bluuebunny/crossref_metadata_2025 huggingface dataset:
The 7 Structures Distal to the Elbow That Are Critical to Successful Anterior Transposition of the Ulnar Nerve
Authors: Felder John M. , Mackinnon Susan E. , Patterson Megan M.
Published: April 2018

Background: Ulnar nerve transposition (UNT) surgery is performed for the treatment of cubital tunnel syndrome. Improperly performed UNT can create iatrogenic pain and neuropathy. The aim of this study is to identify anatomical structures distal to the medial epicondyle that should be recognized by all surgeons performing UNT to prevent postoperative neuropathy. Methods: Ten cadaveric specimens were dissected with attention to the ulnar nerve. Intramuscular UNT surgery was simulated in each. Distal to the medial epicondyle, any anatomical structure prohibiting transposition of the ulnar nerve to a straight-line course across the flexor-pronator mass was noted and its distance from the medial epicondyle was measured. Results: Seven structures were found distal to the medial epicondyle whose recognition is critical to ensuring a successful anterior transposition of the ulnar nerve: (1) Branches of the medial antebrachial cutaneous (MABC) nerve; (2) Osborne’s fascia; (3) branches from the ulnar nerve to the flexor carpi ulnaris (FCU); (4) crossing vascular branches from the ulnar artery to the FCU; (5) the distal medial intermuscular septum between the FCU and flexor digitorum superficialis (FDS); (6) the combined muscular origins of the flexor-pronator muscles; and (7) the investing fascia of the FDS. Measurements are given for each structure. Conclusions: Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle. Surgeons should expect to dissect up to 12 cm distal to the medial epicondyle to adequately address these and prevent kinking of the nerve in transposition.
A study of evaluating an evacuation time
Authors: Lin Cherng Shing , Wu Ming En
Published: April 2018

The occupants inside the fire site often only have a few minutes to evacuate, which is referred to as the golden evacuation time. In this study, total evacuation time was divided into response time, moving time, and waiting time. A regression model was adopted to incorporate three independent variables (floor area, number of exits, and per-floor occupant load) and determine their effect on a dependent variable, called as the evacuation time. Despite its widespread use in multiple domains, regression analysis has not been used to explore the evacuation time. The total evacuation time is to leave a fire site can successfully escape the fire. Here, the results indicated that the occupants left a fire site less than the total evacuation time. The total evacuation time calculation can also be applied to a fire protection system; this allows emergency personnel to update the total evacuation time in real time, while simultaneously informing occupants of the remaining available time to safely escape from a fire site. This study showed that regression analysis is a useful method for evacuation time calculation and can serve as an assessment tool in fire accident–related scientific research and accident investigation.
Genetic variants in miRNA machinery genes associated with clinicopathological characteristics and outcomes of gastric cancer patients
Authors: Liao Yuqian , Liao Yulu , Li Jun , Liu Liyan , Li Junyu , Wan Yiye , Peng Lixiang
Published: April 2018

Background:

Polymorphisms in miRNA machinery genes have been proved to be related to risk or survival of several kinds of cancers, but the results are controversial and the role of these polymorphisms in gastric cancer remains uncertain. In our study, we investigated the association between five genetic variants in miRNA machinery genes ( DICER, RAN, XPO5 [name of the gene]) and clinical outcomes in Chinese gastric cancer patients.

Methods:

A total of 96 patients with stage IB-III gastric cancer treated with radical gastrectomy and adjuvant chemotherapy of oxaliplatin and fluorouracils were analyzed. The MassARRAY MALDI-TOF system was used to determine the genotypes.

Results:

DICER rs3742330 AG+GG genotype was associated with more advanced T stage compared to AA genotype ( P=0.009). More patients with XPO5 rs2257082 CC genotype had poorly differentiated tumors compared with CT+TT genotype carriers. After adjustment by age, sex, differentiation, T stage, and lymph node status, XPO5 rs2257082 CC genotype carriers were found to have worse disease-free survival than CT+TT genotype carriers (adjusted HR 3.099; 95% CI 1.270, 7.564; P=0.013), carriers of RAN rs14035 CC genotype had higher three-year OS rate than carriers of CT+TT genotype (adjusted HR 3.174; 95% CI 1.010, 9.973; P=0.048).

Conclusions:

These results indicated that genetic variants in miRNA machinery genes might be associated with the clinicopathological features and prognosis of completely resected gastric cancer patients.
A systematic narrative review of prosociality in educational leadership
Authors: Yada Takumi , Jäppinen Aini-Kristiina
Published: April 2018

Organizational scholars have vigorously and long studied being prosocial in defining ‘prosociality’ as motivation, behavior, and impact to help or benefit others. This study attempts to provide an overview of previous studies that have approached the elements of being prosocial in educational leadership contexts. However, most of the prosocial elements in education are not explicitly defined as prosociality and have not yet been systematically studied. Thus, this study explored the research questions: (a) What elements could be involved in prosociality within educational leadership? (b) Who could be involved in the process of prosociality in educational leadership? The final corpus of this study was 83 articles published between 1993 and 2016. The reviewed concepts were categorized into three themes proposed in organizational studies: prosocial motivation, prosocial behavior, and prosocial impact. Moreover, the multiple educational actors related to prosocial elements were identified. The findings provide an outline of possible directions for future research according to the three themes.
Excitation-invariant pre-processing of thermographic data
Authors: Moustakidis Serafeim , Anagnostis Athanasios , Chondronasios Apostolos , Karlsson Patrik , Hrissagis Kostas
Published: April 2018

