bluuebunny/crossref_metadata_2025 huggingface dataset:
P.117 Delayed contralateral presentation of a carotid cavernous fistula following trauma
Authors: Husak S , Ko R , Kelly M
Published: June 2016

Background: We present a rare case of a left-sided carotid cavernous fistula (CCF) that presented 15 months post initial trauma with right-sided ophthalmic signs and symptoms. Highlighted is a contralateral endovascular approach to treating this traumatic CCF. Methods: Described is a case of a left-sided CCF caused by a self-inflicted gun shot wound to the head that was initially treated conservatively by neurosurgery and opthomology. The patient presented 15 months later with headache, acute right-sided periorbital swelling, severe right eye and facial pain. Results: Angiography confirmed the presence of a left-sided CCF with preferential drainage into the right cavernous sinus and right superior ophthalmic vein. The left internal carotid artery (ICA) was shown to be narrow and irregular. Multiple attempts to navigate the micro catheter through the vessel were unsuccessful. Instead, the fistula was embolized using a contralateral approach through the right internal carotid artery and across the anterior communicating artery. Imaging post-operatively confirmed successful occlusion of the CCF. Conclusions: This case is a rare example of a left-sided ICA occlusion secondary to trauma presenting 15 months after the initial injury with right-sided ophthalmic signs and symptoms. It is also one of only a few in the literature that describe successful treatment of traumatic CCF through a contralateral approach.
P.122 Restricted diffusion of white matter in infants with subdural hematoma
Authors: Elliott CA , Mehta V , Ramaswamy V
Published: June 2016

Background: Inflicted head injury is a major cause of infant morbidity and mortality. The extent of traumatic brain injury in infants is often best characterized by diffusion weighted magnetic resonance imaging. In this cases series we describe four infants aged 6-19 months, with small unilateral subdural hematomas secondary to abusive head trauma accompanied by extensive areas of restricted diffusion weighted imaging isolated to the cerebral white matter. Methods: Retrospective, single-centre case series of four children with small unilateral subdural hematomas with early and delayed MR imaging with diffusion weighted imaging. Results: In three cases there was acute diffusion restriction ispilateral to the subdural, while in one case diffusion restriction was present bilaterally. All patients had multiple seizures and bilateral multilayered retinal hemorrhages. After non-surgical treatment, all patients survived albeit with significant motor and cognitive deficits and significant cortical atrophy on long-term followup imaging. Conclusions: These four cases highlight that relatively small subdural hematomas following child abuse can manifest with extensive white matter injury only evident at early stages with diffusion weighted imaging. We propose that selective white matter injury as a result of either reperfusion or axonal degeneration in response to the initial insult accounts for this novel pattern of infantile traumatic brain injury.
P.130 The natural history of central cord syndrome and the role of surgical intervention: a retrospective review from 2005-2010
Authors: Dakson A , David BM , Thibault-Halman G , Christie S
Published: June 2016

Background: The management of central cord syndrome (CCS) is controversial. There is a perception that CCS patients tend to improve without the need for surgical intervention. The purpose of this study was to compare the clinical improvements of patients with traumatic SCI, both with and without CCS. Methods: Nova Scotia Provincial Trauma Registry was retrospectively reviewed from 2005-2010. Improvement in the American Spinal Injury Association (ASIA) Impairment Scale (AIS) was determined after mean 5 months follow-up. Results: The study population comprised 96 cases with SCI, subdivided into cases with AIS grade A, non-CCS cases with AIS grades B-D and CCS cases. 88% of the non-CCS and 65% of the CCS patients underwent surgical decompression, with mean operative times being 71.6±137.8 and 102.9±144.6 post injury (p=0.45). The mean improvements in the mean ASIA motor scores for the three groups were 1.3±6.5 and 15.6±35.0 and 22.5±14.6 (p=0.004) respectively, with a statistically significant difference only between the CCS and AIS grade A groups (p<0.001). 20%, 54% and 10% of the patients respectively, underwent an improvement of ≥ one AIS grades (p=0.018, c2=8.0). Conclusions: This retrospective review investigates the natural history of CCS and explores the role of surgical intervention on optimizing patient outcome.
P.138 Corrective Adult Spinal Deformity Procedures in a community hospital: a single institution review
Authors: Yuh S , Warren M , Frangou E , Warren D
Published: June 2016

Background: Adult spinal deformity (ASD) are typically managed in tertiary care centres due to their complexity in surgical planning and peri-operative care. Methods: A retrospective analysis of consecutive corrective ASD surgery performed by a single surgeon at a community based centre performed between 2012 and 2014. Inclusion criteria were age ≥ 18 years with a minimum of 1 year follow-up. We reviewed age, aetiology, mortality, medical and neurological deficit. All standard radiographic deformity parameters were also evaluated and analysed. Results: n=32 corrective spinal deformity procedures were performed. The most common aetiology was de novo degenerative scoliosis. The mean length of stay was 11.94 days. The most common levels fused from T1-pelvis (n=13). L5/S1 was the most common level requiring interbody fusion (n=17). There were n=10 who required a PSO. Only n=4 patients had EBL greater than 3500cc.There were a total of 9 medical complications with post-operative hypotension being the most common (n=3). Hardware failure across the PSO site was the most common long term complication (n=7). There were n=2 death. There were no reported deep infections requiring revisions. Radiographic parameters analysed showed significant improvement. Conclusions: ASD surgery perioperative complication rates in a community hospital are similar to those done in high volume academic centre.
A.01 Targeted analysis of whole exome sequencing and genotype-phenotype correlation in epileptic encephalopathies
Authors: Buerki SE , Toyota EB , Guella I , McKenzie M , Evans D , Adam S , van Allen MI , Boelman C , Horvath G , Van Karnebeek CD , Eydoux P , Huh L , Datta A , Selby KA , Michoulas A , Nelson TN , Farrer MJ , Demos MB , Connolly MB
Published: June 2016

