bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency treatment of hypoglycaemia: a guideline and evidence review
Authors: Villani M. , de Courten B. , Zoungas S.
Published: May 2017

Aim

To examine the current treatment guidelines for the emergency management of hypoglycaemia and the evidence underpinning recommendations.

Methods

International diabetes agencies were searched for hypoglycaemia treatment guidelines. Guidelines were assessed using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. An electronic database search was conducted for evidence regarding emergency treatment of hypoglycaemia in adults, and relevant articles were critically appraised.

Results

Of the international diabetes agencies, six sets of guidelines were deemed relevant and of sufficient detail for appraisal by AGREE II. The evidence search returned 2649 articles, of which 17 pertaining to the emergency management of hypoglycaemia were included. High‐quality evidence for the management of hypoglycaemia was lacking, limiting treatment recommendations. In general, guidelines and studies were somewhat concordant and recommended 15–20 g of oral glucose or sucrose, repeated after 10–15 min for treatment of the responsive adult, and 10% intravenous dextrose or 1 mg intramuscular glucagon for treatment of the unresponsive adult. No evidence was found for other treatment approaches.

Conclusion

Evidence for the emergency treatment of hypoglycaemia in adults is limited, is often low grade and mostly pre‐dates contemporary management of diabetes. Guideline recommendations are limited by the lack of randomized trials. Further high‐quality studies are required to inform the optimum management of this frequently occurring emergency condition.
Sodium‐glucose co‐transporter (SGLT) and glucose transporter (GLUT) expression in the kidney of type 2 diabetic subjects
Authors: Norton Luke , Shannon Christopher E. , Fourcaudot Marcel , Hu Cheng , Wang Niansong , Ren Wei , Song Jun , Abdul‐Ghani Muhammad , DeFronzo Ralph A. , Ren Jimmy , Jia Weiping
Published: May 2017

The sodium‐glucose co‐transporters (SGLTs) are responsible for the tubular reabsorption of filtered glucose from the kidney into the bloodstream. The inhibition of SGLT2‐mediated glucose reabsorption is a novel and highly effective strategy to alleviate hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). However, the effectiveness of SGLT2 inhibitor therapy is diminished due, in part, to a compensatory increase in the maximum reabsorptive capacity (Tm) for glucose in patients with T2DM. We hypothesized that this increase in Tm could be explained by an increase in the tubular expression of SGLT and glucose transporters (GLUT) in these patients. To examine this, we obtained human kidney biopsy specimens from patients with or without T2DM and examined the mRNA expression of SGLTs and GLUTs. The expression of SGLT1 is markedly increased in the kidney of patients with T2DM, and SGLT1 mRNA is highly and significantly correlated with fasting and postprandial plasma glucose and HbA1c. In contrast, our data demonstrate that the levels of SGLT2 and GLUT2 mRNA are downregulated in diabetic patients, but not to a statistically significant level. These important findings are clinically significant and may have implications for the treatment of T2DM using strategies that target SGLT transporters in the kidney.
European consensus for starting and stopping enzyme replacement therapy in adult patients with Pompe disease: a 10‐year experience
Authors: van der Ploeg A. T. , Kruijshaar M. E. , Toscano A. , Laforêt P. , Angelini C. , Lachmann R. H. , Pascual Pascual S. I. , Roberts M. , Rösler K. , Stulnig T. , van Doorn P. A. , Van den Bergh P. Y. K. , Vissing J. , Schoser B. ,   the European Pompe Consortium
Published: May 2017

Background and purpose

Pompe disease is a rare inheritable muscle disorder for which enzyme replacement therapy (ERT) has been available since 2006. Uniform criteria for starting and stopping ERT in adult patients were developed and reported here.

Methods

Three consensus meetings were organized through the European Pompe Consortium, a network of experts from 11 European countries in the field of Pompe disease. A systematic review of the literature was undertaken to determine the effectiveness of ERT in adult patients on a range of clinical outcome measures and quality of life. A narrative synthesis is presented.

Results

Consensus was reached on how the diagnosis of Pompe disease should be confirmed, when treatment should be started, reasons for stopping treatment and the use of ERT during pregnancy. This was based on expert opinion and supported by the literature. One clinical trial and 43 observational studies, covering a total of 586 individual adult patients, provided evidence of a beneficial effect of ERT at group level. At individual patient level, the response to treatment varied, but factors associated with a patient's response to ERT were not described in many studies. Eleven observational studies focused on more severely affected patients, suggesting that ERT can also be beneficial in these patients. There are no studies on the effects of ERT in pre‐symptomatic patients.

Conclusions

This is the first European consensus recommendation for starting and stopping ERT in adult patients with Pompe disease, based on the extensive experience of experts from different countries.
Etiologies of acute demyelinating optic neuritis: an observational study of 110 patients
Authors: Deschamps R. , Lecler A. , Lamirel C. , Aboab J. , Gueguen A. , Bensa C. , Vignal C. , Gout O.
Published: May 2017

Background and purpose

New criteria for the diagnosis of multiple sclerosis (MS) and discovery of myelin oligodendrocyte glycoprotein (MOG) or aquaporin‐4 (AQP4) antibodies (Abs) have changed the management of optic neuritis (ON). Our aim was to specify, in view of these recent advances, the etiologies of acute demyelinating ON for consecutive patients.

Methods

Retrospective database analysis was undertaken of consecutive adult patients with acute ON admitted from 1 December 2014 to 31 January 2016. Diagnosis of MS was made according to the 2010 McDonald criteria. Patients with Abs to AQP4 or MOG were classified as ON‐AQP4 and ON‐MOG, respectively. Patients who did not fulfill the diagnostic criteria and were negative for AQP4 and MOG Ab tests were classified as having idiopathic ON.

