bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal associations of military-related factors on self-reported sleep among U.S. service members
Authors: Cooper Adam D , Kolaja Claire A , Markwald Rachel R , Jacobson Isabel G , Chinoy Evan D 
Published: July 2021

Abstract

Study Objectives
Sleep loss is common in the military, which can negatively affect health and readiness; however, it is largely unknown how sleep varies over a military career. This study sought to examine the relationships between military-related factors and the new onset and reoccurrence of short sleep duration and insomnia symptoms.

Methods
Millennium Cohort Study data were used to track U.S. military service members over time to examine longitudinal changes in sleep. Outcomes were self-reported average sleep duration (categorized as ≤5 h, 6 h, or 7–9 h [recommended]) and/or insomnia symptoms (having trouble falling or staying asleep). Associations between military-related factors and the new onset and reoccurrence of these sleep characteristics were determined, after controlling for multiple health and behavioral factors.

Results
Military-related factors consistently associated with an increased risk for new onset and/or reoccurrence of short sleep duration and insomnia symptoms included active duty component, Army or Marine Corps service, combat deployment, and longer than average deployment lengths. Military officers and noncombat deployers had decreased risk for either sleep characteristic. Time-in-service and separation from the military were complex factors; they lowered risk for ≤5 h sleep but increased risk for insomnia symptoms.

Conclusions
Various military-related factors contribute to risk of short sleep duration and/or insomnia symptoms over time, although some factors affect these sleep characteristics differently. Also, even when these sleep characteristics remit, some military personnel have an increased risk of reoccurrence. Efforts to improve sleep prioritization and implement interventions targeting at-risk military populations, behaviors, and other significant factors are warranted.
Assessment of morning sleep propensity with lemborexant in adults with insomnia disorder in a randomized, placebo-controlled crossover study
Authors: Mayleben David , Rosenberg Russell , Pinner Kate , Hussein Ziad , Moline Margaret 
Published: July 2021

AbstractObjectiveTo evaluate effects of lemborexant (LEM), a dual orexin receptor antagonist, on next-morning sleep propensity assessed by a modified Multiple Sleep Latency Test (M-MSLT) in adults with insomnia disorder.MethodsStudy 107 (E2006-A001-107) was a phase 1, randomized, double-blind, four-period crossover study. Subjects (n = 69) received oral single-dose placebo, LEM 5 mg (LEM5), and LEM 10 mg (LEM10) at bedtime in periods 1–3 in a randomized crossover and open-label flurazepam 30 mg in period 4. After an 8-hour overnight sleep opportunity, the M-MSLT measured average sleep onset latency (SOL). Mean change from baseline in average SOL versus placebo of −6.0 min or more was considered clinically meaningful. Other sleep propensity assessments included the proportion of subjects with average SOL &gt;6 min shorter than placebo. LEM plasma concentrations, safety, and tolerability were also assessed.ResultsM-MSLT assay sensitivity was confirmed by a clinically meaningful decrease in average SOL with flurazepam versus placebo (least squares mean [LSM] difference –6.06 min; 1-sided p &lt; 0.0001). In contrast, decreases in average SOL with LEM5 (LSM difference vs. placebo –1.15 min; 1-sided p = 0.0262) and LEM10 (–3.48 min; p &lt; 0.0001) did not meet the predefined threshold for a clinically meaningful effect (LEM5, –2.12; LEM10, –4.46). Some individuals did experience higher sleep propensity (average SOL &gt;6.0 min shorter than placebo), particularly with LEM10 (LEM10, 29.4%; LEM5, 13.2%).ConclusionsIn contrast to flurazepam, LEM5 and LEM10 did not show clinically meaningful mean increases in next-morning sleep propensity versus placebo. The possibility that some subjects may experience residual morning effects cannot be excluded.Clinical trial registration: ClinicalTrials.gov, NCT02350309
Revision of the montane New Guinean skink genus Lobulia (Squamata: Scincidae), with the description of four new genera and nine new species
Authors: Slavenko Alex , Tamar Karin , Tallowin Oliver J S , Kraus Fred , Allison Allen , Carranza Salvador , Meiri Shai 
Published: July 2021

