bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole‐plant and organ‐level nitrogen isotope discrimination indicates modification of partitioning of assimilation, fluxes and allocation of nitrogen in knockout lines ofArabidopsis thaliana
Authors: Kalcsits Lee A. , Guy Robert D.
Published: February 2013

The nitrogen isotope composition (δ15N) of plants has potential to provide time‐integrated information on nitrogen uptake, assimilation and allocation. Here, we take advantage of existing T‐DNAandγ‐ray mutant lines ofArabidopsis thalianato modify whole‐plant and organ‐level nitrogen isotope composition. Nitrate reductase 2 (nia2), nitrate reductase 1 (nia1) and nitrate transporter (nrt2) mutant lines and the Col‐0 wild type were grown hydroponically under steady‐stateNO3–conditions at either 100 or 1000 μMNO3–for 35 days. There were no significant effects on whole‐plant discrimination and growth in the assimilatory mutants (nia2andnia1). Pronounced root vs leaf differences inδ15N, however, indicated thatnia2had an increased proportion of nitrogen assimilation ofNO3–in leaves whilenia1had an increased proportion of assimilation in roots. These observations are consistent with reported ratios ofnia1andnia2gene expression levels in leaves and roots. Greater whole‐plant discrimination innrt2indicated an increase in efflux of unassimilatedNO3–back to the rooting medium. This phenotype was associated with an overall reduction inNO3–uptake, assimilation and decreased partitioning ofNO3–assimilation to the leaves, presumably because of decreased symplastic intercellular movement ofNO3–in the root. Although the results were more varied than expected, they are interpretable within the context of expected mechanisms of whole‐plant and organ‐level nitrogen isotope discrimination that indicate variation in nitrogen fluxes, assimilation and allocation between lines.
Europeanization of Social Inclusion Policy in Macedonia – Trends, Challenges and Potential Benefits
Authors: Gerovska Mitev Maja
Published: February 2013

The article explores policies, trends and challenges related to social inclusion in Macedonia, and assesses the contribution of EU strategic frameworks and instruments towards the country's greater inclusive growth. In this respect, the article starts by exploring existing instruments for pre‐accession (IPAs) which are relevant for the achievement of the EU 2020 goals. Then the article offers a country analysis related to issues such as poverty, material deprivation, as well as exclusion from the labour market, accompanied by an overview of policies and measures undertaken by the current government in the respective domains. Unfavourable socio‐economic trends, such as undeclared work, jobless growth, high unemployment and poverty rates, present serious challenges to the creation of an effective social inclusion policy. On the other hand, the ‘delayed’ negotiation process with the EU, which in social policy results in a lack of Joint Inclusion Memorandum (JIM) and Joint Assessment Paper (JAP) processes even after seven years of candidate status, slows down the adoption of more strategic policy approach towards sensitive issues, such as social inclusion and anti‐discrimination. The main aim of the article is to assess whether there is a significant difference between current social inclusion policies, measures, indicators and trends with the similar EU standards and practices. In addition, the article explores the potential benefits of the process of Europeanization for Macedonian social inclusion policy.
Differences in prevalence of geohelminth infections between indigenous and settler populations in a remote Amazonian region of Peru
Authors: Briones‐Chávez Carlo , Torres‐Zevallos Hernando , Canales Marco , Stamato Caroline M. , O'Riordan Thomas G. , Terashima Angélica
Published: February 2013

Objective

To compare prevalences of intestinal helminths and waterborne protozoa in indigenous and settler populations in a remote area of Peru. These populations live in adjacent but segregated small urban villages.

Methods

Stool samples were collected from representative members of these two populations and analysed for geohelminths and protozoa.

Results

The risk of soil‐transmitted helminths is significantly higher in the settler than the indigenous population in the same isolated region of Peru (OR 5.18; 95% CI 3.44–7.81; P < 0.001). In contrast, the rates of protozoa presence were similar in both populations (OR 1.28; 95% CI 0.77–2.14; P = 0.336).

Conclusions

Potential explanations for unexpected finding of a lower prevalence of helminths in indigenous relative to the settler population could include housing design in flood – prone areas and the use of local medicinal plants that possibly have antihelmintic properties.
Resistance to paraquat in Mazus pumilus
Authors: Tsuji K , Hosokawa M , Morita S , Miura R , Tominaga T
Published: February 2013

Mazus pumilus is an annual self‐pollinating weed that is commonly found in arable land, vegetable gardens and roadsides. This weed harbours insects and pathogens that attack vegetables. The mechanism of resistance to paraquat of M. pumilus found in Ohita, Japan, was studied. Whole plant bioassays revealed that the resistant (R) biotypes were four to six times less susceptible than controls. Chlorophyll destruction of leaf discs by paraquat treatment in R biotypes was 4–20 times lower than those of susceptible (S) biotypes. Ferric reducing antioxidant power (FRAP) values in R biotypes were higher than those of S biotypes before and after paraquat treatments. The activity of superoxide dismutase (SOD) was also higher in R biotypes than those of S biotypes before and after treatment with paraquat, but the activities of ascorbate peroxidase (APX) and catalase (CAT) were not different between R and S biotypes. Change of ascorbate (AsA) contents before and after paraquat treatment was equivalent in both biotypes. These results indicate that the increased SOD activity and antioxidant capacity in R biotypes contribute to the resistance to paraquat of M. pumilus.
Efficacy for a New Live Attenuated Salmonella Enteritidis Vaccine Candidate to Reduce Internal Egg Contamination
Authors: Nandre R. , Matsuda K. , Lee J. H.
Published: February 2013

