bluuebunny/crossref_metadata_2025 huggingface dataset:
Rural, Suburban, and Urban Differences in Factors That Impact Physician Adherence to Clinical Preventive Service Guidelines
Authors: Khoong Elaine C. , Gibbert Wesley S. , Garbutt Jane M. , Sumner Walton , Brownson Ross C.
Published: May 2013

Purpose

Rural‐urban disparities in provision of preventive services exist, but there is sparse research on how rural, suburban, or urban differences impact physician adherence to clinical preventive service guidelines. We aimed to identify factors that may cause differences in adherence to preventive service guidelines among rural, suburban, and urban primary care physicians.

Methods

This qualitative study involved in‐depth semistructured interviews with 29 purposively sampled primary care physicians (10 rural, 10 suburban, 9 urban) in Missouri. Physicians were asked to describe barriers and facilitators to clinical preventive service guideline adherence. Using techniques from grounded theory analysis, 2 coders first independently conducted content analysis then reconciled differences in coding to ensure agreement on intended meaning of transcripts.

Findings

Patient epidemiologic differences, distance to health care services, and care coordination were reported as prominent factors that produced differences in preventive service guideline adherence among rural, suburban, and urban physicians. Epidemiologic differences impacted all physicians, but rural physicians highlighted the importance of occupational risk factors in their patients. Greater distance to health care services reduced visit frequency and was a prominent barrier for rural physicians. Care coordination among health care providers was problematic for suburban and urban physicians. Patient resistance to medical care and inadequate access to resources and specialists were identified as barriers by some rural physicians.

Conclusions

The rural, suburban, or urban context impacts whether a physician will adhere to clinical preventive service guidelines. Efforts to increase guideline adherence should consider the barriers and facilitators unique to rural, suburban, or urban areas.
Evaluation of Baseline Cortisol, Endogenous ACTH, and Cortisol/ACTH Ratio to Monitor Trilostane Treatment in Dogs with Pituitary‐Dependent Hypercortisolism
Authors: Burkhardt W.A. , Boretti F.S. , Reusch C.E. , Sieber‐Ruckstuhl N.S.
Published: May 2013

Background

The effectiveness of trilostane treatment is currently monitored by regular ACTH stimulation tests, which are time‐consuming and expensive. Therefore, a monitoring system without a stimulation protocol and with less client expense would be preferable.

Hypothesis/Objectives

The aim of our study was to evaluate if baseline cortisol, endogenous ACTH (ACTH) concentration or the baseline cortisol to ACTH ratio (cortisol/ACTH ratio) could replace the ACTH stimulation test.

Animals

Forty trilostane‐treated dogs with pituitary‐dependent hypercortisolism (PDH) were included in this prospective study.

Methods

A total of 148 ACTH stimulation tests and 77 ACTH concentrations and cortisol/ACTH ratios were analyzed. Control of cortisol release was classified according to cortisol concentration after ACTH administration as excessive (<1.5 μg/dL; group 1), adequate (1.5–5.4 μg/dL; group 2), or inadequate (>5.4 μg/dL; group 3).

Results

Baseline cortisol concentrations had considerable overlap between excessively, adequately, and inadequately controlled dogs. Only baseline cortisol >4.4 μg/dL (in 12% of tests) was a reliable diagnosis of inadequate control. Endogenous ACTH concentrations did not differ between groups. The overlap of the cortisol/ACTH ratio between groups was large. Correct classification was only possible if the cortisol/ACTH ratio was >15, which occurred in 4% of tests.

Conclusions and Clinical Importance

To monitor trilostane treatment the ACTH stimulation test cannot be replaced by baseline cortisol, ACTH concentration, or the cortisol/ACTH ratio.
Genotypic variation in traits linked to climate and aboveground productivity in a widespread C4 grass: evidence for a functional trait syndrome
Authors: Aspinwall Michael J. , Lowry David B. , Taylor Samuel H. , Juenger Thomas E. , Hawkes Christine V. , Johnson Mari‐Vaughn V. , Kiniry James R. , Fay Philip A.
Published: May 2013

Examining intraspecific variation in growth and function in relation to climate may provide insight into physiological evolution and adaptation, and is important for predicting species responses to climate change.

Under common garden conditions, we grew nine genotypes of the C4 species Panicum virgatum originating from different temperature and precipitation environments. We hypothesized that genotype productivity, morphology and physiological traits would be correlated with climate of origin, and a suite of adaptive traits would show high broad‐sense heritability (H2).

Genotype productivity and flowering time increased and decreased, respectively, with home‐climate temperature, and home‐climate temperature was correlated with genotypic differences in a syndrome of morphological and physiological traits. Genotype leaf and tiller size, leaf lamina thickness, leaf mass per area (LMA) and C : N ratios increased with home‐climate temperature, whereas leaf nitrogen per unit mass (Nm) and chlorophyll (Chl) decreased with home‐climate temperature. Trait variation was largely explained by genotypic differences (H2 = 0.33–0.85).

