A broad spectrum protein glycosylation system influences type II protein secretion and associated phenotypes in Vibrio cholerae

Protein secretion plays a crucial role for bacterial pathogens, exemplified by facultative human-pathoge

Discrete Accidental Symmetry for a Particle in a Constant Magnetic Field on a Torus

A classical particle in a constant magnetic field undergoes cyclotron motion on a circular orbit. At the quantum level, the fact that all classical orbits are closed gives rise to degeneracies in the spectrum. It is well-known that the spectrum of a charged particle in a constant magnetic field consists of infinitely degenerate Landau levels. Just as for the $1/r$ and $r^2$ potentials, one thus expects some hidden accidental symmetry, in this case with infinite-dimensional representations. Indeed, the position of the center of the cyclotron circle plays the role of a Runge-Lenz vector. After identifying the corresponding accidental symmetry algebra, we re-analyze the system in a finite periodic volume. Interestingly, similar to the quantum mechanical breaking of CP invariance due to the $\theta$-vacuum angle in non-Abelian gauge theories, quantum effects due to two self-adjoint extension parameters $\theta_x$ and $\theta_y$ explicitly break the continuous translation invariance of the classical theory. This reduces the symmetry to a discrete magnetic translation group and leads to finite degeneracy. Similar to a particle moving on a cone, a particle in a constant magnetic field shows a very peculiar realization of accidental symmetry in quantum mechanics.Comment: 25 pages, 2 figure

A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities.

ContextThe internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs.Evidence acquisitionWe conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing--weight, BP, lipids, smoking, physical activity, diet, and blood glucose.Evidence synthesisA total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6-24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners.ConclusionInternet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations

Impact of weight maintenance and loss on diabetes risk and burden: a population-based study in 33,184 participants

$\textbf{Background}$ Weight loss in individuals at high risk of diabetes is an effective prevention method and a major component of the currently prevailing diabetes prevention strategies. The aim of the present study was to investigate the public health potential for diabetes prevention of weight maintenance or moderate weight loss on a population level in an observational cohort with repeated measurements of weight and diabetes status. $\textbf{Methods}$ Height, weight and diabetes status were objectively measured at baseline and 10 year follow-up in a population-based cohort of 33,184 participants aged 30–60 years between 1990 and 2013 in Västerbotten County, Sweden. The association between risk of incident diabetes and change in BMI or relative weight was modelled using multivariate logistic regression. Population attributable fractions (PAF) were used to assess population impact of shift in weight. $\textbf{Results}$ Mean (SD) BMI at baseline was 25.0 (3.6) kg/m$^2$. Increase in relative weight between baseline and follow-up was linearly associated with incident diabetes risk, odds ratio (OR) 1.05 (95% confidence interval (CI) 1.04–1.06) per 1% change in weight. Compared to weight maintenance (±1.0 kg/m$^2$), weight gain of >+1.0 kg/m$^2$ was associated with an increased risk of incident diabetes, OR 1.52 (95% CI 1.32, 1.74), representing a PAF of 21.9% (95% CI 15.8, 27.6%). For moderate weight loss (−1.0 to −2.0 kg/m$^2$) the OR was 0.72 (95% CI 0.52, 0.99). $\textbf{Conclusions}$ Weight maintenance in adulthood is strongly associated with reduced incident diabetes risk and there is considerable potential for diabetes prevention in promoting this as a whole population strategy.This work was supported by the Medical Research Council [MC_UU_12015/ 4], the Swedish Council for Working Life and Social Research [FAS 2006_1512] and the Swedish Research Council [2006-21576-36119-666]. The Västerbotten Intervention Programme is financed by Västerbotten County Council. Dr Feldman is supported by the Raymond and Beverly Sackler Foundation through Churchill College, Cambridge

Evidence-based decision support for pediatric rheumatology reduces diagnostic errors.

BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists. METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software. The evaluation used the SimulConsult® DDSS tool, based on Bayesian pattern matching with temporal onset of each finding in each disease. The tool covered 5405 diseases (averaging 22 findings per disease). Rheumatology content in the database was developed using both primary references and textbooks. The frequency, timing, age of onset and age of disappearance of findings, as well as their incidence, treatability, and heritability were taken into account in order to guide diagnostic decision making. These capabilities allowed key information such as pertinent negatives and evolution over time to be used in the computations. Efficacy was measured by comparing whether the correct condition was included in the differential diagnosis generated by clinicians before using the software ( unaided ), versus after use of the DDSS ( aided ). RESULTS: The 26 clinicians demonstrated a significant reduction in diagnostic errors following introduction of the software, from 28% errors while unaided to 15% using decision support (p \u3c 0.0001). Improvement was greatest for emergency medicine physicians (p = 0.013) and clinicians in practice for less than 10 years (p = 0.012). This error reduction occurred despite the fact that testers employed an open book approach to generate their initial lists of potential diagnoses, spending an average of 8.6 min using printed and electronic sources of medical information before using the diagnostic software. CONCLUSIONS: These findings suggest that decision support can reduce diagnostic errors and improve use of relevant information by generalists. Such assistance could potentially help relieve the shortage of experts in pediatric rheumatology and similarly underserved specialties by improving generalists\u27 ability to evaluate and diagnose patients presenting with musculoskeletal complaints. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02205086

