bluuebunny/crossref_metadata_2025 huggingface dataset:
Bark traits, decomposition and flammability of Australian forest trees
Authors: Grootemaat Saskia , Wright Ian J. , van Bodegom Peter M. , Cornelissen Johannes H. C. , Shaw Veronica
Published: July 2017

Bark shedding is a remarkable feature of Australian trees, yet relatively little is known about interspecific differences in bark decomposability and flammability, or what chemical or physical traits drive variation in these properties. We measured the decomposition rate and flammability (ignitibility, sustainability and combustibility) of bark from 10 common forest tree species, and quantified correlations with potentially important traits. We compared our findings to those for leaf litter, asking whether the same traits drive flammability and decomposition in different tissues, and whether process rates are correlated across tissue types. Considerable variation in bark decomposability and flammability was found both within and across species. Bark decomposed more slowly than leaves, but in both tissues lignin concentration was a key driver. Bark took longer to ignite than leaves, and had longer mass-specific flame durations. Variation in flammability parameters was driven by different traits in the different tissues. Decomposability and flammability were each unrelated, when comparing between the different tissue types. For example, species with fast-decomposing leaves did not necessarily have fast-decomposing bark. For the first time, we show how patterns of variation in decomposability and flammability of bark diverge across multiple species. By taking species-specific bark traits into consideration there is potential to make better estimates of wildfire risks and carbon loss dynamics. This can lead to better informed management decisions for Australian forests, and eucalypt plantations, worldwide.
Drivers of change in the relative abundance of dugongs in New Caledonia
Authors: Cleguer C. , Garrigue C. , Fuentes M. M. P. B. , Everingham Y. , Hagihara R. , Hamann M. , Payri C. , Marsh H.
Published: July 2017

Context
Sound understanding of temporal changes in the abundance of wildlife species is required for assessing their status and for effective conservation and management. In New Caledonia, a single baseline aerial survey of dugongs in 2003 estimated a population of 2026 (± 553 s.e.) individuals. A second, similar survey in 2008 produced a lower estimate of 606 (± 200 s.e.) individuals, leading to concerns that the dugong population was experiencing a decline.

Aims
This study used data collected from additional aerial surveys with the aim of updating information on the current size of the dugong population in New Caledonia and investigating the drivers of change in the estimates.

Methods
Four additional surveys were conducted: one in each of the cool (June) and warm (November) seasons of 2011 and 2012 around the main Island of New Caledonia. Dugong relative abundance and density were calculated and compared among survey years and survey regions. Drivers of change in the dugong population size were then investigated.

Key results
The abundance estimates obtained from our four surveys ranged from 649 (± 195 s.e.) to 1227 (± 296 s.e.) dugongs. These new results were not significantly different to the 2008 estimate but were significantly lower than the 2003 estimate. There was no significant variation in the proportion of calves throughout the entire time series of surveys.

Conclusions
The dugong population of New Caledonia was relatively stable between 2008 and 2012. We could not find sufficient evidence to show whether the discrepancy between 2003 and the remainder of the time series is due to a real decline in the population or the result of the confounding effects of variation in environmental conditions, animal behaviour and sampling biases.

Implications
The stability of the dugong population between 2008 and 2012 is a positive outcome for local conservation and management of dugongs. This study also highlights the advisability of replicating baseline surveys to enable robust interpretation of temporal variation in population size estimates, and in turn, to improve the management of wildlife species.
How words for sensory experiences become terms
Authors: Dubois Danièle
Published: July 2017

Given the double nature ofexperiencing foodas individual as well as shared experience and knowledge, the question is how to connect the observed variability of expressing such a sensory experience with a normalized requirement for developing (food) terminology. On the basis of descriptions of food experiences in actual practices involving the way food is consumed, evaluated and expressed by individuals – experts or not – in all their diversity, we propose to contribute cognitive (psychological and linguistic) expertise to terminology research. We analyze terms as cognitive units, defined within a psychological theory of natural categories as acts of meaning. In tracking the processes of terminological meaning construction in discourse we find intersubjective experience within the complex process of terminologization.
Babel of the senses
Authors: Suárez-Toste Ernesto
Published: July 2017

Of all the varieties of sensory experience, wine appreciation seems to be one of the most rewarding yet also one of the most challenging to verbalize. This is largely due to a lack of scientific terminology capable of describing sensory impressions (in turn related to how little is known about human perception). Wine language is highly unspecific and figurative, depending on a weakly standardized community practice rather than a solid and comprehensive range of descriptors. In this paper I study figurative language and verbal creativity in a corpus of 12,000 English and Spanish wine reviews by focusing specifically on metaphor and synesthesia as the resources that best exemplify (and often manage to overcome) many of the genre’s shortcomings. In addition to the discussion of quantitative results, a case study in synesthesia is offered as illustration of the genre’s complexities, complemented by a contrastive discussion of how similar difficulties are handled in different ways in English and Spanish.
Food terminology as a system of cultural communication
Authors: Faber Pamela , Vidal Claramonte M. Carmen África
Published: July 2017