Background: Epileptic encephalopathy (EE) is a severe condition in which epileptic activity itself may contribute to severe cognitive and behavioural impairments above and beyond what might be expected from the underlying pathology alone. Next generation sequencing technologies such as whole exome sequencing (WES) can detect underlying genetic causes of in EE. Methods: This report describes genotype-phenotype correlation of 29 subjects with unexplained epileptic encephalopathy, in whom WES, targeting a list of 557 epilepsy-associated genes was performed. Epilepsy phenotyping was done according to current ILAE recommendations. Results: Median age at seizure onset was 14 months (range 1-48). Electroclinical syndromes were applicable for 16/29, 8/16 had a definite/likely diagnosis. 6/8 subjects with West syndrome had variants in ALG13, STXBP1, PAFAH1B1, SLC35A2, CDKL5 and ADSL. 2 patients with Dravet syndrome had variants in SCN1A and PCDH19 respectively. 4/29 had unspecified EE and definite/likely diagnosis due to STXBP1, POLG, and KCNQ2 (2) variants. 4/29 had a possible diagnosis involving GABRB3, ARHGEF9, PCDH19 and SCN3A variants. Conclusions: The high diagnostic yield (definite/likely diagnosis in 11/29 = 38%), involving a broad variety of epilepsy-associated genes in different electroclinical syndromes justifies the diagnostic approach of early onset EE by next generation sequencing.
B.03 The Canadian neurology graduate survey
Authors: Murray BJ , Major P , Poppe A , Murphy C , Jenkins M , Nicolle M , Watling C , McMillan HJ , Yeung M , Callen D , Briemberg H , Tang-Wai DF , De Meulemeester C , Brna P , Savard M , Sahlas D , Yeh A , Gubitz G , Moore F , Khan K , Squarey K , Deacon C , Esser M , Vosoughi R , Taylor S , Weiss S , Hollenberg E
Published: June 2016

Background: Planning for neurology training necessitated a reflection on the experience of graduates. We explored practice characteristics, and training experience of recent graduates. Methods: Graduates from 2010-2014 completed a survey. Results: Response rate was 37% of 211. 56% were female. 91% were adult neurologists. 65% practiced in an outpatient setting. 63% worked in academics. 85% completed subspecialty training (median 1 year). 36% work 3 days a week or less. 82% took general call (median 1 night weekly). Role preparation was considered very good or excellent for most; however poor or fair ratings were 17% in advocacy and 8% in leadership. Training feedback was at least “good” for 87%. Burnout a few times a week or more was noted by 5% (6% during residency, particularly PGY1 and 5). 64% felt overly burdened by paperwork. Although most felt training was adequate, it was poor or fair at preparing for practice management (85%) and personal balance (55%). Most conditions were under-observed in training environment. Many noted a need for more independent practice development and community neurology. Conclusions: Although our training was found to be very good, some identified needs included advocacy training, and more training in general neurology in the longitudinal outpatient/community settings.
B.04 Distal and asymmetric myasthenia gravis: a case series of 54 patients
Authors: Florendo-Cumbermack AG , Nicolle MW
Published: June 2016

Background: Distal/asymmetric presentations of myasthenia gravis (MG) are uncommon and occur in 3-7% of patients with MG. This pattern of weakness is often not recognized as a manifestation of MG, leading to inappropriate investigations, delayed diagnosis and potentially missed opportunities for treatment. Our knowledge about this atypical presentation is limited to small case series and individual case reports. This study therefore aims to expand our understanding by describing the clinical course, diagnosis and treatment of a larger series of patients with this presentation. Methods: We conducted a retrospective chart review of patients with definite MG (either acetylcholine receptor [AChR] or MuSK antibody positive or clear evidence of postsynaptic neuromuscular junction dysfunction on electrodiagnostic studies), who attended the MG Clinic in London. Details of the clinical course, electrodiagnostic studies, antibody testing and response to treatment are reported. Results: 5.9% (54/921) of patients with definite MG had distal/asymmetric limb involvement, 56% at onset and 4% developing more than 10 years later. Males predominated (2:1). Finger extensors were most affected. 83% were AChR antibody positive. 7% had thymomas. On repetitive nerve stimulation most patients showed the most significant decrement distally on the more affected side. Almost all patients improved with treatment. Conclusions: This study expands our understanding of distal/asymmetric presentations of MG.
C.02: Whole genome expression profiling of blood-brain barrier endothelial cells after experimental subarachnoid hemorrhage
Authors: Tso MK , Turgeon P , Bosche B , Ai J , Marsden P , Macdonald RL
Published: June 2016

