Plants develop characteristic shoot architectures by extending branches at specific angles. Primary shoots bend in response to gravity and then adjust the orientation through an organ-straightening process to achieve a mechanically favorable shape. However, how plants integrate branch structure with the shoot architecture remains uncertain. Here, we examined the lateral branch morphology of Arabidopsis thaliana mutants for myosin XI motor proteins through a combination of three-dimensional reconstruction and temporal imaging. The wild type and myosin xif mutant formed S-shaped branches and gradually adjusted the branch angle upwards. The myosin xik mutant exhibited straighter and drooping branches and maintained branch angles. The myosin xif xik double mutant formed branches with irregular directional changes with fluctuating angles. These results suggest that MYOSIN XIk and XIf are required for the establishment of branch morphology through upward bending, stabilizing growth direction, and maintaining curvature.

A six-month-old boy with Down syndrome, complete atrioventricular septal defect with intact atrial septum, and moderate left-sided atrioventricular valve regurgitation underwent surgery. The presence of a common atrioventricular junction could not be diagnosed preoperatively. Postoperative left-sided atrioventricular valve regurgitation remained mild by complete cleft closure, direct closure of incised atrial septum, and patch augmentation of the underside of septum primum.

Quasi-BPS categories appear as summands in semiorthogonal decompositions of DT categories for Hilbert schemes of points in the three-dimensional affine space and in the categorical Hall algebra of the two-dimensional affine space. In this paper, we prove several properties of quasi-BPS categories analogous to BPS sheaves in cohomological DT theory.

We first prove a categorical analogue of Davison’s support lemma, namely that complexes in the quasi-BPS categories for coprime length and weight are supported over the small diagonal in the symmetric product of the three-dimensional affine space. The categorical support lemma is used to determine the torsion-free generator of the torus equivariant K-theory of the quasi-BPS category of coprime length and weight.

We next construct a bialgebra structure on the torsion free equivariant K-theory of quasi-BPS categories for a fixed ratio of length and weight. We define the K-theoretic BPS space as the space of primitive elements with respect to the coproduct. We show that all localized equivariant K-theoretic BPS spaces are one-dimensional, which is a K-theoretic analogue of the computation of (numerical) BPS invariants of the three-dimensional affine space.

Viscoelastic flow instability, which is compelled by elastic effects rather than inertia, can be driven to a chaotic state termed elastic turbulence (ET) manifested as strong velocity fluctuations with an algebraic decay in the frequency spectrum and increased mixing. We report the first spatiotemporally complete description of ET by considering a broad volume within a novel three-dimensional ordered porous medium, reconstructing flow at a micrometre characteristic length scale ($\text {Reynolds numbers} \ll 1$) via time-resolved microtomographic particle image velocimetry. Beyond a critical Weissenberg number of 2, we observe an elastic flow instability accompanied by an enhanced pressure drop with spectral characteristics typical of ET. Polymer chains in the ET flow state are advected along increasingly curved streamlines between pores such that they accumulate strain and generate a local flow instability evaluated per an established instability criterion based on local evaluation of elastic tensile stress and streamline curvature. The onset of ET leads to increased pore-scale resistance and positive feedback on upstream streamline curvature. ET is thus characterized by a continuous evolution between states of laminar and unstable flow: pores with unstable flow flood their adjacent peers and thus encourage straightened streamlines and flow stability across the array, while positive feedback from flow resistance on streamline curvature results in the instability propagating upstream along the array. By employing a geometrically ordered medium, we permit flow state communication between pores, yielding generalized insights highlighting the significance of spatial correlation and flow history, and thus provide new avenues for explaining the mechanisms of ET.

Immune system aging, a process known as immunosenescence, involves a striking rearrangement affecting all immune cells, resulting in an increased rate of infections and a major incidence of autoimmune diseases and cancer. Nonetheless, differences in how individuals of the same chronological age carry out this immunosenescence establishment and thus the aging rate have been reported. In the context of neuroimmunoendocrine communication and its role in the response to stress situations, growing evidence suggests that social environments profoundly influence all physiological responses, especially those linked to immunity. Accordingly, negative contexts (loneliness in humans/social isolation in rodents) were associated with immune impairments and decreased lifespan. However, positive social environments have been correlated with adequate immunity and increased lifespan. Therefore, the social context in which an individual lives is proposed as a decisive modulator of the immunosenescence process and, consequently, of the rate of aging. In this review, the most important findings regarding how different social environments (negative and positive) modulate immunosenescence and therefore the aging rate, as well as the role of stress responses, hormesis, and resilience in these environments will be explained. Finally, several possible molecular mechanisms underlying the effects of negative and positive environments on immunosenescence will be suggested.