Our results provide new insight into the role of climate in driving functional trait coordination, local adaptation and genetic divergence within species. These results emphasize the importance of considering intraspecific variation in future climate change scenarios.
Risks to biodiversity from hydraulic fracturing for natural gas in the Marcellus and Utica shales
Authors: Kiviat Erik
Published: May 2013

High‐volume horizontal hydraulic fracturing (HVHHF) for mining natural gas from the Marcellus and Utica shales is widespread in Pennsylvania and potentially throughout approximately 280,000 km2of the Appalachian Basin. Physical and chemical impacts of HVHHF include pollution by toxic synthetic chemicals, salt, and radionuclides, landscape fragmentation by wellpads, pipelines, and roads, alteration of stream and wetland hydrology, and increased truck traffic. Despite concerns about human health, there has been little study of the impacts on habitats and biota. Taxa and guilds potentially sensitive to HVHHF impacts include freshwater organisms (e.g., brook trout, freshwater mussels), fragmentation‐sensitive biota (e.g., forest‐interior breeding birds, forest orchids), and species with restricted geographic ranges (e.g., Wehrle's salamander, tongue‐tied minnow). Impacts are potentially serious due to the rapid development of HVHHF over a large region.
Genome‐wide association study of degenerative bony changes of the temporomandibular joint
Authors: Yamaguchi T , Nakaoka H , Yamamoto K , Fujikawa T , Kim Y‐I , Yano K , Haga S , Katayama K , Shibusawa T , Park SB , Maki K , Kimura R , Inoue I
Published: May 2013

Objectives

To identify susceptibility genes underlying degenerative bony changes of the temporomandibular joint (TMJ).

Materials and Methods

Bony changes of the TMJ condylar head were diagnosed by examination of panoramic radiographs and/or magnetic resonance images and/or computed tomography images. We conducted a genome‐wide association study (GWAS) of 146 cases with TMJ degeneration and 374 controls from East Asian populations using an Illumina HumanOmniExpress BeadChip. After rigorous quality‐control filtering, approximately 550 000 single nucleotide polymorphisms (SNPs) were used for tests of associations with disease status.

Results

Forty‐one SNPs at 22 independent loci showed association signals at P < 1 × 10−4. The SNP rs878962, which maps on an intron of TSPAN9 on chromosome 12, showed the strongest association (combined OR = 1.89, 95% confidence interval = 1.43–2.50, P = 8.1 × 10−6). According to in silico predictions of the 41 SNPs, two intronic SNPs of APOL3 (rs80575) and MRC2 (rs2460300) may fall within regulatory elements and affect DNA–protein interactions. We could not replicate SNPs located on genes that have been reported to be associated with temporomandibular disorder or temporomandibular osteoarthritis in previous studies at P < 1 × 10−4.

Conclusions

Our GWAS identified 22 independent loci showing suggestive association signals with degenerative bony changes of the TMJ. These loci provide good candidates for future follow‐up studies.
Utilizing integrated facility design to improve the quality of a pediatric ambulatory surgery center
Authors: Pelly Nicole , Zeallear Brian , Reed Mark , Martin Lynn
Published: May 2013

Aim

The aim was to use Integrated Facility Design (IFD) to design a surgery center that enhances the delivery of health care by developing processes that provide highly efficient patient, family, and provider flows while adding value and utilizing costly resources effectively.

Background

Integrated Facility Design is an adaptation of the Toyota 3P (Production, Preparation, Process) Program. The goal of IFD is to accelerate development time and lower start‐up costs.

Results

The use of IFD produced a savings of $30 million in project costs and enabled a completion date 3.5 months ahead of schedule. The designed patient flow processes resulted in dramatic improvements in patient, family, and provider throughput.

Conclusions

The use of IFD in the design of a pediatric ambulatory clinic and surgery resulted in significant cost savings and improved clinical efficiency.
Cognitive Function in Older Patients with Postherpetic Neuralgia
Authors: Pickering Gisèle , Pereira Bruno , Clère Florentin , Sorel Marc , de Montgazon Geraldine , Navez Malou , Picard Pascale , Roux Delphine , Morel Véronique , Salimani Rachida , Adda Mireille , Legout Valérie , Dubray Claude
Published: May 2013

Background and aims

Neuropathic pain has been shown to be accompanied by cognitive impairment, but the specific impact of postherpetic neuropathic pain on cognitive processes has not been explored. This study aims to evaluate the impact of pain on several domains of cognition in older patients with postherpetic neuralgia (PHN).

Methods

This cross‐sectional study (clinicaltrial.gov NCT 00989040) included 84 individuals after signature of informed consent. Participants: 42 patients with PHN and 42 healthy volunteers. Of the 42 PHN patients, 21 received systemic treatment (antidepressants, anticonvulsants, opiates) and 21 had topical treatment with the 5% lidocaine medicated plaster. All participants performed a panel of four cognitive tests: reaction time, semantic memory, decision‐making, and visual memory (Cantab®, Cambridge).

Results

Forty men and 44 women with a mean age of 72 ± 8 years participated. Each PHN patient was matched by age and gender with a healthy volunteer. Vigilance, decision‐making, and semantic memory were significantly impaired (P < 0.05) in patients on systemic treatment, especially with antidepressants, while no significant changes were noted between the lidocaine plaster group and their matched controls of healthy volunteers.

Conclusion

This study shows the deleterious effect of systemic PHN treatment on several domains of cognition. Cognitive impairment associated with pain and antidepressants may be reversed by topical pain management. Topical treatment with 5% lidocaine medicated plaster is a valuable alternative for pain alleviation and maintains cognitive integrity in this vulnerable population.
Predictive factors of negative outcome in initial atropine therapy for infantile hypertrophic pyloric stenosis
Authors: Koike Yuhki , Uchida Keiichi , Nakazawa Makoto , Inoue Mikihiro , Kusunoki Masato , Tsukamoto Yoshihide
Published: May 2013

Background

The predictive factors of negative outcome in initial i.v. atropine (IA) therapy of infantile hypertrophic pyloric stenosis (IHPS) are unknown. Conservative therapy for IHPS is useful for infants because it does not have the risk of surgical and anesthetic stress, but some cases of atropine therapy result in failure. This study clarified the predictive markers of negative outcome in initial atropine therapy for IHPS.

