bluuebunny/crossref_metadata_2025 huggingface dataset:
A Class II-Restricted CD8γ13 T-Cell Clone Protects During Chlamydia muridarum Genital Tract Infection
Authors: Johnson Raymond M , Olivares-Strank Norma , Peng Gang
Published: December 2019

Background

The T-cell response to chlamydia genital tract infections in humans and mice is unusual because the majority of antigen-specific CD8 T cells are not class I restricted (referred to here as “unrestricted” or “atypical”). We previously reported that a subset of unrestricted murine chlamydia-specific CD8 T cells had a cytokine polarization pattern that included interferon (IFN)-γ and interleukin (IL)-13.

Methods

In this study, we investigated the transcriptome of CD8γ13 T cells, comparing them to Tc1 clones using microarray analysis. That study revealed that CD8γ13 polarization included IL-5 in addition to IFN-γ and IL-13. Adoptive transfer studies were performed with Tc1 clones and a CD8γ13 T-cell clone to determine whether either influenced bacterial clearance or immunopathology during Chlamydia muridarum genital tract infections.

Results

To our surprise, an adoptively transferred CD8γ13 T-cell clone was remarkably proficient at preventing chlamydia immunopathology, whereas the multifunctional Tc1 clone did not enhance clearance or significantly alter immunopathology. Mapping studies with major histocompatibility complex (MHC) class I- and class II-deficient splenocytes showed our previously published chlamydia-specific CD8 T-cell clones are MHC class II restricted.

Conclusions

The MHC class II-restricted CD8 T cells may play an important role in protection from intracellular pathogens that limit class I antigen presentation or diminish CD4 T-cell numbers or impair their function.
An Evaluation of the Flea Index as a Predictor of Plague Epizootics in the West Nile Region of Uganda
Authors: Eisen Rebecca J , Atiku Linda A , Mpanga Joseph T , Enscore Russell E , Acayo Sarah , Kaggwa John , Yockey Brook M , Apangu Titus , Kugeler Kiersten J , Mead Paul S
Published: December 2019

Plague is a low incidence flea-borne zoonosis that is often fatal if treatment is delayed or inadequate. Outbreaks occur sporadically and human cases are often preceded by epizootics among rodents. Early recognition of epizootics coupled with appropriate prevention measures should reduce plague morbidity and mortality. For nearly a century, the flea index (a measure of fleas per host) has been used as a measure of risk for epizootic spread and human plague case occurrence, yet the practicality and effectiveness of its use in surveillance programs has not been evaluated rigorously. We sought to determine whether long-term monitoring of the Xenopsylla flea index on hut-dwelling rats in sentinel villages in the plague-endemic West Nile region of Uganda accurately predicted plague occurrence in the surrounding parish. Based on observations spanning ~6 yr, we showed that on average, the Xenopsylla flea index increased prior to the start of the annual plague season and tended to be higher in years when plague activity was reported in humans or rodents compared with years when it was not. However, this labor-intensive effort had limited spatial coverage and was a poor predictor of plague activity within sentinel parishes.
Exercise-Induced Bronchoconstriction in Iraq and Afghanistan Veterans With Deployment-Related Exposures
Authors: Klein-Adams Jacquelyn C , Sotolongo Anays M , Serrador Jorge M , Ndirangu Duncan S , Falvo Michael J
Published: December 2019

Introduction

Acute exposure to high-levels of ambient fine particulate matter while exercising results in airway narrowing, but the long-term effects of repeated exposure on exercise-induced bronchoconstriction (EIB) are not well known. The goal of this preliminary study is to determine the rate of EIB among a sample of non-treatment seeking veterans deployed to Iraq and Afghanistan.

Materials and Methods

Twenty-four veterans (median [interquartile range]: 35.0 [27.3, 45] years) without history of asthma volunteered for this study. Spirometry was assessed before and after a standardized exercise challenge. A positive EIB response was defined as an exercise-induced fall in forced expiatory volume in 1 second ≥10%. Secondary criteria (peak flow ≥10% or mid-expiratory flow ≥15%) were also considered as an estimate of probable EIB.

Results

A positive EIB response was observed in 16.7% and probable EIB response was observed in 41.7% of our sample. Median deployment length to Iraq or Afghanistan was 13.0 [10.3, 17.5] months and the median time since deployment was 4.2 [2.7, 7.7] years. At the time of testing, veterans reported persistent cough (58.3%), wheeze (37.5%), and shortness of breath (37.5%). During deployment, veterans reported exposure to dust and sand (70.8%), smoke from burn pits (66.7%), vehicle exhaust (83.3%), and regional air pollution (26.0%) on most days or daily.

