bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of the duodenal eosinophil content in adults: a necessary step for an evidence‐based diagnosis of duodenal eosinophilia
Authors: Genta R. M. , Sonnenberg A. , Turner K.
Published: February 2018

Background

The normal content of eosinophils in the adult duodenum remains undefined. Therefore, there is no foundation for evidence‐based criteria to diagnose eosinophilic duodenitis.

Aim

This study aimed at: (1) establishing the range of the eosinophil density in the mucosa of the duodenum of normal adults, and (2) determining the biopsy‐based prevalence of isolated eosinophilic duodenitis in a large population of adults.

Methods

We counted intact eosinophils in three separate high‐power fields (hpf area = 0.237 mm2 each) with the highest densities of eosinophils from the duodenal biopsy specimens of 370 consecutive adults (60% women) with no history of small intestinal disease and a normal duodenal histology. From a large database we also extracted patients with a diagnosis of elevated duodenal eosinophilia and reviewed their biopsies and clinical history.

Results

The mean eosinophil count for the 370 patients was 8.2 eos/hpf with a standard deviation of ± 6.3. Twenty‐seven of the 370 had eosinophil counts outside the 95% range, which was calculated as: mean + 1.96 × SD = 20.4 eos/hpf. In a database of 458 668 adult subjects, 31 patients (6.8/100 000) had elevated duodenal eosinophilia; 21 of these had other gastrointestinal organs involved by eosinophilia, suggesting eosinophilic gastroenteritis. No significant association between duodenal eosinophilia and any specific symptom was observed.

Conclusions

This study suggests that in this diverse US population, a cut‐off count of 20 eos/hpf would be useful to separate patients with normal from those with elevated duodenal eosinophilic infiltrations. The clinical implications of duodenal eosinophilia, particularly when it is not an expression of eosinophilic gastroenteritis, remain to be established.
PGE2‐EP3 signaling exacerbates hippocampus‐dependent cognitive impairment after laparotomy by reducing expression levels of hippocampal synaptic plasticity‐related proteins in aged mice
Authors: Xiao Jing‐Yu , Xiong Bing‐Rui , Zhang Wen , Zhou Wen‐Chang , Yang Hui , Gao Feng , Xiang Hong‐Bing , Manyande Anne , Tian Xue‐Bi , Tian Yu‐Ke
Published: February 2018

Aim

Multifactors contribute to the development of postoperative cognitive dysfunction (POCD), of which the most important mechanism is neuroinflammation. Prostaglandin E2 (PGE2) is a key neuroinflammatory molecule and could modulate hippocampal synaptic transmission and plasticity. This study was designed to investigate whether PGE2 and its receptors signaling pathway were involved in the pathophysiology of POCD.

Methods

Sixteen‐month old male C57BL/6J mice were exposed to laparotomy. Cognitive function was evaluated by fear conditioning test. The levels of PGE2 and its 4 distinct receptors (EP1‐4) were assessed by biochemical analysis. Pharmacological or genetic methods were further applied to investigate the role of the specific PGE2 receptors.

Results

Here, we found that the transcription and translation level of the EP3 receptor in hippocampus increased remarkably, but not EP1, EP2, or EP4. Immunofluorescence results showed EP3 positive cells in the hippocampal CA1 region were mainly neurons. Furthermore, pharmacological blocking or genetic suppression of EP3 could alleviate surgery‐induced hippocampus‐dependent memory deficits and rescued the expression of plasticity‐related proteins, including cAMP response element‐binding protein (CREB), activity‐regulated cytoskeletal‐associated protein (Arc), and brain‐derived neurotrophic factor (BDNF) in hippocampus.

Conclusion

This study showed that PGE2‐EP3 signaling pathway was involved in the progression of POCD and identified EP3 receptor as a promising treatment target.
Predictive validity of developmental screening in young children with sickle cell disease: a longitudinal follow‐up study
Authors: Schatz Jeffrey , Schlenz Alyssa M , Smith Kelsey E , Roberts Carla W
Published: February 2018

Aim

To assess the predictive validity of developmental screenings in children with sickle cell disease (SCD) for academic outcomes and stroke risk.

Method

Parent questionnaires and medical record data were collected for a cohort receiving developmental screenings between September 2004 and May 2008 as toddlers or early school age. Screening outcomes were dichotomized (positive, negative) by a priori criteria. Questionnaires assessed school and social functioning, services received, and quality of life. Medical record data assessed general SCD morbidity and stroke risk.

Results

Forty‐one toddlers (mean age 2y 5mo; 25 males, 16 females) and 49 early school‐age children (mean age 6y 5mo; 26 males, 23 females) completed follow‐up. The mean follow‐up period was 8 years 6 months (range 6.1–10.8y). For toddlers, positive screenings for language delays predicted lower academic performance (p=0.023). For older children, positive screenings for cognitive delays predicted more frequent academic/attentional problems at school (p<0.001), grade retention (p=0.007), and lower academic performance (p=0.001). Positive screenings were associated with an earlier onset of school problems and lower quality of life. Positive screenings for language/cognitive delays predicted increased stroke risk (both p<0.05).

Interpretation

Screening for language or cognitive development in young children with SCD predicts academic outcomes and stroke risk.