Methods

Seventy‐six patients with IHPS admitted from 1998 to 2011 were included in this study. The predictive risk factors of negative outcome in initial atropine therapy for IHPS were evaluated.

Results

Thirty‐one patients initially underwent non‐operative therapy for IHPS during the study period. Of the 31 patients, 18 (58%) ceased projectile vomiting (PV) with IA and subsequent oral atropine. Univariate analysis showed that lack of bodyweight gain before treatment, elevated urine potassium at admission, and PV occurring ≥5 times (PV ≥5) in total for 3 days from IA initiation were predictive risk factors for negative outcome in IHPS. Multivariate analysis identified only PV ≥5 in total for 3 days after IA initiation as independently associated with failure of atropine for IHPS.

Conclusions

PV ≥5 in total for 3 days after IA initiation is a potential indicator of negative outcome of IA in IHPS patients. The present results provide valuable information for determining whether early surgical intervention for IHPS or initial atropine therapy is the best option.
Effect of Different Manganese Concentrations during in vitro Maturation of Bovine Oocytes on DNA Integrity of Cumulus Cells and Subsequent Embryo Development
Authors: Anchordoquy JP , Anchordoquy JM , Sirini MA , Mattioli G , Picco SJ , Furnus CC
Published: May 2013

Contents

Manganese (Mn) is a trace element present in forages and cereals, and its concentration depends on soil status. Manganese deficiency in cattle, goats and ewes not only impairs oestrous cycle but reduces calf birth weight. The achievement of the first oestrus is delayed, and more attempts are necessary to obtain a successful conception. This study was conducted to investigate the effect of the availability of supplemental Mn during IVM on DNA damage of cumulus cells and total glutathione (GSH) content in oocytes and cumulus cells. The effect of supplementary Mn during IVM on subsequent embryo development was also studied. The results reported here indicate (i) DNA damage in cumulus cells decreased with 0, 2, 5 and 6 ng/ml Mn supplementation during IVM (p < 0.05). (ii) Intracellular GSH‐GSSG content increased (p < 0.01) with different Mn concentrations in oocytes and cumulus cells. Also, cumulus cell number per cumulus oocyte‐complexes (COC) did not differ either before or after IVM. (iii) Addition of Mn to maturation medium resulted in similar cleavage rates (p > 0.05) at 0, 2, 5 and 6 ng/ml Mn. However, subsequent embryo development to blastocyst stage was significantly higher (p < 0.01) in oocytes matured with 5 and 6 ng/ml Mn. (iv) There was also an increase (p < 0.05) in mean cell number per blastocyst obtained from oocytes matured with 5 and 6 ng/ml respect to zero Mn (IVM alone) and 2 ng/ml Mn. This study provides evidence that optimal embryo development to the blastocyst stage was partially dependent on the presence of Mn during IVM. Moreover, the availability of Mn during oocyte maturation ensures ‘normal’ intracellular GSH content in COCs and protects DNA integrity of cumulus cells.
Effect of salbutamol on the measurement of single‐breath diffusing capacity
Authors: Yang Jun , Stanton Josh , Wang Lexin , Beckert Lutz , Frampton Chris , Burton Debbie , Swanney Maureen P.
Published: May 2013

Background and objective

The bronchodilation and cardiovascular effects of bronchodilators may alter alveolar ventilation and perfusion distribution, which could subsequently affect single‐breath diffusing capacity of the lungs for carbon monoxide (DL,CO) measurements. The aim of this study was to investigate the effect of salbutamol on DL,CO in subjects with and without airway obstruction and reversibility.

Methods

Sixty subjects were investigated with 20 in each of the three groups: normal spirometry; irreversible obstruction; and reversible obstruction. Baseline spirometry, plethysmographic lung volumes, DL,CO, pulse rate and arterial blood gases were measured. The same testing sequence was repeated after administration of a placebo inhaler and again after 400 μg salbutamol.

Results

Salbutamol did not affect the mean alveolar volume (VA) (P > 0.05), transfer coefficient for carbon monoxide (DL,CO/VA, KCO) (P > 0.05) or DL,CO (P > 0.05) in the normal and irreversible obstruction groups. In the reversible obstruction group, salbutamol caused an increase in the mean VA compared with placebo (P < 0.001). However, the mean KCO was reduced (P < 0.001). The mean change in DL,CO was not significant (P > 0.05). A considerable reduction in DL,CO was found after salbutamol in four subjects in the reversible group as a result of a minor increase in VA and substantial decrease in KCO. No statistical difference in pulse rate or arterial blood gases values was detected.

