bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of InSeq to Identify Genes Essential for Pseudomonas aeruginosa PGPR2 Corn Root Colonization
Authors: Sivakumar Ramamoorthy , Ranjani Jothi , Vishnu Udayakumar S. , Jayashree Sathyanarayanan , Lozano Gabriel L. , Miles Jessica , Broderick Nichole A. , Guan Changhui , Gunasekaran Paramasamy , Handelsman Jo , Rajendhran Jeyaprakash
Published: July 2018

The reciprocal interaction between rhizosphere bacteria and their plant hosts results in a complex battery of genetic and physiological responses. In this study, we used insertion sequencing (INSeq) to reveal the genetic determinants responsible for the fitness of Pseudomonas aeruginosa PGPR2 during root colonization. We generated a random transposon mutant library of Pseudomonas aeruginosa PGPR2 comprising 39,500 unique insertions and identified genes required for growth in culture and on corn roots. A total of 108 genes were identified as contributing to the fitness of strain PGPR2 on roots. The importance in root colonization of four genes identified in the TnSeq screen was verified by constructing deletion mutants in the genes and testing them for the ability to colonize corn roots singly or in competition with the wild type. All four mutants were affected in corn root colonization, displaying 5-to 100-fold reductions in populations in single inoculations, and all were outcompeted by the wild type by almost 100-fold after seven days on corn roots in mixed inoculations of the wild type and mutant. The genes identified in the screen had homology to genes involved in amino acid catabolism, stress adaptation, detoxification, signal transduction, and transport. INSeq technology proved a successful tool to identify fitness factors in P. aeruginosa PGPR2 for root colonization.
Why is cancer not more common? A changing microenvironment may help to explain why, and suggests strategies for anti-cancer therapy
Authors: Jiang Xiaowei , Tomlinson Ian P.M.
Published: July 2018

One of the great unsolved puzzles in cancer biology is not why cancers occur, but rather, explaining why so few cancers occur compared with the theoretical number that could occur given the number of progenitor cells in the body and the normal mutation rate. We hypothesised that a contributory explanation is that the tumour microenvironment (TME) is not fixed, and that this could impair the ability of neoplastic cells to retain a high enough fitness to become a cancer. The TME has implicitly been assumed to be static in most cancer evolution models, and we therefore developed a mathematical model of spatial cancer evolution assuming that the TME, and thus the optimum cancer phenotype, change over time. Based on simulations, we show how cancer cell populations adapt to diverse changing TME conditions and fitness landscapes. Compared with static TMEs which generate neutral dynamics, changing TMEs lead to complex adaptations with spatio-temporal heterogeneity involving variable sub-clonal fitness, mixing, competition and phylogeny patterns. In many cases, cancer cell populations fail to grow or undergo spontaneous regression, and even extinction. Our analyses predict that cancer evolution in a changing TME is challenging, and can help to explain why cancer is neither inevitable nor as common as expected. Should cancer driver mutations with effects dependent of the TME exist, they are likely to be selected. Anti-cancer prevention and treatment strategies based on changing the TME are feasible and potentially effective.
Social stress as a priming mechanism for Thermal Tolerance During a Poleward Range Shift
Authors: Wood Connor , Fitt Robert N. L. , Lancaster Lesley T.
Published: July 2018

Cold tolerance plays a critical role in determining species’ geographical range limits. Previous studies have found that range shifts in response to climate warming are facilitated by cold acclimation capacities, due to increasingly colder and variable weather at high latitudes, and that cold tolerance can also be influenced by social factors. In this study we combined experiments and field studies to investigate the climatic and social factors affecting cold tolerances in range-shifting populations of the female-polymorphic damselflyIschnura elegansin northeast Scotland. In the field, we observed both environmental (measured via habitat suitability) and social (sex ratio and density) effects on cold tolerance (CTmin). Androchrome females (male-like females) were less susceptible to beneficial social effects on cold tolerance than gynochromes (female-like females), and correspondingly, gynochrome frequency increased at colder, environmentally-limiting sites towards the range margin. Our manipulations of density in the laboratory further provide novel, experimental evidence that social interactions directly impact cold tolerance n this species. These results suggest that reciprocal effects of social environments on thermal acclimation may be an important but commonly overlooked aspect of allee effects which contribute to the formation of range margins. Moreover, our results point to a wider need to consider the role of population and social dynamics to shape both the thermal physiology of individuals and the thermal niches of species.
Enforced expression of phosphatidylinositol 4-phosphate 5-kinase homolog (PIPKH) alters phosphatidylinositol 4,5-bisphosphate distribution and the localization of small G-proteins
Authors: Yang Yanbo , Park Miriam , Fairn Gregory D.
Published: July 2018

