bluuebunny/crossref_metadata_2025 huggingface dataset:
Photometric screens identified Arabidopsis peroxisome proteins that impact photosynthesis under dynamic light conditions
Authors: Li Jiying , Tietz Stefanie , Cruz Jeffrey A. , Strand Deserah D. , Xu Ye , Chen Jin , Kramer David M. , Hu Jianping
Published: October 2018

Plant peroxisomes function collaboratively with other subcellular organelles, such as chloroplasts and mitochondria, in several metabolic processes. To comprehensively investigate the impact of peroxisomal function on photosynthesis, especially under conditions that are more relevant to natural environments, a systematic screen of over 150 Arabidopsis mutants of genes encoding peroxisomal proteins was conducted using the automated Dynamic Environment Photosynthesis Imager (DEPI). Dynamic and high‐light (HL) conditions triggered significant photosynthetic defects in a subset of the mutants, including those of photorespiration (PR) and other peroxisomal processes, some of which may also be related to PR. Further analysis of the PR mutants revealed activation of cyclic electron flow (CEF) around photosystem I and higher accumulation of hydrogen peroxide (H2O2) under HL conditions. We hypothesize that impaired PR disturbs the balance of ATP and NADPH, leading to the accumulation of H2O2 that activates CEF to produce ATP to compensate for the imbalance of reducing equivalents. The identification of peroxisomal mutants involved in PR and other peroxisomal functions in the photometric screen will enable further investigation of regulatory links between photosynthesis and PR and interorganellar interaction at the mechanistic level.
Synergy between Nutritional Immunity and Independent Host Defenses Contributes to the Importance of the MntABC Manganese Transporter during
Staphylococcus aureus
Infection
Authors: Radin Jana N. , Zhu Jamie , Brazel Erin B. , McDevitt Christopher A. , Kehl-Fie Thomas E.
Published: October 2018

During infection, the host utilizes a diverse array of processes to combat invaders, including the restriction of availability of essential nutrients such as manganese. Similarly to many other pathogens,
Staphylococcus aureus
possesses two manganese importers, MntH and MntABC.
Single-Step Gene Knockout of the
SUC2
Gene in
Saccharomyces cerevisiae
: A Laboratory Exercise for Undergraduate Students
Authors: Hageman Jurre , Krikken Arjen M.
Published: October 2018

This article describes a relatively straightforward procedure to knock out the gene that encodes the invertase enzyme in baker’s yeast. The SUC2 gene, which encodes for the invertase enzyme, is knocked out by a single-step PCR knock out method. The knockout is subsequently confirmed at the genetic level by PCR and agarose gel electrophoresis. The knockout is confirmed at the biochemical level by measuring the activity of the invertase enzyme using a colorimetric assay. This tips and tools article describes an easily scalable, inexpensive, yet challenging research project helping undergraduate students at the Bachelor level to conceptualize the effect of the deletion of a gene encoding an enzyme.
Improving Teaching through Triadic Course Alignment
Authors: Pape-Zambito Dana A. , Mostrom Alison M.
Published: October 2018

Triadic alignment is a pedagogical technique that instructors can use to improve their teaching and students’ learning. It involves offering the course learning objectives, teaching and learning activities, and assessments at the same cognitive process level. Though it represents a best practice, few instructors have assessed the efficacy of triadic alignment. Previous research has demonstrated that General Biology courses are commonly misaligned relative to the objectives and assessments. However, little emphasis has been placed on assessing the teaching and learning activities as the third component of triadic alignment. In this article, we describe how a General Biology course was initially misaligned, the process that was taken to align it, and the improved student outcomes that resulted from triadic alignment. We expand our discussion to include types of misalignment and the benefits of triadic alignment for both the students and the faculty member.
Isolation and Characterization of the Novel Botulinum Neurotoxin A Subtype 6
Authors: Moritz Molly S. , Tepp William H. , Bradshaw Marite , Johnson Eric A. , Pellett Sabine
Published: October 2018

Botulinum neurotoxins (BoNTs) have proved to be an effective treatment for a large number of neuropathic conditions. BoNTs comprise a large family of zinc metalloproteases, but BoNT/A1 is used nearly exclusively for pharmaceutical purposes. The genetic inactivation of a second BoNT gene in the native strain enabled expression and isolation of a single BoNT/A6 from cultures. Its characterization indicated that BoNT/A subtype A6 has a long duration of action comparable to A1, while it enters neurons faster and more efficiently and remains more localized after intramuscular injection. These characteristics of BoNT/A6 are of interest for potential use of BoNT/A6 as a novel BoNT-based therapeutic that is effective and has a fast onset, an improved safety profile, and a long duration of action. Use of BoNT/A6 as a pharmaceutical also has the potential to reveal novel treatment motifs compared to currently used treatments.
Newly Identified Nucleoid-Associated-Like Protein YlxR Regulates Metabolic Gene Expression in Bacillus subtilis
Authors: Ogura Mitsuo , Kanesaki Yu
Published: October 2018

Expression of genes encoding NAPs is often temporally regulated. According to results from single-cell analysis, the
ylxR
gene is induced by glucose and expressed in a bistable mode. These characteristics have not previously been reported for NAP gene expression. Transcriptional profiling of the
ylxR
disruptant revealed a change in the expression levels of approximately 400 genes, including genes for synthesis of 12 amino acids and 4 nucleotides, in addition to the SigX/M regulons. Thus, YlxR is a critical regulator of glucose response in
B. subtilis
.
High body mass index in children with sickle cell disease: a retrospective single-centre audit
Authors: Hall Rachael , Gardner Kate , Rees David C , Chakravorty Subarna
Published: October 2018

Objective

To assess the prevalence of high body mass index (BMI) in children with sickle cell disease and assess correlation between BMI and disease severity.