In this study on food terminology and culture, Frame-based Terminology Theory (FBT) (Faber 2012, 2015) was combined with corpus analysis to explore the use of culture-specific terms in the food categories of bread and rice. For the sake of comparison, semplates (Levinson and Burenhult 2009; Burenhult 2008) were formulated for food, bread, and rice, as a kind of cultural frame to highlight the relatedness of these categories, based on the actions that were most frequently linked to them in our corpus. For this purpose, an FBT semantic analysis of these terms in a general language corpus was combined with an analysis of their cultural contexts in the literary work of authors such as Sandra Cisneros, Najat El Hachmi, Chimamanda Adichie, and others. The situations portrayed in their novels reflect the cultural embeddedness of food and its communicative value.
Hydrogen permeation through deformed and heat-treated Armco pure iron
Authors: Van den Eeckhout E. , Laureys A. , Van Ingelgem Y. , Verbeken K.
Published: July 2017

The goal of this study is to obtain a deeper insight in the relation between hydrogen diffusion and hydrogen traps present in Armco pure iron. Cold deformation was applied to this material, which initially contained a limited amount of traps. The cold deformation was applied to increase the dislocation density and modify grain boundary characteristics. In this way, the hydrogen diffusivity decreased as the hydrogen trapping ability of the microstructure increased. A subsequent heat treatment allowed changing the density of microstructural defects again and consequently increased the hydrogen diffusion coefficient. In addition, studying blister formation showed that a higher degree of deformation caused more surface blisters, while recovery lowered the number of blisters. Electron backscatter diffraction characterisation provided the necessary input on the microstructural features and their evolution. Analysis of these samples allowed evaluating the correlation between hydrogen diffusion, blister formation and microstructural defects.

This paper is part of a thematic issue on Hydrogen in Metallic Alloys
Ultrafine-grained W–25 wt-%Cu composite with superior high-temperature characteristics
Authors: Zhang Qiao , Liang Shuhua , Zhuo Longchao
Published: July 2017

In the present work, several ultrafine-grained W–Cu composites with bi-continuous microstructure have been prepared through combined processes of high-energy ball-milling, liquid-phase sintering and infiltration. The microstructure, relative density, hardness and electrical conductivity of the W–Cu composites with copper content ranging from 20 to 35 wt-% were investigated to determine the optimal composition. Then, the high-temperature characteristics such as thermo-mechanical stability, high-temperature compressive performance and high-temperature wear behaviour of the optimal W–25 wt-%Cu composite were systematically assessed in comparison with those of the micron-sized W–25 wt-%Cu composite. The results showed that the ultrafine-grained W–Cu composite exhibited distinctly superior thermo-mechanical stability, as well as high-temperature compressive and wear-resistant properties, indicating its great potential in enduring repeated contact-loading at high temperature.
Abscisic acid modulates salicylic acid biosynthesis for systemic acquired resistance in tomato
Authors: Kusajima Miyuki , Okumura Yasuko , Fujita Moeka , Nakashita Hideo
Published: July 2017

Among the regulatory mechanisms of systemic acquired resistance (SAR) in tomato, antagonistic interaction between salicylic acid (SA) and abscisic acid (ABA) signaling pathways was investigated. Treatment with 1,2-benzisothiazol-3(2H)-one1,1-dioxide (BIT) induced SAR in tomato thorough SA biosynthesis. Pretreatment of ABA suppressed BIT-induced SAR including SA accumulation, suggesting that ABA suppressed SAR by inhibiting SA biosynthesis.
The role of teaching experience in language teachers’ perceptions of a top‐down curriculum change
Authors: Rahimi Mehrak , Alavi Jalil
Published: July 2017

The current study aimed to investigate the role of teaching experience in language teachers’ perceptions of a top‐down curriculum change. One hundred twenty‐seven language teachers who have been experiencing the change for three years participated in the study. Their perceptions of change were quantitatively assessed by perceptions of change survey with three main components: new curriculum, teacher practices, and administrative support of change. Analysis of the quantitative data analysis indicates that experience is associated with more cautious perceptions of change and explains 9% of the variance in the results. To triangulate the findings of the quantitative data analysis, 10 experienced and 8 novice teachers took part in a structured interview and answered 10 questions regarding the old curriculum and the change, their role in the reform, and the administrator's support of the change. The result showed that both experienced and novice teachers are optimistic about the new syllabus. However, experienced teachers are more concerned about the practical issues of change such as time and lack of audiovisual aids. Further, they think that their agency and experiential professionalism are neglected in this change and the problems of implementing change have not been appropriately addressed by the administrators during the last three years.
A novel data structure to support ultra-fast taxonomic classification of metagenomic sequences with k-mer signatures
Authors: Liu Xinan , Yu Ye , Liu Jinpeng , Elliott Corrine F , Qian Chen , Liu Jinze
Published: July 2017

Motivation

Metagenomic read classification is a critical step in the identification and quantification of microbial species sampled by high-throughput sequencing. Although many algorithms have been developed to date, they suffer significant memory and/or computational costs. Due to the growing popularity of metagenomic data in both basic science and clinical applications, as well as the increasing volume of data being generated, efficient and accurate algorithms are in high demand.

Results

We introduce MetaOthello, a probabilistic hashing classifier for metagenomic sequencing reads. The algorithm employs a novel data structure, called l-Othello, to support efficient querying of a taxon using its k-mer signatures. MetaOthello is an order-of-magnitude faster than the current state-of-the-art algorithms Kraken and Clark, and requires only one-third of the RAM. In comparison to Kaiju, a metagenomic classification tool using protein sequences instead of genomic sequences, MetaOthello is three times faster and exhibits 20–30% higher classification sensitivity. We report comparative analyses of both scalability and accuracy using a number of simulated and empirical datasets.

