bluuebunny/crossref_metadata_2025 huggingface dataset:
The Hip Fracture Patient on Warfarin: Evaluating Blood Loss and Time to Surgery
Authors: Cohn Matthew R. , Levack Ashley E. , Trivedi Nikunj N. , Villa Jordan C. , Wellman David S. , Lyden John P. , Lorich Dean G. , Lane Joseph M.
Published: April 2017

Objectives:

To compare blood loss, delay of surgery, and short-term adverse events in (1) patients admitted on warfarin versus nonanticoagulated controls and (2) warfarin patients with day of surgery (DOS) international normalized ratio (INR) of 1.5 or greater versus below 1.5.

Design:

Retrospective cohort.

Setting:

Academic Level I trauma center.

Patients/Participants:

One hundred twenty four patients treated surgically for hip fractures including patients presenting on warfarin (n = 62) and matched controls (n = 62).

Intervention:

Cephalomedullary nailing (CMN), hemiarthroplasty, or total hip arthroplasty.

Main Outcome Measures:

The primary outcome was transfusion rate. Secondary outcomes included calculated blood loss, 30-day complication rate, and hours from emergency department presentation to surgery.

Results:

There was no significant difference in blood transfusion rates between the warfarin and control groups (P = 0.86). Blood transfusion was required in 58.1% of patients in the warfarin group (48.3% of arthroplasties and 65.5% of CMNs) compared with 56.6% of controls (41.9% of arthroplasties and 73.3% of CMNs). There were also no significant differences in calculated blood loss or in complication rates. Patients on warfarin had significantly longer time to surgery (P < 0.01). Subanalysis of the warfarin group showed that patients with DOS INR at or above 1.5 had similar transfusion rates, blood loss, and complications compared with patients with INR below 1.5. Treatment with CMN was the only covariate that was found to be a significant independent predictor of transfusion on multivariable analysis (P = 0.048).

Conclusions:

Patients with hip fractures admitted on warfarin seem to be at similar risk of transfusion or adverse events compared with nonanticoagulated patients. Awaiting normalization of INR delayed surgery without reducing bleeding or preventing complications. Within reason, surgeons may consider proceeding with surgery in patients with INR above 1.5 if patients are otherwise medically optimized. The upper limit above which surgery causes increased blood loss is currently unknown.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Clinical Utility of Flexion-extension Cervical Spine MRI in 22q11.2 Deletion Syndrome
Authors: Kolman Samuel E. , Ohara Stephanie Y. , Bhatia Aashim , Feygin Tamara , Colo Dino , Baldwin Keith D. , Mcdonald-Mcginn Donna , Spiegel David A.
Published: April 2017

Background:

Our goal is to correlate the findings on flexion and extension radiographs with dynamic magnetic resonance imaging (MRI), and the clinical history, in a nonrandomly selected cohort of patients with 22q11.2 deletion syndrome (22q).

Methods:

All patients with the 22q who had a dynamic MRI from January 2004 to March 2015 were included. We analyzed multiple radiographic measurements on both the dynamic plain films and the MRIs, and correlated these findings with a review of each patient’s medical record.

Results:

Multiple congenital anomalies were identified as noted in previous studies, and 61% of the patients had a failure of fusion of the anterior (n=2, 9%), posterior (n=2, 9%), or anterior and posterior arches (n=10, 43%). Quantitative measurements were impossible to report with certainty because of the upper cervical anomalies, and no cases of instability were identified using a qualitative assessment. We identified spinal cord encroachment (30%) and impingement (18%); however, none of the patients had any signal change in their spinal cord. None of these findings could be definitively correlated with any clinical symptoms. A single patient was diagnosed with a Chiari I malformation, while another had cerebellar ectopia.

Conclusions:

Although the upper cervical anomalies are extremely common in 22q, we did not identify cases of instability on dynamic plain radiographs and MRI. Although our findings do not support routine screening with flexion and extension MRI, this study may be required in patients with neurological symptoms and/or findings or abnormalities on dynamic plain radiographs.

Level of Evidence:

Level III.
Hemolysis Following Intraoperative Cell Salvage Replacement in a Scoliosis Patient With Sickle Cell Trait
Authors: You Daniel , Peiro-Garcia Alejandro , Ferri-de-Barros Fabio , Parsons David
Published: April 2017

Study Design.

Case report.

Objective.

To describe a novel presentation of acute renal failure associated with hemolysis after intraoperative cell salvage (ICS) in a neuromuscular scoliosis patient with sickle cell trait (SCT).