What this paper adds

Developmental screening predicts academic outcomes in sickle cell disease.

Children with concerning language/cognitive screenings have early‐onset school difficulties.

Developmental screenings may help predict cerebrovascular complications.
Monitoring anonymous HIV testing in Estonia from 2005 to 2015
Authors: Rüütel K , Kallavus K , Tomera I ,   OptTEST by HiE
Published: February 2018

Objectives

In Estonia, a network of anonymous and free of charge HIV testing sites has been operating since 1988. Services are provided by health care organizations and financed by the National Institute for Health Development from the state budget. The objective of this analysis was to assess anonymous HIV testing in Estonia from 2005 to 2015.

Methods

We used data collected from the National Institute for Health Development's annual reports, Health Board and Estonian Health Insurance Fund.

Results

In Estonia, more than 200 000 HIV‐tests are performed annually, and of these approximately 5–6% are within anonymous HIV testing sites. The percentage tested with rapid tests in anonymous testing sites has increased from 15% in 2010 to 53% in 2015. Furthermore, up to 65% of all newly diagnosed HIV‐cases have been detected in these sites. The proportion of HIV‐positive tests has decreased from 3.8% to 0.5% in anonymous testing sites and from 0.3% to 0.1% in general health care. Simultaneously, the cost of detecting one new HIV case has increased almost six times.

Conclusions

This analysis reveals that anonymous HIV testing services are well accepted by the general population as well as vulnerable populations. The positivity rate among those tested in anonymous testing sites remains higher than among all people tested, showing that the sites reach more of those who are at higher risk of HIV. In the light of decreasing positivity rate, more attention should be paid to people with higher HIV risk and increasing access to testing in community based settings.
The COBATEST network: monitoring and evaluation of HIV community‐based practices in Europe, 2014–2016
Authors: Fernàndez‐López L , Reyes‐Urueña J , Agustí C , Kustec T , Serdt M , Klavs I , Casabona J ,   The COBATEST Network Group
Published: February 2018

Objective

The objective of this paper is to describe the data collected by the CBVCT services from the Community‐based testing (COBATEST) network, from 2014 to 2016, in order to provide an insight into community‐based voluntary counselling and testing (CBVCT) services’ testing activity in Europe.

Methods

A descriptive analysis of HIV testing activity in CBVCT services that are using the COBATEST tools was performed for the period 2014–2016.

Results

During the study period, a total of 30 329 HIV tests were performed on 27 934 individuals, of which 1.8% were reactive. Of these reactive tests, 75.8% had a confirmatory test, 92.2% of those were confirmed as positive, and 90.38% of the confirmed positives were linked to care. The total number of tests performed over the study period increased 19.31%. The proportion of confirmatory tests increased from 63.0% to 90.0% and proportion linked to care increased from 84.1% to 93.8%. Most of the tested individuals were men (70.6%), aged between 21 and 35 years (58.5%) and non‐foreign born (68.1%). A high proportion of individuals tested were men who have sex with men (MSM; 42.2%). The percentage of reactive screening tests was particularly high among transgender people (8.37%) and among male sex workers (6.38%). Repeat testers had a higher percentage of reactive tests (2.02%) than those tested for first time (1.1%).

Conclusions

These results prove the feasibility of collecting standardized data from CBVCT services in different countries across Europe and demonstrate the usefulness of such data.
Monitoring response to hepatitis B and C in EU/EEA: testing policies, availability of data on care cascade and chronic viral hepatitis‐related mortality – results from two surveys (2016)
Authors: Aspinall EJ , Hutchinson SJ , Goldberg DJ , Valerio H , Mozalevskis A , Noori T , Duffell E , Tavoschi L
Published: February 2018

Objectives

The World Health Organization (WHO) developed a European Regional Action Plan (EAP) to fast‐track action towards the goal of eliminating viral hepatitis. Robust monitoring is essential to assess national programme performance. The purpose of this study was to assess the availability of selected monitoring data sources in European Union/European Economic Area (EU/EEA) Member States (MS).

Methods

Availability of data sources at EU/EEA level was assessed using two surveys distributed to 31 EU/EEA MS in 2016. The two surveys covered (A) availability of policy documents on testing; testing practices and monitoring; monitoring of diagnosis and treatment initiation, and; (B) availability of data on mortality attributable to chronic viral hepatitis.

Results

Just over two‐thirds of EU/EEA MS responded to the surveys. 86% (18/21) reported national testing guidance covering HBV, and 81% (17/21) covering HCV; while 33% (7/21) and 38% (8/21) of countries, respectively, monitored the number of tests performed. 71% (15/21) of countries monitored the number of chronic HBV cases diagnosed and 33% (7/21) the number of people treated. Corresponding figures for HCV were 48% (10/21) and 57% (12/21). 27% (6/22) of countries reported availability of data on mortality attributable to chronic viral hepatitis.

