bluuebunny/crossref_metadata_2025 huggingface dataset:
bla
NDM-5
-Bearing IncFII-Type Plasmids of Klebsiella pneumoniae Sequence Type 147 Transmitted by Cross-Border Transfer of a Patient
Authors: Shin Juyoun , Baek Jin Yang , Cho Sun Young , Huh Hee Jae , Lee Nam Yong , Song Jae-Hoon , Chung Doo Ryeon , Ko Kwan Soo
Published: January 2016

The two plasmids extracted from
Klebsiella pneumoniae
sequence type 147 (ST147) isolates were analyzed. The first isolate was obtained from a patient transferred from United Arab Emirates to South Korea. The second isolate was obtained from a Korean patient and was suspected to be transmitted from the first patient. Sequences of two plasmids were almost the same, and genetic structures, including
bla
NDM-5
, of these plasmids were similar to plasmids of NDM-1-producing
Escherichia coli
ST131 isolates found in Europe.
Regulatory Mutations Impacting Antibiotic Susceptibility in an Established Staphylococcus aureus Biofilm
Authors: Atwood Danielle N. , Beenken Karen E. , Lantz Tamara L. , Meeker Daniel G. , Lynn William B. , Mills Weston B. , Spencer Horace J. , Smeltzer Mark S.
Published: January 2016

We previously determined the extent to which mutations of different
Staphylococcus aureus
regulatory loci impact biofilm formation as assessed under
in vitro
conditions. Here we extend these studies to determine the extent to which those regulatory loci that had the greatest effect on biofilm formation also impact antibiotic susceptibility. The experiments were done under
in vitro
and
in vivo
conditions using two clinical isolates of
S. aureus
(LAC and UAMS-1) and two functionally diverse antibiotics (daptomycin and ceftaroline). Mutation of the staphylococcal accessory regulator (
sarA
) or
sigB
was found to significantly increase susceptibilities to both antibiotics and in both strains in a manner that could not be explained by changes in the MICs. The impact of a mutation in
sarA
was comparable to that of a mutation in
sigB
and greater than the impact observed with any other mutant. These results suggest that therapeutic strategies targeting
sarA
and/or
sigB
have the greatest potential to facilitate the ability to overcome the intrinsic antibiotic resistance that defines
S. aureus
biofilm-associated infections.
First Characterization of CTX-M-15-Producing Escherichia coli Strains Belonging to Sequence Type (ST) 410, ST224, and ST1284 from Commercial Swine in South America
Authors: Silva Ketrin C. , Moreno Marina , Cabrera Carlos , Spira Beny , Cerdeira Louise , Lincopan Nilton , Moreno Andrea M.
Published: January 2016

We report for the first time the isolation of CTX-M-15-producing
Escherichia coli
strains belonging to sequence type (ST) 410, ST224, and ST1284 in commercial swine in Brazil. The
bla
CTX-M-15
gene was located on F-::A9::B1 and C1::A9::B1 IncF-type plasmids, surrounded by a new genetic context comprising the IS
26
insertion sequence truncated with the IS
Ecp1
element upstream of
bla
CTX-M-15
. These results reveal that commercial swine have become a new reservoir of CTX-M-15-producing bacteria in South America.
Functions of VPA1418 and VPA0305 Catalase Genes in Growth of Vibrio parahaemolyticus under Oxidative Stress
Authors: Chen Ching-Lian , Fen Shin-yuan , Chung Chun-Hui , Yu Shu-Chuan , Chien Cheng-Lun , Wong Hin-chung
Published: January 2016

The marine foodborne enteropathogen
Vibrio parahaemolyticus
has four putative catalase genes. The functions of two
katE
-homologous genes,
katE1
(VPA1418) and
katE2
(VPA0305), in the growth of this bacterium were examined using gene deletion mutants with or without complementary genes. The growth of the mutant strains in static or shaken cultures in a rich medium at 37°C or at low temperatures (12 and 4°C), with or without competition from
Escherichia coli
, did not differ from that of the parent strain. When 175 μM extrinsic H
2
O
2
was added to the culture medium, bacterial growth of the Δ
katE1
strain was delayed and growth of the Δ
katE1
Δ
katE2
and Δ
katE1
Δ
ahpC1
double mutant strains was completely inhibited at 37°C for 8 h. The sensitivity of the Δ
katE1
strain to the inhibition of growth by H
2
O
2
was higher at low incubation temperatures (12 and 22°C) than at 37°C. The determined gene expression of these catalase and
ahpC
genes revealed that
katE1
was highly expressed in the wild-type strain at 22°C under H
2
O
2
stress, while the
katE2
and
ahpC
genes may play an alternate or compensatory role in the Δ
katE1
strain. This study demonstrated that
katE1
encodes the chief functional catalase for detoxifying extrinsic H
2
O
2
during logarithmic growth and that the function of these genes was influenced by incubation temperature.
Relative Abundance of Nitrotoga spp. in a Biofilter of a Cold-Freshwater Aquaculture Plant Appears To Be Stimulated by Slightly Acidic pH
Authors: Hüpeden Jennifer , Wegen Simone , Off Sandra , Lücker Sebastian , Bedarf Yvonne , Daims Holger , Kühn Carsten , Spieck Eva
Published: January 2016

