bluuebunny/crossref_metadata_2025 huggingface dataset:
The metaethics of nursing codes of ethics and conduct
Authors: Snelling Paul C.
Published: May 2016

Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self‐regulating profession. This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical‐codes and conduct‐codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent‐centeredness. It is argued that conduct‐codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct‐codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct‐codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations.
A sacred command of reason? Deceit, deception, and dishonesty in nurse education
Authors: Rolfe Gary
Published: May 2016

Kant (Grounding for the Metaphysics of Morals. Hackett, Indianapolis, 1797) described honesty as ‘a sacred command of reason’ which should be obeyed at all times and at any cost. This study inquires into the practice of dishonesty, deception, and deceit by universities in the UK in the pursuit of quality indicators such as league table positions, Research Excellence Framework (REF) scores, and student satisfaction survey results. Deception occurs when the metrics which inform these tables and surveys are manipulated to suggest an improvement in quality when, in fact, the raised scores are merely the result of clever strategic planning. Deceit occurs when these manipulated scores are deliberately and knowingly presented as real improvements in research and educational quality. It might be argued that, within the context of the artificial ivory tower world of academe, this is a game played by almost every academic in every higher education institution with no real losers and little wider consequence. However, this study suggests that some of the strategies employed by institutions to improve their scores without directly addressing the issue of quality can, in certain practice‐based disciplines such as nursing, result in dire consequences for practitioners and service users. It concludes with a number of suggestions taken from personal experience to resolve the tension between the contractual demands placed on nurse academics by their employers and the moral and practical obligations of their professional body, most notably the use of subversion. The conclusion, contra Kant, is that the most effective strategy against dishonesty and deception is often more dishonesty and deception.
A comparative analysis reveals little evidence for niche conservatism in aquatic macrophytes among four areas on two continents
Authors: Alahuhta Janne , Ecke Frauke , Johnson Lucinda B. , Sass Laura , Heino Jani
Published: May 2016

One of the most intriguing questions in current ecology is the extent to which the ecological niches of species are conserved in space and time. Niche conservatism has mostly been studied using coarse‐scale data of species' distributions, although it is at the local habitat scales where species' responses to ecological variables primarily take place. We investigated the extent to which niches of aquatic macrophytes are conserved among four study regions (i.e. Finland, Sweden and the US states of Minnesota and Wisconsin) on two continents (i.e. Europe and North America) using data for 11 species common to all the four study areas. We studied how ecological variables (i.e. local, climate and spatial variables) explain variation in the distributions of these common species in the four areas using species distribution modelling. In addition, we examined whether species' niche parameters vary among the study regions. Our results revealed large variation in both species' responses to the studied ecological variables and in species' niche parameters among the areas. We found little evidence for niche conservatism in aquatic macrophytes, though local environmental conditions among the studied areas were largely similar. This suggests that niche shifts, rather than different environmental conditions, were responsible for variable responses of aquatic macrophytes to local ecological variables. Local habitat niches of aquatic macrophytes are mainly driven by variations in local environmental conditions, whereas their climate niches are more or less conserved among regions. This highlights the need to study niche conservatism using local‐scale data to better understand whether species' niches are conserved, because different niches (e.g. local versus climate) operating at various scales may show different degrees of conservatism. The extent to which species' niches are truly conserved has wide practical implications, including for instance, predicting changes in species' distributions in response to global change.
Global TLR2 and 4 deficiency in mice impacts bone resorption, inflammatory markers and atherosclerosis to polymicrobial infection
Authors: Chukkapalli S.S. , Velsko I.M. , Rivera‐Kweh M.F. , Larjava H. , Lucas A.R. , Kesavalu L.
Published: May 2016

Toll‐like‐receptors (TLRs) play a significant role in the generation of a specific innate immune response against invading pathogens. TLR2 and TLR4 signaling contributes to infection‐induced inflammation in periodontal disease (PD) and atherosclerosis. Observational studies point towards a relationship between PD and atherosclerosis, but the role of TLR2 and TLR4 in the recognition of multiple oral pathogens and their modulation of host response leading to atherosclerosis are not clear. We evaluated the role of TLR2 and TLR4 signaling in the induction of both PD and atherosclerosis in TLR2−/− and TLR4−/− mice to polymicrobial infection with periodontal pathogens Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Fusobacterium nucleatum. Polybacterial infections have established gingival colonization in TLR2−/− and TLR4−/− mice and induction of a pathogen‐specific immunoglobulin G immune response. But TLR deficiency dampened accelerated alveolar bone resorption and intrabony defects, indicating a central role in infection‐induced PD. Periodontal bacteria disseminated from gingival tissue to the heart and aorta through intravascular dissemination; however, there was no increase in atherosclerosis progression in the aortic arch. Polybacterial infection does not alter levels of serum risk factors such as oxidized low‐density lipoprotein, nitric oxide, and lipid fractions in both mice. Polymicrobial‐infected TLR2−/− mice demonstrated significant levels (P < 0.05 to P < 0.01) of T helper type 2 [transforming growth factor‐β1, macrophage inflammatory protein‐3α, interleukin‐13 (IL‐13)] and T helper type 17 (IL‐17, IL‐21, IL‐22, IL‐23) splenic T‐cell cytokine responses. Increased heat‐shock protein expression, hspa1a for Hsp 70, was observed for both TLR2−/− and TLR4−/− mice. This study supports a role for TLR2 and TLR4 in PD and atherosclerosis, corroborating an intricate association between two inflammatory diseases.
Nationwide survey of Helicobacter pylori treatment for children and adolescents in Japan
Authors: Okuda Masumi , Kikuchi Shogo , Mabe Katsuhiro , Osaki Takako , Kamiya Shigeru , Fukuda Yoshihiro , Kato Mototsugu
Published: May 2016