Conclusions

Approximately 17% of our sample of non-treatment seeking deployed Iraq and Afghanistan veterans demonstrated EIB, similar to the general population prevalence. However, persistent respiratory symptoms and alternative indices of probable EIB supports continued monitoring of this population.
The growth of bulges and discs in relatively H i-rich galaxies: indication from H i scaling relations
Authors: Chen Xinkai , Wang Jing , Kong Xu , Catinella Barbara , Shao Li , Mo Houjun
Published: December 2019

We study the relation between the properties of the bulge/disc components and the H i mass fraction of galaxies. We find that at fixed stellar mass, disc colours are correlated with the H i mass fraction, while bulge colours are not. The lack of a correlation between the bulge colour and the H i mass fraction is regardless whether the bulges are pseudo, or whether the galaxies host bars or are interacting with a neighbour. There is no strong correlation between the colours of the discs and bulges either. These results suggest that the current total amount of H i is closely related to the formation of discs, but does not necessarily fuel the formation of (pseudo) bulges in an efficient way. We do not find evidence for the star formation in the discs to be quenched by the bulges.
Origin and Evolution of Carboxysome Positioning Systems in Cyanobacteria
Authors: MacCready Joshua S , Basalla Joseph L , Vecchiarelli Anthony G
Published: December 2019

Carboxysomes are protein-based organelles that are essential for allowing cyanobacteria to fix CO2. Previously, we identified a two-component system, McdAB, responsible for equidistantly positioning carboxysomes in the model cyanobacterium Synechococcus elongatus PCC 7942 (MacCready JS, Hakim P, Young EJ, Hu L, Liu J, Osteryoung KW, Vecchiarelli AG, Ducat DC. 2018. Protein gradients on the nucleoid position the carbon-fixing organelles of cyanobacteria. eLife 7:pii:e39723). McdA, a ParA-type ATPase, nonspecifically binds the nucleoid in the presence of ATP. McdB, a novel factor that directly binds carboxysomes, displaces McdA from the nucleoid. Removal of McdA from the nucleoid in the vicinity of carboxysomes by McdB causes a global break in McdA symmetry, and carboxysome motion occurs via a Brownian-ratchet-based mechanism toward the highest concentration of McdA. Despite the importance for cyanobacteria to properly position their carboxysomes, whether the McdAB system is widespread among cyanobacteria remains an open question. Here, we show that the McdAB system is widespread among β-cyanobacteria, often clustering with carboxysome-related components, and is absent in α-cyanobacteria. Moreover, we show that two distinct McdAB systems exist in β-cyanobacteria, with Type 2 systems being the most ancestral and abundant, and Type 1 systems, like that of S. elongatus, possibly being acquired more recently. Lastly, all McdB proteins share the sequence signatures of a protein capable of undergoing liquid–liquid phase separation. Indeed, we find that representatives of both McdB types undergo liquid–liquid phase separation in vitro, the first example of a ParA-type ATPase partner protein to exhibit this behavior. Our results have broader implications for understanding carboxysome evolution, biogenesis, homeostasis, and positioning in cyanobacteria.
Insights from Empirical Analyses and Simulations on Using Multiple Fossil Calibrations with Relaxed Clocks to Estimate Divergence Times
Authors: Carruthers Tom , Scotland Robert W
Published: December 2019

Relaxed clock methods account for among-branch-rate-variation when estimating divergence times by inferring different rates for individual branches. In order to infer different rates for individual branches, important assumptions are required. This is because molecular sequence data do not provide direct information about rates but instead provide direct information about the total number of substitutions along any branch, which is a product of the rate and time for that branch. Often, the assumptions required for estimating rates for individual branches depend heavily on the implementation of multiple fossil calibrations in a single phylogeny. Here, we show that the basis of these assumptions is often critically undermined. First, we highlight that the temporal distribution of the fossil record often violates key assumptions of methods that use multiple fossil calibrations with relaxed clocks. With respect to “node calibration” methods, this conclusion is based on our inference that different fossil calibrations are unlikely to reflect the relative ages of different clades. With respect to the fossilized birth–death process, this conclusion is based on our inference that the fossil recovery rate is often highly heterogeneous. We then demonstrate that methods of divergence time estimation that use multiple fossil calibrations are highly sensitive to assumptions about the fossil record and among-branch-rate-variation. Given the problems associated with these assumptions, our results highlight that using multiple fossil calibrations with relaxed clocks often does little to improve the accuracy of divergence time estimates.
Molecular Evolutionary Genetics Analysis (MEGA) for macOS
Authors: Stecher Glen , Tamura Koichiro , Kumar Sudhir
Published: December 2019

The Molecular Evolutionary Genetics Analysis (MEGA) software enables comparative analysis of molecular sequences in phylogenetics and evolutionary medicine. Here, we introduce the macOS version of the MEGA software. This new version eliminates the need for virtualization and emulation programs previously required to use MEGA on Apple computers. MEGA for macOS utilizes memory and computing resources efficiently for conducting evolutionary analyses on macOS. It has a native Cocoa graphical user interface that is programmed to provide a consistent user experience across macOS, Windows, and Linux. MEGA for macOS is available from www.megasoftware.net free of charge.
Neglected Emotions
Authors: Elpidorou Andreas
Published: December 2019

Given the importance of emotions in our everyday lives, it is no surprise that in recent decades the study of emotions has received tremendous attention by a number of different disciplines. Yet despite the many and great advantages that have been made in understanding the nature of emotions, there remains a class of emotional states that is understudied and that demands further elucidation. All contributions to this issue consider either emotions or aspects of emotions that deserve the label ‘neglected’. In doing so, they break new theoretical ground and further our understanding of the nature of the emotions that they consider. The aim of the present paper is to introduce the special issue on neglected emotions by articulating the different ways in which emotions can be said to be neglected.
Pre-folded structures govern folding pathways of human telomeric G-quadruplexes
Authors: Frelih Tjaša , Wang Baifan , Plavec Janez , Šket Primož
Published: December 2019