Summary of Background Data.

Hemolysis-associated acute renal failure after ICS in patients with SCT has not been previously reported. Sickle cell disease is regarded as a relative contraindication for ICS due to the risk of red blood cell sickling in the hypoxic cell saver reservoir. A previous case series demonstrated successful ICS reinfusion after elective caesarean section in two patients with SCT. However, a decision to not reinfuse ICS collected blood due to increased sickling after blood processing was reported in general surgery.

Methods.

A 14-year-old female with Group I neuromuscular scoliosis underwent a navigated T3-S1posterior spinal instrumentation fusion. Three hundred milliliters of blood collected by ICS was reinfused intraoperatively along with two units of packed red blood cells.

Results.

Postoperatively, the patient had delayed emergence from the general anesthetic and gross hematuria was observed in the urinary catheter bag. The patient was transferred to the intensive care unit and was treated successfully for hemolysis-induced renal failure.

Conclusion.

Given the potential seriousness of hemolysis-associated acute renal failure associated with ICS, we recommend against the use of ICS in patients with SCT.

Level of Evidence: 5
Clinical Evidence for Spinal Cord Stimulation for Failed Back Surgery Syndrome (FBSS)
Authors: Kapural Leonardo , Peterson Erika , Provenzano David A. , Staats Peter
Published: April 2017

Study Design.

A systematic review.

Objective.

A systematic literature review of the clinical data from prospective studies was undertaken to assess the efficacy of spinal cord stimulation (SCS) in the treatment of failed back surgery syndrome (FBSS) in adults.

Summary of Background Data.

For patients with unrelenting back pain due to mechanical instability of the spine, degenerative disc disease, spinal injury, or deformity, spinal surgery is a well-accepted treatment option; however, even after surgical intervention, many patients continue to experience chronic back pain that can be notoriously difficult to treat. Clinical evidence suggests that for patients with FBSS, repeated surgery will not likely offer relief. Additionally, evidence suggests long-term use of opioid pain medications is not effective in this population, likely presents additional complications, and requires strict management.

Methods.

A systematic literature review was performed using several bibliographic databases, prospective studies in adults using SCS for FBSS were included.

Results and Conclusion.

SCS has been shown to be a safe and efficacious treatment for this patient population. Recent technological developments in SCS offer even greater pain relief to patients’ refractory to other treatment options, allowing patients to regain functionality and improve their quality of life with significant reductions in pain.

Level of Evidence: N/A
Noninvasive iPhone Measurement of Left Ventricular Ejection Fraction Using Intrinsic Frequency Methodology*
Authors: Pahlevan Niema M. , Rinderknecht Derek G. , Tavallali Peyman , Razavi Marianne , Tran Thao T. , Fong Michael W. , Kloner Robert A. , Csete Marie , Gharib Morteza
Published: April 2017

Objective:

The study is based on previously reported mathematical analysis of arterial waveform that extracts hidden oscillations in the waveform that we called intrinsic frequencies. The goal of this clinical study was to compare the accuracy of left ventricular ejection fraction derived from intrinsic frequencies noninvasively versus left ventricular ejection fraction obtained with cardiac MRI, the most accurate method for left ventricular ejection fraction measurement.

Design:

After informed consent, in one visit, subjects underwent cardiac MRI examination and noninvasive capture of a carotid waveform using an iPhone camera (The waveform is captured using a custom app that constructs the waveform from skin displacement images during the cardiac cycle.). The waveform was analyzed using intrinsic frequency algorithm.

Setting:

Outpatient MRI facility.

Subjects:

Adults able to undergo MRI were referred by local physicians or self-referred in response to local advertisement and included patients with heart failure with reduced ejection fraction diagnosed by a cardiologist.

Interventions:

Standard cardiac MRI sequences were used, with periodic breath holding for image stabilization. To minimize motion artifact, the iPhone camera was held in a cradle over the carotid artery during iPhone measurements.

Measurements and Main Results:

Regardless of neck morphology, carotid waveforms were captured in all subjects, within seconds to minutes. Seventy-two patients were studied, ranging in age from 20 to 92 years old. The main endpoint of analysis was left ventricular ejection fraction; overall, the correlation between ejection fraction–iPhone and ejection fraction–MRI was 0.74 (r = 0.74; p < 0.0001; ejection fraction–MRI = 0.93 × [ejection fraction–iPhone] + 1.9).