The functioning of recirculation aquaculture systems (RAS) is essential to maintain water quality for fish health, and one crucial process here is nitrification. The investigated RAS was connected to a rainbow trout production system and operated at an average temperature of 13°C and pH 6.8. Community analyses of the nitrifying biofilm revealed a coexistence ofNitrospiraandNitrotoga, and it is hypothesized that a slightly acidic pH in combination with lower temperatures favors the growth of the latter. Modification of the standard cultivation approach toward lower pH values of 5.7 to 6.0 resulted in the successful enrichment (99% purity) ofNitrotogasp. strain HW29, which had a 16S rRNA sequence similarity of 99.0% toNitrotoga arctica. Reference cultures ofNitrospira defluviiand the novelNitrotogasp. HW29 were used to confirm differentiation of these nitrite oxidizers in distinct ecological niches.Nitrotogasp. HW29 revealed pH and temperature optima of 6.8 and 22°C, respectively, whereasNitrospira defluviidisplayed the highest nitrite oxidation rate at pH 7.3 and 32°C. We report here the occurrence ofNitrotogaas one of the main nitrite-oxidizing bacteria in freshwater aquaculture systems and indicate that a slightly acidic pH, in addition to temperatures below 20°C, can be applied as a selective isolation criterion for this microorganism.
Depletion of Phagocytic Cells during Nonlethal Plasmodium yoelii Infection Causes Severe Malaria Characterized by Acute Renal Failure in Mice
Authors: Terkawi Mohamad Alaa , Nishimura Maki , Furuoka Hidefumi , Nishikawa Yoshifumi
Published: January 2016

In the current study, we examined the effects of depletion of phagocytes on the progression of
Plasmodium yoelii
17XNL infection in mice. Strikingly, the depletion of phagocytic cells, including macrophages, with clodronate in the acute phase of infection significantly reduced peripheral parasitemia but increased mortality. Moribund mice displayed severe pathological damage, including coagulative necrosis in liver and thrombi in the glomeruli, fibrin deposition, and tubular necrosis in kidney. The severity of infection was coincident with the increased sequestration of parasitized erythrocytes, the systematic upregulation of inflammation and coagulation, and the disruption of endothelial integrity in the liver and kidney. Aspirin was administered to the mice to minimize the risk of excessive activation of the coagulation response and fibrin deposition in the renal tissue. Interestingly, treatment with aspirin reduced the parasite burden and pathological lesions in the renal tissue and improved survival of phagocyte-depleted mice. Our data imply that the depletion of phagocytic cells, including macrophages, in the acute phase of infection increases the severity of malarial infection, typified by multiorgan failure and high mortality.
Characterization of RNA Helicase CshA and Its Role in Protecting mRNAs and Small RNAs of Staphylococcus aureus Strain Newman
Authors: Kim Samin , Corvaglia Anna-Rita , Léo Stefano , Cheung Ambrose , Francois Patrice
Published: January 2016

The toxin MazF
sa
in
Staphylococcus aureus
is a sequence-specific endoribonuclease that cleaves the majority of the mRNAs
in vivo
but spares many essential mRNAs (e.g.,
secY
mRNA) and, surprisingly, an mRNA encoding a regulatory protein (i.e.,
sarA
mRNA). We hypothesize that some mRNAs may be protected by RNA-binding protein(s) from degradation by MazF
sa
. Using heparin-Sepharose-enriched fractions that hybridized to
sarA
mRNA on Northwestern blots, we identified among multiple proteins the DEAD box RNA helicase CshA (NWMN_1985 or SA1885) by mass spectroscopy. Purified CshA exhibits typical RNA helicase activities, as exemplified by RNA-dependent ATPase activity and unwinding of the DNA-RNA duplex. A severe growth defect was observed in the
cshA
mutant compared with the parent when grown at 25°C but not at 37°C. Activation of MazF
sa
in the
cshA
mutant resulted in lower CFU per milliliter accompanied by a precipitous drop in viability (∼40%) compared to those of the parent and complemented strains. NanoString analysis reveals diminished expression of a small number of mRNAs and 22 small RNAs (sRNAs) in the
cshA
mutant versus the parent upon MazF
sa
induction, thus implying protection of these RNAs by CshA. In the case of the sRNA teg049 within the
sarA
locus, we showed that the protective effect was likely due to transcript stability as revealed by reduced half-life in the
cshA
mutant versus the parent. Accordingly, CshA likely stabilizes selective mRNAs and sRNAs
in vivo
and as a result enhances
S. aureus
survival upon MazF
sa
induction during stress.
Regulation of Expression of Uropathogenic Escherichia coli Nonfimbrial Adhesin TosA by PapB Homolog TosR in Conjunction with H-NS and Lrp
Authors: Engstrom Michael D. , Mobley Harry L. T.
Published: January 2016