Availability and implementation

MetaOthello is a stand-alone program implemented in C ++. The current version (1.0) is accessible via https://doi.org/10.5281/zenodo.808941.

Supplementary information

Supplementary data are available at Bioinformatics online.
Relationship between symptom burden and health status: analysis of the MDASI-BT and EQ-5D
Authors: Vera Elizabeth , Acquaye Alvina A , Mendoza Tito R , Gilbert Mark R , Armstrong Terri S
Published: July 2017

Background

Patients with glioma are highly symptomatic and often have functional limitations from the time of diagnosis. Measuring health status may have value in determining impact of disease. This study provided a description of health status and utility scores in glioma patients throughout the illness trajectory using the EQ-5D (a functional measure of general health status). Furthermore, it evaluated the information provided by the MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT; a measure of symptom burden and interference) in describing health-related quality of life as assessed by the EQ-5D.

Methods

Glioma patients completed the EQ-5D and MDASI-BT. Disease and clinical details were collected by medical record review. Linear regression evaluated whether MDASI-BT scores adequately predict patient health outcomes measured by the EQ-5D.

Results

The sample included 100 patients (65% male, 78% with a glioblastoma, median age 52 [range, 20–75], 56% in active treatment). Seventy-two percent of patients reported functional limitations in at least 1 area. Extreme cases reported inability to perform usual activities (8%) and significant anxiety/depression (5%). The MDASI-BT neurologic factor and activity-related interference (walking/activity/work) explained 52% of the variability in the EQ-5D in this patient population while adjusting for the effect of tumor grade, recurrence status, and performance status.

Conclusions

The majority of glioma patients reported at least 1 functional limitation on the EQ-5D. Over half of the variance in the EQ-5D was explained by the MDASI-BT, performance status, tumor grade, and recurrence status. The resultant model demonstrates the significant contribution of symptom burden on health status in glioma patients.
Exploring Faculty Developers’ Experiences to Inform Our Understanding of Competence in Faculty Development
Authors: Baker Lindsay , Leslie Karen , Panisko Danny , Walsh Allyn , Wong Anne , Stubbs Barbara , Mylopoulos Maria
Published: July 2017

Purpose

Now a mainstay in medical education, faculty development has created the role of the faculty developer. However, faculty development research tends to overlook faculty developers’ roles and experiences. This study aimed to develop an empirical understanding of faculty developer competence by digging deeper into the actions, experiences, and perceptions of faculty developers as they perform their facilitator role.

Method

A constructivist grounded theory approach guided observations of faculty development activities, field interviews, and formal interviews with 31 faculty developers across two academic institutions from 2013 to 2014. Analysis occurred alongside and informed data collection. Themes were identified using a constant comparison process.

Results

Consistent with the literature, findings highlighted the knowledge and skills of the faculty developer and the importance of context in the design and delivery of faculty development activities. Three novel processes (negotiating, constructing, and attuning) were identified that integrate the individual faculty developer, her context, and the evolution of her competence.

Conclusions

These findings suggest that faculty developer competence is best understood as a situated construct. A faculty developer’s ability to attune to, construct, and negotiate her environment can both enhance and minimize the impact of contextual variables as needed. Thus, faculty developers do not passively experience context; rather, they actively interact with their environment in ways that maximize their performance. Faculty developers should be trained for the adaptive, situated use of knowledge.
Association Between Clinical and Neurophysiological Outcomes in Patients With Mechanical Neck Pain and Whiplash-associated Disorders
Authors: Castaldo Matteo , Catena Antonella , Chiarotto Alessandro , Villafañe Jorge H. , Fernández-de-las-Peñas César , Arendt-Nielsen Lars
Published: July 2017

Objectives:

To investigate the association between pain, disability, trigger points (TrPs), and pressure pain thresholds (PPTs) in patients with mechanical neck pain (MNP) or whiplash-associated disorders (WAD).

Materials and Methods:

In total, 46 MNP and 51 WAD patients underwent a physical examination consisting of cervical range of motion, PPTs in the upper trapezius and tibialis anterior muscles, TrPs examination in the upper trapezius, and collection of clinical data including disability, pain intensity, and spontaneous symptomatic pain area.

Results:

A significantly moderate positive association between pain and disability was found in both groups (P<0.01). Significantly negative associations between pain intensity and PPT in the upper trapezius (P=0.008 and 0.041), pain and PPT in tibialis anterior (P=0.015 and 0.038), disability and PPT in upper trapezius (both, P=0.006) were also found in both MNP and WAD groups. Individuals with MNP showed significantly positive association between pain area and disability (P=0.034) and negative association between disability and PPT in the tibialis anterior (P=0.003). Patients with active TrPs in the upper trapezius exhibited higher intensity of neck pain, higher neck disability, and lower PPTs than those with latent TrPs in upper trapezius in both groups.

