bluuebunny/crossref_metadata_2025 huggingface dataset:
Safer and more appropriate opioid prescribing: a large healthcare system's comprehensive approach
Authors: Losby Jan L. , Hyatt Joel D. , Kanter Michael H. , Baldwin Grant , Matsuoka Denis
Published: July 2017

Rationale, aims, and objectives

The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long‐term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow‐up processes, and clinical coordination through electronic health record integration. The purpose of this paper is to describe the implementation of these interventions and assess the impact of this set of interventions on opioid prescribing.

Method

The study used a retrospective pre‐post evaluation design to track outcomes before and after the intervention. Kaiser Permanente Southern California members age 18 and older excluding cancer, hospice, and palliative care patients and this sub‐population of 3 203 880 was approximately 75% of all Kaiser Permanente Southern California members. All data are from Kaiser Permanente's pharmacy data systems and electronic health record collected on a rolling basis as interventions were implemented from January 2010 to December 2015.

Results

There were reductions in all tracked outcomes: a 30% reduction in prescribing opioids at high doses; a 98% reduction in the number of prescriptions with quantities greater than 200 pills; a 90% decrease in the combination of an opioid prescription with benzodiazepines and carisoprodol; a 72% reduction in the prescribing of Long Acting/Extended Release opioids; and a 95% reduction in prescriptions of brand name opioid‐acetaminophen products. In addition, methadone prescribing did not increase during this period.

Conclusions

This study adds promising results that a comprehensive system‐level strategy has the ability to positively affect opioid prescribing. The basic components of the intervention are generalizable and applicable to other health care settings.
A Minchinia mercenariae‐like parasite infects cockles Cerastoderma edule in Galicia (NW Spain)
Authors: Ramilo A , Abollo E , Villalba A , Carballal M J
Published: July 2017

The cockle Cerastoderma edule fishery has traditionally been the most important shellfish species in terms of biomass in Galicia (NW Spain). In the course of a survey of the histopathological conditions affecting this species in the Ria of Arousa, a haplosporidan parasite that had not been observed in Galicia was detected in one of the most productive cockle beds of Galicia. Uni‐ and binucleate cells and multinucleate plasmodia were observed in the connective tissue mainly in the digestive area, gills and gonad. The parasite showed low prevalence, and it was not associated with abnormal cockle mortality. Molecular identification showed that this parasite was closely related to the haplosporidan Minchinia mercenariae that had been reported infecting hard clams Mercenaria mercenaria from the Atlantic coast of the United States. The molecular characterization of its SSU rDNA region allowed obtaining a fragment of 1,796 bp showing 98% homology with M. mercenariae parasite. Phylogenetic analysis supported this identification as this parasite was clustered in the same clade as M. mercenariae from the United States and other M. mercenariae‐like sequences from the UK, with bootstrap value of 99%. The occurrence of M. mercenariae‐like parasites infecting molluscs outside the United States is confirmed.
Characterization of spaC‐type Erysipelothrix sp. isolates causing systemic disease in ornamental fish
Authors: Pomaranski E K , Reichley S R , Yanong R , Shelley J , Pouder D B , Wolf J C , Kenelty K V , Van Bonn B , Oliaro F , Byrne B , Clothier K A , Griffin M J , Camus A C , Soto E
Published: July 2017

Since 2012, low‐to‐moderate mortality associated with an Erysipelothrix sp. bacterium has been reported in ornamental fish. Histological findings have included facial cellulitis, necrotizing dermatitis and myositis, and disseminated coelomitis with abundant intralesional Gram‐positive bacterial colonies. Sixteen Erysipelothrix sp. isolates identified phenotypically as E. rhusiopathiae were recovered from diseased cyprinid and characid fish. Similar clinical and histological changes were also observed in zebrafish, Danio rerio, challenged by intracoelomic injection. The Erysipelothrix sp. isolates from ornamental fish were compared phenotypically and genetically to E. rhusiopathiae and E. tonsillarum isolates recovered from aquatic and terrestrial animals from multiple facilities. Results demonstrated that isolates from diseased fish were largely clonal and divergent from E. rhusiopathiae and E. tonsillarum isolates from normal fish skin, marine mammals and terrestrial animals. All ornamental fish isolates were PCR positive for spaC, with marked genetic divergence (<92% similarity at gyrB, <60% similarity by rep‐PCR) between the ornamental fish isolates and other Erysipelothrix spp. isolates. This study supports previous work citing the genetic variability of Erysipelothrix spp. spa types and suggests isolates from diseased ornamental fish may represent a genetically distinct species.
Secondary immune response of rainbow trout following repeated immersion vaccination
Authors: Jaafar R M , Al‐Jubury A , Chettri J K , Dalsgaard I , Kania P W , Buchmann K
Published: July 2017