There is a large number of industries that make extensive use of composite materials in their respective sectors. This rise in composites’ use has necessitated the development of new non-destructive inspection techniques that focus on manufacturing quality assurance, as well as in-service damage testing. Active infrared thermography is now a popular nondestructive testing method for detecting defects in composite structures. Non-uniform emissivity, uneven heating of the test surface, and variation in thermal properties of the test material are some of the crucial factors in experimental thermography. These unwanted thermal effects are typically coped with the application of a number of well-established thermographic techniques including pulse phase thermography and thermographic signal reconstruction. This article addresses this problem of the induced uneven heating at the pre-processing phase prior to the application of the thermographic processing techniques. To accomplish this, a number of excitation invariant pre-processing techniques were developed and tested in this article addressing the unwanted effect of non-uniform excitation in the collected thermographic data. Various fitting approaches were validated in light of modeling the non-uniform heating effect, and new normalization approaches were proposed following a time-dependent framework. The proposed pre-processing techniques were validated on a testing composite sample with pre-determined defects. The results demonstrated the effectiveness of the proposed processing algorithms in terms of removing the unwanted heat distribution effect along with the signal-to-noise ratio of the produced infrared images.
A robust leukocyte recognition method based on multi-scale regional growth and mean-shift clustering
Authors: Lin Liqun , Wang Weixing
Published: April 2018

Although there are many independent studies on the detection of white blood cell or classification of white blood cell, few papers have taken them into consideration. This study proposed a method for recognizing five types of leukocytes based on multi-scale regional growth and mean-shift clustering. The key idea of the proposed method is to extract texture features of leukocytes in a visual manner. And it is a non-parametric texture features extracting method different from traditional algorithms. Finally, SVM (Support Vector Machine) is used for classification. Some leukocyte images were used and the overall correct recognition rate reached 97.96%, indicating the feasibility and robustness of the proposed method.
Framing the ‘White Widow’: Using intersectionality to uncover complex representations of female terrorism in news media
Authors: Auer Meagan , Sutcliffe John , Lee Martha
Published: April 2018

Following 21 September 2013, news media in the UK offered extensive and elaborate coverage of the Westgate Mall Massacre in Nairobi, Kenya. This act of terrorism, perpetrated by Al-Shabaab, left over 60 people dead. What news media considered particularly captivating was not the devastation of the attack, but the suspected involvement of Samantha Lewthwaite. She remained at the center of news media in Britain for several months after the attack, dubbed the ‘White Widow’. In this article, the authors employ an intersectional approach to explore the ways that race, religion, nationality, age, class, and gender converge in mediated representations of Lewthwaite. They argue that the application of intersectionality results in a more holistic understanding of the content and discursive impact of news narratives about female terrorists and find that news media both vilify and normalize Lewthwaite, representing her participation in terrorism through complex constellations of identity.
The role of the pharmacist in the intensive care unit
Authors: Borthwick Mark
Published: April 2018

The use of medication to support patients and optimise outcomes is a fundamental strand of care. Pharmacists provide a key role managing medication within the complexity of various routes of administration, severe and rapidly shifting pharmacokinetic and dynamic parameters, and extremes of physiology in critical illness. Pharmacists intercept and resolve medication errors, optimise medication therapy and undertake broader professional activities within the job role that contribute to the smooth running of ICU. These activities are associated with improved quality, reduced mortality and reduced costs.
Analysis of ethanol and butanol direct-injection spark-ignition sprays using two-phase structured laser illumination planar imaging droplet sizing
Authors: Koegl Matthias , Mishra Yogeshwar Nath , Storch Michael , Conrad Chris , Berrocal Edouard , Will Stefan , Zigan Lars
Published: April 2018

This paper reports on the spray structure of the biofuels, ethanol, and butanol generated by a multihole direct-injection spark-ignition injector, which is studied in a constant volume chamber. The spray shape and structure are analyzed using two-phase structured laser illumination planar imaging where both laser-induced fluorescence and Mie-scattering light are recorded simultaneously for the extraction of instantaneous laser-induced fluorescence/Mie-scattering ratio images. Quantitative planar measurements of the droplet Sauter mean diameter are conducted, using calibration data from phase-Doppler anemometry. The resulting Sauter mean diameters are presented for ethanol and butanol at various fuel temperatures at different times after the start of injection. It is found that an increase in fuel temperature results in a faster atomization and higher evaporation rate, which leads to reduced spray tip penetration and smaller droplet Sauter mean diameter. At equivalent conditions, butanol consistently showed larger spray tip penetration in comparison to ethanol. This behavior is due to the higher surface tension and viscosity of butanol resulting in the formation of larger droplets and larger Sauter mean diameters in the whole spray region. Finally, the butanol injection also shows larger cyclic variations in the spray shape from injection to injection which is explained by the internal nozzle flow that is influenced by larger fuel viscosity as well. The Sauter mean diameter distribution is also compared to phase-Doppler anemometry data showing good agreement and an uncertainty analysis of the structured laser illumination planar imaging-laser-induced fluorescence/Mie-scattering technique for planar droplet sizing in direct-injection spark-ignition sprays is presented.
Incidence of and Risk Factors for Venous Thromboembolism After Foot and Ankle Surgery
Authors: Huntley Samuel R. , Abyar Eildar , Lehtonen Eva J. , Patel Harshadkumar A. , Naranje Sameer , Shah Ashish
Published: April 2018