The generation of phosphatidylinositol 4,5-bisphosphate (PtdIns(4,5)P2) by phosphatidylinositol 4-phosphate 5-kinases (PIP5Ks) is essential for many of the functions including the control of cytoskeleton, signal transduction and endocytosis. Additionally, due to its presence in the plasma membrane and its anionic charge PtdIns(4,5)P2, together with phosphatidylserine, imbue the inner leaflet of the plasma membrane with a negative surface charge. This negative charge helps to define the identity of the plasma membrane as serves to recruit or regulate a multitude of proteins that contain polybasic domains or patches. Here we determine that the phosphatidylinositol 4-phosphate 5-kinase homolog (PIPKH) alters the subcellular distribution of PtdIns(4,5)P2 by re-localizing the PIP5Ks to endomembranes. Consistently, we find a redistribution of the PIP5K family members to endomembrane structures upon PIPKH overexpression that is accompanied by an accumulation of PtdIns(4,5)P2 and phosphatidylinositol 3,4,5-trisphosphate (PtdIns(3,4,5)P3), which further influences the distribution of endosomes and lysosomes. Additionally, we demonstrate that the accumulation of polyphosphoinositides increases their negative surface charge that in turn leads to the relocalization of surface charge probes as well as the polycationic proteins K-Ras and Rac1.
What determines bank interest rate spread? Evidence from Sub-Saharan Africa
Authors: Tarus Daniel Kipkirong , Manyala Philip Otieno
Published: July 2018

Purpose

The purpose of this paper is to examine the determinants of bank interest rate spread in Sub-Saharan African countries, which were categorized into macro-specific, bank-specific and institutional variables.

Design/methodology/approach

The authors used fixed effects estimations to analyze the data. The data were drawn from a pool of 20 Sub-Saharan African countries for a period of ten years spanning 2003–2012. The countries were categorized into low-income, lower middle-income and upper middle-income countries based on World Bank income classifications.

Findings

The results show that inflation has a negative and significant effect on interest rate spread, while operating costs and bank concentration have a positive and significant effect on interest rate spread. Similarly, government effectiveness, rule of law and political stability are negatively related to the interest rate spread.

Practical implications

The paper provides evidence that interest rate spread is determined by both bank-specific, macro-economic and institutional variables. The paper also indicates that the income status of a country is important in explaining the variations in the interest rate spread across the region. Therefore, the policy makers should design policies that take into account the variables in order to help in planning by all economic agents, including banks.

Originality/value

The paper uses data from Sub-Saharan Africa and introduces institutional variables in the model, which have been found to be critical in the context.
Perceptions and pathways of resilience in Addis Ababa
Authors: Baron Nicole , Cherenet Zegeye
Published: July 2018

Purpose

Resilience has recently attracted widespread interest in the field of urban planning and theory. However, the research that has been conducted on urban resilience in Africa has major theoretical and methodological gaps. This can lead to problems when designing and implementing resilience strategies there. Understanding African perspectives can be a way of tackling these. The paper aims to discuss these issues.

Design/methodology/approach

Using the example of Addis Ababa, Ethiopia, this paper analyses expert interviews based on a grounded theory approach. The goal is to explore locally specific perceptions of and pathways to urban resilience. By comparing these findings to those reported in the existing literature, differences and overlaps are identified.

Findings

This study provides evidence for the existence of locally specific perceptions of and pathways to urban resilience. Furthermore, it identifies urban development pathways such as complete urban makeover (tabula rasa) and complete negation of change (resistance).

Research limitations/implications

Because this study uses Addis Ababa as a singular case and expert interviews as method, it rather represents an initial attempt at exploring a new research field than claiming generalisability. Its quality and significance lie in its discursive approach and theory formation.

Practical implications

This exemplary study from Ethiopia demonstrates that a regionally specific understanding of urban resilience is valuable for the design and implementation of urban resilience strategies.

Originality/value

This study offers unique insights into urban resilience from an African perspective and into the manifestation of urban resilience in Addis Ababa.
Adaptive trajectory tracking controller design for a quadrotor UAV with payload variation
Authors: An Shuai , Yuan Suozhong , Li Huadong
Published: July 2018

Purpose

The purpose of this paper is to enhance the quadrotor’s capability of short-distance delivery to satisfy the large demand for quadrotor, which is used for goods distribution in huge warehouses, under time-varying payload and external wind disturbance.

Design/methodology/approach

A trajectory tracking controller design based on the combination of an adaptive sliding mode control (ASMC) method and the active disturbance rejection control (ADRC) technique is proposed. Besides, an inner–outer loop control system structure is adopted.

Findings

Simulation results of different trajectory tracking verify the effectiveness and robustness of the proposed tracking control method under various conditions, including parameter uncertainty and external wind disturbance. The proposed control strategy ensures that quadrotor UAV is capable of tracking linear and spiral trajectory well whether it loads or unloads goods in the presence of the external wind disturbance.

Originality/value

The proposed method of designing a trajectory tracking controller is based on an integral ADRC and ASMC scheme so as to deal with the trajectory tracking problem for a quadrotor with payload variation.
Platform-based service innovation and system design: a literature review
Authors: Fu Wenhui , Wang Qiang , Zhao Xiande
Published: July 2018

Purpose

The purpose of this paper is to systematically review the platform literature and synthesize the various topics of research into a common framework to reveal the relations between platform-based service innovation, system design and other platform-related factors.

Design/methodology/approach

A quantitative descriptive analysis led to an overview of the distribution of research focuses of the 187 sample articles identified by a well-established search strategy. A qualitative in-depth review was then used to clarify the detailed research topics and generate an overall conceptual model to link them, with a focus on platform-based service innovation and system design.