Teleosts are able to raise a protective immune response, comprising both innate and adaptive elements, against various pathogens. This is the basis for a widespread use of vaccines, administered as injection or immersion, in the aquaculture industry. It has been described that repeated injection vaccination of fish raises a secondary immune response, consisting of rapid, accelerated and increased antibody reaction. This study reports how rainbow trout responds to repeated immersion vaccination against yersiniosis (ERM) caused by the bacterial pathogen Yersinia ruckeri. It was found that rainbow trout does not raise a classical secondary response following repeated immersion vaccination. Serum antibody titres were merely slightly increased even after three immunizations, using 30‐s immersion into a bacterin consisting of formalin‐inactivated Y. ruckeri (serotype O1, biotypes 1 and 2), performed over a 3‐month period. The densities of IgM‐positive lymphocytes in spleen of fish immunized three times were increased compared to control fish, but no general trend for an increase with the number of immunizations was noted. The lack of a classical secondary response following repeated immersion vaccination may partly be explained by limited uptake of antigen by immersion compared to injection.
Comparison of nutrient intake in adolescents and adults with and without food allergies
Authors: Maslin K. , Venter C. , MacKenzie H. , Vlieg‐Boerstra B. , Dean T. , Sommer I.
Published: July 2017

Background

Exclusion diets for the management of food allergy pose a risk of nutritional deficiencies and inadequate growth in children, yet less is known about their effect in adolescents and adults. The present study aimed to compare the dietary intake of adolescents and adults with food allergies with that of a control group.

Methods

A food allergic and a control group were recruited from Portsmouth and the Isle of Wight in the UK. Participants were recruited from a food allergy charity, allergy clinics, a local school and university, and previous research studies. Macro and micronutrient intake data were obtained using a 4‐day estimated food diary. Sociodemographic and anthropometric data was collected via a constructed questionnaire.

Results

This cross‐sectional study included 81 adolescents (48 food allergic and 33 controls) aged 11–18 years and 70 adults aged 19–65 years (23 food allergic and 47 controls). Overall, 19 (22.8%) adolescents and 19 (27.1%) adults took dietary supplements, with no difference according to food allergic status. Adolescents with food allergy had higher intakes of niacin and selenium than adolescents without (P < 0.05). This difference persisted when dietary supplements were removed from the analysis. Adults with food allergies had higher intakes of folate and zinc than those without (P < 0.05); however, this difference did not persist when dietary supplements were removed from the analysis. Across all participants, the intake of several micronutrients was suboptimal. There was no difference in protein or energy intake, or body mass index, according to food allergic status.

Conclusions

The dietary intake of food allergic participants was broadly similar and, in some cases, better than that of control participants. However, suboptimal intakes of several micronutrients were observed across all participants, suggesting poor food choices.
Comparison of the paracrine activity of mesenchymal stem cells derived from human umbilical cord, amniotic membrane and adipose tissue
Authors: Dabrowski Filip A. , Burdzinska Anna , Kulesza Agnieszka , Sladowska Anna , Zolocinska Aleksandra , Gala Kamila , Paczek Leszek , Wielgos Miroslaw
Published: July 2017

Aim

The study was conducted to investigate secretory activity and define the paracrine potential of mesenchymal stem cells from human umbilical cord and amniotic membrane (UC‐MSCs and AM‐MSCs, respectively).

Methods

UC‐MSCs (n = 6) were obtained from tissue explants using an adherent method after two weeks of incubation. AM‐MSCs (n = 6) were obtained by digestion with tripsin and collagenase. MSC phenotype was confirmed in vitro by performing flow cytometry, differentiation assays and vimentin staining. Supernatants were collected after 48 h culturing in serum‐free conditions and the following concentrations were determined: epidermal growth factor (EGF), interleukin (IL)‐6, IL‐10, tumor necrosis factor‐α, transforming growth factor‐β (TGF‐β), vascular endothelial growth factor‐α (VEGF‐α) and metalloproteinase (MMP) 1, 8 and 13, using multiplex supernatant cytokine assay. Data were compared with adipose tissue derived MSCs (AD‐MSCs, n = 6).

Results

Both UC‐MSC and AM‐MSC populations were positively identified as MSCs by flow cytometry and differentiation potential into bone, cartilage and adipose tissue. Using a multiple cytokine detection assay, we proved that both UC‐MSCs and AM‐MSCs show high secretive capacity. However, the secretion profile differed between cells from various sources. UC‐MSCs showed significantly higher production of TGF‐β and lower production of VEGF‐α, compared to AD‐MSCs (P = 0.004) and AM‐MSCs (P = 0.039) and lower levels of EGF (P = 0005). AM‐MSCs showed significantly lower levels of MMP‐8 than UC‐MSCs (P = 0.024); however, there was no difference in levels of released cytokines compared to AD‐MSCs.

