bluuebunny/crossref_metadata_2025 huggingface dataset:
What you need is what you eat? Prey selection by the batMyotis daubentonii
Authors: Vesterinen Eero J. , Ruokolainen Lasse , Wahlberg Niklas , Peña Carlos , Roslin Tomas , Laine Veronika N. , Vasko Ville , Sääksjärvi Ilari E. , Norrdahl Kai , Lilley Thomas M.
Published: February 2016

Optimal foraging theory predicts that predators are selective when faced with abundant prey, but become less picky when prey gets sparse. Insectivorous bats in temperate regions are faced with the challenge of building up fat reserves vital for hibernation during a period of decreasing arthropod abundances. According to optimal foraging theory, prehibernating bats should adopt a less selective feeding behaviour – yet empirical studies have revealed many apparently generalized species to be composed of specialist individuals. Targeting the diet of the batMyotis daubentonii, we used a combination of molecular techniques to test for seasonal changes in prey selectivity and individual‐level variation in prey preferences.DNAmetabarcoding was used to characterize both the prey contents of bat droppings and the insect community available as prey. To test for dietary differences amongM. daubentoniiindividuals, we used ten microsatellite loci to assign droppings to individual bats. The comparison between consumed and available prey revealed a preference for certain prey items regardless of availability. Nonbiting midges (Chironomidae) remained the most highly consumed prey at all times, despite a significant increase in the availability of black flies (Simuliidae) towards the end of the season. The bats sampled showed no evidence of individual specialization in dietary preferences. Overall, our approach offers little support for optimal foraging theory. Thus, it shows how novel combinations of genetic markers can be used to test general theory, targeting patterns at both the level of prey communities and individual predators.
Transcriptomic profiling of Alexandrium fundyense during physical interaction with or exposure to chemical signals from the parasite Amoebophrya
Authors: Lu Yameng , Wohlrab Sylke , Groth Marco , Glöckner Gernot , Guillou Laure , John Uwe
Published: February 2016

Toxic microalgae have their own pathogens, and understanding the way in which these microalgae respond to antagonistic attacks may provide information about their capacity to persist during harmful algal bloom events. Here, we compared the effects of the physical presence of the parasite Amoebophrya sp. and exposure to waterborne cues from cultures infected with this parasite, on gene expression by the toxic dinoflagellates, Alexandrium fundyense. Compared with control samples, a total of 14 882 Alexandrium genes were differentially expressed over the whole‐parasite infection cycle at three different time points (0, 6 and 96 h). RNA sequencing analyses indicated that exposure to the parasite and parasitic waterborne cues produced significant changes in the expression levels of Alexandrium genes associated with specific metabolic pathways. The observed upregulation of genes associated with glycolysis, the tricarboxylic acid cycle, fatty acid β‐oxidation, oxidative phosphorylation and photosynthesis suggests that parasite infection increases the energy demand of the host. The observed upregulation of genes correlated with signal transduction indicates that Alexandrium could be sensitized by parasite attacks. This response might prime the defence of the host, as indicated by the increased expression of several genes associated with defence and stress. Our findings provide a molecular overview of the response of a dinoflagellate to parasite infection.
Evaluating the safety and the effects on colonic compliance of neostigmine during motility testing in patients with chronic constipation
Authors: Mouchli M. A. , Camilleri M. , Lee T. , Parthasarathy G. , Vijayvargiya P. , Halland M. , Acosta A. , Bharucha A. E.
Published: February 2016

Background

Neostigmine, an acetyl cholinesterase inhibitor, stimulates colonic motor activity and may induce vagally mediated cardiovascular effects. Our aim was to evaluate effects of i.v. neostigmine on colonic compliance and its safety in patients with chronic constipation.

Methods

We retrospectively reviewed medical records of a selected group of 144 outpatients with chronic constipation who were refractory to treatment. These patients had undergone intracolonic motility and compliance measurements with an infinitely compliant balloon linked to a barostat. Data abstracted included barostat balloon mean volumes with increases in pressure (4 mmHg steps from 0 to 44 mmHg) before and after i.v. neostigmine. Vital signs and oxygen saturation before and after neostigmine were recorded.

Key Results

Of the 144 patients, 133 were female, mean age was 41.0 ± 15.4 years (SD), and duration of constipation was 12.9 ± 13.8 years. Among patients who had undergone colonic transit measurement by scintigraphy, the overall colonic transit at 24 h (geometric center, GC24 [n = 115]) was 1.5 ± 0.7 (normal >1.3), and at 48 h (GC48 [n = 75]) it was 2.3 ± 0.9 (normal >1.9). Neostigmine decreased colonic compliance at lower distension pressures (e.g., 12 and 20 mmHg [both p < 0.001]), but not at 40 mmHg. There were expected minor changes in vital signs in response to neostigmine in 144 patients; however, one patient developed unresponsiveness, significant bradycardia, hypotension, and muscular rigidity that responded to 400 mcg i.v. atropine.