Conclusions

Salbutamol had no effect on the mean DL,CO in any group. However, salbutamol may considerably reduce DL,CO in some individuals with reversibility secondary to its effects on VA and KCO.
On the Galilean Invariance of Some Nonlinear Dispersive Wave Equations
Authors: Duran Angel , Dutykh Denys , Mitsotakis Dimitrios
Published: May 2013

Surface water waves in ideal fluids have been typically modeled by asymptotic approximations of the full Euler equations. Some of these simplified models lose relevant properties of the full water wave problem. One of these properties is the Galilean symmetry, that is, the invariance under Galilean transformations. In this paper, a mechanism to incorporate Galilean invariance in classical water wave models is proposed. The technique is applied to the Benajmin–Bona–Mahony (BBM) equation and the Peregrine (classical Boussinesq) system, leading to the corresponding Galilean invariant versions of these models. Some properties of the new equations are presented, with special emphasis on the computation and interaction of solitary wave solutions. A comparison with the Euler equations demonstrates the relevance of the Galilean invariance in the description of water waves.
On a Boussinesq Capillarity System: Hamiltonian Reductions and Associated Quartic Geometries
Authors: Rogers C. , Schief W. K.
Published: May 2013

A nonlinear Boussinesq‐type capillarity model system is shown to admit exact reductions to coupled Hamiltonian subsystems associated with time‐modulated quartic density distributions. In particular, in 3+1 dimensions, time‐modulated “red blood cell” geometries for the density distribution are isolated.
Experimental Investigation of Strain Behaviour of Heated Cement Paste and Concrete
Authors: Ring T. , Zeiml M. , Lackner R. , Eberhardsteiner J.
Published: May 2013

The material degradation of concrete subjected to fire events has a severe influence on the load‐carrying capacity of support structures. Spalling of concrete layers, exposing the reinforcement bars and degradation of the material properties (Young's modulus, compressive strength) may lead to significant damage of the reduced cross‐section and, therefore, cause failure of the structure. In order to understand the stress build‐up at the heated surface caused by thermal expansion due to fire loading, finally leading to damage and spalling of concrete, the strain behaviour of cement paste and concrete exposed to combined thermo‐mechanical loading is the focus of this work. Hereby, the evolution of thermal strains, Young's modulus and Poisson's ratio with increasing temperature are investigated experimentally. For this purpose, the specimens are loaded uniaxially while the temperature is increased up to 800 °C. The obtained results provide the proper basis for the development of realistic material models, allowing more sophisticated simulations of structures exposed to fire.
Spectral domain optical coherence tomography imaging of the posterior segment of the eye in the retinal dysplasia and degeneration chicken, an animal model of inherited retinal degeneration
Authors: McKibbin Martin , Ali Manir , Inglehearn Chris , Shires Mike , Boyle Kenny , Hocking Paul M.
Published: May 2013

Objective

To investigate qualitative and quantitative differences in the structure of the posterior segment of the eye in 1‐day post‐hatch and 12‐month‐old retinal dysplasia and degeneration (rdd) and wild‐type chickens.

Animal studied

Retinal dysplasia and degeneration and wild‐type chickens.

Procedure

Using a commercially available spectral domain optical coherence tomography (OCT) system, 15° horizontal line scans were performed in both eyes of 24 live birds. Qualitative differences in retinal lamination and choroidal structure were investigated, and retinal and choroidal thickness were measured.

Results

Progressive retinal thinning with loss of outer retinal lamination and changes in the appearance of the choroid were seen in the rdd birds. Mean total retinal thickness was 202 μm (SD 7.8) and 251 μm (SD 8.8) in the rdd and wild‐type chicks and 154 μm (SD 18) and 280 μm (SD 10.8) in the adult birds. Much of the difference was the result of loss of outer retinal lamination and thickness in the rdd birds. Mean choroidal thickness was 76 μm (SD 19.6) and 112 μm (SD 36.9) in the rdd and wild‐type chicks and 85 μm (SD 23.7) and 228 μm (SD 44.1) in the rdd and wild‐type adult birds, respectively.

Conclusions

Differences in retinal and choroidal structure and thickness between rdd and wild‐type birds were evident on spectral domain OCT imaging at 1‐day post‐hatch and more marked at 1 year. Spectral domain OCT may provide a reliable end point for therapeutic intervention in this animal model of inherited retinal degeneration.
Lung texture in serial thoracic CT scans: Registration‐based methods to compare anatomically matched regions
Authors: Cunliffe Alexandra R. , Armato Samuel G. , Fei Xianhan M. , Tuohy Rachel E. , Al‐Hallaq Hania A.
Published: May 2013

Purpose:

The aim of this study was to compare three demons registration‐based methods to identify spatially matched regions in serial computed tomography (CT) scans for use in texture analysis.

Methods:

Two thoracic CT scans containing no lung abnormalities and acquired during serial examinations separated by at least one week were retrospectively collected from 27 patients. Over 1000 regions of interest (ROIs) were randomly placed in the lungs of each baseline scan. Anatomically matched ROIs in the corresponding follow‐up scan were placed by mapping the baseline scan ROI center pixel to (1) the original follow‐up scan, (2) the follow‐up scan resampled to match the baseline scan voxel size, and (3) the follow‐up scan aligned to the baseline scan through affine registration. Mappings used the vector field obtained through demons deformable registration of each follow‐up scan variant to the baseline scan. 140 texture features distributed among five feature classes were calculated in all ROIs. Feature value differences between paired ROIs were evaluated using Bland‐Altman 95% limits of agreement. For each feature, (1) the mean feature value change and (2) the difference between the upper and lower limits of agreement were normalized to the mean feature value to obtain, respectively, the normalized bias and normalized range of agreement (nRoA). Nonparametric tests were used to evaluate differences in normalized bias and nRoA across the three methods.

