normal tissues (P < .001). The expression level of tissue BLACAT1 was statistically correlated with tumor size (P = .04), Karnofsky Performance Status (KPS) (P = .006), and WHO grade (P = .017). Kaplan–Meier analysis with the log-rank test revealed that BLACAT1 up-regulation was correlated with shorter overall survival time of patients with glioma (Log Rank test, P = .012). In multivariate Cox analysis, BLACAT1 expression was found to be an independent prognostic factor for overall survival in patients with glioma (HR = 2.739; 95% CI: 1.785–8.229; P = .035). Our study demonstrates that up-regulation of BLACAT1 is able to predict aggressive clinicopathologic characteristics and poor prognosis of glioma patients. These findings may have significant implications for potential treatment options and prognosis for patients with glioma.
The ballooning time in endoscopic papillary balloon dilation for removal of bile duct stones
Authors: Wang Qiang , Fu Luyao , Wu Tao , Ding Xiong
Published: March 2021

Background:

So far, there was no consensus regarding balloon dilation time in endoscopic papillary balloon dilation (EPBD). Thus, we conducted a systematic review and meta-analysis to compare the stone removal and overall complication rates of dilation of short and long duration with EPBD.

Methods:

The Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library), Web of Science, EMBASE Databases, and PubMed were searched from their inception to December 1, 2019 for all articles regarding balloon dilation time in EPBD for removal of bile duct stones. The data were extracted and the methodology quality was assessed. Meta-analysis was performed using RevMan5.3 software.

Results:

Four studies involving a total of 1553 patients were included, 918 in the short dilation group and 635 in the long dilation group. The results of meta-analysis showed that there was no significant difference between the 2 different dilation groups in the complete stone removal in randomized controlled trails (RCTs) group (P = .10) and non-RCTs group (P = 0.45), mechanical lithotripsy requirement (RCTs: P = .92; non-RCTs: P = .47), pancreatitis (RCTs: P = .48; non-RCTs: P = .45), bleeding (RCTs: P = .95; non-RCTs: P = .60), infection of biliary (RCTs: P = .58; non-RCTs: P = .29), perforation (RCTs: P = .32; non-RCTs: P = .37).

Conclusion:

This systematic review suggests that there no significant difference in the efficacy and safety of dilation of short and long duration for removal of bile duct stones with EPBD.
Effect of TIMP2/TIMP3 genes on the risk of osteosarcoma in Zhejiang population
Authors: Wu Zhongwei , Chen Huali , Pan Liwei , Yu Weiyang , Lou Chao , Chen Jian , He Dengwei
Published: March 2021

Osteosarcoma is a malignant tumor that develops from a mesenchymal cell line and is caused by gene–environment interactions. This study aimed to explore whether TIMP2/TIMP3 polymorphisms influenced the osteosarcoma risk.

The expression of the TIMP2 and TIMP3 genes in osteosarcoma histiocytes was analyzed by immunohistochemistry. In this case-control study, which includes samples from 499 patients and 500 healthy controls, 10 single-nucleotide polymorphisms (SNPs) in TIMP2 and TIMP3 were selected. Furthermore, we used the Agena MassARRAY platform for genotyping. The statistical analysis was performed using χ
2 test/Fisher exact test, and logistic regression analysis.

The immunohistochemistry results showed that the expression of TIMP2 is obvious higher in osteosarcoma histiocytes than in the normal histiocytes. The association study indicated that the allele of rs2277698 and rs4789936 were protective SNPs reducing the risk of osteosarcoma (odds ratios  > 1, P < .05) by the χ
2 test. In the genetic model, logistic regression analyses revealed that the rs2277698 and rs4789936 were associated with decreasing the risk of osteosarcoma under the codominant model, dominant model, and log-additive model. Stratification analysis revealed that 2 SNPs (rs2277698 and rs4789936) were significantly associated with a reduced risk of osteosarcoma in allele and genetic model after stratification by gender or age (P < .05). In addition, the haplotype “Trs2277698Crs2009169Crs7342880” of TIMP2 was associated with decreasing the osteosarcoma risk. The “Ars9609634Trs11547635” of TIMP3 was associated with reducing the osteosarcoma risk.