Findings

In total, 11 research topics of three research perspectives were identified and linked by a framework that accounts for the relationships between platform-based service innovation and system design and their influences on platform evolution. A small panel of industry experts validated the accuracy and utility of the proposed framework.

Originality/value

This paper provides an integrated framework for separately developed research perspectives and the topics investigated in the platform literature. Through the proposed framework, this paper helps to improve the knowledge on platform study and management, and lays a foundation for exploring the research opportunities in platform-based service innovation and system design.
Political Pressure or Rent Seeking? The Role of Mutual Funds in China's Split Share Structure Reform
Authors: Jiang Ping , Shao Xinjian , Xue Yi
Published: July 2018

In this paper, we provide further evidence on the role of mutual funds in China using the split share structure reform as an experiment. We find no supportive evidence for the political pressure hypothesis of Firth et al. (2010), but provide a set of unique results that are consistent with rent‐seeking behaviour by mutual funds. In addition, fund‐level governance can weaken the negative relationship between compensation ratio and fund ownership. Finally, we document a specific form of private benefits that can contribute to rent‐seeking behaviour by mutual funds.
Weeds, Pheasants and Wild Dogs: Resituating the Ecological Paradigm in Postindustrial Detroit
Authors: Draus Paul , Roddy Juliette
Published: July 2018

The Chicago School of urban sociology has been criticized for its over‐reliance on organic and ecological metaphors. We propose that a useful updated integration of urban sociology and ecology could be achieved with the aid of complementary concepts, such as patch dynamics and assemblage, from both fields. In this exploratory article, we draw on more than 50 qualitative interviews conducted with residents of three different Detroit neighborhoods, together with field observations, photographs and documentary evidence, to examine both actual and metaphorical references to the natural world. We consider allusions to ‘drug infestation’ as well as other references to territorialization processes and associations with plants and animals that emerged out of our interviews and interactions with neighborhood residents. In conclusion, we maintain that social science may have much to learn from contemporary ecological research, and that a resituated ecological paradigm would challenge and benefit contemporary urban research.
Income Dynamics, Pro‐Poor Mobility and Poverty Persistence Curves
Authors: Creedy John , Gemmell Norman
Published: July 2018

This paper explores poverty income dynamics in the form of income mobility by the poor and poverty persistence, making use of simple diagrams. It seeks to illustrate the extent to which income mobility is pro‐poor and when mobility is associated with persistence below, or movement across, a poverty line over a specified time period. While statistical measures can be used to examine detailed characteristics of income dynamics, two simple diagrams are shown to capture the extent of pro‐poor mobility and poverty persistence respectively in ways that allow convenient comparisons. These are referred to as a ‘three Is of mobility’ curve, and a ‘poverty persistence curve’, The curves are illustrated using anonymised Inland Revenue longitudinal individual income data for New Zealand over 2006–2010.
Impact of the National Emergency Access Target policy on emergency departments’ performance: A time‐trend analysis for New South Wales, Australian Capital Territory and Queensland
Authors: Forero Roberto , Man Nicola , McCarthy Sally , Richardson Drew , Mohsin Mohammed , Toloo Ghasem (Sam) , FitzGerald Gerry , Ngo Hanh , Mountain David , Fatovich Daniel , Celenza Antonio , Gibson Nick , Xu Fenglian , Nahidi Shizar , Hillman Ken
Published: July 2018

Objective

To evaluate the impact of the Australian National Emergency Access Target (NEAT) policy introduced in 2012 on ED performance.

Methods

A longitudinal cohort study of NEAT implementation using linked data, for 12 EDs across New South Wales (NSW), Australian Capital Territory (ACT) and Queensland (QLD) between 2008 and 2013. Segmented regression in a multi‐level model was used to analyse ED performance over time before and after NEAT introduction. The main outcomes measures were ED length of stay ≤4 h, access block, number of ED presentations, short‐stay admission (≤24 h), >24 h admissions, unplanned ED re‐attendances within 7 days and ‘left at own risk’ (including ‘did not wait for assessment’).

Results

Two years after NEAT introduction, ED length of stay ≤4 h increased in NSW and QLD (odds ratio [OR] = 2.48 and 3.24; P < 0.001) and access block decreased (OR = 0.41 and 0.22; P < 0.001), but not in ACT (OR = 1.28; P > 0.05). ED presentations increased over time before and after NEAT introduction with a significant increase above the projected trend in NSW after NEAT (mean ratio = 1.07). Short‐stay admissions increased in QLD (OR = 2.60), ACT (OR = 1.68) and NSW (OR = 1.35). Unplanned ED re‐attendances did not change significantly. Those who left at their own risk decreased significantly in NSW and QLD (OR = 0.38 and 0.67).