Design

Retrospective chart review followed by statistical analysis.

Setting

A single tertiary paediatric clinic in inner city London.

Patients

All patients with sickle cell disease, including homozygous haemoglobin (HbSS) and compound heterozygous Hb (HbSC), age 2–18 years receiving clinical care at the centre, were included in the study.

Interventions

Height and weight measurements, steady-state laboratory blood tests, hospital admission rates, adjunct therapy such as hydroxycarbamide or blood transfusions and obstructive sleep apnoea (OSA) data were obtained from the hospital electronic patient records.

Main outcome measures

To study the prevalence of high BMI and to identify any correlation between BMI and disease severity.

Results

385 patients were included. 64 children (17%) were overweight or obese, of which a significantly higher number of children with HbSC were obese or overweight (23 out of 91, 25%) compared with those with HbSS (36 out of 273, 13%), p≤0.001. No correlation was found between high BMI and presence of OSA, and markers of disease severity such as admission rates, fetal haemoglobin or lactate dehydrogenase levels.

Conclusions

High BMI did not correlate with disease severity in this cohort of patients with sickle cell disease. Obesity was more prevalent in females and those with HbSC. Further prospective studies are needed to determine long-term effects of BMI in disease severity and outcome.
Assessment of the performance of blood glucose monitoring systems for monitoring dysglycaemia in neonatal patients
Authors: Ba Yin , Xu Jin , Yuan Lin , Zhu Haiyan , Yang Yipei , Lam Mei Mei , Zhang Shulian , Xiao Mili , Xu Jiayin , Zhang Rong , Chen Chao
Published: October 2018

Objective

To validate a three-step protocol that assesses the clinical risk associated with using blood glucose monitoring systems (BGMS) in neonates for the management of dysglycaemia.

Method

The three-step validation approach included confirmation of the accuracy of the reference method using National Institute of Standards and Technology (NIST) glucose standards, assessment of analytical risk performed on whole blood collected from paediatric patients routinely tested for glucose and a clinical risk assessment performed using heel stick capillary samples collected from 147 new-born babies and neonates admitted to intensive care. BGMS glucose measurements were compared with the NIST aligned laboratory reference method.

Results

The accuracy of the laboratory reference method was confirmed with the NIST standards. Specificity studies demonstrated that the accuracy of one of the BGMS was affected, particularly, in the hypoglycaemic range, by known interference factors including haematocrit, ascorbic acid, lactose, galactose, N-acetylcysteine and glutathione. The accuracy of the other BGMS was unaffected. The clinical performance of this BGMS in neonates met the system accuracy criteria of Clinical and Laboratory Standards Institute (CLSI) POCT 12-A3 standard for evaluating hospital BGMS with 95.1% of glucose measurements within±0.67 mmol/L for samples ≤5.55 mmol/L and 95.6% within±12.5% for samples>5.55 mmol/L.

Conclusions

This three-step validation protocol provides a challenging approach for determining the accuracy and reliability of BGMS for managing dysglycaemia in neonates. StatStrip BGMS achieved analytical and clinical performance criteria confirming its suitability for use in neonates. We advocate that this validation approach should be considered for performance evaluations of both BGMS and continuous glucose monitoring systems going forward.
Understanding feline idiopathic cystitis
Authors: Sparkes Andrew
Published: October 2018

Feline idiopathic cystitis is a common disease of unknown aetiology. Despite numerous studies, our understanding of this disease remains poor and although there are some interesting and attractive theories about the pathogenesis of the disease, much remains to be confirmed. Along with our poor understanding of the pathogenesis of disease, knowledge of effective therapeutic intervention is also rudimentary. This article explores the current state of knowledge of these aspects of the disease and takes an evidence‐based approach to managing feline idiopathic cystitis.
Chemoresistant pleomorphic rhabdomyosarcoma: whole exome sequencing reveals underlying cancer predisposition and therapeutic options
Authors: Tlemsani Camille , Leroy Karen , Gimenez-Roqueplo Anne-Paule , Mansuet-Lupo Audrey , Pasmant Eric , Larousserie Frederique , Boudou-Rouquette Pascaline , Vidaud Michel , Cadranel Jacques , Blons Helene , Goldwasser Francois , Laurent-Puig Pierre
Published: October 2018

Background

Rhabdomyosarcoma (RMS) is rare cancer affecting children and adults. Pleomorphic RMS histology is almost exclusive to adult patients and often resistant to chemotherapy.

Objective

We report the case of a 19-year-old patient who presented with a metastatic chemoresistant pleomorphic RMS.

Methods

Considering the poor prognosis and the few systemic therapeutic options, we decided to carry out a whole exome sequencing (WES) of the tumour and germline DNA.