Background: The pathophysiology of subarachnoid hemorrhage (SAH) is complex and includes disruption of the blood-brain barrier (BBB). We freshly isolated BBB endothelial cells (BECs) by 2 distinct methods after experimental SAH and then interrogated their gene expression profiles with the goal of uncovering new therapeutic targets. Methods: SAH was induced using the prechiasmatic blood injection mouse model. BBB permeability studies were performed by administering intraperitoneal cadaverine dye injections at 24h and 48h. BECs were isolated either by sequential magnetic-based sorting for CD45-CD31+ cells or by fluorescence-activated cell sorting (FACS) for Tie2+Pdgfrb- cells. Total RNA was extracted and analyzed using Affymetrix Mouse Gene 2.0 ST Arrays. Results: BBB impairment occurred at 24h and resolved by 48h after SAH. Analysis of gene expression patterns in BECs at 24h reveal clustering of SAH and sham samples. We identified 707 (2.8%) significant differentially-expressed genes (403 upregulated, 304 downregulated) out of 24,865 interrogated probe sets. Many significantly upregulated genes were involved in inflammatory pathways. These microarray results were validated with real-time polymerase chain reaction (RT-PCR). Conclusions: This study is the first to investigate in an unbiased manner, whole genome expression profiling of freshly-isolated BECs in an SAH animal model, yielding targets for novel therapeutic intervention.
C.05 Canadian neurosurgery operative landscape
Authors: Tso MK , Bigder M , Dakson A , Elliott C , Guha D , Iorio-Morin C , Kameda-Smith M , Lavergne P , Makarenko S , Taccone M , Wang B , Winkler-Schwartz A , Christie S , Sankar T
Published: June 2016

Background: The Canadian Neurosurgery Research Collaborative (CNRC) is a trainee-led multi-centre collaboration made up of representatives from 12 of 14 neurosurgical centres with residency programs. To demonstrate the potential of this collaborative network, we gathered administrative operative data from each centre in order to provide a snapshot of the operative landscape in Canadian neurosurgery. Methods: Residents from each training program provided adult neurosurgical operative data for the 2014 calendar year, including the number of surgeries in the subcategories cranial, spinal, and peripheral nerve. Because some residency programs have surgeries distributed among more than one hospital, we calculated mean case load per residency program and per hospital. Results: Interim results from 6 neurosurgery residency programs are presented (with data from other programs forthcoming). Overall, there were on average 2,352 operative cases per residency program (n=6) and 1,176 operative cases per adult hospital (n=12). Among 5 programs with more detailed operative data, the mean numbers of cranial, spinal, peripheral nerve, and miscellaneous surgeries per residency program were 757 (47%), 487 (30%), 47 (3%), and 319 (20%) respectively. Conclusions: We show as a proof-of-concept that a trainee-led nation-wide research collaborative can generate meaningful data in a Canadian context.
C.07 Door to decompression should be the benchmark in trauma craniotomies
Authors: Marcoux J , Bracco D
Published: June 2016

Background: Quality control indicators for mass lesion in TBI use the delay between emergency department (ED) and OR arrival to measure quality of care. It does not provide the timing of brain decompression. The goals of this study are to observe step by step where delays occur from hospital admission until effective decompression of the brain. Methods: A prospective observational data collection of timing from ED admission to decompression was conducted for all emergency trauma craniotomies over a period of 15 months. Results: Sixty-five patients were included. Doing a CT at the outside institution instead of transferring the patient prior to CT resulted in a 112min delay in care. Neurosurgery team notification prior to patient’s arrival to ED shortened delivery of care by 51min. The time elapsed between OR arrival and brain decompression was 50min: anesthesia time 3min, surgical positioning/preparation 29min and surgical time 17min. Burrhole decompression followed by craniotomy (9min) shortened the decompression time by 17min compared to standard 4 holes craniotomy approach (26min). Conclusions: Benchmark for trauma system performance in emergency craniotomies should be door to decompression time. Bypassing CT in local hospitals, pre-alerting neurosurgeons, and burrhole decompression followed by standard craniotomy significantly decrease door to decompression time.
D.07 Clinical electromyography training in Canada: The experience of neurology and physiatry residents
Authors: Berger MJ , Florendo-Cumbermack AG , Gray DA , Côté-Mantha É , Chapman K , Winston P , Venance S
Published: June 2016

Background: There are currently no national standards for clinical electromyography (EMG) training for residents in neurology and physiatry in Canada. The purpose of this study was to obtain demographic and qualitative data pertaining to EMG residency training in Canada, with the goal of facilitating discourse that could lead to national standards for EMG training. Methods: An online survey was distributed to senior neurology and physiatry residents (post-graduate years 3-5), at seven tertiary Canadian centres. The study authors, who are trainees and consultants with a broad range of EMG expertise (junior and senior resident, clinical neuromuscular fellows, senior physiatrist and neuromuscular neurologists), developed pertinent demographic and qualitative questions. Results: Thirty-eight residents completed the survey (23 neurology, 15 physiatry). There was inter-program variation in quantity of the training experience, content of the curriculum, access to expertise (including technologists) and goals for future training and practice. Similarly, differences were identified between the training experiences of neurology and physiatry residents. Conclusions: Inter-program variability in EMG training was identified. Additionally, differences were identified between neurology and physiatry resident training. This data provides evidence of training discrepancies across the country and can be used to establish national training standards for EMG in Canada.
E.01 Lost productivity in stroke survivors: a new econometrics model
Authors: Vyas MV , Hackam DG , Silver FL , Laporte A , Kapral MK
Published: June 2016

