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PurposeSepsis is recognized as a global public health problem, but the proportion due to hospital-acquired infections remains unclear. We aimed to summarize the epidemiological evidence related to the burden of hospital-acquired (HA) and ICU-acquired (ICU-A) sepsis.MethodsWe searched MEDLINE, Embase and the Global Index Medicus from 01/2000 to 03/2018. We included studies conducted hospital-wide or in intensive care units (ICUs), including neonatal units (NICUs), with data on the incidence/prevalence of HA and ICU-A sepsis and the proportion of community and hospital/ICU origin. We did random-effects meta-analyses to obtain pooled estimates; inter-study heterogeneity and risk of bias were assessed.ResultsOf the 13,239 studies identified, 51 met the inclusion criteria; 22 were from low- and middle-income countries. Twenty-eight studies were conducted in ICUs, 13 in NICUs, and ten hospital-wide. The proportion of HA sepsis among all hospital-treated sepsis cases was 23.6% (95% CI 17–31.8%, range 16–36.4%). In the ICU, 24.4% (95% CI 16.7–34.2%, range 10.3–42.5%) of cases of sepsis with organ dysfunction were acquired during ICU stay and 48.7% (95% CI 38.3–59.3%, range 18.7–69.4%) had a hospital origin. The pooled hospital incidence of HA sepsis with organ dysfunction per 1000 patients was 9.3 (95% CI 7.3–11.9, range 2–20.6)). In the ICU, the pooled incidence of HA sepsis with organ dysfunction per 1000 patients was 56.5 (95% CI 35–90.2, range 9.2–254.4) and it was particularly high in NICUs. Mortality of ICU patients with HA sepsis with organ dysfunction was 52.3% (95% CI 43.4–61.1%, range 30.1–64.6%). There was a significant inter-study heterogeneity. Risk of bias was low to moderate in ICU-based studies and moderate to high in hospital-wide and NICU studies.ConclusionHA sepsis is of major public health importance, and the burden is particularly high in ICUs. There is an urgent need to improve the implementation of global and local infection prevention and management strategies to reduce its high burden among hospitalized patients.

Sepsis is prevalent globally, causing a significant disease burden in global health. Sepsis is a complex disease condition, and therefore, the effective strategies to overcome sepsis need to be set up in layers across different sectors and populations. Over the years, the global society has been making progress in addressing sepsis as a public health threat. This review aims to examine and describe the current sepsis strategies globally and to sustain the fight against sepsis in the context of global health.

Cercospora beticola Sacc. is the most destructive pathogen of sugar beet (Beta vulgaris L.) and causes Cercospora leaf spot (CLS). Since 1986, fungicides that function as demethylation inhibitors (DMIs) have been used to control CLS in Hokkaido, which is the only area in Japan where sugar beet is grown. Reduced sensitivity of C. beticola to DMI fungicides, based on the half maximal effective concentration (EC50), was first reported in Hokkaido in 1999, however the fungicides continued to be used effectively until 2014. In a field experiment in 2016, we found that the efficacy of difenoconazole against the field population of C. beticola was greatly reduced. We subsequently tested over 600 isolates collected throughout the sugar beet-growing region of Hokkaido and revealed that the mean resistance factor of four DMI fungicides (difenoconazole, fenbuconazole, tebuconazole, and tetraconazole) were high, which indicates that DMI-resistant isolates were distributed throughout the beet cultivation area. Moreover, we identified three types of isolates that have unique cross-resistance patterns between difenoconazole and fenbuconazole, with their EC50 rate (= difenoconazole EC50/ fenbuconazole EC50) converged to 31, 4.0, and 0.40, respectively, which appeared to be affected by the local history of fungicide usage. The F144L substitution in CbCYP51 was only found in the group whose EC50 rate was 0.40. This is the first report of DMI resistance in C. beticola in Japan, and the findings in this study could contribute to our understanding of the mechanism of DMI resistance.