This finding shed new light on the high expression of TIMP2 polymorphisms may contribute to decreasing the osteosarcoma risk in Zhejiang populations.
A comparison of the analysis of 3 types of body fluids using the XN-350 hematology analyzer versus light microscopy assessment
Authors: Lee Jiwon , Cho Younggeun , Kim Han-Sung , Kang Hee Jung , Kim Miyoung , Lee Young Kyung
Published: March 2021

We evaluated the capacity of the XN-350 instrument to analyze 3 different types of body fluid samples under “body fluid mode.”

The performance of XN-350 was evaluated in terms of precision, carryover, limit of blank, limit of detection, limit of quantification, and linearity. Cell enumeration and differential data produced by the XN-350 were compared to manual chamber counting results in 63 cerebrospinal fluid (CSF), 51 ascitic fluid, and 51 pleural fluid (PF) samples. Comparisons between XN-350 versus Cytospin data were also performed in PF samples.

The precision, carry-over, limit of blank, and linearity of the XN-350 were acceptable. The limits of detection for white blood cells (WBCs) and red blood cells were 1.0/μL, and 1,000.0/μL, respectively; the corresponding limits of quantitation (LOQs) were 5.0/μL and 2,000.0/μL, respectively. The XN-350's cell enumeration and differential counting correlated well with those of manual chamber counting for all 3 sample types (except for differential counting in CSF samples), particularly parameters involving monocytes (r = 0.33) and mononuclear cells (MO- body fluid [BF]; r = 0.26), as well as total cell (TC-BF) enumeration (r = 0.50) and WBC-BF (r = 0.50) in PF samples. The MO-BF in CSF samples differed significantly from manual chamber counting results, but neither TC-BF nor WBC-BF in PF samples did. The XN-350 also showed good correlations with Cytospin analyses for differential counting of neutrophils, lymphocytes, and monocytes in PF samples. The differential counting of eosinophils via the XN-350 and Cytospin were not significantly correlated, but the difference between them was not significant.

The XN-350 is an acceptable alternative to manual fluid analysis. Samples with low cellularity around the LOQ should be checked manually. Moreover, manual differential counting should be performed on CSF samples, particularity those with low cell numbers.
Critical thinking intervention for stress reduction among undergraduates in the Nigerian Universities
Authors: Ugwuozor Felix Okechukwu , Otu Mkpoikanke Sunday , Mbaji Isaac Nnamdi
Published: March 2021

Background:

The stress level of undergraduates is increasing at an alarming rate. This study's objective was to determine the effect of critical thinking intervention (CTI) for stress reduction among undergraduates in Nigerian Universities.

Methods:

This research used a pretest-posttest design. Participants were 103 undergraduates who had experienced a high level of stress. The Academic Stress Questionnaire (ASQ) and the Educational Stress Scale (ESSS) were the measures used for data collection in the study, while repeated measures analysis of variance was used for data analysis.

Results:

Before the intervention, assessment results showed that the stress level of participants was high, with no difference between those undergraduates in the treatment group and those in the no-treatment control group. After the intervention, the assessment results indicated a significant reduction in the undergraduates’ stress level in the treatment group compared to those in the no-treatment control group. Further significant reduction was observed in the undergraduates’ stress level in the treatment group compared to those in the no-treatment control group after follow-up assessment.

Conclusion:

The authors concluded that CTI intervention was significantly effective for stress reduction among undergraduates in Nigerian Universities. Therefore, counselors are called upon to adopt the principle of CTI intervention to help patients under stress reduce their stress levels.
Shearwave elastography of the Sartorius muscle
Authors: Bedewi Mohamed A. , Elsifey Ayman A. , Alfaifi Tariq , Saleh Ayman K. , Swify Sherine M. , Sandougah Kholoud J.
Published: March 2021

The aim of the study was to study sonoelastographic features of thesartorius muscle, and its relation to the demographic factors.

The study included 70 muscles in 35 healthy subjects. High-resolution ultrasound and shearwave elastography were used to evaluate the sartorius muscle. Stiffness values were measured.

The mean shear elastic modulus of the sartorius muscle was 21.96 ± 5.1 kPa. Demographic factors showed no relation to the elastic modulus of the left sartorius muscle. Positive statistical correlation was noted between the elastic modulus of the right sartorius muscle, weight, and body mass index.