Results

WES identified a germline variation (c.1863_1864insT) in the MLH1 gene corresponding to a pathogenic mutation: (p. Leu622Serfs*10), whereas the family history did not fit with classical criteria for Lynch syndrome. Loss-of-heterozygosity at MLH1 locus was found in the tumour. Immunohistochemistry showed loss of MLH1 and PMS2 nuclear expression in the tumour cells. In view of the mismatch repair defects and a high programmed cell death ligand 1 (PD-L1) expression (60% of tumour cells expressed PD-L1), we administrated an anti-PD-1 antibody to the patient. He achieved a rapid complete response of the lung metastases, which appears sustained after a 1-year follow-up.

Conclusion

This observation of an RMS revealing an unexpected Lynch syndrome underlines the overlap between tumorous and germline molecular genetics and emphasises the major impact of cancer genomic medicine in clinical practice for guiding treatment decision.
A moderately elevated soy protein diet mitigates inflammatory changes in gut and in bone turnover during chronic TNBS-induced inflammatory bowel disease
Authors: Metzger Corinne E. , Narayanan S. Anand , Zawieja David C. , Bloomfield Susan A.
Published: October 2018

Inflammatory bowel disease is a condition that leads to gut pathologies such as abnormal lymphatic architecture, as well as to systemic comorbidities such as bone loss. Furthermore, current therapies are limited to low efficacy and incur side effects. Dietary interventions have been explored minimally, but may provide a treatment for improving gut outcomes and comorbidities. Indeed, plant-based soy protein has been shown to exert anti-inflammatory effects. Here, we tested the impact of a moderately elevated soy protein diet in a chronic, 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis model on gut and bone inflammatory-mediated pathophysiological adaptations. Colitis was induced by intrarectal administration of TNBS. Gut histopathology was scored, and lymphatic structural changes and the local inflammatory state were assessed via immunofluorescence. In addition, the effects of gut inflammation on bone turnover and osteocyte proteins were determined via histomorphometry and immunohistochemistry, respectively. The moderately elevated soy protein diet produced improvements in both colonic and bone tissues. In TNBS animals given the soy protein intervention, colon histological scores were reduced and the abnormal lymphatic architecture resolved. There were also improvements in bone formation and reduced bone resorption. In addition, TNBS increased inflammatory cytokines such as tumor necrosis factor-α and receptor activator of nuclear factor κ-B ligand in the gut and bone, but this was resolved in both tissues with the dietary soy protein intervention. The moderately elevated soy protein diet mitigated gut and bone inflammation in a chronic, TNBS-induced colitis model, demonstrating the potential for soy protein as a potential anti-inflammatory dietary intervention for inflammatory bowel disease.
Alteration of Bcl11b upon stimulation of both the MAP kinase- and Gsk3-dependent signaling pathways in double-negative thymocytes
Authors: Selman Wisam Hussein , Esfandiari Elahe , Filtz Theresa M.
Published: October 2018

B-cell lymphoma/leukemia 11B (Bcl11b) is a transcription factor critical for thymocyte development. We have previously characterized the kinetic post-translational modifications (PTMs) of Bcl11b in double-positive (DP) thymocytes during stimulation of the T cell receptor-activated MAP kinase pathway. However, the PTMs of Bcl11b in thymocytes from other developmental stages in the thymus, primarily double-negative (DN) cells, have not been previously identified. We found that kinetic modifications of Bcl11b in DN cells are somewhat different than the patterns observed in DP cells. Distinct from DP thymocytes, phosphorylation and sumoylation of Bcl11b in DN cells were not oppositely regulated in response to activation of MAP kinase, even though hyper-phosphorylation of Bcl11b coincided with near complete desumoylation. Additionally, prolonged stimulation of the MAP kinase pathway in DN cells, unlike DP thymocytes, did not alter Bcl11b levels of sumoylation or ubiquitinylation, or stability. On the other hand, activation of Wnt–Gsk3-dependent signaling in DN cells resulted in composite dephosphorylation and sumoylation of Bcl11b. Moreover, stimulation of MAP kinase and (or) Wnt signaling pathways differentially affects gene expression of some Bcl11b target and maturation-associated genes. Defining the signaling pathways and regulation of sequence-specific transcription factors by PTMs at various stages of thymopoiesis may improve our understanding of leukemogenesis.
Development of pre-breeding diploid potato germplasm displaying wide phenotypic variations as induced by ethyl methane sulfonate mutagenesis
Authors: Somalraju Ashok , Ghose Kaushik , Main David , Bizimungu Benoit , Fofana Bourlaye
Published: October 2018

Mutations are the key drivers for evolution and diversification in plants. In varietal selection, sources for variation are always sought as starting breeding materials. Thus, in the absence of desired natural variations in breeding populations, targeted or random mutagenesis is applied to induce variations. Cultivated potato (Solanum tuberosum L.) is autotetraploid crop species with a narrow and highly heterozygous genetic base, and the complexity of its genome makes its genetic studies more difficult. In the current study, induced mutagenesis was performed in diploid potato using ethyl methane sulfonate (EMS) to enlarge the genetic variability for its use as pre-breeding materials in both polyploid and diploid potato breeding. As starting materials, true potato seeds were treated with 1.2% EMS for 4–6 h along with untreated seeds as controls. A large variation in terms of germination rate, plant, flower, and tuber phenotype was observed in EMS-treated plants compared with their untreated counterparts. In particular, abnormal phenotypes including twisted stem, partial and (or) completely chlorotic leaves and stems, variations in stem colour and weak-stemmed plants with lateral growth habit as well as plants with determinate growth habit were observed along with normal plant characteristics. Moreover, variations in flower colour and tuber colour, shape, and size, as well as yield potential, were observed in EMS-treated lines. The reported phenotypic characterization of EMS mutagenized diploid potato collection is to our knowledge the first in its kind and represents a premium genetic resource for potato breeding programs and plant biologists for genes functional characterization in potato.
EXPLORING EMERGING ECOSYSTEM BOUNDARIES: DEFINING ‘THE GAME’
Authors: PHILLIPS MARK A. , SRAI JAGJIT SINGH
Published: October 2018