Background: Venous thromboembolism (VTE) is a rare but potentially lethal complication after orthopaedic foot and ankle surgery. The true incidence of VTE after orthopaedic foot and ankle surgery stratified by specific procedure has yet to be examined. The purpose of this study is to report the incidence of and identify risk factors for VTE in a large sample of patients receiving orthopaedic foot and ankle surgery. Methods: In this study, we retrospectively analyzed data from the National Surgical Quality Improvement Program 2006 to 2015 data files. The incidence of VTE was calculated for 30 specific orthopaedic foot and ankle surgeries and for 4 broad types of foot and ankle surgery. Demographic, comorbidity, and complication variables were analyzed to determine associations with development of VTE. Results: The overall incidence of VTE in our sample was 0.6%. The types of procedures with the highest frequency of VTE were ankle fractures (105/15 302 cases, 0.7%), foot pathologies (28/5466, 0.6%), and arthroscopy (2/398, 0.5%). Female gender, increasing age, obesity, inpatient status, and nonelective surgery were all significantly associated with VTE. Conclusion: Although VTE after orthopaedic foot and ankle surgery is a rare occurrence, several high-risk groups and procedures may be especially indicated for chemical thromboprophylaxis.

Levels of Evidence: Level III: Retrospective, comparative study
Qualitative exploration of practices to prevent medication errors in neonatal intensive care units: a focus group study
Authors: Rishoej Rikke Mie , Lai Nielsen Henriette , Strzelec Stina Maria , Fritsdal Refer Jane , Allermann Beck Sanne , Gramstrup Hanne Marie , Thybo Christesen Henrik , Juel Kjeldsen Lene , Hallas Jesper , Almarsdóttir Anna Birna
Published: April 2018

Background:

Medication errors (MEs) in neonates are frequent and associated with increased potential for harm compared with adults. The effect of learning from reported MEs is potentially lacking due to underreporting, lack of feedback and missing actions to improve medication safety. A new approach involving positive recognition of current and future strategies may facilitate greater exploration of how to improve medication safety in neonates. We aimed to explore current and potential future practices to prevent MEs in neonatal intensive care units (NICUs).

Methods:

Focus group interviews of physicians and nurses were conducted at three Danish NICUs. Participants were included if they had at least 1 month of working experience and provided direct patient care. A semistructured interview guide involving three questions was used: (a) how do you feel about discussing prevention of MEs? (b) how do you currently prevent MEs from occurring? and (c) how can we become better at preventing MEs in the future? Content analysis was used to identify themes in the interviews.

Results:

Participants commented that MEs still occur and that action must be taken to improve medication safety. Current practices to prevent MEs involved technology, procedures, education, skills and hospital pharmacy services. Potential future practices to prevent MEs included customizing the computerized physician order entry systems to support optimal prescribing, standardizing the double-check process, training of calculation skills and teamwork and increased use of hospital pharmacy services.

Conclusions:

Several current and potential future practices to reduce MEs in NICUs were identified, highlighting the complexity of MEs. Our findings support an interdisciplinary multifaceted intervention involving both technical and nontechnical elements to improve medication safety in NICUs.
Effects of Controllability of Athlete Celebrity Endorsers’ Drug Scandals on Punitive Opinions: Sensation Seeking as a Moderator
Authors: Kim Soojung , Eisenschmid Tanja , Cavanah Sarah
Published: April 2018

Guided by the attribution theory and sensation seeking (SS), this study found that a news article featuring an athlete celebrity endorser’s drug scandal resulting from a controllable cause (e.g., taking performance-enhancing substance) generated stronger punitive opinions, stronger attribution of the scandal to the athlete, and lower sympathy for the athlete. When a news article presented the drug scandal as due to an uncontrollable cause (e.g., taking a medication to relieve a health problem), low sensation seekers had more negative attitudes and were more in favor of punishment than high sensation seekers. Attributions and sympathy were found to be mediators of the interaction effects of controllable versus uncontrollable messages and SS on punitive opinions. This study contributes to research on the attribution theory and SS in the sports communication context and provides practical implications for sports marketers and public relations professionals.
The Risk Factors of Performance-Based Early Frailty in Midlife and Older Age
Authors: Peterson Matthew J.
Published: April 2018