To evaluate the efficacy of a novel attenuated Salmonella Enteritidis (△lon△cpxR) vaccine candidate (JOL919), chickens were immunized through oral and intramuscular routes to reduce egg contamination against S. Enteritidis challenge. Birds were orally immunized with JOL919 on the first day of life and were subsequently boosted in the 6th and 16th weeks through oral (group B) or intramuscular (group C) route, while control birds were unimmunized (group A). The chickens of all groups were challenged intravenously with the virulent S. Enteritidis strain in the 24th week. The immunized groups B and C showed significantly higher plasma IgG and intestinal secretory IgA levels as compared to those of the control group. The lymphocyte proliferation response and CD45+CD3+ T‐cell number in the peripheral blood of the groups B and C were significantly increased. In addition, the egg contamination rates were significantly lower in the group B (0%, 10.7% and 0%) and the group C (3.6%, 14.3% and 3.6%) as compared to the group A (28.6%, 42.8% and 28.6%) in the 1st, 2nd and 3rd weeks post‐challenge. All animals in the groups B and C showed lower organ lesion scores in the liver and spleen and lower bacterial counts in the liver, spleen and ovary at the 3rd week post‐challenge. These results indicate that this vaccine candidate can be an efficient tool for prevention of Salmonella infections by inducing protective humoral and cellular immune responses. In addition, this vaccine did not prevent egg contamination, but did appear to reduce incidence. Booster immunizations, especially via oral administration route, showed an efficient protection against internal egg contamination with S. Enteritidis.
A Simple Goniometer for Use Intraoperatively in Total Knee Arthroplasty
Authors: McGann W. , Peter J. , Currey J. M. , Buckley J. M. , Liddle K. D.
Published: February 2013

Intraoperative range of motion (ROM) assessment can be challenging during total knee arthroplasty (TKA) surgery. As computer assisted surgery is costly and not readily available to many surgeons, we have developed a simple, cost-effective intraoperative device to precisely measure knee flexion and extension. A simple knee goniometer system was constructed consisting of a digital level mounted to a base that rigidly attaches two standard needles. The needles are pushed through the overlying soft tissue of the distal femur. The device is then applied to the proximal tibia, where an angle measurement of the knee is registered. A validation study for this device was conducted on two pairs of intact cadaveric lower limbs at 0 deg, 10 deg, 15 deg, 20 deg, 25 deg, and 30 deg. Two orthopedic surgeons experienced with the system performed three measurements at each angle. Systematic error, defined as the goniometer reading at 0 deg flexion anatomically as determined by the navigation system, ranged from −9.1 deg to 3.0 deg, consistent for each operator on every case. Measurement error, defined as the variability in repeated, fixed angle measurements made with the goniometer, was 1.5 ± 1.0 deg across all surgeons, cases, and prescribed flexion angles. For both surgeons and all imposed flexion angles, measurement errors were below the 4 deg clinical threshold. The simple knee goniometer system generated accurate, repeatable measures of changes in flexion angle intraoperatively with measurement error comparable to errors obtained using the commercial navigation system (1 deg–2 deg). However, the knee goniometer is less complex, less time intensive, and less costly than currently available computer assistive devices. Taken together, our results are very promising for the continued development of this device.
A Portable Atmospheric Air Plasma Device for Biomedical Treatment Applications
Authors: Thiyagarajan Magesh
Published: February 2013

A portable atmospheric pressure resistive barrier plasma (RBP) device is designed, constructed, and characterized for plasma surface treatment procedures applied in biomedical applications. The design and construction aspects of the RBP plasma device are presented including the electrode configuration, electrical, cooling, and gas flow rates. The RBP device can operate in both dc (battery) as well as in standard 60/50 Hz low frequency ac power input. The RBP device can function effectively in both direct and indirect plasma exposure configurations depending on the type of treatment targets. The portable RBP device is characterized for plasma jet exit velocity, plasma temperatures, and reactive nitrogen species (RNS) using laser shadowgraphy, emission spectroscopy, and gas analyzer diagnostics. We have measured the average velocity of the plasma jet to be 150–200 m/s at 1 cm from the probe end. The gas temperature which is equivalent to the rotational (Trot) temperatures of the plasma is measured by simulation fitting the experimental emission spectra. A high-temperature ceramic fiber-insulated-wire thermocouple probe is used to measure the temperatures of the downstream jet after 2 cm where the plasma emission drops. Addition of external cooling unit brought the temperatures of reactive species and other gases close to room temperature. The spatial concentrations of the reactive oxygen species from the plasma jet tip are measured at 5 cm distance from the electrode. The nitric oxide level is measured to be in the range of 500–660 ppm and it drops to ∼100 ppm at 60 cm. The ppm values of nitric oxides after the cooling unit are observed to be at the same order of magnitude as the plasma jet. The preliminary results on the effectiveness of the portable RBP device for bacterial inactivation as well as the effects of indirect exposure of the portable RBP device on monocytic leukemia cancer cells (THP-1) are briefly presented.
MBE growth of GaSb-based photodetectors on 6-inch diameter GaAs substrates via select buffers
Authors: Fastenau Joel M. , Lubyshev Dmitri , Qiu Yueming , Liu Amy W. K. , Koerperick Edwin J. , Olesberg Jon T. , Norton Dennis
Published: February 2013