Conclusion

AM‐MSCs show similar IL production as AD‐MSCs, while UC‐MSCs have a significantly different profile, which suggests diverse biological potential of both cell types for immunomodulative and regenerative therapy.
Giant fetal hydrometrocolpos associated with cloacal anomaly causing postnatal respiratory distress
Authors: Kanda Tatsuhito , Iizuka Takashi , Yamazaki Rena , Iwadare Junpei , Ono Masanori , Fujiwara Hiroshi
Published: July 2017

Persistent cloaca is a rare presentation wherein the urethra, vagina, and rectum converge into a common channel with a single perineal opening. Fetal hydrometrocolpos can result if fluid accumulates behind an obstruction of this common channel. A 29‐year‐old woman (G4P1021) was referred at 36 2/7 weeks of gestation for evaluation of a fetal abdominal cystic mass. Detailed ultrasonography and magnetic resonance imaging showed two symmetric cystic masses, bilateral hydronephrosis, and oligohydramnios. Elective cesarean delivery was performed at 37 0/7 weeks; the baby weighed 4043 g with Apgar scores of 5 and 6 at 1 and 5 min. Intubation was performed for respiratory distress, and the infant was noted to have an imperforate anus; persistent cloaca was diagnosed. Drainage of the hydrometrocolpos improved the infant's breathing remarkably, and extubation was achieved. This child's imaging findings are among the largest ever reported, and resulted in neonatal respiratory distress.
Rapid modulation of the silent information regulator 1 by melatonin after hypoxia‐ischemia in the neonatal rat brain
Authors: Carloni Silvia , Riparini Giulia , Buonocore Giuseppe , Balduini Walter
Published: July 2017

Increasing evidence indicates that melatonin possesses protective effects toward different kinds of damage in various organs, including the brain. In a neonatal model of hypoxia‐ischemia (HI), melatonin was neuroprotective and preserved the expression of the silent information regulator 1 (SIRT1) 24 hours after the insult. This study aimed to gain more insight into the role of SIRT1 in the protective effect of melatonin after HI by studying the early (1 hour) modulation of SIRT1 and its downstream targets, and the consequences on necrosis, apoptosis, autophagy, and glial cell activation. We found that melatonin administered 5 minutes after the ischemic insult significantly reduced necrotic cell death assessed 1 hour after its administration. In parallel, we found a reduced activation of the early phases of intrinsic apoptosis, detected by reduced BAX translocation to the mitochondria and preservation of the mitochondrial expression of cytochrome C, indicating a reduced outer mitochondrial membrane permeabilization in the melatonin‐treated ischemic animals. These effects were concomitant to increased expression and activity of SIRT1, reduced expression and acetylation of p53, and increased autophagy activation. Melatonin also reduced HI‐induced glial cells activation. SIRT1 was expressed in neurons after HI and melatonin but not in reactive glial cells expressing GFAP. Colocalization between SIRT1 and GFAP was found in some cells in control conditions. In summary, our results provide more insight into the connection between SIRT1 and melatonin in neuroprotection. The possibility that melatonin‐induced SIRT1 activity might contribute to differentiate neuronal progenitor cells during the neurodegenerative process needs to be further investigated.
A reproducible microcosm biofilm model of subgingival microbial communities
Authors: Fernandez y Mostajo M. , Exterkate R. A. M. , Buijs M. J. , Beertsen W. , van der Weijden G. A. , Zaura E. , Crielaard W.
Published: July 2017

Objective

To develop a reproducible subgingival microcosm biofilm model.

Material and Methods

Subgingival plaque samples were collected from four deep pockets (probing pocket depth ≥6 mm) in each of seven patients with periodontitis and from shallow pockets (probing pocket depth ≤3 mm) in two periodontally healthy donors. An active attachment model and a peptone medium (Thompson et. al., Appl Environ Microbiol 2015;81:8307–8314) supplemented with 30% serum was used. Biofilms were harvested at 2 and 4 weeks. DNA of dead cells was blocked for amplification by propidium monoazide treatment. Composition was analyzed using 16S rRNA gene amplicon pyrosequencing. Similarities between the biofilm samples were assessed by non‐metric multidimensional scaling using the Bray‐Curtis similarity index and similarity percentage analysis. Data from duplicate experiments, different biofilm sources and different biofilm age were compared.

Results

The non‐metric multidimensional scaling revealed a strong clustering by the inoculum source, the donor and their periodontal status. Statistically significant differences were found between the sources of inoculum (P=.0001) and biofilm age (P=.0016). Furthermore, periodontitis biofilms (P) were distinct in composition from health‐derived biofilms (H) by genera: Porphyromonas (P=19%; H=0%), Filifactor (P=10%; H=0%), Anaeroglobus (P=3%; H=0%), Phocaeicola (P=1.5%; H=0%), Parvimonas (P=19%; H=14%), Fusobacterium (P=2%; H=26%), Peptostreptococcus (P=20%; H=30%), Veillonella (P=7%; H=8%) and 57 other genera. Similarity distances (Bray‐Curtis) (mean 0.73, SD 0.15) and the Shannon diversity index (mean 2, SD 0.2) revealed no differences between duplicate experiments (P=.121).

