More Like this

1. Breath-synchronized electrical stimulation of the expiratory muscles in mechanically ventilated patients: a randomized controlled feasibility study and pooled analysis

   https://doi.org/10.1186/s13054-020-03352-0  

   Jonkman, Annemijn H.; Frenzel, Tim; McCaughey, Euan J.; McLachlan, Angus J.; Boswell-Ruys, Claire L.; Collins, David W.; Gandevia, Simon C.; Girbes, Armand R.; Hoiting, Oscar; Kox, Matthijs; et al (December 2020, Critical Care)

   null (Ed.)

   Abstract Background Expiratory muscle weakness leads to difficult ventilator weaning. Maintaining their activity with functional electrical stimulation (FES) may improve outcome. We studied feasibility of breath-synchronized expiratory population muscle FES in a mixed ICU population (“Holland study”) and pooled data with our previous work (“Australian study”) to estimate potential clinical effects in a larger group. Methods Holland: Patients with a contractile response to FES received active or sham expiratory muscle FES (30 min, twice daily, 5 days/week until weaned). Main endpoints were feasibility (e.g., patient recruitment, treatment compliance, stimulation intensity) and safety. Pooled: Data on respiratory muscle thickness and ventilation duration from the Holland and Australian studies were combined ( N  = 40) in order to estimate potential effect size. Plasma cytokines (day 0, 3) were analyzed to study the effects of FES on systemic inflammation. Results Holland: A total of 272 sessions were performed (active/sham: 169/103) in 20 patients ( N  = active/sham: 10/10) with a total treatment compliance rate of 91.1%. No FES-related serious adverse events were reported. Pooled: On day 3, there was a between-group difference ( N  = active/sham: 7/12) in total abdominal expiratory muscle thickness favoring the active group [treatment difference (95% confidence interval); 2.25 (0.34, 4.16) mm, P  = 0.02] but not on day 5. Plasma cytokine levels indicated that early FES did not induce systemic inflammation. Using a survival analysis approach for the total study population, median ventilation duration and ICU length of stay were 10 versus 52 ( P  = 0.07), and 12 versus 54 ( P  = 0.03) days for the active versus sham group. Median ventilation duration of patients that were successfully extubated was 8.5 [5.6–12.2] versus 10.5 [5.3–25.6] days ( P  = 0.60) for the active ( N  = 16) versus sham ( N  = 10) group, and median ICU length of stay was 10.5 [8.0–14.5] versus 14.0 [9.0–19.5] days ( P  = 0.36) for those active ( N  = 16) versus sham ( N  = 8) patients that were extubated and discharged alive from the ICU. During ICU stay, 3/20 patients died in the active group versus 8/20 in the sham group ( P  = 0.16). Conclusion Expiratory muscle FES is feasible in selected ICU patients and might be a promising technique within a respiratory muscle-protective ventilation strategy. The next step is to study the effects on weaning and ventilator liberation outcome. Trial registration: ClinicalTrials.gov, ID NCT03453944. Registered 05 March 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03453944 . 

   more » « less
2. Semi‐quantitative group testing for efficient and accurate qPCR screening of pathogens with a wide range of loads

   Nambiar, Ananthan; Pan, Chao; Rana, Vishal; Cheraghchi, Mahdi; Ribeiro, Joao; Maslov, Sergei; Milenkovic, Olgica (May 2024, BMC bioinformatics)

   Abstract Background: Results: To address these issues, we introduce a novel adaptive semi-quantitative group testing (SQGT) scheme to e ciently screen populations via two-stage qPCR testing. The SQGT method quantizes cycle threshold (Ct) values into multiple bins, leveraging the information from the rst stage of screening to improve the detection sensitivity. Dynamic Ct threshold adjustments mitigate dilution e ects and enhance test accuracy. Comparisons with traditional binary outcome GT methods show that SQGT reduces the number of tests by 24% on the only complete real-world qPCR group testing dataset from Israel, while maintaining a negligible false negative rate. Conclusion: In conclusion, our adaptive SQGT approach, utilizing qPCR data and dynamic threshold adjustments, o ers a promising solution for e cient population screening. With a reduction in the number of tests and minimal false negatives, SQGT holds potential to enhance disease control and testing strategies on a global scale. Keywords: Group testing, Pooled testing, Semiquantitative group testing, qPCR, Ct values, Viral load, COVID-19 

   more » « less
3. The Recent Decline and Recovery of Indian Summer Monsoon Rainfall: Relative Roles of External Forcing and Internal Variability

   https://doi.org/10.1175/JCLI-D-19-0833.1  

   Huang, Xin; Zhou, Tianjun; Turner, Andrew; Dai, Aiguo; Chen, Xiaolong; Clark, Robin; Jiang, Jie; Man, Wenmin; Murphy, James; Rostron, John; et al (June 2020, Journal of Climate)

   null (Ed.)