Our results could be a reference point for evaluating sartorius muscle stiffness in future research considering different pathologies.
Sedentary time and physical activity patterns of stroke survivors during the inpatient rehabilitation week
Authors: de Jong Amy U. , Smith Moira , Callisaya Michele L. , Schmidt Matthew , Simpson Dawn B.
Published: March 2021

Physical activity is recommended after stroke. However, the rehabilitation day is largely spent sedentary. Understanding patterns of physical activity across the rehabilitation week may help identify opportunities to improve participation. We aimed to examine: (1) differences between weekday and weekend sedentary time and physical activity, (2) the pattern of 24-h rehabilitation activity. Participants with stroke (n = 29) wore an activity monitor continuously during the final 7-days of inpatient rehabilitation. Linear mixed models (adjusted for waking hours) were performed with activity (sedentary, steps per day, walking time) as the dependent variable, and day type (weekday or weekend) as the independent variable. Patterns of upright time during the 24-h period were determined by averaging daily activity in 60-min intervals and generating a heat map of activity levels as a function of time. Participant mean age was 69 (SD 13) years (52% male) and mean National Institutes of Health Stroke Scale score was 7.0 (SD, 5.5). There was no significant difference in sedentary time between weekdays and weekends. At the weekend, participants spent 8.4 min less time walking (95% CI, −12.1 to −4.6) taking 624 fewer steps/day (95% CI, −951 to −296) than during the week. Activity patterns showed greatest upright time in the morning during the week. Afternoon and evening activities were low on all days. Sedentary time did not change across the 7-day rehabilitation week, but less walking activity occurred on the weekend. There are opportunities for stroke survivors to increase physical activity during afternoons and evenings and on weekend mornings during rehabilitation.
Psychometric properties of the International Classification of Functioning, Disability and Health Rehabilitation Set: a Rasch analysis
Authors: Gao Yan , Yan Tiebin , You Liming , Li Kun , Zhang Lifang , Zhang Malan
Published: March 2021

The International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set was proposed by the WHO ICF Research branch as a minimum standard for assessing and reporting functioning in a wide range of clinical settings. This study investigates the psychometric properties of ICF Rehabilitation Set using Rasch analysis. It was a multicenter, cross-sectional study involving 515 inpatients in the subacute or chronic phase of recovery from various health conditions selected by quota sampling (stratified by neurological, cardiopulmonary, musculoskeletal and other conditions). Registered physicians or nurses used the developed operational items of the ICF Rehabilitation Set to rate patients’ functioning. A Rasch model was performed in assessing the psychometric properties of the ICF Rehabilitation Set. Good reliability was observed in the activity and participation components, but the body functions component needs additional items to distinguish among people with moderate or severe problems. After recalibration, the body functions, activities and participation components showed fit to the Rasch model. However, deletions mandated by the Rasch model decreased the functioning information reflected by the ICF Rehabilitation Set.
Advancing Quality Improvement in Public Health by Exploring CQI in Alabama's Home Visiting Program
Authors: Fifolt Matthew , Arbour MaryCatherine , Johnson Heather H. , Johns Elisabeth , Preskitt Julie
Published: March 2021

Continuous Quality Improvement (CQI) is the use of a deliberate and defined improvement process to advance organizational systems. Quality improvement in public health is increasingly widespread, but there are still limited examples of success or descriptions of developmental trajectories for building CQI capacity. The goal of this article is to add to the extant knowledge on the topic by describing one state's implementation of evidence-based CQI in the Maternal, Infant, and Early Childhood Home Visiting program between 2014 and 2019. On the basis of a systematic review of Annual Yearly Progress reports and semistructured key informant interviews, analysis yielded 3 themes that facilitated successful implementation of CQI in Alabama: starting small and building capacity; engaging in continuous and supported learning; and establishing and maintaining a culture of quality. This project demonstrates that CQI can help public health practitioners refine processes and grow capacity to best serve clients' diverse needs.
Training Networks of Local Health Departments: A Regional Assessment
Authors: Harris Jenine K. , Leider Jonathon P. , Kulik Phoebe , Beck Angela
Published: March 2021

Objective:

The public health system faces major challenges in 2020, including an aging workforce, reductions in funding, and 2 simultaneous major threats to public health—the coronavirus pandemic and racial injustice. To effectively harness promising new technologies and address these and other public health challenges ahead, public health professionals must be trained on evidence-based practices for protecting and improving public health. This project sought to understand the network of health departments and organizations that provide training in order to inform strategic efforts to fill training gaps and improve access to training for local health departments (LHDs), thereby strengthening the public health system.