The issue of boundary determination in ecosystems remains problematic which is exaggerated in a dynamic, emerging innovation context, with actors joining and leaving. As part of wider research, on how firms innovate in emerging ecosystems, the boundaries of several early innovation ecosystems were explored.

Using evolutionary approaches, with extensive interviews and mapping, the wider ecosystem was initially researched. Then, five in-depth firm-focussed case studies were undertaken, and specific innovation ecosystem boundaries were mapped as they emerged and evolved.

The findings point to ‘identity’, a common early approach, being limited as the ecosystem evolves. The influence of competence and relationships play an increasing role. It is suggested that as the innovation ecosystem develops through its lifecycle, different approaches aligned to Santos and Eisenhardt’s (2005) four foci can be employed, starting with identity, then competence, then power and finally issues of efficiency.
A Quantitative Perceptual Model for Tactile Roughness
Authors: Tymms Chelsea , Gardner Esther P. , Zorin Denis
Published: October 2018

Everyone uses the sense of touch to explore the world, and roughness is one of the most important qualities in tactile perception. Roughness is a major identifier for judgments of material composition, comfort, and friction, and it is tied closely to manual dexterity. The advent of high-resolution 3D printing technology provides the ability to fabricate arbitrary 3D textures with surface geometry that confers haptic properties. In this work, we address the problem of mapping object geometry to tactile roughness. We fabricate a set of carefully designed stimuli and use them in experiments with human subjects to build a perceptual space for roughness. We then match this space to a quantitative model obtained from strain fields derived from elasticity simulations of the human skin contacting the texture geometry, drawing from past research in neuroscience and psychophysics. We demonstrate how this model can be applied to predict and alter surface roughness, and we show several applications in the context of fabrication.
Iterative Depth Warping
Authors: Lee Sungkil , Kim Younguk , Eisemann Elmar
Published: October 2018

This article presents an iterative backward-warping technique and its applications. It predictively synthesizes depth buffers for novel views. Our solution is based on a fixed-point iteration that converges quickly in practice. Unlike the previous techniques, our solution is a pure backward warping without using bidirectional sources. To efficiently seed the iterative process, we also propose a tight bounding method for motion vectors. Non-convergent depth holes are inpainted via deep depth buffers. Our solution works well with arbitrarily distributed motion vectors under moderate motions. Many scenarios can benefit from our depth warping. As an application, we propose a highly scalable image-based occlusion-culling technique, achieving a significant speed-up compared to the state of the art. We also demonstrate the benefit of our solution in multi-view soft-shadow generation.
One tool, many languages: language-parametric transformation with incremental parametric syntax
Authors: Koppel James , Premtoon Varot , Solar-Lezama Armando
Published: October 2018

We present a new approach for building source-to-source transformations that can run on multiple programming languages, based on a new way of representing programs called incremental parametric syntax. We implement this approach in Haskell in our Cubix system, and construct incremental parametric syntaxes for C, Java, JavaScript, Lua, and Python. We demonstrate a whole-program refactoring tool that runs on all of them, along with three smaller transformations that each run on several. Our evaluation shows that (1) once a transformation is written, little work is required to configure it for a new language (2) transformations built this way output readable code which preserve the structure of the original, according to participants in our human study, and (3) our transformations can still handle language corner-cases, as validated on compiler test suites.
BioScript: programming safe chemistry on laboratories-on-a-chip
Authors: Ott Jason , Loveless Tyson , Curtis Chris , Lesani Mohsen , Brisk Philip
Published: October 2018

This paper introduces BioScript, a domain-specific language (DSL) for programmable biochemistry which executes on emerging microfluidic platforms. The goal of this research is to provide a simple, intuitive, and type-safe DSL that is accessible to life science practitioners. The novel feature of the language is its syntax, which aims to optimize human readability; the technical contributions of the paper include the BioScript type system and relevant portions of its compiler. The type system ensures that certain types of errors, specific to biochemistry, do not occur, including the interaction of chemicals that may be unsafe. The compiler includes novel optimizations that place biochemical operations to execute concurrently on a spatial 2D array platform on the granularity of a control flow graph, as opposed to individual basic blocks. Results are obtained using both a cycle-accurate microfluidic simulator and a software interface to a real-world platform.
Are the metabolic benefits of resistance training in type 2 diabetes linked to improvements in adipose tissue microvascular blood flow?
Authors: Hu Donghua , Russell Ryan D. , Remash Devika , Greenaway Timothy , Rattigan Stephen , Squibb Kathryn A. , Jones Graeme , Ross Renee M. , Roberts Christian K. , Premilovac Dino , Richards Stephen M. , Keske Michelle A.
Published: October 2018