Urinary tract infections (UTIs) are a major burden to human health. The overwhelming majority of UTIs are caused by uropathogenic
Escherichia coli
(UPEC) strains. Unlike some pathogens, UPEC strains do not have a fixed core set of virulence and fitness factors but do have a variety of adhesins and regulatory pathways. One such UPEC adhesin is the nonfimbrial adhesin TosA, which mediates adherence to the epithelium of the upper urinary tract. The
tos
operon is AT rich, resides on pathogenicity island
aspV
, and is not expressed under laboratory conditions. Because of this, we hypothesized that
tosA
expression is silenced by H-NS. Lrp, based on its prominent function in the regulation of other adhesins, is also hypothesized to contribute to
tos
operon regulation. Using a variety of
in vitro
techniques, we mapped both the
tos
operon promoter and TosR binding sites. We have now identified TosR as a dual regulator of the
tos
operon, which could control the
tos
operon in association with H-NS and Lrp. H-NS is a negative regulator of the
tos
operon, and Lrp positively regulates the
tos
operon. Exogenous leucine also inhibits Lrp-mediated
tos
operon positive regulation. In addition, TosR binds to the
pap
operon, which encodes another important UPEC adhesin, P fimbria. Induction of TosR synthesis reduces production of P fimbria. These studies advance our knowledge of regulation of adhesin expression associated with uropathogen colonization of a host.
MyD88 Mediates Instructive Signaling in Dendritic Cells and Protective Inflammatory Response during Rickettsial Infection
Authors: Bechelli Jeremy , Smalley Claire , Zhao Xuemei , Judy Barbara , Valdes Patricia , Walker David H. , Fang Rong
Published: January 2016

Spotted fever group rickettsiae cause potentially life-threatening infections throughout the world. Several members of the Toll-like receptor (TLR) family are involved in host response to rickettsiae, and yet the mechanisms by which these TLRs mediate host immunity remain incompletely understood. In the present study, we found that host susceptibility of MyD88−/−mice to infection withRickettsia conoriiorRickettsia australiswas significantly greater than in wild-type (WT) mice, in association with severely impaired bacterial clearancein vivo.R. australis-infected MyD88−/−mice showed significantly lower expression levels of gamma interferon (IFN-γ), interleukin-6 (IL-6), and IL-1β, accompanied by significantly fewer inflammatory infiltrates of macrophages and neutrophils in infected tissues, than WT mice. The serum levels of IFN-γ, IL-12, IL-6, and granulocyte colony-stimulating factor were significantly reduced, while monocyte chemoattractant protein 1, macrophage inflammatory protein 1α, and RANTES were significantly increased in infected MyD88−/−mice compared to WT mice. Strikingly,R. australisinfection was incapable of promoting increased expression of MHC-IIhighand production of IL-12p40 in MyD88−/−bone marrow-derived dendritic cells (BMDCs) compared to WT BMDCs, although costimulatory molecules were upregulated in both types of BMDCs. Furthermore, the secretion levels of IL-1β byRickettsia-infected BMDCs and in the sera of infected mice were significantly reduced in MyD88−/−mice compared to WT controls, suggesting thatin vitroandin vivoproduction of IL-1β is MyD88 dependent. Taken together, our results suggest that MyD88 signaling mediates instructive signals in DCs and secretion of IL-1β and type 1 immune cytokines, which may account for the protective inflammatory response during rickettsial infection.
The Variable Region of Pneumococcal Pathogenicity Island 1 Is Responsible for Unusually High Virulence of a Serotype 1 Isolate
Authors: Harvey Richard M. , Trappetti Claudia , Mahdi Layla K. , Wang Hui , McAllister Lauren J. , Scalvini Alexandra , Paton Adrienne W. , Paton James C.
Published: January 2016

Streptococcus pneumoniae
is the leading infectious cause of death in children in the world. However, the mechanisms that drive the progression from asymptomatic colonization to disease are poorly understood. Two virulence-associated genomic accessory regions (ARs) were deleted in a highly virulent serotype 1 clinical isolate (strain 4496) and examined for their contribution to pathogenesis. Deletion of a prophage encoding a platelet-binding protein (PblB) resulted in reduced adherence, biofilm formation, reduced initial infection within the lungs, and a reduction in the number of circulating platelets in infected mice. However, the region's overall contribution to the survival of mice was not significant. In contrast, deletion of the variable region of pneumococcal pathogenicity island 1 (vPPI1) was also responsible for a reduction in adherence and biofilm formation but also reduced survival and invasion of the pleural cavity, blood, and lungs. While the 4496ΔPPI1 strain induced higher expression of the genes encoding interleukin-10 (IL-10) and CD11b in the lungs of challenged mice than the wild-type strain, very few other genes exhibited altered expression. Moreover, while the level of IL-10 protein was increased in the lungs of 4496ΔPPI1 mutant-infected mice compared to strain 4496-infected mice, the levels of gamma interferon (IFN-γ), CXCL10, CCL2, and CCL4 were not different in the two groups. However, the 4496ΔPPI1 mutant was found to be more susceptible than the wild type to phagocytic killing by a macrophage-like cell line. Therefore, our data suggest that vPPI1 may be a major contributing factor to the heightened virulence of certain serotype 1 strains, possibly by influencing resistance to phagocytic killing.
The LonA Protease Regulates Biofilm Formation, Motility, Virulence, and the Type VI Secretion System in Vibrio cholerae
Authors: Rogers Andrew , Townsley Loni , Gallego-Hernandez Ana L. , Beyhan Sinem , Kwuan Laura , Yildiz Fitnat H.
Published: January 2016