Results

Of 110 patients assessed, 78 had ON related to MS (70.9%). All patients without MS were tested for AQP4 and MOG Abs: 11 had MOG Ab (10%), 5 had AQP4 Ab (4.5%) and 16 were considered as having idiopathic ON (14.5%). Presence of intrathecal IgG oligoclonal bands was strongly associated with MS (mean, 88.4% vs. 34.4% in patients without MS; after Bonferroni correction, P < 0.0001).

Conclusions

Optic neuritis related to MOG Ab was the second cause identified of demyelinating ON in our center. Idiopathic ON was as frequent as both ON‐AQP4 and ON‐MOG combined.
Maxillary bone cysts in two horses: Diagnosis and treatment including intralesional formalin injection
Authors: van Delft T. V. A. F. , Pollaris E. , Gielen I. , Vanderperren K. , Tuerlinckx L. , Vlaminck L.
Published: May 2017

Cystic lesions are not very common in the horse. When occurring in the equine skull, they are mainly located in the paranasal sinuses, but occasionally lesions in the maxillary bone and mandible have been reported. The expansive character of these cystic lesions necessitates surgical treatment. The conventional surgical treatment of cystic lesions usually involves drainage, surgical excision and curettage of the cystic wall and all abnormal tissue. This case report describes the diagnosis and treatment of maxillary bone cysts in two cases. Due to the anatomical location of the bone cysts in the presented cases, excision and extensive curettage would have caused considerable collateral damage to important structures. For this reason, the surgical treatment was performed minimally invasively, including intralesional injection with 10% formalin solution, after which the lesions were flushed with saline solution.
Epigallocatechin‐3‐gallate ameliorates intrahepatic cholestasis of pregnancy by inhibiting matrix metalloproteinase‐2 and matrix metalloproteinase‐9
Authors: Zhang Mei , Xu Meimei
Published: May 2017

Matrix metalloproteinase (MMP)‐2 and matrix metalloproteinase‐9 are involved in many illnesses affecting pregnant women, including intrahepatic cholestasis of pregnancy (ICP), a serious liver abnormality during pregnancy. Epigallocatechin‐3‐gallate (EGCG) has been widely reported to inhibit activities of MMP‐2 and MMP‐9. We aimed to investigate the role of EGCG in ameliorating ICP symptoms in a rat model. Using 17α‐ethinylestradiol to induce ICP in pregnant rats, we investigated the efficacy of EGCG administration on ICP symptoms, including bile flow rate, total bile acids (TBA) and MMP‐2 and MMP‐9 activities. Correlation study was conducted among levels of the two MMPs with other ICP symptoms. In ICP rats, activities of both MMP‐2 and MMP‐9 were significantly elevated. EGCG administration could inhibit the upregulation of MMP‐2 and MMP‐9 post‐transcriptionally. Furthermore, EGCG ameliorated ICP symptoms, as evidenced by restored bile flow rate and TBA, showing efficient treatment outcomes. At last, levels of TBA and the two MMPs were found to be strongly correlated. Our study demonstrates that, for the first time, the efficacy of EGCG in ameliorating ICP symptoms by inhibiting both MMP‐2 and MMP‐9, which supports its potential as a novel drug in ameliorating ICP.
Offspring desertion and parental care in the Whiskered TernChlidonias hybrida
Authors: Ledwoń Mateusz , Neubauer Grzegorz
Published: May 2017

In species with biparental care, a conflict of interest can arise if one mate tries to maximize its own reproductive success at the expense of the other's. One of the mates can desert the brood to accrue a number of benefits to enhance its own fitness, leaving parental care to the remaining parent. This study is the first to describe the desertion pattern in a tern species (Sternidae). We investigated offspring desertion in the Whiskered TernChlidonias hybrida, a species with semi‐precocial chicks. Offspring desertion was recorded in 52% of nests prior to fledging (n = 131 nests). Females also deserted during the post‐fledging period. Of the deserters, 97% were females. Desertions started when chicks were 5 days old and no longer required intense brooding. Desertions before fledging did not affect fledging success. Provisioning rates between pair members differed, and females supplied much less food than males. Female provisioning rate affected the chances of nest desertion significantly: daily desertion rates were lower when females supplied more food. After females had deserted, males increased their provisioning rates but compensated for the loss of female care only partly in two‐ and three‐chick broods. Only in small (one‐chick) broods was compensation full. We conclude that male and female Whiskered Terns adopt different reproductive strategies in the population studied here. Females invest much less in parental care than males, providing less food and deserting more frequently. Given the ready availability of food and low predation pressure, benefits appear to accrue to females that desert; selection forces may therefore not be acting against female desertion.
Mechanical behavior of SiC joints brazed using an active Ag‐Cu‐In‐Ti braze at elevated temperatures
Authors: Moszner Frank , Mata‐Osoro Gustavo , Chiodi Mirco , Janczak‐Rusch Jolanta , Blugan Gurdial , Kuebler Jakob
Published: May 2017