Conclusions:

Analysis of carotid waveforms using intrinsic frequency methods can be used to document left ventricular ejection fraction with accuracy comparable with that of MRI. The measurements require no training to perform or interpret, no calibration, and can be repeated at the bedside to generate almost continuous analysis of left ventricular ejection fraction without arterial cannulation.
Preclinical models for translational sarcoma research
Authors: Hamacher Rainer , Bauer Sebastian
Published: April 2017

Purpose of review

Sarcoma is a basket term for mesenchymal tumors for which more than 75 genetically and histologically distinct subtypes are recognized. Therapeutic progress has largely been achieved with classical chemotherapeutic drugs that were tested in empirical clinical trials. However, outcome in metastatic patients remains poor and with few exceptions numerous trials have failed or only provided limited improvement in recent years.

Recent findings

Given the genomic heterogeneity, preclinical model systems will be indispensable to identify new molecular targets and to prioritize drugs and drug combinations. Cell culture is still widely used in preclinical sarcoma research to identify potential novel therapeutic approaches and resistance mechanisms. New and improved techniques in genome-wide and proteome-wide screens enable a better characterization. In addition to cell line xenograft mouse models, patient-derived xenografts crucially broadened and improved preclinical studies using primary human samples. Finally, novel strategies for genome editing, like CRISPR/Cas and sleeping beauty transposon, lead to development of novel genetically engineered cell lines and mouse models.

The present review gives a non-comprehensive overview on current model systems used in sarcoma research and discusses their translational relevance. Those include cell lines, subtype-specific patient-derived cell lines and xenografts as well as developments in genome editing and genetically engineered cell lines and mouse models.
Telehealth Intensive Care Unit Nurse Surveillance of Sepsis
Authors: Rincon Teresa A. , Manos E. LaVerne , Pierce Janet D.
Published: April 2017

The purpose of this article is to describe the usability and human factors engineering standards used in development of a sepsis alert known as the sepsis prompt. Sensory processing, cognitive processing, signal detection, criterion response, and user satisfaction were evaluated with controlled user testing and critical incident response techniques. Nurses reported that the sepsis prompt was visible and distinct, making it easily detectable. The prompt provided a clear response mechanism and adequately balanced the number of false alerts with the likelihood of misses. Designers were able to use a mental model approach as they designed the prompt because the nurses were already using a manual sepsis detection process. This may have predisposed the nurses to response bias, and as such, they were willing to accommodate more false alarms than nurses who are not familiar with sepsis screening (surveillance). Nurses not currently screening for sepsis may not place the same value on this alert and find it an annoyance. The sepsis prompt met usability standards, and the nurses reported that it improved efficiency over the manual screening method.
Protective Effect of Botulinum Toxin Type A Against Atopic Dermatitis–Like Skin Lesions in NC/Nga Mice
Authors: Han Sang Bum , Kim Hyeree , Cho Sang Hyun , Chung Jin Ho , Kim Hei Sung
Published: April 2017

BACKGROUND

Botulinum neurotoxin (BTX) A possesses various biological activities, including anti-inflammatory and antipruritic actions. Human and animal studies have shown that BTX is effective in treating histamine-induced itch, lichen simplex chronicus, psoriasis, rosacea, allergic rhinitis, and scar prevention. However, its effect on atopic dermatitis (AD) has not been studied yet.

OBJECTIVE

To examine the effect of BTX on AD using a mouse model. The primary outcome was skin thickness and transepidermal water loss (TEWL), and the secondary outcome was the alteration in skin severity scores, histological, and laboratory test results.

METHODS

Forty-two NC/Nga mice (a mouse model for AD) were allocated into 6 groups (the untreated, 2-Chloro-1,3,5-trinitrobenzene [TNCB] alone, TNCB + BTX 30 U/kg, TNCB + BTX 60 U/kg, TNCB + vehicle [0.9% saline], TNCB + 0.03% tacrolimus). Those of the BTX group received intradermal injections of BTX on the rostral back once on the day of TNCB sensitization. The effect of BTX in TNCB-treated NC/Nga mice was assessed by measuring skin thickness, TEWL (primary outcome), the skin severity scores, histological changes of test skin including mast cell count, interleukin (IL)-4 mRNA and protein expression, and total serum IgE (secondary outcome).

RESULTS

A single intradermal injection of BTX significantly suppressed skin thickness and TEWL in the TNCB-applied skin. The clinical severity scores, acanthosis and mast cell infiltration, were less in the BTX groups. BTX injection also inhibited TNCB-induced increase in IL-4 mRNA and protein expression in mice, but its effect on serum IgE level was not significant.