Background: Stroke leads to a substantial societal economic burden. We aimed to characterize productivity and factors associated with employability in Canadian stroke survivors. Methods: We used the Canadian Community Health Survey (CCHS) 2010-2011 to identify stroke survivors and employment status. We used multivariable models to determine the impact of stroke on employment and factors associated with employability. We used the Heckman model to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). Results: We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted Odds Ratio 0.39, 95% CI 0.33 to 0.46) and had hourly wages 17.7% (95% CI 8.3% to 27.1%) lower compared to the general population, although there was no association between work hours and being a stroke survivor. Older age, being single and having medical comorbidities were associated with lower odds of employment in stroke survivors. Conclusions: Stroke survivors are less likely to be employed and earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies around return to work could be considered to address this lost productivity among stroke survivors.
E.06 Developing and evidence-based palliative care curriculum for neurology resident trainees
Authors: Laiwah JY , Sarpal A , Schulz V , Gofton TE
Published: June 2016

Background: Graduating neurology residents require general palliative care skills. This study aims to develop an evidence-based palliative care curriculum to provide neurology residents with the general palliative care skills required for providing patient care along the continuum of life. Methods: A needs assessment of the palliative skills necessary for a neurology resident was performed. Focus groups were held with physicians, allied health care and senior residents. Semi-structured interviews were held with patients and their caregivers. Interviews analysed using qualitative thematic analysis techniques. The Kolb learning style inventory will determine the learning style of neurology residents and inform the curricular design. Results: Qualitative analysis identified 3 overarching challenges for neurology residents: 1) uncertainty regarding disease trajectory in neurology and timing of palliative care discussions; 2) cohesiveness of the health care team regarding end of life issues; 3) the role of the resident in initiating palliative care. Other principals identified for inclusion were: symptom management, communication, psychosocial aspects of care, care coordination and access, and myths and pitfalls in palliative care. Conclusions: This project will identify the current best evidence and expert opinion in palliative care neurology. The data will be used to develop a novel Canadian neurological palliative care curriculum.
E.07 The role of the neurologist in advanced multiple sclerosis: the patient’s perspective
Authors: Falet J , Moore F , Sigler G , Al-Jassim A
Published: June 2016

Background: Few evidence-based disease-modifying treatments exist for progressive multiple sclerosis (MS). How can neurologists best care for patients with advanced MS? Little is known about how patients with progressive MS view their relationship with their treating neurologist, and if the role of the neurologist matches their needs and preferences. Methods: A qualitative cross-sectional analysis of patient preferences regarding the role of the neurologist in their care. Patients with progressive MS and an EDSS score of 6 or more were invited to participate. Patients and caregivers completed separate written questionnaires and were then interviewed by one of the authors. Data were subjected to thematic coding to group common themes and the distribution of themes among different disability sub-groups was analyzed. Results: Full results will be available at the time of the conference. Preliminary results suggest that the neurologist has an important role in updating patients on the progress of their disease and responding to questions. Patients are fearful of becoming dependent on others for their care. The concept of palliative care is unfamiliar to most patients. Conclusions: Despite a lack of disease-modifying treatments for progressive multiple sclerosis, patients believe that the neurologist has an important role in their care.
Knowledge across Contexts. A Problem for Subject-Sensitive Invariantism
Authors: BAUMANN PETER
Published: June 2016

The possibility of knowledge attributions across contexts (where attributor and subject find themselves in different epistemic contexts) can create serious problems for certain views of knowledge. Amongst such views is subject-sensitive invariantism—the view that knowledge is determined not only by epistemic factors (belief, truth, evidence, etc.), but also by non-epistemic factors (practical interests, etc.). I argue that subject-sensitive invariantism either runs into a contradiction or has to make very implausible assumptions. The problem has been very much neglected but is so serious that one should look for alternative accounts of knowledge.
Temperature and parasite life-history are important modulators of the outcome ofTrypanosoma rangeli–Rhodnius prolixusinteractions
Authors: RODRIGUES JULIANA DE O. , LORENZO MARCELO G. , MARTINS-FILHO OLINDO A. , ELLIOT SIMON L. , GUARNERI ALESSANDRA A.
Published: June 2016

Trypanosoma rangeliis a protozoan parasite, which does not cause disease in humans, although it can produce different levels of pathogenicity to triatomines, their invertebrate hosts. We tested whether infection imposed a temperature-dependent cost on triatomine fitness usingT. rangeliwith different life histories. Parasites cultured only in liver infusion tryptose medium (cultured) and parasites exposed to cyclical passages through mice and triatomines (passaged) were used. We held infected insects at four temperatures between 21 and 30 °C and measuredT. rangeligrowthin vitroat the same temperatures in parallel. Overall,T. rangeliinfection induced negative effects on insect fitness. In the case ofculturedinfection, parasite effects were temperature-dependent. Intermoult period, mortality rates and ecdysis success were affected in those insects exposed to lower temperatures (21 and 24 °C). Forpassaged-infected insects, the effects were independent of temperature, intermoult period being prolonged in all infected groups.Trypanosoma rangeliseem to be less tolerant to higher temperatures sincecultured-infected insects showed a reduction in the infection rates andpassaged-infected insects decreased the salivary gland infection rates in those insects submitted to 30 °C.In vitrogrowth ofT. rangeliwas consistent with these results.
Treatment with synthetic lipophilic tyrosyl ester controls Leishmania major infection by reducing parasite load in BALB/c mice
Authors: SGHAIER RABIAA M. , AISSA IMEN , ATTIA HANÈNE , BALI AYMEN , LEON MARTINEZ PABLO A. , MKANNEZ GHADA , GUERFALI FATMA Z. , GARGOURI YOUSSEF , LAOUINI DHAFER
Published: June 2016