Conclusion

This biofilm model allows reproducible production of complex subgingival microbial communities.
Autonomous demand, Harrodian instability and the supply side
Authors: Skott Peter
Published: July 2017

A recent literature introduces autonomous demand as the driver of long‐run economic growth and as a stabilizing force that tames Harrodian instability. The argument is unconvincing. The stabilizing effect is modest for plausible parameter values and more importantly, it is questionable whether any components of aggregate demand can be viewed as autonomous in the long run. By contrast, models that include the supply side (the labor market) and/or economic policy can address Harrodian instability and produce level and growth effects that resemble those derived in the literature on autonomous demand.
A Gricean Theory of Malaprops
Authors: Unnsteinsson Elmar
Published: July 2017

Gricean intentionalists hold that what a speaker says and means by a linguistic utterance is determined by the speaker's communicative intention. On this view, one cannot really say anything without meaning it as well. Conventionalists argue, however, that malapropisms provide powerful counterexamples to this claim. I present two arguments against the conventionalist and sketch a new Gricean theory of speech errors, called the misarticulation theory. On this view, malapropisms are understood as a special case of mispronunciation. I argue that the Gricean theory is supported by empirical work in phonetics and phonology and, also, that conventionalism inevitably fails to do this work justice. I conclude, from this, that the conventionalist fails to show that malapropisms constitute a counterexample to a Gricean theory.
Heterogeneity in non‐epitope loop sequence and outer membrane protein complexes alters antibody binding to the major porin protein PorB in serogroup B Neisseria meningitidis
Authors: Matthias Kathryn A. , Strader Michael Brad , Nawar Hesham F. , Gao Yamei S. , Lee Joonseong , Patel Dhilon S. , Im Wonpil , Bash Margaret C.
Published: July 2017

PorB is a well‐characterized outer membrane protein that is common among Neisseria species and is required for survival. A vaccine candidate, PorB induces antibody responses that are directed against six variable surface‐exposed loops that differ in sequence depending on serotype. Although Neisseria meningitidis is naturally competent and porB genetic mosaicism provides evidence for strong positive selection, the sequences of PorB serotypes commonly associated with invasive disease are often conserved, calling into question the interaction of specific PorB loop sequences in immune engagement. In this report, we provide evidence that antibody binding to a PorB epitope can be altered by sequence mutations in non‐epitope loops. Through the construction of hybrid PorB types and PorB molecular dynamics simulations, we demonstrate that loops both adjacent and non‐adjacent to the epitope loop can enhance or diminish antibody binding, a phenotype that correlates with serum bactericidal activity. We further examine the interaction of PorB with outer membrane‐associated proteins, including PorA and RmpM. Deletion of these proteins alters the composition of PorB‐containing native complexes and reduces antibody binding and serum killing relative to the parental strain, suggesting that both intramolecular and intermolecular PorB interactions contribute to host adaptive immune evasion.
Myelinating cocultures of rodent stem cell line‐derived neurons and immortalized Schwann cells
Authors: Ishii Tomohiro , Kawakami Emiko , Endo Kentaro , Misawa Hidemi , Watabe Kazuhiko
Published: July 2017

Myelination is one of the most remarkable biological events in the neuron–glia interactions for the development of the mammalian nervous system. To elucidate molecular mechanisms of cell‐to‐cell interactions in myelin synthesis in vitro, establishment of the myelinating system in cocultures of continuous neuronal and glial cell lines are desirable. In the present study, we performed co‐culture experiments using rat neural stem cell‐derived neurons or mouse embryonic stem (ES) cell‐derived motoneurons with immortalized rat IFRS1 Schwann cells to establish myelinating cultures between these cell lines. Differentiated neurons derived from an adult rat neural stem cell line 1464R or motoneurons derived from a mouse ES cell line NCH4.3, were mixed with IFRS1 Schwann cells, plated, and maintained in serum‐free F12 medium with B27 supplement, ascorbic acid, and glial cell line‐derived neurotrophic factor. Myelin formation was demonstrated by electron microscopy at 4 weeks in cocultures of 1464R‐derived neurons or NCH4.3‐derived motoneurons with IFRS1 Schwann cells. These in vitro coculture systems utilizing the rodent stable stem and Schwann cell lines can be useful in studies of peripheral nerve development and regeneration.
Workplace continuing education for nurses caring for hospitalised older people
Authors: Baumbusch Jennifer , Shaw Maureen , Leblanc Marie‐Eve , Kjorven Mary , Kwon Jae‐Yung , Blackburn Lorraine , Lawrie Barb , Shamatutu Marilyn , Wolff Angela C.
Published: July 2017

Aims and objectives

To develop, implement and evaluate a workplace continuing education programme about nursing care of hospitalised older people.

Background

The healthcare system cannot rely solely upon nurses’ prelicensure education to prepare them to meet the evolving needs of hospitalised older patients. Over the past decade, there has been a dramatic rise in the proportion of older people in hospitals, yet many nurses do not have specialised knowledge about the unique care needs of this population.

Design

A multimethod pre‐to post‐design was employed.

Methods

Between September 2013 and April 2014, data were collected via surveys, focus groups and interviews. Thirty‐two Registered Nurses initially enrolled in the programme of which 22 completed all data points. Three managers also participated in interviews. One‐way repeated‐measures ANOVAs were conducted to evaluate the effect of the programme and change over time. Qualitative data were analysed using thematic analysis.