Conclusions & Inferences

Neostigmine significantly decreases colonic compliance in patients with refractory chronic constipation. Symptomatic bradycardia in response to neostigmine should be promptly reversed with atropine.
AGENCIFICATION AND BLAME SHIFTING: EVALUATING A NEGLECTED SIDE OF PUBLIC SECTOR REFORMS
Authors: MORTENSEN PETER B.
Published: February 2016

The establishment of autonomous agencies has been a strong trend in the public sector across countries for about 25 years. In line with the official rhetoric accompanying such reforms, almost all reform evaluations have focused on various kinds of performance improvements. This article investigates a set of behavioural consequences of such reforms, which have been claimed by the blame avoidance literature, but have never been subjected to systematic empirical analysis. In particular, the article examines how a reform of agencification influences the propensity of agency managers to blame the political principals when the agency is subject to public criticism. Furthermore, it examines how the reform influences the blaming rhetoric of ministers and MPs. To evaluate such reform effects systematically, the article introduces a new empirical approach and illustrates the utility of the approach in a case study of the transformation of the national Danish railway company from 1995 to 2007.
Gender Differences in Patients with Fibromyalgia Undergoing Cognitive‐Behavioral Therapy for Insomnia: Preliminary Data
Authors: Lami María J. , Martínez María P. , Sánchez Ana I. , Miró Elena , Diener Fabián N. , Prados German , Guzmán Manuel A.
Published: February 2016

Fibromyalgia (FM) is a chronic musculoskeletal pain syndrome that significantly affects patients’ quality of life. Its main symptoms are pain, fatigue, and sleep disturbances.

Aim

The aim of this study was to assess the efficacy of cognitive‐behavioral therapy for insomnia (CBT‐I) in men and women with FM and compare sleep and clinical features between both genders.

Methods

Fifteen women and 13 men were selected to participate in nine weekly CBT‐I sessions that involved completing several self‐reported questionnaires at pretreatment, post‐treatment, and follow‐up. Patients were recruited from the Rheumatology Service and Pain Unit of Hospital and a fibromyalgia association. Group psychotherapy was performed at clinical unit of the Faculty of Psychology.

Results

Both groups showed significant clinical and statistical improvements in sleep quality and the main symptoms associated with FM (ie, pain intensity, fatigue, anxiety, pain catastrophizing, and pain‐related anxiety). Differential treatment responsiveness between sexes was observed. Male group exhibited significant changes at post‐treatment in sleep disturbances and pain‐related anxiety and catastrophizing. The female group showed post‐treatment improvements in sleep latency, general fatigue, and depression, which persisted at follow‐up.

Conclusions

Differential responses to treatment between men and women were observed in some sleep‐ and pain‐related variables. Outcomes show the needed to design different treatments for men and women with FM is discussed.
Development of a novel‐type transgenic cotton plant for control of cotton bollworm
Authors: Yue Zhen , Liu Xiaoguang , Zhou Zijing , Hou Guangming , Hua Jinping , Zhao Zhangwu
Published: February 2016

The transgenic Bt cotton plant has been widely planted throughout the world for the control of cotton budworm Helicoverpa armigera (Hubner). However, a shift towards insect tolerance of Bt cotton is now apparent. In this study, the gene encoding neuropeptide F (NPF) was cloned from cotton budworm H. armigera, an important agricultural pest. The npf gene produces two splicing mRNA variants—npf1 and npf2 (with a 120‐bp segment inserted into the npf1 sequence). These are predicted to form the mature NPF1 and NPF2 peptides, and they were found to regulate feeding behaviour. Knock down of larval npf with dsNPF in vitro resulted in decreases of food consumption and body weight, and dsNPF also caused a decrease of glycogen and an increase of trehalose. Moreover, we produced transgenic tobacco plants transiently expressing dsNPF and transgenic cotton plants with stably expressed dsNPF. Results showed that H. armigera larvae fed on these transgenic plants or leaves had lower food consumption, body size and body weight compared to controls. These results indicate that NPF is important in the control of feeding of H. armigera and valuable for production of potential transgenic cotton.
The Arabidopsis transcriptional regulator DPB3‐1 enhances heat stress tolerance without growth retardation in rice
Authors: Sato Hikaru , Todaka Daisuke , Kudo Madoka , Mizoi Junya , Kidokoro Satoshi , Zhao Yu , Shinozaki Kazuo , Yamaguchi‐Shinozaki Kazuko
Published: February 2016

The enhancement of heat stress tolerance in crops is an important challenge for food security to facilitate adaptation to global warming. In Arabidopsis thaliana, the transcriptional regulator DNA polymerase II subunit B3‐1 (DPB3‐1)/nuclear factor Y subunit C10 (NF‐YC10) has been reported as a positive regulator of Dehydration‐responsive element binding protein 2A (DREB2A), and the overexpression of DPB3‐1 enhances heat stress tolerance without growth retardation. Here, we show that DPB3‐1 interacts with DREB2A homologues in rice and soya bean. Transactivation analyses with Arabidopsis and rice mesophyll protoplasts indicate that DPB3‐1 and its rice homologue OsDPB3‐2 function as positive regulators of DREB2A homologues. Overexpression of DPB3‐1 did not affect plant growth or yield in rice under nonstress conditions. Moreover, DPB3‐1‐overexpressing rice showed enhanced heat stress tolerance. Microarray analysis revealed that many heat stress‐inducible genes were up‐regulated in DPB3‐1‐overexpressing rice under heat stress conditions. However, the overexpression of DPB3‐1 using a constitutive promoter had almost no effect on the expression of these genes under nonstress conditions. This may be because DPB3‐1 is a coactivator and thus lacks inherent transcriptional activity. We conclude that DPB3‐1, a coactivator that functions specifically under abiotic stress conditions, could be utilized to increase heat stress tolerance in crops without negative effects on vegetative and reproductive growth.
Benzoate Allergy in Children—From Foods to Personal Hygiene Products
Authors: Jacob Sharon E. , Hill Hannah , Lucero Hanna , Nedorost Susan
Published: February 2016