GaSb-based, 6.1 Å lattice-constant, infrared photodetector materials were grown on large diameter, 6-in. GaAs substrates by molecular beam epitaxy. Multiple metamorphic buffer architectures, including bulk GaSb nucleation, AlAsSb superlattices, and graded GaAsSb ternary alloys, were investigated to bridge the 7.8% mismatch gap between the GaAs substrates and the GaSb-based epitaxial layers. Unique surface morphologies and crystal structure properties, as revealed by atomic force microscopy and cross-section transmission electron microscopy, pointed to different relaxation mechanisms for different buffer architectures. GaSb nucleation results in a more island-like surface morphology with a mix of 90° misfit and 60°-type threading dislocations, while the graded ternary buffer results in a cross-hatch surface morphology with effective filtering of the threading dislocations. Low root-mean-square roughness values of 5–20 Å were obtained for this type of metamorphic epilayer growth. A generic InAsSb/AlAsSb nBn photodiode structure, where the first “n” is the contact layer, the “B” is the wide-bandgap barrier layer, and the second “n” is the n-type narrow bandgap absorber layer, with ∼4 μm cutoff wavelength was grown on 6 in. GaAs substrates using the different metamorphic buffers. Cross-wafer optical and structural measurements showed excellent epitaxial layer uniformity, with PL wavelength variation <0.1 μm. Dark currents of 2–3 × 10−6 A/cm2 were measured on devices fabricated from the photodiode material grown on GaAs. This was about 5-times higher than measured on the same structure grown on GaSb substrates. This work demonstrates a promising path to satisfy the increasing demand for even larger area focal plane array detectors in a commercial production environment.
Complete Genome Sequence of a Highly Virulent Newcastle Disease Virus Currently Circulating in Mexico
Authors: Xiao Sa , Paldurai Anandan , Nayak Baibaswata , Mirande Armando , Collins Peter L. , Samal Siba K.
Published: February 2013

The complete genome sequence was determined for a highly virulent Newcastle disease virus strain from vaccinated chicken farms in Mexico during outbreaks in 2010. On the basis of phylogenetic analysis this strain was classified into genotype V in the class II cluster that was closely related to Mexican strains that appeared in 2004–2006.
Genome of a Gut Strain of Bacillus subtilis
Authors: Schyns Ghislain , Serra Cláudia R. , Lapointe Thomas , Pereira-Leal José B. , Potot Sébastien , Fickers Patrick , Perkins John B. , Wyss Markus , Henriques Adriano O.
Published: February 2013

Bacillus subtilis
is a Gram-positive, rod-shaped, spore-forming bacterium. We present the genome sequence of an undomesticated strain, BSP1, isolated from poultry. The sequence of the BSP1 genome supports the view that
B. subtilis
has a biphasic lifestyle, cycling between the soil and the animal gastrointestinal tract, and it provides molecular-level insight into the adaptation of
B. subtilis
to life under laboratory conditions.
Genome Sequence of Campylobacter showae UNSWCD, Isolated from a Patient with Crohn's Disease
Authors: Tay Aidan P. , Kaakoush Nadeem O. , Deshpande Nandan P. , Chen Zhiliang , Mitchell Hazel , Wilkins Marc R.
Published: February 2013

Campylobacter showae
UNSWCD was isolated from a patient with Crohn's disease. Here we present a 2.1 Mb draft assembly of its genome.
Genome Sequence of Non-O1 Vibrio cholerae PS15
Authors: Kumar Sanath , Lindquist Ingrid E. , Sundararajan Anitha , Rajanna Chythanya , Floyd Jared T. , Smith Kenneth P. , Andersen Jody L. , He Guixin , Ayers Ryan M. , Johnson Judith A. , Werdann James J. , Sandoval Ava A. , Mojica Nadia M. , Schilkey Faye D. , Mudge Joann , Varela Manuel F.
Published: February 2013

The draft genome sequence of a non-O1
Vibrio cholerae
strain, PS15, organized into 3,512 open reading frames within a 3.9-Mb genome, was determined. The PS15 genome sequence will allow for the study of the evolution of virulence and environmental adaptation in
V. cholerae
.
An endo-aesthetic management of crown dilaceration in a permanent mandibular central incisor
Authors: Wankhade Abhijit D , Pandey Ramesh Kumar , Singh Rajeev Kumar , Naphade Milind V
Published: February 2013

Traumatic injuries to primary dentition may result in a wide range of developmental disturbances to succedaneous permanent teeth. The prevalence of morphological disturbances, secondary to dental injuries in the primary dentition, ranges from 12% to 69%. One of the morphological disturbances are crown dilacerations which are defined as the displacement of a portion of the developing crown at an angle to the longitudinal axis of the tooth. The prevalence of crown dilaceration constitutes 3% of the total injuries in developing teeth and is usually because of intrusion or avulsion of their primary predecessors. The present article narrates a case of crown dilaceration of a permanent mandibular right central incisor with open apex and large periradicular pathosis and its endo-aesthetic management with 2 years of follow-up.
Bilateral posterior ischaemic optic neuropathy after severe diabetic ketoacidosis, cardiopulmonary resuscitation and respiratory failure
Authors: Wirth Christina Doris , Leitner Christoph , Perrig Martin
Published: February 2013

