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INTRODUCTION Virtual Health (VH) is posited to be a force multiplier for Military Medicine, delivering digital healthcare to the point of need for the warfighter. To date, there are no studies on the impact of both synchronous and asynchronous VH modalities during a deployment. VH usage by the 1st Squadron, 2nd Cavalry Regiment (1/2 CR) during a 6 month deployment to rural Poland was evaluated prospectively to identify mission days saved for Commanders. MATERIALS AND METHODS VH Europe staff trained 1/2 CR Garrison and Deployed Medical Staff on VH modalities. Workflows for communication to higher echelons of medical care were developed. Usage of VH was prospectively tracked to identify trends and outcomes. RESULTS 213 Soldier Mission Days during a 6 month deployment were saved through the use of VH versus in-person travel for care. The predominance of VH was for synchronous video VH for the Warfighter (VIEW) (90%), followed by asynchronous Health Experts onLine Portal (HELP) consultations (10%). Lost Soldier productivity of $87,330 was avoided. CONCLUSION Operational VH is a force multiplier that brings the resources of the Medical Center to the Warfighter at the point of need. The full spectrum of VH modalities offers the greatest benefit for deployed units. Expansion of these technologies throughout the Department of Defense will reduce medical evacuations, increase Active Duty Service Member time on mission, and reduce risks for Commanders. © The Association of Military Surgeons of the United States. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.Broilers stocked in high densities may be prone to oxidative and inflammatory insults, resulting in impaired health status, growth performance, and meat quality. This study was to determine if 30% extra supplemental DL-methionine alleviated or prevented those adverse effects of a higher stocking density in broiler chickens. A total of 560 male Cornish Cross cockerels (day old) were divided into four groups two stocking densities (9 and 12 birds/m2) and two supplementations of methionine (grower 2.90 or 3.77 g/kg and finisher 2.60 or 3.38 g/kg). Growth performance was recorded weekly. Blood and tissues were sampled at the end of each period. High stocking density decreased (P 28%, P less then 0.05) glutathione concentration in the plasma, breast, and thigh of growers, but decreased (P less then 0.05) it in the liver of growers and thigh of finishers. Interaction effects (P less then 0.05) between dietary methionine and stocking density were found on activities of the antioxidant enzyme glutathione S-transferase in the liver of growers and breast, thigh, and adipose tissue of finishers. The interaction effect was also found on activities of glutathione peroxidase and superoxide dismutase in the thigh of growers. The extra methionine decreased (P less then 0.05) hepatic gene expression of heat shock protein 90 (18%) and thigh and breast malondialdehyde concentrations of the finishers (35%). In conclusion, the 30% extra DL-methionine supplementation was able to partially mitigate adverse effects caused by the higher stocking density and to improve redox status of the broilers. © The Author(s) 2020. FK228 Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.Acetaminophen (APAP) overdose induced acute liver failure is an important clinical problem in the United States and the current antidote N-acetylcysteine, has a short early therapeutic window. Since most patients present late to the clinic, there is need for novel late acting therapeutic options. Though the neuronal guidance cue netrin-1, has been shown to promote hepatic repair and regeneration during liver ischemia/reperfusion injury, its effect in APAP - induced hepatotoxicity is unknown. In the quest for a late-acting therapeutic intervention in APAP-induced liver injury, we examined the role of netrin-1 in a mouse model of APAP overdose. Male C57BL/6J mice were co-treated with exogenous netrin-1 or vehicle control, along with 300mg/kg APAP and euthanized at 6, 12 and 24h. Significant elevations in ALT indicative of liver injury were seen in control mice at 6h and this was not affected by netrin-1 administration. Also, netrin-1 treatment did not influence mitochondrial translocation of phospho-JNK, or peroxynitrite formation indicating that there was no interference with APAP-induced injury processes. Interestingly however, netrin-1 administration attenuated liver injury at 24h, as seen by ALT levels and histology, at which time significant elevations in the netrin-1 receptor, adenosine A2B (A2BAR) as well as macrophage infiltration was evident. Removal of resident macrophages with clodronate liposomes or treatment with the A2BAR antagonist PSB1115 blocked the protective effects of netrin-1. Thus, our data indicate a previously unrecognized role for netrin-1 in attenuation of APAP hepatotoxicity by enhancing recovery and regeneration, which is mediated through the A2BAR and involves resident liver macrophages. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For permissions, please email journals.permissions@oup.com.Dimensionality reduction is a key step in the analysis of single-cell RNA sequencing data. It produces a low-dimensional embedding for visualization and as a calculation base for downstream analysis. Nonlinear techniques are most suitable to handle the intrinsic complexity of large, heterogeneous single cell data. However, with no linear relation between gene and embedding coordinate, there is no way to extract the identity of genes driving any cell's position in the low-dimensional embedding, making it more difficult to characterize the underlying biological processes. In this paper, we introduce the concepts of local and global gene relevance to compute an equivalent of principal component analysis loadings for non-linear low-dimensional embeddings. Global gene relevance identifies drivers of the overall embedding, while local gene relevance identifies those of a defined subregion. We apply our method to single-cell RNAseq datasets from different experimental protocols and to different low dimensional embedding techniques. This shows our method's versatility to identify key genes for a variety of biological processes. To ensure reproducibility and ease of use, our method is released as part of destiny 3.0, a popular R package for building diffusion maps from single-cell transcriptomic data. It is readily available through Bioconductor. © The Author(s) 2020. Published by Oxford University Press.The present study aimed to determine whether apelin-13 could attenuate cardiac fibrosis via inhibiting the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathway to inhibit reactive oxygen species in heart failure (HF) rats. HF models were established by inducing ischemia myocardial infarction (MI) through ligation of the left anterior descending artery in Sprague-Dawley (SD) rats. MI-induced changes in hemodynamics and cardiac function were reversed by apelin-13 administration. The increases in the levels of collagen I, collagen III, α-smooth muscle actin (SMA), and transforming growth factor-β (TGF-β) in the heart of MI rats and cardiac fibroblasts (CFs) treated with angiotensin (Ang) II were inhibited by apelin-13. The levels of PI3K and p-Akt increased in Ang II-treated CFs, and these increases were blocked by apelin-13. The PI3K overexpression reversed the effects of apelin-13 on Ang II-induced increases in collagen I, collagen III, α-SMA, and TGF-β, NADPH oxidase activity and superoxide anions in CFs. Apelin-13 reduced the increases in the levels of NADPH oxidase activity and superoxide anions in the heart of MI rats and CFs with Ang II treatment. The results demonstrated that apelin-13 improved cardiac dysfunction, impaired cardiac hemodynamics, and attenuated fibrosis of CFs induced by Ang II via inhibiting the PI3K/Akt signaling pathway to inhibit oxidative stress. © 2020 The Author(s).MOTIVATION The discrimination ability of score functions to separate correct from incorrect peptide-spectrum matches in database-searching-based spectrum identification are hindered by many superfluous peaks belonging to unexpected fragmentation ions or by the lacking peaks of anticipated fragmentation ions. RESULTS Here, we present a new method, called BoltzMatch, to learn score functions using a particular stochastic neural networks, called restricted Boltzmann machines, in order to enhance their discrimination ability. BoltzMatch learns chemically explainable patterns among peak pairs in the spectrum data, and it can augment peaks depending on their semantic context or even reconstruct lacking peaks of expected ions during its internal scoring mechanism. As a result, BoltzMatch achieved 50% and 33% more annotations on high- and low-resolution MS2 data than XCorr at a 0.1% false discovery rate in our benchmark; conversely, XCorr yielded the same number of spectrum annotations as BoltzMatch, albeit with 4-6 times more errors. In addition, BoltzMatch alone does yield 14% more annotations than Prosit (which runs with Percolator), and BoltzMatch with Percolator yields 32% more annotations than Prosit at 0.1% FDR level in our benchmark. AVAILABILITY BoltzMatch is freely available at https//github.com/kfattila/BoltzMatch. SUPPORTING INFORMATION Supplementary materials are available at Bioinformatics Online. © The Author(s) (2020). Published by Oxford University Press. All rights reserved. For Permissions, please email journals.permissions@oup.com.INTRODUCTION In 2010, the Joint Trauma System published a clinical practice guideline (CPG) for providing care to patients with suspicion of spinal cord injury. The CPG advocated for liberal use of cervical collars and adequate documentation of the practice. This performance improvement project examined C-spine CPG adherence in both the prehospital and military treatment facility (MTF) settings. Understanding challenges in CPG adherence facilitates evaluation of future CPGs and their success at implantation of the clinical guidance. MATERIALS AND METHODS The Department of Defense Trauma Registry was used to identify US Military casualties meeting the criteria for cervical collar placement between January 1, 2007 and December 31, 2018. Criteria for cervical collar placement were defined as any patient who experienced a mechanism of injury relating to an explosion, fall, or motor-vehicle-related injury. Any patients with an AIS severity score greater than 1 to the head or having any ICD injury codes related to ata accurately portray nonadherence or adherence with lack of documentation. Future research and resources would benefit and expand the results collected in this paper, and cement the importance of CPG publication and adherence. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.MOTIVATION Protein Structural Annotations are essential abstractions to deal with the prediction of Protein Structures. link2 Many increasingly sophisticated Protein Structural Annotations have been devised in the last few decades. However the need for annotations that are easy to compute, process and predict has not diminished. This is especially true for protein structures that are hardest to predict such as novel folds. RESULTS We propose Brewery, a suite of ab initio predictors of 1D Protein Structural Annotations. Brewery uses multiple sources of evolutionary information to achieve state-of-the-art predictions of Secondary Structure, Structural Motifs, Relative Solvent Accessibility and Contact Density. link3 AVAILABILITY The web server, standalone program, Docker image and training sets of Brewery are available at http//distilldeep.ucd.ie/brewery/. © The Author(s) (2020). Published by Oxford University Press. All rights reserved. For Permissions, please email journals.permissions@oup.com.