Background

To prevent gastric cancer, a test‐and‐treat strategy for Helicobacter pylori has been proposed. This retrospective study assessed the clinical features, efficacy and safety of treatment for H. pylori infection in children and adolescents.

Methods

Questionnaires concerning the clinical features and treatment of H. pylori in children and adolescents were sent to doctors in 2013. It included questions on patient background, H. pylori‐associated disease, first‐ and second‐line treatment, success or failure of eradication, resistance to antibiotics, and occurrence of adverse events. In 2014, serious adverse events associated with treatment were analyzed.

Results

Invitation letters and questionnaires were sent to 1097 doctors, of whom 409 (37.3%) participated. Finally, 332 patients (mean age, 11.6 ± 3.4 years; male, n = 200) treated from 1997 to 2013 were analyzed. H. pylori‐associated gastritis, iron deficiency anemia, and duodenal ulcer occurred most frequently. Success rates for first‐ and second‐line treatments were 73.1% and 79.6%, respectively. Seventy‐six H. pylori strains were analyzed for resistance to amoxicillin (AMPC) and clarithromycin (CAM), and 64 were analyzed for resistance to metronidazole (MNZ). CAM resistance was most frequent, occurring in 43.4% of patients; that of MNZ was 21.9%. Adverse events were observed in 13.8% of cases. In total, 587 cases of H. pylori infection were analyzed and no serious adverse events were observed.

Conclusions

Treatment for H. pylori in children and adolescents is safe, but further studies on treatment regimens should be conducted to improve eradication rates and monitor increasing CAM resistance.
Synthesis of TiO2/CNT Composites and its Photocatalytic Activity Toward Sudan (I) Degradation
Authors: Miribangul Amat , Ma Xiaoli , Zeng Chen , Zou Huan , Wu Yahui , Fan Tengpeng , Su Zhi
Published: May 2016

Semiconductor photocatalysis has the potential for achieving sustainable energy generation and degrading organic contaminants. In TiO2, the addition of carbonaceous nanomaterials has attracted extensive attention as a means to increase its photocatalytic activity. In this study, composites of TiO2 and carbon nanotubes (CNT) in various proportions were synthesized by the hydrothermal method. The crystalline structures, morphologies, and light absorption properties of the TiO2/CNT photocatalysts were characterized by PXRD, TEM and UV–Vis absorption spectra. The photocatalytic efficiency of the composites was evaluated by the degradation of Sudan (I) in UV–Vis light. Introducing 0.1–0.5 wt% CNT was shown to substantially improve the photoactivity of TiO2. The composite with 0.3 wt% CNT showed the best catalytic activity, and its reaction activation energy was calculated as 39.57 kJ mol−1 from experimental rates. The degradation products of Sudan (I) with different irradiation durations were characterized by Fourier transform infrared spectroscopy, and a degradation reaction process was proposed.
Remittances and the Effectiveness of Foreign Aid
Authors: Minasyan Anna , Nunnenkamp Peter
Published: May 2016

We argue that donors could improve the effectiveness of foreign aid by pursuing complementary and coherent non‐aid policies. In particular, we hypothesize that aid has stronger growth effects if recipients receive more aid from donors who allow for (temporary) worker mobility and (more permanent) migration. We focus on overall remittances paid by the donor countries to proxy for worker mobility and migration. Our empirical results support the hypothesis that higher remittances paid by donor countries strengthen the growth effects of foreign aid.
Plastic mulching increased soil CO2 concentration and emissions from an oasis cotton field in Central Asia
Authors: Yu Y. , Zhao C. , Stahr K. , Zhao X. , Jia H.
Published: May 2016