Benzoate allergy may be an overlooked allergen in children and one that may be of increasing importance with its increasing role as a preservative in pediatric personal hygiene formulations. The cases herein report an association with cola and benzoate allergy and discusses the implications of replacement of formaldehyde by benzoates in personal hygiene products.
Eosinophilic gastroenteritis in a patient with Bruton's tyrosine kinase deficiency
Authors: Yamazaki Susumu , Ohtsuka Yoshikazu , Yokokura Tomoaki , Yokota Rena , Honjo Asuka , Inage Eisuke , Baba Yosuke , Mori Mari , Suzuki Ryuyo , Iwata Tsutomu , Shimizu Toshiaki
Published: February 2016

Eosinophilic gastrointestinal diseases (EGID) are relatively rare diseases characterized by eosinophilic infiltration of the gastrointestinal tract resulting in various gastrointestinal symptoms. EGID are often caused by allergic reactions or systemic eosinophilic disorders, but their comorbidity with Bruton's tyrosine kinase (BTK) deficiency has not been previously documented. Here, we report a case of eosinophilic gastroenteritis (EG) in a patient with BTK deficiency. Despite adequate replacement immunoglobulin (Ig) therapy, trough serum IgG was not maintained. To identify the underlying cause of the low trough level and chronic diarrhea, the intestine was investigated on endoscopy. We also screened for the variable number of tandem repeat polymorphism in FCGRT. Genetic analysis could not explain the low trough IgG, but endoscopy indicated eosinophilic enterocolitis. EG may be an important differential diagnosis when primary immunodeficiency patients have chronic diarrhea or continued low serum IgG.
Pediatric liver transplantation in Latin America: Where do we stand?
Authors: Feier Flavia , Antunes Eduardo , D′Agostino Daniel , Varela‐Fascinetto Gustavo , Jarufe Nicolas , Patillo Juan C. , Vera Alonso , Carrasco Felix , Kondo Mario , Porta Gilda , Chapchap Paulo , Seda‐Neto Joao
Published: February 2016

LT started in LA in 1968, and pediatric LT records are available starting in the 1990s. Currently, eight countries perform pediatric LT in LA. Registries by national organizations fail to report robust data on pediatric LT. The aim of this paper was to report on the pediatric LT activity in LA. Data were gathered retrospectively through information available in the national registries websites and from local centers. Of the eight countries that report pediatric LT activity, Brazil, Argentina, Mexico, and Colombia have adequate registries of the numbers of LT performed. These countries concentrate most of the activity for pediatric LT. A total of 4593 pediatric LT were reported in LA. Websites for national organizations do not provide open data on post‐transplant survival rates or waiting list mortality. The information herein is based on reports by local centers. Overall, survival from select centers is similar to that reported on North American and European registries, between 80 and 90% in the first year post‐transplant. In conclusion, pediatric LT activity is growing in LA, especially in Brazil and Argentina. However, the lack of an appropriate LA registry restricts the assessment of quality and therefore restricts interventions aimed at quality improvements in different regions.
Gemmamyces bud blight of Picea pungens: a sudden disease outbreak in Central Europe
Authors: Černý K. , Pešková V. , Soukup F. , Havrdová L. , Strnadová V. , Zahradník D. , Hrabětová M.
Published: February 2016

Due to its high tolerance to acid rain, the North American Colorado blue spruce (Picea pungens) has been among the most frequent substitute tree species used in reforestation programmes in spruce mountain forests in the Ore and Sudeten Mountains in the Czech Republic after destruction by sulphur dioxide pollution in the second half of the last century. This species was planted on more than 8800 ha of destroyed mountain forest stands in the Ore Mountains alone. New plantations prospered until a massive outbreak of the gemmamyces bud blight, first identified in 2009. The causal agent, Gemmamyces piceae, induced massive bud blight in infected trees – bud loss progressively increased to 70–80% or more, and because the trees were not able to replace the natural loss of older needles, they quickly withered and died. Many plantations disrupted by the pathogen had to be cut down. Although several resistant genotypes have been identified, the cultivation of this species in forest stands has no future in this area. Because this disease was also identified in several ornamental plantations in the area, the bud blight epidemic haunts public green space administrators and nursery and Christmas tree plantation owners. Other pathogens and pests, such as Lophodermium piceae, Sirococcus conigenus and Elatobium abietinum, have also been identified as involved in the damage to P. pungens.
Outlier Robust Small‐Area Estimation Under Spatial Correlation
Authors: Schmid Timo , Tzavidis Nikos , Münnich Ralf , Chambers Ray
Published: February 2016