Background: Identifying impairments prior to onset of physical frailty may inform targeted interventions. An objective, clinically feasible early frailty measure, termed performance-based early frailty (PBEF) was developed, and antecedent and current risk factors were examined. Method: Data were from N = 104 participants of the Fels Longitudinal Study. PBEF was derived from age-specific cut points for time to complete five chair stands and walk four meters. “Pre-PBEF” and “PBEF” were defined as impairment in one or both measures, respectively. Candidate PBEF risk factors included body composition, health and quality of life, grip strength, and biomarker measures. Results: Pre-PBEF was identified in 26% and 30% of midlife and older adults, and PBEF was identified in 11% and 14% of midlife and older adults, respectively. When predicting midlife PBEF, only current physical activity was significant (odds ratio [OR] = 0.18). In older adults, PBEF status was predicted by previous heavier drinking (OR = 3.09), previous better grip strength (OR = 0.92), current poorer sleep habits (OR = 1.19), and current higher C-reactive protein concentrations (OR = 1.20). Conclusion: Differing age group patterns of predictors emerged, suggesting that PBEF in midlife is likely a state influenced by current health status, whereas older age PBEF is influenced by both current and antecedent factors.
Role of exosomes as a proinflammatory mediator in the development of EBV-associated lymphoma
Authors: Higuchi Hiroshi , Yamakawa Natsuko , Imadome Ken-Ichi , Yahata Takashi , Kotaki Ryutaro , Ogata Jun , Kakizaki Masatoshi , Fujita Koji , Lu Jun , Yokoyama Kazuaki , Okuyama Kazuki , Sato Ai , Takamatsu Masako , Kurosaki Natsumi , Alba Syakira Mohamad , Azhim Azran , Horie Ryouichi , Watanabe Toshiki , Kitamura Toshio , Ando Kiyoshi , Kashiwagi Takao , Matsui Toshimitsu , Okamoto Akinao , Handa Hiroshi , Kuroda Masahiko , Nakamura Naoya , Kotani Ai
Published: April 2018

Key Points

EBV-coding miRNAs are transferred from infected into noninfected cells by exosome to regulate the function for the tumorigenesis. Production of EBV-coding miRNAs will be an excellent diagnostic marker to separate patients with EBV+ diffuse large B-cell lymphoma into 2 groups.
The quality of primary care provided to the elderly in Israel
Authors: Podell Rachel , Kaufman-Shriqui Vered , Sagy Yael Wolff , Manor Orly , Ben-Yehuda Arie
Published: April 2018

Background

In view of increasing global and local trends in population ageing and the high healthcare utilization rates among the elderly, this study assesses the quality of primary care provided to the elderly population in Israel. It examines changes in quality over time, how quality varies across sub-groups of the elderly, and how quality in Israel compares with other countries. Data originate from the National Program for Quality Indicators in Community Healthcare (QICH), which operates in full collaboration with Israel’s four HMOs.

Methods

The study population included all elderly Israeli residents aged 65 years or older during 2002–2015 (N = 879,671 residents in 2015). Seven elderly-specific quality indicators from within the QICH framework were included: influenza and pneumococcal vaccinations, benzodiazepine overuse, long-acting benzodiazepine use, body weight documentation, weight loss and underweight. In addition, two non-age specific quality indicators relating to diabetes mellitus were included: the rate of HbA1C documentation and uncontrolled diabetes. Data were collected from patient electronic medical records (EMR) in accordance with each HMO, and aggregated by three variables: gender, age, and socio-economic position (SEP).

Results

During the measurement period, vaccination rates significantly increased (Influenza: from 42.0% in 2002 to 63.2% in 2015; and pneumococcal vaccination: from 25.8% in 2005 to 77.0% in 2015). Body weight documentation (in 65–74 year old persons) increased from only 16.3% in 2003 to 80.9% in 2015. The rate of underweight (BMI < 23 kg/m2) and significant weight-loss (10% or more of their body weight) was only measured in 2015. The overall rate of benzodiazepine overuse remained steady from 2011 to 2015 at around 5%, while the rate of long-acting benzodiazepine use decreased from 3.8% in 2011 to 2.4% in 2015.

The rate of HbA1c documentation for elderly diabetics was higher than for non-elderly diabetics in 2015 (92.2% vs 87.9%). The rate of uncontrolled diabetes was lower for the elderly than the non-elderly population in 2015 (6.9% vs. 15.7%).

Gender disparities were observed across all measures, after age stratification, with worse indicator rates among females compared to males. SEP-disparities were not consistent across measures.

In all indicators except benzodiazepine overuse, Israel showed a higher quality of care for the elderly in comparison with the international healthcare community.

Conclusions

Overall, the quality of care received by elderly Israelis has improved substantially since measurements first began; yet, females receive lower quality care than males. Monitoring results of primary care quality indicators can contribute to population’s successful aging; both chronic conditions at earlier ages (e.g. diabetes), and short-term hazardous conditions such as the use of potentially harmful medications and weight loss should be evaluated.
Mentalising skills in generic mental healthcare settings: can we make our day-to-day interactions more therapeutic?
Authors: Welstead H. J. , Patrick J. , Russ T. C. , Cooney G. , Mulvenna C. M. , Maclean C. , Polnay A.
Published: April 2018

Aims and method

Caring for patients with personality disorder is one of the biggest challenges in psychiatric work. We investigated whether mentalisation-based treatment skills (MBT-S) teaching improves clinicians' understanding of mentalising and attitudes towards personality disorder. Self-report questionnaires (Knowledge and Application of MBT (KAMQ) and Attitudes to Personality Disorder (APDQ)) were completed at baseline and after a 2-day MBT-S workshop.

Results

Ninety-two healthcare professionals completed questionnaires before and after training. The mean within-participant increase in scores from baseline to end-of-programme was 11.6 points (95% CI 10.0–13.3) for the KAMQ and 4.0 points (1.8–6.2) for the APDQ.