The microcirculation in adipose tissue is markedly impaired in type 2 diabetes (T2D). Resistance training (RT) often increases muscle mass and promotes a favorable metabolic profile in people with T2D, even in the absence of fat loss. Whether the metabolic benefits of RT in T2D are linked to improvements in adipose tissue microvascular blood flow is unknown. Eighteen sedentary people with T2D (7 women/11 men, 52 ± 7 yr) completed 6 wk of RT. Before and after RT, overnight-fasted participants had blood sampled for clinical chemistries (glucose, insulin, lipids, HbA1c, and proinflammatory markers) and underwent an oral glucose challenge (OGC; 50 g glucose × 2 h) and a DEXA scan to assess body composition. Adipose tissue microvascular blood volume and flow were assessed at rest and 1 h post-OGC using contrast-enhanced ultrasound. RT significantly reduced fasting blood glucose ( P = 0.006), HbA1c ( P = 0.007), 2-h glucose area under the time curve post-OGC ( P = 0.014), and homeostatic model assessment of insulin resistance ( P = 0.005). This was accompanied by a small reduction in total body fat ( P = 0.002), trunk fat ( P = 0.023), and fasting triglyceride levels ( P = 0.029). Lean mass ( P = 0.003), circulating TNF-α ( P = 0.006), and soluble VCAM-1 ( P < 0.001) increased post-RT. There were no significant changes in adipose tissue microvascular blood volume or flow following RT; however those who did have a higher baseline microvascular blood flow post-RT also had lower fasting triglyceride levels ( r = −0.476, P = 0.045). The anthropometric, glycemic, and insulin-sensitizing benefits of 6 wk of RT in people with T2D are not associated with an improvement in adipose tissue microvascular responses; however, there may be an adipose tissue microvascular-linked benefit to fasting triglyceride levels.
The influence of input excitation on the inter- and intra-day reliability of the motor unit firing rate versus recruitment threshold relationship
Authors: Colquhoun Ryan J. , Tomko Patrick M. , Magrini Mitchel A. , Muddle Tyler W. D. , Jenkins Nathaniel D. M.
Published: October 2018

Decomposition of the surface electromyographic (sEMG) signal is commonly used to examine motor unit (MU) firing behavior. However, the intra- and inter-day reliability of these measurements has yet to be quantified or reported. This investigation 1) examined the effect of input excitation on the mean firing rate (MFR) vs. recruitment threshold (RT) relationship and 2) determined the inter- and intra-day reliability of the MFR vs. RT relationship at 30%, 50%, and 70% of maximum voluntary isometric strength (MVIC). Twenty-eight healthy males (23 ± 3 yr) completed two experimental visits, during which they performed MVIC testing and isometric ramp contractions at 30%, 50%, and 70% MVIC. sEMG signals were recorded from the vastus lateralis during the ramp contractions and decomposed to establish the MFR vs. RT relationship for the detected MUs. Intra- and inter-day reliability was then established for the slopes and y-intercepts of the MFR vs. RT relationship at each contraction intensity. All participants displayed significant MFR vs. RT relationships ( r range: −0.662 to −0.999; P ≤ 0.001–0.006). Intra- and inter-day intraclass correlation coefficients (ICCs) ranged from 0.766–0.824 and 0.867–0.919 for the slopes and from 0.780–0.915 and 0.804–0.927 for the y-intercepts, respectively. Furthermore, the slope coefficient was significantly greater at 70% than at 30% MVIC, and the y-intercepts increased with increasing contraction intensities. Changes in input excitation to the MU pool alter the magnitude, but not the reliability, of the slopes and y-intercepts of the MFR vs. RT relationship.

NEW & NOTEWORTHY The firing behavior of the motor unit (MU) pool is often characterized using the mean firing rate vs. recruitment threshold relationship of the active MUs. Although this relationship has been widely used, this is the first study to report the effects of input excitation (contraction intensity) on the intra- and inter-day reliability of this relationship. The criteria used for MU analysis and the model utilized in this study allow for generalization to outside investigators and laboratories.
Necrotizing Fasciitis of the Breast: Case Report with Literature Review
Authors: ALShareef Basem , ALSaleh Nourah
Published: October 2018

Necrotizing fasciitis is a life-threatening aggressive soft tissue infection which usually affects the extremities, abdominal wall, or perineum. Breasts are rarely affected, with most cases presenting after trauma or surgical intervention. It may be misdiagnosed as abscess or cellulitis, leading to treatment delays. Here, we report a case of necrotizing fasciitis affecting both breasts in a 60-year-old female. Treatment included core biopsy managed with intravenous antibiotic and surgical debridement followed by a simple mastectomy. Currently, the patient is disease-free with a completely healed wound.
Gait Speed Is Not Associated with Vasogenic Shock or Cardiogenic Shock following Cardiac Surgery, but Is Associated with Increased Hospital Length of Stay
Authors: Clark Kimmie , Leathers Taylor , Rotich Duncan , He Jianghua , Wirtz Katy , Daon Emmanuel , Flynn Brigid C.
Published: October 2018