A 44-year-old male European with type I diabetes mellitus fell into diabetic ketoacidosis. In the emergency room, he developed an episode of asystole and respiratory failure requiring one cycle of cardiopulmonary resuscitation and extracorporeal membrane oxygenation (ECMO). Waking up 7 days later, he presented a bilateral complete loss of vision. Ophthalmological examination including funduscopy on days 1 and 10, after extubation, showed bilateral large round pupils non-reactive to light and a normal fundus. Neuroimaging studies, including MRI and MRA of the brain, were all within normal limits. A lumbar puncture and comprehensive serological testing excluded an infectious or rheumatic cause. An empirical high-dose intravenous steroid treatment administered for 5 days had no effect on his vision. His eye examination at 1.5 months follow-up showed a normal fundus except for progressive bilateral optic nerve disc pallor, which pointed towards the diagnosis of a posterior ischaemic optic neuropathy.
Return-to-play guidelines following facial fractures
Authors: Fowell Christopher John , Earl Philip
Published: February 2013

Despite bone healing and the management options of facial fractures being reported at length, there is a lack of evidence-based return-to-play criteria for sportspeople who have sustained these fractures. This shortage of evidence has resulted in a lack of consensus among health professionals. A prospective study of 20 cases of sportsmen who have returned to competitive play 3 weeks after injury or treatment for facial fractures is reported. The risks and benefits of early return-to-play are discussed and return-to-play guidelines for these patients are proposed.
Describing and predicting frequent callers to an ambulance service: analysis of 1 year call data
Authors: Scott Jason , Strickland Annette Patricia , Warner Karen , Dawson Pamela
Published: February 2013

Aims

Ambulance services in England receive around 8 million calls a year, and no known studies have explored characteristics of frequent callers. This study aimed to identify the characteristics of the most frequent callers to Yorkshire Ambulance Service (YAS) between April 2010 and March 2011.

Methods

Top 100 frequent callers to YAS were analysed using population comparison, case control and multiple regression methods. 7808 calls were made by the frequent callers, and data were analysed to predict total number of calls made, and explore characteristics of frequent callers.

Results

Six call codes were associated with a higher number of calls. Frequent callers were assigned slower response levels, or often no call code. Calls increased during the times of 4:00–9:00, 16:00–20:00 and 22:00–2:00, and in the months of December, January and February. Men and patients with all but the very highest conveyance rates had a higher number of different reasons for calling. Patients with a medical diagnosis were more likely to be conveyed, while patients with a psychiatric classification had a higher number of different reasons for calling, were older and were more likely to call for ‘assault/sexual assault’ or ‘haemorrhage/laceration’.

Conclusions

Frequent callers to YAS were a heterogeneous group that differed from the overall population served, resulting in numerous implications for the delivery of services for this group of patients. Further research is required to determine if and how frequent callers differ from frequent attenders at emergency departments.
Association between ASA grade and complication rate in patients receiving procedural sedation for relocation of dislocated hip prostheses in a UK emergency department
Authors: Dawson Neil , Dewar Alistair , Gray Alasdair , Leal Alexis ,   on behalf of the Emergency Medicine Research Group, Edinburgh
Published: February 2013

Objective

To determine the association between the American Society of Anesthiologists (ASA) grade and the complication rate of patients receiving procedural sedation for relocation of hip prosthesis in an adult emergency department (ED) in the UK.

Design

Retrospective study of registry data from a large UK teaching hospital ED. Consecutive adult patients (aged 16 years and over) in whom ASA grade could be calculated, with an isolated dislocation of a hip prosthesis between 8 September 2006 and 16 April 2010 were included for analyses (n=303). The primary outcome measure was association between ASA and complication rate (any of desaturation <90%; apnoea; vomiting; aspiration; hypotension <90 mm Hg; cardiac arrest). Secondary outcome measures were relationship between ASA grade and procedural success, choice of sedative agent and sedation depth, and complications and choice of sedative agent, arrival time and sedation depth.

Results

There was no significant difference between ASA grade and the risk of complication (p=0.800). Moreover, there was no significant difference between ASA grade and procedural success (p=0.284), ASA and choice of sedative agent (p=0.243), or ASA and sedation depth (p=0.48). There was no association between complications and sedative agent (p=0.18), or complications and arrival time (p=0.12). There was a significant difference between sedative depth and complications (p<0.001).

Conclusions

There is no clear association between a patient's physical status (ASA grade) and the risk of complications, chance of procedural success or choice of sedative agent in relocation of hip prostheses. There is a higher rate of complications with higher levels of sedation (p<0.001).
The prognostic performance of the predisposition, infection, response and organ failure (PIRO) classification in high-risk and low-risk emergency department sepsis populations: comparison with clinical judgement and sepsis category
Authors: de Groot Bas , Lameijer Joost , de Deckere Ernie R J T , Vis Alice
Published: February 2013

Objective

To compare the prognostic performance of the predisposition, infection, response and organ failure (PIRO) score with the traditional sepsis category and clinical judgement in high-risk and low-risk Dutch emergency department (ED) sepsis populations.

Methods

Prospective study in ED patients with severe sepsis and septic shock (high-risk cohort), or suspected infection (low-risk cohort). Outcome: 28-day mortality. Prognostic performance of PIRO, sepsis category and clinical judgement were assessed with Cox regression analysis with correction for quality of ED treatment and disposition. Illness severity measures were divided into four groups with the lowest illness severity as reference category; discrimination was quantified by receiver operator characteristics with area under the curve (AUC) analysis.