Modern systems of official statistics require the estimation and publication of business statistics for disaggregated domains, for example, industry domains and geographical regions. Outlier robust methods have proven to be useful for small‐area estimation. Recently proposed outlier robust model‐based small‐area methods assume, however, uncorrelated random effects. Spatial dependencies, resulting from similar industry domains or geographic regions, often occur. In this paper, we propose an outlier robust small‐area methodology that allows for the presence of spatial correlation in the data. In particular, we present a robust predictive methodology that incorporates the potential spatial impact from other areas (domains) on the small area (domain) of interest. We further propose two parametric bootstrap methods for estimating the mean‐squared error. Simulations indicate that the proposed methodology may lead to efficiency gains. The paper concludes with an illustrative application by using business data for estimating average labour costs in Italian provinces.
Contemporary Epidemiology: A Review of Critical Discussions Within the Discipline and A Call for Further Dialogue with Social Theory
Authors: Wemrell Maria , Merlo Juan , Mulinari Shai , Hornborg Anne‐Christine
Published: February 2016

The discipline of epidemiology, which holds major influence on public health policy as well as on clinical medical practice, has in recent decades to a large extent been concerned with the identification of factors and markers of risk for disease. Much health information and intervention is thus informed by a wealth of studies on a variety of risk factors, of which the individual is encouraged to keep informed and to be responsible about. Meanwhile, risk factor epidemiology has been subject to intense debate, both within and outside the discipline. The following review offers an overview of critical intradisciplinary debates. It then opens discussion on three partially overlapping areas where social theory has been called upon to contribute to epidemiological inquiry, namely analysis of macro‐social determinants of health and disease, of categories of human difference and of embodiment. The review ends with, and is motivated by, a plea for further integration of and dialogue between epidemiology and social theory.
Gender and the Artist Archetype: Understanding Gender Inequality in Artistic Careers
Authors: Miller Diana L.
Published: February 2016

Women artists are systematically disadvantaged across cultural fields. Although some of these disadvantages resemble gender inequalities in non‐artistic work, such as lower pay, underrepresentation, work–family conflict, and symbolic devaluation, others are unique to artistic careers. In this essay, I extend Acker's work on the implicit gendering of the ideal‐typical worker to show how gender implicitly organizes social expectations around artists and artistic work. I highlight themes emerging from past research on gender relations in artistic careers, which suggest that the ideal‐typical artist builds on a masculine model in at least three ways. First, collective understandings of creative genius center a masculine subject. Second, bias in aesthetic evaluations systematically favors men over women. Third, the structure of artistic careers, particularly the need for entrepreneurial labor and self‐promotion, requires artists to engage in behaviors that are more socially acceptable in men than in women.
Abnormal findings in peers during skills learning
Authors: Wearn Andy , Nakatsuji Miriam , Bhoopatkar Harsh
Published: February 2016

Background

Peer physical examination (PPE), where students examine each other, is common in contemporary clinical skills learning. A range of benefits and risks have been explored in the literature. One persistent concern has been the identification and management of abnormal physical findings. Two previous studies have attempted to quantify the risk, one through the discussion of two exemplar cases and the other with a retrospective student survey.

Methods

Here, we report the first prospective study of the number and type of abnormalities encountered as part of early clinical skills learning in a medical programme. We have a formal written consent process for PPE, which includes the management of abnormal findings through the completion of an event form. Our data come from cohorts undertaking years 2 and 3 of the programme between 2003 and 2014.

One persistent concern (of PPE) has been the identification and management of abnormal physical findings

Results

Nineteen event forms were completed over this period. The incidence rates per year ranged from 0.23 to 1.05 per cent. Abnormal findings included raised blood pressure, heart murmur, abnormal bedside test values, and eye and skin conditions.

Discussion

The low event rate, along with a feasible process for dealing with this issue, goes some way to reassuring those with concerns. We acknowledge that some abnormalities may have been missed, and that some data may have been lost as a result of incorrect process; however, even the highest annual rate is low in absolute terms. We recommend a formal process for managing abnormalities. Ideally this would be part of an overall PPE written policy, communicated to students, enacted by tutors and approved by the local ethics committee.
Virology, serology, and demography of hepatitis E viremic blood donors in South East England
Authors: Tedder Richard S. , Tettmar Kate I. , Brailsford Su R. , Said Bengu , Ushiro‐Lumb Ines , Kitchen Alan , Morgan Dilys , Lattimore Sam , Tossell Joanne , Ijaz Samreen , Hewitt Patricia E.
Published: February 2016

BACKGROUND

Hepatitis E virus (HEV) Genotype 3 (G3) in England comprises two principal phylogenetic groups (Group 1 and Group 2) and can be transmitted by transfusion. Unselected screening identified 79 viremic donors; 76 participated in a follow‐up study.

STUDY DESIGN AND METHODS

Viral RNA dynamics, phylogenetics, and seroconversion were characterized in the donors. Detailed demographic, travel, clinical, and lifestyle questionnaires were undertaken.

RESULTS

The majority of viremic individuals (57/79) were seronegative at time of donation but all seroconverted. Viremia was short‐lived, with a median of 6.5 weeks to confirmed viral clearance. All infections were acquired in the United Kingdom and were G3, with Group 2 viruses predominating (43/54; 80%). Infection was associated with some clinical symptoms both at and after donation (8/77; 10%). Viral loads and symptoms were more pronounced in Group 1 infections. There was no serologic evidence of reinfection. Donors were more commonly male (p = 0.002); both male and female donors were older than comparator donors. Animal contact was unlikely to be the source of infection. Consumption of chicken and pig meat was common to all infected donors; processed pig meat was most commonly purchased from one particular retail chain.