Discussion:

The association between pain, disability, and PPTs is common in patients with neck pain regardless of the origin of neck pain. The presence of active TrPs was related to higher pain intensity and related-disability and lower PPTs.
Noise History and Auditory Function in Young Adults With and Without Type 1 Diabetes Mellitus
Authors: Spankovich Christopher , Le Prell Colleen G. , Lobarinas Edward , Hood Linda J.
Published: July 2017

Objectives:

The purpose of this study was to examine the relationship between noise exposure history, type 1 diabetes mellitus (DM), and suprathreshold measures of auditory function.

Design:

A cross-sectional study was conducted; 20 normal-hearing participants without type 1 DM were matched on age and sex to 20 normal-hearing participants with type 1 DM (n=40). Participants, all having normal audiometric thresholds, completed noise history questionnaires and a battery of auditory physiological tests including transient evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brainstem responses (ABR) at 80 dB nHL and at 2 different stimulus rates in both ears. Amplitude and latency for waves I and V are presented. Statistical analysis included analysis of variance and multivariate linear regression.

Results:

No statistically significant difference for noise exposure history, otoacoustic emissions (OAE), or ABR findings were found between type 1 DM and matched controls. Males and females showed statistically significant differences for OAE amplitudes and ABR amplitude and latencies. However, no statistically significant relationship was found between noise outcomes and OAE or ABR findings.

Conclusions:

No statistically significant relationship between noise history and our suprathreshold ABR or OAE findings was indicated for individuals with type 1 DM or matched controls. The lack of evidence of noise related neuropathology might be due to inadequate noise exposure or lack of comorbidities in our DM group. Implications of these findings are discussed.
Is low cholesterol a risk factor for cancer mortality?
Authors: Parsa Nader , Taravatmanesh Samira , Trevisan Maurizio
Published: July 2017

Although a large number of studies have shown the associations of high plasma lipid profile levels with cancer, few studies demonstrate the association between low serum cholesterol (<160 mg/dl) and risk for cancer mortality. The aim of this study was to determine the association of low serum cholesterol level as a risk factor for mortality in cancer. The prospective cohort studies were conducted on 19 of 52 cohort studies including 30 179 male and 26 005 female participants who were followed up for 9 years. Cox proportion hazard model was applied to analyze these data. The associations are presented as hazard ratios (HRs) with 95% confidence intervals (CI). The statistical package for the social sciences software was used for analysis. The multivariate analysis results showed risk associations with low serum cholesterol for the first decile among male participants (cancer: HR=1.52, 95% CI: 1.06–2.18; noncancer liver dysfunction: HR=10.73, 95% CI: 3.74–30.18) and female participants (cancer: HR=1.03, 95% CI: 0.52–2.05; noncancer liver dysfunction: HR=25.8, 95% CI: 3.09–217.70). Furthermore, in the second decile, this association among male patients (noncancer liver dysfunction: HR=3.73, 95% CI: 1.16–11.95) had a statistically significant result. For the remaining deciles in both sexes, cancer and noncancer liver dysfunction has some risk or protective association, although not significant. Findings of this study indicated an inverse association between low serum cholesterol and cancer and noncancer liver dysfunction mortality.
Exercise Training Prevents Dexamethasone-induced Rarefaction
Authors: Herrera Naiara A. , Jesus Isley , Dionísio Evandro J. , Dionísio Thiago J. , Santos Carlos F. , Amaral Sandra L.
Published: July 2017

Dexamethasone (DEX) causes rarefaction. In contrast, training (T) prevents rarefaction and stimulates angiogenesis. This study investigated the mechanisms responsible for the preventive role of T in DEX-induced rarefaction. Rats underwent T or were kept sedentary (8 weeks) and were treated with DEX or saline during the following 14 days. Tibialis anterior muscle was used for measurements of capillary density (CD), capillary-to-fiber ratio (C:F ratio), superoxide dismutase CuZn (SOD-1), superoxide dismutase MnSOD (SOD-2), catalase (CAT) mRNA as well as SOD-1, SOD-2, CAT, vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2 (VEGF-R2), cyclooxygenase-2 (COX-2), B-cell lymphoma 2 (Bcl-2), Bd-2-like protein 4 (Bax), p-Bax, and caspase-3 cleaved protein levels. DEX decreased CD (−38.1%), C:F ratio (−30.0%), VEGF (−19.0%), VEGFR-2 (−20.1%), COX-2 (−22.8%), Bcl-2 (−20.5%), Bcl-2/Bax ratio (−13.7%), p-Bax/Bax (−20.0%) and increased SOD-2 (+41.6%) and caspase-3 cleaved (+24.1%). Conversely, T prevented reductions in CD (+54.2%), C:F ratio (+32.9%), VEGF (+25.3%), VEGFR-2 (+22.2%), COX-2 (+31.5%), Bcl-2 (+35.5%), Bcl-2/Bax ratio (+19.9%), p-Bax/Bax (+32.1%), and caspase-3 cleaved increase (−7.8%). T increased CAT mRNA (+21.5%) in the DEX-treated group. In conclusion, T prevented the DEX-induced rarefaction by increasing antioxidant enzymes resulting in a better balance between apoptotic and anti-apoptotic protein levels.
The impact of middle manager affective commitment on perceived improvement program implementation success
Authors: Fryer Ashley-Kay , Tucker Anita L. , Singer Sara J.
Published: July 2017

Background:

Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success.

Purpose:

We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment.

Methodology:

We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units’ falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success.