Understanding the mechanism by which biological macromolecules fold into their functional native conformations represents a problem of fundamental interest. DNA oligonucleotides derived from human telomeric repeat d[TAGGG(TTAGGG)3] and d[TAGGG(TTAGGG)3TT] fold into G-quadruplexes through diverse steps. Varying the pH and temperature by the use of nuclear magnetic resonance and other methods enabled detection of pre-folded structures that exist in solution before completely formed G-quadruplexes upon addition of cations. Pre-folded structures are in general hard to detect, however their knowledge is crucial to set up folding pathways into final structure since they are believed to be a starting point. Unexpectedly well-defined pre-folded structures composed of base triples for both oligonucleotides were detected at certain pH and temperature. These kinds of structures were up to now only hypothesized as intermediates in the folding process. All revealed pre-folded structures irrespective of the pH and temperature exhibited one common structural feature that could govern folding process.
Cockayne syndrome group A and B proteins function in rRNA transcription through nucleolin regulation
Authors: Okur Mustafa N , Lee Jong-Hyuk , Osmani Wasif , Kimura Risako , Demarest Tyler G , Croteau Deborah L , Bohr Vilhelm A
Published: December 2019

Cockayne Syndrome (CS) is a rare neurodegenerative disease characterized by short stature, accelerated aging and short lifespan. Mutations in two human genes, ERCC8/CSA and ERCC6/CSB, are causative for CS and their protein products, CSA and CSB, while structurally unrelated, play roles in DNA repair and other aspects of DNA metabolism in human cells. Many clinical and molecular features of CS remain poorly understood, and it was observed that CSA and CSB regulate transcription of ribosomal DNA (rDNA) genes and ribosome biogenesis. Here, we investigate the dysregulation of rRNA synthesis in CS. We report that Nucleolin (Ncl), a nucleolar protein that regulates rRNA synthesis and ribosome biogenesis, interacts with CSA and CSB. In addition, CSA induces ubiquitination of Ncl, enhances binding of CSB to Ncl, and CSA and CSB both stimulate the binding of Ncl to rDNA and subsequent rRNA synthesis. CSB and CSA also increase RNA Polymerase I loading to the coding region of the rDNA and this is Ncl dependent. These findings suggest that CSA and CSB are positive regulators of rRNA synthesis via Ncl regulation. Most CS patients carry mutations in CSA and CSB and present with similar clinical features, thus our findings provide novel insights into disease mechanism.
Trauma and work factors as predictors of firefighters’ psychiatric distress
Authors: Teoh K R H , Lima E , Vasconcelos A , Nascimento E , Cox T
Published: December 2019

Background

Studies into the mental health of firefighters have primarily focussed on individual factors (e.g. biological and psychological factors). Little is known about how exposure to traumatic events and psychosocial and organizational work factors influence firefighters’ mental health despite the evidence that these are important for employee health.

Aims

To study job demands, job control, social support and operational trauma as predictors of firefighters’ psychiatric morbidity, and whether job control and social support moderate these relationships.

Methods

Participants were drawn from a longitudinal cohort study of firefighters in Brazil. Portuguese-language variants of the Self-Report Questionnaire (SRQ-20) and Traumatic Events List for Emergency Professionals measured psychiatric morbidity and exposure to traumatic events. Job demands, job control and social support were measured by the Job Stress Scale. Hierarchical regressions were run controlling for socio-demographics and previous psychiatric morbidity. Subsequent regression steps first included the proposed predictors followed by their interactions.

Results

Thirteen per cent of the sample (n = 40/312) met the caseness criteria indicating psychiatric morbidity. Operational trauma, job demands, job control and social support predicted psychiatric morbidity. Both job control and social support functioned as moderators and where these moderators were high, the job demands and psychiatric morbidity relationships were weaker.

Conclusions

These findings show that psychosocial factors and operational trauma predict firefighters’ psychiatric morbidity. Crucially, the results that improving social support and job control could mitigate the detrimental influence of job demands highlight the need for more research and practice towards organizational-level interventions.
Masquerading dacryocystitis
Authors: Huffman Clayton A , Timoney Peter J
Published: December 2019

Intravascular papillary endothelial hyperplasia (IPEH), otherwise known as Masson’s tumor, is a benign lesion of the skin with no known malignant transformations reported. It is considered a non-neoplastic lesion, as it is reactive to some vascular insult, usually a thrombus in a vein leading to vascular endothelial cell proliferation. Masson’s tumor typically presents as a slow-growing, indolent lesion commonly affecting the head, neck and arms with a female predominance. It comprises ~2% of all malignant and non-malignant vascular tumors of the skin and subcutaneous tissue. We are presenting the first case of Masson’s tumor of the right medial canthal subcutaneous tissue, masquerading as dacryocystitis.
Linear dermatomyofibroma over the nape of neck: a report of an unusual case and literature review
Authors: AlZamil Lama R , AlSaif Fahad M , AlRikabi Ammar C , AlMazroua Aljohara M
Published: December 2019