CONCLUSION

Viremic donors represent primary infection in older members of the community and reflect a widespread zoonotic in the United Kingdom. The two phylogenetic groups of HEV G3 display different pathogenicity and the more common Group 2 appears less adapted to humans. There are no objective demographic criteria that can identify donors at enhanced HEV risk.
TOLERABILITY AND TUMOR RESPONSE OF A NOVEL LOW‐DOSE PALLIATIVE RADIATION THERAPY PROTOCOL IN DOGS WITH TRANSITIONAL CELL CARCINOMA OF THE BLADDER AND URETHRA
Authors: Choy Kevin , Fidel Janean
Published: February 2016

Previously reported radiation protocols for transitional cell carcinoma of the canine lower urinary tract have been ineffective or associated with increased side effects. Objectives of this retrospective, cross‐sectional study were to describe safety of and tumor responses for a novel palliative radiation protocol for transitional cell carcinoma in dogs. Included dogs had cytologically or histologically confirmed transitional cell carcinoma of the bladder or urethra, and were treated with 10 once‐daily fractions (Monday–Friday) of 2.7 Gy. Thirteen dogs were sampled, with six treated using radiation as first‐line (induction) therapy and seven treated using radiation as rescue therapy after failing previous chemotherapy. Within 6 weeks of radiation, 7.6% (1/13) dogs had a complete response, 53.8% (7/13) partial response, 38.5% (5/13) stable disease, and none had progressive disease. Three patients presenting with urethral obstruction had spontaneous micturition restored during the treatment protocol. A single patient with unilateral ureteral obstruction was patent at recheck examination. Median survival time from time of initial diagnosis was 179 days. Median survival time from start of radiation was 150 days. Acute radiation side effects occurred in 31% (4/13) patients and were classified as grade 1 or 2. No significant late side radiation side effects were reported. No variables examined were identified as prognostic factors. Findings indicated that the reported radiation protocol was safe in this sample of dogs with bladder and urethral transitional cell carcinoma. Future prospective studies are needed to determine utility of this treatment as a rescue therapy in patients with complete urinary tract obstruction.
Psychometric Properties of the Slovak and Czech Versions of the Evidence‐Based Practice Beliefs and Implementation Scales
Authors: Zeleníková Renáta , Gurková Elena , Žiaková Katarína , Tomagová Martina , Jarošová Darja , Fineout‐Overholt Ellen
Published: February 2016

Background

The Evidence‐Based Practice Beliefs (EBP‐B) and Evidence‐Based Practice Implementation (EBP‐I) scales are psychometrically sound instruments that were used, within an educational setting, to systematically study students’ beliefs about and their implementation of evidence‐based practice (EBP). Czech and Slovak versions of these instruments were developed and evaluated using a sample population of nursing students.

Purpose

The purpose of the study was to test the psychometric properties of the Czech and Slovak versions of the EBP‐B and EBP‐I scales.

Methods

Psychometric properties were evaluated using a sample of undergraduate and graduate (nearly graduated) nursing students (n= 223) completing EBP courses. To test psychometric properties of the questionnaire, its reliability and validity were explored. Cronbach´s alpha was computed to evaluate internal structure and internal consistency.

Results

The Slovak versions of both the EBP‐B and the EBP‐I scale have good internal consistency (Cronbach's alpha: .82 and .94, respectively). Similarly, the Czech versions of the EBP‐B and the EBP‐I scales both have good internal consistency (Cronbach's alpha: .85 and .89, respectively).

Linking Evidence to Action

The results of psychometric analysis of the Czech and Slovak versions of the EBP‐B and the EBP‐I scales are consistent with the results of the original study and indicate that the Czech and Slovak versions have the potential to be valid, reliable, and sensitive instruments for measuring an individual's beliefs about the value of EBP and their ability to implement it. Both instruments can be used to assess changes in nurses´ beliefs about EBP over time as well as the effectiveness of strategies aimed at promoting the use of evidence in practice.
Calcifying tendinitis of the shoulder: arthroscopic needling versus complete calcium removal and rotator cuff repair. A prospective comparative study
Authors: Castagna Alessandro , De Giorgi Silvana , Garofalo Raffaele , Conti Marco , Tafuri Silvio , Moretti Biagio
Published: February 2016

Purpose: the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair.

Methods: from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2). Both groups followed the same rehabilitation program. The two groups were compared at 6 and 12 months of follow-up for the presence of residual calcifications and for the following clinical outcomes: Constant score, American Shoulder and Elbow Surgeons Evaluation Form (ASES) shoulder score, University of California Los Angeles (UCLA) shoulder rating scale, Simple Shoulder Test (SST) and Visual Analogue Scale (VAS).

Results: all the clinical scores (Constant, ASES, UCLA, SST and VAS scores) improved significantly between baseline and postoperative follow-up, both at 6 and at 12 months. no differences at final follow-up were found between the two groups.

Conclusions: both the techniques were effective in solving the symptoms of calcifying tendinitis of the shoulder. Clinical scores improved in both groups. Residual calcifications were found in only a few cases and were always less than 10 mm.

Level of evidence:Level II, prospective comparative study.
Anterior cruciate ligament reconstruction and rehabilitation: predictors of functional outcome
Authors: Della Villa Francesco , Ricci Margherita , Perdisa Francesco , Filardo Giuseppe , Gamberini Jacopo , Caminati Daniele , Della Villa Stefano
Published: February 2016

Surgical reconstruction of an injured anterior cruciate ligament (ACL) leads to full recovery of function and sports activity in a high percentage of cases. The aim of the present study was to analyze variables related to the patient, the surgical technique and the post-surgical rehabilitation methods, seeking to identify predictors of outcome and recovery time after ACL reconstruction.