The behavior of SiC ceramic joints brazed with commercially available Incusil ABA (Ag‐32.25Cu‐12.5In‐1.25Ti, in wt.%) was characterized especially with respect to the mechanical performance at temperatures up to 550°C using four‐point bending and torsional shear tests. The failure mechanisms with changing temperature were investigated with the aid of fractography. Additionally, the microstructure of brazed specimens was characterized in detail by high resolution scanning electron microscopy. The test geometry and setup for the high temperature torsional shear test is presented. The change in mechanical behavior of the joints as a function of temperature is shown and discussed. The brazed joints interestingly showed that flexural bending strength was maintained with only a small decrease up to 300°C. Above 300°C, the bending strength decreased much faster. For the first time, this joint system was characterized in torsional shear test at temperatures up to 550°C to achieve the intrinsic shear strength values. Very strong joints were achieved, resulting in failure through the ceramic base materials up to (torsional shear) testing temperatures of 400°C. The results indicate that SiC joints brazed with Incusil ABA exhibit excellent mechanical performance for applications up to 300°C.
Thermoelectric transport properties of Sn1−xGexSe (x=0‐0.03) prepared by melting synthesis method
Authors: Gao Junling , Shao Ziming , Xu Guiying
Published: May 2017

P‐type Sn1−xGexSe (x=0‐0.03) polycrystals were prepared through direct melting synthesis method. The composition and microstructure of the samples were analyzed, and the thermoelectric transport properties were investigated in temperatures ranging from 303 to 773 K. The results indicate that the electrical conductivity decreases as Ge content increases. A significant improvement was found for the Seebeck coefficient. The maximal value of 647 μV/K was achieved at 473 K for the sample of Sn0.97Ge0.03Se. The Hall transport properties result indicates that the carrier concentration decreases with Ge content increasing at room temperature. In addition, the total thermal conductivities (κtot) of all samples decrease with rising temperature.
Development of optical grade (TbxY1−x)3Al5O12 ceramics as Faraday rotator material
Authors: Aung Yan Lin , Ikesue Akio
Published: May 2017

Super full dense (TbxY1−x)3Al5O12 (x=0.5‐1.0) ceramics with optical grade (pore‐free) were successfully produced by solid‐state reaction between Tb4O7 and Al2O3 raw powders. Transparent sintered bodies were obtained by sintering at 1720°C for 5 hours in vacuum furnace. By additional HIP treatment, optical scattering centers were effectively removed, and finally the optical quality of the sintered bodies was improved to optical grade. Optical loss of the obtained samples at 1064 nm was approximately 0.1%/cm, and optically inhomogeneous parts were not observed inside the materials. Gaussian mode laser beam quality was not deteriorated after passing through the sample. Transmitted wavefront distortion inspected by interferometry was as excellent as λ/12. Verdet constant increased with an increase of Tb content in the garnet composition. When x=1.0, the Verdet constant was 307, 196, and 60 rad T−1 m−1 for 532, 633, and 1064 nm, respectively, at each measuring wavelength. These values were about 1.5 times higher than that of the commercially available TGG (Tb3Ga3O12) crystal. Insertion loss of the produced (Tb0.6Y0.4)3Al5O12 and TAG ceramics at 1064 nm was 0.01 and 0.05 dB, respectively, and extinction ratio was 39.5 and 40.3 dB, respectively. These properties were superior to that of the commercial high‐quality TGG single crystal (insertion loss: 0.05 dB, extinction ratio: 35.0 dB).
Addition of enamel matrix derivatives to bone substitutes for the treatment of intrabony defects: A systematic review, meta‐analysis and trial sequential analysis
Authors: Troiano Giuseppe , Laino Luigi , Zhurakivska Khrystyna , Cicciù Marco , Lo Muzio Lorenzo , Lo Russo Lucio
Published: May 2017

Aim

In order to enhance clinical improvement of intrabony defects, the addition of enamel matrix derivatives (EMD) to bone substitues (BS) has been investigated. The aim of this systematic review is to figure out whether such a combination, in comparison to the treatment with BS alone has beneficial effects on the following outcomes: clinical attachment level (CAL) gain, probing depth (PD) reduction and recession (REC).

Methods

Electronic databases (PUBMED, SCOPUS, EBSCO Host Research Databases and Web of Knowledge) were searched for randomized controlled trials in humans addressing the use of a combination of BS and EMD versus a control group with BS alone for the treatment of intrabony defects, with a minimum of 6 months of follow‐up; meta‐analysis and trial sequential analysis were then performed.

Results

From a total of 1,197 records screened by title and abstract, nine studies were read full‐text and five out of them included in the meta‐analysis. No significant differences have been demonstrated both for CAL gain, PD reduction and REC between test and control groups.

Conclusions

In the treatment of intrabony defects, the addition of EMD to BS seems to be not beneficial in terms of CAL gain, PD reduction and REC changes. However, such results should be considered with caution because of the small number of studies included in the meta‐analysis and their heterogeneity.
Antibodies against H1N1 influenza virus cross‐react with α‐cells of pancreatic islets
Authors: Qi Zongli , Hu Hanyu , Wang Zhihua , Wang Guanghua , Li Yan , Zhao Xiangrong , Feng Yangmeng , Huo Xueping , Sun Jingying , Feng Qing , Liu Yang , Wang Nana , Guo Chunyan , Li Yuan , Wang Ruian , Hu Jun
Published: May 2017

Epidemiological studies have documented that the incidence of human type 1 diabetes was significantly increased after H1N1 epidemic. However, a direct link between human type 1 diabetes and virus infection remains elusive. We generated 84 clones of murine monoclonal antibodies against the H1N1, and carried out immunohistochemistry in normal human tissue microarray. The results showed that two clones specifically cross‐reacted with human α‐cells of pancreatic islets. Reverse transcription polymerase chain reaction and deoxyribonucleic acid sequencing showed that the amino acid sequences of light and heavy chains of these clones were different. Importantly, the expression profiles of two monoclonal antibodies were individual different. For the first time, we provide direct evidence that monoclonal antibodies against H1N1 can cross‐react with human pancreas α‐cells, another source of β‐cells, suggesting α‐cells might be a novel target to be investigated in diabetes research.
Temporal and regional onset of leptin resistance in diet‐induced obese mice
Authors: Rizwan M. Z. , Mehlitz S. , Grattan D. R. , Tups A.
Published: May 2017