Although previous researchers suggest that carbon dioxide (CO2) emissions are influenced by plastic mulching, the effects of this method on soil CO2 concentration and emissions remain uncertain. Soil CO2 concentration and emissions from ridge and furrow soils under mulched and nonmulched treatments in 2014 and 2015 were measured. The soil CO2 concentration was observed using modified diffusion equilibrium samplers, and the soil CO2 emissions were measured using a closed‐chamber method. In the ridge soil, although the plastic mulching increased the CO2 concentration by 49% (0–40 cm), no significant difference in CO2 emissions was found between the mulched and nonmulched treatments. Accordingly, the relationship between soil CO2 concentration and CO2 emissions was affected by plastic mulching, with a lower slope of the linear equation found in the mulched treatment compared to the nonmulched treatment. In the furrow soil, the plastic mulching increased the CO2 concentration and emissions by 15% and 21%, respectively. In conclusion, plastic mulching significantly increased the CO2 concentration in both the ridge and furrow soils and increased the cumulative CO2 emissions by 8%. The temperature sensitivity of the soil CO2 concentration increased with soil depth, whereas the plastic mulching only influenced the temperature sensitivity of the soil CO2 concentration in both the ridge and furrow soils at a depth of 40 cm. Our results suggest that the temperature sensitivity of the soil CO2 concentration not only reflects the effects of temperature on CO2 production but also indicates poor diffusion in the deep profile.
Phylogeny and species delimitation of North European Lumbricillus (Clitellata, Enchytraeidae)
Authors: Klinth Mårten J. , Martinsson Svante , Erséus Christer
Published: May 2016

The enchytraeid genus Lumbricillus comprises about 80 described species of clitellate worms, which are up to a few centimetres long, and they mostly inhabit the littoral zone of non‐tropical marine and brackish waters world‐wide. The phylogeny of this genus is poorly studied, but previous work has suggested that Lumbricillus is a non‐monophyletic group. In this study, species boundaries and the phylogeny of this genus is re‐assessed using more than 300 DNA‐barcoded specimens (using COI mtDNA), part of which was also sequenced for two additional mitochondrial and four nuclear molecular markers. Statistical and coalescent based applications were used for the delimitation of a total of 24 species, of which 20 were identified as belonging to 17 described morphospecies; one morphospecies was found to be a complex of four delimited species, and another four delimited species could not be matched with any described species. Furthermore, gene trees, concatenation and multispecies coalescent based species trees were estimated using Bayesian inference. The estimated phylogenies confirm a non‐monophyletic Lumbricillus as L. semifuscus is clearly excluded from the genus. Furthermore, the placement of a monophyletic clade consisting of L. arenarius, L. dubius, and an unidentified species varies between analyses; they are either found as the sister‐group to the genus Grania or as sister‐group to the remaining Lumbricillus, where the latter relationship is supported by the multispecies coalescent, which we consider as the most reliable method.
A Fluctuating Elastic Plate Model Applied to Graphene
Authors: Liang Xiaojun , Purohit Prashant K.
Published: May 2016

Over the past few decades, the measurement and analysis of thermal undulations has provided a route to estimate the mechanical properties of membranes. Theoretically, fluctuating elastic membranes have been studied mostly by Fourier analysis coupled with perturbation theory (to capture anharmonic effects), or by computer simulations of triangulated surfaces. These techniques as well as molecular dynamic simulations have also been used to study the thermal fluctuations of graphene. Here, we present a semi-analytic approach in which we view graphene as a triangulated membrane, but compute the statistical mechanical quantities using Gaussian integrals. The nonlinear coupling of in-plane strains with out-of-plane deflections is captured using a penalty energy. We recover well-known results for the scaling of the fluctuations with membrane size, but we show that the fluctuation profile strongly depends on boundary conditions and type of loading applied on the membrane. Our method quantitatively predicts the dependence of the thermal expansion coefficient of graphene on temperature and shows that it agrees with several experiments. We also make falsifiable predictions for the dependence of thermal expansion coefficient and the heat capacity of graphene on applied loads and temperature.
Finite-Time Synchronization for High-Dimensional Chaotic Systems and Its Application to Secure Communication
Authors: Liu Yongjian , Li Lijie , Feng Yu
Published: May 2016

The finite-time synchronization for the high-dimensional chaotic system is studied. A method is derived from the finite-time stability theory and adaptive control technique. To show the wider applicability of our method, an illustration is given using four-dimensional (4D) hyperchaotic systems. Numerical simulations are also used to verify the effectiveness of the technique. Then, the synchronization is applied to secure communication through chaos masking. Simulation results show that the two high-dimensional chaotic systems can realize monotonous synchronization, and the information signal, which is masked, can be recovered undistortedly.
Compliant Needle Vibration Cutting of Soft Tissue
Authors: Barnett Andrew C. , Jones Justin A. , Lee Yuan-Shin , Moore Jason Z.
Published: May 2016