Dermatomyofibroma is a rare cutaneous mesenchymal tumor of benign fibroblastic and myofibroblastic derivations. It predominantly affects young women, and it usually presents as a reddish-brown plaque or nodule, which is commonly located over the upper trunk. We report the case of a 41-year-old female patient who presented with progressive linear dermatomyofibroma over the nape of her neck. This case report expands the knowledge about the clinical and histopathological features of this rare, benign and cutaneous tumor.
An atypical manifestation of lateral medullary syndrome
Authors: Chakraborty Uddalak , Banik Biswajit , Chandra Atanu , Pal Jyotirmoy
Published: December 2019

Lateral medullary syndrome is a common brainstem stroke associated with a classical triad of Horner’s Syndrome, ipsilateral ataxia and hypalgesia and thermoanasthesia of ipsilateral face. We report a case of a 49-year-old diabetic, non-hypertensive, postmenopausal female who presented with symptoms involving the left dorsal medulla along with right sided hemiparesis and left UMN-type facial palsy. Contralateral hemiparesis was explained by caudal extension of infarct involving the pyramids before decussation at the medulla, known as Babinski–Nageotte Syndrome. UMN-type facial palsy was attributed to involvement of hypothetical supranuclear aberrant corticobulbar fibres of facial nerve which descend down in the contralateral ventromedial medulla, decussate at level of upper medulla and then ascend in the dorsolateral medulla to reach the facial nerve nucleus. Association of these two entities with Wallenberg’s Syndrome have been reported separately in literature, but not together as in this case.
Enhanced Relative Electron Transport Rate Contributes to Increased Photosynthetic Capacity in Autotetraploid Pak Choi
Authors: Zhang Changwei , Wang Huiyu , Xu Yuanyuan , Zhang Shuning , Wang Jianjun , Hu Bing , Hou Xilin , Li Ying , Liu Tongkun
Published: December 2019

Autopolyploids often show growth advantages over their diploid progenitors because of their increased photosynthetic activity; however, the underlying molecular basis of such mechanism remains elusive. In this study, we aimed to characterize autotetraploid pak choi (Brassica rapa ssp. chinensis) at the physiological, cellular and molecular levels. Autotetraploid pak choi has thicker leaves than its diploid counterparts, with relatively larger intercellular spaces and cell size and greater grana thylakoid height. Photosynthetic data showed that the relative electron transport rate (rETR) was markedly higher in autotetraploid than in diploid pak choi. Transcriptomic data revealed that the expressions of genes involved in ‘photosynthesis’ biological process and ‘thylakoids’ cellular component were mainly regulated in autotetraploids. Overall, our findings suggested that the increased rETR in the thylakoids contributed to the increased photosynthetic capacity of autotetraploid leaves. Furthermore, we found that the enhanced rETR is associated with increased BrPetC expression, which is likely altered by histone modification. The ectopic expression of BrPetC in Arabidopsis thaliana led to increased rETR and biomass, which were decreased in BrPetC-silenced pak choi. Autotetraploid pak choi also shows altered hormone levels, which was likely responsible for the increased drought resistance and the impaired powdery mildew resistance of this lineage. Our findings further our understanding on how autotetraploidy provides growth advantages to plants.
Preharvest Detection and Postharvest Incidence of Phlyctema vagabunda on ‘Cripps Pink’ Apples in South Africa
Authors: Den Breeyen Alana , Rochefort Jessica , Russouw Andre , Meitz-Hopkins Julia , Lennox Cheryl L.
Published: December 2019

Phlyctema vagabunda is responsible for significant postharvest losses in ‘Cripps Pink’ apples in South Africa. The first objective of this study was to determine the presence and incidence of P. vagabunda on stored commercial ‘Cripps Pink’ apple in five major pome fruit growing regions in the Western Cape. As the fungus remains latent until postharvest, the second objective was to develop a rapid molecular detection tool to determine the presence of P. vagabunda on asymptomatic ‘Cripps Pink’ apples from two commercial orchards. Postharvest disease incidence in ‘Cripps Pink’ apples in the Western Cape ranged from 0 to 73% in the 2010/2011, 0 to 6% in 2011/2012, and 0 to 30% in 2012/2013 seasons. P. vagabunda spores were also detected on ‘Cripps Pink’ fruit from December to February and from March to April. In December and January, P. vagabunda spores were detected on the ‘Hillieri’ crab apple pollinator. The knowledge that P. vagabunda conidia are present on the surface of ‘Cripps Pink’ apples and ‘Hillieri’ crab apples during the growing season could be applied to improving current management practices in the orchards.
Is there an indication to utilize intravenous iron in acute trauma patients? Why, how, and when
Authors: Froessler Bernd , Kurmis Andrew , Papendorf David
Published: December 2019

Purpose of review

Traumatic injury has been described as a growing pandemic which has significant implications for global health. In the trauma setting, anemia is a common occurrence and is frequently inadequately addressed. It is associated with significant morbidity and incurs great cost – both to the patient and to the health system. The cause is multifactorial, and the pathophysiology is incompletely understood. Appropriate care of the trauma patient is a multidisciplinary responsibility and a focused approach to anemia is vital. The recommendation for restrictive transfusion strategies and the potential benefit of intravenous iron (IVI) in the perioperative setting, make the intervention an attractive proposition in the anemic trauma patient.