Results:

Middle manager affective commitment to their unit’s falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers’ affective commitment to their unit’s falls program mediates the relationship between perceived organizational support for the program and perceived implementation success.

Conclusion:

We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program.

Practice Implications:

Increasing levels of middle manager affective commitment to an improvement program could strengthen program implementation success by facilitating frontline worker support for the program. Furthermore, providing the organizational support items in our survey construct may bolster middle manager affective commitment.
Noninvasive follicular thyroid neoplasm with papillary-like nuclear features
Authors: Ghuzlan Abir A. , Ramos Helton E. , Schlumberger Martin
Published: July 2017

Purpose of review

The purpose of this review is to present an overview regarding the renaming of encapsulated follicular variant of papillary thyroid cancer as ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’.

Recent findings

A recent retrospective study has shown the excellent clinical outcomes of noninvasive encapsulated follicular variant of papillary thyroid cancer, for which the diagnosis is based on a thorough examination of all tumor tissue and its capsule to exclude any vascular or capsular invasion. Given the extremely low malignant potential of this entity, the term cancer was eliminated from its name, as this tumor requires less aggressive follow-up and treatment.

The low-risk tumor was previously treated conservatively prior to its renaming. However, elimination of the term cancer from its name may decrease the psychological and social consequences of its diagnosis.
Randomized clinical trial: the impact of gastrointestinal risk factor screening and prophylactic proton pump inhibitor therapy in patients receiving dual antiplatelet therapy
Authors: Jensen Berit E.S. , Hansen Jane M. , Larsen Kasper S. , Junker Anders B. , Lassen Jens F. , Jensen Svend E. , Schaffalitzky de Muckadell Ove B.
Published: July 2017

Objective

Dual antiplatelet therapy reduces the risk of ischemic complications after acute coronary syndrome, but increases the risk of bleeding including upper gastrointestinal bleeding (UGIB).

The aim of this study was to examine the effect of screening for risk of UGIB and prophylactic proton pump inhibitor (PPI) treatment in dual-antiplatelet-treated patients at risk of UGIB and to assess the significance of dual antiplatelet therapy compliance for cardiovascular events.

Patients and methods

In a register-based randomized-controlled trial, 2009 patients were included at the time of first percutaneous coronary intervention and randomized to either screening or control. Screened high-risk patients were prescribed pantoprazole 40 mg during the 1-year after percutaneous coronary intervention.

Results

The incidence of UGIB was 0.8 versus 1.3% in screened patients and controls, respectively (P=0.381).

Significantly fewer screened patients (5.4%) than controls (8.0%) underwent upper gastrointestinal endoscopy (P=0.026). Screened patients (2.9%) had significantly fewer events of unstable angina pectoris than controls (4.7%) (P=0.036) and a higher compliance to dual antiplatelet therapy (88.3 vs. 85.0%) (P=0.035), but no statistically difference was observed in the incidences of myocardial infarction and all-cause mortality (1.0 vs. 1.5%) (P=0.422).

Conclusion

Screening for risk factors for UGIB and subsequent prophylactic PPI treatment did not significantly reduce the incidence of UGIB. Prescription of PPI was associated with a higher compliance with dual antiplatelet therapy and decreases the risk of recurrent cardiovascular events.
Acute Myeloid Leukemia in a Patient With X-linked Severe Combined Immunodeficiency
Authors: Shigemura Tomonari , Motobayashi Mitsuo , Matsuda Kazuyuki , Shimodaira Takahiro , Kurata Takashi , Kobayashi Norimoto , Agematsu Kazunaga , Nakazawa Yozo
Published: July 2017

Severe combined immunodeficiency (SCID) is a defect in the differentiation and function of T cells. An increased malignancy risk, mainly lymphatic malignancy, has been described in patients with SCID. We report a patient with X-linked SCID who developed acute myeloid leukemia, derived from the recipient with somatic NRAS mutation 4 months after cord blood transplantation (CBT). Loss of heterozygosity phenomenon of the recipient at 6q14 locus was observed at 2 months post-CBT and progressed to 6q deletion (6q−) chromosome abnormality. Somatic NRAS mutation was detected at 3 months post-CBT. Thus, 6q− and NRAS mutation were strongly associated with the leukemic transformation in our patient.
Prenatally Diagnosed Infant AML
Authors: Schlosser Mary-Pat , Bucking Shannon , Lemyre Brigitte , Grynspan David , Padmore Ruth , Johnston Donna
Published: July 2017

We report the first case of a fetus with acute myeloid leukemia, without Down syndrome, diagnosed in utero. A cordocentesis sample prepared to investigate hepatomegaly led to further evaluations revealing acute myeloid leukemia, monocytic type, in the fetus. Cytogenetic analysis showed mixed lineage leukemia duplication, no gene disruption or trisomy. Planned treatment included intrauterine exchange transfusion to extend gestation, low-dose chemotherapy at birth, and full chemotherapy once stable. Before any intervention, the child was delivered emergently for maternal condition and died 2 hours later. Although it is now possible to diagnose hematologic malignancy in a fetus, there is little information to direct management.
A Rare Case of Spontaneous Remission of Terminal Deoxynucleotidyl Transferase Negative B-acute Lymphoblastic Leukemia
Authors: Iqbal Asneha , Weinstein Joanna , Angelova Victoria , Dighe Dipti , Giordano Lisa
Published: July 2017