This work investigates the performance of a novel compliant needle for cutting tissue. The novel cutting geometry transfers axial vibration to transverse motion at the tip. The cutting edge of the geometry is defined in terms of the time-dependent inclination and rake angle. Finite element analysis was performed to determine the compliant geometry effect on the axial vibration modes of the needles. An ultrasonic transducer is used to apply the axial vibration. An ultrasonic horn was developed to increase the amplitude of vibration. Experiments were performed to determine the effectiveness of the compliant needle geometry. The motion of the compliant needle is measured with a stereomicroscope. The two compliant geometries developed transverse motion of 4.5 μm and 16.0 μm. The control needle with fixed geometry developed no measured transverse motion. The insertion force was recorded for two different compliant geometries and a control geometry inserted into a polyurethane sheet. The puncture force of the control needle with applied vibration and the two compliant needles was up to 29.5% lower than the control insertion without applied vibration. The compliant needles reduced the friction force up to 71.0%. The significant reduction of the friction force is explained by the compliant needles' ability to create a larger crack in the material because of their transverse motion.
Numerical Simulation of Stall Inception Mechanisms in a Centrifugal Compressor With Vaned Diffuser
Authors: Bousquet Y. , Binder N. , Dufour G. , Carbonneau X. , Roumeas M. , Trebinjac I.
Published: May 2016

The present paper numerically investigates the stall inception mechanisms in a centrifugal compressor stage composed of a splittered unshrouded impeller and a vaned diffuser. Unsteady numerical simulations have been conducted on a calculation domain comprising all the blade passages over 360 deg for the impeller and the diffuser. Three stable operating points are simulated along a speed line, and the full path to instability is investigated. The paper focusses first on the effects of the mass flow reduction on the flow topology at the inlet of both components. Then, a detailed analysis of stall inception mechanisms is proposed. It is shown that at the inlet of both components, the mass flow reduction induces boundary layer separation on the blade suction side, which results in a vortex tube having its upper end at the casing and its lower end at the blade wall. Some similarities with flows in axial compressor operating at stall condition are outlined. The stall inception process starts with the growth of the amplitude of a modal wave rotating in the vaneless space. As the flow in the compressor is subsonic, the wave propagates upstream and interacts with the impeller flow structure. This interaction leads to the drop in the impeller pressure ratio.
Directional moisture transfer through a wild silkworm cocoon wall
Authors: Jin Xing , Zhang Jin , Gao Weimin , Du Shan , Li Jingliang , Wang Xungai
Published: May 2016

A silkworm cocoon is a porous biological structure with multiple protective functions. In the current work, the authors have used both experimental and numerical methods to reveal the unique moisture transfer characteristics through a wild Antheraea pernyi silkworm cocoon wall, in comparison with the long-domesticated Bombyx mori silkworm cocoon walls. The water vapor transmission and water vapor permeability (WVP) properties show that the A. pernyi cocoons exhibit directional moisture transfer behavior, with easier moisture transfer from inside out than outside in [e.g., the average WVP is 0.057 g/(h m bar) from inside out and is 0.034 g/(h m bar) from outside in]. Numerical analysis shows that the cubic mineral crystals in the outer section of the A. pernyi cocoon wall create a rough surface that facilitates air turbulence and promotes disturbance amplitude of the flow field, leading to lengthened water vapor transfer path and increased tortuosity of the moist air. It also indicates the vortex of water vapor can be generated in the outer section of cocoon wall, which increases the diffusion distance of water vapor and enhances the turbulence kinetic energy and turbulence eddy dissipation, signifying higher moisture resistance in the outer section. The difference in moisture resistance of the multiple A. pernyi cocoon layers is largely responsible for the unique directional moisture transfer behavior of this wild silkworm cocoon. These findings may inspire a biomimicry approach to develop novel lightweight moisture management materials and structures.
The role of spectral detail in the binaural transfer function on perceived externalization in a reverberant environment
Authors: Hassager Henrik Gert , Gran Fredrik , Dau Torsten
Published: May 2016

Individual binaural room impulse responses (BRIRs) were recorded at a distance of 1.5 m for azimuth angles of 0° and 50° in a reverberant room. Spectral details were reduced in either the direct or the reverberant part of the BRIRs by averaging the magnitude responses with band-pass filters. For various filter bandwidths, the modified BRIRs were convolved with broadband noise and listeners judged the perceived position of the noise when virtualized over headphones. Only reductions in spectral details of the direct part obtained with filter bandwidths broader than one equivalent rectangular bandwidth affected externalization. Reductions in spectral details of the reverberant part had only little influence on externalization. In both conditions, externalization was not as pronounced at 0° as at 50°. To characterize the auditory processes that may be involved in the perception of externalization, a quantitative model is proposed. The model includes an echo-suppression mechanism, a filterbank describing the frequency selectivity in the cochlea and a binaural stage that measures the deviations of the interaural level differences between the considered input and the unmodified input. These deviations, integrated across frequency, are then mapped to a value that corresponds to the perceived externalization.
On the sampling criterion for structural radiation in fluid
Authors: Veronesi Giorgio , Nijman Eugène J. M.
Published: May 2016

