Telestroke value through the eyes of emergency medicine providers: A counterfactual analysis.

Objectives: Emergency Medicine (EM) provider experiences consulting telestroke (TS) are poorly studied. In this qualitative study, we aimed to determine how TS changes patient management and to measure TS effects on EM provider confidence with acute ischemic stroke (AIS) treatment.

Materials And Methods: We designed a survey for EM providers querying perceptions of TS value, confidence with treating AIS, and counterfactuals regarding what EM providers would have done without TS.

A method for generating synthetic longitudinal health data.

Getting access to administrative health data for research purposes is a difficult and time-consuming process due to increasingly demanding privacy regulations. An alternative method for sharing administrative health data would be to share synthetic datasets where the records do not correspond to real individuals, but the patterns and relationships seen in the data are reproduced. This paper assesses the feasibility of generating synthetic administrative health data using a recurrent deep learning model.

Time-domain modeling of wave-based room acoustics including viscothermal and relaxation effects in air.

Air absorption can be a significant source of attenuation, which should be considered in long-duration wideband acoustics simulations. In this short contribution, a time-domain model for three-dimensional wave propagation including viscothermal and relaxation effects (air absorption) is developed and coupled with locally reactive impedance wall conditions through a conservative energy framework. The model is discretised with a finite-difference time-domain method, and numerical stability is established with a discrete energy balance.

Feasibility of a finite-difference time-domain model in large-scale acoustic simulations.

Wave-based techniques for room acoustics simulations are commonly applied to low frequency analysis and small-sized simplified environments. The constraints are generally the inherent computational cost and the challenging implementation of proper complex boundary conditions. Nevertheless, the application field of wave-based simulation methods has been extended in the latest research decades.

An innovative outpatient monitor service for gynecological patients in the United Kingdom: Case study evaluation of clinical effectiveness, economic outcomes, patient safety, and service improvement.

Background: Failure to attend appointments places a huge strain on health care systems around the world, resulting in poorer care for the patients, waste of staff time and increased waiting times. This study looked at the impact of an Outpatient-Monitor-Service (OMS) on clinical, economic, patient safety and service improvement outcomes in gynaecology patients compared with care as usual (with no access to the OMS).

Methods: We conducted a retrospective match-pair controlled study at a London-based hospital.

Incorporating source directivity in wave-based virtual acoustics: Time-domain models and fitting to measured data.

The modeling of source directivity is a problem of longstanding interest in virtual acoustics and auralisation. This remains the case for newer time domain volumetric wave-based approaches to simulation such as the finite difference time domain method. In this article, a spatio-temporal model of acoustic wave propagation, including a source term is presented.

Passive volumetric time domain simulation for room acoustics applications.

A major design consideration for volumetric wave-based time-domain room acoustics simulation methods, such as finite difference time domain (FDTD) methods, must be sufficiently general, or robust, to handle irregular room geometries and frequency-dependent and spatially varying wall conditions. A general framework for the design of such schemes is presented here, based on the use of the passivity concept, which underpins realistic wall conditions. This analysis is based on the use of conservative finite volume methods, allowing for a representation of the room system as a feedback connection of a lossless part, corresponding to wave propagation over the interior, and a lossy subsystem, representing the effect of wall admittances.

A library of chemically defined human N-glycans synthesized from microbial oligosaccharide precursors.

Synthesis of homogenous glycans in quantitative yields represents a major bottleneck to the production of molecular tools for glycoscience, such as glycan microarrays, affinity resins, and reference standards. Here, we describe a combined biological/enzymatic synthesis that is capable of efficiently converting microbially-derived precursor oligosaccharides into structurally uniform human-type N-glycans. Unlike starting material obtained by chemical synthesis or direct isolation from natural sources, which can be time consuming and costly to generate, our approach involves precursors derived from renewable sources including wild-type Saccharomyces cerevisiae glycoproteins and lipid-linked oligosaccharides from glycoengineered Escherichia coli.

A challenge to lepton universality in B-meson decays.

One of the key assumptions of the standard model of particle physics is that the interactions of the charged leptons, namely electrons, muons and taus, differ only because of their different masses. Whereas precision tests comparing processes involving electrons and muons have not revealed any definite violation of this assumption, recent studies of B-meson decays involving the higher-mass tau lepton have resulted in observations that challenge lepton universality at the level of four standard deviations. A confirmation of these results would point to new particles or interactions, and could have profound implications for our understanding of particle physics.

Audibility of dispersion error in room acoustic finite-difference time-domain simulation as a function of simulation distance.

Finite-difference time-domain (FDTD) simulation has been a popular area of research in room acoustics due to its capability to simulate wave phenomena in a wide bandwidth directly in the time-domain. A downside of the method is that it introduces a direction and frequency dependent error to the simulated sound field due to the non-linear dispersion relation of the discrete system. In this study, the perceptual threshold of the dispersion error is measured in three-dimensional FDTD schemes as a function of simulation distance.

A comparison of juice extraction methods in the pungency measurement of onion bulbs.

Background: Onion pungency is estimated by measuring the pyruvic acid content in juice extracted from fresh tissues. We compared pyruvic acid content and its variation in the juices extracted by the pressing, maceration, blending with no water, or blending with water (blend/water) methods.