Conclusions

The results of this study suggest that sources of information in EU/EEA Member States to monitor the progress towards the EAP milestones and targets related to viral hepatitis diagnosis, cascade of care and attributable mortality are limited. Our analysis should raise awareness among EU/EEA policy makers and stimulate higher prioritisation of efforts to improve the monitoring of national viral hepatitis programmes.
HIV testing for key populations in Europe: A decade of technological innovation and patient empowerment complement the role of health care professionals
Authors: Platteau T , van Lankveld J , Apers L , Fransen K , Rockstroh J , Florence E
Published: February 2018

Objectives

With persisting high numbers of new HIV diagnoses in Europe, HIV testing remains an important aspect of HIV prevention. The traditional centralized and medicalized HIV testing approach has been complemented with newly developed and evaluated non‐traditional approaches. Two important factors guided this process: technological innovation and empowerment of the patient.

Methods

We present a matrix to develop an HIV testing approach, and elaborate on three commonly used ones: community based testing, self‐testing, and self‐sampling. Despite non‐traditional HIV testing approaches, barriers for testing remain. A potential disadvantage for users is the risk for false‐reactive test results. As users receive an orientation test result, a reactive result should be confirmed. Another issue is the window phase, which is longer for some orientation tests compared to a traditional, laboratory‐based test.

Results

Future implementation of non‐traditional HIV testing approaches will depend on legal frameworks throughout Europe. Community testing centers may additionally improve empowerment of key populations by expanding their portfolio to testing and treatment for sexually transmitted infections. Community engagement and ownership may imply a shrinking role for health care providers, but they remain crucial actors for personalized information, counselling and referral to specialized HIV‐care for many people.

Conclusions

A highly effective HIV testing strategy to reduce undiagnosed people living with HIV in Europe is needed. Any approach, chosen according to the principles outlined in this paper, should reach the right people, diagnose them in the most accurate way, and optimize linkage to care.
Community‐based education: Experiences of undergraduate dental therapy students at the University of KwaZulu‐Natal, South Africa
Authors: Moodley I , Singh S
Published: February 2018

Background

Community‐based education (CBE) is a learning strategy that provides meaningful opportunities for students to apply theory learnt in a larger social and cultural context in various community settings. Although the benefits of CBE to health professional students are well documented, to date, there is little evidence describing dental therapy students' experiences.

Objectives

To describe the experience of CBE by undergraduate dental therapy students in the School of Health Sciences at the University of KwaZulu‐Natal.

Methods

This descriptive study, conducted in 2016, gives insight into the experiences of community‐based education among dental therapy students using a self‐administered questionnaire eliciting qualitative data. Ethical clearance was obtained from the institution.

Results

Students reported perceived benefits of improved professional and personal growth, and a deeper understanding of cultural, social and economic influences on oral health care. Some of the perceived challenges included language barrier, limited resources and adapting to new environments.

Conclusion

The reported experiences of undergraduate dental therapy students involved in community‐based clinical training suggest that students gained awareness of the context‐specific challenges facing communities and health professionals in different oral health settings.
Downside Risk Aversion and the Downside Risk Premium
Authors: Stapleton Richard C. , Zeng Qi
Published: February 2018

We search for a definition of the downside risk premium analogous to the Pratt–Arrow definition of the risk premium. However, even in the local analysis difficulties arise. To overcome these, we propose a definition based on the difference between two gambles. Further, a global analysis reveals that higher‐order terms affect the downside risk premium and these cannot be ignored. We show that all five measures of the intensity of downside risk aversion that have been suggested are invalid in the case of the global analysis.
Children with ADHD draw‐and‐tell about what makes their life really good
Authors: Barfield Patricia A. , Driessnack Martha
Published: February 2018

Purpose

The purpose of this study was to engage children with attention deficit hyperactivity disorder (ADHD) in a developmentally sensitive way to explore the children's subjective well‐being. Explicitly, their life satisfaction, or what makes their life “really good.” To date, little is known about the subjective life experience of children with ADHD or how incorporating children's views separate from the purview of adults and pathology might enhance our understanding or change our approach to evaluation and/or intervention.

Design and Methods

A parallel convergent mixed‐methods design was used to collect data from a convenience sample of children with ADHD (N = 20) ages 7 to 11 years old. This article focuses solely on the qualitative data obtained through semi‐structured interviews using the art‐based approach draw‐and‐tell conversation (DTC). The DTC data were analyzed using qualitative content analysis. In addition, each parent (N = 20) independently completed demographic and health‐related forms to provide descriptive and contextual variables.

Results

Three themes were discerned in the DTC analysis–activity, nature, and connections. Most children (90%) described engaging in some form of activity, often outdoors, and with others; though the focus of activity was varied. Nature was evidenced directly and indirectly in many of the children's (85%) stories. Over half (65%) of the children described some variation in relational connection across a continuum that contributed to, or detracted from, their sense of well‐being/life satisfaction.