The presence of the Lon protease in all three domains of life hints at its biological importance. The prokaryotic Lon protease is responsible not only for degrading abnormal proteins but also for carrying out the proteolytic regulation of specific protein targets. Posttranslational regulation by Lon is known to affect a variety of physiological traits in many bacteria, including biofilm formation, motility, and virulence. Here, we identify the regulatory roles of LonA in the human pathogen
Vibrio cholerae
. We determined that the absence of LonA adversely affects biofilm formation, increases swimming motility, and influences intracellular levels of cyclic diguanylate. Whole-genome expression analysis revealed that the message abundance of genes involved in biofilm formation was decreased but that the message abundances of those involved in virulence and the type VI secretion system were increased in a
lonA
mutant compared to the wild type. We further demonstrated that a
lonA
mutant displays an increase in type VI secretion system activity and is markedly defective in colonization of the infant mouse. These findings suggest that LonA plays a critical role in the environmental survival and virulence of
V. cholerae
.

IMPORTANCE
Bacteria utilize intracellular proteases to degrade damaged proteins and adapt to changing environments. The Lon protease has been shown to be important for environmental adaptation and plays a crucial role in regulating the motility, biofilm formation, and virulence of numerous plant and animal pathogens. We find that LonA of the human pathogen
V. cholerae
is in line with this trend, as the deletion of LonA leads to hypermotility and defects in both biofilm formation and colonization of the infant mouse. In addition, we show that LonA regulates levels of cyclic diguanylate and the type VI secretion system. Our observations add to the known regulatory repertoire of the Lon protease and the current understanding of
V. cholerae
physiology.
Unusual neurological presentation ofFusobacterium necrophorumdisease
Authors: Haddad Nasrean , Morris Trefor , Dhillon Rishi , Gibbon Frances
Published: January 2016

A 2-year-old girl presented to hospital, with reduced consciousness and fever. She had a 4-week history of fever treated with two courses of amoxicillin for tonsillitis diagnosed in primary care. Neuroimaging revealed multiple cerebral abscesses and subdural empyema. Pus aspirated from the intracranial collections grewFusobacterium necrophorumand meropenem was started. Following neurosurgery, the patient continued to be agitated with fluctuating fever. She underwent close monitoring with regular neuroimaging. To control the progression of intracranial infection, she underwent three separate neurosurgical procedures following which she made a good recovery. This case demonstrates how an organism rarely associated with childhood illnesses presented atypically and progressed into a complex potentially fatal intracranial infection requiring a high degree of neurosurgical intervention. Awareness of this organism is important. The combination of source control together with appropriate antibiotic use was crucial in controlling the infection.
Scaphoid non-union in osteogenesis imperfecta
Authors: Pinder Elizabeth , Fok Jonathan , Crossman Paul
Published: January 2016

We report a case of scaphoid non-union in a child with osteogenesis imperfecta (OI) presenting 7 months after a fall. Following diagnosis, conservative treatment was initiated, but despite 4 months in a plaster cast, the fracture had failed to unite. Open reduction and internal fixation was performed (Acutrak screw) with bone graft harvested from the distal radius. Postoperative immobilisation continued for 10 weeks, and at 4 months the child was pain free and had resumed normal activities. The fracture had fully united radiologically at 9 months. Non-union is reported to occur in 23% of paediatric scaphoid fractures when treatment is delayed, and conservative and surgical treatment have both been described. Since OI increases the risk of non-union in long bone fractures, the scaphoid may also be at risk. We recommend a high level of suspicion for non-union in this patient group and a low threshold for consideration of surgical treatment.
Macular infarction in a patient with Toxoplasma retinochoroditis
Authors: Kumar Vinod , Takkar Brijesh , Chandra Parijat , Kumar Atul
Published: January 2016

Toxoplasma retinochoroditis is one of the commonest causes of infectious posterior uveitis and may lead to occlusive retinitis. We present a case of a patient with Toxoplasma retinochoroditis who developed macular infarction after initial improvement on pharmacotherapy. The potential aetiology and outcome are described.
Aggressive eosinophilic granulomatosis with polyangiitis and transverse sinus thrombosis
Authors: Ananth Snegha , Sankaralingam Rajeswari , Manoj Manesh
Published: January 2016

We report a case of a patient with eosinophilic granulomatosis with polyangiitis (EGPA, previously known as Churg-Strauss syndrome) who succumbed to respiratory failure complicated by sepsis, pneumonitis and transverse sinus thrombosis. In the absence of antineutrophilic cytoplasmic antibodies positivity, a clinical diagnosis was made based on The American College of Rheumatology–1990 criteria. Glucocorticoids, cyclophosphamide, rituximab and intravenous immunoglobulin were administered at different stages. The patient recovered momentarily after each cycle of treatment, but his vasculitis progressed and he eventually died. Cardiac or renal involvement, which is more commonly associated with an adverse outcome, was not present.
Colonic vasculopathy and perforation in the initial presentation of adult dermatomyositis in a patient with improving muscle weakness
Authors: Kibbi Nour , Bekui Amenuve , Buckley Lenore M
Published: January 2016