Background Chronic low back pain (CLBP) is a highly prevalent disease with poorly understood underlying mechanisms. In particular, altered trunk muscle coordination in response to specific trunk tasks remains largely unknown. Methods We investigated the muscle synergies during 11 trunk movement and stability tasks in 15 healthy individuals (8 females and 7 males, aged 21. 3 (20.1–22.8) ± 0.6 years) and in 15 CLBP participants (8 females and 7 males, aged 20. 9 (20.2–22.6) ± 0.7 years) by recording the surface electromyographic activities of 12 back and abdominal muscles (six muscles unilaterally). Non-negative matrix factorization was performed to extract the muscle synergies. Results We found six trunk muscle synergies and temporal patterns in both groups. The high similarity of the trunk synergies and temporal patterns in the groups suggests that both groups share the common feature of the trunk coordination strategy. We also found that trunk synergies related to the lumbar erector spinae showed lower variability in the CLBP group. This may reflect the impaired back muscles that reshape the trunk synergies in the fixed structure of CLBP. Furthermore, the higher variability of trunk synergies in the other muscle regions such as in the latissimus dorsi and oblique externus, which were activated in trunk stability tasks in the CLBP group, represented more individual motor strategies when the trunk tasks were highly demanding. Conclusion Our work provides the first demonstration that individual modular organization is fine-tuned while preserving the overall structures of trunk synergies and temporal patterns in the presence of persistent CLBP.

Key messageA putative ketoacyl-ACP reductase (CaKR1) that was not previously known to be associated with pungency of Capsicum was identified from map-based cloning and functional characterization.The pungency of chili pepper fruits is due to the presence of capsaicinoids, which are synthesized through the convergence of the phenylpropanoid and branched-chain fatty acid pathways. The extensive, global use of pungent and non-pungent peppers underlines the importance of understanding the genetic mechanism underlying capsaicinoid biosynthesis for breeding pepper cultivars. Although Capsicum is one of the earliest domesticated plant genera, the only reported genetic causes of its loss of pungency are mutations in acyltransferase (Pun1) and putative aminotransferase (pAMT). In this study, a single recessive gene responsible for the non-pungency of pepper No.3341 (C. chinense) was identified on chromosome 10 using an F2 population derived from a cross between Habanero and No.3341. Five candidate genes were identified in the target region, within a distance of 220 kb. A candidate gene, a putative ketoacyl-ACP reductase (CaKR1), of No.3341 had an insertion of a 4.5-kb transposable element (TE) sequence in the first intron, resulting in the production of a truncated transcript missing the region coding the catalytic domain. Virus-induced gene silencing of CaKR1 in pungent peppers resulted in the decreased accumulation of capsaicinoids, a phenotype consistent with No.3341. Moreover, GC–MS analysis of 8-methyl-6-nonenoic acid, which is predicted to be synthesized during the elongation cycle of branched-chain fatty acid biosynthesis, revealed that its deficiency in No.3341. Genetic, genomic, transcriptional, silencing, and biochemical precursor analyses performed in combination provide a solid ground for the conclusion that CaKR1 is involved in capsaicinoid biosynthesis and that its disruption results in a loss of pungency.

To identify suggestions for future research on spinal movement variability (SMV) in individuals with low back pain (LBP) by investigating (1) the methodologies and statistical tools used to assess SMV; (2) characteristics that influence the direction of change in SMV; (3) the methodological quality and potential biases in the published studies; and (4) strategies for optimizing SMV in LBP patients. We searched literature databases (CENTRAL, Medline, PubMed, Embase, and CINAHL) and comprehensively reviewed the relevant papers up to 5 May 2020. Eligibility criteria included studies investigating SMV in LBP subjects by measuring trunk angle using motion capture devices during voluntary repeated trunk movements in any plane. The Newcastle-Ottawa risk of bias tool was used for data quality assessment. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Eighteen studies were included: 14 cross-sectional and 4 prospective studies. Seven linear and non-linear statistical tools were used. Common movement tasks included trunk forward bending and backward return, and object lifting. Study results on SMV changes associated with LBP were inconsistent. Two of the three interventional studies reported changes in SMV, one of which was a randomized controlled trial (RCT) involving neuromuscular exercise interventions. Many studies did not account for the potential risk of selection bias in the LBP population. Designers of future studies should recognize that each of the two types of statistical tools assesses functionally different aspects of SMV. Future studies should also consider dividing participants into subgroups according to LBP characteristics, as three potential subgroups with different SMV characteristics were proposed in our study. Different task demands also produced different effects. We found preliminary evidence in a RCT that neuromuscular exercises could modify SMV, suggesting a rationale for well-designed RCTs involving neuromuscular exercise interventions in future studies.