In common forms of obesity, leptin fails to convey its regulatory effect. This so called “leptin resistance” is not well understood, and solving this puzzle is a key to understanding how obesity develops. In the present study, we investigated the temporal and regional onset of leptin resistance in response to a diet enriched with long‐chain saturated fatty acids (high‐fat diet; HFD) in mice. Mice were exposed to either a low‐fat diet (LFD) or a HFD for 4 hours, 24 hours, 10 days and 28 days. Mice in each group received an i.p. injection of either phosphate‐buffered saline or leptin and the number of phosphorylated signal transducer and activator of transcription‐3 (pSTAT3) immunoreactive (‐IR) cells in the arcuate nucleus (ARC), ventromedial nucleus of the hypothalamus (VMH) and dorsomedial nucleus of the hypothalamus (DMH) was analysed 30 or 120 minutes after treatment. In the ARC, as soon as 24 hours of HFD, the molecular leptin response was reduced by 40% (P≤.01). Compared to at 24 hours, after 10 days, the number of leptin‐induced pSTAT3‐IR cells was elevated after 120 minutes, suggesting a sustained response and a partial return of leptin sensitivity. After 28 days, leptin failed to induce the number of pSTAT3‐IR over control levels, suggesting a markedly reduced sensitivity to leptin. In the VMH after 24 hours, we observed a 50% reduction in leptin‐induced pSTAT‐3‐IR cells, followed by a further decline after 10 days. However, after 28 days, there was a significant increase in pSTAT‐3‐IR cells (P≤.05), indicating partial recovery of leptin sensitivity. By contrast to these two regions, in the DMH, no loss of leptin sensitivity was observed at any time‐point. These findings demonstrate that a loss of sensitivity to leptin occurs rapidly after exposure to HFD in the ARC and VMH but not the DMH. However, there appears to be a biphasic pattern of leptin responsiveness, with a partial return of leptin sensitivity occurring after 10 days in the arcuate nucleus, and after 28 days in the VMH. By 28 days, the response to leptin in the arcuate nucleus was completely lost. These findings suggest that the molecular responses to leptin are altered after high‐fat feeding in a time‐ and region‐specific manner.
Normalization of timed neuropsychological tests with the PATA rate and nine‐hole pegboard tests
Authors: Saccà Francesco , Costabile Teresa , Abate Filomena , Liguori Agnese , Paciello Francesca , Pane Chiara , De Rosa Anna , Manganelli Fiore , De Michele Giuseppe , Filla Alessandro
Published: May 2017

Introduction

Despite neurological patients show frequent physical impairment, timed neuropsychological tests do not take this into account during scoring procedures.

Objective

We propose a normalization method based on the PATA Rate Task (PRT) and on the nine‐hole pegboard test (9HPT) as a measure of dysarthria and upper limb dysfunction.

Methods

We tested 65 healthy controls on timed neuropsychological tests (Attentional Matrices [AM], Trail Making Test, Symbol Digit Modalities Test, Verbal Fluencies) to determine the time spent on phonation or on hand movement during test execution. We developed correction formulas to normalize test times considering the patient's PRT/9HPT, their normality limits, and the test timing. We tested the method on 24 patients with Friedreich Ataxia (FRDA), as a model of motor and speech impairment.

Results

In healthy controls, phonation or hand movement is 13.5–61.7% of total test time. In FRDA patients, the effect of normalization improved all test results (range: 0.51–48.4%; p < .001). FRDA patients had worst scores in all tests when compared to controls, and the difference remained significant after correction except for the AM. At the individual level, the normalization method improved equivalent scores with fever patients showing impaired scores after correction.

Conclusions

We propose an innovative normalization method to reduce the impact of neurological disability on timed neuropsychological tests. This could be easily integrated in a clinical setting, as it requires a simple preliminary test with the PRT and 9HPT.
Cytological and cytomorphometric evaluation of the oral mucosa in HIV‐infected patients undergoing antiretroviral therapy
Authors: Alves Mônica Ghislaine Oliveira , Lima Carta Celina Faig , Brandão Adriana Aigotti Haberbeck , Furtado Juvencio José Duailibe , Marcucci Marcelo , Almeida Janete Dias
Published: May 2017

Background

To evaluate HIV infection‐induced alterations in the oral mucosa by comparing inflammation, cell maturation, and cytomorphometric changes in oral mucosal cells between HIV‐infected patients undergoing highly active antiretroviral therapy (HAART) and non‐HIV‐infected patients.

Methods

Thirty HIV‐infected patients undergoing HAART and 30 non‐HIV‐infected patients were studied. Four smears were obtained from the lateral border of the tongue and floor of the mouth with a cytobrush. One sample was stained by the Papanicolaou technique, and three samples were processed for Feulgen staining. Papanicolaou‐stained smears were analyzed by light microscopy, and the cytoplasmic (CA) and nuclear (NA) area were measured with the Software AxioVision 4.7.

Results

The Wilcoxon signed‐rank test showed a significant difference in intermediate epithelial cell types between the HIV‐infected and non‐HIV‐infected groups (P=.005). However, this difference was not observed for superficial epithelial cell types with (P=.672) and without a nucleus (P=.069). Comparative analysis revealed no significant difference in CA (P=.604), NA (P=.298) or NA/CA (P=.456) between the HIV‐infected and non‐HIV‐infected groups. Keratohyalin granules were more frequent in the non‐HIV‐infected group (P=.0001).