One hundred and four patients (81 M, 23 F) undergoing a step-based rehabilitation protocol after ACL reconstruction were evaluated. 43.2% of them had an isolated ACL lesion, whereas 56.8% had one or more concurrent injuries. Data relating to personal characteristics, surgery and post-operative management were collected and analyzed for correlation. Clinical outcome was evaluated with IKDC subjective score and the Tegner score, and the time to reach full recovery was noted as well.

Young patients with a higher pre-injury Tegner activity level or who practice sport at professional level, no concurrent capsular lesions and no postoperative knee bracing had better clinical results and took shorter time to recover. Also, a higher percentage of on-thefield rehabilitation sessions, and absence of significant muscle strength deficits at the first knee isokinetic test emerged as rehabilitation-related factors leading to a better post-surgical outcome.

Personal, surgical and rehabilitation factors should be considered in order to optimize patient management and maximize the expected results. Further studies are needed to find the strongest factors in different patients.

Level of evidence: Level IV, retrospective study.
Nitrogen incorporation in sputter deposited molybdenum nitride thin films
Authors: Stöber Laura , Konrath Jens Peter , Haberl Verena , Patocka Florian , Schneider Michael , Schmid Ulrich
Published: February 2016

In this paper, the authors report on the high temperature performance of sputter deposited molybdenum (Mo) and molybdenum nitride (Mo2N) thin films. Various argon and nitrogen gas compositions are applied for thin film synthetization, and the amount of nitrogen incorporation is determined by Auger measurements. Furthermore, effusion measurements identifying the binding conditions of the nitrogen in the thin film are performed up to 1000 °C. These results are in excellent agreement with film stress and scanning electron microscope analyses, both indicating stable film properties up to annealing temperatures of 500 °C.
Variability of Stimulant Levels in Nine Sports Supplements Over a 9-Month Period
Authors: Attipoe Selasi , Cohen Pieter A. , Eichner Amy , Deuster Patricia A.
Published: February 2016

Many studies have found that some dietary supplement product labels do not accurately reflect the actual ingredients. However, studies have not been performed to determine if ingredients in the same dietary supplement product vary over time. The objective of this study was to assess the consistency of stimulant ingredients in popular sports supplements sold in the United States over a 9-month period. Three samples of nine popular sports supplements were purchased over the 9-month period. The 27 samples were analyzed for caffeine and several other stimulants (including adulterants). The identity and quantity of stimulants were compared with stimulants listed on the label and stimulants found at earlier time points to determine the variability in individual products over the 9-month period. The primary outcome measure was the variability of stimulant amounts in the products examined. Many supplements did not contain the same number and quantity of stimulants at all time points over the 9-month period. Caffeine content varied widely in five of the six caffeinated supplements compared with the initial measurement (–7% to +266%). In addition, the stimulants—synephrine, octopamine, cathine, ephedrine, pseudoephedrine, strychnine, and methylephedrine—occurred in variable amounts in eight of the nine products. The significance of these findings is uncertain: the sample size was insufficient to support statistical analysis. In our sample of nine popular sports supplements, the presence and quantity of stimulants varied over a 9-month period. However, future studies are warranted to determine if the variability found is significant and generalizable to other supplements.
Timing of expression of the core clock gene
Bmal1
influences its effects on aging and survival
Authors: Yang Guangrui , Chen Lihong , Grant Gregory R. , Paschos Georgios , Song Wen-Liang , Musiek Erik S. , Lee Vivian , McLoughlin Sarah C. , Grosser Tilo , Cotsarelis George , FitzGerald Garret A.
Published: February 2016

Postnatal knockout of a core clock gene in mice prompts reevaluation of the systemic role of the molecular clock in the biology of aging.
Mathematical modeling of herpes simplex virus-2 suppression with pritelivir predicts trial outcomes
Authors: Schiffer Joshua T. , Swan David A. , Magaret Amalia , Corey Lawrence , Wald Anna , Ossig Joachim , Ruebsamen-Schaeff Helga , Stoelben Susanne , Timmler Burkhard , Zimmermann Holger , Melhem Murad R. , Van Wart Scott A. , Rubino Christopher M. , Birkmann Alexander
Published: February 2016

A mathematical model for antiviral clinical trials improves dose selection and understanding of drug-virus interaction.
Aging metabolism: Evitable or inevitable?
Authors: Lanza Ian R.
Published: February 2016

Lifestyle factors can explain many, but not all, of aging-related metabolic disturbances.
The mRNA “game changer” in gene therapy
Authors: Wang Andrew Z.
Published: February 2016

A new type of nanomaterial can deliver siRNA and mRNA in vivo with high efficiency and low toxicity.
Two Modes of the Axonal Interferon Response Limit Alphaherpesvirus Neuroinvasion
Authors: Song Ren , Koyuncu Orkide O. , Greco Todd M. , Diner Benjamin A. , Cristea Ileana M. , Enquist Lynn W.
Published: February 2016