Sudden cardiac death in patients with ischemic heart failure undergoing coronary artery bypass grafting results from the STICH randomized clinical trial (Surgical Treatment for Ischemic Heart Failure)

Background—The risk of sudden cardiac death (SCD) in patients with heart failure following CABG has not been examined in a contemporary clinical trial of surgical revascularization. This analysis describes the incidence, timing and clinical predictors of SCD after CABG. Methods—Patients enrolled in the Surgical Treatment of Ischemic Heart Failure (STICH) trial who underwent CABG with or without surgical ventricular reconstruction (SVR) were included. We excluded patients with prior ICD and those randomized only to medical therapy. The primary outcome was SCD as adjudicated by a blinded committee. A Cox model was used to examine and identify predictors of SCD. The Fine and Gray method was used to estimate the incidence of SCD accounting for the competing risk of other deaths. Results—Over a median follow-up of 46 months, 113 patients of 1411 patients who received CABG without (n = 934) or with SVR (n = 477) had SCD; 311 died of other causes. The mean LVEF at enrollment was 28±9%. The 5-year cumulative incidence of SCD was 8.5%. Patients who had SCD and those who did not die were younger and had fewer comorbid conditions than those who died for reasons other than SCD. In the first 30 days after CABG, SCD (n=5) accounted for 7% of all deaths. The numerically greatest monthly rate of SCD was in the 31-90 day time period. In a multivariable analysis including baseline demographics, risk factors, coronary anatomy and LV function, ESVI and BNP were most strongly associated with SCD. Conclusions—The monthly risk of SCD shortly after CABG among patients with a low LVEF is highest between the first and third month, suggesting that risk stratification for SCD should occur early in the postoperative period, particularly in patients with increased preoperative ESVI and/or BNP

Alliance or acquisition? A mechanisms‐based, policy‐capturing analysis

Research summary: While alliance researchers view prior partner‐specific alliance experience as influencing firms' subsequent alliance or acquisition decisions, empirical evidence on the alliance versus acquisition decision is surprisingly mixed. We offer a reconciliation by proposing and testing an analytical framework that recognizes prior partner‐specific experiences as heterogeneous along three fundamental dimensions: partner‐specific trust, routines, and value certainty. This allows us to use a policy‐capturing methodology to rigorously operationalize and test our mechanism‐level predictions. We find that all three mechanisms can increase the likelihood of a subsequent alliance or acquisition, and in terms of the comparative choice between alliances versus acquisitions, partner‐specific trust pulls towards alliances, and value certainty pulls towards acquisitions. We conclude with a discussion of the theoretical and empirical implications of our approach and method. Managerial summary: This study focuses on an important corporate decision: When a firm has had an alliance with another firm, how would that experience affect the likelihood of a future alliance or acquisition with that same firm? We first suggest that it will depend on three factors: the level of trust that existed in that prior alliance, the extent to which specific work routines were developed, and the degree to which the firm was able to confidently assess the value of the partner firm's resources. We then find that trust is a particularly strong predictor of future alliances, while confidence regarding value more strongly predicts future acquisitions. In this way, we demonstrate more precisely how past corporate choices can affect (consciously or unconsciously) future ones

Dark matter and sub-GeV hidden U(1) in GMSB models

Motivated by the recent PAMELA and ATIC data, one is led to a scenario with heavy vector-like dark matter in association with a hidden $U(1)_X$ sector below GeV scale. Realizing this idea in the context of gauge mediated supersymmetry breaking (GMSB), a heavy scalar component charged under $U(1)_X$ is found to be a good dark matter candidate which can be searched for direct scattering mediated by the Higgs boson and/or by the hidden gauge boson. The latter turns out to put a stringent bound on the kinetic mixing parameter between $U(1)_X$ and $U(1)_Y$: $\theta \lesssim 10^{-6}$. For the typical range of model parameters, we find that the decay rates of the ordinary lightest neutralino into hidden gauge boson/gaugino and photon/gravitino are comparable, and the former decay mode leaves displaced vertices of lepton pairs and missing energy with distinctive length scale larger than 20 cm for invariant lepton pair mass below 0.5 GeV. An unsatisfactory aspect of our model is that the Sommerfeld effect cannot raise the galactic dark matter annihilation by more than 60 times for the dark matter mass below TeV.Comment: 1+15 pages, 4 figures, version published in JCAP, references added, minor change

On the alpha activity of natural tungsten isotopes

The indication for the alpha decay of 180-W with a half-life T1/2=1.1+0.8-0.4(stat)+-0.3(syst)x10^18 yr has been observed for the first time with the help of the super-low background 116-CdWO_4 crystal scintillators. In conservative approach the lower limit on half-life of 180-W has been established as T1/2>0.7x10^18 yr at 90% C.L. Besides, new T1/2 bounds were set for alpha decay of 182-W, 183-W, 184-W and 186-W at the level of 10^20 yr.Comment: 16 pages, 8 figures, accepted in Phys. Rev.