Results:

Because patient CT scans contained no pathology, minimal changes in feature values were expected (i.e., low nRoA and normalized bias). Seventy‐five features with very large feature value variability (nRoA ≥ 100%) were excluded from further analysis. Across the remaining 65 features, significant differences in normalized bias were observed among the three methods. The lowest normalized bias (median: 0.06%) was achieved when feature values were calculated on original follow‐up scans. The affine registration method achieved the lowest nRoA, though nRoA was not significantly increased using original follow‐up scans. Features with low nRoA values also had low normalized bias, though the converse was not necessarily true. Using nRoA as a metric, a set of 20 features having both low nRoA and normalized bias were identified.

Conclusions:

Three methods to facilitate texture analysis of serial CT scans using demons registration for ROI placement were evaluated. The bias in feature value change between matched ROIs was minimized when feature values were calculated on original baseline and follow‐up scans. A set of features that had both low bias and variability (nRoA) in feature value change using this method were identified. This texture analysis approach could facilitate future measurement of pathologic changes between CT scans without necessitating calculation of feature values on deformed scans.
Periodic Segregation of Solute Atoms in Fully Coherent Twin Boundaries
Authors: Nie J. F. , Zhu Y. M. , Liu J. Z. , Fang X. Y.
Published: May 2013

The Strength of Impurities

The practical strength of a material (rather than its theoretical strength) is influenced by the presence of defects between crystalline domains and the inclusion of impurities. In some cases, synergistic effects may arise where the impurity atoms segregate to the domain boundaries, although kinetic barriers may limit the extent to which the impurity atoms can order.

Nie
et al.

(p.
957
) show the segregation of oversized and undersized solute atoms at coherent twin boundaries in a magnesium alloy. The minimization of strain energy drives the differently sized impurities to different twin boundaries, strengthening the material.
The Cells and Circuitry for Itch Responses in Mice
Authors: Mishra Santosh K. , Hoon Mark A.
Published: May 2013

The Master Switch for Itch?

Recently, gastrin-releasing peptide (GRP) has been implicated as the primary neurotransmitter between itch-sensitive nerve fibers and downstream neurons in the spinal cord. However,
Mishra and Hoon
(p.
968
) challenge this view, provide evidence that natriuretic polypeptide b (Nppb) is the central itch neurotransmitter, and suggest that GRP is released by second-order neurons in the spinal dorsal horn that express the Nppb receptor and are excited by Nppb.
Separation of Hexane Isomers in a Metal-Organic Framework with Triangular Channels
Authors: Herm Zoey R. , Wiers Brian M. , Mason Jarad A. , van Baten Jasper M. , Hudson Matthew R. , Zajdel Pawel , Brown Craig M. , Masciocchi Norberto , Krishna Rajamani , Long Jeffrey R.
Published: May 2013

Telling Hexanes Apart

The efficiency of modern internal combustion engines depends on the relative reactivity of the hydrocarbons that comprise the fuel. In particular, branched hydrocarbons are less likely than their linear counterparts to react prematurely—a property reflected in the fuel mixture's octane number.

Herm
et al.

(p.
960
) report a metal organic framework material with triangular pore channels that discriminate among the differently shaped isomers of hexane more finely than the commercial standard.
Response to Comments on “ApoE-Directed Therapeutics Rapidly Clear β-Amyloid and Reverse Deficits in AD Mouse Models”
Authors: Landreth Gary E. , Cramer Paige E. , Lakner Mitchell M. , Cirrito John R. , Wesson Daniel W. , Brunden Kurt R. , Wilson Donald A.
Published: May 2013

The data reported in the Technical Comments by Fitz
et al
., Price
et al
., Tesseur
et al
., and Veeraraghavalu
et al
. replicate and validate our central conclusion that bexarotene stimulates the clearance of soluble β-amyloid peptides and results in the reversal of behavioral deficits in mouse models of Alzheimer’s disease (AD). The basis of the inability to reproduce the drug-stimulated microglial-mediated reduction in plaque burden is unexplained. However, we concluded that plaque burden is functionally unrelated to improved cognition and memory elicited by bexarotene.
Unveiling the Malaria Parasite's Cloak of Invisibility?
Authors: Philip Nisha , Waters Andrew P.
Published: May 2013

Identification of a surface protein in
Plasmodium falciparum
reveals how it can escape detection by the mosquito immune system.

[Also see Report by

Molina-Cruz
et al.

]
Hubs Aim to Reinvent DOE Research Culture
Authors: Cho Adrian
Published: May 2013

The U.S. Department of Energy has funded a series of energy innovation hubs to tackle big energy challenges from start to finish. But their future is uncertain.
Are Isle Royale's Wolves Chasing Extinction?
Authors: Mlot Christine
Published: May 2013

Wolves in an iconic predator-prey study are not producing pups, leaving scientists to confront a genetic rescue—or the project's demise.
Real-Time Genomic Epidemiological Evaluation of Human Campylobacter Isolates by Use of Whole-Genome Multilocus Sequence Typing
Authors: Cody Alison J. , McCarthy Noel D. , Jansen van Rensburg Melissa , Isinkaye Tomide , Bentley Stephen D. , Parkhill Julian , Dingle Kate E. , Bowler Ian C. J. W. , Jolley Keith A. , Maiden Martin C. J.
Published: May 2013