Results

Death occurred in 72/323 (22%, high-risk) and 23/385 (6%, low-risk) patients. For the low-risk cohort, corrected HRs (95% CI) for categories 2–4 were 2.0 (0.4 to 11.9), 4.3 (0.8 to 24.7) and 17.8 (2.8 to 113.0: PIRO); 0.5 (0.05 to 5.4), 2.1 (0.2 to 21.8) and 7.5 (0.6 to 92.9: sepsis category). Patients discharged home (category 1) all survived. HRs were 4.5 (0.5 to 39.1) and 13.6 (4.3 to 43.5) for clinical judgement categories 3–4. Prognostic performance was consistently better in the low-risk than in the high-risk cohort. For PIRO AUCs were 0.68 (0.61 to 0.74; high-risk) and 0.83 (0.75 to 0.91; low-risk); for sepsis category AUCs were 0.50 (0.42 to 0.57; high-risk) and 0.73 (0.61 to 0.86; low-risk); for clinical judgement AUCs were 0.69 (0.60 to 0.78; high-risk) and 0.84 (0.73 to 0.96; low-risk).

Conclusions

The accuracy and discriminative performance of the PIRO score and clinical judgement are similar, but better than the sepsis category. Prognostic performance of illness severity scores is less in high-risk cohorts, while in high-risk populations a risk stratification tool would be most useful.
Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case–crossover design
Authors: Harris M Anne , Reynolds Conor C O , Winters Meghan , Cripton Peter A , Shen Hui , Chipman Mary L , Cusimano Michael D , Babul Shelina , Brubacher Jeffrey R , Friedman Steven M , Hunte Garth , Monro Melody , Vernich Lee , Teschke Kay
Published: February 2013

Background

This study examined the impact of transportation infrastructure at intersection and non-intersection locations on bicycling injury risk.

Methods

In Vancouver and Toronto, we studied adult cyclists who were injured and treated at a hospital emergency department. A case–crossover design compared the infrastructure of injury and control sites within each injured bicyclist's route. Intersection injury sites (N=210) were compared to randomly selected intersection control sites (N=272). Non-intersection injury sites (N=478) were compared to randomly selected non-intersection control sites (N=801).

Results

At intersections, the types of routes meeting and the intersection design influenced safety. Intersections of two local streets (no demarcated traffic lanes) had approximately one-fifth the risk (adjusted OR 0.19, 95% CI 0.05 to 0.66) of intersections of two major streets (more than two traffic lanes). Motor vehicle speeds less than 30 km/h also reduced risk (adjusted OR 0.52, 95% CI 0.29 to 0.92). Traffic circles (small roundabouts) on local streets increased the risk of these otherwise safe intersections (adjusted OR 7.98, 95% CI 1.79 to 35.6). At non-intersection locations, very low risks were found for cycle tracks (bike lanes physically separated from motor vehicle traffic; adjusted OR 0.05, 95% CI 0.01 to 0.59) and local streets with diverters that reduce motor vehicle traffic (adjusted OR 0.04, 95% CI 0.003 to 0.60). Downhill grades increased risks at both intersections and non-intersections.

Conclusions

These results provide guidance for transportation planners and engineers: at local street intersections, traditional stops are safer than traffic circles, and at non-intersections, cycle tracks alongside major streets and traffic diversion from local streets are safer than no bicycle infrastructure.
Effectiveness of gentamicin for gonorrhoea treatment: systematic review and meta-analysis
Authors: Dowell Deborah , Kirkcaldy Robert D
Published: February 2013

Objectives

The development of resistance to multiple antimicrobial agents has limited treatment options for gonorrhoea. The potential emergence of cephalosporin resistance in Neisseria gonorrhoeae and cephalosporin allergy in some patients make it necessary to evaluate the effectiveness of other available antimicrobial agents. Gentamicin is widely available in the USA and is used for gonorrhoea treatment in several countries. We conducted a systematic review of the medical literature to assess the effectiveness of gentamicin for treatment of uncomplicated urogenital gonococcal infections.

Methods

Two reviewers assessed relevant articles and independently selected studies that met prespecified selection criteria (including systematic enrolment and assignment to treatment and culture-confirmed diagnosis and outcome). Summary measures for selected studies were pooled using inverse variance-weighted averages with fixed effects. Heterogeneity was assessed using I2, which estimates proportion (0–100%) of variability attributable to heterogeneity between studies. Pooled percentage with negative follow-up culture was compared with Centers for Disease Control and Prevention (CDC) criteria for selection of recommended therapy (lower 95% CI of efficacy ≥95%).

Results

Twenty-nine potentially relevant studies were identified; three met inclusion criteria. Two studies used 240 mg intramuscular gentamicin and one used 280 mg. Percentages with negative culture after single-dose treatment were 90.7% (n=86), 91.4% (n=220) and 95.0% (n=40). Pooled percentage with negative culture after single-dose treatment was 91.5% (95% CI 88.1% to 94.0%, I2=0%).

Conclusions

Gentamicin does not meet current CDC criteria for recommended treatment of gonorrhoea. However, if cephalosporin resistance emerges, gentamicin may be a useful alternative agent. Evaluation of additional regimens, including combination therapy, is warranted.
The distribution of new HIV infections by mode of exposure in Morocco
Authors: Mumtaz Ghina R , Kouyoumjian Silva P , Hilmi Nahla , Zidouh Ahmed , Rhilani Houssine El , Alami Kamal , Bennani Aziza , Gouws Eleanor , Ghys Peter Denis , Abu-Raddad Laith J
Published: February 2013

Objectives

Building on a wealth of new empirical data, the objective of this study was to estimate the distribution of new HIV infections in Morocco by mode of exposure using the modes of transmission (MoT) mathematical model.