Infection by alphaherpesviruses, including herpes simplex virus (HSV) and pseudorabies virus (PRV), typically begins at epithelial surfaces and continues into the peripheral nervous system (PNS). Inflammatory responses are induced at the infected peripheral site prior to invasion of the PNS. When the peripheral tissue is first infected, only the innervating axons are exposed to this inflammatory milieu, which includes the interferons (IFNs). The fundamental question is how do PNS cell bodies respond to these distant, potentially damaging events experienced by axons. Using compartmented cultures that physically separate neuron axons from cell bodies, we found that pretreating isolated axons with beta interferon (IFN-β) or gamma interferon (IFN-γ) significantly diminished the number of herpes simplex virus 1 (HSV-1) and PRV particles moving in axons toward the cell bodies in a receptor-dependent manner. Exposing axons to IFN-β induced STAT1 phosphorylation (p-STAT1) only in axons, while exposure of axons to IFN-γ induced p-STAT1 accumulation in distant cell body nuclei. Blocking transcription in cell bodies eliminated antiviral effects induced by IFN-γ, but not those induced by IFN-β. Proteomic analysis of IFN-β- or IFN-γ-treated axons identified several differentially regulated proteins. Therefore, unlike treatment with IFN-γ, IFN-β induces a noncanonical, local antiviral response in axons. The activation of a local IFN response in axons represents a new paradigm for cytokine control of neuroinvasion.

IMPORTANCE
Neurons are highly polarized cells with long axonal processes that connect to distant targets. PNS axons that innervate peripheral tissues are exposed to various situations that follow infection, inflammation, and damage of the tissue. After viral infection in the periphery, axons represent potential front-line barriers to PNS infection and damage. Indeed, most viral infections do not spread to the PNS, yet the mechanisms responsible are not well studied. We devised an experimental system to study how axons respond to inflammatory cytokines that would be produced by infected tissues. We found that axons respond differentially to type I and type II interferons. The response to type I interferon (IFN-β) is a rapid axon-only response. The response to type II interferon (IFN-γ) involves long-distance signaling to the PNS cell body. These responses to two interferons erect an efficient and rapid barrier to PNS infection.
Will Regulatory and Financial Considerations Dampen Innovation in the Clinical Microbiology Laboratory?
Authors: Gilligan Peter H. , Miller Melissa B.
Published: February 2016

Over a million prosthetic joints are placed in patients in the United States annually. Of those that fail, 25% will be due to infection, with an estimated cost approaching 1 billion dollars. Despite the clinical and economic importance of these infections, the techniques for their detection are relatively insensitive. An innovative method for detecting these infections by using blood culture bottles (BCB) to culture specimens of periprosthetic tissue (PPT) was described in a recent article [T. N. Peel, et al., mBio 7(1):e01776-15, 2016, doi:10.1128/mBio.01776-15]. There are two potential stumbling blocks to the widespread implementation of this innovation. First, the FDA judges such an application of BCB as an “off-label use” and as such, a laboratory-developed test (LDT). LDTs are coming under greater scrutiny by the FDA and may require extensive, costly validation studies in laboratories that adopt this methodology. Second, the Center for Medicare and Medicaid Services has established a Hospital Acquired Condition Reduction Act under which institutions performing in the lowest quartile forfeit 1% of their Medicare reimbursement. Hospital-acquired infections are an important component of this quality metric. Although prosthetic joint infection (PJI) rates are not currently a hospital quality metric, given their cost and increasing frequency, it is reasonable to expect that they may become one. Will those with financial oversight allow an innovative technique that will require an expensive validation and may put the institution at risk for loss of CMS reimbursement?
Preclinical Efficacy of Clumping Factor A in Prevention of Staphylococcus aureus Infection
Authors: Li Xue , Wang Xiaogang , Thompson Christopher D. , Park Saeyoung , Park Wan Beom , Lee Jean C.
Published: February 2016

Treatment of
Staphylococcus aureus
infections has become increasingly difficult because of the emergence of multidrug-resistant isolates. Development of a vaccine to prevent staphylococcal infections remains a priority. To determine whether clumping factor A (ClfA) is a good target protein for inclusion in a multivalent vaccine, we evaluated its efficacy in a variety of relevant staphylococcal infection models, challenging with different
S. aureus
strains. ClfA adsorbed to Alhydrogel and mixed with Sigma Adjuvant System was more immunogenic and stimulated a more robust Th17 response than ClfA administered with alum alone. ClfA immunization induced the production of functional antibodies in rabbits and mice that blocked
S. aureus
binding to fibrinogen and were opsonic for
S. aureus
strains that produced little or no capsular polysaccharide. Mice immunized with ClfA showed a modest reduction in the bacterial burden recovered from subcutaneous abscesses provoked by
S. aureus
USA300 strain LAC. In addition, the ClfA vaccine reduced lethality in a sepsis model following challenge with strain Newman, but not ST80. Vaccination with ClfA did not protect against surgical wound infection, renal abscess formation, or bacteremia. Passive immunization with antibodies to ClfA did not protect against staphylococcal bacteremia in mice or catheter-induced endocarditis in rats. Some enhancement of bacteremia was observed by ClfA immunization or passive administration of ClfA antibodies when mice were challenged by the intraperitoneal route. Although rodent models of staphylococcal infection have their limitations, our data do not support the inclusion of ClfA in an
S. aureus
multivalent vaccine.