Design/Setting/Participants:

We conducted a Web-based survey of 501 LHDs in the 6 states constituting Region V of the Department of Health & Human Services. The survey focused on the training relationship between LHDs and state and national organizations that provide public health training, allowing for a social network analysis. We used data visualization and descriptive statistics to examine the network.

Results:

Of 290 participating health departments (58% response rate), 248 had monthly or more frequent contact with at least 1 organization for the purpose of training. Altogether, the 248 LHDs were connected to 47 state-level organizations and 10 national-level organizations. In 5 of 6 states, more LHDs were connected to the state health department for training than to any other organization type. Universities, national nonprofits, and national membership organizations provided training to the fewest LHDs. Local health department characteristics did not have a clear relationship with its number of training connections.

Conclusions:

State health departments may benefit from the support of universities, national nonprofits, and national membership organizations by partnering to offer training or by recommending training from these organizations to LHDs. Additional qualitative information from local and state health departments would be useful to determine the best strategies for universities, national nonprofits, and national membership organizations to participate in training local practitioners to improve LHD capacity.
Public Health Emergency Response Leadership Training: A Qualitative Assessment of Existing Educational Opportunities and Perceived Facilitators, Barriers, and Priorities in Professional Development
Authors: Li Yang , Hsu Edbert B. , Davis Xiaohong M. , Stennies Gail M. , Pham Nhu N. , Fisher Mary C. , Pearson Juliana L. , Barnett Daniel J. , Trigoso Silvia M. , Podgornik Michelle N. , Hunter David W. , Vagi Sara J.
Published: March 2021

Objective:

We aimed to understand the current training environment for developing public health emergency response leaders and highlight facilitators and barriers in accessing targeted training.

Design:

We designed 4 focus groups to gather organizational perspectives on public health emergency response leadership development. Discussions were recorded, transcribed, coded, and analyzed to synthesize key themes.

Setting:

Focus groups were convened at the 2019 Preparedness Summit (March 27-28) in St Louis, Missouri.

Participants:

Twenty-three public health professionals from 9 Public Health Emergency Preparedness (PHEP) Cooperative Agreement award recipient jurisdictions and 12 local health departments participated.

Main Outcome Measures:

We examined the current availability, relevance, specificity, and utility of educational content and delivery modalities. Facilitators and barriers were identified as opportunities to improve training access.

Results:

Generic emergency management training is considered important and widely available but with limited application in public health practice. Existing leadership training opportunities in public health emergency response are limited and not widely known. While organizational support and accessible training facilitate participation, resource constraints (ie, funding, time, and staff) exist as key barriers. In addition, frequent staff turnover and attrition that result in loss of institutional knowledge likely hinder effective public health emergency responses.

Conclusion:

Effective public health emergency response depends on capable leaders not only well versed in specialized technical disciplines and practices but also familiar with—or preferably fluent in—emergency management principles and functions. This study demonstrated that well-aimed training strategies and organizational planning are essential in developing public health emergency response leaders. Specifically, leadership development may accrue considerable benefit from a standardized training curriculum. In addition, scalable training programs developed through public, private, and academic partnerships may lessen resource demands on individual organizations to facilitate training access. Finally, training practicums (eg, mentoring, shadowing) may provide opportunities to facilitate active learning and preserve institutional knowledge through leadership transitions.
Exploring the Linkage Between Accreditation Outcomes and Public Health Emergency Preparedness and Response
Authors: Kennedy Mallory , Heffernan Megan , Gonick Shannon A. , Siegfried Alexa L.
Published: March 2021