Methods

The MoT model was implemented within a collaboration with the Morocco Ministry of Health and the Joint United Nations Programme on HIV/AIDS. The model was parameterised through a comprehensive review and synthesis of HIV and risk behaviour data in Morocco, mainly through the Middle East and North Africa HIV/AIDS Synthesis Project. Uncertainty analyses were used to assess the reliability of and uncertainty around our calculated estimates.

Results

Female sex workers (FSWs), clients of FSWs, men who have sex with men (MSM) and injecting drug users (IDUs) contributed 14%, 24%, 14% and 7% of new HIV infections, respectively. Two-thirds (67%) of new HIV infections occurred among FSWs, clients of FSWs, MSM and IDUs, or among the stable sexual partners of these populations. Casual heterosexual sex contributed 7% of HIV infections. More than half (52%) of HIV incidence is among females, but 71% of these infections are due to an infected spouse. The vast majority of HIV infections among men (89%) are due to high-risk behaviour. A very small HIV incidence is predicted to arise from medical injections or blood transfusions (0.1%).

Conclusions

The HIV epidemic in Morocco is driven by HIV incidence in high-risk population groups, with commercial heterosexual sex being the largest contributor to incidence. There is a need to focus HIV response more on these populations, mainly through proactive and sustainable HIV surveillance, and the expansion and increased geographical coverage of services such as condom promotion among FSWs, voluntary counselling and testing, harm reduction and treatment.
Signal Recognition Particle: An Essential Protein-Targeting Machine
Authors: Akopian David , Shen Kuang , Zhang Xin , Shan Shu-ou
Published: February 2013

The signal recognition particle (SRP) and its receptor compose a universally conserved and essential cellular machinery that couples the synthesis of nascent proteins to their proper membrane localization. The past decade has witnessed an explosion in in-depth mechanistic investigations of this targeting machine at increasingly higher resolutions. In this review, we summarize recent work that elucidates how the SRP and SRP receptor interact with the cargo protein and the target membrane, respectively, and how these interactions are coupled to a novel GTPase cycle in the SRP·SRP receptor complex to provide the driving force and enhance the fidelity of this fundamental cellular pathway. We also discuss emerging frontiers in which important questions remain to be addressed.
The Anthropocene
Authors: Ruddiman William F.
Published: February 2013

The start of the period of large-scale human effects on this planet (the Anthropocene) is debated. The industrial view holds that most significant impacts have occurred since the early industrial era (∼1850), whereas the early-anthropogenic view recognizes large impacts thousands of years earlier. This review focuses on three indices of global-scale human influence: forest clearance (and related land use), emissions of greenhouse gases (CO2 and CH4), and effects on global temperature. Because reliable, systematic land-use surveys are rare prior to 1950, most reconstructions for early-industrial centuries and prior millennia are hind casts that assume humans have used roughly the same amount of land per person for 7,000 years. But this assumption is incorrect. Historical data and new archeological databases reveal much greater per-capita land use in preindustrial than in recent centuries. This early forest clearance caused much greater preindustrial greenhouse-gas emissions and global temperature changes than those proposed within the industrial paradigm.
Initiation and Evolution of Plate Tectonics on Earth: Theories and Observations
Authors: Korenaga Jun
Published: February 2013

The inception of plate tectonics on Earth and its subsequent evolution are discussed on the basis of theoretical considerations and observational constraints. The likelihood of plate tectonics in the past depends on what mechanism is responsible for the relatively constant surface heat flux that is indicated by the likely thermal history of Earth. The continuous operation of plate tectonics throughout Earth's history is possible if, for example, the strength of convective stress in the mantle is affected by the gradual subduction of surface water. Various geological indicators for the emergence of plate tectonics are evaluated from a geodynamical perspective, and they invariably involve certain implicit assumptions about mantle dynamics, which are either demonstrably wrong or yet to be explored. The history of plate tectonics is suggested to be intrinsically connected to the secular evolution of the atmosphere, through sea-level changes caused by ocean-mantle interaction.
Provocative Questions in Cancer Epidemiology in a Time of Scientific Innovation and Budgetary Constraints
Authors: Lam Tram Kim , Schully Sheri D. , Rogers Scott D. , Benkeser Rachel , Reid Britt , Khoury Muin J.
Published: February 2013

In a time of scientific and technological developments and budgetary constraints, the National Cancer Institute's (NCI) Provocative Questions Project offers a novel funding mechanism for cancer epidemiologists. We reviewed the purposes underlying the Provocative Questions Project, present information on the contributions of epidemiologic research to the current Provocative Questions portfolio, and outline opportunities that the cancer epidemiology community might capitalize on to advance a research agenda that spans a translational continuum from scientific discoveries to population health impact. Cancer Epidemiol Biomarkers Prev; 22(4); 496–500. ©2013 AACR.
Acute Effects of Isocaloric Meals with Different Fiber and Antioxidant Contents on Inflammatory Markers in Healthy Individuals
Authors: Chaves Daniela Fojo Seixas , Solis Marina Yazigi , Gandin Paula , Benatti Fabiana Braga , Rodrigues Vinícius Lio , Paschoal Valéria , Naves Andréia , Lancha Jr. Antonio Herbert
Published: February 2013