   Abstract The Indian summer monsoon (ISM) rainfall affects a large population in South Asia. Observations show a decline in ISM rainfall from 1950 to 1999 and a recovery from 1999 to 2013. While the decline has been attributed to global warming, aerosol effects, deforestation, and a negative-to-positive phase transition of the interdecadal Pacific oscillation (IPO), the cause for the recovery remains largely unclear. Through analyses of a 57-member perturbed-parameter ensemble of model simulations, this study shows that the externally forced rainfall trend is relatively weak and is overwhelmed by large internal variability during both 1950–99 and 1999–2013. The IPO is identified as the internal mode that helps modulate the recent decline and recovery of the ISM rainfall. The IPO induces ISM rainfall changes through moisture convergence anomalies associated with an anomalous Walker circulation and meridional tropospheric temperature gradients and the resultant anomalous convection and zonal moisture advection. The negative-to-positive IPO phase transition from 1950 to 1999 reduces what would have been an externally forced weak upward rainfall trend of 0.01 to −0.15 mm day −1 decade −1 during that period, while the rainfall trend from 1999 to 2013 increases from the forced value of 0.42 to 0.68 mm day −1 decade −1 associated with a positive-to-negative IPO phase transition. Such a significant modulation of the historical ISM rainfall trends by the IPO is confirmed by another 100-member ensemble of simulations using perturbed initial conditions. Our findings highlight that the interplay between the effects of external forcing and the IPO needs be considered for climate adaptation and mitigation strategies in South Asia. 

   more » « less
4. Geometry of the Wiman–Edge monodromy

   https://doi.org/10.1142/S1793525321500503  

   Stover, Matthew (September 2023, Journal of Topology and Analysis)

   The Wiman–Edge pencil is a pencil of genus 6 curves for which the generic member has automorphism group the alternating group [Formula: see text]. There is a unique smooth member, the Wiman sextic, with automorphism group the symmetric group [Formula: see text]. Farb and Looijenga proved that the monodromy of the Wiman–Edge pencil is commensurable with the Hilbert modular group [Formula: see text]. In this note, we give a complete description of the monodromy by congruence conditions modulo 4 and 5. The congruence condition modulo 4 is new, and this answers a question of Farb–Looijenga. We also show that the smooth resolution of the Baily–Borel compactification of the locally symmetric manifold associated with the monodromy is a projective surface of general type. Lastly, we give new information about the image of the period map for the pencil. 

   more » « less
5. Risk of Facilitated Invasion Depends Upon Invader Identity, Not Environmental Severity, Along an Aridity Gradient

   https://doi.org/10.3389/fevo.2022.886690  

   Lucero, Jacob E.; Faist, Akasha M.; Lortie, Christopher J.; Callaway, Ragan M. (May 2022, Frontiers in Ecology and Evolution)

   Positive interactions can drive the assembly of desert plant communities, but we know little about the species-specificity of positive associations between native shrubs and invasive annual species along aridity gradients. These measures are essential for explaining, predicting, and managing community-level responses to plant invasions and environmental change. Here, we measured the intensity of spatial associations among native shrubs and the annual plant community—including multiple invasive species and their native neighbors—along an aridity gradient across the Mojave and San Joaquin Deserts, United States. Along the gradient, we sampled the abundance and species richness of invasive and native annual species using 180 pairs of shrub and open microsites. Across the gradient, the invasive annuals Bromus madritensis ssp. rubens ( B. rubens ), B. tectorum , B. diandrus, Hordeum murinum , and Brassica tournefortii were consistently more abundant under shrubs than away from shrubs, suggesting positive effects of shrubs on these species. In contrast, abundance of the invasive annual Schismus spp. was greater away from shrubs than under shrubs, suggesting negative effects of shrubs on this species. Similarly, native annual abundance (pooled) and native species richness were greater away from shrubs than under shrubs. Shrub-annual associations were not influenced by shrub size or aridity. Interestingly, we found correlative evidence that B. rubens reduced native abundance (pooled), native species richness, and exotic abundance (pooled) under, but not away from shrubs. We conclude that native shrubs have considerable potential to directly (by increasing invader abundance) and indirectly (by increasing negative impacts of invaders on neighbors) facilitate plant invasions along broad environmental gradients, but these effects may depend more upon invader identity than environmental severity. 

   more » « less