Public health emergency preparedness is a critical health department function. The national public health accreditation program may enhance public health preparedness by building the capabilities and overall capacity of health departments and also by improving capabilities specific to preparedness. This study presents findings from a survey sent to health departments 1 year after achieving accreditation, with a focus on accreditation outcomes related to public health preparedness. Between April 2014 and February 2020, 214 health departments responded to the survey. Most respondents indicated that accreditation had positively influenced their health department's performance within each of the selected topic areas that may influence public health preparedness: workforce development; quality improvement efforts; use of evidence and data to drive decisions; and partnerships, accountability, and credibility among external stakeholders. Enhancing overall health department capacity through accreditation may support the ability of health departments to prepare for, respond to, and recover from public health emergencies.
Training Needs and Awareness of Emerging Areas of Public Health Practice Among Epidemiologists Working in State Health Agency Central Offices in the United States, 2017
Authors: Daly Elizabeth R. , Gendelman Moriah , Arrazola Jessica , Sellers Katie
Published: March 2021

Context:

Epidemiologists working in state health agency central offices (SHA-CO) are key professionals working to monitor population health indicators. Assessing training needs to identify gaps is critical to ensuring a competent public health workforce.

Objective:

The objective of this research was to identify training needs of SHA-CO epidemiologists and their awareness of emerging areas of public health practice (EAoP) using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS).

Design:

SHA-CO epidemiologists were surveyed in fall 2017 using a Web-based tool. Balanced repeated replication weights were used to account for complex sample design. Differences in responses by tenure, education level, and supervisory status were assessed using multinomial logistic regression.

Setting:

Forty-seven state health agencies.

Participants:

Permanently employed SHA-CO epidemiologists.

Main Outcome Measures:

Training needs were identified by classifying skill gaps as those skills that participants self-reported as high relevance to day-to-day work but self-rated as having low proficiency. Awareness of EAoP was self-reported.

Results:

Systems and strategic thinking and budget and financial management were the areas with the greatest training needs. For most skill domains, fewer participants reported skill gaps with increasing years of public health work experience. Participants with 16 or more years of work experience were less likely to be motivated by most training motivators listed by epidemiologists with 5 or fewer years of experience. The EAoP participants reported greatest awareness of evidence-based public health practice (67%), and the EAoP they reported hearing least about was Health in All Policies (14%).

Conclusions:

Stratified analyses by tenure identified important differences in training needs and motivators that employers can use to customize workforce development strategies. SHA-CO epidemiologists reported varying amounts of awareness of EAoP. Specialized training approaches may contribute to improved employee engagement and reduce skill gaps among SHA-CO epidemiologists.
Applying Latent Class Analysis on Cancer Registry Data to Identify and Compare Health Disparity Profiles in Colorectal Cancer Surgical Treatment Delay
Authors: Montiel Ishino Francisco A. , Odame Emmanuel A. , Villalobos Kevin , Whiteside Martin , Mamudu Hadii , Williams Faustine
Published: March 2021

Context:

Colorectal cancer (CRC) surgical treatment delay (TD) has been associated with mortality and morbidity; however, disparities by TD profiles are unknown.

Objectives:

This study aimed to identify CRC patient profiles of surgical TD while accounting for differences in sociodemographic, health insurance, and geographic characteristics.

Design:

We used latent class analysis (LCA) on 2005-2015 Tennessee Cancer Registry data of CRC patients and observed indicators that included sex/gender, age at diagnosis, marital status (single/married/divorced/widowed), race (White/Black/other), health insurance type, and geographic residence (non-Appalachian/Appalachian).

Setting:

The state of Tennessee in the United States that included both Appalachian and non-Appalachian counties.

Participants:

Adult (18 years or older) CRC patients (N = 35 412) who were diagnosed and surgically treated for in situ (n = 1286) and malignant CRC (n = 34 126).

Main Outcome Measure:

The distal outcome of TD was categorized as 30 days or less and more than 30 days from diagnosis to surgical treatment.

Results:

Our LCA identified a 4-class solution and a 3-class solution for in situ and malignant profiles, respectively. The highest in situ CRC patient risk profile was female, White, aged 75 to 84 years, widowed, and used public health insurance when compared with respective profiles. The highest malignant CRC patient risk profile was male, Black, both single/never married and divorced/separated, resided in non-Appalachian county, and used public health insurance when compared with respective profiles. The highest risk profiles of in situ and malignant patients had a TD likelihood of 19.3% and 29.4%, respectively.