Conclusion

ED presentations continued to increase over time in all jurisdictions. NSW and QLD, but not ACT, showed significant improvements in time‐based measures. Significant increases in short‐stay admissions suggest a strategic change in ED process associated with NEAT implementation. Rates of unplanned ED re‐attendances and those leaving at their own risk showed no evidence for adverse effects from NEAT.
Employee performance, well‐being, and differential effects of human resource management subdimensions: Mutual gains or conflicting outcomes?
Authors: Ogbonnaya Chidiebere , Messersmith Jake
Published: July 2018

The human resource management (HRM) literature supports the idea that coherent systems of HRM practices can induce attitudinal effects when perceived subjectively by employees. Recently, scholars have proposed that subdimensions of HRM systems exist and account for variance in outcomes. This study explores differential effects of three subdimensions of HRM systems (skill‐, motivation‐, and opportunity‐enhancing HRM practices) on employee innovative behaviours and well‐being. Our predictions are based on the mutual gains perspective, which specifies positive relationships between HRM practices and employee performance, and the conflicting outcomes perspective that links HRM practices to higher job demands and stress. Using data from the Finnish 2012 Practices of Working Life Survey, we find support for both the mutual gains and conflicting outcomes perspectives; however, we also show that the effects of the subsets of HRM practices are heterogeneous.
Stereotactic radiosurgery to surgical cavity post resection of brain metastases: Local recurrence and overall survival rates. A single‐centre experience
Authors: Higgins Martin J , Burke Orlaidh , Fitzpatrick David , Nugent Killian G , Skourou Christina , Dunne Mary , Javadpour Mohsen , Faul Clare
Published: July 2018

Introduction

We reviewed local control (LC) and overall survival (OS) post intracranial SRS to cavity post resection of brain metastases at one institution, and factors affecting LC.

Methods

A retrospective review was conducted of adjuvant SRS at one institution from 2013 to 2016. Patient records, treatment plans and diagnostic images were reviewed. Local failure was MRI defined. Categorical variables were analysed using chi‐square and Fisher's exact tests. Continuous variables were analysed using Mann–Whitney tests. The Kaplan–Meier method was used to estimate survival times and the log‐rank test was used to compare differences in survival.

Results

Forty‐seven patients with 48 cavities were treated with SRS post operatively. LC rate was 69%, and the distant intracranial failure rate was 47% for entirety of the follow‐up period. The 12‐month freedom from local recurrence (FFLR) was 77% (63–91%). Median OS (95% CI) was 22.7 (14.6–30.8) months. Patients with a single metastasis had longer FFLR (30.1 vs 14.4 months; P = 0.014). Median interval from surgery to SRS was 6.3 weeks. Patients with interval >7 weeks had increased local recurrence (LR) (62%) than <7 weeks (37%), P = 0.025. Patients with a margin < 2 mm were more likely to experience LR (48%) than those with margin equal to 2 mm (20%); this approached statistical significance (P = 0.063). The median follow‐up for all patients was 15.4 months (2–41).

Conclusions

We determined LC and OS post adjuvant SRS at our institution. Based on the findings of this retrospective review SRS should be given promptly post operatively with a 2 mm PTV margin.
Contrasting community composition of endospores and vegetative Firmicutes in a marine sediment suggests both endogenous and exogenous sources of endospore accumulation
Authors: Cupit Carina , Lomstein Bente Aagaard , Kjeldsen Kasper Urup
Published: July 2018

Bacterial endospores are highly abundant in marine sediments, but their taxonomic identity and ecology is largely unknown. We selectively extracted DNA from endospores and vegetative cells and sequenced 16S rRNA genes to characterize the composition of the endospore and vegetative Firmicutes communities in the sediment and water column of Aarhus Bay (Denmark). The endospore community in the sediment was dominated by the families Bacillaceae, Lachnospiraceae, Clostridiaceae and Ruminoccocaceae. These families were also represented in the vegetative community in the sediment and the endospore community in the water column. OTUs of high relative abundance in the endospore community were also represented in the vegetative Firmicutes community. Other OTUs were exclusively found in the endospore communities. This suggests that endospores accumulate in marine sediments due to passive deposition from the water column and sporulation of vegetative cells in the sediment. Some OTUs were detected in the endospore community of the water column and the vegetative community the sediment indicating that endospores deposited from the water column may germinate upon burial/deposition in the sediment. We provide novel insight into the composition of endospore communities in marine sediments and highlight their role in microbial dispersal and as a seed bank in subsurface sediments.
Long‐term carriage and rapid transmission of extended spectrum beta‐lactamase‐producing E. coli within a flock of Mallards in the absence of antibiotic selection
Authors: Sandegren Linus , Stedt Johan , Lustig Ulrika , Bonnedahl Jonas , Andersson Dan I. , Järhult Josef D.
Published: July 2018

Wild birds have been suggested as transmitters and reservoirs for antibiotic resistant bacteria. We performed an experimental study investigating carriage time and interindividual transmission of extended spectrum beta‐lactamase‐ (ESBL‐)producing Escherichia coli in Mallards (Anas platyrhynchos) to assess if the birds carry the bacteria long enough to transfer them geographically during migration. Mallards were inoculated intraoesophageally with four different strains of ESBL‐producing E. coli and kept together in a flock. The ESBL‐strains belonged to sequence types previously shown to spread between birds and humans. Culturing from faecal samples showed presence of ESBL‐producing E. coli the entire 29 day experimental period. An extensive and rapid transmission of the different ESBL‐strains between individuals (including non‐inoculated controls) was observed. In necropsy samples, we detected ESBL‐strains in the cecum even in faeces‐negative birds, indicating that this part of the intestine could function as a reservoir of resistant bacteria. We demonstrate that birds can carry ESBL‐producing E. coli for long enough times to travel far during migration and the extensive interindividual transmission suggests spread between individuals in a dense bird population as a mechanism that allow persistence of resistant bacteria.
Give the machine a hand: A Boolean time‐based decision‐tree template for rapidly finding animal behaviours in multisensor data
Authors: Wilson Rory P. , Holton Mark D. , di Virgilio Agustina , Williams Hannah , Shepard Emily L. C. , Lambertucci Sergio , Quintana Flavio , Sala Juan E. , Balaji Bharathan , Lee Eun Sun , Srivastava Mani , Scantlebury D. Michael , Duarte Carlos M.
Published: July 2018

The development of multisensor animal‐attached tags, recording data at high frequencies, has enormous potential in allowing us to define animal behaviour.