Spontaneous remission of untreated pediatric leukemia is an extremely rare occurrence. The underlying mechanism may be because of an immune-mediated process or increased cortisol production during stress or infection. We describe a rare case of terminal deoxynucleotidyl transferase negative B-acute lymphoblastic leukemia with concurrent infection that went into remission without treatment with chemotherapy or corticosteroids. Though B-acute lymphoblastic leukemia can rarely go into spontaneous remission, these patients require close follow-up as most patients will eventually develop recurrence.
DNP-Prepared Nurse Leaders
Authors: Tyczkowski Brenda L. , Reilly Janet
Published: July 2017

It is no secret that there is a nursing faculty shortage due to aging faculty, retention issues, and an increased need for more nurses with the DNP degree. This parallels the ongoing nursing shortage, as lack of faculty limits nursing student capacity. Explanation of how DNP-prepared faculty can help fill the nursing faculty shortage and strategies are explored in this article.
High Expression of Yes-activated Protein-1 in Papillary Thyroid Carcinoma Correlates With Poor Prognosis
Authors: Liu Zeming , Zeng Wen , Maimaiti Yusufu , Ming Jie , Guo Yawen , Liu Yan , Liu Chunping , Huang Tao
Published: July 2017

Context:

The Hippo signal transduction pathway is highly conserved in mammals. It plays a critical role in tissue and organ size by regulating the balance between cell proliferation and apoptosis. However, there have been few reports concerning Yes-activated protein-1 (YAP-1) elevation in papillary thyroid cancer (PTC).

Objective:

The objective of this study was to determine whether YAP-1 expression is a biomarker and high-risk clinicopathologic prognosticator in PTC.

Design:

A large series of patients of PTC with a long follow-up were investigated for YAP-1 expression.

Setting:

Our study was carried out in the laboratory of breast and thyroid and Department of pathology.

Patients or Other Participants:

Immunohistochemical staining was performed on 240 patient-derived PTC specimens to analyze the correlation of YAP-1 expression with clinicopathologic features and prognosis in patients with PTC.

Intervention:

The 240 PTC patients were immunohistochemically assessed for YAP-1 expression.

Outcome Measures:

Kaplan-Meier analysis was conducted to assess recurrence-free survival (RFS). Univariate and multivariate analyses were conducted to determine prognosticators of RFS.

Results:

YAP-1 expression was observed in 62.1% of PTC tumors. There were significant positive correlations between YAP-1 expression and tumor size, lymph node metastases, extrathyroidal extension, and tissue infiltration. YAP-1 expression was significantly associated with RFS. Univariate analysis revealed that YAP-1 expression significantly affects RFS. YAP-1 and extrathyroidal extension were significant independent prognosticators for RFS.

Conclusions:

YAP-1 expression was significantly correlated with high-risk clinicopathologic features and inferior RFS in patients with PTC.
Hyaluronidase-Assisted Resuscitation in Kenya for Severely Dehydrated Children
Authors: Zubairi Hijab , Nelson Brett D. , Tulshian Priyanka , Fredricks Karla , Altawil Zaid , Mireles Sarah , Odongo Fred , Burke Thomas F.
Published: July 2017

Background

Dehydration, mainly due to diarrheal illnesses, is a leading cause of childhood mortality worldwide. Intravenous (IV) therapy is the standard of care for patients who were unable to tolerate oral rehydration; however, placing IVs in fragile, dehydrated veins can be challenging. Studies in resource-rich settings comparing hyaluronidase-assisted subcutaneous rehydration with standard IV rehydration in children have demonstrated several benefits of subcutaneous rehydration, including time and success of line placement, ease of use, satisfaction, and cost-effectiveness.

Methods

A single-arm trial assessing the feasibility of hyaluronidase-assisted subcutaneous resuscitation for the treatment of moderately to severely dehydrated individuals in western Kenya was conducted. Children aged 2 months or older who presented with moderately to severely dehydration clinically warranting parenteral rehydration and had at least 2 failed IV attempts were eligible. Study staff received training on standard dehydration management and hyaluronidase infusion processes. Children received all other standards of care. They were monitored from presentation and through discharge, with a 1-week phone follow-up. Predischarge surveys were completed by caregivers, and semistructured interviews with providers were performed.

Results

A total of 51 children were enrolled (median age, 13.0 months; interquartile range of 18 months). Fifty-one patients (100%) had severe dehydration. The median length of subcutaneous infusion was 3.0 hours (interquartile range [IQR], 2.95). The median total subcutaneous infusion was 700.0 mL (IQR, 420 mL). Median time to resolution of moderate to severe dehydration symptoms was 3.0 hours (IQR, 2.95 hours). There were no significant complications.

Conclusions

Hyaluronidase-assisted subcutaneous resuscitation is a feasible alternative to IV hydration in moderately to severely dehydrated children with difficult to obtain IV access in resource-limited areas.
Nitrous Oxide 70% for Procedural Analgosedation in a Pediatric Emergency Department–With or Without Intranasal Fentanyl?
Authors: Seiler Michelle , Landolt Markus A. , Staubli Georg
Published: July 2017

Objectives

Nitrous oxide 70% (N20 70%) is an excellent medication for procedural analgosedation in a pediatric emergency department. However, its analgesic efficacy remains uncertain for painful procedures; therefore, a combination with intranasal fentanyl (INF), an opioid, was suggested. This study aimed at observing and assessing the analgesic efficacy and rate of adverse events using N20 70% with and without INF.