Conclusions:

While our findings are not meant for diagnostic purposes, we found that Blacks had lower TD with in situ CRC. The opposite was found in the malignant profiles where Blacks had the highest TD. Although TD is not a definitive marker of survival, we observed that non-Appalachian underserved/underrepresented groups were overrepresented in the highest TD profiles. The observed disparities could be indicative of intervenable risk.
Pharmacokinetics of darunavir and cobicistat in pregnant and postpartum women with HIV
Authors: Momper Jeremiah D. , Wang Jiajia , Stek Alice , Shapiro David E. , Scott Gwendolyn B. , Paul Mary E. , Febo Irma L. , Burchett Sandra , Smith Elizabeth , Chakhtoura Nahida , Denson Kayla , Rungruengthanakit Kittipong , George Kathleen , Yang Derek Z. , Capparelli Edmund V. , Mirochnick Mark , Best Brookie M.
Published: March 2021

Objective:

To evaluate darunavir and cobicistat pharmacokinetics during pregnancy compared with postpartum and in infant washout samples after delivery.

Design:

Nonrandomized, open-label, parallel-group, multicenter phase-IV prospective study of darunavir and cobicistat pharmacokinetics in pregnant women with HIV and their children in the United States.

Methods:

Intensive steady-state 24-h pharmacokinetic profiles were performed after administration of 800 mg of darunavir and 150 mg of cobicistat orally in fixed dose combination once-daily during the second trimester, third trimester, and postpartum. Infant washout samples were collected after birth. Darunavir and cobicistat were measured in plasma by validated HPLC-UV and liquid chromatography with tandem mass spectrometry detection (LC-MS)/MS assays, respectively. A two-tailed Wilcoxon signed-rank test (α = 0.10) was employed for paired within-participant comparisons.

Results:

A total of 29 pregnant women receiving darunavir and cobicistat once-daily enrolled in the study. Compared with paired postpartum data, darunavir AUC0--24 was 53% lower in the second trimester [n = 12, P = 0.0024, geometric mean of ratio (GMR)=0.47, 90% confidence interval (CI) 0.33 – 0.68] and 56% lower in the third trimester (n = 18, P < 0.0001, GMR = 0.44, 90% CI 0.36 – 0.54), whereas cobicistat AUC0--24 was 50% lower in the second trimester (n = 12, P = 0.0024, GMR = 0.50, 90% CI 0.36–0.69) and 56% lower in the third trimester (n = 18, P < 0.0001, GMR = 0.44, 90% CI 0.35–0.55). Placental transfer of darunavir and cobicistat was limited.

Conclusion:

Standard darunavir/cobicistat dosing during pregnancy results in significantly lower exposure during pregnancy, which may increase the risk of virologic failure and perinatal transmission.
Dasotraline in adults with attention deficit hyperactivity disorder: a placebo-controlled, fixed-dose trial
Authors: Adler Lenard A. , Goldman Robert , Hopkins Seth C. , Koblan Kenneth S. , Kent Justine , Hsu Jay , Loebel Antony
Published: March 2021

In a previous study, dasotraline demonstrated efficacy at a dose of 8 mg/day in adults with attention deficit hyperactivity disorder (ADHD). The aim of the current study was to evaluate the efficacy and safety of dasotraline in doses of 4 and 6 mg/day. Adults meeting Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria for ADHD were randomized to 8 weeks of double-blind, once-daily, fixed-dose treatment with dasotraline 4 mg/day, 6 mg/day, or placebo. The primary efficacy endpoint was changed in the ADHD Rating Scale, Version IV (ADHD RS-IV) total score. Secondary efficacy endpoints included the Clinical Global Impression, Severity (CGI-S) Scale. Least squares mean reduction at week 8 in the ADHD RS-IV HV total score was not significantly greater (vs. placebo) in the dasotraline 4 mg/day group (−15.0 vs. −13.9; n.s.; or in the dasotraline 6 mg/day group (−16.5 vs. −13.9; P = 0.074; Hochberg correction). Treatment with dasotraline 6 mg/day was significant at week 8 (uncorrected) on the ADHD RS-IV total score (P = 0.037) and the CGI-S score (P = 0.011). Treatment with the 4 mg/day dose of dasotraline was NS. Treatment with dasotraline was generally well tolerated. The results provide additional evidence that supports the potential efficacy of dasotraline, in doses of 6 mg/day, in adults with ADHD.
Are human natal sex ratio differences across the world adaptive? A test of Fisher's principle
Authors: Douhard Mathieu , Dray Stéphane
Published: March 2021