Results

Survey results indicated improvements in perceptions about nursing care of older people but no changes in knowledge. Themes generated from the qualitative data focused on participants’ experiences of taking part in the programme and included: (i) relevance of content and delivery mode, (ii) value of participating in the programme and (iii) continuing education in the context of acute care.

Conclusions

This study illustrated the potential role of workplace continuing education in improving care for hospitalised older people, particularly the potential to change nurses’ perceptions about this population. Nurses prefer learning opportunities that are varied in delivery of educational elder‐focused content and accessible at work. Organisational leaders need to consider strategies that minimise potential barriers to workplace continuing education.

Implications for practice

Workplace continuing education can play a key role in improving quality of care for hospitalized older adults and ought to be a priority for employers planning education for nurses.
A Visual Analog Scale to assess anxiety in children during anesthesia induction (VAS‐I): Results supporting its validity in a sample of day care surgery patients
Authors: Berghmans Johan M. , Poley Marten J. , van der Ende Jan , Weber Frank , Van de Velde Marc , Adriaenssens Peter , Himpe Dirk , Verhulst Frank C. , Utens Elisabeth
Published: July 2017

Background

The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time‐consuming. A Visual Analog Scale, in contrast, requires no training, is easy‐to‐use and quickly completed.

Aim

The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut‐offs to distinguish between anxious and nonanxious children.

Methods

Four hundred and one children (1.5‐16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State‐Trait Anxiety Inventory); (iii) cross‐informant agreement using Bland‐Altman analysis; (iv) cut‐offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30).

Results

Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high‐anxious parents were higher than those of low‐anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (−56.1 to 63.3). To classify anxious children, cut‐offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established.

Conclusions

The present data provide preliminary data for the validity of a Visual Analog Scale to assess children's anxiety during induction.
Various LED Wavelengths Affected Myofiber Development and Satellite Cell Proliferation of Chick Embryos via the IGF‐1 Signaling Pathway
Authors: Wang Yao , Bai Xinjie , Wang Zixu , Cao Jing , Dong Yulan , Dong Yanjun , Chen Yaoxing
Published: July 2017

An effect of monochromatic light illumination on muscle mass has been discovered in chickens; however, its effect on the development of embryonic muscle remains unclear. Our previous studies demonstrated that monochromatic green light promoted satellite cell proliferation and muscle growth in posthatching broilers. In this study, we investigated the effects and mechanisms of monochromatic light exposure on muscle development in late embryogenesis. Seven hundred and fifty fertile broiler eggs were randomly assigned to blue (B‐group), green (G‐group), red (R‐group), white (W‐group) lights or darkness (D‐group) throughout the incubation period. The muscle weight and fiber size were highest in the G‐group compared to the other groups during embryonic days (E) 17 to E20. The proliferation of satellite cells isolated from the G‐group was highest, and in vivo green light remarkably increased the number of proliferating cell nuclear antigen (PCNA)‐positive cells in skeletal muscle. Meanwhile, plasma IGF‐1 was higher (15.5–16.2%) in the G‐group than that in D‐ and R‐groups, and the satellite cells isolated from the G‐group had a more sensitive response to IGF‐1. These findings demonstrate green monochromatic photobiomodulation promoted the muscle growth and satellite cell proliferation was related to the IGF‐1 signaling pathway in late embryogenesis.
Identification of a novel allele, HLA‐C*01:135, by full‐length genomic sequencing
Authors: Park Y. , Im J. , Yoon C. E. , Kim H. S.
Published: July 2017

The HLA‐C*01:135 allele differs by a single nucleotide at codon 265 compared with HLA‐C*01:02:01:01.
Cytomegalovirus appendicitis after hematopoietic stem cell transplantation
Authors: Kothari Atul , Caradine Kari D. , Rico Crescencio Juan Carlos , Sasapu Appalanaidu , Veeraputhiran Muthu K. , Jethava Yogesh , Burgess Mary J.
Published: July 2017

We present the case of a young man with acute lymphoblastic leukemia who developed cytomegalovirus (CMV) appendicitis after receiving alemtuzumab for acute refractory graft‐versus‐host disease after allogeneic hematopoietic stem cell transplantation (HSCT). CMV appendicitis is a rare complication; and we are reporting the first case to our knowledge of CMV appendicitis following HSCT. Our case highlights the importance of recognition of CMV viral reactivation following the use of alemtuzumab. Using a preemptive strategy of checking CMV PCR, with initiation of early effective treatment on detection of CMV replication, may be appropriate following use of alemtuzumab in hematologic malignancies in patients after HSCT.
Ownership Concentration, Financial Leverage and Inefficient Investment-evidence from Chinese A-share Market
Authors: Xinyuan Zhang , Nan Bao , Yufei Zhao
Published: July 2017