Practice Implications

Children shared that doing things, outdoors, with others, [emphasis added] made their life “really good”. Children's stories yielded insightful and actionable information that is relevant to each individual child/family, and to nursing assessment, intervention, and advocacy. These child‐granted insights also extend our attention beyond pharmacological and behavioral focused interventions, to include the children's own innate health promoting interests that help to make their life really good.
Evaluating differences in the shape of native and alien plant trait distributions will bring new insights into invasions of plant communities
Authors: Hulme Philip E. , Bernard‐Verdier Maud
Published: February 2018

Failure to quantify differences in the shape of inter‐specific trait distributions (e.g., skew, kurtosis) when comparing co‐occurring alien and native plants hinders the integration of biological invasions and plant community ecology. Within a plant community, understanding the circumstances that lead to the shape of the inter‐specific distribution of one or more functional plant traits being unimodal, bimodal, multimodal or skewed has the potential to shed new light on community vulnerability to invasion, subsequent ecosystem impacts and the selection pressures (e.g., stabilizing, directional or disruptive) acting upon native and alien species. Ignoring differences in the shape of inter‐specific trait distributions of alien and native species could miss important insights into plant invasions, including: the existence of unsaturated native plant communities, empty niches, shifting trait optima of species as a result of environmental change and incomplete colonization–extinction processes following invasion. Future comparisons of functional trait differences between native and alien species should include assessment of the shapes of inter‐specific trait distributions since these may differ even when the mean values of traits are similar for native and alien species. The infrequent application of such approaches may explain the limited generalizations regarding the drivers and consequences of plant invasions in plant communities.
Manatee behavioral response to boats
Authors: Rycyk Athena M. , Deutsch Charles J. , Barlas Margaret E. , Hardy Stacie K. , Frisch Katherine , Leone Erin H. , Nowacek Douglas P.
Published: February 2018

The long‐term viability of the Florida manatee is threatened in part by mortality from boat collisions. This study investigated manatee behavior during boat approaches to better understand factors that lead to manatee–boat collisions. Digital acoustic recording tags (DTAGs) and Argos‐linked GPS tags were deployed on 18 manatees in southwest Florida, and boat traffic around them was mapped. Suites of manatee behavioral, environmental, and boat‐related factors were recorded during opportunistic boat passes. We built generalized linear mixed models to determine which factors accounted for variation in occurrence, number, and timing of manatee behavioral changes during boat passes. Manatees responded to boats, changing their orientation, depth, and fluking behavior most often when a boat approached closely (<10 m). Manatees were also more likely to change their depth when not on a seagrass bed and when actively fluking before a boat pass. Boat speed did not affect the occurrence or intensity of manatee response. Compared to fast approaches, however, slower passes allowed the manatee more time to respond, and behavioral change occurred earlier relative to the time of the boat's closest point of approach. We conclude that faster boats likely pose a greater risk of collision with manatees than do slower boats.
Inhibition of ZERO‐BK by PKC is involved in carbachol‐induced enhancement of rat colon smooth muscle motility
Authors: Xin F. , Huang H. , Liu P. , Ren J. , Zhang S. , Cheng Y. , Wang W.
Published: February 2018

Background

Muscarinic acetylcholine receptor (mAChR) activation is an important factor to enhance the motility of gastrointestinal (GI) smooth muscle. Large conductance Ca2+‐activated potassium (BK) channels are widely expressed in GI smooth muscle. Roles of BK in carbachol (a mAChR agonist) induced enhancement of GI motility and the molecular mechanisms remains unknown and were investigated in this study.

Methods

Colonic smooth muscle (CSM) strip was perfused to record motility in vitro. The patch‐clamp technique was used to record BK currents. RT‐PCR was used to detect the expression of BK channels in rat CSM tissues. Two different types BK channels were constructed in HEK293 cells to investigate the regulation mechanism. Paired t tests were set with a P < .05 regarded as significant.

Key Results

Carbachol enhanced CSM contraction through M3 receptor (M3R) were attenuated by IbTX, an inhibitor of BK. Carbachol inhibited BK currents in CSM cells and Go6983, an inhibitor of protein kinase C (PKC), reversed the effect. PKC activator, phorbol 12‐myristate 13‐acetate (PMA), inhibited BK currents. Two types of BK channels (ZERO‐BK and STREX‐BK) were detected in CSM. ZERO‐ but not STREX‐BK channels expressed in HEK293 cells were inhibited by PMA.

Conclusion

Our results provide strong evidence that inhibition of ZERO‐BK but not STREX‐BK channels via PKC pathway is involved in the enhancement of CSM motility by mAChR activation. Besides the activation of BK by an increase in intracellular calcium, inhibition of BK played an important role in GI motility regulation during mAChR activation.
Electro‐acupuncture at ST37 and ST25 induce different effects on colonic motility via the enteric nervous system by affecting excitatory and inhibitory neurons
Authors: Liang C. , Wang K.‐Y. , Gong M.‐R. , Li Q. , Yu Z. , Xu B.
Published: February 2018

Background

On the basis of the importance of the enteric nervous system (ENS) in gastrointestinal motility, we hypothesized that the ENS may mediate the therapeutic efficacy of electro‐acupuncture (EA) in constipation by regulating the mechanisms underlying the effects of EA on gastrointestinal function.

Methods

Model mice with constipation were generated by gastric instillation of 0‐4°C normal saline. Defecation time and stool (form and wet and dry weight) were assessed. The effect of EA at ST37 or ST25 on colorectal motility and proximal colonic motility was assessed using a water‐filled balloon. The expression of protein gene product 9.5 (PGP9.5), the cholinergic neuron marker acetyltransferase (ChAT) and the anticholinergic neuron marker nitric oxide synthase (nNOS) was detected by immunohistochemistry, real‐time quantitative polymerase chain reaction (qPCR) and western blot analysis.