Fisher's principle states that natural selection favours an equal number of male and female births at the population level, unless there are sex differences in rearing costs or sex differences in mortality before the end of the period of parental investment. Sex differences in rearing costs should be more pronounced in low- than in high-resource settings. We, therefore, examined whether human development index and sex differences in child mortality contribute to the natural variation in human sex ratio at birth across the globe. As predicted by Fisher's principle, the proportion of male births increased with both increasing male-biased childhood mortality and level of development of each country. However, these relationships were absent after accounting for spatial autocorrelation in the residuals, which our inference is conditioned on. This work shows how the failure to account for residual spatial autocorrelation can lead to incorrect conclusions regarding support for predictions from sex allocation theory.
Ancient DNA from the extinct Haitian cave-rail (Nesotrochis steganinos) suggests a biogeographic connection between the Caribbean and Old World
Authors: Oswald Jessica A. , Terrill Ryan S. , Stucky Brian J. , LeFebvre Michelle J. , Steadman David W. , Guralnick Robert P. , Allen Julie M.
Published: March 2021

Worldwide decline in biodiversity during the Holocene has impeded a comprehensive understanding of pre-human biodiversity and biogeography. This is especially true on islands, because many recently extinct island taxa were morphologically unique, complicating assessment of their evolutionary relationships using morphology alone. The Caribbean remains an avian hotspot but was more diverse before human arrival in the Holocene. Among the recently extinct lineages is the enigmatic genusNesotrochis,comprising three flightless species. Based on morphology,Nesotrochishas been considered an aberrant rail (Rallidae) or related to flufftails (Sarothruridae). We recovered a nearly complete mitochondrial genome ofNesotrochis steganinosfrom fossils, discovering that it is not a rallid but instead is sister to Sarothruridae, volant birds now restricted to Africa and New Guinea, and the recently extinct, flightless Aptornithidae of New Zealand. This result suggests a widespread or highly dispersive most recent common ancestor of the group. Prior to human settlement, the Caribbean avifauna had a far more cosmopolitan origin than is evident from extant species.
Odour boosts visual object approach in flies
Authors: Cheng Karen Y. , Frye Mark A.
Published: March 2021

Multisensory integration is synergistic—input from one sensory modality might modulate the behavioural response to another. Work in flies has shown that a small visual object presented in the periphery elicits innate aversive steering responses in flight, likely representing an approaching threat. Object aversion is switched to approach when paired with a plume of food odour. The ‘open-loop’ design of prior work facilitated the observation of changing valence. How does odour influence visual object responses when an animal has naturally active control over its visual experience? In this study, we use closed-loop feedback conditions, in which a fly's steering effort is coupled to the angular velocity of the visual stimulus, to confirm that flies steer toward or ‘fixate’ a long vertical stripe on the visual midline. They tend either to steer away from or ‘antifixate’ a small object or to disengage active visual control, which manifests as uncontrolled object ‘spinning’ within this experimental paradigm. Adding a plume of apple cider vinegar decreases the probability of both antifixation and spinning, while increasing the probability of frontal fixation for objects of any size, including a normally typically aversive small object.
A closed form for Jacobian reconstruction from time series and its application as an early warning signal in network dynamics
Authors: Barter Edmund , Brechtel Andreas , Drossel Barbara , Gross Thilo
Published: March 2021

The Jacobian matrix of a dynamical system describes its response to perturbations. Conversely, one can estimate the Jacobian matrix by carefully monitoring how the system responds to environmental noise. We present a closed-form analytical solution for the calculation of a system’s Jacobian from a time series. Being able to access the Jacobian enables a broad range of mathematical analyses by which deeper insights into the system can be gained. Here we consider in particular the computation of the leading Jacobian eigenvalue as an early warning signal for critical transitions. To illustrate this approach, we apply it to ecological meta-foodweb models, which are strongly nonlinear dynamical multi-layer networks. Our analysis shows that accurate results can be obtained, although the data demand of the method is still high.