Abstract
The skink genus Lobulia is endemic to New Guinea, the largest and highest tropical island in the world. Lobulia and its related genera represent an important component of the montane herpetofauna of New Guinea, but it remains understudied and poorly known. We here provide the first, large-scale, systematic revision of Lobulia, using molecular phylogenetic and morphological comparisons to assess the monophyly of the genus and the diversity of species within it. We find that Lobulia, as currently defined, is polyphyletic. The eight species currently assigned to it form three clades. Furthermore, many specimens from New Guinea of unknown specific affinity are genetically and morphologically distinct from each other. Based on these data, we re-diagnose Lobulia and two of its closely related genera, Prasinohaema and Papuascincus. We erect four new genera (Alpinoscincus gen. nov., Nubeoscincus gen. nov., Ornithuroscincus gen. nov. and Palaia gen. nov.) to address the problem of polyphyly and describe nine new species Lobulia fortis sp. nov., Lobulia huonensis sp. nov., Loublia marmorata sp. nov., Lobulia vogelkopensis sp. nov., Ornithuroscincus bengaun sp. nov., Ornithuroscincus inornatus sp. nov., Ornithuroscincus pterophilus sp. nov., Ornithuroscincus shearmani sp. nov. and Ornithuroscincus viridis sp. nov. We supplement this taxonomic revision by investigating the biogeographic history of Lobulia s.l. and find evidence for a large radiation in the accreted terranes of New Guinea, with multiple independent colonizations of montane habitats and subsequent recolonization of lowland habitats. Our study reinforces the uniqueness and richness of the montane herpetofauna of New Guinea and the importance of mountains to biodiversity in the Tropics.
Unsupervised Spatially Embedded Deep Representation of Spatial Transcriptomics
Authors: Fu Huazhu , Xu Hang , Chong Kelvin , Li Mengwei , Ang Kok Siong , Lee Hong Kai , Ling Jingjing , Chen Ao , Shao Ling , Liu Longqi , Chen Jinmiao 
Published: July 2021

AbstractSpatial transcriptomics enable us to dissect tissue heterogeneity and map out inter-cellular communications. Optimal integration of transcriptomics data and associated spatial information is essential towards fully exploiting the data. We present SEDR, an unsupervised spatially embedded deep representation of both transcript and spatial information. The SEDR pipeline uses a deep autoencoder to construct a low-dimensional latent representation of gene expression, which is then simultaneously embedded with the corresponding spatial information through a variational graph autoencoder. We applied SEDR on human dorsolateral prefrontal cortex data and achieved better clustering accuracy, and correctly retraced the prenatal cortex development order with trajectory analysis. We also found the SEDR representation to be eminently suited for batch integration. Applying SEDR to human breast cancer data, we discerned heterogeneous sub-regions within a visually homogenous tumor region, identifying a tumor core with pro-inflammatory microenvironment and an outer ring region enriched with tumor associated macrophages which drives an immune suppressive microenvironment.
Low frequency of community-acquired bacterial co-infection in patients hospitalized for COVID-19 based on clinical, radiological and microbiological criteria; a retrospective cohort study
Authors: Coenen Sophie , de la Court Jara R. , Buis David T.P. , Meijboom Lilian J. , Schade Rogier P. , Visser Caroline E. , van Hest Reinier , Kuijvenhoven Marianne , Prins Jan M. , Nijman Suzan F.M. , Sieswerda Elske , Sigaloff Kim C.E. 
Published: July 2021

AbstractBackgroundTo define the frequency of respiratory community-acquired bacterial co-infection in patients with coronavirus disease 2019 (COVID-19) based on a complete clinical assessment, including prior antibiotic use, clinical characteristics, inflammatory markers, chest computed tomography (CT) results and microbiological test results.MethodsThis study was conducted within a cohort of prospectively included patients admitted for COVID-19 in our tertiary medical centres between 1-3-2020 and 1-6-2020. A multidisciplinary study team developed a diagnostic protocol to retrospectively categorize patients as unlikely, possible or probable bacterial co-infection based on clinical, radiological and microbiological parameters in the first 72 hours of admission. Within the three categories, we summarized patient characteristics and antibiotic consumption.ResultsAmong 281 included COVID-19 patients, bacterial co-infection was classified as unlikely in 233 patients (82.9%), possible in 35 patients (12.4%) and probable in 3 patients (1.1%). Ten patients (3.6%) could not be classified due to inconclusive data. Within 72 hours of hospital admission, 81% of the total study population and 78% of patients classified as unlikely bacterial co-infection received antibiotics.ConclusionsCOVID-19 patients are unlikely to have a respiratory community-acquired bacterial co-infection. Prospective studies should define the safety of restrictive antibiotic use in COVID-19 patients.
The COVID-related mental health load of neonatal healthcare professionals: A multicentre study in Italy
Authors: Gagliardi Luigi , Grumi Serena , Gentile Marzia , Cacciavellani Roberta , Placidi Giulia , Vaccaro Angelina , Maggi Claudia , Gambi Beatrice , Magi Letizia , Crespin Laura , Memmini Graziano , DeFilippo Marcello , Verucci Elena , Malandra Liliana , Mele Laura , Azzarà Angelo , Provenzi Livio 
Published: July 2021