Key Results

ST37 and ST25 improved colorectal pressure; however, ST37 but not ST25 improved proximal colonic pressure. In the proximal colon, the expression of PGP9.5 returned to normal after EA at ST 37, while EA at ST25 did not have this effect. In addition, qPCR and western blot analysis showed that ST37 could downregulate the expression of nNOS and upregulate the expression of ChAT to normal levels, while ST25 could only downregulate the expression of nNOS to normal levels.

Conclusions and Inferences

Electro‐acupuncture at specific acupoints can improve intestinal motility in constipation by altering the ENS and differentially affecting excitatory and inhibitory neurons, restoring the coordination between contraction and relaxation muscles, and working in concert with the central nervous system and peripheral neural pathways.
Determinants of the Eurosystem's Central Banks Provisions
Authors: Klose Jens
Published: February 2018

Central bank provisions may be used as a measure of the perceived risk of the balance sheet composition by a central bank. We identify three possible sources that may change the size of the provisions. These are: The length of the balance sheet, the central bank revenues, and measures of fiscal stress. Using data of the 11 founding members of the Eurosystem for the years 1999–2015, we are able to test each of the three determinants. We find that provisions are increased with the size of the balance sheet especially in the recent financial crisis. Moreover, provisions are increased at the cost of lower central bank revenues. While this holds for the pre‐crisis period this relationship seems to be less pronounced in the crisis period probably because of the more active collateral policy. Finally, central banks do not tend to lower provisions because of fiscal tensions. This is even more true in the crisis period.
Retrospective evaluation of plasma cholesterol concentration in septic dogs and its association with morbidity and mortality: 51 cases (2005–2015)
Authors: Hardy Jack P. , Streeter Elizabeth M. , DeCook Rhonda R.
Published: February 2018

Objective

To determine whether plasma cholesterol concentrations in dogs with sepsis is associated with morbidity or in‐hospital mortality.

Design

Retrospective cohort study from 2005–2015.

Setting

Two private referral centers.

Animals

Fifty‐one dogs diagnosed with sepsis.

Interventions

None.

Measurements and Main Results

Dogs were classified as septic if they displayed ≥2 criteria of the systemic inflammatory response syndrome in conjunction with a documented underlying infectious cause. Dogs were excluded if they had been diagnosed previously with any concurrent illness reported to alter plasma cholesterol concentrations. Plasma cholesterol concentrations at the time of sepsis diagnosis were statistically analyzed for association with morbidity, as measured by the presence of organ dysfunction, the number of dysfunctional organs, duration of hospitalization, cost of hospitalization, and in‐hospital mortality.

Twenty‐eight (55%) dogs survived to discharge, 15 (29%) were euthanized during hospitalization, and 8 (16%) died despite treatment. While median cholesterol concentrations were significantly different when comparing survivors to discharge versus nonsurvivors who died naturally despite treatment (P = 0.0245), they were not significantly different when comparing survivors to all nonsurvivors (P = 0.1821). Receiver operating characteristic curve analysis showed a cholesterol cutoff of 4.5 mmol/L (174 mg/dL) with a sensitivity of 75% and a specificity of 50% for predicting in‐hospital mortality. For surviving dogs, plasma cholesterol concentrations were not associated with increased length of hospital stay. Number of dysfunctional organs and plasma cholesterol concentration were the 2 most significant individual predictors for survival, and when incorporated into a multivariate logistic regression model used for prediction, the model yielded a sensitivity of 94% and specificity of 63%.

Conclusion

Plasma cholesterol concentration can provide prognostic information in dogs with sepsis. Further prospective studies investigating the role of cholesterol in sepsis are needed.
First record of the genus Punicodoxa (Acari: Microdispidae) from Asia, with description of a new species phoretic on termites (Insecta: Isoptera)
Authors: Azhari Shahrzad , Hajiqanbar Hamidreza , Talebi Ali Asghar
Published: February 2018

A new species of the genus Punicodoxa Mahunka, 1978 (Acari: Prostigmata: Microdispidae) is described and illustrated from Southwestern Iran: Punicodoxa termitophila Azhari and Hajiqanbar sp. nov., discovered from a termite Anacanthotermes sp. (Isoptera: Hodotermitidae). This species is the second representative of the genus Punicodoxa which is the first record of the genus form Asia. Furthermore, phoretic association between mites of the family Microdispidae and termites of the family Hodotermitidae, and also phoresy on insects in the genus Punicodoxa are reported for the first time.
Metabolism, Excretion, and Mass Balance of Solithromycin in Humans
Authors: MacLauchlin Christopher , Schneider Stephen E. , Keedy Kara , Fernandes Prabhavathi , Jamieson Brian D.
Published: February 2018