This paper analyzes the data from Chinese A-share market during 2 years from 2014 to 2015. Basing on 2297 listed firms, we use theoretical analysis and empirical analysis to explore and validate the relationship between ownership concentration, financial leverage and the company's inefficient investment behavior. The result shows that in Chinese A-share market, financial leverage can effectively inhibit the company's inefficient investment behavior; the concentration of equity will effectively inhibit the company's inefficient investment behavior.
First Genome Sequences of Dengue Virus Strains Isolated during the First DENV-4 Outbreak in São Paulo, Brazil
Authors: Ortiz-Baez Ayda Susana , Silva Danielle Ferreira , Ferreira Daniel , Zanotto Paolo M.
Published: July 2017

Dengue virus (DENV) is an arbovirus belonging to the genus
Flavivirus
, family
Flaviviridae
. In Brazil, the reemergence and spread of DENV type 4 (DENV-4) across the country were responsible for a significant outbreak in Guarujá, São Paulo, Brazil. Here, we report the first genomic sequences of DENV strains circulating in Guarujá during the 2013 outbreak.
Draft Genome Sequences of 1,183
Salmonella
Strains from the 100K Pathogen Genome Project
Authors: Kong Nguyet , Davis Matthew , Arabyan Narine , Huang Bihua C. , Weis Allison M. , Chen Poyin , Thao Kao , Ng Whitney , Chin Ning , Foutouhi Soraya , Foutouhi Azarene , Kaufman James , Xie Yi , Storey Dylan B. , Weimer Bart C.
Published: July 2017

Salmonella
is a common food-associated bacterium that has substantial impact on worldwide human health and the global economy. This is the public release of 1,183
Salmonella
draft genome sequences as part of the 100K Pathogen Genome Project. These isolates represent global genomic diversity in the
Salmonella
genus.
Genome Sequence of Oxalobacter formigenes Strain OXCC13
Authors: Hatch Marguerite , Allison Milton J. , Yu Fahong , Farmerie William
Published: July 2017

The lack of
Oxalobacter formigenes
colonization in the human gut is generally acknowledged as a risk factor for kidney stone formation since this microorganism can play an important role in oxalate homeostasis. Here, we present the genome sequence of OXCC13, a human strain isolated from an individual residing in Germany.
Genome Sequences of New Faustovirus Strains ST1 and LC9, Isolated from the South of France
Authors: Cherif Louazani Amina , Andreani Julien , Ouarhache Maryem , Aherfi Sarah , Baptiste Emeline , Levasseur Anthony , La Scola Bernard
Published: July 2017

Faustoviruses are amoeba-infecting giant viruses closely related to the
Asfarviridae
family. Here, we report the isolation, genome sequencing, and annotation of ST1 and LC9, two new strains belonging to lineages L and E9 of faustoviruses, currently represented by only one representative each.
Draft Genome Sequence of
Alkalinema
sp. Strain CACIAM 70d, a Cyanobacterium Isolated from an Amazonian Freshwater Environment
Authors: Lima Alex Ranieri Jerônimo , Castro Wendel de Oliveira , Moraes Pablo Henrique Gonçalves , Siqueira Andrei Santos , Aguiar Délia Cristina Figueira , de Lima Clayton Pereira Silva , Vianez-Júnior João Lídio Silva Gonçalves , Nunes Márcio Roberto Teixeira , Dall’Agnol Leonardo Teixeira , Gonçalves Evonnildo Costa
Published: July 2017

In order to increase the genomic data of cyanobacterial strains isolated in Brazil, we hereby present the draft genome sequence of the
Alkalinema
sp. strain CACIAM 70d, isolated from an Amazonian freshwater environment. This report describes the first genome available for this genus.
Takotsubo cardiomyopathy-related complete heart block and torsades de pointes
Authors: Inayat Faisal , Virk Hafeez Ul Hassan , Ullah Waqas , Riaz Iqra
Published: July 2017

Takotsubo cardiomyopathy (TCM) is a relatively recently recognised clinical entity. It frequently mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. TCM is a reversible condition, and the prognosis is usually well. However, in rare instances, it can be associated with life-threatening arrhythmic complications. Herein, we report the case of a patient with TCM who developed complete atrioventricular block followed by QT prolongation and torsades de pointes. Furthermore, we undertook a literature review of this rare complication of TCM and discussed the formidable therapeutic challenge encountered in such patients.
Is FCH PET able to identify foci of infection superiorly to FDG PET?
Authors: Hardy Liesel Elisabeth , Hessamodini Hannah , Wallace Michael , Francis Roslyn
Published: July 2017

We report a case of a brain abscess identified on fluorine-18 choline (FCH) positron emission tomography (PET) scan, which was not identified on fluorodeoxyglucose (FDG) PET scan. To our knowledge, there are no previous case reports of incidental brain abscess identified by FCH PET imaging. A 51-year-old man, with liver cirrhosis complicated by hepatocellular carcinoma (HCC) was enrolled in a research trial comparing HCC detection in FCH PET versus FDG PET. During the course of the trial, he underwent radiofrequency ablation (RFA) for HCC. A repeat FCH PET scan post-RFA incidentally revealed a 2.5â€‰cm lesion with avid uptake in the left occipital area of the brain. The patient was asymptomatic. MRI suggested this was an abscess. A craniotomy and drainage was performed, with culture ofStreptococcus intermedius(S.millerigroup) from the thick-walled collection, a causative organism for previous episode of pneumonia. He successfully completed a 6 week course of antibiotics.
Measuring patient safety culture in maternal and child health institutions in China: a qualitative study
Authors: Wang Yuanyuan , Liu Weiwei , Shi Huifeng , Liu Chaojie , Wang Yan
Published: July 2017

Introduction

Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients.