When experimentally investigating the sound radiating from vibrating structures the surface is discretised into elemental areas also referred to as patches in which the surface vibrations are considered uniform. In many cases the structural Nyquist criterion imposes very small patch sizes which turn the experimental analysis into an overwhelmingly elaborate and error-prone task. The possibility to use a coarse sampling scheme for the surface velocity can greatly enhance the practical feasibility of such experimental investigations. Here the special case of a simply supported baffled plate excited by a broadband point force is considered. It is shown that accurate approximations of the radiated power may be obtained well beyond the frequency limit imposed by the structural Nyquist sampling criterion, provided the complex-valued vibration field is averaged over each patch. This is due to the fact that the structural wave components with wavenumbers greater than the acoustic wavenumber tend to be averaged out, owing to the mutual canceling of areas which vibrate out-of-phase within each patch, leaving only those components that contribute significantly to the radiated sound. It turns out, however, that this canceling process is not complete and that an error is introduced by the spatial aliasing. An analytical expression is derived allowing one to quantify this error and to optimise the patch size given a desired accuracy level and frequency range for the assessment of the radiated power. The proposed sampling criterion not only allows one to significantly reduce the measurement efforts when the radiation of vibro-acoustic systems are experimentally investigated but can also be applied to reduce the size of numerical models for weakly coupled structural-acoustic systems.
Suppressing the killer instinct
Authors: Campbell Kerry S.
Published: May 2016

A study extends the list of proteins targeted by the phosphatase SHP-1 to inhibit natural killer cell activation.
Forget about thrombosis: Platelets and Alzheimer’s disease, yet another sticky situation
Authors: McFadyen James , Peter Karlheinz
Published: May 2016

Antiplatelet drugs might inhibit the nexus of platelet activation and amyloid-β aggregation in Alzheimer’s disease.
Papers of note in
Science Translational Medicine
Authors: Ferrarelli Leslie K.
Published: May 2016

This week’s articles describe how SMAC mimetics kill leukemia cells and their application for patients.
Up-regulation of miR-31 in human atrial fibrillation begets the arrhythmia by depleting dystrophin and neuronal nitric oxide synthase
Authors: Reilly Svetlana N. , Liu Xing , Carnicer Ricardo , Recalde Alice , Muszkiewicz Anna , Jayaram Raja , Carena Maria Cristina , Wijesurendra Rohan , Stefanini Matilde , Surdo Nicoletta C. , Lomas Oliver , Ratnatunga Chandana , Sayeed Rana , Krasopoulos George , Rajakumar Timothy , Bueno-Orovio Alfonso , Verheule Sander , Fulga Tudor A. , Rodriguez Blanca , Schotten Ulrich , Casadei Barbara
Published: May 2016

Atrial microRNA-31 up-regulation causes dystrophin and nNOS depletion, which in turn contributes to the electrical phenotype of atrial fibrillation.
Dormant breast cancer micrometastases reside in specific bone marrow niches that regulate their transit to and from bone
Authors: Price Trevor T. , Burness Monika L. , Sivan Ayelet , Warner Matthew J. , Cheng Renee , Lee Clara H. , Olivere Lindsey , Comatas Karrie , Magnani John , Kim Lyerly H. , Cheng Qing , McCall Chad M. , Sipkins Dorothy A.
Published: May 2016

Breast cancer cells traffic to and from the peripheral blood within specific vascular niches, and this migration can be therapeutically targeted.
Amyloid-β peptide protects against microbial infection in mouse and worm models of Alzheimer’s disease
Authors: Kumar Deepak Kumar Vijaya , Choi Se Hoon , Washicosky Kevin J. , Eimer William A. , Tucker Stephanie , Ghofrani Jessica , Lefkowitz Aaron , McColl Gawain , Goldstein Lee E. , Tanzi Rudolph E. , Moir Robert D.
Published: May 2016

β-Amyloid protein oligomerization and fibrillization, known to be pathogenic in Alzheimer’s disease, may play a physiological role in microbial entrapment and innate immunity.
Staphylococcus aureus Protein A Mediates Interspecies Interactions at the Cell Surface of Pseudomonas aeruginosa
Authors: Armbruster Catherine R. , Wolter Daniel J. , Mishra Meenu , Hayden Hillary S. , Radey Matthew C. , Merrihew Gennifer , MacCoss Michael J. , Burns Jane , Wozniak Daniel J. , Parsek Matthew R. , Hoffman Lucas R.
Published: May 2016

While considerable research has focused on the properties of individual bacteria, relatively little is known about how microbial interspecies interactions alter bacterial behaviors and pathogenesis.
Staphylococcus aureus
frequently coinfects with other pathogens in a range of different infectious diseases. For example, coinfection by
S. aureus
with
Pseudomonas aeruginosa
occurs commonly in people with cystic fibrosis and is associated with higher lung disease morbidity and mortality.
S. aureus
secretes numerous exoproducts that are known to interact with host tissues, influencing inflammatory responses. The abundantly secreted
S. aureus
staphylococcal protein A (SpA) binds a range of human glycoproteins, immunoglobulins, and other molecules, with diverse effects on the host, including inhibition of phagocytosis of
S. aureus
cells. However, the potential effects of SpA and other
S. aureus
exoproducts on coinfecting bacteria have not been explored. Here, we show that
S. aureus
-secreted products, including SpA, significantly alter two behaviors associated with persistent infection. We found that SpA inhibited biofilm formation by specific
P. aeruginosa
clinical isolates, and it also inhibited phagocytosis by neutrophils of all isolates tested. Our results indicate that these effects were mediated by binding to at least two
P. aeruginosa
cell surface structures—type IV pili and the exopolysaccharide Psl—that confer attachment to surfaces and to other bacterial cells. Thus, we found that the role of a well-studied
S. aureus
exoproduct, SpA, extends well beyond interactions with the host immune system. Secreted SpA alters multiple persistence-associated behaviors of another common microbial community member, likely influencing cocolonization and coinfection with other microbes.