Solithromycin, a novel macrolide and the first fluoroketolide, is being developed as a therapy for community-acquired bacterial pneumonia, with a distinct mechanism that provides activity against macrolide-resistant bacteria. The pharmacokinetics, metabolism, and excretion of solithromycin were studied in healthy male subjects after oral administration of a single 800-mg (∼100-μCi) dose of [
14
C]solithromycin. Solithromycin was well tolerated, and absorption from the solution occurred with a median time to peak concentration of 4.0 h. Solithromycin and the total radioactivity had similar profiles with no long-lived metabolites. The whole-blood total radioactivity was approximately 75% of the plasma total radioactivity. Recovery was essentially complete (mean, 90.6%), with 76.5% and 14.1% of the dose recovered in feces and urine, respectively. Unchanged solithromycin (CEM-101) was the predominant circulating radioactive component in plasma (77% of the total radioactivity area under the concentration-time curve [AUC]), with two minor plasma metabolites, CEM-214 and CEM-122 (
N
-acetyl-CEM-101), each accounting for approximately 5% of the total radioactivity. Urinary excretion was predominantly like that of the parent. Solithromycin was primarily eliminated in the feces after extensive metabolism via a complex metabolic pathway with CEM-262 as the major constituent (27.36% of the administered dose). Overall oxidative pathways, presumably carried out mostly by CYP3A4, represented the majority of the metabolism, with
N
-acetylation present to a lesser extent. No disproportionate human metabolites were observed.
Genome Sequence of a Byssochlamys sp. Strain Isolated from Fouled B20 Biodiesel
Authors: Stamps Blake W. , Andrade Oderay C. , Lyon Wanda J. , Floyd James G. , Nunn Heather S. , Bojanowski Caitlin L. , Crookes-Goodson Wendy J. , Stevenson Bradley S.
Published: February 2018

Byssochlamys
sp. strain AF001 is a filamentous fungus isolated from fouled B20 biodiesel. Its growth on B20 biodiesel results in the degradation and fouling of the fuel and higher rates of corrosion in affected storage tanks. The genome of
Byssochlamys
sp. AF001 is 35.9 Mbp and is composed of 10 scaffolds, with a G+C content of 45.89%.
Complete Genome Sequence of a Swiss Hepatitis E Virus Isolate from the Liver of a Fattening Pig
Authors: Wist Valerie , Kubacki Jakub , Lechmann Julia , Steck Marco , Fraefel Cornel , Stephan Roger , Bachofen Claudia
Published: February 2018

We present here the full-length genome sequence of a hepatitis E genotype 3 virus (HEV-3) isolate, CH_VW117, from the liver of a healthy fattening pig collected at the slaughter level. Sequence analysis implies that this strain belongs to the newly proposed HEV subtype 3s.
Complete Genome Sequence of a Ciprofloxacin-Resistant Salmonella enterica subsp. enterica Serovar Kentucky Sequence Type 198 Strain, PU131, Isolated from a Human Patient in Washington State
Authors: Shah Devendra H. , Paul Narayan C. , Guard Jean
Published: February 2018

Strains of the ciprofloxacin-resistant (Cip
r
)
Salmonella enterica
subsp.
enterica
serovar Kentucky sequence type 198 (ST198) have rapidly and extensively disseminated globally to become a major food safety and public health concern. Here, we report the complete genome sequence of a Cip
r
S.
Kentucky ST198 strain, PU131, isolated from a human patient in Washington State (USA).
Draft Genome Sequence of Sphingorhabdus sp. Strain EL138, a Metabolically Versatile Alphaproteobacterium Isolated from the Gorgonian Coral Eunicella labiata
Authors: Silva Sandra Godinho , Lago-Lestón Asunción , Costa Rodrigo , Keller-Costa Tina
Published: February 2018

Here, we report the draft genome sequence of
Sphingorhabdus
sp. strain EL138, an alphaproteobacterium that shows potential to degrade polycyclic aromatic compounds and to cope with various heavy metals and antibiotics. Moreover, the strain, isolated from the gorgonian coral
Eunicella labiata
, possesses several genes involved in the biosynthesis of polyphosphates, polyketides, and terpenoids.
Draft Genome Sequence of Ezakiella peruensis Strain M6.X2, a Human Gut Gram-Positive Anaerobic Coccus
Authors: Diop Awa , Diop Khoudia , Tomei Enora , Raoult Didier , Fenollar Florence , Fournier Pierre-Edouard
Published: February 2018

We report here the draft genome sequence of
Ezakiella peruensis
strain M6.X2
T
. The draft genome is 1,672,788 bp long and harbors 1,589 predicted protein-encoding genes, including 26 antibiotic resistance genes with 1 gene encoding vancomycin resistance. The genome also exhibits 1 clustered regularly interspaced short palindromic repeat region and 333 genes acquired by horizontal gene transfer.
Complete Genome Sequence of a
Pepper mild mottle virus
Isolate from Northeast China
Authors: Yu Man , Zhou Tao , Wu Yuanhua , An Mengnan
Published: February 2018

The complete genome sequence of a
Pepper mild mottle virus
(PMMoV) isolate obtained from Northeast China was determined by reverse transcription-PCR (RT-PCR) and rapid amplification of cDNA ends (RACE). Phylogenetic analysis showed that the virus isolate is closely related to Japanese, Chinese, Spanish, and U.S. isolates.
Budget impact analysis of heparin-bonded polytetrafluoroethylene grafts (Propaten) against standard polytetrafluoroethylene grafts for below-the-knee bypass in patients with critical limb ischaemia in France
Authors: Vergnaud Simon , Riche Valéry-Pierre , Tessier Philippe , Mauduit Nicolas , Kaladji Adrien , Gouëffic Yann
Published: February 2018

Objectives

To evaluate the budget impact of progressive replacement of standard polytetrafluoroethylene (PTFE) grafts by heparin-bound PTFE (Propaten) for below-the-knee (BTK) bypass in patients with critical limb ischaemia (CLI).