CONCLUSION

The preliminary results suggest that BTX may be a novel approach to the prevention and supplemental treatment of acute AD lesions.
Novel Risk Assessment Tool for Immunoglobulin Resistance in Kawasaki Disease
Authors: Takeuchi Masato , Inuzuka Ryo , Hayashi Taiyu , Shindo Takahiro , Hirata Yoichiro , Shimizu Nobutaka , Inatomi Jun , Yokoyama Yoshiki , Namai Yoshiyuki , Oda Yoichiro , Takamizawa Masaru , Kagawa Jiro , Harita Yutaka , Oka Akira
Published: April 2017

Background:

Resistance to intravenous immunoglobulin (IVIG) therapy is a risk factor for coronary lesions in patients with Kawasaki disease (KD). Risk-adjusted initial therapy may improve coronary outcome in KD, but identification of high risk patients remains a challenge. This study aimed to develop a new risk assessment tool for IVIG resistance using advanced statistical techniques.

Methods:

Data were retrospectively collected from KD patients receiving IVIG therapy, including demographic characteristics, signs and symptoms of KD and laboratory results. A random forest (RF) classifier, a tree-based machine learning technique, was applied to these data. The correlation between each variable and risk of IVIG resistance was estimated.

Results:

Data were obtained from 767 patients with KD, including 170 (22.1%) who were refractory to initial IVIG therapy. The predictive tool based on the RF algorithm had an area under the receiver operating characteristic curve of 0.916, a sensitivity of 79.7% and a specificity of 87.3%. Its misclassification rate in the general patient population was estimated to be 15.5%. RF also identified markers related to IVIG resistance such as abnormal liver markers and percentage neutrophils, displaying relationships between these markers and predicted risk.

Conclusions:

The RF classifier reliably identified KD patients at high risk for IVIG resistance, presenting clinical markers relevant to treatment failure. Evaluation in other patient populations is required to determine whether this risk assessment tool relying on RF has clinical value.
The PhyStat 7
Authors: Bohannon Richard W.
Published: April 2017

This observational study was undertaken to describe a battery of 7 measurements of physical status, the PhyStat 7, and to determine the time requirements and clinimetric properties of the battery. Ten men and 10 women (aged 60-79 years) were examined during 2 sessions 10 to 14 days apart. A younger comparison group of 10 men and 10 women (aged 20-29 years) was also examined. During the first session, each of 2 testers independently obtained 7 measurements from all participants: (1) body mass index (BMI); (2) tragus-to-wall (TTW) distance; (3) unipedal stance time (UST); (4) 5-repetition sit-to-stand (STS) time; (5) grip strength; (6) gait speed; and (7) 2-Minute Walk Test (2MWT) distance. During the second session, 1 of the 2 testers repeated the 7 measurements with the older participants. The PhyStat 7 took an average of 12 minutes to administer. For individual items of the PhyStat 7, intraclass correlation coefficients (ICCs [model 3,1]) describing intertester reliability ranged from 0.712 to 0.997 and ICCs describing test-retest reliability ranged from 0.676 to 0.998. For a total PhyStat 7 score derived by adding z-transformed individual items, the ICCs for intertester reliability and test-retest reliability were 0.939 and 0.893, respectably. Content validity was supported by loadings on 2 factors—physical structure (BMI and TTW distance) and physical performance (UST, STS time, grip strength, gait speed, and 2MWT). Known-groups validity was demonstrated by significant differences between the older and younger groups in all items except BMI and gait speed.
Development of an Evidence-Based Intervention Program for Patients With Mild Cognitive Impairment After Stroke
Authors: Oh HyunSoo , Park JongSuk , Seo WhaSook
Published: April 2017

This study was conducted to develop a home-based, online cognitive rehabilitation program that can be easily and repeatedly implemented and integrates cognitive training into daily activities. A program was devised in 3 stages: analysis, design, and development. Specific program contents were determined on the basis of needs assessment and systematic literature review. The developed program consists of general information about stroke, outlines of cognitive impairments, strategies and guidelines of the cognitive rehabilitation program, and a cognitive training workbook. The program appeared to be helpful as determined by validity testing and was found to be satisfactory by users.
Examining the Dietary Intake of Hemodialysis Patients on Treatment Days and Nontreatment Days
Authors: Mirza Muznah , Shahsavarian Natalie , St-Jules David E. , Rhee Connie M. , Pompeii Mary Lou , Kalantar-Zadeh Kamyar , Sevick Mary Ann
Published: April 2017