The high volumes of data, are pushing us towards machine‐learning as a powerful option for distilling out behaviours. However, with increasing parallel lines of data, systems become more likely to become processor limited and thereby take appreciable amounts of time to resolve behaviours.

We suggest a Boolean approach whereby critical changes in recorded parameters are used as sequential templates with defined flexibility (in both time and degree) to determine individual behavioural elements within a behavioural sequence that, together, makes up a single, defined behaviour.

We tested this approach, and compared it to a suite of other behavioural identification methods, on a number of behaviours from tag‐equipped animals; sheep grazing, penguins walking, cheetah stalking prey and condors thermalling.

Overall behaviour recognition using our new approach was better than most other methods due to; (1) its ability to deal with behavioural variation and (2) the speed with which the task was completed because extraneous data are avoided in the process.

We suggest that this approach is a promising way forward in an increasingly data‐rich environment and that workers sharing algorithms can provide a powerful library for the benefit of all involved in such work.
Clonal expansion of mitochondrial DNA deletions is a private mechanism of aging in long‐lived animals
Authors: Lakshmanan Lakshmi Narayanan , Yee Zhuangli , Ng Li Fang , Gunawan Rudiyanto , Halliwell Barry , Gruber Jan
Published: July 2018

Disruption of mitochondrial metabolism and loss of mitochondrial DNA (mtDNA) integrity are widely considered as evolutionarily conserved (public) mechanisms of aging (López‐Otín et al., Cell, 153, 2013 and 1194). Human aging is associated with loss in skeletal muscle mass and function (Sarcopenia), contributing significantly to morbidity and mortality. Muscle aging is associated with loss of mtDNA integrity. In humans, clonally expanded mtDNA deletions colocalize with sites of fiber breakage and atrophy in skeletal muscle. mtDNA deletions may therefore play an important, possibly causal role in sarcopenia. The nematode Caenorhabditis elegans also exhibits age‐dependent decline in mitochondrial function and a form of sarcopenia. However, it is unclear if mtDNA deletions play a role in C. elegans aging. Here, we report identification of 266 novel mtDNA deletions in aging nematodes. Analysis of the mtDNA mutation spectrum and quantification of mutation burden indicates that (a) mtDNA deletions in nematode are extremely rare, (b) there is no significant age‐dependent increase in mtDNA deletions, and (c) there is little evidence for clonal expansion driving mtDNA deletion dynamics. Thus, mtDNA deletions are unlikely to drive the age‐dependent functional decline commonly observed in C. elegans. Computational modeling of mtDNA dynamics in C. elegans indicates that the lifespan of short‐lived animals such as C. elegans is likely too short to allow for significant clonal expansion of mtDNA deletions. Together, these findings suggest that clonal expansion of mtDNA deletions is likely a private mechanism of aging predominantly relevant in long‐lived animals such as humans and rhesus monkey and possibly in rodents.
A Case–Control Study of Sonographic Maximum Ovarian Diameter as a Predictor of Ovarian Torsion in Emergency Department Females With Pelvic Pain
Authors: Budhram Gavin , Elia Tala , Dan Jeff , Schroeder Michele , Safain Golien , Schlech Walter , Friderici Jennifer , Knee Alex , Anthouard Magalie , Schoenfeld Elizabeth
Published: July 2018

Background

Color and power Doppler ultrasound are commonly used in the evaluation of ovarian torsion but are unreliable. Because normal‐sized ovaries are unlikely to cause torsion, maximum ovarian diameter (MOD) could theoretically be used as a screening test in the ED. Identification of MOD values below which torsion is unlikely would be of benefit to providers interpreting radiology department or point‐of‐care pelvic ultrasound.

Objectives

The objective was to determine if sonographic MOD can be used as a screening tool to rule out torsion in selected patients.

Methods

Via a retrospective case–control study spanning a 14‐year period, we examined the ultrasound characteristics of patients with torsion and age‐matched controls, all presenting to the emergency department with lower abdominal pain and receiving a radiology department pelvic ultrasound for “rule‐out torsion.” Standardized data collection forms were utilized. Distributions of MOD were compared and sensitivity, specificity, and likelihood ratios were calculated for multiple cutoffs.

Results

We identified 92 cases of surgically confirmed ovarian torsion and selected 92 age‐matched controls. In postmenarchal patients the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 3‐ and 5‐cm MODs were 100% (96%–100%), 30% (20%–41%), 1.4 (1.3–1.7), and 0 and 91% (83%–97%), 92% (83%–97%), 11.2 (5.5–22.9), and 0.09 (0.04–0.19), respectively. The 5‐cm MOD, however, excluded an additional 52 of 84 (62%) postmenarchal patients.