Design

From a review of the scientific literature, we calculated a theoretical BTK primary patency for Propaten grafts. Using the French hospital expenditure database (PMSI), we retrospectively estimated a rehospitalisation rate for standard PTFE grafts. From these data, a model was created to assess the budget impact of a progressive replacement from standard PTFE grafts to Propaten grafts over a 5-year horizon. We performed an univariate sensitivity analysis to assess the robustness of our results.

Setting

French National Health Insurance (FNHI) perspective.

Participant

Patients with CLI.

Main outcome measures

Budget impact analysis.

Results

Data extraction from the PMSI revealed that 656 patients were treated with PTFE grafts in 2011 in French public hospitals for a BTK bypass. Assuming a 2-year survival rate of 76.8%, observed reinterventions rate for standard PTFE grafts at 24 months from the PMSI was 35.1%. The mean rehospitalisation cost was €10 689. The budget impact analysis based on these data found a net cumulative 5-year payer budget reduction of €112 420 in favour of Propaten, under the assumption of a 75.6% primary patency for Propaten grafts for a projected population of 3215 patients of which 801 received a Propaten graft.

Conclusions

Our budget impact analysis showed a positive impact on the national health insurance budget of the replacement of standard PTFE grafts by Propaten grafts for BTK bypass in patients with CLI in France. This supports the enactment of a reimbursement policy by the FNHI.
Emergency department presentation and readmission after index psychiatric admission: a data linkage study
Authors: Li Xue , Srasuebkul Preeyaporn , Reppermund Simone , Trollor Julian
Published: February 2018

Objective

To use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission.

Design

A retrospective data-linkage study.

Setting

Cohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia.

Participants

People who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010.

Outcome measures

ORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation.

Results

Index admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied.

Conclusion

Social determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve trajectories after index admission.
Extent and cost of inappropriate use of tumour markers in patients with pulmonary disease: a multicentre retrospective study in Shanghai, China
Authors: Zhang Haichen , Song Yunxiao , Zhang Xiong , Hu Jun , Yuan Suwei , Ma Jin
Published: February 2018

Objectives

The currently implemented healthcare reform in China requires substantial capital investment. Although overtreatment results in serious waste, inappropriate laboratory use is widespread, and overuse of tumour markers (TMs) has attracted increasing attention.

Design

Retrospective study.

Setting

The respiratory, thoracic surgery and oncology departments of three hospitals in Shanghai from 2014 to 2015.

Participants

Patients with chronic obstructive pulmonary disease (COPD) and primary bronchogenic lung cancer (PLC). Based on clinical guidelines and physician experience, the criteria of suitability of TM examinations were determined, and the number, cost and proportion of inappropriate TM requests were analysed.

Results

The area under the receiver operating characteristic curve for carcinoembryonic antigen+cytokeratin fragment 21-1+squamous cell carcinoma antigen+neuron-specific enolase in patients with COPD and PLC was 0.813, in accordance with the cost-effectiveness principle, indicating good clinical and health economics values. In the 2706 patients, 12 496–16 956 (58.27%–79.06%) of TM requests were inappropriate. Furthermore, the involved expense was 650 200–1 014 156 yuan, accounting for 7.69%–12.00% of examination expenses and 1.35%–2.11% of hospitalisation costs.

Conclusions

We found that the inappropriate use of TMs was widespread for patients with pulmonary disease. Clinicians should use TMs strictly according to the guidelines to effectively manage laboratory resources and control costs.
Empathy, burn-out and the use of gut feeling: a cross-sectional survey of Danish general practitioners
Authors: Pedersen Anette Fischer , Ingeman Mads Lind , Vedsted Peter
Published: February 2018

Objective

Research has suggested that physicians’ gut feelings are associated with parents’ concerns for the well-being of their children. Gut feeling is particularly important in diagnosis of serious low-incidence diseases in primary care. Therefore, the aim of this study was to examine whether empathy, that is, the ability to understand what another person is experiencing, relates to general practitioners’ (GPs) use of gut feelings. Since empathy is associated with burn-out, we also examined whether the hypothesised influence of empathy on gut feeling use is dependent on level of burn-out.

Design

Cross-sectional questionnaire survey. Participants completed the Jefferson Scale of Physician Empathy and The Maslach Burnout Inventory.

Setting

Primary care.

Participants

588 active GPs in Central Denmark Region (response rate=70%).

Primary outcome measures

Self-reported use of gut feelings in clinical practice.

Results

GPs who scored in the highest quartile of the empathy scale had fourfold the odds of increased use of gut feelings compared with GPs in the lowest empathy quartile (OR 3.99, 95% CI 2.51 to 6.34) when adjusting for the influence of possible confounders. Burn-out was not statistically significantly associated with use of gut feelings (OR 1.29, 95% CI 0.90 to 1.83), and no significant interaction effects between empathy and burn-out were revealed.