Objectives

This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China.

Methods

The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes.

Results

The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC.

Conclusions

Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of ‘patient safety’ goes beyond the traditional definition of patients. General well-being, health and disease prevention are important anchor points for defining PSC in such settings.
Long-term patient survival in a Swedish population-based cohort of patients with ANCA-associated vasculitis
Authors: Heijl Caroline , Mohammad Aladdin J , Westman Kerstin , Höglund Peter
Published: July 2017

Objectives

Patients with antineutrophil cytoplasmatic antibodies-associated vasculitides (AAV) exhibit higher mortality than the general population. In the current study, we assessed whether cluster affiliation based on clinical presentation might predict mortality.

Methods

With case record review, the outcomes for a population-based cohort of patients diagnosed with AAV in southern Sweden (catchment area of 0.7 million inhabitants) between 1997 and 2010 were assessed. Based on organ involvement at presentation, the cohort was stratified into the following clusters: gastrointestinal, cardiovascular, non-renal, renal with proteinase 3 (PR3) and renal without PR3. Cluster affiliation, demographics, clinical and laboratory values at entry were tested as prognostic factors for survival in multivariable models.

Results

195 patients (98 female) with a median age of 69 years (IQR 55–77) at diagnosis were included in the cohort. The median time of follow-up was 4 years for the 98 patients (50%) who died during follow-up and 11 years for those alive at end of follow-up. The 1-year, 2-year, 5-year and 10-year survival was 87%, 82%, 70% and 55%, respectively. Prognostic factors for survival were sex, age, renal function and cluster affiliation. The mortality of patients with AAV was significantly increased compared with the general population except in the non-renal cluster. The cardiovascular and gastrointestinal clusters showed the highest mortality.

Conclusion

Even though the mortality in patients with AAV is increased compared with the general population this does not apply to patients without gastrointestinal, cardiovascular or renal involvement at diagnosis. We suggest that the initial clinical presentation is an important predictor for survival.
Nardilysin is involved in autoimmune arthritis via the regulation of tumour necrosis factor alpha secretion
Authors: Fujii Takayuki , Nishi Eiichiro , Ito Hiromu , Yoshitomi Hiroyuki , Furu Moritoshi , Okabe Namiko , Ohno Mikiko , Nishi Kiyoto , Morita Yusuke , Morita Yugo , Azukizawa Masayuki , Okahata Akinori , Tomizawa Takuya , Kimura Takeshi , Matsuda Shuichi
Published: July 2017

Objective

Tumour necrosis factor alpha (TNF-α) plays an important role in rheumatoid arthritis (RA). TNF-α is synthesised as a membrane-anchored precursor and is fully activated by a disintegrin and metalloproteinase 17 (ADAM17)-mediated ectodomain shedding. Nardilysin (NRDC) facilitates ectodomain shedding via activation of ADAM17. This study was undertaken to elucidate the role of NRDC in RA.

Methods

NRDC-deficient (Nrdc–/–) mice and macrophage-specific NRDC-deficient (NrdcdelM) mice were examined in murine RA models, collagen antibody-induced arthritis (CAIA) and K/BxN serum transfer arthritis (K/BxN STA). We evaluated the effect of gene deletion or silencing ofNrdcon ectodomain shedding of TNF-α in macrophages or monocytes. NRDC concentration in synovial fluid from patients with RA and osteoarthritis (OA) were measured. We also examined whether local gene silencing ofNrdcameliorated CAIA.

Results

CAIA and K/BxN STA were significantly attenuated inNrdc–/–mice andNrdcdelMmice. Gene deletion or silencing ofNrdcin macrophages or THP-1 cells resulted in the reduction of TNF-α shedding. The level of NRDC is higher in synovial fluid from RA patients compared with that from OA patients. Intra-articular injection of anti-Nrdcsmall interfering RNA ameliorated CAIA.

Conclusion

These data indicate that NRDC plays crucial roles in the pathogenesis of autoimmune arthritis and could be a new therapeutic target for RA treatment.
Mortality in patients with interstitial lung disease treated with rituximab or TNFi as a first biologic
Authors: Druce Katie L , Iqbal Kundan , Watson Kath D , Symmons Deborah P M , Hyrich Kimme L , Kelly Clive
Published: July 2017

Objectives

Guidelines cautioned prescribing of tumour necrosis factor inhibitors (TNFi) to patients with rheumatoid arthritis and interstitial lung disease (RA-ILD) after reports of new or worsening of ILD. Less is known about outcomes among patients with RA-ILD who receive rituximab (RTX). This study compares mortality in patients with RA-ILD who received RTX or TNFi as their first biologic.