Sequence-based typing is essential for understanding the epidemiology of
Campylobacter
infections, a major worldwide cause of bacterial gastroenteritis. We demonstrate the practical and rapid exploitation of whole-genome sequencing to provide routine definitive characterization of
Campylobacter jejuni
and
Campylobacter coli
for clinical and public health purposes. Short-read data from 384
Campylobacter
clinical isolates collected over 4 months in Oxford, United Kingdom, were assembled
de novo
. Contigs were deposited at the
pubMLST.org
/campylobacter website and automatically annotated for 1,667 loci. Typing and phylogenetic information was extracted and comparative analyses were performed for various subsets of loci, up to the level of the whole genome, using the Genome Comparator and Neighbor-net algorithms. The assembled sequences (for 379 isolates) were diverse and resembled collections from previous studies of human campylobacteriosis. Small subsets of very closely related isolates originated mainly from repeated sampling from the same patients and, in one case, likely laboratory contamination. Much of the within-patient variation occurred in phase-variable genes. Clinically and epidemiologically informative data can be extracted from whole-genome sequence data in real time with straightforward, publicly available tools. These analyses are highly scalable, are transparent, do not require closely related genome reference sequences, and provide improved resolution (i) among
Campylobacter
clonal complexes and (ii) between very closely related isolates. Additionally, these analyses rapidly differentiated unrelated isolates, allowing the detection of single-strain clusters. The approach is widely applicable to analyses of human bacterial pathogens in real time in clinical laboratories, with little specialist training required.
Comparison of Five Media for Detection of Extended-Spectrum Beta-Lactamase by Use of the Wasp Instrument for Automated Specimen Processing
Authors: Grohs P. , Tillecovidin B. , Caumont-Prim A. , Carbonnelle E. , Day N. , Podglajen I. , Gutmann L.
Published: May 2013

Overall, 2,337 rectal screening samples (RSSs) were seeded by using the Wasp instrument for automated microbiological processing with five media for detection of extended-spectrum β-lactamase (ESBL): CHROMagar, ChromID, Brilliance, BD Drigalski, and HEGP media. Of 354 RSSs harboring ESBL-producing isolates, 89.3% were found to be positive on all media. Sensitivity and specificity ranged from 95.5 to 98.3% and from 57.9 to 72.3%, respectively. No medium was perfectly ESBL selective, and non-ESBL-producing strains were mainly
Enterobacteriaceae
overproducing AmpC β-lactamase and nonfermenting Gram-negative bacilli, mostly
Pseudomonas aeruginosa
.
Evaluation of Trans-Vag Broth, Colistin-Nalidixic Agar, and CHROMagar StrepB for Detection of Group B Streptococcus in Vaginal and Rectal Swabs from Pregnant Women in South Africa
Authors: Kwatra Gaurav , Madhi Shabir A. , Cutland Clare L. , Buchmann Eckhart J. , Adrian Peter V.
Published: May 2013

Maternal vaginal colonization with group B streptococcus (GBS) is a major risk factor for invasive GBS infection in newborns. The CDC-recommended method for detecting GBS colonization is to culture vaginal and rectal swabs in a selective broth followed by subculture on blood agar or a selective medium. A high incidence of antimicrobial resistance in the fecal microflora can compromise the recovery of GBS from the selective broth. Here, we compared CHROMagar StrepB (CA), Columbia colistin-nalidixic agar (CNA), and Trans-Vag selective broth enrichment for the isolation of GBS from 130 vaginal and 130 rectal swabs from pregnant women. The swabs were randomized for plating first on either CA or CNA, and they then were inoculated in Trans-Vag broth. GBS was cultured from 37.7% of the vaginal swabs and 33.1% of the rectal swabs. There were no differences in the detection rates for the vaginal swabs between CA (31.5%), CNA (26.2%), and the selective broth (30.0%). The sensitivities in relation to a composite score were 83.7%, 69.4%, and 79.6%, respectively. However, recovery of GBS from the rectal swabs was significantly higher from CA (29.2%;
P
< 0.0001) and CNA (23.8%;
P
= 0.002) than from the selective broth (9.2%). The sensitivities were 88.4%, 72.1%, and 27.9%, respectively. The order of plating on the solid medium was significant (
P
= 0.003), with GBS detection rates of 30.8% and 24.6% when swabs were plated first and second, respectively. These findings show that a selective broth is not suitable for the recovery of GBS from rectal swabs in settings such as ours, due to masking of the GBS colonies by persistent microflora.
Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting
Authors: Merkier Andrea Karina , Rodríguez María Cecilia , Togneri Ana , Brengi Silvina , Osuna Carolina , Pichel Mariana , Cassini Marcelo H. ,   Serratia marcescens Argentinean Collaborative Group, Centrón Daniela
Published: May 2013

Serratia marcescens
causes health care-associated infections with important morbidity and mortality. Particularly, outbreaks produced by multidrug-resistant isolates of this species, which is already naturally resistant to several antibiotics, including colistin, are usually described with high rates of fatal outcomes throughout the world. Thus, it is important to survey factors associated with increasing frequency and/or emergence of multidrug-resistant
S. marcescens
nosocomial infections. We report the investigation and control of an outbreak with 40% mortality due to multidrug-resistant
S. marcescens
infections that happened from November 2007 to April 2008 after treatment with colistin for
Acinetobacter baumannii
meningitis was started at hospital H1 in 2005. Since that year, the epidemiological pattern of frequently recovered species has changed, with an increase of
S. marcescens
and
Proteus mirabilis
infections in 2006 in concordance with a significant decrease of the numbers of
P. aeruginosa
and
A. baumannii
isolates. A single pulsed-field gel electrophoresis (PFGE) cluster of
S. marcescens
isolates was identified during the outbreak. When this cluster was compared with
S. marcescens
strains (
n
= 21) from 10 other hospitals (1997 to 2010), it was also identified in both sporadic and outbreak isolates circulating in 4 hospitals in Argentina. In132::IS
CR1
::
bla
CTX-M-2
was associated with the multidrug-resistant cluster with epidemic behavior when isolated from outbreaks. Standard infection control interventions interrupted transmission of this cluster even when treatment with colistin continued in several wards of hospital H1 until now. Optimizing use of colistin should be achieved simultaneously with improved infection control to prevent the emergence of species naturally resistant to colistin, such as
S. marcescens
and
P. mirabilis
.
Systems To Establish Bunyavirus Genome Replication in the Absence of Transcription
Authors: Klemm Carolin , Reguera Juan , Cusack Stephen , Zielecki Florian , Kochs Georg , Weber Friedemann
Published: May 2013