Conclusions

Physician empathy, but not burn-out, was strongly associated with use of gut feelings in primary care. As preliminary results suggest that gut feelings have diagnostic value, these findings highlight the importance of incorporating empathy and interpersonal skills into medical training to increase sensitivity to patient concern and thereby increase the use and reliability of gut feeling.
How many patients could benefit from REBOA in prehospital care? A retrospective study of patients rescued by the doctors of the Paris fire brigade
Authors: Thabouillot Oscar , Bertho K , Rozenberg E , Roche N-C , Boddaert G , Jost D , Tourtier J-P
Published: February 2018

Introduction

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique to control haemorrhage by placing a retrograde catheter in an artery and inflating a balloon at its tip. This retrospective study aimed to evaluate the proportion of injured people who could potentially have benefited from this technique prior to hospitalisation, including on the scene or during transport.

Methods

A retrospective analysis was conducted of all patients with trauma registered in the Paris Fire Brigade emergency medical system between 1 January and 31 December 2014. Inclusion criteria included all patients over 18 years of age with bleeding of supposedly abdominal and/or pelvic and/or junctional origin, uncontrolled haemorrhagic shock or cardiac arrest with attempted resuscitation.

Results

During this study period, a total of 1159 patients with trauma (3.2%) would have been eligible to undergo REBOA. Death on scene rate was 83.8% (n=31) and six patients had a beating heart when they arrived at the hospital. Ten out of the 37 patients had spontaneous circulatory activity. Among them, four people died on the scene or during transport. Thirty-six out of 37 patients were intubated, one benefited from the use of a haemostatic dressing and one benefited from a tourniquet.

Conclusions

REBOA can be seen as an effective non-surgical solution to ensure complete haemostasis during the prehospital setting. When comparing the high mortality rate following haemorrhage with the REBOA’s rare side effects, the risk–benefit balance is positive. Given that 3% of all patients with trauma based on this study would have been eligible for REBOA, we believe that this intervention should be available in the prehospital setting. The results of this study will be used: educational models for REBOA balloon placement using training manikins, with an ultimate aim to undertake a prospective feasibility study in the prehospital setting.
Noncommutative Reissner–Nordstrøm black hole
Authors: Soto-Campos Carlos A. , Valdez-Alvarado Susana
Published: February 2018

In this work we construct a deformed embedding of the Reissner–Nordstrøm (R-N) space–time within the framework of a noncommutative Riemannian geometry. We provide noncommutative corrections to the usual Riemannian expressions for the metric and curvature tensors. For the case of the metric tensor, the expression obtained possesses terms that are valid to all orders in the deformation parameter. Then we calculate the correction to the area of the event horizon of the corresponding noncommutative R-N black hole, obtaining an expression for the area of the black hole, which is correct up to fourth-order terms in the deformation parameter. Finally we include some comments on the noncommutative version on one of the second-order scalar invariants of the Riemann tensor, the so-called Kretschmann invariant, a quantity that is regularly used to extend gravity to the quantum level.
Energy cutoff effect in CORSIKA on the detected particles of ππ0 decay channel
Authors: Atik Yılmaz Şeyma , Yılmaz Ali , Denizli Haluk , Oyulmaz Kaan Yüksel
Published: February 2018

CORSIKA (COsmic Ray SImulations for Kascade) has various features in the creation of the extensive air showers with several characteristics where the users can configure the input card to achieve the desired result. ECUT is a parameter defined as the low energy cutoff of the particle kinetic energy for hadrons, muons, electrons, and photons. We investigate the effect of the different ECUT values on the detected particles in 107 – 5 × 108 GeV primary particle energy range where π–π0 decay channel chosen with 5 km shower development length. The selected ECUT values in this study are 0.05 and 0.1 GeV for both hadrons and muons and 0.05 GeV for electrons and photons. The effect of the reducing by half on the energy cutoff value is studied for the detector array located on an inclined plane, which is planned for upward τ detection.
A model for the mass and distribution of particles in dark matter halos
Authors: Runstedtler Allan
Published: February 2018

This model is intended for dark-matter-dominated galaxies and galaxy clusters for which the centrifugal force caused by system rotation is negligible. Such systems, ostensibly dark matter halos, would tend to be spherical. Consider a uniform sphere of identical, massive particles in equilibrium (not contracting or expanding). In the quantum model, gravitation pulls the particles together and quantum uncertainty pushes them apart. In the corresponding classical model, gravitation pulls the particles together and thermal motion pushes them apart. This model provides an expression for particle mass as a function of the total mass and density of the system and its quantum state or temperature. Using the measured total mass and density of our dark-matter-dominated galaxy, and assuming the system is in the ground state, the particle mass is found to be 10.5 eV and the temperature 0.042 K. This represents the lowest possible system temperature and particle mass. If, on the other hand, the system is in equilibrium with the cosmic microwave background, the particle mass is found to be 693 eV. This range of inferred particle masses supports the hypothesis of “low-mass dark matter” with approximate mass 100 eV. However, the system temperature is not presently known so it is possible that the temperature is higher and, consequently, the particles are heavier. The average speed of the particles is found to be approximately 1/1000 the speed of light in our galaxy. Remarkably, this result does not depend on the system temperature and, therefore, does not depend on the particle mass. The extension of this model to variable density provides a straightforward solution to the “core-cusp problem” because the distribution of dark matter that minimizes the system energy has a flat central dark matter density profile.