Synthesized lipophilic tyrosyl ester derivatives with increasing lipophilicity were effective against Leishmania (L.) major and Leishmania infantum species in vitro. These findings prompted us to test in vivo leishmanicidal properties of these molecules and their potential effect on the modulation of immune responses. The experimental BALB/c model of cutaneous leishmaniasis was used in this study. Mice were infected with L. major parasites and treated with three in vitro active tyrosyl esters derivatives.

Among these tested tyrosylcaprate (TyC) compounds, only TyC10 exhibited an in vivo anti-leishmanial activity, when injected sub-cutaneously (s.c.). TyC10 treatment of L. major-infected BALB/c mice resulted in a decrease of lesion development and parasite load. TyC10 s.c. treatment of non-infected mice induced an imbalance in interferon γ/interleukin 4 (IFN-γ/IL-4) ratio cytokines towards a Th1 response. Our results indicate that TyC10 s.c. treatment improves lesions’ healing and parasite clearance and may act on the cytokine balance towards a Th1 protective response by decreasing IL-4 and increasing IFN-γ transcripts. TyC10 is worthy of further investigation to uncover its mechanism of action that could lead to consider this molecule as a potential drug candidate.
English as the language of marketspeak
Authors: Selvi Ali Fuad
Published: June 2016

The ubiquitous spread of English is vividly observed in local linguistic landscapes and urban spaces around the world, and Turkey is no exception. Emerging as abona fideline of inquiry at the nexus of sociolinguistics, sociology, social psychology, geography and media studies (Sebba, 2010), linguistic landscaping examines the dynamic relationship of English vis-à-vis the local languages, and documents, analyzes and interprets the attributes, patterns, characteristics, meanings and the creative uses of English in such domains as advertising (Kelly-Holmes, 2005; Vettorel, 2013) and shop signs (MacGregor, 2003; Ong, Ghesquière & Serwe, 2013; Schlick, 2002). These studies provide contextualized accounts of language contact situated in local sociolinguistic contexts and contribute to the representation of reflections from various parts of the world (e.g. see Backhaus (2007) and MacGregor (2003) forJapan; McArthur (2000) forSwitzerland and Sweden; Griffin (2004) and Ross (1997) for Italy; Schlick (2002) for Austria, Italy and Slovenia; Dimova (2007) for Macedonia; Hasanova (2010) for Uzbekistan; Ong, Ghesquière & Serwe (2013) for Singapore; El-Yasin & Mahadin (1996) for Jordan; Wang (2013) for China; Ben Said (2010) for Tunisia; Schlick (2003) for Slovenia, Austria, Italy, and the UK; Stewart & Fawcett (2004) for Portugal; Thonus (1991) for Brazil; and Baumgardner (2006) for Mexico).
Short-term impacts of floods on enteric infectious disease in Qingdao, China, 2005–2011
Authors: ZHANG F. , LIU Z. , GAO L. , ZHANG C. , JIANG B.
Published: June 2016

The current study aimed to examine the relationship between floods and the three enteric infectious diseases, namely bacillary dysentery (BD), hand-foot-mouth disease (HFMD) and other infectious diarrhoea (OID) in Qingdao, China. Relative risks (RRs) and 95% confidence intervals (CIs) of floods on BD, HFMD and OID were calculated using a quasi-Poisson generalized linear model, adjusting for daily average temperature, daily average relative humidity, and seasonal and long-term temporal trends. Two separate models within two different periods were designed. Model 1 for the summer period showed that floods were positively associated with BD for 4- to 12-day lags, with the greatest effects for 7-day (RR 1·41, 95% CI 1·22–1·62) and 11-day (RR 1·42, 95% CI 1·22–1·64) lags. Similar findings were found in model 2 for the whole study period for 5- to 12-day lags. However, HFMD and OID were not significantly associated with floods in both models. Results from this study will provide insight into the health risks associated with floods and may help inform public health precautionary measures for such disasters.
Estimating the risk of acute rheumatic fever in New Zealand by age, ethnicity and deprivation
Authors: GURNEY J. K. , STANLEY J. , BAKER M. G. , WILSON N. J. , SARFATI D.
Published: June 2016