Recent findings

In an era where the importance of patient blood management is recognized, there is significant attention being given to both the implications and the appropriate management of anemia, in various settings. Advances have been made in the understanding of the mechanisms underlying the anemia associated with traumatic injury and the efficacy of current interventions is being explored. This increased understanding of the pathophysiology behind the condition has also facilitated the postulation of potential therapeutic targets for the future.

Suboptimally managed anemia impacts on clinical outcome and contributes to the burden of costs associated with trauma. The cause of the anemia associated with trauma is multifactorial and should be addressed at several levels. The role of IVI in this setting is yet to be clearly defined.
Correlation Between Heart Rate Characteristic Index Score and Severity of Brain Injury in Neonates With Hypoxic-Ischemic Encephalopathy
Authors: Kayton Allyson , DeGrazia Michele , Sharpe Elizabeth , Smith Denise , Perez Jose A. , Weiss Michael D.
Published: December 2019

Background:

Hypoxic-ischemic encephalopathy (HIE) remains devastating for neonates despite widespread treatment with therapeutic hypothermia (TH). The heart rate characteristic (HRC) index score, a measure of heart rate variability, could prove useful in the management of neonates with HIE as new therapies emerge or when withdrawal-of-support decisions are being considered.

Purpose:

The main purpose was to describe correlation between HRC index scores and brain magnetic resonance imaging (MRI) severity of injury for neonates with HIE.

Methods/Analysis:

Low/high HRC index scores retrieved at initiation of TH (baseline), 24, 48, 72, and 96 hours, brain MRI severity of injury, and National Institute of Child Health and Human Development Death/Disability and Death scores were collected and analyzed retrospectively. Independent t tests and linear regression were used to examine relationships for each outcome measure.

Results:

Twenty-seven neonates were stratified into 2 groups: noninjury (n = 11) and injury (n = 16). Statistically significant relationships were observed. Strikingly, mean low HRC index score for the noninjury group ranged between 0.37 and 0.65 and was between 0.61 and 0.86 for the injury group. Mean high HRC index score for the noninjury group ranged between 0.66 and 1.02 and was between 1.04 and 1.41 for the injury group.

Implications for Practice:

HRC index score may be a useful guide in the future management of neonates with HIE.

Implications for Research:

This study established correlations between HRC index and MRI injury scores in neonates treated with TH. Further research is warranted to establish important relationships between brain injury and HRC index scores before this tool can be used clinically for this purpose.
Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip
Authors: Alsiddiky Abdulmonem , Alatassi Raheef , Alqarni Mahdi M. , Bakerman Khalid
Published: December 2019

Children older than 18 months with developmental dysplasia of the hip (DDH) for the first time or who do not respond to closed treatment require open reduction with/without acetabuloplasty. We determined whether open reduction and pelvic acetabuloplasty using the Pemberton or Dega technique for both hips simultaneously was well tolerated and offered better outcomes. A total of 140 hips of 70 patients with bilateral DDH were identified. All patients were diagnosed after they started walking. Patients were treated with bilateral single-stage open reduction with acetabuloplasty using the Pemberton or Dega procedure. All patients were prospectively followed up between 2007 and 2018. Results were considered satisfactory if the acetabular index was <24°. Hemoglobin levels were evaluated in all patients. At the final follow-up, the results were evaluated radiologically and clinically based on the modified Severin’s classification and modified McKay criteria, respectively. The mean age at surgery was 20.3 months (range, 16–24). The mean operative time was 228 minutes. The mean postoperative hemoglobin level was 90.5 g/L (range, 61–122; SD, ±13.4). The mean differences between the preoperative and postoperative acetabular index values for both hips were 22.36° (SD, ±6.69°) and 22.64° (SD, ±6.69°) for the right and left hips, respectively. Open reduction with pelvic acetabuloplasty using the Pemberton or Dega technique simultaneously in both hips was well tolerated, cost-effective, had excellent outcomes, and posed no additional risk to patients with DDH younger than 24 months.
Patient-Centered Care: Total Hip Arthroplasty for Displaced Femoral Neck Fracture Does Not Increase Infection Risk
Authors: Campbell Abigail , Lott Ariana , Gonzalez Leah , Kester Benjamin , Egol Kenneth A.
Published: December 2019

Introduction:

Total hip arthroplasty (THA) is often used for displaced femoral neck fracture. In this study, institutional hip arthroplasty data were compared with the National American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data for any differences in outcomes between our hospital, with an integrated hip fracture care pathway, and those of the country as a whole.

Methods:

Elective THA was compared with arthroplasty performed for acute fracture. Outcomes for both groups included thromboembolic event (VTE), death, and deep prosthetic infection.

Results:

Institutional data revealed no increased rate of infection after THA for fracture compared with elective. National Surgical Quality Improvement Program analysis revealed higher infection rates in fracture arthroplasty. There was an increased VTE rate in fracture performed for arthroplasty compared with elective in both institutional and NSQIP data.