Conclusions

A threshold MOD of 5 cm on pelvic ultrasound may be useful to rule out ovarian torsion in postmenarchal females presenting with lower abdominal and pelvic pain.
Asthma diagnosis using integrated analysis of eosinophil microRNAs
Authors: Rodrigo‐Muñoz José M. , Cañas José A. , Sastre Beatriz , Rego Natalia , Greif Gonzalo , Rial Manuel , Mínguez Pablo , Mahíllo‐Fernández Ignacio , Fernández‐Nieto Mar , Mora Inés , Barranco Pilar , Quirce Santiago , Sastre Joaquín , del Pozo Victoria
Published: July 2018

Background

Asthma is a syndrome characterized by airway inflammation and obstruction. Due to its heterogeneity, the difficulties in asthma diagnosis and treatment make the discovery of new biomarkers a focus of research. So, we determined the differential miRNA expression of eosinophils between healthy and asthmatic patients and to establish a differentially expressed miRNA profile detectable in sera for use as biomarker.

Methods

MicroRNAs from peripheral eosinophils from healthy and asthmatic subjects were isolated and analyzed by next‐generation sequencing and confirmed by quantitative PCR in 29 asthmatics and 10 healthy individuals. The levels of serum miRNAs were performed by quantitative PCR in 138 asthmatics and 39 healthy subjects. Regression analysis and Random Forest models were performed.

Results

We found a set of miRNAs whose expression differs between eosinophils from asthmatics and healthy subjects. These miRNAs can classify asthmatics into two clusters that differed in the number of eosinophils and periostin concentration in serum. Some of these miRNAs were also confirmed in sera, as miR‐185‐5p which discriminates asthmatics from healthy subjects. Together with other two miRNAs, miR‐185‐5p allowed us to create a logistic regression model to discriminate better both conditions and a Random Forest model that can even sort the asthmatics into intermittent, mild persistent, moderate persistent, and severe persistent asthma.

Conclusion

Our data show that miRNAs profile in eosinophils can be used as asthma diagnosis biomarker in serum and that this profile is able to rank asthma severity.
A multicentre prospective cohort study of the accuracy of conventional landmark technique for cricoid localisation using ultrasound scanning
Authors: Lee D , Czech A. J. , Elriedy M. , Nair A. , El‐Boghdadly K. , Ahmad I.
Published: July 2018

Cricoid pressure is employed during rapid sequence induction to reduce the risk of pulmonary aspiration. Correct application of cricoid pressure depends on knowledge of neck anatomy and precise identification of surface landmarks. Inaccurate localisation of the cricoid cartilage during rapid sequence induction risks incomplete oesophageal occlusion, with potential for pulmonary aspiration of gastric contents. It may also compromise the laryngeal view for the anaesthetist. Accurate localisation of the cricoid cartilage therefore has relevance for the safe conduct of rapid sequence induction. We conducted a multicentre, prospective cohort study to determine the accuracy of cricoid cartilage identification in 100 patients. The cranio‐caudal midpoint of the cricoid cartilage was identified by a qualified anaesthetic assistant using the conventional landmark technique and marked. While maintaining the patient in the same position, a second mark was made by identifying the midpoint of the cricoid cartilage using ultrasound scanning. The mean (SD) distance between the two marks was 2.07 (8.49) mm. In 41% of patients the midpoint was incorrectly identified by a margin greater than 5 mm. This error was uniformly distributed both above and below the midpoint of the cricoid cartilage. The Pearson correlation coefficient of this error with respect to body mass index was 0.062 (p = 0.539) and with age was −0.020 (p = 0.843). There were also no significant differences in error between male and female patients. Identification of cricoid position using a landmark technique has a high degree of variability and has little correlation with age, sex or body mass index. These findings have significant implications for the safe application of cricoid pressure in the context of rapid sequence induction.
BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program
Authors: Puślecki Mateusz , Ligowski Marcin , Dąbrowski Marek , Stefaniak Sebastian , Ładzińska Małgorzata , Ładziński Piotr , Pawlak Aleksander , Zieliński Marcin , Dąbrowska Agata , Artyńska Aniela , Gezela Mariusz , Sobczyński Paweł , Szarpak Łukasz , Perek Bartłomiej , Jemielity Marek
Published: July 2018