Results: There were considerable differences in the pyruvic acid content and coefficient of variation (CV) among these methods, and there was an interaction between the onion cultivars and the juice extraction methods.

Human gut Bacteroidetes can utilize yeast mannan through a selfish mechanism.

Yeasts, which have been a component of the human diet for at least 7,000 years, possess an elaborate cell wall α-mannan. The influence of yeast mannan on the ecology of the human microbiota is unknown. Here we show that yeast α-mannan is a viable food source for the Gram-negative bacterium Bacteroides thetaiotaomicron, a dominant member of the microbiota.

Community-based control of the brown dog tick in a region with high rates of Rocky Mountain spotted fever, 2012-2013.

Rocky Mountain spotted fever (RMSF) transmitted by the brown dog tick (Rhipicephalus sanguineus sensu lato) has emerged as a significant public health risk on American Indian reservations in eastern Arizona. During 2003-2012, more than 250 RMSF cases and 19 deaths were documented among Arizona's American Indian population. The high case fatality rate makes community-level interventions aimed at rapid and sustained reduction of ticks urgent.

Depression, somatic symptoms, and perceived neighborhood environments among US-born and non-US-born free clinic patients.

Objectives: The study's purpose was to examine the impact of somatic symptoms and perceived neighborhood environment on depression using a comparison among US-born and non-US-born free clinic patients.

Methods: US-born English speakers (n = 99), non-US-born English speakers (n = 89), and non-US-born Spanish speakers (n = 158) 18 years old or older (N = 346) were surveyed at a free clinic that provides primary care to people without health insurance. Depression, somatic symptoms, and perceived neighborhood environment were measured using standardized instruments.

Inhibition of influenza virus infection and hemagglutinin cleavage by the protease inhibitor HAI-2.

Influenza virus remains a significant concern to public health, with the continued potential for a high fatality pandemic. Vaccination and antiviral therapeutics are effective measures to circumvent influenza virus infection, however, multiple strains have emerged that are resistant to the antiviral therapeutics currently on the market. With this considered, investigation of alternative antiviral therapeutics is being conducted.

Quality of life among free clinic patients associated with somatic symptoms, depression, and perceived neighborhood environment.

Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. The purpose of this study is to examine health-related quality of life (HRQoL) among free clinic patients and its association with somatic symptoms, depression, and perceived neighborhood environment. Free clinic patients (n = 186) aged 18 years or older completed a self-administered survey.

Mutation in spike protein cleavage site and pathogenesis of feline coronavirus.

Feline coronaviruses (FCoV) exist as 2 biotypes: feline enteric coronavirus (FECV) and feline infectious peritonitis virus (FIPV). FECV causes subclinical infections; FIPV causes feline infectious peritonitis (FIP), a systemic and fatal disease. It is thought that mutations in FECV enable infection of macrophages, causing FIP.

Cleavage activation of human-adapted influenza virus subtypes by kallikrein-related peptidases 5 and 12.

A critical step in the influenza virus replication cycle is the cleavage activation of the HA precursor. Cleavage activation of influenza HA enables fusion with the host endosome, allowing for release of the viral genome into the host cell. To date, studies have determined that HA activation is driven by trypsin-like host cell proteases, as well as yet to be identified bacterial proteases.

Acquisition of a novel eleven amino acid insertion directly N-terminal to a tetrabasic cleavage site confers intracellular cleavage of an H7N7 influenza virus hemagglutinin.

A critical feature of highly pathogenic avian influenza viruses (H5N1 and H7N7) is the efficient intracellular cleavage of the hemagglutinin (HA) protein. H7N7 viruses also exist in equine species, and a unique feature of the equine H7N7 HA is the presence of an eleven amino acid insertion directly N-terminal to a tetrabasic cleavage site. Here, we show that three histidine residues within the unique insertion of the equine H7N7 HA are essential for intracellular cleavage.

Influenza virus-mediated membrane fusion: determinants of hemagglutinin fusogenic activity and experimental approaches for assessing virus fusion.

Hemagglutinin (HA) is the viral protein that facilitates the entry of influenza viruses into host cells. This protein controls two critical aspects of entry: virus binding and membrane fusion. In order for HA to carry out these functions, it must first undergo a priming step, proteolytic cleavage, which renders it fusion competent.

Cleavage activation of the human-adapted influenza virus subtypes by matriptase reveals both subtype and strain specificities.

Cleavage activation of the hemagglutinin (HA) precursor is an essential step in the influenza virus replication cycle that is driven by host cell proteases. HA cleavage activation is required for virus-endosome membrane fusion and the subsequent release of the influenza virus genome into the cytoplasm. Previous studies have determined that HA cleavage is most likely driven by either membrane-bound or extracellular trypsin-like proteases that reside in the respiratory tract.

Synthesis of N-terminally linked protein and peptide dimers by native chemical ligation.

Dimerization can be utilized to double the molecular weight of proteins and peptides and potentially increase their avidity of binding to target receptors. These dimerization effects may be utilized to increase in vivo half-lives in a manner similar to PEGylation and may also improve biological activity. In this paper, we report a new strategy for the synthesis of N-terminally linked protein and peptide homodimers utilizing native chemical ligation to conjugate a short dithioester linker to the N-terminal cysteines of protein and peptide monomers to form dimers in a single step.