Chronic inflammation contributes to the pathophysiology of many chronic diseases. Dietary fibers and antioxidants may exert anti-inflammatory effects. The objective of this study was to determine whether meals with different fibers and antioxidants may elicit a different response in inflammatory markers in healthy volunteers. On 3 separate days, subjects (n = 8) consumed one of three isocaloric meals with different antioxidant (vitamin E, selenium and β-carotene) and fiber content (high, intermediate and low) in a randomized crossover design. Blood samples were collected at different times: 0 min (before the meal), and 30 and 240 min after the meal. Plasma interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, glucose and insulin content were evaluated at each time point. There were no significant differences for any of the parameters at baseline. Furthermore, plasma levels of TNF-α, IL-6 and IL-10 were unchanged at the 30- and 240-min time points whatever meal consumed. Moreover, the cytokine responses to glucose and insulin intake were not significantly different between experimental conditions. In conclusion, isocaloric meals with different fiber, β-carotene, vitamin E and selenium contents do not acutely affect inflammatory markers in healthy young males.
Mortality in Cerebral Venous Thrombosis: Results from the National Inpatient Sample Database
Authors: Nasr D.M. , Brinjikji W. , Cloft H.J. , Saposnik G. , Rabinstein A.A.
Published: February 2013

Background: Outcomes of cerebral venous thrombosis (CVT) vary from full recovery to death. Few studies have been performed examining epidemiologic and medical risk factors associated with high mortality in CVT. In this study, we examined the National Inpatient Sample (NIS) to determine the epidemiologic and medical risk factors associated with increased mortality from CVT. Materials and Methods: Using the NIS from 2001 to 2008, patients who suffered from CVT were identified using the ICD-9 codes 437.6 (nonpyogenic thrombosis of intracranial venous sinus), 325 (phlebitis and thrombophlebitis of intracranial venous sinuses) and 671.5 (peripartum phlebitis and thrombosis, cerebral venous thrombosis, thrombosis of intracranial venous sinus). We analyzed the associations of demographic factors, risk factors, comorbidities, complications of CVT, and therapeutic interventions with in-hospital mortality. We performed a multivariate logistic regression analysis to determine which variables were independently associated with in-hospital mortality. Results: 11,400 patients were hospitalized with CVT between 2001 and 2008. Two-hundred and thirty-two (2.0%) suffered in-hospital mortality. Patients 15–49 years old had the lowest mortality rate (1.5%) compared with 2.8% for patients aged 50–64 (p < 0.001) and 6.1% for patients ≥65 years old (p < 0.001). The most common condition associated with CVT was pregnancy/puerperium (24.6%), and these women had a low mortality rate (0.4%). On multivariate analysis, the comorbidity most strongly associated with increased risk of mortality was sepsis (mortality rate 15.6%, OR = 7.5, 95% CI = 4.79–11.53, p < 0.001). Malignancy, underlying autoimmune disease and substance abuse were also independently associated with mortality, but with lower mortality rates (<5%). Complications associated with increased risk of mortality included paralysis (8.0%, OR = 3.4, 95% CI = 3.17–6.96, p < 0.001), intracranial hemorrhage (8.7%, OR = 5.4, 95% CI = 4.38–7.96, p < 0.001), and hydrocephalus (15.0%, OR = 3.2, 95% CI = 5.54–15.11, p = 0.004). Demographic variables associated with decreased mortality on multivariate analysis were male gender (2.1%, OR = 0.62, 95% CI = 0.43–0.87, p = 0.006) and Asian/Pacific Islander race (OR = 0.00, 95% CI = 0–0.27, p < 001). Conclusions: CVT is associated with a low in-hospital mortality rate. Amongst patients suffering CVT, male gender and Asian/Pacific Islander race were independently associated with lower odds of in-hospital mortality when compared to their female and white counterparts, respectively. Septic patients with CVT have the greatest risk of in-hospital mortality. Hydrocephalus, intracranial hemorrhage, and motor deficits are also associated with higher risk of death. Our results build on previous evidence that serves to define a group of patients with CVT at high risk of early death.
Increased Benefit of Alteplase in Patients with Ischemic Stroke and a High Body Temperature
Authors: de Ridder Inger , den Hertog Heleen , van Gemert Maarten , Dippel Diederik , van der Worp Bart ,   for the PAIS investigators
Published: February 2013

Background: In observational studies, a high body temperature has been associated with unfavorable outcome. In in vitro studies, the fibrinolytic activity of alteplase decreased 5% per degree Celsius reduction in temperature. The modifying effect of body temperature on treatment with alteplase in patients with acute ischemic stroke is unclear. We assessed the influence of baseline body temperature on the effect of alteplase on functional outcome in patients with acute ischemic stroke, included in the Paracetamol (Acetaminophen) in Stroke (PAIS) trial. Methods: PAIS was a randomized, double-blind clinical trial to assess the effect of high-dose paracetamol on functional outcome in patients with acute stroke. For this study, we selected all patients with ischemic stroke and randomization within 6 h of symptom onset. We estimated the effect of treatment with alteplase on the modified Rankin Scale score at 3 months with ordinal logistic regression, stratified by baseline body temperature. We made adjustments for confounding factors and expressed associations as adjusted odds ratios (aOR) with 95% confidence intervals (CI). We also tested for interaction between treatment with alteplase and body temperature. Results: We included 647 of the 1,400 patients in PAIS in our study. Treatment with alteplase was associated with improved functional outcome at 3 months (aOR 1.51, 95% CI 1.09–2.08). In the 286 patients (44%) with a baseline body temperature of 37.0°C or higher, alteplase was associated with a larger effect (aOR 2.13, 95% CI 1.28–3.45) than in patients with a temperature below 37.0°C (aOR 1.11, 95% CI 0.71–1.69). A test for interaction between body temperature and alteplase did not reach statistical significance (p = 0.18). Conclusion: Patients with ischemic stroke and a high body temperature may have a larger benefit of treatment with alteplase than patients with lower body temperatures. These findings are in line with those from in vitro studies, in which lowering temperature decreased the fibrinolytic activity of the enzyme alteplase. This interaction should be explored further in randomized clinical trials of thrombolytic therapy or modification of body temperature. Trials of therapeutic hypothermia should be controlled for treatment with thrombolytics, and trials of thrombolytic treatment should consider body temperature as a potential effect modifier.
Apathy Secondary to Stroke: A Systematic Review and Meta-Analysis
Authors: Caeiro Lara , Ferro José M. , Costa João
Published: February 2013