The implemented “ECMO for Greater Poland” program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases. ECMO enables recovery of organs’ function after unsuccessful lifesaving treatment. Because this organizational model is complex and expensive, we use advanced high‐fidelity medical simulation to prepare for real‐life implementation. During the first four months, we performed scenarios mimicking “ECMO for DCD,” “ECMO for ECPR (extended cardiopulmonary resuscitation),” “ECMO for RRF” and “ECMO in hypothermia.” It helped to create algorithms for aforementioned program arms. In the following months, three ECMO courses for five departments in Poznan (capitol city of Greater Poland) were organized and standardized operating procedures for road ECMO transportation within Medical Emergency System were created. Soon after simulation program, 38 procedures with ECMO perfusion therapy including five road transportations on ECMO were performed. The Maastricht category II DCD procedures were done four times on real patients and in two cases double successful kidney transplantations were carried out for the first time in Poland. ECMO was applied in two patients with hypothermia, nine adult patients with heart failure, and five with RRF, for the first time in the region. In the pediatric group, ECMO was applied in four patients with RRF and 14 with heart failure after cardiac surgery procedures. Additionally, one child was treated successfully following 200 km‐long road transport on ECMO. We achieved good and promising results especially in VV ECMO therapy. Simulation‐based training enabled us to build a successful procedural chain, and to eliminate errors at the stage of identification, notification, transportation, and providing ECMO perfusion therapy. We discovered the important role of medical simulation, not only to test the medical professional’s skills, but also to promote ECMO therapy in patients with critical/life‐threatening states. Moreover, it also resulted in increase of the potential organ pool from DCD in the Greater Poland region.
Oximetry knowledge in neonatal units in Victoria, Australia: can we do better?
Authors: Jamieson Katharine , Davey Margot J. , Nixon Gillian M.
Published: July 2018

Aim

Pulse oximetry has become a widely used technology in medicine and is a standard part of monitoring in neonatal medicine. Knowledge of basic principles, clinical and technical considerations is important to optimise clinical benefit of use, but have been shown to be insufficient in paediatric staff. We aimed to assess knowledge of pulse oximetry in neonatal medical staff, a population not previously studied.

Methods

A 21‐item questionnaire (seven demographic, 14 knowledge) was devised and then administered to neonatal medical staff at all postgraduate levels working in the major public neonatal services in the state of Victoria, Australia.

Results

Average test score was 64.4% (range 30.8–92.3%) with no correlation between years of experience and score. All respondents reported experience with oximetry, but only 57% reported adequate training in practical oximetry skills and only 28% in interpretation of downloaded oximetry data. About 45% reported knowing what an averaging time was but only 29% were able to provide an acceptable definition and only 10% knew what averaging time was used on devices in their units.

Conclusion

Significant knowledge deficits regarding oximetry are evident in neonatal staff, supporting the need for targeted and continuous training in oximetry.
Histopathological examination of the placenta in twin pregnancies
Authors: Fitzgerald Brendan
Published: July 2018

Twin placentas are frequently received in pathology laboratories for evaluation of chorionicity and because twin pregnancies have higher rates of pregnancy complications. In addition to pathologies common in singleton pregnancies, twin pregnancies have increased frequencies of complications such as preterm birth and velamentous cord insertions and also are affected by complications unique to multiple pregnancies that are mediated by vascular connections between the placental territories of certain types of twins. This article aims to provide an approach to examination of the twin placenta for practicing pathologists or those interested in placental pathology while outlining the key characteristics of twin complications as seen in the placenta.
Indications for submission and macroscopic examination of the placenta
Authors: Baergen Rebecca N.
Published: July 2018

The placenta is a fetal organ, composed of fetal DNA and as such reflects the fetal phenotype. The placenta consists of an umbilical cord, fetal membranes (amnion and chorion), and the placental disc which in turn is comprised of villous tissue. Both maternal and fetal disorders have placental sequelae and placental abnormalities can affect both maternal and fetal well‐being. As such, placentas are often helpful in future maternal and neonatal healthcare. Thus, examination of the placenta is important for both mother and infant. On this basis, a list of indications for placental examinations has been created by a multidisciplinary group of pathologists, maternal‐fetal‐medicine specialists, and neonatologists that, if followed, will ensure that the vast majority of placentas that ultimately show any significant pathology will be examined (Arch Pathol Lab Med, 121, 1997, 449–76). This list include fetal, maternal, and placental indications. This chapter will discuss those indications as well as give a brief overview of macroscopic placental examination and procedure.
The placenta in intrauterine demise
Authors: Boyd Theonia K.
Published: July 2018

Placental changes in intrauterine demise can be similar to antemortem pathologic processes. This chapter provides an overview of postmortem placental changes, and provides an algorithmic set of considerations for discriminating between ante‐ and postmortem pathology.
Maternal vascular malperfusion of the placental bed
Authors: Ernst Linda M.
Published: July 2018

Maternal vascular malperfusion (MVM) of the placental bed represents a recognizable pattern of placental injury related to altered uterine and intervillous blood flow. MVM consists of a constellation of placental pathologic findings seen in the maternal decidual vessels, reflecting abnormal spiral artery remodeling, as well as in the villous parenchyma, reflecting abnormalities in oxygenation and flow dynamics in the intervillous space. This review is dedicated to the gross pathology, microscopic pathology, updated terminology, and clinical implications of MVM.
Early Holocene sea level in the Canadian Beaufort Sea constrained by radiocarbon dates from a deep borehole in the Mackenzie Trough, Arctic Canada
Authors: O'Regan Matt , Coxall Helen , Hill Philip , Hilton Robert , Muschitiello Francesco , Swärd Henrik
Published: July 2018