The L polymerase of bunyaviruses replicates and transcribes the viral genome. While replication products are faithful copies of the uncapped genomic RNA, transcription products contain capped 5′ extensions which had been cleaved from host cell mRNAs. For La Crosse virus (LACV; genus
Orthobunyavirus
), the nuclease responsible for host cell mRNA cleavage is located at the N terminus of the L protein, with an active site of five conserved amino acids (H34, D52, D79, D92, and K94) surrounding two Mn
2+
ions (J. Reguera, F. Weber, and S. Cusack, PLoS Pathog. 6:e1001101, 2010). Here, we present reverse genetics systems and L mutants enabling us to study bunyaviral genome replication in the absence of transcription. Transcription was evaluated with an enhanced minigenome system consisting of the viral polymerase L, nucleocapsid protein N, a negative-sense minigenome, and—to alleviate antiviral host responses—a dominant-negative mutant (PKRΔE7) of the antiviral kinase protein kinase R (PKR). The transcriptional activity was strongly reduced by mutation of any of the five key amino acids, and the H34K, D79A, D92A, and K94A LACV L mutants were almost entirely silent in transcription. The replication activity of the L mutants was measured by packaging of progeny minigenomes into virus-like particles (VLPs). All mutant L proteins except K94A retained full replication activity. To test the broader applicability of our results, we introduced the homolog of mutation D79A (D111A) into the L sequence of Rift Valley fever virus (RVFV; genus
Phlebovirus
). As for LACV D79A, the RVFV D111A was incapable of transcription but fully active in replication. Thus, we generated mutants of LACV and RVFV L polymerases that are specifically deficient in transcription. Genome replication by bunyavirus polymerases can now be studied in the absence of transcription using convenient reverse genetics systems.
Recombinant IgA Is Sufficient To Prevent Influenza Virus Transmission in Guinea Pigs
Authors: Seibert Christopher W. , Rahmat Saad , Krause Jens C. , Eggink Dirk , Albrecht Randy A. , Goff Peter H. , Krammer Florian , Duty J. Andrew , Bouvier Nicole M. , García-Sastre Adolfo , Palese Peter
Published: May 2013

A serum hemagglutination inhibition (HAI) titer of 40 or greater is thought to be associated with reduced influenza virus pathogenesis in humans and is often used as a correlate of protection in influenza vaccine studies. We have previously demonstrated that intramuscular vaccination of guinea pigs with inactivated influenza virus generates HAI titers greater than 300 but does not protect vaccinated animals from becoming infected with influenza virus by transmission from an infected cage mate. Only guinea pigs intranasally inoculated with a live influenza virus or a live attenuated virus vaccine, prior to challenge, were protected from transmission (A. C. Lowen et al., J. Virol. 83:2803–2818, 2009.). Because the serum HAI titer is mostly determined by IgG content, these results led us to speculate that prevention of viral transmission may require IgA antibodies or cellular immune responses. To evaluate this hypothesis, guinea pigs and ferrets were administered a potent, neutralizing mouse IgG monoclonal antibody, 30D1 (Ms 30D1 IgG), against the A/California/04/2009 (H1N1) virus hemagglutinin and exposed to respiratory droplets from animals infected with this virus. Even though HAI titers were greater than 160 1 day postadministration, Ms 30D1 IgG did not prevent airborne transmission to passively immunized recipient animals. In contrast, intramuscular administration of recombinant 30D1 IgA (Ms 30D1 IgA) prevented transmission to 88% of recipient guinea pigs, and Ms 30D1 IgA was detected in animal nasal washes. Ms 30D1 IgG administered intranasally also prevented transmission, suggesting the importance of mucosal immunity in preventing influenza virus transmission. Collectively, our data indicate that IgG antibodies may prevent pathogenesis associated with influenza virus infection but do not protect from virus infection by airborne transmission, while IgA antibodies are more important for preventing transmission of influenza viruses.
The Rabies Virus Interferon Antagonist P Protein Interacts with Activated STAT3 and Inhibits Gp130 Receptor Signaling
Authors: Lieu Kim G. , Brice Aaron , Wiltzer Linda , Hirst Bevan , Jans David A. , Blondel Danielle , Moseley Gregory W.
Published: May 2013

Immune evasion by rabies virus depends on targeting of the signal transducers and activator of transcription 1 (STAT1) and STAT2 proteins by the viral interferon antagonist P protein, but targeting of other STAT proteins has not been investigated. Here, we find that P protein associates with activated STAT3 and inhibits STAT3 nuclear accumulation and Gp130-dependent signaling. This is the first report of STAT3 targeting by the interferon antagonist of a virus other than a paramyxovirus, indicating that STAT3 antagonism is important to a range of human-pathogenic viruses.
A laparoscopic transgastric approach to the treatment of sphincter of Oddi dysfunction postgastric bypass
Authors: Dickinson Karen J , Beckett Conrad G , May John C , Halstead James C
Published: May 2013