Methods

Children who received N20 70% in a tertiary children's hospital emergency department from January 1, 2014 to June 30, 2015 were included in this observational study with prospective data collection. Physicians decided individually whether INF was administered. Medical staff documented the child's behavior during the procedure, adverse events, and satisfaction rate.

Results

A total of 442 children were included; 206 (46.6%) received INF. Group differences regarding patient behavior were not statistically significant; however, N20 70% application time was longer in the INF group (P= .02). Nausea was the most frequent adverse event with 13.1% in the INF group versus 8.1% without INF. Inadequate procedural analgosedation was documented only in the INF group, affecting 1.8% of all patients (P= .002). In contrast, anxiety was exclusively observed in the group without INF, which was presumably misjudged pain (P= .03); the satisfaction rate in the INF group was 95.6% compared with 98.7% without INF.

Conclusions

Because of the study design and limitations, no conclusions about adding INF to N20 70% can be made. Additional research is needed to investigate the effect of combining N20 70% with INF.
Magnetic Resonance Lymphography at 9.4 T Using a Gadolinium-Based Nanoparticle in Rats
Authors: Müller Andreas , Fries Peter , Jelvani Bijan , Lux François , Rübe Claudia E. , Kremp Stephanie , Giovanoli Pietro , Buecker Arno , Menger Michael D. , Laschke Matthias W. , Frueh Florian S.
Published: July 2017

Objectives

Magnetic resonance lymphography (MRL) in small animals is a promising but challenging tool in preclinical lymphatic research. In this study, we compared the gadolinium (Gd)-based nanoparticle AGuIX with Gd-DOTA for interstitial MRL in healthy rats and in a chronic rat hindlimb lymphedema model.

Materials and Methods

A comparative study with AGuIX and Gd-DOTA for interstitial MRL was performed in healthy Lewis rats (n = 6). For this purpose, 75 μL of 3 mM AGuIX (containing 30 mM Gd-DOTA side residues) and 75 μL 30 mM Gd-DOTA were injected simultaneously in the right and left hindlimbs. Repetitive high-resolution, 3-dimensional time-of-flight gradient recalled echo MRL sequences were acquired over a period of 90 minutes using a 9.4 T animal scanner. Gadofosveset-enhanced MR angiography and surgical dissection after methylene blue injection served as supportive imaging techniques. In a subsequent proof-of-principle study, AGuIX-based MRL was investigated in a hindlimb model of chronic lymphedema (n = 4). Lymphedema of the right hindlimbs was induced by means of popliteal and inguinal lymphadenectomy and irradiation with 20 Gy. The nonoperated left hindlimbs served as intraindividual controls. Six, 10, and 14 weeks after lymphadenectomy, MRL investigations were performed to objectify lymphatic reorganization. Finally, skin samples of the lymphedematous and the contralateral control hindlimbs were analyzed by means of histology and immunohistochemistry.

Results

AGuIX-based MRL resulted in high-resolution anatomical depiction of the rodent hindlimb lymphatic system. Signal-to-noise ratio and contrast-to-noise ratio of the popliteal lymph node were increased directly after injection and remained significantly elevated for up to 90 minutes after application. AGuIX provided significantly higher and prolonged signal intensity enhancement as compared with Gd-DOTA. Furthermore, AGuIX-based MRL demonstrated lymphatic regeneration in the histopathologically verified chronic lymphedema model. Collateral lymphatic vessels were detectable 6 weeks after lymphadenectomy.

Conclusions

This study demonstrates that AGuIX is a suitable contrast agent for preclinical interstitial MRL in rodents. AGuIX yields anatomical imaging of lymphatic vessels with diameters greater than 200 μm. Moreover, it resides in the lymphatic system for a prolonged time. AGuIX may therefore facilitate high-resolution MRL-based analyses of the lymphatic system in rodents.
Monocyte-Dependent Suppression of T-Cell Function in Postoperative Patients and Abdominal Sepsis
Authors: Albertsmeier Markus , Prix Niclas J. , Winter Hauke , Bazhin Alexandr , Werner Jens , Angele Martin K.
Published: July 2017

Introduction:

Surgical trauma causes inflammation and postoperative immunosuppression. Previous studies have shown a T-cell-dependent suppression of MHC II expression and other functions of antigen-presenting cells. The aim of this study was to determine which immune cell initiates postoperative immunosuppression and consecutive sepsis.

Methods:

We separated T-cells and monocytes in human abdominal surgery (n = 11) patients preoperatively as well as 24 h postoperatively and in patients who developed postoperative sepsis (n = 6). We analyzed their surface markers and then coincubated these cells with naïve preoperative cells of the other cell type, respectively. Cytokine secretion from naïve cells was measured by a multiplex immunoassay, serving as a bioassay for the function of the stimulating postoperative cell.