Deglacial and Holocene relative sea level (RSL) in the Canadian Beaufort Sea was influenced by the timing and extent of glacial ice in the Mackenzie River corridor and adjacent coastal plains. Considerable evidence indicates extensive ice cover in this region of northwestern Canada during the Late Wisconsinan. However, no absolute ages exist to constrain maximum RSL lowering before the late Holocene (4.2–0 ka). In 1984, the Geological Survey of Canada drilled an 81.5‐m‐deep borehole in the western Mackenzie Trough at 45 m water depth (MTW01). The lower 52.5 m of the borehole was interpreted as a deltaic progradational sequence deposited during a period of rising sea level. The upper 29 m was described as foraminifer‐bearing marine sediments deposited after transgression of the site, when RSL rose above ~−74 m. Here, we present radiocarbon measurements from MTW01, acquired from benthic foraminifera, mollusc fragments and particulate organic carbon in the >63 μm fraction (POC>63 μm) in an attempt to constrain the chronology of sediments within this borehole and date the timing of transgression. The deepest carbonate macrofossil was acquired from 8 m above the transgressive surface (equivalent to 21 m b.s.l.), where mollusc fragments returned a date of 9400 +180–260 cal. a BP (2σ). This provides the oldest constraint on Holocene sea‐level lowering in the region, and implies that transgression at this site occurred prior to the early Holocene. Ages obtained from the lower 52.5 m of the borehole are limited to POC>63 μm samples. These indicate that progradational sediments were deposited rapidly after 24 820 +390–380 cal. a BP (2σ). Due to the incorporation of older reworked organic matter, the actual age of progradation is likely to be younger, occurring after Late Wisconsinan glacial ice retreated from the coast.
Sensitization to Hymenoptera venom marker allergens: Prevalence, predisposing factors, and clinical implications
Authors: Stoevesandt Johanna , Hosp Christine , Kerstan Andreas , Trautmann Axel
Published: July 2018

Background

The prevalence and predisposing factors of asymptomatic sensitization to Hymenoptera venom marker allergens are largely unknown.

Objective

To evaluate sensitization profiles in a group of 490 dermatologic patients without a history of sting‐induced anaphylaxis.

Methods

Clinical data were collected using a structured questionnaire; sera were tested for total IgE and specific IgE to venom preparations, recombinant venom marker allergens, inhalative allergens, and cross‐reactive carbohydrate determinants.

Results

The lifetime prevalence of Hymenoptera stings was 85.3%. IgE rates exceeding cut‐off values of 0.35 kUA/L were 17.3% for rVes v 1, 18.0% for rVes v 5, and 3.5% for rApi m 1. Median specific/total IgE ratios for the above mentioned marker allergens were 0.05%, 0.02%, and 0.00%, respectively. Marker allergen‐directed sensitization was detectable in 85.5% of 138 Vespula venom‐reactive sera. Of 68 bee venom‐reactive participants, 23.5% were sensitized to rApi m 1 and 64.7% to any one or several of five commercially available bee venom allergens. Although double reactivity to bee and Vespula venom was clearly associated with sensitization to cross‐reactive carbohydrate determinants (P < 0.001), sensitization to marker allergens of both species was detectable in most double‐reactive sera (56.5%). Vespula venom marker allergen‐directed sensitization was associated with recent stings (P = 0.010), large local reactions (P = 0.009), total IgE elevation (P < 0.001), and sensitization to cross‐reactive carbohydrate determinants (P = 0.008).

Conclusions and Clinical Relevance

The high sensitization rates observed in individuals without a history of sting‐induced anaphylaxis as well as total IgE levels and cross‐reactive carbohydrate determinant‐directed reactivity as potential confounders need to be considered in any interpretation of positive test results for Hymenoptera venom marker allergens.
Immunogenicity and predictors of response to a single dose trivalent seasonal influenza vaccine in multiple sclerosis patients receiving disease‐modifying therapies
Authors: Metze Christoph , Winkelmann Alexander , Loebermann Micha , Hecker Michael , Schweiger Brunhilde , Reisinger Emil Christian , Zettl Uwe Klaus
Published: July 2018

Aims

To evaluate the immunogenicity and safety of a seasonal influenza vaccine in a cohort of multiple sclerosis (MS) patients receiving different immunomodulating/immunosuppressive therapies and assess predictors of immune response.

Methods

A prospective, multicenter, non‐randomized observational study including 108 patients receiving a trivalent seasonal influenza vaccination was conducted. Influenza‐specific antibody titers (H1N1, H3N2, and influenza B) were measured to evaluate rates of seroprotection and seroconversion/significant titer increase. Univariable and multivariable analyses were performed to identify prognostic factors of vaccination outcomes.

Results

Regarding the whole cohort, seroprotection rates >70% were achieved for each influenza strain. Interferon‐treated patients reached high seroprotection rates (>84%). Good seroprotection rates were seen in patients treated with glatiramer acetate. In particular for H3N2, response rates were low in natalizumab‐treated patients and in the small subgroup of fingolimod‐treated patients. Patients with a previous disease‐modifying therapy and a longer disease duration were less likely to respond sufficiently. No severe adverse events were reported. MS disease activity was not increased after a one‐year follow‐up period.

Conclusion

Vaccination led to good immunogenicity, especially in MS patients treated with interferons and glatiramer acetate. At least for the H1N1 strain, rates of seroprotection and seroconversion/significant titer increase were high (>70% and >60%, respectively) for all therapeutic subgroups. Patients with a longer duration of the disease are exposed to an increased risk of insufficient immune response to vaccination.