In New Zealand, efforts to control acute rheumatic fever (ARF) and its sequelae have focused on school-age children in the poorest socioeconomic areas; however, it is unclear whether this approach is optimal given the strong association with demographic risk factors other than deprivation, especially ethnicity. The aim of this study was to estimate the stratum-specific risk of ARF by key sociodemographic characteristics. We used hospitalization and disease notification data to identify new cases of ARF between 2010 and 2013, and used population count data from the 2013 New Zealand Census as our denominator. Poisson logistic regression methods were used to estimate stratum-specific risk of ARF development. The likelihood of ARF development varied considerably by age, ethnicity and deprivation strata: while risk was greatest in Māori and Pacific children aged 10–14 years residing in the most extreme deprivation, both of these ethnic groups experienced elevated risk across a wide age range and across deprivation levels. Interventions that target populations based on deprivation will include the highest-risk strata, but they will also (a) include groups with very low risk of ARF, such as non-Māori/non-Pacific children; and (b) exclude groups with moderate risk of ARF, such as Māori and Pacific individuals living outside high deprivation areas.
Emerging LED Technologies for Fluorescence Microscopy
Authors: Aswani Kavita K.
Published: June 2016

Fluorescence microscopy has employed mercury arc lamps for decades because of their high power and broad spectrum. Fluorophores and filter sets have been developed around the peaks of the spectrum offered by these lamps. When LEDs first entered the fluorescence microscopy arena, prices were high and output was low, but in recent years there have been significant advancements in LED capabilities for microscopy. This article aims to educate users of fluorescence microscopy about the benefits of LEDs compared to conventional mercury arc lamps.
Reconciling and Thematizing Definitions of Mindfulness: The Big Five of Mindfulness
Authors: Nilsson Håkan , Kazemi Ali
Published: June 2016

Mindfulness is an emerging concept in many professions and spheres of social life. However, mindfulness (or sati in Buddhism) can connote many plausible meanings. Thus, the concept is not easily defined and the definitions provided in the literature easily confuse the reader. Some mindfulness researchers offer definitions whereas others do not and take the definition of mindfulness for granted. Beyond the problem of defining mindfulness, the fact that the phenomenon is of great interest to various disciplines, each of which has its own theoretical and methodological approaches, different authors use different terms in describing this phenomenon. In the present article 33 definitions of mindfulness were extracted from a pool of 308 peer-reviewed full-length theoretical or empirical articles written in English, published between 1993 and March 2016, after systematic searches in Google Scholar, PsycARTICLES, and SocINDEX. The definitions were analyzed with a particular focus on the defining attributes or core elements of the concept of mindfulness. The analysis yielded 4 core elements of awareness and attention, present-centeredness, external events, and cultivation. Furthermore, an additional core element emerged from this analysis as being absent in Western definitions of mindfulness. This formed the basis for formulation of a new definition of mindfulness with an emphasis on ethical-mindedness. We argue that this core element is instrumental in filling in the gap that exists in current Western definitions, and with highlighting this element we hope to bridge the Western and Buddhist notions of mindfulness.
Meaning in Life as Comprehension, Purpose, and Mattering: Toward Integration and New Research Questions
Authors: George Login S. , Park Crystal L.
Published: June 2016

To advance meaning in life (MIL) research, it is crucial to integrate it with the broader meaning literature, which includes important additional concepts (e.g., meaning frameworks) and principles (e.g., terror management). A tripartite view, which conceptualizes MIL as consisting of 3 subconstructs—comprehension, purpose, and mattering—may facilitate such integration. Here, we outline how a tripartite view may relate to key concepts from within MIL research (e.g., MIL judgments and feelings) and within the broader meaning research (e.g., meaning frameworks, meaning making). On the basis of this framework, we review the broader meaning literature to derive a theoretical context within which to understand and conduct further research on comprehension, purpose, and mattering. We highlight how future research may examine the interrelationships among the 3 MIL subconstructs, MIL judgments and feelings, and meaning frameworks.
Systemic TLR2 agonist exposure regulates hematopoietic stem cells via cell-autonomous and cell-non-autonomous mechanisms
Authors: Herman A C , Monlish D A , Romine M P , Bhatt S T , Zippel S , Schuettpelz L G
Published: June 2016

Toll-like receptor 2 (TLR2) is a member of the TLR family of receptors that play a central role in innate immunity. In addition to regulating effector immune cells, where it recognizes a wide variety of pathogen-associated and nonpathogen-associated endogenous ligands, TLR2 is expressed in hematopoietic stem cells (HSCs). Its role in HSCs, however, is not well understood. Furthermore, augmented TLR2 signaling is associated with myelodysplastic syndrome, an HSC disorder characterized by ineffective hematopoiesis and a high risk of transformation to leukemia, suggesting that aberrant signaling through this receptor may have clinically significant effects on HSCs. Herein, we show that systemic exposure of mice to a TLR2 agonist leads to an expansion of bone marrow and spleen phenotypic HSCs and progenitors, but a loss of HSC self-renewal capacity. Treatment of chimeric animals shows that these effects are largely cell non-autonomous, with a minor contribution from cell-autonomous TLR2 signaling, and are in part mediated by granulocyte colony-stimulating factor and tumor necrosis factor-α. Together, these data suggest that TLR2 ligand exposure influences HSC cycling and function via unique mechanisms from TLR4, and support an important role for TLR2 in the regulation of HSCs.
Floquet topological insulators for sound
Authors: Fleury Romain , Khanikaev Alexander B , Alù Andrea
Published: June 2016