Clinical implications

MBT-S is a short intervention that is effective in improving clinicians' knowledge of personality disorder and mentalisation. That attitudes to personality disorder improved overall is encouraging in relation to the possibility of deeper learning in staff and, ultimately, improved care for patients with personality disorder.

Declaration of interest

None.
Communication About Prognosis With Adolescent and Young Adult Patients With Cancer: Information Needs, Prognostic Awareness, and Outcomes of Disclosure
Authors: Mack Jennifer W. , Fasciano Karen M. , Block Susan D.
Published: April 2018

Purpose

Communication about prognosis affects decisions patients and family members make about cancer care, and most patients say they want to know about their chances of cure. We sought to evaluate experiences with prognosis communication among adolescents and young adults (AYAs) with cancer.

Patients and Methods

We surveyed 203 AYAs with cancer age 15 to 29 years (response rate, 74%) treated at Dana-Farber Cancer Institute and their oncologists. Patients were approached within 6 weeks of diagnosis and asked to report on their prognosis communication preferences and experiences, their beliefs about likelihood of cure, and psychosocial outcomes of communication, such as trust (using an item from the Trust in Physician Scale), peace of mind (using select items from the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale), and anxiety and depression (using the Hospital Anxiety and Depression Scale). Oncologists were asked to report the patient’s likelihood of cure.

Results

Most patients (83%, 167 of 203 patients) considered prognostic information to be extremely or very important. Patients who reported having received more extensive prognostic disclosure had higher odds of trust in the oncologist (odds ratio [OR], 1.30; 95% CI, 1.01 to 1.67; P = .05), peace of mind (OR, 2.13; 95% CI, 1.29 to 3.51; P = .002), and hope related to physician communication (OR, 1.27; 95% CI, 1.01 to 1.59; P = .04), after adjusting for patient sex, age, race or ethnicity, prognosis, and diagnosis. Disclosure was also associated with lower distress related to knowing about prognosis (OR, 0.65; 95% CI, 0.44 to 0.95; P = .03). However, a majority of patients (62%) reported prognostic estimates that exceeded those reported by physicians (McNemar P < .001).

Conclusion

Most AYAs with cancer value receiving prognostic information, which is positively associated with aspects of well-being. However, most overestimate chances of cure relative to oncologists, highlighting the importance of efforts to improve communication with this young population.
Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis
Authors: Rae-Grant Alexander , Day Gregory S. , Marrie Ruth Ann , Rabinstein Alejandro , Cree Bruce A.C. , Gronseth Gary S. , Haboubi Michael , Halper June , Hosey Jonathan P. , Jones David E. , Lisak Robert , Pelletier Daniel , Potrebic Sonja , Sitcov Cynthia , Sommers Rick , Stachowiak Julie , Getchius Thomas S.D. , Merillat Shannon A. , Pringsheim Tamara
Published: April 2018

Objective

To develop recommendations for disease-modifying therapy (DMT) for multiple sclerosis (MS).

Methods

A multidisciplinary panel developed DMT recommendations, integrating findings from a systematic review; followed an Institute of Medicine–compliant process to ensure transparency and patient engagement; and developed modified Delphi consensus–based recommendations concerning starting, switching, and stopping DMTs pertinent to people with relapsing-remitting MS, secondary progressive MS, primary progressive MS, and clinically isolated syndromes of demyelination. Recommendations were supported by structured rationales, integrating evidence from one or more sources: systematic review, related evidence (evidence not from the systematic review), principles of care, and inference from evidence.

Results

Thirty recommendations were developed: 17 on starting DMTs, including recommendations on who should start them; 10 on switching DMTs if breakthrough disease develops; and 3 on stopping DMTs. Recommendations encompassed patient engagement strategies and individualization of treatment, including adherence monitoring and disease comorbidity assessment. The panel also discussed DMT risks, including counseling about progressive multifocal leukoencephalopathy risk in people with MS using natalizumab, fingolimod, rituximab, ocrelizumab, and dimethyl fumarate; and made suggestions for future research to evaluate relative merits of early treatment with higher potency DMTs vs standard stepped-care protocols, DMT comparative effectiveness, optimal switching strategies, long-term effects of DMT use, definitions of highly active MS, and effects of treatment on patient-specified priority outcomes. This guideline reflects the complexity of decision-making for starting, switching, or stopping MS DMTs. The field of MS treatment is rapidly changing; the Academy of Neurology development process includes planning for future updates.
Expansion of DUB functionality generated by alternative isoforms – USP35, a case study
Authors: Leznicki Pawel , Natarajan Jayaprakash , Bader Gerd , Spevak Walter , Schlattl Andreas , Abdul Rehman Syed Arif , Pathak Deepika , Weidlich Simone , Zoephel Andreas , Bordone Marie C. , Barbosa-Morais Nuno L. , Boehmelt Guido , Kulathu Yogesh
Published: April 2018

Protein ubiquitylation is a dynamic post-translational modification that can be reversed by deubiquitylating enzymes (DUBs). It is unclear how the small number (∼100) of DUBs present in mammalian cells regulate the thousands of different ubiquitylation events. Here, we analysed annotated transcripts of human DUBs and found ∼300 ribosome-associated transcripts annotated as protein coding, which thus increases the total number of DUBs. By using USP35, a poorly studied DUB, as a case study, we provide evidence that alternative isoforms contribute to the functional expansion of DUBs. We show that there are two different USP35 isoforms that localise to different intracellular compartments and have distinct functions. Our results reveal that isoform 1 is an anti-apoptotic factor that inhibits staurosporine- and TNF-related apoptosis-inducing ligand (TRAIL; also known as TNFSF10)-induced apoptosis. In contrast, USP35 isoform 2 is an integral membrane protein of the endoplasmic reticulum (ER) that is also present at lipid droplets. Manipulations of isoform 2 levels cause rapid ER stress, likely through deregulation of lipid homeostasis, and lead to cell death. Our work highlights how alternative isoforms provide functional expansion of DUBs and sets directions for future research.