Obesity is endemic and bariatric surgery is increasing in an attempt to reduce the physiological and social cost. As the prevalence of bariatric surgery increases, in particular laparoscopic roux-en-Y gastric bypass (LRYGB), the need to investigate and treat subsequent pathology in the gastric remnant and biliary tree will accrue. We describe a novel combined surgical and endoscopic technique addressing the challenges of postoperative anatomy, allowing investigation and treatment of the gastric remnant and biliary tract. We present the case of a patient with sphincter of Oddi dysfunction post-LRYGB who underwent laparoscopic transgastric endoscopic injection of Botox into the ampulla with an excellent symptomatic relief. Subsequent laparoscopic transgastric sphincterotomy allowed definitive treatment and allowed symptom resolution at 6 months follow-up. Laparoscopic transgastric endoscopic investigation and treatment is a novel approach to circumvent the restrictions of post-LRYGB anatomy and may assume greater importance in an ageing obese population.
Non-syndromic multiple supernumerary teeth in permanent dentition: a rare phenomenon
Authors: Yadav Rakesh Kumar , Rao Jitendra , Yadav Lakhya , Hasija Mukesh
Published: May 2013

Hyperdontia or supernumerary teeth in the absence of associated systemic condition or syndrome is an uncommon phenomenon. Non-syndromic supernumerary teeth need to have periodical radiographic observation. In the case of asymptomatic condition, as they impacted in the jaw, a careful examination is necessary because they may develop into pathological status such as dentigerous cysts. Surgical removal of such teeth is indicated if evidence of any pathologies, such as cystic lesion, resorption, delayed eruption, altered eruption and displacement of adjacent teeth, is evident or have occurred.
Porphyria: varied ocular manifestations and management
Authors: Sati Alok , Sangwan Virender S , Basu Sayan
Published: May 2013

On review of past 10 years medical records, we could find four typical cases of porphyria with rare ocular manifestations. Cases 1, 2 and 4 have presented with features suggestive of acute scleritis. Based on clinical, biochemical and dermatological evaluation, all these three cases were diagnosed to have congenital erythropoietic porphyria. Case 1 was initially managed with scleral patch graft which on subsequent melt was managed with double layered amniotic membrane grafting along with conjunctival advancement and lateral paramedian tarsorrhaphy in both the eyes. Cases 2 and 4 were managed conservatively with artificial tear drops and general protective measures. Case 3 was presented with multiple failed grafts due to repeated ulceration and infection. Owing to multiple failed grafts, Boston keratoprosthesis was done and the patient is doing well with stable kertaoprosthesis at the last follow-up visit.
Ventriculoperitoneal shunt disconnection associated with spontaneous knot formation in the peritoneal catheter
Authors: Lo William B , Ramirez Roberto , Rodrigues Desiderio , Solanki Guirish A
Published: May 2013

A 10-year-old girl underwent distal ventriculoperitoneal (VP) shunt revision 3 weeks earlier and developed further shunt malfunction. During the current shunt revision, a disconnection at the straight connector site in the cervical subcutaneous tissue was confirmed and a knot was identified in the peritoneal catheter. Postoperatively, the patient made a rapid neurological recovery and was discharged 48 h later. This is the first case of VP shunt disconnection associated with a spontaneous distal knot formation. The likely mechanism was that the spontaneously formed knot acted as an anchor at the peritoneal wall, preventing free relative movement of the distal catheter. The resultant tension led to failure at the weakest point of the system, resulting in a disconnection at the proximal straight connector site.
Intracranial haemorrhage 4 days after receiving thrombolytic therapy in a young woman with myocardial infarction
Authors: Ali Sameera Mohamed , Rajani Ali Raza , Baslaib Fahad Omar
Published: May 2013

Intracranial haemorrhage is a known complication after fibrinolytic therapy and occurs usually in the first 24 h. We report a 35-year-old woman who presented with severe central chest pain and she was diagnosed as anterior ST elevation myocardial infarction. She was given fibrinolytic therapy with Tenecteplase. She responded well to the treatment with a decrease in the intensity of chest pain and resolution of the ST segment elevation. She was taken for coronary angiogram the next day, which revealed an occlusion of the left anterior descending (LAD) artery, and stenting of LAD was carried out. Four  days later, she developed severe headache, confusion, slurring of speech and right haemiparesis. CT brain revealed intracerebral haemorrhage and she was referred to an neurosurgeon who advised for conservative management. Her condition gradually improved with physiotherapy and was discharged home with no marked functional impairment.
Generalized ghost dark energy in Brans–Dicke theory
Authors: Sheykhi A. , Ebrahimi E. , Yousefi Y.
Published: May 2013

It was argued that the vacuum energy of the Veneziano ghost field of QCD, in a time-dependent background, can be written in the general form, H + O(H2), where H is the Hubble parameter. Based on this, a phenomenological dark energy model whose energy density is of the form ρ = αH + βH2 was recently proposed to explain the dark energy dominated universe. In this paper, we investigate this generalized ghost dark energy model in the setup of Brans–Dicke cosmology. We study the cosmological implications of this model. In particular, we obtain the equation of state, the deceleration parameters, and a differential equation governing the evolution of this dark energy model. It is shown that the equation of state parameter of the generalized ghost dark energy can cross the phantom line (wD = −1) in some range of the parameters spaces.