Objective. Frailty has been associated with adverse outcomes following cardiac surgery. Gait speed has been validated as a marker of frailty. Slow gait speed has been found to be associated with mortality after cardiac surgery. However, it is unknown why slow gait speed predisposes to cardiac surgical mortality.Design. A retrospective analysis.Participants.Patients undergoing cardiac surgery who had a 5-meter walk test performed preoperatively (n=333of 1735 total surgical patients) from January 2013 to March 2017.Setting. A tertiary care academic hospital.Measurements and main results.Gait speeds were stratified by tertiles: <0.83 m/s, 0.83–1 m/s, and >1 m/s. There was no difference in the incidence of cardiogenic or vasogenic shock when comparing the gait speed groups. Total hospital length of stay was significantly different among the gait speed groups (p=0.0050). Also, patients in the slowest gait speed tertile had a significant association with need for a postoperative permanent pacemaker (p=0.0298).Conclusion. There was no significant association between gait speed and the incidence of cardiogenic or vasogenic shock after cardiac surgery. Gait speed was associated with increased hospital length of stay and need for a permanent pacemaker after cardiac surgery.
Blood Pressure Estimation Using Photoplethysmography Only: Comparison between Different Machine Learning Approaches
Authors: Khalid Syed Ghufran , Zhang Jufen , Chen Fei , Zheng Dingchang
Published: October 2018

Introduction. Blood pressure (BP) has been a potential risk factor for cardiovascular diseases. BP measurement is one of the most useful parameters for early diagnosis, prevention, and treatment of cardiovascular diseases. At present, BP measurement mainly relies on cuff-based techniques that cause inconvenience and discomfort to users. Although some of the present prototype cuffless BP measurement techniques are able to reach overall acceptable accuracies, they require an electrocardiogram (ECG) and a photoplethysmograph (PPG) that make them unsuitable for true wearable applications. Therefore, developing a single PPG-based cuffless BP estimation algorithm with enough accuracy would be clinically and practically useful. Methods. The University of Queensland vital sign dataset (online database) was accessed to extract raw PPG signals and its corresponding reference BPs (systolic BP and diastolic BP). The online database consisted of PPG waveforms of 32 cases from whom 8133 (good quality) signal segments (5 s for each) were extracted, preprocessed, and normalised in both width and amplitude. Three most significant pulse features (pulse area, pulse rising time, and width 25%) with their corresponding reference BPs were used to train and test three machine learning algorithms (regression tree, multiple linear regression (MLR), and support vector machine (SVM)). A 10-fold cross-validation was applied to obtain overall BP estimation accuracy, separately for the three machine learning algorithms. Their estimation accuracies were further analysed separately for three clinical BP categories (normotensive, hypertensive, and hypotensive). Finally, they were compared with the ISO standard for noninvasive BP device validation (average difference no greater than 5 mmHg and SD no greater than 8 mmHg). Results. In terms of overall estimation accuracy, the regression tree achieved the best overall accuracy for SBP (mean and SD of difference: −0.1 ± 6.5 mmHg) and DBP (mean and SD of difference: −0.6 ± 5.2 mmHg). MLR and SVM achieved the overall mean difference less than 5 mmHg for both SBP and DBP, but their SD of difference was >8 mmHg. Regarding the estimation accuracy in each BP categories, only the regression tree achieved acceptable ISO standard for SBP (−1.1 ± 5.7 mmHg) and DBP (−0.03 ± 5.6 mmHg) in the normotensive category. MLR and SVM did not achieve acceptable accuracies in any BP categories. Conclusion. This study developed and compared three machine learning algorithms to estimate BPs using PPG only and revealed that the regression tree algorithm was the best approach with overall acceptable accuracy to ISO standard for BP device validation. Furthermore, this study demonstrated that the regression tree algorithm achieved acceptable measurement accuracy only in the normotensive category, suggesting that future algorithm development for BP estimation should be more specific for different BP categories.
Internal Mammary Artery Injury without Chest Wall Fractures after Cardiopulmonary Resuscitation: A Case Report
Authors: Tokioka Sayuri , Masuda Shinichiro , Shirokawa Masamitsu , Shibui Takashi
Published: October 2018

High-quality cardiopulmonary resuscitation (CPR) is crucial for survival from cardiac arrest. However, various chest compression-associated injuries have been reported. Internal mammary artery (IMA) injury is one of the rare complications after CPR, and most of cases include rib and sternum fractures. In this report, we describe a rare case of IMA injury without chest wall fractures after CPR. An 85-year-old man with a history of acute myocardial infarction 2 weeks prior visited to our hospital for sustained ventricular tachycardia (VT). After admission, sustained VT requiring CPR occurred several times. Emergency coronary angiogram revealed 90% stenosis at the left anterior descending artery. Hence, emergency percutaneous coronary intervention (PCI) was performed. During the PCI, blood gas analysis showed decreasing serum hemoglobin levels. Contrast computed tomography revealed hemothorax and extravasation at the branch of the right IMA without chest wall fractures. The patient’s deteriorating hemodynamic condition precluded thoracotomy or embolization to stop the bleeding. The patient died on the next day of hospitalization. IMA injury can occur after CPR, regardless of chest wall fractures and can be fatal without early diagnosis. For an emergency physician, IMA injury should be considered as a cause of unknown anemia after CPR.
Effects of Informal Contracts on Innovative Cooperation among Enterprises in Industrial Clusters: An Evolutionary Game Analysis
Authors: Han Ying , Chen Guohong , Poh Elena
Published: October 2018