Conclusions:

When performed at an academic medical center with an integrated care program, THA for fracture can have similar infection rates to elective THA. By contrast, national data showed significantly higher rates of infection and VTE for arthroplasty for fracture compared with elective. The contrast in complication rates may be related to well-functioning comprehensive interdisciplinary pathways. Patient-centered care pathways may be optimal for hip fracture patients.
Noninvasive positive pressure ventilation in stable patients with COPD
Authors: Wiles Samuel P. , Aboussouan Loutfi S. , Mireles-Cabodevila Eduardo
Published: December 2019

Purpose of review

Long-term noninvasive positive pressure ventilation (NIV) used to be a controversial form of therapy for patients with stable hypercapnic chronic obstructive pulmonary disease (SH-COPD). New evidence described in this review defines the optimal settings, timing and target population for NIV utilization in SH-COPD necessary to maximize its benefit.

Recent findings

NIV, when titrated appropriately, leads to improved clinical outcomes. High inspiratory positive airway pressures aimed at decreasing CO2 levels can ensure NIV success in SH-COPD. NIV initiated when patients remain hypercapnic whereas in a clinical stable state following an acute exacerbation can prolong the time to a readmission. Technological advances in NIV algorithms and remote monitoring have the potential to improve use and titration. NIV and portable NIV improve exercise tolerance and may accentuate the benefits derived from pulmonary rehabilitation alone.

Use of high-intensity NIV in SH-COPD is beneficial yet appropriate patient selection and implementation is paramount.
Racial Disparities in Resection of Early Stage Non–Small Cell Lung Cancer
Authors: Ezer Nicole , Mhango Grace , Bagiella Emilia , Goodman Emily , Flores Raja , Wisnivesky Juan P.
Published: December 2019

Background:

Racial disparities in resection of non–small cell lung cancer (NSCLC) are well documented. Patient-level and system-level factors only partially explain these findings. Although physician-related factors have been suggested as mediators, empirical evidence for their contribution is limited.

Objective:

To determine if racial disparities in receipt of thoracic surgery persisted after patients had a surgical consultation and whether there was a physician contribution to disparities in care.

Methods:

The authors identified 19,624 patients with stage I-II NSCLC above 65 years of age from the Surveillance-Epidemiology and End-Results-Medicare database. They studied black and white patients evaluated by a surgeon within 6 months of diagnosis. They assessed for racial differences in resection rates among surgeons using hierarchical linear modeling. Our main outcome was receipt of NSCLC resection. A random intercept was included to test for variability in resection rates across surgeons. Interaction between patient race and the random surgeon intercept was used to evaluate for heterogeneity between surgeons in resection rates for black versus white patients.

Results:

After surgical consultation, black patients were less likely to undergo resection (adjusted odds ratio, 0.57; 95% confidence interval, 0.47–0.69). Resection rates varied significantly between surgeons (P<0.001). A significant interaction between the surgeon intercept and race (P<0.05) showed variability beyond chance across surgeons in resection rates of black versus white patients. When the model included thoracic surgery specifalization the physician contribution to disparities in care was decreased.

Conclusions:

Racial disparities in resection of NSCLC exist even among patients who had access to a surgeon. Heterogeneity between surgeons in resection rates between black and white patients suggests a physician’s contribution to observed racial disparities. Specialization in thoracic surgery attenuated this contribution.
The Significance of a Knee Injury in the Investigation of an Unsuspected Motor Vehicle-Pedestrian Collision
Authors: Halari Moheem Masumali , Shkrum Michael James
Published: December 2019

Characteristic injury patterns have been described in pedestrians struck by motor vehicles. The common injury pattern seen in upright pedestrians consists of a triad of head, pelvis, and lower extremity trauma. There are several factors such as vehicular type, design, mass and speed, and impact surfaces that influence the type and distribution of these injuries. We report a case that illustrates the importance of examination of the knee at autopsy when the typical lower extremity diaphyseal fractures that are usually seen in a motor vehicle-pedestrian collision are absent.
Sources of Variability in Pediatric Head Computed Tomography Use Among Emergency Departments in New Jersey
Authors: Holmes Aline M. , Sacchetti Alfred , Bukata W. Richard , Sheth Soniya
Published: December 2019

Objective

Published guidelines have been developed to limit ionizing radiation exposure in children related to diagnostic computed tomography (CT). This study examines the sources of variability in head CT use in children in emergency departments (EDs) in New Jersey despite the presence of such consensus recommendations.

Methods

The New Jersey Hospital Association (NJHA) Clinical Repository was queried for study data on all patients younger than 18 years discharged from the ED over a 1-year period. Patient information collected included: treating hospital, patient age, discharge diagnosis, use of head CT, children's hospital (CH) certification, presence of licensed in-patient pediatric beds, association with a hospital system and hospital annual pediatric ED volume. A potential diagnosis requiring a head CT (PDRCT) was defined as one of the following discharge diagnoses: Head Injury, Seizure, Syncope or Headache. Analysis of CT use per 10,000 ED visits was performed through ANOVA, analysis of means for variances, and χ2.