Conclusions

The results showed alterations in cell maturation in HIV‐infected patients undergoing HAART with undetectable viral load, but no morphometric changes were observed.
Genomic analysis of a cardinalfish with larval homing potential reveals genetic admixture in the Okinawa Islands
Authors: Gould A. L. , Dunlap P. V.
Published: May 2017

Discrepancies between potential and observed dispersal distances of reef fish indicate the need for a better understanding of the influence of larval behaviour on recruitment and dispersal. Population genetic studies can provide insight on the degree to which populations are connected, and the development of restriction site‐associated sequencing (RAD‐Seq) methods has made such studies of nonmodel organisms more accessible. We applied double‐digest RAD‐Seq methods to test for population differentiation in the coral reef‐dwelling cardinalfish, Siphamia tubifer, which based on behavioural studies, have the potential to use navigational cues to return to natal reefs. Analysis of 11,836 SNPs from fish collected at coral reefs in Okinawa, Japan, from eleven locations over 3 years reveals little genetic differentiation between groups of S. tubifer at spatial scales from 2 to 140 km and between years at one location: pairwise FST values were between 0.0116 and 0.0214. These results suggest that the Kuroshio Current largely influences larval dispersal in the region, and in contrast to expectations based on studies of other cardinalfishes, there is no evidence of population structure for S. tubifer at the spatial scales examined. However, analyses of outlier loci putatively under selection reveal patterns of temporal differentiation that indicate high population turnover and variable larval supply from divergent source populations between years. These findings highlight the need for more studies of fishes across various geographic regions that also examine temporal patterns of genetic differentiation to better understand the potential connections between early life‐history traits and connectivity of reef fish populations.
Directiveness in psychotherapy: A phenomenological‐narrative study of therapist attitudes
Authors: Rautalinko Erik
Published: May 2017

Objectives

This study of directiveness draws on the literature on patient–therapist matching, neutrality, and resistance. Our aim was to investigate how psychotherapists conceptualize directiveness as an attitude, with a focus on pantheoretical aspects of directiveness.

Design and methods

Our data are narratives from 18 interviews with psychotherapists of different theoretical orientations (cognitive‐behavioural, family‐systems, humanistic‐experiential, and psychodynamic), and from focus‐group discussions with six other psychotherapists.

Results

The analysis yielded four general themes: expression of directiveness (behaviour, agency, structure), its presence (depending on phase of and goals for therapy), its positive and negative outcomes (for patients and therapists, respectively), and therapist awareness (initial and shifting, depending on theoretical orientation).

Conclusions

Directiveness may be construed as an attitude. It supposedly increases via certain responses, but only a few of these are considered positive by therapists at large. Directiveness may be more present in early and late phases of therapy, and more warranted with patients that function poorly. There are both positive and negative outcomes of directiveness, but therapists are more prone to disclose the former.

Practitioner points

Therapist directiveness supposedly increases via advice, questions, clarifications, steering to topics, goal setting, self‐disclosure, and session management. Directiveness is seen as more present in early and late phases of therapy.

Directing is more warranted with patients who function poorly. Possible positive outcomes of directiveness are clarity, feeling of security, and saving time; negative outcomes are decrease of agency, increase of resistance, and less patient self‐attribution of improvement.

It is unlikely that therapists disclose adverse directive behaviours. Those who do, attribute them to psychotherapy structure if their attitudes are negative, and to personal choice if they are positive. This may hamper therapists managing their own level of directiveness.
Inflation pressures and times during initial resuscitation in preterm infants
Authors: Bhat Prashanth , Hunt Katie , Harris Christopher , Murthy Vadivelam , Milner Anthony D , Greenough Anne
Published: May 2017

Background

The optimal combination of inflation pressures and times to produce adequate expiratory tidal volumes during initial resuscitation in prematurely born infants has not been determined. The aim of this study was therefore to assess combinations of inflation pressures and times and the resulting expiratory tidal volume levels using a respiratory function monitor.

Methods

Sixty‐four infants born before 34 weeks of gestation were studied. The infants were divided according to whether the inflation pressure (peak inflation pressure minus positive end expiratory pressure) was < or ≥20 cmH2O during the first five inflations delivered by a face mask, and those groups were then subdivided according to whether the inflation time was < or ≥1.5 s.

Results

Inflation pressure ≥20 cmH2O compared with lower pressure at both inflation times produced significantly higher expiratory tidal volume. Longer compared with shorter inflation times when the inflation pressure was ≥20 cmH2O resulted in no significant difference in expiratory tidal volume. At <20 cmH2O inflation pressure, longer inflation time overall resulted in higher end tidal volume, but the majority of infants had a tidal volume less than the anatomical dead space.