This article has an associated First Person interview with the first author of the paper.
Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts
Authors: BLACKWELL JAMES E. M. , DOLEMAN BRETT , HERROD PHILIP J. J. , RICKETTS SAMUEL , PHILLIPS BETHAN E. , LUND JONATHAN N. , WILLIAMS JOHN P.
Published: April 2018

Background and Aim

Exercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts.

Methods

This systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (<8 wk) HIIT versus either no exercise control (CON) or moderate continuous training (MCT) within diseased cohorts. Literature searches of the following databases were performed: MEDLINE, EMBASE, CINAHL, AMED, and PubMed (all from inception to December 1, 2017), with further searches of Clinicaltrials.gov and citations via Google Scholar. Primary outcomes were effect on CRF variables: V˙O2peak and anaerobic threshold.

Results

Thirty-nine studies met the inclusion criteria. HIIT resulted in a clinically significant increase in V˙O2peak compared with CON (mean difference [MD] = 3.32 mL·kg−1·min−1, 95% confidence interval [CI] = 2.56–2.08). Overall HIIT provided added benefit to V˙O2peak over MCT (MD = 0.79 mL·kg−1·min−1, 95% CI = 0.20–1.39). The benefit of HIIT was most marked in patients with cardiovascular disease when compared with MCT (V˙O2peak: MD = 1.66 mL·kg−1·min−1, 95% CI = 0.60–2.73; anaerobic threshold: MD = 1.61 mL·kg−1·min−1, 95% CI = 0.33–2.90).

Conclusions

HIIT elicits improvements in objective measures of CRF within 8 wk in diseased cohorts compared with no intervention. When compared with MCT, HIIT imparts statistically significant additional improvements in measures of CRF, with clinically important additional improvements in V˙O2peak in cardiovascular patients. Comparative efficacy of HIIT versus MCT combined with an often reduced time commitment may warrant HIIT’s promotion as a viable clinical exercise intervention.
VALIDATE: Exploiting the synergy between complex intracellular pathogens to expedite vaccine research and development for tuberculosis, leishmaniasis, melioidosis and leprosy
Authors: Fletcher Helen A. , Chatterjee Mitali , Cooper Andrea , Hussell Tracy , Kaye Paul M. , Prior Joann , Reljic Rajko , Vermaak Samantha , Vordermeier Martin , Williams Ann , McShane Helen
Published: April 2018

For several complex intracellular pathogens, we have an urgent need for effective vaccines and yet there are common barriers to vaccine development. These diseases, including tuberculosis, leishmaniasis, leprosy and melioidosis, cause a huge burden of disease and disproportionately affect low and middle income countries. They are therefore often neglected due to the marginalisation of affected populations and the poor predicted commercial return on investment. Barriers to vaccine development include an incomplete understanding of protective immunity and translation from the bench into clinical vaccine trials. The current linear approach to vaccine research and development for these pathogens, which involves basic research, vaccine design, and vaccine evaluation in preclinical challenge models and clinical trials, is inefficient for these complex intracellular pathogens. We have established a Global Challenges Research Fund Network for VAccine deveLopment for complex Intracellular neglecteD pAThogEns, “VALIDATE”, where we aim to adopt a more flexible, integrated cross-pathogen approach to accelerate vaccine research and clinical development for these four pathogens, by cross-pathogen analyses, cross-discipline collaborations, and repeated integration of data from human and animal studies.

This network provides a unique opportunity to bring together individuals working on four exemplar complex intracellular neglected pathogens (M.tb, Leishmania spp., B. pseudomallei and M.leprae), which share a common lifestyle as pathogens of macrophages, induce similar end-stage pathologies and alter host immune and metabolic responses. The horizontal collaborations established throughout this network, together with the provision of a protected environment for early data sharing, will exploit these biological synergies.  By interrogating mechanisms that lead from infection to disease, we will be able to develop common vaccine development strategies for these and other complex intracellular pathogens.
Edge effects on beetle assemblages in an Atlantic forest fragment and pasture in Sergipe, Brazil
Authors: Dantas José Oliveira , Ferreira Adeilma Nascimento , Oliveira Ingrid Ruany Pimentel , Alves Moisés Oliveira , Ribeiro Genésio Tâmara , Araújo-Piovezan Talita Guimarães de
Published: April 2018