Results

A total of 735,866 ED visits were examined with 16,942 (2.3%) undergoing head CTs. Mean Pediatric Head CT use per 10,000 ED visits for the state was 275 (±16; range, 27–640). During the study period 47,169 (6.4%) ED visits met the PDRCT criteria, 11,495 (27%) of which underwent head CTs. Mean Pediatric Head CT use in this group per 10,000 PDRCT visits was 2948 (±152; range, 728–5806). Characteristics associated with lowest use of head CTs in the PDRCT group included: ED census greater than 10,000 visits per year, CH designation, and younger patient. The presence of in-patient pediatric beds and association with a hospital system with or without an in system CH were not associated with lower head CT use.

Conclusions

Despite existing recommendation regarding head CTs in children, there exists a large degree of variability in use of this diagnostic study in EDs in New Jersey.
Respiratory Motion Detection and Correction for MR Using the Pilot Tone
Authors: Vahle Thomas , Bacher Mario , Rigie David , Fenchel Matthias , Speier Peter , Bollenbeck Jan , Schäfers Klaus P. , Kiefer Berthold , Boada Fernando E.
Published: December 2019

Objectives

The aim of this study was to develop a method for tracking respiratory motion throughout full MR or PET/MR studies that requires only minimal additional hardware and no modifications to the sequences.

Materials and Methods

Patient motion that is caused by respiration affects the quality of the signal of the individual radiofrequency receive coil elements. This effect can be detected as a modulation of a monofrequent signal that is emitted by a small portable transmitter placed inside the bore (Pilot Tone). The frequency is selected such that it is located outside of the frequency band of the actual MR readout experiment but well within the bandwidth of the radiofrequency receiver, that is, the oversampling area. Temporal variations of the detected signal indicate motion. After extraction of the signal from the raw data, principal component analysis was used to identify respiratory motion. The approach and potential applications during MR and PET/MR examinations that rely on a continuous respiratory signal were validated with an anthropomorphic, PET/MR-compatible motion phantom as well as in a volunteer study.

Results

Respiratory motion detection and correction were presented for MR and PET data in phantom and volunteer studies. The Pilot Tone successfully recovered the ground-truth respiratory signal provided by the phantom.

Conclusions

The presented method provides reliable respiratory motion tracking during arbitrary imaging sequences throughout a full PET/MR study. All results can directly be transferred to MR-only applications as well.
Induction of Allograft Tolerance While Maintaining Immunity Against Microbial Pathogens: Does Coronin 1 Hold a Key?
Authors: Jayachandran Rajesh , Pieters Jean
Published: December 2019

Selective suppression of graft rejection while maintaining anti-pathogen responses has been elusive. Thus far, the most successful strategies to induce suppression of graft rejection relies on inhibition of T-cell activation. However, the very same mechanisms that induce allograft-specific T-cell suppression are also important for immunity against microbial pathogens as well as oncogenically transformed cells, resulting in significant immunosuppression-associated comorbidities. Therefore, defining the pathways that differentially regulate anti-graft versus antimicrobial T-cell responses may allow the development of regimen to induce allograft-specific tolerance. Recent work has defined a molecular pathway driven by the immunoregulatory protein coronin 1 that regulates the phosphodiesterase/cyclic adenosine monophosphate pathway and modulates T cell responses. Interestingly, disruption of coronin 1 promotes allograft tolerance while immunity towards a range of pathogenic microbes is maintained. Here, we briefly review the work leading up to these findings as well as their possible implications for transplantation medicine.
Effects of Multidrug-resistant Bacteria in Donor Lower Respiratory Tract on Early Posttransplant Pneumonia in Lung Transplant Recipients Without Pretransplant Infection
Authors: Lee Kyoung Hwa , Jeong Su Jin , Kim Song Yee , Han Sang Hoon , Park Moo Suk , Lee Jin Gu , Yoo Seul Gi , La Yeonju , Kwon Da Eun , Lee Chang Young , Song Yong Goo , Paik Hyo Chae
Published: December 2019

Background.

Multidrug-resistant (MDR) bacteria in the lower respiratory tracts of allografts may be risk factors for early posttransplant pneumonia (PTP) that causes detrimental outcomes in lung transplant recipients (LTRs). We evaluated the effects of immediate changes in MDR bacteria in allografts on early PTP and mortality rates in LTRs.

Methods.

We reviewed 90 adult bilateral LTRs without pretransplant infections who underwent lung transplantation between October 2012 and May 2018. Quantitative cultures were performed with the bronchoalveolar lavage fluids of the allografts preanastomosis and within 3 days posttransplant. The International Society for Heart and Lung Transplantation consensus defines early PTP as pneumonia acquired within 30 days posttransplant and not associated with acute rejection.

Results.

MDR Acinetobacter baumannii (11/34, 32.4%) and Staphylococcus aureus (9/34, 26.5%) were identified in 24.4% (22/90) of the preanastomosis allografts. Four LTRs had the same MDR bacteria in allografts preanastomosis and posttransplant. Allograft MDR bacteria disappeared in 50% of the LTRs within 3 days posttransplant. Early PTP and all-cause in-hospital mortality rates were not different between LTRs with and without preanastomosis MDR bacteria (P = 0.75 and 0.93, respectively). MDR bacteria ≥104 CFU/mL in the lungs within 3 days posttransplant was associated with early PTP (odds ratio, 5.8; 95% confidence interval, 1.3-27.0; P = 0.03).

Conclusions.