Industrial cluster theory has important guiding significance for regional industrial development and industrial agglomeration advantages. Cooperation among enterprises is the corner stone of industrial clusters. The purpose of the paper is to explore the effects of cluster informal contracts on cluster enterprises and the behavior of external partners. Based on the dynamic evolutionary game theory, this paper constructs a model, which incorporates several main factors influencing the innovative cooperation among local and external cluster enterprises. By calculating the replicator dynamics equations and analyzing the evolutionary stable strategies, this paper discusses the evolution process of cooperation strategies of enterprises in different situation. Furthermore, by using MATLAB software to simulate the model, this paper verifies the accuracy and reliability of the game model. Results show that, in addition to the formal market contract, effective implementations of cluster informal contracts can reduce opportunistic behavior in innovative cooperation among internal and external enterprises. Meanwhile, we should pay attention to strengthen the external innovative cooperation, increase severity of penalties, enhance the credit network externality, and avoid the relevant risks. The paper enriches our understanding about how informal contracts can help promote and cultivate good cooperative order in innovative cooperation of clusters.
Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break
Authors: Bonfiglio Vincenza , Toro Mario D. , Longo Antonio , Avitabile Teresio , Rejdak Robert , Nowomiejska Katarzyna , Choragiewicz Tomasz , Russo Andrea , Fallico Matteo , Kaminska Agnieszka , Ortisi Elina , Zenoni Stefano , Reibaldi Michele
Published: October 2018

Purpose. To evaluate the effects of a modification of the traditional 25-gauge pars plana vitrectomy technique in the treatment of uncomplicated macula-on rhegmatogenous retinal detachment (RRD) with intermediate retinal break(s) and marked vitreous traction in the phakic eye. Methods. Prospective, noncomparative, and interventional case series. All consecutive phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, with at least 1 year of postoperative follow-up, were enrolled. In all eyes, “localized 25-gauge vitrectomy” under air infusion with localized removal of the vitreous surrounding the retinal break(s), in association with laser photocoagulation and air tamponade, was performed. The primary end point was the rate of primary retinal attachment. Secondary end points were cataract progression and assessed by digital Scheimpflug lens photography (mean change of nuclear density units) and the rate of complications. Results. Thirty-two phakic eyes were included in the final analysis. At 12 months, the primary outcome of anatomical success was achieved in 94% of eyes. The mean nuclear density units did not change significantly at any time point during the follow-up. After localized vitrectomy, one eye developed an epiretinal membrane, and one eye developed cystoid macular edema; no other significant complications were reported. Conclusions. “Localized vitrectomy” has a high anatomical success rate in phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, without causing progression of cataract.
Functional and Structural Plasticity of Brain in Elite Karate Athletes
Authors: Duru Adil Deniz , Balcioglu Taylan Hayri
Published: October 2018

The structural and functional neural differences between the elite karate athletes and control group have been investigated in the concept of this study. 13 elite karate athletes and age-gender matched 13 volunteers who have not performed regular exercises participated in the study. Magnetic resonance imaging was used to acquire the anatomical and functional maps. T1-weighted anatomical images were segmented to form gray and white matter images. Voxel-based morphometry is used to elucidate the differences between the groups. Moreover, resting state functional measurements had been done, and group independent component analysis was implemented in order to exhibit the resting state networks. Then, second-level general linear models were used to compute the statistical maps. It has been revealed that increased GM volume values of inferior/superior temporal, occipital, premotor cortex, and temporal pole superior were present for the elite athletes. Additionally, WM values were found to be increased in caudate nucleus, hypothalamus, and mammilary region for the elite karate players. Similarly, for the elite karate players, the brain regions involved in the movement planning and visual perception are found to have higher connectivity values. The differences in these findings can be thought to be originated from the advances gained through the several years of training which is required to be an elite karate athlete.
Clostridium difficile Causing Empyema
Authors: Mohamed Abdalla , Sostre Vanessa , Patel Hiren , Patel Prem , Ortiz Luis C. , Baddoura Walid J.
Published: October 2018

Extraintestinal Clostridium difficile infection (CDI) is extremely uncommon. High mortality and poor outcomes have been observed among individuals with this rare medical condition. Empyema is one of the extraintestinal manifestations of CDI. Possible mechanisms to develop this parapneumonic effusion are aspiration and contamination of the chest tube. We present a 42-year-old Hispanic male with C. difficile empyema without any prior history of CDI.
Breast Cancer Metastasis in the Skin with Hyperkeratotic Pigmentation Caused by Melanocyte Colonization
Authors: Ishihara-Yusa Shino , Fujimura Taku , Lyu Chunbing , Sugawara Masayuki , Sakamoto Kazuhiro , Aiba Setsuya
Published: October 2018