Methods

Participants with RA-ILD recruited to the British Society for Rheumatology Biologics Register for RA were included. Death rates were calculated and risk comparisons were made using Cox regression. Causes of death, including the frequency in which ILD was recorded on death certificates were examined.

Results

43 patients on RTX and 309 on TNFi were included. RTX recipients had shorter disease duration and less disability. Death rates were 94.8 (95%CI: 74.4 to 118.7) and 53.0 (22.9 to 104.6) per 1000 person years, respectively. The adjusted mortality risk was halved in the RTX cohort, but the difference was not statistically significant (HR 0.53, 95% CI: 0.26 to 1.10). ILD was the underlying cause of death in 1 of 7 RTX deaths (14%) and 12 of 76 TNFi deaths (16%).

Conclusions

Patients with RA-ILD who received RTX had lower mortality rates compared to TNFi. The absence of information on ILD severity or subtype prevents conclusions of which drug represents the best choice in patients with RA-ILD and active arthritis.
Regulation of the insulin–Akt signaling pathway and glycolysis during dehydration stress in the African clawed frogXenopus laevis
Authors: Wu Cheng-Wei , Tessier Shannon N. , Storey Kenneth B.
Published: July 2017

Estivation is an adaptive stress response utilized by some amphibians during periods of drought in the summer season. In this study, we examine the regulation of the insulin signaling cascade and glycolysis pathway in the African clawed frog Xenopus laevis during the dehydration stress induced state of estivation. We show that in the brain and heart of X. laevis, dehydration reduces the phosphorylation of the insulin growth factor-1 receptor (IGF-1R), and this is followed by similar reductions in the phosphorylation of the Akt and mechanistic target of rapamycin (mTOR) kinase. Interestingly, phosphorylation levels of IGF-1R and mTOR were not affected in the kidney, and phosphorylation levels of P70S6K and the ribosomal S6 protein were elevated during dehydration stress. Animals under estivation are also susceptible to periods of hypoxia, suggesting that glycolysis may also be affected. We observed that protein levels of many glycolytic enzymes remained unchanged during dehydration; however, the hypoxia response factor-1 alpha (HIF-1α) protein was elevated by greater than twofold in the heart during dehydration. Overall, we provide evidence that shows that the insulin signaling pathway in X. laevis is regulated in a tissue-specific manner during dehydration stress and suggests an important role for this signaling cascade in mediating the estivation response.
Particles on the rotating channels in the wormhole metrics
Authors: Arsenadze G. , Osmanov Z.
Published: July 2017

In the Ellis–Bronnikov wormhole (WH) metrics, the motion of a particle along the curved rotating channels is studied. By taking into account a prescribed shape of a trajectory, we derive the reduced 1 + 1 metrics, obtain the corresponding Langrangian of a free particle and analytically and numerically solve the corresponding equations of motion. We have shown that if the channels are twisted and lagged behind rotation, under certain conditions, beads might asymptotically reach infinity, leaving the WH, which is not possible for straight corotating trajectories. The analytical and numerical study is performed for two- and three-dimensional cases and initial conditions of particles are analyzed in the context of possibility of passing through the WH.
Modeling Dual-Channel Supply Chain Based on Fuzzy System and Genetic Algorithm
Authors: Mahmoudi Amin , Shavandi Hassan , Vakili Mohammad Reza
Published: July 2017

In this paper, we have proposed a dual-channel supply chain model in uncertain environment to analyze the demand of manufacturer and retailer demand in which the profit being maximized. Linguistic terms are also utilized to establish two fuzzy systems for estimating the demand in direct and retail channels. In order to do that, a mathematical model is proposed based on decentralized situation of supply chain. To solve the model, we have developed a hybrid solution method of genetic algorithm, fuzzy system, and L-P metric. Finally, several test problems are first generated; then, the computational results are analyzed.
Fuzzy Similarity Measure Based Spectral Clustering Framework for Noisy Image Segmentation
Authors: Goyal Subhanshu , Kumar Sushil , Zaveri M. A. , Shukla A. K.
Published: July 2017

In recent times, graph based spectral clustering algorithms have received immense attention in many areas like, data mining, object recognition, image analysis and processing. The commonly used similarity measure in the clustering algorithms is the Gaussian kernel function which uses sensitive scaling parameter and when applied to the segmentation of noise contaminated images leads to unsatisfactory performance because of neglecting the spatial pixel information. The present work introduces a novel framework for spectral clustering which embodied local spatial information and fuzzy based similarity measure to tackle the above mentioned issues. In our approach, firstly we filter the noise components from original image by using the spatial and gray–level information. The similarity matrix is then constructed by employing a similarity measure which takes into account the fuzzy c-partition matrix and vectors of the cluster centers obtained by fuzzy c-means clustering algorithm. In the last step, spectral clustering technique is realized on derived similarity matrix to obtain the desired segmentation result. Experimental results on segmentation of synthetic and Berkeley benchmark images with noise demonstrates the effectiveness and robustness of the proposed method, giving it an edge over the clustering based segmentation method reported in the literature.