Conclusions

At higher inflation pressure, a longer inflation time was not necessary to increase expiratory tidal volume.
Protonation–state‐Coupled Conformational Dynamics in Reaction Mechanisms of Channel and Pump Rhodopsins
Authors: Bondar Ana‐Nicoleta , Smith Jeremy C.
Published: May 2017

Channel and pump rhodopsins use energy from light absorbed by a covalently bound retinal chromophore to transport ions across membranes of microbial cells. Ion transfer steps, including proton transfer, can couple to changes in protein conformational dynamics and water positions. Although general principles of how microbial rhodopsins function are largely understood, key issues pertaining to reaction mechanisms remain unclear. In this review, we compare the protonation‐coupled dynamics of pump and channelrhodopsins, highlighting the roles that water dynamics, protein electrostatics and protein flexibility can have in ion transport mechanisms. We discuss observations supporting important functional roles of inter‐ and intra‐helical carboxylate/hydroxyl hydrogen‐bonding motifs. As specific examples, we use the proton pump bacteriorhodopsin, the sodium pump KR2, channelrhodopsins and Anabaena sensory rhodopsin. We outline the usefulness of theoretic biophysics approaches to the study of retinal proteins, challenges in studying the hydrogen‐bond dynamics of rhodopsin active sites, and implications for conformational coupling in membrane transporters.
Study on the Basic Performance of Three‐phase Fluidized Bed Equipment for Solar Photocatalysis–Membrane Separation
Authors: Sha Li , Xie Liping , Li Miaomiao , Fei Xuening , Du Jinshan , Zou Chenxi
Published: May 2017

In this study, three‐phase fluidized bed equipment for the solar photocatalysis–membrane separation (E‐SPME), comprising solar photocatalytic degradation and membrane separation zones, was first introduced, and the photocatalytic degradation of acid red B wastewater (ARBW) with a TiO2 photocatalyst was investigated using the E‐SPME. The experimental results indicated the circulating flow of wastewater between the two zones and the increase in the ARBW photocatalytic degradation efficiency with decreasing membrane flux. The same experimental phenomenon was observed with the change in the aeration rate in the lower water tank from 0.10 to 0.40 m3 h−1, but the degradation efficiency started to decrease with further increase in the aeration rate to 0.50 m3 h−1. The degradation efficiency on a clear day was greater than that on a cloudy day; however, it was significantly improved with the opened UV lamps on a cloudy day. The steady operation of the E‐SPME was still possible by the opening of the UV lamps on completely cloudy and clear days with a solar light intensity of <13.0 W m−2.
Ultrastructural study on the interaction between Physcomitrella patens and Botrytis cinerea
Authors: Yan H. Q. , Zhang T. T. , Lan S. C. , Jiang S.
Published: May 2017

Little is known about the interactions of bryophytes with their pathogens compared with those of flowering plants. This study used the moss Physcomitrella patens and fungal pathogen Botrytis cinerea to investigate their interaction at the ultrastructural level. Infection behaviour of B. cinerea in moss tissues was observed for 1–7 days after inoculation. Some appressoria directly penetrated P. patens cytoplasm through leaf cell walls, and others entered the intercellular spaces of leaves and infected cytoplasm. Infection hyphae were observed in sclerenchyma cells of P. patens stems for the first time. The results demonstrated that the ratio of hyphae‐inoculated leaf cells to leaf numbers could be used to quantify the disease development process at 24 h after inoculation. The ultrastructural studies revealed two responses of P. patens to B. cinerea inoculation: reinforcement of cell walls, including papillae formation; and cell death. This was the first observation of papillae for P. patens–B. cinerea interaction at the ultrastructural level. Papillae in P. patens had a similar ultrastructure to those of higher plants, and may be involved in the defence response to B. cinerea infection. Thus papillae formation is probably an evolutionarily conserved defence mechanism from the early land colonization by plants. Cell death during the P. patens–B. cinerea interaction had some features of programmed cell death, with hydrogen peroxide produced in cytoplasm membranes, suggesting something like a hypersensitive response. These ultrastructural studies suggest that P. patens could be a useful system for studying phytopathogens and could provide theoretical bases for defence mechanisms in evolutionary development.
Anaerobic soil disinfestation is an alternative to soil fumigation for control of some soilborne pathogens in strawberry production
Authors: Shennan C. , Muramoto J. , Koike S. , Baird G. , Fennimore S. , Samtani J. , Bolda M. , Dara S. , Daugovish O. , Lazarovits G. , Butler D. , Rosskopf E. , Kokalis‐Burelle N. , Klonsky K. , Mazzola M.
Published: May 2017

Alternatives to soil fumigation are needed for soilborne disease control. The aim of this study was to test anaerobic soil disinfestation (ASD) as an alternative to soil fumigation for control of critical soilborne pathogens in Californian strawberry production. Controlled environment experiments were conducted at 25 and 15 °C to test different materials as carbon sources for ASD using soil inoculated with Verticillium dahliae. Field trials were conducted in three locations comparing ASD with 20 Mg ha−1 rice bran (RB) against fumigated and untreated controls, steam, mustard seed meal and fish emulsion. In ASD‐treated soils, temperature and extent of anaerobic conditions were critical for control of V. dahliae, but multiple carbon inputs reduced inoculum by 80–100%. In field trials, ASD with RB provided control of a number of pathogens, and in three of four trials produced marketable fruit yields equivalent to fumigation. Little weed control benefit from ASD was found. ASD with RB also induced changes in the soil microbiome that persisted through the growing season. When equivalent yields were obtained, net returns above harvest and treatment costs with ASD RB were 92–96% of those with bed fumigation based on average prices over the previous 5 years. ASD can be a viable alternative for control of some soilborne pathogens. Growers are adopting ASD in California strawberry production, but research to determine optimal soil temperatures, anaerobicity thresholds and carbon sources for effective control of specific pathogens is needed.
Sorting nexin 27 interactome in T‐lymphocytes identifies zona occludens‐2 dynamic redistribution at the immune synapse
Authors: Tello‐Lafoz María , Martínez‐Martínez Gonzalo , Rodríguez‐Rodríguez Cristina , Albar Juan Pablo , Huse Morgan , Gharbi Severine , Merida Isabel
Published: May 2017