IMPORTANCE
Bacteria rarely exist in isolation, whether on human tissues or in the environment, and they frequently coinfect with other microbes. However, relatively little is known about how microbial interspecies interactions alter bacterial behaviors and pathogenesis. We identified a novel interaction between two bacterial species that frequently infect together—
Staphylococcus aureus
and
Pseudomonas aeruginosa
. We show that the
S. aureus
-secreted protein staphylococcal protein A (SpA), which is well-known for interacting with host targets, also binds to specific
P. aeruginosa
cell surface molecules and alters two persistence-associated
P. aeruginosa
behaviors: biofilm formation and uptake by host immune cells. Because
S. aureus
frequently precedes
P. aeruginosa
in chronic infections, these findings reveal how microbial community interactions can impact persistence and host interactions during coinfections.
Antagonism of the Sodium-Potassium ATPase Impairs Chikungunya Virus Infection
Authors: Ashbrook Alison W. , Lentscher Anthony J. , Zamora Paula F. , Silva Laurie A. , May Nicholas A. , Bauer Joshua A. , Morrison Thomas E. , Dermody Terence S.
Published: May 2016

Chikungunya virus (CHIKV) is a reemerging alphavirus that has caused epidemics of fever, arthralgia, and rash worldwide. There are currently no licensed vaccines or antiviral therapies available for the prevention or treatment of CHIKV disease. We conducted a high-throughput, chemical compound screen that identified digoxin, a cardiac glycoside that blocks the sodium-potassium ATPase, as a potent inhibitor of CHIKV infection. Treatment of human cells with digoxin or a related cardiac glycoside, ouabain, resulted in a dose-dependent decrease in infection by CHIKV. Inhibition by digoxin was cell type-specific, as digoxin treatment of either murine or mosquito cells did not diminish CHIKV infection. Digoxin displayed antiviral activity against other alphaviruses, including Ross River virus and Sindbis virus, as well as mammalian reovirus and vesicular stomatitis virus. The digoxin-mediated block to CHIKV and reovirus infection occurred at one or more postentry steps, as digoxin inhibition was not bypassed by fusion of CHIKV at the plasma membrane or infection with cell surface-penetrating reovirus entry intermediates. Selection of digoxin-resistant CHIKV variants identified multiple mutations in the nonstructural proteins required for replication complex formation and synthesis of viral RNA. These data suggest a role for the sodium-potassium ATPase in promoting postentry steps of CHIKV replication and provide rationale for modulation of this pathway as a broad-spectrum antiviral strategy.

IMPORTANCE
Mitigation of disease induced by globally spreading, mosquito-borne arthritogenic alphaviruses requires the development of new antiviral strategies. High-throughput screening of clinically tested compounds provides a rapid means to identify undiscovered, antiviral functions for well-characterized therapeutics and illuminate host pathways required for viral infection. Our study describes the potent inhibition of Chikungunya virus and related alphaviruses by the cardiac glycoside digoxin and demonstrates a function for the sodium-potassium ATPase in Chikungunya virus infection.
Differential Functional Constraints Cause Strain-Level Endemism in
Polynucleobacter
Populations
Authors: Sangwan Naseer , Zarraonaindia Iratxe , Hampton-Marcell Jarrad T. , Ssegane Herbert , Eshoo Tifani W. , Rijal Geeta , Negri M. Cristina , Gilbert Jack A.
Published: May 2016

Understanding the biological factors influencing habitat-wide genetic endemism is important for explaining observed biogeographic patterns.
Polynucleobacter
is a genus of bacteria that seems to have found a way to colonize myriad freshwater ecosystems and by doing so has become one of the most abundant bacteria in these environments. We sequenced metagenomes from locations across the Chicago River system and assembled
Polynucleobacter
genomes from different sites and compared how the nucleotide composition, gene codon usage, and the ratio of synonymous (codes for the same amino acid) to nonsynonymous (codes for a different amino acid) mutations varied across these population genomes at each site. The environmental pressures at each site drove purifying selection for functional traits that maintained a streamlined core genome across the Chicago River
Polynucleobacter
population while allowing for site-specific genomic adaptation. These adaptations enable
Polynucleobacter
to become dominant across different riverine environmental gradients.
Multicentre prospective survey of SeHCAT provision and practice in the UK
Authors: Summers Jennifer A , Peacock Janet , Coker Bolaji , McMillan Viktoria , Ofuya Mercy , Lewis Cornelius , Keevil Stephen , Logan Robert , McLaughlin John , Reid Fiona
Published: May 2016

Objective

A clinical diagnosis of bile acid malabsorption (BAM) can be confirmed using SeHCAT (tauroselcholic (75selenium) acid), a radiolabelled synthetic bile acid. However, while BAM can be the cause of chronic diarrhoea, it is often overlooked as a potential diagnosis. Therefore, we investigated the use of SeHCAT for diagnosis of BAM in UK hospitals.