The unique conduction properties of condensed matter systems with topological order have recently inspired a quest for the similar effects in classical wave phenomena. Acoustic topological insulators, in particular, hold the promise to revolutionize our ability to control sound, allowing for large isolation in the bulk and broadband one-way transport along their edges, with topological immunity against structural defects and disorder. So far, these fascinating properties have been obtained relying on moving media, which may introduce noise and absorption losses, hindering the practical potential of topological acoustics. Here we overcome these limitations by modulating in time the acoustic properties of a lattice of resonators, introducing the concept of acoustic Floquet topological insulators. We show that acoustic waves provide a fertile ground to apply the anomalous physics of Floquet topological insulators, and demonstrate their relevance for a wide range of acoustic applications, including broadband acoustic isolation and topologically protected, nonreciprocal acoustic emitters.
Pairing in a dry Fermi sea
Authors: Maier T. A , Staar P. , Mishra V. , Chatterjee U. , Campuzano J. C. , Scalapino D. J.
Published: June 2016

In the traditional Bardeen–Cooper–Schrieffer theory of superconductivity, the amplitude for the propagation of a pair of electrons with momentum k and −k has a log singularity as the temperature decreases. This so-called Cooper instability arises from the presence of an electron Fermi sea. It means that an attractive interaction, no matter how weak, will eventually lead to a pairing instability. However, in the pseudogap regime of the cuprate superconductors, where parts of the Fermi surface are destroyed, this log singularity is suppressed, raising the question of how pairing occurs in the absence of a Fermi sea. Here we report Hubbard model numerical results and the analysis of angular-resolved photoemission experiments on a cuprate superconductor. In contrast to the traditional theory, we find that in the pseudogap regime the pairing instability arises from an increase in the strength of the spin–fluctuation pairing interaction as the temperature decreases rather than the Cooper log instability.
High-field plasma acceleration in a high-ionization-potential gas
Authors: Corde S. , Adli E. , Allen J. M. , An W. , Clarke C. I. , Clausse B. , Clayton C. E. , Delahaye J. P. , Frederico J. , Gessner S. , Green S. Z. , Hogan M. J. , Joshi C. , Litos M. , Lu W. , Marsh K. A. , Mori W. B. , Vafaei-Najafabadi N. , Walz D. , Yakimenko V.
Published: June 2016

Plasma accelerators driven by particle beams are a very promising future accelerator technology as they can sustain high accelerating fields over long distances with high energy efficiency. They rely on the excitation of a plasma wave in the wake of a drive beam. To generate the plasma, a neutral gas can be field-ionized by the head of the drive beam, in which case the distance of acceleration and energy gain can be strongly limited by head erosion. Here we overcome this limit and demonstrate that electrons in the tail of a drive beam can be accelerated by up to 27 GeV in a high-ionization-potential gas (argon), boosting their initial 20.35 GeV energy by 130%. Particle-in-cell simulations show that the argon plasma is sustaining very high electric fields, of ∼150 GV m−1, over ∼20 cm. The results open new possibilities for the design of particle beam drivers and plasma sources.
Microbial interactions lead to rapid micro-scale successions on model marine particles
Authors: Datta Manoshi S. , Sliwerska Elzbieta , Gore Jeff , Polz Martin F. , Cordero Otto X.
Published: June 2016

In the ocean, organic particles harbour diverse bacterial communities, which collectively digest and recycle essential nutrients. Traits like motility and exo-enzyme production allow individual taxa to colonize and exploit particle resources, but it remains unclear how community dynamics emerge from these individual traits. Here we track the taxon and trait dynamics of bacteria attached to model marine particles and demonstrate that particle-attached communities undergo rapid, reproducible successions driven by ecological interactions. Motile, particle-degrading taxa are selected for during early successional stages. However, this selective pressure is later relaxed when secondary consumers invade, which are unable to use the particle resource but, instead, rely on carbon from primary degraders. This creates a trophic chain that shifts community metabolism away from the particle substrate. These results suggest that primary successions may shape particle-attached bacterial communities in the ocean and that rapid community-wide metabolic shifts could limit rates of marine particle degradation.
Mid Pleistocene foraminiferal mass extinction coupled with phytoplankton evolution
Authors: Kender Sev , McClymont Erin L. , Elmore Aurora C. , Emanuele Dario , Leng Melanie J. , Elderfield Henry
Published: June 2016

Understanding the interaction between climate and biotic evolution is crucial for deciphering the sensitivity of life. An enigmatic mass extinction occurred in the deep oceans during the Mid Pleistocene, with a loss of over 100 species (20%) of sea floor calcareous foraminifera. An evolutionarily conservative group, benthic foraminifera often comprise >50% of eukaryote biomass on the deep-ocean floor. Here we test extinction hypotheses (temperature, corrosiveness and productivity) in the Tasman Sea, using geochemistry and micropalaeontology, and find evidence from several globally distributed sites that the extinction was caused by a change in phytoplankton food source. Coccolithophore evolution may have enhanced the seasonal ‘bloom’ nature of primary productivity and fundamentally shifted it towards a more intra-annually variable state at ∼0.8 Ma. Our results highlight intra-annual variability as a potential new consideration for Mid Pleistocene global biogeochemical climate models, and imply that deep-sea biota may be sensitive to future changes in productivity.
The polyglutamine-expanded androgen receptor responsible for spinal and bulbar muscular atrophy inhibits the APC/CCdh1 ubiquitin ligase complex
Authors: Bott Laura C. , Salomons Florian A. , Maric Dragan , Liu Yuhong , Merry Diane , Fischbeck Kenneth H. , Dantuma Nico P.
Published: June 2016