Abstract.  The advancement of agricultural frontiers and pastures has contributed to the fragmentation of the forest, and these fragments are affected by disturbances of varying degrees of intensity that influence the local fauna and flora. The objective of this work was to analyze how do the magnitude and extent of edge effects and seasonality chance to richness and abundance of beetle. The experiment was conducted in an area containing forest, border and pasture belonging to the Federal Institute of Sergipe. A total of 1,173 specimens from 16 species were collected. The border areas showed a greater richness and abundance of species characterized by being an area of intermediate disturbance, while the anthropic area (pasture) presented the lowest abundance and abundance of Coleoptera and a greater variety of pest beetles, suggesting that the occurrence of some species of pest beetles may be an indication of degraded areas. The abundance and richness of the coleoptera community decreased in the rainy season. Small distances between the pasture, the edge of the forest fragment and the interior of this fragment seem to be crucial to determine the structure of the beetle community, reinforcing attention to the conservation of habitats for its development.Efeitos de borda sobre assembleias de besouros em fragmento de Mata Atlântica e pastagem em Sergipe, Brasil Resumo. O avanço das fronteiras agrícolas e das pastagens contribuiu para a fragmentação da mata, e estes fragmentos são afetados por distúrbios de diferentes graus de intensidade que influenciam a fauna e a flora local. O objetivo deste trabalho foi analisar como a magnitude e extensão do efeito de borda e a sazonalidade influencia na riqueza e abundância de besouros. O experimento foi conduzido em uma área contendo mata, borda e pastagem pertencente ao Instituto Federal de Sergipe. Foram coletados 1.173 espécimes pertencentes a 16 espécies.As áreas de borda se destacaram apresentando maior riqueza e abundância de espécies caracterizada por ser uma área de distúrbio intermediário, enquanto que a área antropizada (pastagem) apresentou a menor riqueza e abundância de Coleópteros e maior variedade de besouros pragas, sugerindo que a ocorrência de algumas espécies de besouros-praga pode ser uma indicação de áreas degradadas. A abundância e riqueza da comunidade de coleópteros diminuíram na estação chuvosa. Pequenas distâncias entre o pasto, a borda do fragmento florestal e o interior deste fragmento parecem ser cruciais para determinar a estrutura da comunidade de besouros, reforçando a atenção à conservação de habitats para seu desenvolvimento.
Accelerated detection and treatment of atrial fibrillation in stroke patients by changing clinical pathways
Authors: Bourke Paula , Joseph Sujatha , Akhtar Naveed , Morgan Deborah , Santos Mark , Shuaib Ashfaq
Published: April 2018

Aim and objective:

Atrial fibrillation (AF), a major cause of thromboembolic stroke, is under-detected. Our aim was to compare the established pathway of AF detection, reporting to point-of-treatment decision, with a pilot pathway coordinated by the clinical nurse specialists (CNS) for stroke in Qatar.

Methods:

The established system uses traditional holter monitors, attached by a technician. The report is sent to cardio-electrophysiology physicians, and then uploaded onto electronic records. The piloted stroke system used a cardiac monitoring device capable of prolonged recording. The device is calibrated, downloaded, reviewed and uploaded onto electronic records by the CNS.

Results:

319 holters were requested during the 6-month pilot period, 217 via the stroke cardiac monitor service (SCMS) and 102 via the hospital holter monitor service (HHMS). Sixty-two percent of the SCMS reports were attached within 24 hours of admission compared to 31% of the HHMS reports. The reports were available within 48 hours in 2% of patients in the HHMS as compared to 76% with SCMS. The time from detachment to the consultant's decision was 2.6 days in SCMS versus 18.4 days in the HHMS.

Conclusion:

Utilising the skills of the CNS team for the application, interpretation and reporting provided a more efficient service with improved initiation of anticoagulation treatment for patients.
Planning a lesson for a job interview
Authors: Webb Helen
Published: April 2018

The lesson is a key part of any teaching job interview and often causes the most stress for applicants. Helen Webb looks at how to plan your job interview lessons
DIFERENCIAS INTERCULTURALES EN EL AUTOCONCEPTO, DIMENSIÓN ESTABILIDAD EMOCIONAL, EN ADOLESCENTES
Authors: Plangger Lea , Rodríguez Quintana Esther , González Uriel Clara
Published: April 2018

INTRODUCCIÓN. Esta investigación tiene como objeto describir la dimensión del autoconcepto, estabilidad emocional, en función del género y el origen. MÉTODO. La metodología utilizada es de carácter cuantitativo, con diseño no experimental siguiendo el método correlacional, siendo un estudio ex-post-facto. El instrumento utilizado es el ESEA-2, revisión realizada por González- Pienda del SDQ-II de Marsh que analiza el autoconcepto en sus diferentes dimensiones de adolescentes que cursan segundo de la ESO (n=2,701), en la Comunidad de Madrid. RESULTADOS. Los resultados de los estudios descriptivos y correlacionales muestran que no existen diferencias en función del género en estabilidad emocional, a excepción de los varones de origen ecuatoriano que presentaban una mayor estabilidad emocional que las mujeres ecuatorianas. Sin embargo, sí se encontraron diferencias en función del país o la agrupación de origen. Asimismo, se hallaron diferencias significativas, algunas con correlaciones negativas y otras con correlaciones positivas, en función de la valoración que realizaban de la cultura española y de su cultura de origen. DISCUSIÓN. Teniendo en cuenta que esta dimensión del autoconcepto implica el grado de estrés y preocupación que muestra el estudiante por los diversos problemas a resolver en el proceso de construcción del yo, es relevante detectar que no existen diferencias entre hombres y mujeres, pudiendo ser indicativo de la efectividad de las intervenciones en igualdad de género. Sin embargo, sí se detectan diferencias en relación con la nacionalidad o el país de origen, encontrándose una importante relación entre esta dimensión del autoconcepto y la valoración que hacen de su cultura de origen y la española. Se concluye que es necesario diseñar investigaciones que tengan en cuenta las diferencias en la valoración de las culturas entre los diferentes orígenes para favorecer la implementación de intervenciones eficaces.
Characterization of Human Salivary Extracellular RNA by Next-generation Sequencing
Authors: Li Feng , Kaczor-Urbanowicz Karolina Elżbieta , Sun Jie , Majem Blanca , Lo Hsien-Chun , Kim Yong , Koyano Kikuye , Rao Shannon Liu , Kang So Young , Kim Su Mi , Kim Kyoung-Mee , Kim Sung , Chia David , Elashoff David , Grogan Tristan R , Xiao Xinshu , Wong David T W
Published: April 2018