Background: Apathy is a disturbance of motivation, frequent in survivors of stroke. Several studies have evaluated the rate of apathy secondary to stroke and risk factors. Different conclusions and contradictory findings have been published. We aimed to perform a systematic review and meta-analysis of all studies evaluating apathy secondary to stroke to better estimate its rate and risk factors, and explore associations with poorer outcomes. Methods: We searched PubMed, Cochrane Library, PsychINFO and PsycBITE databases and screened references of included studies and review articles for additional citations. Search results and data extraction was performed independently. We systematically reviewed available publications reporting investigations on ischemic and intracerebral hemorrhagic stroke and apathy. Quality assessment of the studies was performed independently. Subgroup analyses were performed according to stroke phase (acute and post-acute), stroke past history (first-ever and any-stroke) and patient age (younger and older patients). Pooled odds ratios (OR) and standardized mean difference, and 95% confidence intervals (CI), were derived by random-effects meta-analysis. Heterogeneity was assessed with I2 test. Results: From the initial 1,399 publications, we included 19 studies (2,221 patients). The pooled rate of apathy was 36.3% (95% CI 30.3–42.8; I2 = 46.8), which was similar for acute [39.5% (95% CI 28.9–51.1)] and post-acute phase [34.3% (95% CI 27.8–41.4)], and about three times higher than the rate of depression [12.1% (95% CI 8.2–17.3)]. Apathetic patients were on average 2.74 years older (95% CI 1.25–4.23; I2 = 0%). No gender differences were found. Depression (OR 2.29; 95% CI 1.41–3.72; I2 = 44%) and cognitive impairment (OR 2.90; 95% CI 1.09–7.72; I2 = 14%) were more frequent and severe in apathetic patients. Apathy rate was similar for ischemic and hemorrhagic stroke type and for left- and right-sided hemispheric lesions. Clinical global outcome was similar between apathetic and nonapathetic patients. Conclusion: Apathy secondary to stroke is a more frequent neuropsychiatric disturbance than depression. Apathetic patients are more frequently and severely depressed and cognitively impaired. A negative impact of apathy secondary to stroke on clinical global outcome cannot be ascribed. Future research should properly address its predictor factors and evaluate the impact of apathy treatment options in stroke patients.
Decreased Levels of Angiogenic Growth Factors in Intracranial Atherosclerotic Disease despite Severity-Related Increase in Endothelial Progenitor Cell Counts
Authors: Massot A. , Navarro-Sobrino M. , Penalba A. , Arenillas J.F. , Giralt D. , Ribó M. , Molina C.A. , Alvarez-Sabín J. , Montaner J. , Rosell A.
Published: February 2013

Background: Intracranial atherosclerotic disease (ICAD) is an important cause of ischemic stroke (IS) and endothelial dysfunction plays a critical role in its onset and progression. Endothelial progenitor cells (EPCs) and endothelial production of angiogenic growth factors (AGFs) may play an essential role in this process. This study investigated the association of EPCs and AGFs with ICAD severity. Methods: A total of 42 patients who had experienced a transient ischemic attack (TIA) or IS attributable to symptomatic ICAD were included. Clinical and neurosonological evaluations were conducted between 2.4 and 8.7 years after the initial cerebrovascular event. Severe ICAD was defined as the presence of at least 1 severe intracranial stenosis, and extensive ICAD as 3 or more intracranial stenoses. Blood samples were obtained to determine EPC levels using flow cytometry (CD34+KDR+ cells), and the plasma levels of several growth factors were assessed with a protein array (Searchlight®). Twenty-two individuals without cerebrovascular disease and with normal ultrasonographic examination were also included. Results: No difference in the count of circulating EPCs was found between patients and controls, and a moderate increase in the number of EPCs/ml was noted in patients with extensive ICAD (p = 0.05). Patients presented decreased levels of fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF-BB) compared with controls (p = 0.002, p = 0.079 and p = 0.061, respectively). Higher levels of FGF, VEGF and PDGF-BB were found in patients with severe ICAD (p = 0.007, p = 0.07 and p = 0.07, respectively), but there was no correlation between any AGFs and EPCs. Conclusions: Symptomatic ICAD patients have decreased levels of AGFs with no correlation to the number of circulating EPCs, while patients with severe ICAD have higher levels of EPCs, FGF, VEGF and PDGF-BBs. This suggests that reduced EPC and proangiogenic factor production capacity is implicated in ICAD pathogenesis, while the more severe forms of chronic brain hypoperfusion in ICAD patients might stimulate EPC mobilization and AGF production.