ABSTRACTBackgroundThe COVID-19 pandemic has dramatically affected healthcare professionals’ lives. We investigated the potential mental health risk faced by healthcare professionals working in neonatal units in a multicentre cross-sectional observational study.MethodsWe included all healthcare personnel of 7 level-3 and 6 level-2 neonatal units in Tuscany, Italy. We measured the level of physical exposure to COVID-19 risk, self-reported COVID-related stress, and mental health load outcomes (anxiety, depression, burnout, psychosomatic, and post-traumatic symptoms) via validated, self-administered, on-line questionnaires.ResultsWe analysed 314 complete answers. Scores above the clinical cutoff were reported by 91% of participants for anxious symptoms, 29% for post-traumatic symptoms, 13% for burnout, and 3% for depressive symptoms. Moreover, 50% of the participants reported at least one psychosomatic symptom. COVID-related stress (but not actual physical exposure) was significantly associated with all the measured mental health load outcomes, with a Risk Ratio of 3.33 (95% Confidence interval: 1.89, 5.85) for clinically relevant anxiety, 2.39 (1.69, 3.38) for post-traumatic symptoms, 1.79 (1.16, 2.75) for emotional exhaustion, and 2.51 (0.98, 6.44) for depression.ConclusionsDespite a low clinical impact of COVID-19 in neonatology, neonatal professionals are a specific population at risk for psychological consequences during the pandemic.KeynotesWe studied the mental health load (anxiety, post-traumatic, psychosomatic symptoms, burnout, depression) of healthcare professionals working in 13 neonatal units in Tuscany during the COVID-19 pandemic.We found very high levels of anxiety and psychosomatic symptoms, and moderate-high post-traumatic and burnout symptoms.Mental health load was higher in neonatal intensive (vs non-intensive) settings and in nurses (vs physicians). Mental health load outcomes were associated with COVID-related stress (rather than actual physical exposure to the virus).
Nowcasting food insecurity on a global scale
Authors: Martini Giulia , Bracci Alberto , Jaiswal Sejal , Corea Matteo , Riches Lorenzo , Rivers Jonathan , Omodei Elisa 
Published: July 2021

AbstractLack of regular physical or economic access to safe, nutritious and sufficient food is a critical issue affecting millions of people world-wide. Estimating how many and where these people are is of fundamental importance for governments and humanitarian organizations to take informed and timely decisions on relevant policies and programmes. In this study, we propose a machine learning approach to predict the prevalence of people with insufficient food consumption and of people using crisis or above crisis food-based coping when primary data is not available. Making use of a unique global data set, we show that the proposed models can explain up to 78% of the variation in insufficient food consumption and crisis or above food-based coping levels. We also show that the proposed models can be used to nowcast the food security situation in near-real time and propose a method to identify which variables are driving the changes observed in predicted trends, which is key to make predictions serviceable to decision makers.
Genomic epidemiology of SARS-CoV-2 in Pakistan
Authors: Song Shuhui , Li Cuiping , Kang Lu , Tian Dongmei , Badar Nazish , Ma Wentai , Zhao Shilei , Jiang Xuan , Wang Chun , Sun Yongqiao , Li Wenjie , Lei Meng , Li Shuangli , Qi Qiuhui , Ikram Aamer , Salman Muhammad , Umair Massab , Shireen Huma , Batool Fatima , Zhang Bing , Chen Hua , Yang Yungui , Abbasi Amir Ali , Li Mingkun , Xue Yongbiao , Bao Yiming 
Published: July 2021