The extent to which muscle synergies represent the neural control of human behavior remains unknown. Here, we tested whether certain sets of muscle synergies that are fundamentally necessary across behaviors exist. We measured the electromyographic activities of 26 muscles, including bilateral trunk and lower limb muscles, during 24 locomotion, dynamic and static stability tasks, and we extracted the muscle synergies using non-negative matrix factorization. Our results show that 13 muscle synergies that may have unique functional roles accounted for almost all 24 tasks by combinations of single and/or merging of synergies. Therefore, our results may support the notion of the low dimensionality in motor outputs, in which the central nervous system flexibly recruits fundamental muscle synergies to execute diverse human behaviors. Further studies are required to validate the neural representation of the fundamental components of muscle synergies.

How to achieve sustainable food production while reducing environmental impacts is a major concern in agricultural science, and advanced breeding techniques are promising for achieving such goals. However, rice is usually grown under field conditions and influenced by surrounding ecological community members. How ecological communities influence the rice performance in the field has been underexplored despite the potential of ecological communities to establish an environment-friendly agricultural system. In the present study, we demonstrate an ecological-network-based approach to detect potentially influential, previously overlooked organisms for rice ( Oryza sativa ). First, we established small experimental rice plots, and measured rice growth and monitored ecological community dynamics intensively and extensively using quantitative environmental DNA metabarcoding in 2017 in Japan. We detected more than 1000 species (including microbes and macrobes such as insects) in the rice plots, and nonlinear time series analysis detected 52 potentially influential organisms with lower-level taxonomic information. The results of the time series analysis were validated under field conditions in 2019 by field manipulation experiments. In 2019, we focused on two species, Globisporangium nunn and Chironomus kiiensis , whose abundance was manipulated in artificial rice plots. The responses of rice, namely, the growth rate and gene expression patterns, were measured before and after the manipulation. We confirmed that, especially in the G. nunn -added treatment, rice growth rate and gene expression pattern were changed. In the present study, we demonstrated that intensive monitoring of an agricultural system and the application of nonlinear time series analysis were helpful to identify influential organisms under field conditions. Although the effects of the manipulations were relatively small, the research framework presented here has future potential to harness the ecological complexity and utilize it in agriculture. Our proof-of-concept study would be an important basis for the further development of field-basis system management.

High-copy-number transposable elements comprise the majority of eukaryotic genomes where they are major contributors to gene and genome evolution. However, it remains unclear how a host genome can survive a rapid burst of hundreds or thousands of insertions because such bursts are exceedingly rare in nature and therefore difficult to observe in real time. In a previous study we reported that in a few rice strains the DNA transposon mPing was increasing its copy number by approximately 40 per plant per generation. Here we exploit the completely sequenced rice genome to determine 1,664 insertion sites using high-throughput sequencing of 24 individual rice plants and assess the impact of insertion on the expression of 710 genes by comparative microarray analysis. We find that the vast majority of transposable element insertions either upregulate or have no detectable effect on gene transcription. This modest impact reflects a surprising avoidance of exon insertions by mPing and a preference for insertion into 5' flanking sequences of genes. Furthermore, we document the generation of new regulatory networks by a subset of mPing insertions that render adjacent genes stress inducible. As such, this study provides evidence for models first proposed previously for the involvement of transposable elements and other repetitive sequences in genome restructuring and gene regulation.

Rapid digitalization has resulted in an increase in the number of older adults playing electronic sports (eSports). Therefore, it must be investigated whether eSports have a positive effect on cognitive function in older adults. We explored the traits of facial color modification in Japanese older individuals while playing eSports by employing the facial color analysis technique proposed in this study. With the aging population, eSports have garnered interest as a means of extending healthy life expectancy. The quantitative detection of emotions obtained from eSports can function as an indicator for evaluating the degree to which individuals enjoy the games and can aid in the assessment of eSports to extend healthy life expectancy. Thus, in this study, we aimed to develop an indicator for quantitatively assessing the emotions experienced while playing eSports. The investigation revealed that information on color saturation in the cheek region exhibited a distinct relationship with the emotions generated while playing eSports. The identified characteristics can also be utilized in techniques to estimate the emotions generated during eSports activities. This can contribute to the evaluation of eSports in extending the healthy life expectancy of older adults. Furthermore, it can aid in the development of technologies that support remote communication.