BACKGROUND

It was recently discovered that abundant and stable extracellular RNA (exRNA) species exist in bodily fluids. Saliva is an emerging biofluid for biomarker development for noninvasive detection and screening of local and systemic diseases. Use of RNA-Sequencing (RNA-Seq) to profile exRNA is rapidly growing; however, no single preparation and analysis protocol can be used for all biofluids. Specifically, RNA-Seq of saliva is particularly challenging owing to high abundance of bacterial contents and low abundance of salivary exRNA. Given the laborious procedures needed for RNA-Seq library construction, sequencing, data storage, and data analysis, saliva-specific and optimized protocols are essential.

METHODS

We compared different RNA isolation methods and library construction kits for long and small RNA sequencing. The role of ribosomal RNA (rRNA) depletion also was evaluated.

RESULTS

The miRNeasy Micro Kit (Qiagen) showed the highest total RNA yield (70.8 ng/mL cell-free saliva) and best small RNA recovery, and the NEBNext library preparation kits resulted in the highest number of detected human genes [5649–6813 at 1 reads per kilobase RNA per million mapped (RPKM)] and small RNAs [482–696 microRNAs (miRNAs) and 190–214 other small RNAs]. The proportion of human RNA-Seq reads was much higher in rRNA-depleted saliva samples (41%) than in samples without rRNA depletion (14%). In addition, the transfer RNA (tRNA)-derived RNA fragments (tRFs), a novel class of small RNAs, were highly abundant in human saliva, specifically tRF-4 (4%) and tRF-5 (15.25%).

CONCLUSIONS

Our results may help in selection of the best adapted methods of RNA isolation and small and long RNA library constructions for salivary exRNA studies.
Application of model-based inversion technique in a field in the coastal swamp depobelt, Niger delta
Authors: Austin Okoli , Samuel I. Onyekuru , Agbasi Okechukwu , Abdulrazzaq Zaidoon Taha
Published: April 2018

Considering the heterogeneity of the reservoir sands in the Niger Delta basin which are primary causes of low hydrocarbon recovery efficiency, poor sweep, early breakthrough and pockets of bypassed oil there arises a need for in-depth quantitative interpretation and more analysis to be done on seismic data to achieve a reliable reservoir characterization to improve recovery, plan future development wells within field and achieve deeper prospecting for depths not penetrated by the wells and areas far away from well locations. An effective tool towards de-risking prospects is seismic inversion which transforms a seismic reflection data to a quantitative rock-property description of a reservoir. The choice of model-based inversion in this study was due to well control, again considering the heterogeneity of the sands in the field. X-26, X-30, and X-32 were used to generate an initial impedance log which is used to update the estimated reflectivity from which we would obtain our inverted volumes. Acoustic impedance volumes were generated and observations made were consistent with depth trends established for the Niger Delta basin, inverted slices of Poisson impedances validated the expected responses considering the effect of compaction. This justifies the use of inversion method in further characterizing the plays identified in the region.
Phasic Stimulation of Midbrain Dopamine Neuron Activity Reduces Salt Consumption
Authors: Sandhu Eleanor C. , Fernando Anushka B. P. , Irvine Elaine E. , Tossell Kyoko , Kokkinou Michelle , Glegola Justyna , Smith Mark A. , Howes Oliver D. , Withers Dominic J. , Ungless Mark A.
Published: April 2018

Salt intake is an essential dietary requirement, but excessive consumption is implicated in hypertension and associated conditions. Little is known about the neural circuit mechanisms that control motivation to consume salt, although the midbrain dopamine system, which plays a key role in other reward-related behaviors, has been implicated. We, therefore, examined the effects on salt consumption of either optogenetic excitation or chemogenetic inhibition of ventral tegmental area (VTA) dopamine neurons in male mice. Strikingly, optogenetic excitation of dopamine neurons decreased salt intake in a rapid and reversible manner, despite a strong salt appetite. Importantly, optogenetic excitation was not aversive, did not induce hyperactivity, and did not alter salt concentration preferences in a need-free state. In addition, we found that chemogenetic inhibition of dopamine neurons had no effect on salt intake. Lastly, optogenetic excitation of dopamine neurons reduced consumption of sucrose following an overnight fast, suggesting a more general role of VTA dopamine neuron excitation in organizing motivated behaviors.