ABSTRACTPakistan has been severely affected by the COVID-19 pandemic. To investigate the initial introductions and transmissions of the SARS-CoV-2 in the country, we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected before June 1, 2020. We identified a total of 347 variants, 29 of which were over-represented in Pakistan. Meanwhile, we found over one thousand intra-host single-nucleotide variants. Several of them occurred concurrently, indicating possible interactions among them. Some of the hypermutable positions were not observed in the polymorphism data, suggesting strong purifying selections. The genomic epidemiology revealed five distinctive spreading clusters. The largest cluster consisted of 74 viruses which were derived from different geographic locations and formed a deep hierarchical structure, indicating an extensive and persistent nation-wide transmission of the virus that was probably contributed by a signature mutation of this cluster. Twenty-eight putative international introductions were identified, several of which were consistent with the epidemiological investigations. No progenies of any of these 150 viruses have been found outside of Pakistan, most likely due to the nonphmarcological intervention to control the virus. This study has inferred the introductions and transmissions of SARS-CoV-2 in Pakistan, which could provide a guidance for an effective strategy for disease control.
Gut microbiome diversity measures for metabolic conditions: a systematic scoping review
Authors: Samuthpongtorn Chatpol , Nopsopon Tanawin , Pongpirul Krit 
Published: July 2021

ABSTRACTObjectiveEvidence on the association between the gut microbiome and metabolic conditions has been increasing during the past decades. Unlike the straightforward identification of beneficial non-pathogenic bacteria as a potential probiotic for clinical use, the analysis of gut microbiome diversity is more complex and required a better understanding of various measures. We aim to summarize an elaborated list of gut microbiome diversity measures.DesignSystematic search was conducted in three databases: PubMed, Embase, and Cochrane Central Register of Clinical Trials for randomized controlled trials, quasi-experimental and observational studies for the relationship between gut microbiota and metabolic diseases published in 2019 with the English language.ResultsThe measurement methods of alpha diversity and beta diversity were explored. Of 5929 potential studies, 47 were included in the systematic review (14632 patients). Of 13 alpha diversity measures, the Shannon index was the most commonly used in 37 studies (78.7%), followed by Chao1 index (19 studies), Operational Taxonomic Unit (OTU) richness (15 studies), Simpson index (13 studies), and Abundance-based Coverage Estimators (ACE) index (10 studies). Of 2 beta diversity measures, the UniFrac was the most commonly used in 24 studies (unweighted 17 studies and weighted 16 studies), followed by Bray-Curtis dissimilarity (16 studies).ConclusionVarious measurement of gut microbiome diversity have been used in the literature. All measurements have unique characteristics, advantages, and disadvantages which lead to different usage frequency. The measures were chosen considering cost, simplicity, and types of research.Significance of this studyWhat is already known on this subject?▸Alpha diversity, including Shannon index diversity, chao1 diversity, etc., is the average species diversity within a habitat type at a local scale while beta-diversity, such as Bray-Curtis dissimilarity and UniFrac, indicates the differentiation between microbial communities from different environments.▸Alpha- and beta-diversity are the two most diverse measures of gut microbiota diversity with no consensus on which measurement methods should be used in metabolic condition study.What are the new findings?▸Distinct characteristics, advantages, and disadvantages of each microbiome diversity measurement method lead to a variety of usage frequencies in metabolic condition studies. Shannon diversity is the most widely used alpha diversity while there is no predilection for beta diversity.How might it impact on clinical practice in the foreseeable future?▸Further researchers on metabolic condition with microbiome diversity measurement will have impartial evidence on which measurement methods are most rationally appropriate for their studies regarding simplicity, cost, and efficacy.
A Cascaded Droplet Microfluidic Platform Enables High-throughput Single Cell Antibiotic Susceptibility Testing at Scale
Authors: Zhang Pengfei , Kaushik Aniruddha , Hsieh Kuangwen , Li Sixuan , Lewis Shawna , Mach Kathleen E. , Liao Joseph C. , Carroll Karen C. , Wang Tza-Huei 
Published: July 2021

AbstractSingle-cell antibiotic susceptibility testing (AST) offers a promising technology by achieving unprecedented rapid testing time; however, its potential for clinical use is marred by its limited capacity for performing AST with scalable antibiotic numbers and concentrations. To lift the one antibiotic condition per device restriction common in single-cell AST, we develop a cascaded droplet microfluidic platform that uses an assembly line design to enable scalable single-cell AST. Such scalability is achieved by executing bacteria/antibiotic mixing, single-cell encapsulation, incubation, and detection in a streamlined workflow, facilitating susceptibility testing of each new antibiotic condition in 2 min after a 90 min setup time. As a demonstration, we test 3 clinical isolates and 8 positive urine specimens against 15 antibiotic conditions for generating antiprograms in ∼2 h and achieve 100% and 93.8% categorical agreement, respectively, compared to laboratory-based clinical microbiology reports which becomes available only after 48 h.
Runners with mid-portion Achilles tendinopathy have greater triceps surae intracortical inhibition than healthy controls
Authors: Fernandes Gabriel L. , Orssatto Lucas B. R. , Shield Anthony J. , Trajano Gabriel S. 
Published: July 2021