High levels of preexisting MDR bacteria in allografts did not increase early PTP and mortality rates in LTRs. Despite the small and highly selective study population, lung allografts with MDR bacteria may be safely transplanted with appropriate posttransplant antibiotic therapy.
Effectiveness of interpretive front-of-pack nutritional labelling schemes on the promotion of healthier food choices: a systematic review
Authors: Feteira-Santos Rodrigo , Fernandes João , Virgolino Ana , Alarcão Violeta , Sena Catarina , Vieira Carlota P. , Gregório Maria João , Nogueira Paulo , Costa Andreia , Graça Pedro , Santos Osvaldo
Published: December 2019

Aims:

Interpretive front-of-package nutrition labelling can contribute to healthier food habits. This systematic review aimed to examine the effectiveness of interpretive front-of-package nutrition labelling schemes on consumers’ food choices, namely at the moment of food purchase, and to analyse if this potential front-of-package nutrition labelling's effect varies according to different socioeconomic groups.

Methods:

Electronic databases (Cochrane Library, PubMed, Scopus, and Web of Science) search was performed to identify peer-reviewed articles describing longitudinal studies evaluating the effect of front-of-package nutrition labelling schemes on consumers’ food choices, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Equity 2012 Extension guidelines. No publication-period or language restrictions were applied. PROGRESS-Plus framework was used to report if and how socioeconomic factors were considered in analyses of front-of-package nutrition labelling-related interventions’ effect.

Results:

Nine studies were selected for narrative synthesis (seven randomized controlled trials and two cross-over trials). When compared with no-interpretive-label conditions, front-of-package nutrition labelling showed a positive impact for nutritional content understanding, healthiness perception of products, selection of products with better nutritional quality, and purchase intention. However, there is no robust evidence of superiority of a specific front-of-package nutrition labelling scheme's effect, neither on consumers’ understanding of nutritional content nor on food choices. An evaluation of the studies following the PROGRESS-Plus framework revealed that socioecononomic status and education were the most frequently used dimensions, when assessing the effect of interpretative front-of-pack nutrition labels. More evidence is necessary to determine the role of front-of-pack nutrition labels in decreasing inequalities between different population subgroups, namely among the most vulnerable subgroups, on the promotion of healthy food choices.

Conclusion:

Well controlled longitudinal studies, following a real-world evidence approach, are needed to clarify front-of-package nutrition labelling's impact on consumers’ food choices, namely at purchase points, taking into account the most vulnerable population subgroups, such as those with lower literacy and/or financial resources.
Mentor–mentee relationships as anchors for pre service teachers’ coping on professional placement
Authors: Wilson Anat , Huynh Minh
Published: December 2019

Purpose

Mentor–mentee relationships are important for individual wellbeing, mental health, professional agency and confidence. In the context of an initial teacher education (ITE) programme, these relationships become a key factor. Pre-service teachers’ capacity to cope on a professional placement is closely linked to the quality of the mentoring relationship. The purpose of this paper is to identify the negative coping strategies used by pre-service teachers who struggle to cope in a school placement in Melbourne, Australia, highlighting the importance of providing quality mentorship.

Design/methodology/approach

A mixed-methods approach was used for the analysis of pre-service teachers’ coping on a teaching practicum and to identify common related beliefs. A total of 177 pre-service teachers, who have completed at least one supervised practicum participated in this study. The Coping Scale for Adults second edition (CSA-2) was administered alongside an open-ended questionnaire to identify frequently used coping styles and associated thoughts and beliefs.

Findings

The results show that pre-service teachers who favour non-productive coping strategies were more likely to express feelings of loneliness, pointed at poor communication with their mentor and described thoughts about leaving the teaching profession.

Originality/value

Using the Coping Scale for Adults in the context of practicum provides an insight into individual experiences. The implications of mentor–mentee relationships for individuals’ coping are highlighted. initial teacher education programs and schools have significant roles in supporting mentor–mentee relationships and practical supportive interventions are offered.
Teacher vs student responsibility for course outcomes
Authors: Williams Robert , Wallace Monica
Published: December 2019

Purpose

The purpose of this paper is primarily to identify factors that accounted for the differences in course evaluation and course performance in two sections of the same course taught by the same instructor. Potential contributors to these differences included critical thinking, grade point average (GPA) and homework time in the course. Secondarily, the authors also examined whether season of the year and academic status of students (1st year through 3rd year) might have contributed to differences in course ratings and exam performance. The data in the study included some strictly quantitative variables and some qualitative judgments subsequently converted to quantitative measures.

Design/methodology/approach

The outcome variables included student objective exam scores and course ratings on the University’s eight-item rating form. Variables that may have contributed to performance and course evaluation differences between the two groups included student effort in the course, GPA and critical thinking.

Findings

The higher-performing section obtained significantly higher scores on course exams than the lower-preforming group and also rated the course significantly higher (average of 4.15 across the evaluation items) than the lower performing section (3.64 average in item ratings). The two performance groups did not differ on critical thinking and GPA, but did differ significantly in hours spent per week outside of class in studying for the course.

Originality/value

Although many studies have examined the predictive validity of course ratings, instructors are typically held responsible for both high and low student ratings. This particular action study suggests that it may be student effort rather than instructor behavior that has the stronger impact on both student performance and course evaluations.