IMPORTANCE
Antibiotics are often ineffective in eradicating
Staphylococcus aureus
infections, and thus, a preventative vaccine is sorely needed. Two single-component vaccines and two immunoglobulin preparations failed to meet their designated endpoints in phase III clinical trials. Importantly, recipients of an
S. aureus
surface protein (iron surface determinant B) vaccine who developed a staphylococcal infection experienced a higher rate of multiorgan failure and mortality than placebo controls, raising safety concerns. Multicomponent
S. aureus
vaccines have now been generated, and several include surface protein clumping factor A (ClfA). We immunized mice with ClfA and generated a robust T cell response and serum antibodies that were functional
in vitro
. Nonetheless, ClfA was not protective in a number of relevant animal models of
S. aureus
infection, and high levels of ClfA antibodies enhanced bacteremia when mice were challenged with community-acquired methicillin-resistant
S. aureus
strains. Evidence supporting ClfA as a vaccine component is lacking.
Metastatic small bowel neuroendocrine tumour with bilateral carcinoid heart disease
Authors: Jahagirdar V , Kamal Ali , Steeds R , Ayuk John
Published: February 2016

A 63-year-old woman was admitted with a year's history of exertional breathlessness, anxiety attacks, syncopal episodes, diarrhoea, fatigue, reduced appetite, 2 stones weight loss, and flushing affecting her face and trunk. Investigations revealed raised urine 5-hydroxy indole acetic acid (5-HIAA) and chromogranin A. CT scan demonstrated extensive soft tissue encasing the major vessels intra-abdominally, and a retroperitoneal mass.111In-octreotide single-photon emission CT (SPECT CT) showed increased focal activity in the mediastinum, retroperitoneum and mesenteric lymph nodes. Para aortic lymph node biopsy confirmed the diagnosis of metastatic well-differentiated grade 1 gastrointestinal neuroendocrine tumour (NET). Extensive cardiac investigations confirmed severe mitral regurgitation, moderate aortic and tricuspid regurgitation, and mild pulmonary regurgitation. The patient's symptoms of flushing and diarrhoea were controlled with octreotide LAR, and she underwent mechanical aortic and mitral valve replacement. Following discharge from surgery, she went on to develop hydronephrosis and urosepsis, followed by infective endocarditis, resulting in recurrent admissions, and eventually passed away in her sleep nearly 14 months after her initial diagnosis.
Spontaneously recovered severe thrombocytopaenia following zoledronic acid infusion for osteoporosis
Authors: Kulkarni Pooja , Cushman Terra , Donthireddy Vijayalakshmi , Rao Sudhaker
Published: February 2016

Zoledronic acid is widely used for the treatment of various skeletal disorders. While acute phase reactions are commonly seen, hypocalcaemia, femoral shaft fractures, osteonecrosis of the jaw and renal failure are rare. Two cases of fatal thrombocytopaenic purpura have been reported following zoledronic acid infusion. We report a case of non-fatal thrombocytopaenia with spontaneous recovery. A 70-year woman with osteoporosis participated in a research study. Complete blood and platelet counts prior to zoledronic acid infusion were normal (138 000/µL), but had declined slightly from 185 000/µL 2 years ago. One year after the first zoledronic acid infusion, her platelet count declined to 50 000/µL without any clinical manifestations, and rose slowly returning to normal (156 000/µL) over the next 1 year. Extensive evaluation did not reveal any specific abnormalities, and the pathogenesis of her transient severe thrombocytopaenia after two infusions of zoledronic acid remains unclear.
Evaluation of the feasibility and acceptability of the ‘Care for Stroke’ intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke
Authors: Sureshkumar K , Murthy GVS , Natarajan S , Naveen C , Goenka S , Kuper H
Published: February 2016

Objectives

(1) To identify operational issues encountered by study participants in using the ‘Care for Stroke’ intervention; (2) to evaluate the feasibility and acceptability of the intervention.

Design

Mixed-methods research design.

Setting

Participant's home. Participants were selected from a tertiary hospital in Chennai, South India.

Participants

Sixty stroke survivors treated and discharged from the hospital, and their caregivers.

Intervention

‘Care for Stroke’ is a smartphone-enabled, educational intervention for management of physical disabilities following stroke. It is delivered through a web-based, smartphone-enabled application. It includes inputs from stroke rehabilitation experts in a digitised format.

Methods

Evaluation of the intervention was completed in two phases. In the first phase, the preliminary intervention was field-tested with 30 stroke survivors for 2 weeks. In the second phase, the finalised intervention was provided to a further 30 stroke survivors to be used in their homes with support from their carers for 4 weeks.

Primary and secondary outcome measures

Primary outcomes: (1) operational difficulties in using the intervention; (2) feasibility and acceptability of the intervention in an Indian setting. Disability and dependency were assessed as secondary outcomes.

Results

Field-testing identified operational difficulties related to connectivity, video-streaming, picture clarity, quality of videos, and functionality of the application. The intervention was reviewed, revised and finalised before pilot-testing. Findings from the pilot-testing showed that the ‘Care for Stroke’ intervention was feasible and acceptable. Over 90% (n=27) of the study participants felt that the intervention was relevant, comprehensible and useful. Over 96% (n=29) of the stroke survivors and all the caregivers (100%, n=30) rated the intervention as excellent and very useful. These findings were supported by qualitative interviews.

Conclusions

Evaluation indicated that the ‘Care for Stroke’ intervention was feasible and acceptable in an Indian context. An assessment of effectiveness is now warranted.