AbstractObjectivesThis study aimed to investigate short-interval intracortical inhibition (SICI) and muscle function in the Triceps surae of runners with mid-portion Achilles tendinopathy (AT).MethodsRunners with (n=11) and without (n=13) AT were recruited. Plantar flexor isometric peak torque and rate of torque development (RTD) were measured using an isokinetic dynamometer. Triceps surae endurance was measured as single leg heel raise (SLHR) to failure test. SICI was assessed using paired-pulse transcranial magnetic stimulation during a sustained contraction at 10% of plantar flexor isometric peak torque.ResultsTriceps surae SICI was 14.3% (95%CI: -2.1 to 26.4) higher in AT than control group (57.9%, 95%CI: 36.2, to 79.6; and 43.6% 95%CI:16.2 to 71.1; p=0.032) irrespective of the tested muscle. AT performed 16 (95%CI: 7.9 to 23.3, p<0.001) fewer SLHR repetitions on the symptomatic side compared to controls, and 14 (95%CI: 5.8 to 22.0, p=0.004), fewer SLHR repetitions on the non-symptomatic compared to controls. We found no between-groups differences in isometric peak torque (p=0.971) or RTD (p=0.815).PerspectiveOur data suggest greater intracortical inhibition for the Triceps surae muscles for the AT group accompanied by reduced SLHR endurance, without deficits in isometric peak torque or RTD. The increased SICI observed in the AT group could be negatively influencing Triceps surae endurance; thus, rehabilitation aiming to reduce intracortical inhibition should be considered to improve patient outcomes. Furthermore, SLHR is a useful clinical tool to assess plantar flexor function in AT patients.
Moderate-Intensity Exercise Versus High-Intensity Interval Training to Recover Walking Post-Stroke: Protocol for a Randomized Controlled Trial
Authors: Miller Allison , Reisman Darcy S. , Billinger Sandra A. , Dunning Kari , Doren Sarah , Ward Jaimie , Wright Henry , Wagner Erin , Carl Daniel , Gerson Myron , Awosika Oluwole , Khoury Jane , Kissela Brett , Boyne Pierce 
Published: July 2021

ABSTRACTBackgroundStroke results in neurologic impairments and aerobic deconditioning that contribute to limited walking capacity which is a major barrier post-stroke. Current exercise recommendations and stroke rehabilitation guidelines recommend moderate-intensity aerobic training post-stroke. Locomotor high-intensity interval training is a promising new strategy that has shown significantly greater improvements in aerobic fitness and motor performance than moderate-intensity aerobic training in other populations. However, the relative benefits and risks of high-intensity interval training and moderate-intensity aerobic training remain poorly understood following stroke. In this study, we hypothesize that locomotor high-intensity interval training will result in greater improvements in walking capacity than moderate-intensity aerobic training.MethodsUsing a single-blind, 3-site randomized controlled trial, 50 chronic (>6 months) stroke survivors are randomly assigned to complete 36 locomotor training sessions of either high-intensity interval training or moderate-intensity aerobic training. Main eligibility criteria are: age 40-80 years, single stroke for which the participant received treatment (experienced 6 months to 5 years prior to consent), walking speed ≤1.0 m/s, able to walk at least 3 minutes on the treadmill at ≥ 0.13 m/s (0.3 mph), stable cardiovascular condition (American Heart Association class B), and the ability to walk 10 meters overground without continuous physical assistance. The primary outcome (walking capacity) and secondary outcomes (self-selected and fast gait speed, aerobic fitness and fatigue) are assessed prior to initiating training and after 4 weeks, 8 weeks, and 12 weeks of training.DiscussionThis study will provide fundamental new knowledge to inform the selection of intensity and duration dosing parameters for gait recovery and optimization of aerobic training interventions in chronic stroke. Data needed to justify and design a subsequent definitive trial will also be obtained. Thus, the results of this study will inform future stroke rehabilitation guidelines on how to optimally improve walking capacity following stroke.Trial RegistrationClinicalTrials.govIdentifier:NCT03760016. First posted: November 30, 2018.https://clinicaltrials.gov/ct2/show/NCT03760016