Pigmented breast cancer in the skin caused by nonneoplastic melanocytes of epidermal origin is a rare condition of metastasis from breast cancer, but the pathogenesis of this phenomenon is almost unknown. In this report, we describe a case of breast cancer metastasis in the skin with prominent hyperkeratotic pigmentation caused by nonneoplastic melanocyte colonization. Immunohistochemical staining revealed that the metastatic tumor cells produced IL-23, which is reported not only to induce IL-17 but also to inhibit cell apoptosis in breast cancer cells, which affects tumor progression. In addition to IL-23, substantial numbers of IL-17-producing cells were detected at the peritumoral area, suggesting that IL-17 might induce not only melanogenesis but also keratinocyte proliferation and tumorigenesis. Our report suggests possible mechanisms of hyperkeratotic pigmentation of breast cancer metastasis in the skin.
Comparison of the Efficacy of Ultra-Mini PCNL, Flexible Ureteroscopy, and Shock Wave Lithotripsy on the Treatment of 1–2 cm Lower Pole Renal Calculi
Authors: Zhang He , Hong Tian yu , Li Gang , Jiang Ning , Hu Chuanyi , Cui Xingang , Chu Chuanmin , Zhao Jun Long
Published: October 2018

Objective: To compare the efficacy of new percutaneous technique (“ultra-mini PCNL”, UMP), shock wave lithotripsy (SWL) and flexible ureteroscopy (FURS) on the treatment of 1–2 cm lower pole kidney stones, and to determine the advantages and disadvantages of each method. Materials and Methods: This prospective study was based on data collected from the files of patients between March 2015 and March 2017. This study recruited a total of 180 patients with single radio-opaque lower caliceal calculi of 1–2 cm. All patients were randomly divided into 3 groups: group A was treated with UMP, group B was treated with FURS by using holmium laser and group C was treated with SWL by using the electromagnetic lithotripter. The average age, sex, size of the stone, the time of operation, the rate of no stone, the time of hospitalization, the rate of retreatment, the cost and the complications of the 3 groups were compared. The success of the operation was defined as no residual stone or < 0.3 cm on computed tomography at 3 months postoperatively. Results: The stone burdens of the groups were equivalent. The re-treatment rate in group C was significantly higher than that in group A and B (30 vs. 1.6%, 5%). The average operating time in group B (93.35 ± 21.64 min) was statistically significantly longer than that in group A and C (68.58 ± 15.82 min, 46.33 ± 5.81 min). Although the time of hospitalization of group A (5.32 ± 1.20 day) was longer than that of group B (3.22 ± 0.52 day) and C (1.08 ± 0.28 day; p < 0.05). The stone-free rate (SFR) in UMP, FURS, SWL were 98, 92, and 73% respectively; the highest SFR was in the UMP group (p < 0.05). The complication rates were evaluated by using the Clavien grading system, which were determined to be 16.67% in UMP, 6.67% in SWL and 8.33% in FURS. In particular, the complications of GI and GII were more common in group A (p < 0.05). Conclusions: UMP, FURS, and SWL are all safe and effective in the treatment of 1–2 cm lower pole kidney stones. UMP and FURS had a better SFR than SWL, but the time of hospitalization in UMP group was longer and there were more complications in the UMP group. In addition, the operation time of FURS is longer as compared to UMP and SWL, and there is a higher rate of postoperative fever. The invasiveness and cost of SWL were lower than that of UMP and FURS, but the re-treatment rate was higher.
Unmet Needs and Therapeutic Strategies in Cardio-Hemato-Oncology
Authors: Schamroth Pravda Nili Ronit , Kornowski Ran
Published: October 2018

With the increasing survival of cancer patients and therapeutic advancements, the cardiovascular complications of therapy have become a significant issue. A dedicated, integrated team is important in providing the balance between acquiring a hematological/oncological response and cardiovascular morbidity and mortality. This article aims to shed light on this field – providing some examples of therapies with cardiotoxic potential as well as the cardiologist’s approach to patient assessment before, during, and after therapy.
Coagulation Disturbances in Patients with Argininemia
Authors: Kiykim Ertugrul , Zubarioglu Tanyel , Cansever Mehmet Serif , Celkan Tiraje , Häberle Johannes , Aktuglu Zeybek Ayse Cigdem
Published: October 2018

Background: Argininemia is an autosomal recessive urea cycle disorder (UCD). Unlike other UCD, hyperammonemia is rarely seen. Patients usually present in childhood with neurological symptoms. Uncommon presentations like neonatal cholestasis or cirrhosis have been reported. Although transient elevations of liver transaminases and coagulopathy have been reported during hyperammonemia episodes, a permanent coagulopathy has never been reported. Methods: In this retrospective study, coagulation disturbances are examined in 6 argininemia patients. All of the patients were routinely followed up for hepatic involvement due to argininemia. Laboratory results, including liver transaminases, albumin, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), and clotting factor levels, were assessed in all of the patients. Results: All of the patients had a prolonged PT and an increased INR, while none of the patients had a prolonged aPTT. Five patients had slightly elevated liver transaminases. A liver biopsy was performed in 1 patient but neither cirrhosis nor cholestasis was documented. Five of the 6 patients had low factor VII and factor IX levels, while other clotting factors were normal. Conclusions: Argininemia patients should be investigated for coagulation disorders even if there is no apparent liver dysfunction or major bleeding symptoms.
New combinations and names for continental American Calyptranthes (Myrtaceae: Myrcia s.l.)
Authors: LOURENÇO ANA RAQUEL LIMA , PARRA-O. CARLOS , SÁNCHEZ-CHÁVEZ ERANDI , LUCAS EVE
Published: October 2018

129 currently accepted names (all continental American Calyptranthes, but six also occurring in the Caribbean) are here transferred to Myrcia, a required step towards a new classification of the Myrcia s.l. group supported by molecular phylogenetic and morphological studies. Geographical distribution is indicated for each species.