Results:

Surface marker analysis showed a postoperative suppression of CD3+ cells and the activation marker CD28 (P = 0.02), which was further reduced in septic patients. FACS analysis revealed a significant increase in CD14+ monocytes (P = 0.02) and CD14+CD86+, CD14+HLA-DR+ subpopulations 2 h postoperatively. In sepsis patients, HLA-DR expression was reduced compared with postoperative levels (P < 0.01). After coincubation with postoperative T-cells, secretion of IL-6 (P < 0.01) and IL-10 (P < 0.01) from naïve monocytes was increased, whereas T-cells from sepsis patients resulted in suppressed cytokine secretion. After coincubation with postoperative monocytes, secretion of IFN-gamma (P < 0.01) and IL-10 (P < 0.01) from naïve T-cells was significantly diminished, whereas monocytes from septic patients triggered only insignificant IL-10 secretion from naïve and septic T-cells.

Conclusions:

Our results show that in the early postoperative period, T-cells are suppressed but able to trigger the release of cytokines from monocytes, whereas activated monocytes seem to induce T-cell suppression. In sepsis patients, a global suppression of both cell types in terms of absolute numbers and function seems to occur.
A Simplified Mortality Score Using Delta Neutrophil Index and the Thrombotic Microangiopathy Score for Prognostication in Critically Ill Patients
Authors: Goag Eun K. , Lee Jong W. , Roh Yun H. , Leem Ah Y. , Kim Song Y. , Song Joo H. , Kim Eun Y. , Jung Ji Y. , Park Moo S. , Kim Young S. , Kim Se K. , Chang Joon , Chung Kyung S.
Published: July 2017

Background:

This study was conducted to assess the prognostic value of a simplified mortality score (SMS) using the delta neutrophil index (DNI) and thrombotic microangiopathy (TMA) score, both easily obtained from the complete blood count, to identify critically ill patients at high risk of death.

Methods:

This was a retrospective study performed in the medical ICU at Yonsei University College of Medicine from June 2015 to February 2016. The primary end point was 28-day all-cause mortality. Participants were divided into two groups: a training (n = 232) and a test (n = 57) set. We used Cox proportional-hazards analysis, Harrell's C index, and Kaplan–Meier survival analysis to derive the SMS and test its internal validity.

Results:

We enrolled 289 patients. The 28-day mortality rate was 31.1% (n = 90). Nonsurvivors had higher APACHE II, SOFA, and TMA scores, and DNI. The SMS, derived by Cox proportional-hazards analysis, consisted of age, sex, DNI, and TMA score. We assigned a weighted point to each variable in the SMS, as follows: age + 11 if male + (2 × DNI) + (61 [TMA = 1], 76 [TMA = 2], 74 [TMA = 3], 26 [TMA = 4], 99 [TMA = 5]). Nonsurvivors had a higher median SMS than survivors, and the Harrell's C index was 0.660. Analysis of survival by risk group according to SMS (low, intermediate, high risk) showed a significant difference among these three groups (P < 0.001). We then investigated this SMS in the test set to determine internal validity; the results were similar to those of the training set.

Conclusions:

The SMS is a more rapid, simple prognostic score for predicting 28-day mortality and stratifying risk than the APACHE II or SOFA scores. However, external validation using a larger sample is needed.
Cerebral Alterations Following Experimental Multiple Trauma and Hemorrhagic Shock
Authors: Vogt Nina , Herden Christiane , Roeb Elke , Roderfeld Martin , Eschbach Daphne , Steinfeldt Thorsten , Wulf Hinnerk , Ruchholtz Steffen , Uhl Eberhard , Schöller Karsten
Published: July 2017

Multiple trauma (MT) associated with hemorrhagic shock (HS) might lead to cerebral hypoperfusion and brain damage. We investigated cerebral alterations using a new porcine MT/HS model without traumatic brain injury (TBI) and assessed the neuroprotective properties of mild therapeutic hypothermia. Male pigs underwent standardized MT with HS (45% or 50% loss of blood volume) and resuscitation after 90/120 min (T90/T120). In additional groups (TH90/TH120) mild hypothermia (33°C) was induced following resuscitation. Normothermic or hypothermic sham animals served as controls. Intracranial pressure, cerebral perfusion pressure (CPP), and cerebral oxygenation (PtiO2) were recorded up to 48.5 h. Serum protein S-100B and neuron-specific enolase (NSE) were measured by ELISA. Cerebral inflammation was quantified on hematoxylin and eosin -stained brain slices; Iba1, S100, and inducible nitric oxide synthase (iNOS) expression was assessed using immunohistochemistry. Directly after MT/HS, CPP and PtiO2 were significantly lower in T90/T120 groups compared with sham. After resuscitation both parameters showed a gradual recovery. Serum protein S-100B and NSE increased temporarily as a result of MT/HS in T90 and T90/T120 groups, respectively. Cerebral inflammation was found in all groups. Iba1-staining showed significant microgliosis in T90 and T120 animals. iNOS-staining indicated a M1 polarization. Mild hypothermia reduced cerebral inflammation in the TH90 group, but resulted in increased iNOS activation. In this porcine long-term model, we did not find evidence of gross cerebral damage when resuscitation was initiated within 120 min after MT/HS without TBI. However, trauma-related microglia activation and M1 microglia polarization might be a consequence of temporary hypoxia/ischemia and further research is warranted to detail underlying mechanisms. Interestingly, mild hypothermia did not exhibit neuroprotective properties when initiated in a delayed fashion.