This article concerns the tail probabilities of a light-tailed Markov-modulated Lévy process stopped at a state-dependent Poisson rate. The tails are shown to decay exponentially at rates given by the unique positive and negative roots of the spectral abscissa of a certain matrix-valued function. We illustrate the use of our results with an application to the stationary distribution of wealth in a simple economic model in which agents with constant absolute risk aversion are subject to random mortality and income fluctuation.

A common type of fungal disease investigation involves hospital-associated clusters of invasive mold infections (IMIs), which typically occur among immunocompromised patients. Responding to IMI clusters can be challenging for public health and hospital personnel for several reasons such as difficulty of confirming the existence of an outbreak, difficulty of determining source. Although many resources exist to guide patient notification about healthcare incidents (eg, bloodborne exposures, disease outbreaks), IMI clusters involve special considerations related to the complex diseases, uncertain exposures, and differential benefits and risks of notification. Early, nuanced communication about hospital-associated IMI clusters is almost always the best course of action to help reduce risks to patients’ health and foster trust between patients and hospitals.

This paper presents a novel speech emotion recognition scheme that leverages the individuality of emotion perception. Most conventional methods simply poll multiple listeners and directly model the majority decision as the perceived emotion. However, emotion perception varies with the listener, which forces the conventional methods with their single models to create complex mixtures of emotion perception criteria. In order to mitigate this problem, we propose a majority-voted emotion recognition framework that constructs listener-dependent (LD) emotion recognition models. The LD model can estimate not only listener-wise perceived emotion, but also majority decision by averaging the outputs of the multiple LD models. Three LD models, fine-tuning, auxiliary input, and sub-layer weighting, are introduced, all of which are inspired by successful domain-adaptation frameworks in various speech processing tasks. Experiments on two emotional speech datasets demonstrate that the proposed approach outperforms the conventional emotion recognition frameworks in not only majority-voted but also listener-wise perceived emotion recognition.

Background: Candida auris is of global concern due to its increasing frequency in intensive care units (ICUs), reported resistance to antifungal agents, propensity to cause outbreaks, and persistence in clinical environments. We investigated an increase in C. auris cases in an ICU in Kenya to determine the source of transmission and to control the spread of the disease. Methods: To identify cases, we reviewed laboratory records of patients with blood cultures yielding C. auris and organisms for which it is commonly misidentified by Vitek 2 v 8.01 software (ie, C. haemulonii, C. duobushaemulonii and C. famata) during January 2018–May 2019. We retrospectively reviewed medical charts of C. auris patients to extract information on demographics, underlying conditions, hospital procedures, treatments, and outcomes. We also enhanced infection control efforts by implementing contact precautions, equipment, and environmental disinfection, and hand hygiene training and compliance observations. Results: We identified 32 C. auris patients (Fig. 1). Median patient age was 55 years (IQR, 43–65), and 57% were male. Length of hospitalization before C. auris isolation was 30 days (IQR, 14–36). All had been admitted to the ICU. The most common reasons for admission were sepsis (50%), pneumonia (34%), surgery (25%), and stroke or other neurologic diagnosis (25%). Underlying comorbidities included hypertension (38%), diabetes mellitus (25%), and malignancy (29%). Two patients had HIV. Moreover, 61% of cultures yielded multidrug-resistant bacteria. Also, 33% of the patients had been admitted to this hospital in the preceding 3 months; 21% had been admitted to a hospital outside of Kenya; and 10% had been admitted to another hospital in Kenya in the previous year. Almost all (97%) had a central venous catheter, 45% had an acute dialysis catheter, 66% had an endotracheal tube, and 34% had a tracheostomy, with 69% receiving mechanical ventilation before C. auris isolation. Most (94%) had urinary catheters, 84% had nasogastric tubes, 91% had received total parenteral nutrition, and 75% had received blood products. All patients received broad-spectrum antibiotics and 49% received an antifungal before C. auris isolation. All-cause in-hospital mortality was 64% for the 28 patients whose outcomes were available. Following implementation of a hand hygiene campaign and improved equipment and environmental disinfection, no further cases were identified. Conclusions: We identified C. auris bloodstream infections associated with high all-cause mortality in a Kenyan hospital ICU. All patients had treatments and procedures suggesting severe underlying illness. Enhanced infection control contained the outbreak.