T Lymphocyte recognition of antigens leads to the formation of a highly organized structure termed immune synapse (IS) by analogy with the neuronals synapse. Sorting nexin 27 (SNX27) controls the endosomal traffic of PSD95, Dlg1, ZO‐1 (PDZ) domain‐interacting proteins, and its alteration is associated with impaired synaptic function and neurological diseases. In T‐lymphocytes, SNX27‐positive vesicles polarize to the IS, the identity of SNX27 interactors in these conditions nonetheless remains unknown. Here we used proteomics to analyze the SNX27 interactome purified from IS‐forming T cells, and confirmed the conserved nature of the SNX27/WASH/retromer association in hematopoietic cells. Furthermore, our comparative interactome analysis of SNX27 wild‐type and a mutant‐deficient for PDZ cargo recognition identified the epithelial cell‐cell junction protein zona occludens‐2 (ZO‐2) as an IS component. Biochemistry and microscopy approaches in T cells confirmed SNX27/ZO‐2 PDZ‐dependent interaction, and demonstrated its role controlling the dynamic localization of ZO‐2 at the IS. This study broadens our knowledge of SNX27 function in T lymphocytes, and suggests that pathways that delimit polarized structures in nervous and epithelial systems also participate in IS regulation.
Outcome and complications in dogs with appendicular primary bone tumors treated with stereotactic radiotherapy and concurrent surgical stabilization
Authors: Boston Sarah E. , Vinayak Arathi , Lu Xiaomin , Larue Susan , Bacon Nicholas J. , Bleedorn Jason A. , Souza Carlos H. M. , Ehrhart Nicole P.
Published: May 2017

Objective

To document the outcome of dogs with appendicular primary bone tumors treated with stereotactic radiotherapy (SRT) and concurrent stabilization.

Study design

Multi‐institutional retrospective case series.

Animals

Eighteen dogs with presumptive or definitive diagnosis of appendicular osteosarcoma.

Methods

Medical records of dogs with appendicular primary bone tumors treated with SRT and stabilization were reviewed for signalment, preoperative staging and diagnostics, radiation dose, stabilization method, and outcome.

Results

The distal radius was affected in 13/18 cases. Osteosarcoma or sarcoma was confirmed cytologically or histologically in 15/18 cases. Seven dogs were diagnosed with a pathological fracture at the time of treatment, and 11 were considered at high risk for pathological fracture. Dogs received a single dose (n = 5) or 3 doses (n = 13) of SRT. Surgical stabilization was performed under the same anesthetic event as the final dose of SRT in 10 dogs. Stabilization was achieved with a bone plate (n = 15) or interlocking nail (n = 3). Seventeen dogs received adjuvant chemotherapy. Complications occurred in 16/17 dogs, 15/17 of those being considered major complications. Four dogs experienced more than one complication. Infection was the most common complication, diagnosed in 15/17 cases, and considered as a major complication in 13/15 cases. Postoperative fracture was recorded as a major complication in 3 cases. Nine dogs were amputated at a median of 152 days. The median survival time was 344 days.

Conclusion

Treatment of bone tumors with SRT and concurrent stabilization was associated with a prohibitively high complication rate in dogs. Alternative methods for limb salvage should be considered for dogs at risk for pathologic fracture.
Oral l‐tyrosine supplementation augments the vasoconstriction response to whole‐body cooling in older adults
Authors: Lang James A. , Smaller Kevin A.
Published: May 2017

New Findings

What is the central question of this study?

Ageing is associated with altered sympathetic responses to stress, which are explained in part by reduced noradrenergic function. The impact of supplementation with oral l‐tyrosine, the amino acid precursor for catecholamine synthesis, on the effector responses to cold and exercise stress has yet to be examined.

What is the main finding and its importance?

Oral l‐tyrosine ingestion augmented the sympathetically mediated vasoconstriction response to cold exposure in aged skin. This suggests that l‐tyrosine supplementation might improve thermoregulatory function in older adults.

l‐Tyrosine is the primary substrate for noradrenaline biosynthesis within sympathetic axon terminals. In stressful conditions requiring increased catecholamine production, the axonal l‐tyrosine concentration may limit the full expression of the sympathetic effector response and this may be particularly evident in older adults. We hypothesize that oral l‐tyrosine supplementation will increase the sympathetic response to whole‐body cooling and muscle metaboreflex activation. In a randomized, double‐blind design, 11 young (Y = 24 ± 1 years) and 11 older participants (O = 68 ± 4 years) ingested either 150 mg kg−1 of l‐tyrosine or placebo before commencing 30 min of whole‐body cooling to induce a gradual decline in skin temperature from 34 to 30.5°C. Laser Doppler flux (LDF) was measured at the ventral forearm, and cutaneous vascular conductance (CVC) was calculated as CVC = LDF/mean arterial pressure and expressed as a percentage change from baseline (%ΔCVC). Two minutes of static hand‐grip exercise (35% maximal voluntary contraction) followed by 3 min of postexercise ischaemia were implemented before and toward the end of the cooling bout. l‐Tyrosine supplementation did not affect blood pressure or heart rate responses to exercise or postexercise ischaemia. However, the blunted vasoconstriction response to whole‐body cooling in older adults (placebo: Y = 39 ± 5%ΔCVC and O = 16 ± 2 %ΔCVC; P < 0.05) was augmented after l‐tyrosine supplementation (l‐tyrosine: Y = 40 ± 4%ΔCVC and O = 32 ± 5 %ΔCVC; P < 0.05). These results suggest that l‐tyrosine bioavailability might limit thermoregulatory function in an older population.
Experimental evidence of hourglass fermion in the candidate nonsymmorphic topological insulator KHgSb
Authors: Ma Junzhang , Yi Changjiang , Lv Baiqing , Wang ZhiJun , Nie Simin , Wang Le , Kong Lingyuan , Huang Yaobo , Richard Pierre , Zhang Peng , Yaji Koichiro , Kuroda Kenta , Shin Shik , Weng Hongming , Bernevig Bogdan Andrei , Shi Youguo , Qian Tian , Ding Hong
Published: May 2017