A 63-year-old woman with diabetes presented with 8 weeks of proximal muscle weakness and change in bowel habits. Muscle biopsy confirmed myositis, and serological studies were consistent with dermatomyositis (DM), without evidence of overlapping connective tissue disease or malignancy. On day 12 of prednisone therapy and after receiving one dose of IVIG with improvement in muscle strength, the patient developed abdominal pain and was diagnosed with a gastrointestinal (GI) perforation and peritonitis requiring emergent colectomy. The pathology revealed diffuse mucosal ulceration, prominent lymphoplasmacytic infiltration, venous occlusion and arterial hyperplasia. Although GI manifestations due to GI vasculopathy are rare in adult DM and are often a delayed complication, in this patient, it was one of the initial manifestations of this condition. In addition to being a fatal complication, clinicians should be aware of these complications, as immunosuppression used to control the muscular and cutaneous inflammation may not control the GI vasculopathy.
Etanercept-induced myositis: do we have to stop it? A surprising outcome
Authors: Tariq Hassan , Ayesha Bibi , Weidenheim Karen , Franchin Giovanni
Published: January 2016

We discuss a case of a 47-year-old man who presented with progressive proximal muscle weakness of the upper and lower extremities and unstable gait. He had been on etanercept for 6 months for severe psoriasis and psoriatic arthritis with good control of his disease. Serum creatine kinase (CK) level was found to be 5666 U/L and muscle biopsy showed a marked inflammatory myopathic process likely secondary to etanercept. He was started on high-dose steroids and advised to discontinue etanercept. Despite our recommendation, he never stopped using etanercept due to fear of a psoriasis flare. Three months later, he had significant improvement of clinical symptoms, normalised serum CK levels and discontinued prednisone.
The harms of smoking and benefits of smoking cessation in women compared with men with type 2 diabetes: an observational analysis of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron modified release Controlled Evaluation) trial
Authors: Blomster Juuso I , Woodward Mark , Zoungas Sophia , Hillis Graham S , Harrap Stephen , Neal Bruce , Poulter Neil , Mancia Giuseppe , Chalmers John , Huxley Rachel
Published: January 2016

Objectives

In general populations, the adverse effects of smoking on coronary risk have been demonstrated to be greater in women than in men; whether this is true for individuals with diabetes is unclear.

Design

Cohort study.

Setting

20 countries worldwide participating in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron modified release Controlled Evaluation) trial.

Participants

11 140 patients with type 2 diabetes aged ≥55 years and in cardiovascular risk at the time of randomisation.

Primary and secondary outcome measures

Major cardiovascular events (death from cardiovascular disease, non-fatal stroke or non-fatal myocardial infarction (MI)), all cardiovascular events (major cardiovascular event or peripheral arterial disease or transient ischaemic attack), and all-cause mortality. Secondary outcome measures were major coronary events (fatal and non-fatal MI), major cerebrovascular events (fatal and non-fatal stroke), nephropathy (new or worsening renal disease), and all cancer.

Results

At baseline, 6466 (56% women) participants were never-smokers, 1550 (28% women) were daily smokers and 3124 (21% women) were former smokers. Median follow-up time was 5 years. In Cox regression models after multiple adjustments, compared with never smoking, daily smoking was associated with increased risk of all primary and secondary outcomes with the exception of major cerebrovascular disease. Only for major coronary events was there any evidence of a stronger effect in women than in men (ratio of the adjusted HRs women:men; 1.64 (0.83 to 3.26) p=0.08). For all other outcomes considered, the hazards of smoking were similar in men and women. Quitting smoking was associated with a 30% reduction in all-cause mortality (p=0.001) in both sexes.

Conclusions

In individuals with diabetes, the effects of smoking on all major forms of cardiovascular disease are equally as hazardous in women and men with the possible exception of major coronary events where there was some evidence of a greater hazard in women.

Trial registration number

NCT00145925.
How safe is primary care? A systematic review
Authors: Panesar Sukhmeet Singh , deSilva Debra , Carson-Stevens Andrew , Cresswell Kathrin M , Salvilla Sarah Angostora , Slight Sarah Patricia , Javad Sundas , Netuveli Gopalakrishnan , Larizgoitia Itziar , Donaldson Liam J , Bates David W , Sheikh Aziz
Published: January 2016

Importance

Improving patient safety is at the forefront of policy and practice. While considerable progress has been made in understanding the frequency, causes and consequences of error in hospitals, less is known about the safety of primary care.

Objective

We investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.

Evidence review

We searched 18 databases and contacted international experts to identify published and unpublished studies available between 1 January 1980 and 31 July 2014. Patient safety incidents of any type were eligible. Eligible studies were critically appraised using validated instruments and data were descriptively and narratively synthesised.

Findings

Nine systematic reviews and 100 primary studies were included. Studies reported between <1 and 24 patient safety incidents per 100 consultations. The median from population-based record review studies was 2–3 incidents for every 100 consultations/records reviewed. It was estimated that around 4% of these incidents may be associated with severe harm, defined as significantly impacting on a patient's well-being, including long-term physical or psychological issues or death (range <1% to 44% of incidents). Incidents relating to diagnosis and prescribing were most likely to result in severe harm.

Conclusions and relevance

Millions of people throughout the world use primary care services on any given day. This review suggests that safety incidents are relatively common, but most do not result in serious harm that reaches the patient. Diagnostic and prescribing incidents are the most likely to result in avoidable harm.