Design

A multicentre survey was conducted capturing centre and patient-level information detailing patient care-pathways, clinical history, SeHCAT results, treatment with bile acid sequestrants (BAS), and follow-up in clinics. Eligible data from 38 centres and 1036 patients were entered into a validated management system.

Results

SeHCAT protocol varied between centres, with no standardised patient positioning, and differing referral systems. Surveyed patients had a mean age of 50 years and predominantly women (65%). The mean SeHCAT retention score for all patients was 19% (95% CI 17.8% to 20.3%). However, this differed with suspected BAM type: type 1: 9% (95% CI 6.3% to 11.4%), type 2: 21% (95% CI 19.2% to 23.0%) and type 3: 22% (95% CI 19.6% to 24.2%). Centre-defined ‘abnormal’ and ‘borderline’ results represented over 50% of the survey population. BAS treatment was prescribed to only 73% of patients with abnormal results.

Conclusions

The study identified a lack of consistent cut-off/threshold values, with differing centre criteria for defining an ‘abnormal’ SeHCAT result. BAS prescription was not related in a simple way to the SeHCAT result, nor to the centre-defined result, highlighting a lack of clear patient care-pathways. There is a clear need for a future diagnostic accuracy study and a better understanding of optimal management pathways.
State-level and community-level salt reduction initiatives: a systematic review of global programmes and their impact
Authors: Christoforou Anthea , Trieu Kathy , Land Mary-Anne , Bolam Bruce , Webster Jacqui
Published: May 2016

Background

High-salt diets are linked to elevated blood pressure, a major risk factor for cardiovascular diseases, particularly stroke. State and community salt reduction strategies may complement nationally led initiatives and contribute to achieving global salt reduction targets. We aim to systematically review such interventions and document reported impact where programmes have been evaluated.

Methods

Electronic databases were searched up to June 2015 using terms ‘salt’ or ‘sodium’ and ‘state’ and ‘community’ in combination with ‘campaign’, ‘initiative’, ‘project’, ‘strategy’, ‘intervention’ or ‘programme’. Data from evaluated and unevaluated interventions were included. Studies were analysed in relation to intervention components and outcome measures and appraised for quality using a Cochrane Risk-of-Bias Tool.

Results

39 state and community programmes were identified. Settings varied from whole communities (n=23), state-owned buildings (n=5), schools (n=7), workplaces (n=3) and correctional facilities (n=1). Strategies included nutrition education programmes, public education campaigns, changes to the food environment, other ‘novel’ approaches and multifaceted approaches. Of the 28 studies that evaluated intervention effectiveness, significant reductions were observed in terms of salt intake from dietary assessment (n=7), urinary sodium excretion (n=8), blood pressure (n=11) and sodium in foods (n=9). Six studies reported positive changes in consumer knowledge, attitudes and behaviours. All but two studies had some methodological limitations.

Conclusions

State and community salt reduction programmes may be effective in a range of settings but more robust evaluation methods are needed. Scaling up these efforts in coordination with national initiatives could provide the most effective and sustainable approach to reducing population salt intake.
Comparison of Safety and Efficacy of Laparoscopic Pyelolithotomy versus Percutaneous Nephrolithotomy in Patients with Large Renal Pelvic Stones: A Meta-Analysis
Authors: Rui Xuefang , Hu Haiyi , Yu Yanlan , Yu Shicheng , Zhang Zhigen
Published: May 2016

To compare percutaneous nephrolithotomy (PCNL) and laparoscopic pyelolithotomy (LP) for surgical management for large (>2 cm) renal stones. We searched MEDLINE, Cochrane, and EMBASE databases until March 11, 2015, using the following search terms: renalpelvic stone, percutaneous nephrolithotomy, laparoscopic pyelolithotomy. Randomized controlled and prospective and retrospective two-armed studies were included. Sensitivity analysis and assessment of the quality of the included studies and publication bias were performed. Nine studies were included in the study with a patient population of 622. The studies were homogeneous with respect to the primary end point of stone-free rate, but were heterogeneous with respect to operation time, length of hospital stay, and blood loss. A higher percentage of patients who received LP remained stone-free following surgery compared with patients who were treated with PCNL (p=0.001). However, the mean operation time was longer for patients with LP than for those treated with PCNL (p=0.002). There was no difference between procedures with regard to length of hospital stay or blood loss (p≥0.071). Sensitivity and quality analysis indicated that the data are reliable and the included studies are of good quality. No publication bias was observed. The study suggests that both procedures are effective and safe for removing large renal stones. However, LP may be more efficacious than PCNL in treating large kidney stones.
US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary
Authors: Floto R Andres , Olivier Kenneth N , Saiman Lisa , Daley Charles L , Herrmann Jean-Louis , Nick Jerry A , Noone Peadar G , Bilton Diana , Corris Paul , Gibson Ronald L , Hempstead Sarah E , Koetz Karsten , Sabadosa Kathryn A , Sermet-Gaudelus Isabelle , Smyth Alan R , van Ingen Jakko , Wallace Richard J , Winthrop Kevin L , Marshall Bruce C , Haworth Charles S
Published: May 2016

Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease, such as cystic fibrosis (CF). Pulmonary disease (PD) caused by NTM has emerged as a major threat to the health of individuals with CF, but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition.
Evaluation of 10‐minute versus 30‐minute tourniquet time for intravenous regional limb perfusion with amikacin sulfate in standing sedated horses
Authors: Kilcoyne I. , Dechant J. E. , Nieto J. E.
Published: May 2016

The objective of the article is to determine the synovial fluid concentrations of amikacin sulfate (AS) after performing an intravenous regional limb perfusion (IVRLP) with the tourniquet in place for 10 minutes and compare this with 30 minutes. This is a randomised crossover experimental design. Animals were seven healthy adult horses. Horses underwent two IVRLP procedures in a randomised, crossover design. The horses received IVRLP with 2 g AS diluted to 60 ml using 0.9% saline in the cephalic vein of alternate limbs with the tourniquet in place for either 10 or 30 minutes, with a washout period between procedures. Movement of the horses was recorded. Synovial fluid was collected from the radiocarpal and metacarpophalangeal joints at five minutes and 24 hours after IVRLP, and amikacin concentration was compared between groups. Amikacin was quantified by a fluorescence polarisation immunoassay. There was no significant difference between the synovial amikacin concentrations noted between 10 minute and 30 minute IVRLP. Horses in the 30 minute tourniquet application group demonstrated more movement than the 10 minute tourniquet group. There was a significant difference between groups with regard to the systemic venous blood concentration of amikacin one minute after tourniquet release with mean systemic venous blood concentrations of AS being higher (P=0.001) in the 10 minute group. Ten minute application of a wide elastic tourniquet may be sufficient when performing IVRLP in standing sedated horses.
Traditional Chinese Medications for Knee Osteoarthritis Pain: A Meta-Analysis of Randomized Controlled Trials
Authors: Chen Bo , Zhan Hongsheng , Marszalek Jolanta , Chung Mei , Lin Xun , Zhang Min , Pang Jian , Wang Chenchen
Published: May 2016

Traditional Chinese medication (TCM) has analgesic and anti-inflammatory effects in patients with knee osteoarthritis (OA). We conducted the first systematic review of the best quantitative and qualitative evidence currently available in order to evaluate the effectiveness of TCM in relieving pain in knee OA. A comprehensive literature search was conducted using three English and four Chinese biomedical databases from their inception through March 1, 2015. We included randomized controlled trials of TCM for knee OA with intervention durations of at least two weeks. The effects of TCM on pain and other clinical symptoms were measured with the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The total effectiveness rate, which was used to assess overall pain, physical performance and wellness, was also measured. Two researchers independently extracted data on study design, population characteristics, duration, intervention, outcomes, risk of bias, and primary results. We performed a random-effects meta-analysis when appropriate. We also explored factors that could explain the heterogeneity by conducting subgroup and meta-regression analyses. Twenty-three studies, totaling 2362 subjects, met the eligibility criteria. Treatments were formulated with an average of 8 Chinese herbs and were prescribed based on the traditional Chinese diagnostic method of syndrome differentiation. The mean treatment duration was seven weeks, with oral administration occurring one to three times a day. Compared with non-steroidal anti-inflammatory drugs and intra-articular hyaluronate injections, 18 of the studies showed significantly improved VAS pain scores (Mean Difference [MD] [Formula: see text] 0.56; 95% confidence interval [CI], 0.18 to 0.94; [Formula: see text]), six of the studies showed significantly improved WOMAC pain subscale scores (MD [Formula: see text] 2.23; 95% CI, 0.56 to 3.91; [Formula: see text]), and 16 of the trials showed significantly improved total effectiveness rates (risk ratio [Formula: see text] 1.12; 95% CI, 1.05 to 1.19; [Formula: see text] 0.0003). In addition, TCM showed a lower risk of adverse events than standard western treatments. This evidence suggests that TCM is safe and effective for improving pain, function, and wellness in treatments of knee OA. However, there is inherent clinical heterogeneity (diverse TCM formulations, controls, and treatment regimens) among the included trials. Despite these limitations, the potential analgesic effects of TCM warrant further methodologically rigorous research to determine the clinical implications of TCM on pain management in knee OA.