Photoemission established KHgSb as a nonsymmorphic topological insulator, which hosts hourglass-shaped surface states.
Resonant laser printing of structural colors on high-index dielectric metasurfaces
Authors: Zhu Xiaolong , Yan Wei , Levy Uriel , Mortensen N. Asger , Kristensen Anders
Published: May 2017

Colors of materials are precisely laser-controlled using new manufacturing technology with nanopatterned semiconductor surfaces.
Machine learning of accurate energy-conserving molecular force fields
Authors: Chmiela Stefan , Tkatchenko Alexandre , Sauceda Huziel E. , Poltavsky Igor , Schütt Kristof T. , Müller Klaus-Robert
Published: May 2017

The law of energy conservation is used to develop an efficient machine learning approach to construct accurate force fields.
A chlorine-free protocol for processing germanium
Authors: Glavinović Martin , Krause Michael , Yang Linju , McLeod John A. , Liu Lijia , Baines Kim M. , Friščić Tomislav , Lumb Jean-Philip
Published: May 2017

A quinone/catechol redox platform replaces Cl
2
or HCl for processing germanium metal or germanium dioxide to germanes.
Ubiquitination of STING at lysine 224 controls IRF3 activation
Authors: Ni Guoxin , Konno Hiroyasu , Barber Glen N.
Published: May 2017

The E3 ligase MUL1 regulates STING-dependent innate immune responses to cytosolic DNA.
Platelets subvert T cell immunity against cancer via GARP-TGFβ axis
Authors: Rachidi Saleh , Metelli Alessandra , Riesenberg Brian , Wu Bill X. , Nelson Michelle H. , Wallace Caroline , Paulos Chrystal M. , Rubinstein Mark P. , Garrett-Mayer Elizabeth , Hennig Mirko , Bearden Daniel W. , Yang Yi , Liu Bei , Li Zihai
Published: May 2017

T cell immunity against cancer in mice is enhanced with platelet-specific deletion of GARP and by platelet inhibitors.
Beyond spell checking: Adding function to precision medicine
Authors: Henrickson Sarah E.
Published: May 2017

Immunoprofiling signaling pathways in rare immunodeficiencies aid design of targeted therapies.
Genome Stability in Engineered Strains of the Extremely Thermophilic Lignocellulose-Degrading Bacterium Caldicellulosiruptor bescii
Authors: Williams-Rhaesa Amanda M. , Poole Farris L. , Dinsmore Jessica T. , Lipscomb Gina L. , Rubinstein Gabriel M. , Scott Israel M. , Conway Jonathan M. , Lee Laura L. , Khatibi Piyum A. , Kelly Robert M. , Adams Michael W. W.
Published: May 2017

Caldicellulosiruptor bescii
is the most thermophilic cellulose degrader known and is of great interest because of its ability to degrade nonpretreated plant biomass. For biotechnological applications, an efficient genetic system is required to engineer it to convert plant biomass into desired products. To date, two different genetically tractable lineages of
C. bescii
strains have been generated. The first (JWCB005) is based on a random deletion within the pyrimidine biosynthesis genes
pyrFA
, and the second (MACB1018) is based on the targeted deletion of
pyrE
, making use of a kanamycin resistance marker. Importantly, an active insertion element, IS
Cbe4
, was discovered in
C. bescii
when it disrupted the gene for lactate dehydrogenase (
ldh
) in strain JWCB018, constructed in the JWCB005 background. Additional instances of IS
Cbe4
movement in other strains of this lineage are presented herein. These observations raise concerns about the genetic stability of such strains and their use as metabolic engineering platforms. In order to investigate genome stability in engineered strains of
C. bescii
from the two lineages, genome sequencing and Southern blot analyses were performed. The evidence presented shows a dramatic increase in the number of single nucleotide polymorphisms, insertions/deletions, and IS
Cbe4
elements within the genome of JWCB005, leading to massive genome rearrangements in its daughter strain, JWCB018. Such dramatic effects were not evident in the newer MACB1018 lineage, indicating that JWCB005 and its daughter strains are not suitable for metabolic engineering purposes in
C. bescii
. Furthermore, a facile approach for assessing genomic stability in
C. bescii
has been established.

IMPORTANCE
Caldicellulosiruptor bescii
is a cellulolytic extremely thermophilic bacterium of great interest for metabolic engineering efforts geared toward lignocellulosic biofuel and bio-based chemical production. Genetic technology in
C. bescii
has led to the development of two uracil auxotrophic genetic background strains for metabolic engineering. We show that strains derived from the genetic background containing a random deletion in uracil biosynthesis genes (
pyrFA
) have a dramatic increase in the number of single nucleotide polymorphisms, insertions/deletions, and IS
Cbe4
insertion elements in their genomes compared to the wild type. At least one daughter strain of this lineage also contains large-scale genome rearrangements that are flanked by these IS
Cbe4
elements. In contrast, strains developed from the second background strain developed using a targeted deletion strategy of the uracil biosynthetic gene
pyrE
have a stable genome structure, making them preferable for future metabolic engineering studies.