Systematic review registration

This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42012002304).
Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study
Authors: Overdyk Frank J , Dowling Oonagh , Newman Sheldon , Glatt David , Chester Michelle , Armellino Donna , Cole Brandon , Landis Gregg S , Schoenfeld David , DiCapua John F
Published: January 2016

Importance

Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive.

Objective

We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times.

Design, setting

Prospective, cluster randomised study in a 23-operating room (OR) suite.

Participants

Surgeons, anaesthesia providers, nurses and support staff.

Exposure

ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a period during which all ORs received feedback.

Main outcome(s) and measure(s)

Checklist compliance (Pass/Fail) during sign-in, time-out and sign-out demonstrated by (1) use of checklist, (2) team attentiveness, (3) required duration, (4) proper sequence and duration of case turnover times.

Results

Sign-in, time-out and sign-out PASS rates increased from 25%, 16% and 32% during baseline phase (n=1886) to 64%, 84% and 68% for feedback ORs versus 40%, 77% and 51% for no-feedback ORs (p<0.004) during the intervention phase (n=2693). Pass rates were 91%, 95% and 84% during the all-feedback phase (n=2001). For scheduled cases (n=1406, 71%), feedback reduced mean turnover times by 14% (41.4 min vs 48.1 min, p<0.004), and the improvement was sustained during the all-feedback period. Feedback had no effect on turnover time for unscheduled cases (n=587, 29%).

Conclusions and relevance

Our data indicate that remote video auditing with feedback improves surgical safety checklist compliance for all cases, and turnover time for scheduled cases, but not for unscheduled cases.
Response to belimumab among patients with systemic lupus erythematosus in clinical practice settings: 24-month results from the OBSErve study in the USA
Authors: Collins C E , Dall'Era M , Kan H , Macahilig C , Molta C , Koscielny V , Chang D J
Published: January 2016

Objective

To examine disease activity and clinical outcomes, and describe overall patterns of systemic lupus erythematosus (SLE) care in patients who received belimumab in a real-world clinical setting.

Methods

This observational cohort study was conducted in US clinical practices. Rheumatologists (n=92) identified adults with SLE who had received ≥8 infusions of belimumab plus standard of care (SoC). Physicians assessed disease outcomes at 6-month intervals using patient medical charts, for up to 24 months. The primary outcome was physician-assessed change in SLE disease. Other outcomes included change in steroid use, laboratory tests and healthcare resource utilisation (HCRU).

Results

Of 501 patients (intent-to-treat population (ITT)), 446 were female, mean age was 43.3 years and 98% had moderate/severe disease activity at baseline (first dose of belimumab). Data for 277 patients who completed 24 months of belimumab treatment were available. Among the ITT, a ≥50% improvement in overall clinical response between baseline and month 6 was reported for 48.7% of patients; continued improvement was seen at all subsequent 6-month intervals relative to the previous timepoint. The percentage of patients with moderate/severe disease also decreased at each timepoint. At baseline, 77.0% of patients received steroids at a mean (SD) prednisone equivalent dose of 19.9 (14.39) mg/day, which decreased to 8.4 (7.35) mg/day at month 6 and 6.1 (9.31) mg/day at month 24. Abnormal laboratory values typically associated with SLE also demonstrated improvements at month 6, which continued through 24 months. HCRU decreased over the duration of the study.

Conclusions

Patients with SLE who received belimumab plus SoC for up to 24 months demonstrated improvements in disease severity and laboratory values and a reduction in steroid use and HCRU as early as month 6. Improvements continued through 24 months, providing evidence of reduced disease activity among patients taking belimumab in real-world clinical practice.
What constitutes the M1 segment of the middle cerebral artery?
Authors: Goyal Mayank , Menon Bijoy K , Krings Timo , Patil Shivanand , Qazi Emmad , McTaggart Ryan A , Almekhlafi Mohammed A , Jehan Reza , Saver Jeffrey , Jayaraman Mahesh V
Published: January 2016

Intravenous tissue plasminogen activator has limited efficacy in fibrinolysis of large proximal intracranial thrombi. Thus, recent endovascular acute stroke trials restricted their selection criteria to patients with proximal occlusions in the anterior circulation. Although the terminal internal carotid artery occlusion is relatively easy to identify, there is often a debate as to what constitutes a proximal (involving the M1 segment) versus a distal (involving the M2 segment and beyond) middle cerebral artery occlusion. In light of overwhelming evidence demonstrating superiority of endovascular treatment in patients with proximal occlusion, this distinction has significant practical implications in patient selection. Here we present a brief review of the proximal (M1) segment of the middle cerebral artery anatomy and provide practical methods to recognize and separate the M1 and M2 segments. In keeping with the belief that CT angiography (CTA) (preferably multiphase CTA) is the ideal screening test for patients with emergent large vessel occlusion, we have provided tips for expeditious and accurate vascular imaging interpretation.
Heart rate never lies: interventional cardiologist and Braude's quote revised
Authors: Cook Stéphane , Stauffer Jean-Christophe , Goy Jean-Jacques , Graf Denis , Puricel Serban , Frobert Aurélien , Muller Olivier , Togni Mario , Arroyo Diego
Published: January 2016

Background

Interventional cardiologists may be immune to stress, allowing them to perform complex percutaneous interventions under pressure.