Funding: None

Disclosures: None

Background: Candida auris is an emerging pathogen associated with nosocomial outbreaks. During January to May 2019, 11 invasive cases of C. auris were identified in the intensive care unit (ICU) and high-dependency unit (HDU) at a hospital in Nairobi, Kenya. We report on the interventions implemented to control the outbreak. Methods: Intensified infection prevention and control (IPC) interventions were implemented. All patients infected or colonized with C. auris were placed in single-patient rooms with strict contact precautions. Cleaning of the patient care environment was enhanced by instituting a 3-step procedure of cleaning with soap and water, disinfecting with 0.5% chlorine, and rinsing with water. Glo-Germ gel was used to evaluate the cleaning processes, and percentage of missed surfaces was calculated. Hand hygiene training and compliance observations were conducted to enforce adherence to hand hygiene. The IPC team provided training and observational feedback of IPC to staff, patients, and their families. The IPC interventions were guided by screening activities. To monitor ongoing transmission, a biweekly point-prevalence survey (PPS) was performed to screen all previously negative ICU and HDU patients for C. auris. Furthermore, admission and contact screening were added to guide patient placement. Screening was conducted by collecting a composite swab from the bilateral axilla and groin. Samples were incubated in salt dulcitol broth for 5 days at 40°C then subcultured onto Sabouraud dextrose agar. Colony identification was performed using a Vitek 2 system (bioMérieux). Results: In total, 177 patients were placed in single-patient rooms under contact precautions during May–August 2019. We conducted 123 environmental cleaning observations, and the percentage of missed surfaces decreased from 71% (10 of 14) in June to 7% (1 of 16) in August. Hand hygiene compliance among ICU and HDU staff was 79% (204 of 257) in May, 71% (159 of 223) in June, 73% (170 of 233) in July, and 81% (534 of 657) in August. In total, 283 screening swabs from 234 patients were processed during May–August 2019. Overall, 18 of 88 PPS swabs (20%), 13 of 180 admission screening swabs (7%), and 0 of 15 contact screening swabs (0%) were positive for C. auris. The PPS results showed a rapid decrease in colonization: 6 of 14 (43%) in May, 12 of 54 (22%) in June, 9 of 98 (9%) in July, and 1 of 70 (2%) in August. No new C. auris infections were identified from June to October 2019. Conclusions: The control of C. auris in a hospital outbreak requires multimodal interventions, including enhanced IPC interventions, PPS, admission and contact screening for colonization, rigorous monitoring, and team effort.

Funding: None

Disclosures: None

Using transport models, the impacts of trapped electrons on zonal flows and turbulence in helical field configurations are studied. The effect of the trapped electrons on the characteristic quantities of the linear response for zonal flows is investigated for two different field configurations in the Large Helical Device. The turbulent potential fluctuation, zonal flow potential fluctuation and ion energy transport are quickly predicted by the reduced models for which the linear and nonlinear simulation results are used to determine dimensionless parameters related to turbulent saturation levels and typical zonal flow wavenumbers. The effects of zonal flows on the turbulent transport for the case of the kinetic electron response are much smaller than or comparable to those in an adiabatic electron condition for the two different field configurations. It is clarified that the effect of zonal flows on the turbulent transport due to the trapped electrons changes, depending on the field configurations.

To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey—large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.

To compile the findings of studies assessing emotional and behavioral changes in the survivors of the 2011 Fukushima nuclear disaster, we performed a systematic review in August 2019 using four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI). Peer-reviewed manuscripts, either in English or Japanese, were included in the searches. Sixty-one studies were retrieved for the review. Of these, 41 studies (67.2%) assessed emotional consequences, 28 studies (45.9%) evaluated behavioral consequences, and 8 studies (13.1%) evaluated both emotional and behavioral outcomes. The main research topic in emotional change was radiation exposure-associated risk perception, as reported in 15 studies. This risk perception included immediate health effects (eg, acute radiation syndrome) as well as future health effects (eg, future cancer and genetic effects). Lowered subjective well-being was reported in eight studies. Six studies reported perceived discrimination/stigmatization in the disaster survivors. The most critical behavioral change was an increase in suicides compared with residents in the whole of Japan or affected by the earthquake and tsunami, but not by the nuclear disaster. Increased rate of alcohol and tobacco use was reported, although the effect on one’s health was inconsistent. As a conclusion, the Fukushima nuclear disaster survivors suffered issues in risk perception, well-being, stigmatization, and alcohol/tobacco use in the first 8 years after the disaster. The present study is important in order to better understand the emotional and behavioral responses to future nuclear/radiological disasters as well as other “invisible” disasters, such as chemical and biological public health crises.