Polyglutamine expansion in the androgen receptor (AR) causes spinal and bulbar muscular atrophy (SBMA), an X-linked neuromuscular disease that is fully manifest only in males. It has been suggested that proteins with expanded polyglutamine tracts impair ubiquitin-dependent proteolysis due to their propensity to aggregate, but recent studies indicate that the overall activity of the ubiquitin-proteasome system is preserved in SBMA models. Here we report that AR selectively interferes with the function of the ubiquitin ligase anaphase-promoting complex/cyclosome (APC/C), which, together with its substrate adaptor Cdh1, is critical for cell cycle arrest and neuronal architecture. We show that both wild-type and mutant AR physically interact with the APC/CCdh1 complex in a ligand-dependent fashion without being targeted for proteasomal degradation. Inhibition of APC/CCdh1 by mutant but not wild-type AR in PC12 cells results in enhanced neurite outgrowth which is typically followed by rapid neurite retraction and mitotic entry. Our data indicate a role of AR in neuronal differentiation through regulation of APC/CCdh1 and suggest abnormal cell cycle reactivation as a pathogenic mechanism in SBMA.
3d Transition Metal Adsorption Induced the valley-polarized Anomalous Hall Effect in Germanene
Authors: Zhou P. , Sun L. Z.
Published: June 2016

Based on DFT + U and Berry curvature calculations, we study the electronic structures and topological properties of 3d transition metal (TM) atom (from Ti to Co) adsorbed germanene (TM-germanene). We find that valley-polarized anomalous Hall effect (VAHE) can be realized in germanene by adsorbing Cr, Mn, or Co atoms on its surface. A finite valley Hall voltage can be easily detected in their nanoribbon, which is important for valleytronics devices. Moreover, different valley-polarized current and even reversible valley Hall voltage can be archived by shifting the Fermi energy of the systems. Such versatile features of the systems show potential in next generation electronics devices.
Microfluidic Assessment of Frying Oil Degradation
Authors: Liu Mei , Xie Shaorong , Ge Ji , Xu Zhensong , Wu Zhizheng , Ru Changhai , Luo Jun , Sun Yu
Published: June 2016

Monitoring the quality of frying oil is important for the health of consumers. This paper reports a microfluidic technique for rapidly quantifying the degradation of frying oil. The microfluidic device generates monodispersed water-in-oil droplets and exploits viscosity and interfacial tension changes of frying oil samples over their frying/degradation process. The measured parameters were correlated to the total polar material percentage that is widely used in the food industry. The results reveal that the steady-state length of droplets can be used for unambiguously assessing frying oil quality degradation.
Kolumbo submarine volcano (Greece): An active window into the Aegean subduction system
Authors: Rizzo Andrea Luca , Caracausi Antonio , Chavagnac Valèrie , Nomikou Paraskevi , Polymenakou Paraskevi N. , Mandalakis Manolis , Kotoulas Georgios , Magoulas Antonios , Castillo Alain , Lampridou Danai
Published: June 2016

Submarine volcanism represents ~80% of the volcanic activity on Earth and is an important source of mantle-derived gases. These gases are of basic importance for the comprehension of mantle characteristics in areas where subaerial volcanism is missing or strongly modified by the presence of crustal/atmospheric components. Though, the study of submarine volcanism remains a challenge due to their hazardousness and sea-depth. Here, we report3He/4He measurements in CO2–dominated gases discharged at 500 m below sea level from the high-temperature (~220 °C) hydrothermal system of the Kolumbo submarine volcano (Greece), located 7 km northeast off Santorini Island in the central part of the Hellenic Volcanic Arc (HVA). We highlight that the mantle below Kolumbo and Santorini has a3He/4He signature of at least 7.0 Ra (being Ra the3He/4He ratio of atmospheric He equal to 1.39×10−6), 3 Ra units higher than actually known for gases-rocks from Santorini. This ratio is also the highest measured across the HVA and is indicative of the direct degassing of a Mid-Ocean-Ridge-Basalts (MORB)-like mantle through lithospheric faults. We finally highlight that the degassing of high-temperature fluids with a MORB-like3He/4He ratio corroborates a vigorous outgassing of mantle-derived volatiles with potential hazard at the Kolumbo submarine volcano.
A Quasi-Solid State DSSC with 10.1% Efficiency through Molecular Design of the Charge-Separation and -Transport
Authors: Suzuka Michio , Hayashi Naoki , Sekiguchi Takashi , Sumioka Kouichi , Takata Masakazu , Hayo Noriko , Ikeda Hiroki , Oyaizu Kenichi , Nishide Hiroyuki
Published: June 2016

Organic-based solar cells potentially offer a photovoltaic module with low production costs and low hazard risk of the components. We report organic dye-sensitized solar cells, fabricated with molecular designed indoline dyes in conjunction with highly reactive but robust nitroxide radical molecules as redox mediator in a quasi-solid gel form of the electrolyte. The cells achieve conversion efficiencies of 10.1% at 1 sun and maintain the output performance even under interior lighting. The indoline dyes, customized by introducing long alkyl chains, specifically interact with the radical mediator to suppress a charge-recombination process at the dye interface. The radical mediator also facilitates the charge-transport with remarkably high electron self-exchange rate even in the quasi-solid state electrolyte to lead to a high fill factor.