Objectives

To assess heart rate (HR) variations as a surrogate marker of stress of interventional cardiologists during percutaneous cardiac procedures and in every-day life.

Design

This is a single-centre observational study including a total of six male interventional cardiologists performing coronary interventions and pacemaker implantations. Participants were asked to record their HR with the Apple Watch Device during procedures, every-day life and control activities such as outpatient consultations, sport, marital conflicts and sexual intercourse.

Results

Average daily HR was 88±17 bpm. During work days, HR increased significantly during procedures (90±17 bpm) compared with days outside the cathlab (87±17 bpm, p=0.02). The average HR was higher during a regular week working (88±16 bpm) compared with weekends off (84±18 bpm, p=0.002). Complex cardiac procedures were associated with higher HR up to 122 bpm. Peak HR were higher during physical exertion. Of note, participants complained of hypersexuality and mania after night shifts.

Conclusions

Work and especially percutaneous cardiac procedures increase HR independently of physical exertion suggesting that interventional cardiologists experience mental stress and emotions.
About the infinite dimensional skew and obliquely reflected Ornstein–Uhlenbeck process
Authors: Röckner Michael , Trutnau Gerald
Published: January 2016

Based on an integration by parts formula for closed and convex subsets [Formula: see text] of a separable real Hilbert space [Formula: see text] with respect to a Gaussian measure, we first construct and identify the infinite dimensional analogue of the obliquely reflected Ornstein–Uhlenbeck process (perturbed by a bounded drift [Formula: see text]) by means of a Skorokhod type decomposition. The variable oblique reflection at a reflection point of the boundary [Formula: see text] is uniquely described through a reflection angle and a direction in the tangent space (more precisely through an element of the orthogonal complement of the normal vector) at the reflection point. In case of normal reflection at the boundary of a regular convex set and under some monotonicity condition on [Formula: see text], we prove the existence and uniqueness of a strong solution to the corresponding SDE. Subsequently, we consider an increasing sequence [Formula: see text] of closed and convex subsets of [Formula: see text] and the skew reflection problem at the boundaries of this sequence. We present concrete examples and obtain as a special case the infinite dimensional analogue of the [Formula: see text]-skew reflected Ornstein–Uhlenbeck process.
Expressive Completeness of Separation Logic with Two Variables and No Separating Conjunction
Authors: Demri Stephane , Deters Morgan
Published: January 2016

Separation logic is used as an assertion language for Hoare-style proof systems about programs with pointers, and there is an ongoing quest for understanding its complexity and expressive power. Herein, we show that first-order separation logic with one record field restricted to two variables and the separating implication (no separating conjunction) is as expressive as weak second-order logic, substantially sharpening a previous result. Capturing weak second-order logic with such a restricted form of separation logic requires substantial updates to known proof techniques. We develop these and, as a by-product, identify the smallest fragment of separation logic known to be undecidable: first-order separation logic with one record field, two variables, and no separating conjunction. Because we forbid ourselves the use of many syntactic resources, this underscores even further the power of separating implication on concrete heaps.
27
th
ACM International Conference on Hypertext and Social Media
Authors: Blustein Jamie , Herder Eelco , Rubart Jessica , Ashman Helen
Published: January 2016

The 27
th
2016 ACM international conference on Hypertext and Social Media will be held in Halifax, Canada, from July 10 to 13. It will be collocated with UMAP 2016, the 24th international conference on User Modeling, Adaptation and Personalization. This newsletter article briefly introduces the conference and its venue.
"Robust statistical methods in web retrieval" by Carsten Eickhoff and Arjen P. de Vries, with Martin Vesely as coordinator
Authors: Eickhoff Carsten , de Vries Arjen P.
Published: January 2016

Information retrieval systems rely on multitudes of individual features in order to determine the ranking of documents for a given user and query combination. Current solutions to this challenge are often inconsistent with the formal probabilistic framework in which constituent scores were estimated, or use sophisticated learning methods that make it difficult for humans to understand the origin of the final scores. To address these issues, we employ copulas, a family of robust statistical methods, introducing their formal background and empirically demonstrating their merit in a number of settings, including ranking, score fusion and language modelling.
Open Network Interfaces for Carrier Networks
Authors: Panda Aurojit , McCauley James Murphy , Tootoonchian Amin , Sherry Justine , Koponen Teemu , Ratnasamy Syliva , Shenker Scott
Published: January 2016

With the increasing prevalence of middleboxes, networks today are capable of doing far more than merely delivering packets. In fact, to realize their full potential for both supporting innovation and generating revenue, we should think of carrier networks as service-delivery platforms. This requires providing open interfaces that allow third-parties to leverage carrier-network infrastructures in building global-scale services. In this position paper, we take the first steps towards making this vision concrete by identifying a few such interfaces that are both simple-to-support and safe-to-deploy (for the carrier) while being flexibly useful (for third-parties).
Towards an Information Centric Network Architecture for Universal Internet Access
Authors: Trossen Dirk , Sathiaseelan Arjuna , Ott Jörg
Published: January 2016

Enabling universal Internet access has been recognized as a key issue to enabling sustained economic prosperity, evidenced by the myriad of initiatives in this space. However, the existing Internet architecture is seriously challenged to ensure universal service provisioning at economically sustainable price points, largely due to the costs associated with providing services in a perceived always-on manner. This paper puts forth our vision to provide global access to the Internet through a universal communication architecture that combines two emerging paradigms, namely that of Information Centric Networking (ICN) and Delay Tolerant Networking (DTN). The decoupling in space and time, achieved through these underlying paradigms, is key to aggressively widen the connectivity options and provide flexible service models beyond what is currently pursued in the game around universal service provisioning. In this paper, we provide an outlook on the main concepts underlying our universal architecture and the opportunities arising from it. We also offer some insight into ongoing work to realize our vision in a concrete test bed and trial setting.
The Second Named Data Networking Community Meeting (NDNcomm 2015)
Authors: Afanasyev Alexander , Yu Yingi , Zhang Lixia , Burke Jeff , claffy kc , Polterock Joshua
Published: January 2016

This report is a brief summary of the second NDN Community Meeting held at UCLA in Los Angeles, California on September 28-29, 2015. The meeting provided a platform for the attendees from 49 institutions across 13 countries to exchange their recent NDN research and development results, to debate existing and proposed functionality in NDN forwarding, routing, and security, and to provide feedback to the NDN architecture design evolution.
Dynamic ridesharing
Authors: Shen Bilong , Huang Yan , Zhao Ying
Published: January 2016

Ridesharing, which offers empty seats in a car to other passengers, is an efficient way of transportation. In this way, the utilization of seats can be improved and the number of cars used can be reduced. Ridesharing has the potential to solve the problems of congestion, pollution, high travel cost, and energy. The development of internet, smart phone, GPS allows dynamic matchings of travel requests with available cars through real-time travel planning systems. However, matching requests and cars under certain constrains in large scale remains challenging. In this paper, we formally address the problem of dynamic ridesharing and introduce the solution framework of filter and refine, under which we summarize existing state-of-the-art works. Finally, we point out possible research directions and problems needed to be solved.
Geo-social media data analytic for user modeling and location-based services
Authors: Bao Jie , Lian Defu , Zhang Fuzheng , Yuan Nicholas Jing
Published: January 2016

More and more geo-tagged social media data is generated, nowadays, from the geo-tagged tweets, geo-tagged photos to check-ins. Analyzing this flourish data enables the possibility for us to discover users daily mobility patterns, profiles and preferences. As a result, based on the analyzed results, new types of location-based services emerge. In this article, we first introduce the recent advances in location-based user preferences modeling, which includes: 1) inferring users demographics, 2) identifying users novelty-seeking characteristics and 3) discovering users shopping impulsiveness. After that, we present a comprehensive summary on the state-of-arts of the location-based services, which take advantage of the geo-social media, including: 1) location-based recommendations, 2) location-based predication.
Point-of-interest recommendations in location-based social networks
Authors: Zhang Jia-Dong , Chow Chi-Yin
Published: January 2016

Location-based social networks (LBSNs), e.g., Foursquare, Gowalla and Yelp, bridge the physical world with the virtual online world. LBSNs have accumulated plenty of community-contributed data such as social links between users, check-ins of users on points-of-interest (POIs), geographical information and categories of POIs, which reflect the preferences of users to POIs. Recommending users with their preferred POIs benefits people to explore new places and businesses to discover potential customers. This paper aims to recommend personalized POIs for users based on their preferences that are learned from the community-contributed data. To this end, this paper models the social, categorical, geographical, sequential, and temporal influences on the visiting preferences of users to POIs.
IWGS 2015 workshop report
Authors: Zhang Chengyang , Banaei-Kashani Farnoush , Hendawi Abdeltawab
Published: January 2016

The ACM SIGSPATIAL International Workshop on Geostreaming (IWGS) was held for the sixth time in conjunction with the 23rd ACM SIGSPATIAL International Conference on Advances in Geographic Information Systems (ACMGIS 2015). The workshop has been a successful event that attracted participants from both academia and industry. The workshop addressed topics that are at the intersection of data streaming and geospatial systems. The workshop fostered an environment where geospatial researchers can benefit from the advances in geosensing technologies and data streaming systems.
Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia
Authors: Misra Ranjita , Fitch Cindy , Roberts David , Wright Dana
Published: January 2016

This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1) the validated 7-item diabetes risk assessment survey and (2) hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were51.2±16.4,31.1±7.5, and5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents), overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221,P<0.001). In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.
Optimized Data Replication for Small Files in Cloud Storage Systems
Authors: Fu Xiong , Liu Wenjie , Cang Yeliang , Gong Xiaojie , Deng Song
Published: January 2016

Cloud storage has become an important part of a cloud system nowadays. Most current cloud storage systems perform well for large files but they cannot manage small file storage appropriately. With the development of cloud services, more and more small files are emerging. Therefore, we propose an optimized data replication approach for small files in cloud storage systems. A small file merging algorithm and a block replica placement algorithm are involved in this approach. Small files are classified into four types according to their access frequencies. A number of small files will be merged into the same block based on which type they belong to. And the replica placement algorithm helps to improve the access efficiencies of small files in a cloud system. Related experiment results demonstrate that our proposed approach can effectively shorten the time spent reading and writing small files, and it performs better than the other two already known data replication algorithms: HAR and SequenceFile.