Previous literature has shown that hemodialysis patients have impaired dietary intakes on dialysis days (DDs), which may contribute to malnutrition and poor outcomes. In this study, we examined dietary intakes of 140 hemodialysis patients based on 3 nonconsecutive days food records (collected on 1 DD and 2 non-DDs). Patients had lower energy intake and other key nutrient intake on DDs; however, upon adjusting for energy intake, nutrient differences were no longer significant. None of the patient characteristics examined were associated with impaired intakes on DDs (P > .05).
The Effect of Combined Aerobic and Strength Training on a Weight Loss and Metabolic Profile
Authors: Luglio Harry Freitag , Sulistyoningrum Dian Caturini , Apriliana Nur Laila , Putri Syari Ernawati , Larasati Ayu , Tsani Ahmed Fahmy Arif , Kandarina B. J. Istiti , Sofro Zaenal M. , Huriyati Emy
Published: April 2017

The aim of this study was to develop a new exercise regime with a mixture of aerobic and strength training combined with a low-calorie diet (1200 kcal/d) and to evaluate its health benefit in overweight/obese individuals. In 8 weeks of study, participants were divided into 2 groups: a low-calorie diet alone and a low-calorie diet with exercise regimen. The low-calorie diet combined with aerobic and strength training had a superior effect on weight loss and improved body composition (but not on glucose and lipid profile compared with low-calorie diet alone).
How Do Consumers Use Nutrition Labels on Food Products in the United States?
Authors: Zhang Yuanting , Chen John T. , Wang Suohong , Andrews J. Craig , Levy Alan
Published: April 2017

This study examined how consumers use food labels in the United States. Based on the results from the cluster analysis, eight nutrition label questions from the Health and Diet Survey fell into 2 categories of label usage: for shopping or for dietary decisions. Survey respondents reported equal or more consideration of nutrition-label information for dietary choices than for shopping decisions in 2008 compared with prior survey years. Female consumers, frequent label users, well-educated, consumers aged 50 to 59, or consumers with any health issues were significantly more likely to use food labels for all kinds of purposes than their corresponding counterparts.
Lyme disease ecology in a changing world: consensus, uncertainty and critical gaps for improving control
Authors: Kilpatrick A. Marm , Dobson Andrew D. M. , Levi Taal , Salkeld Daniel J. , Swei Andrea , Ginsberg Howard S. , Kjemtrup Anne , Padgett Kerry A. , Jensen Per M. , Fish Durland , Ogden Nick H. , Diuk-Wasser Maria A.
Published: April 2017

Lyme disease is the most common tick-borne disease in temperate regions of North America, Europe and Asia, and the number of reported cases has increased in many regions as landscapes have been altered. Although there has been extensive work on the ecology and epidemiology of this disease in both Europe and North America, substantial uncertainty exists about fundamental aspects that determine spatial and temporal variation in both disease risk and human incidence, which hamper effective and efficient prevention and control. Here we describe areas of consensus that can be built on, identify areas of uncertainty and outline research needed to fill these gaps to facilitate predictive models of disease risk and the development of novel disease control strategies. Key areas of uncertainty include: (i) the precise influence of deer abundance on tick abundance, (ii) how tick populations are regulated, (iii) assembly of host communities and tick-feeding patterns across different habitats, (iv) reservoir competence of host species, and (v) pathogenicity for humans of different genotypes ofBorrelia burgdorferi. Filling these knowledge gaps will improve Lyme disease prevention and control and provide general insights into the drivers and dynamics of this emblematic multi-host–vector-borne zoonotic disease.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications'.
Nearly 400 million people are at higher risk of schistosomiasis because dams block the migration of snail-eating river prawns
Authors: Sokolow Susanne H. , Jones Isabel J. , Jocque Merlijn , La Diana , Cords Olivia , Knight Anika , Lund Andrea , Wood Chelsea L. , Lafferty Kevin D. , Hoover Christopher M. , Collender Phillip A. , Remais Justin V. , Lopez-Carr David , Fisk Jonathan , Kuris Armand M. , De Leo Giulio A.
Published: April 2017

Dams have long been associated with elevated burdens of human schistosomiasis, but how dams increase disease is not always clear, in part because dams have many ecological and socio-economic effects. A recent hypothesis argues that dams block reproduction of the migratory river prawns that eat the snail hosts of schistosomiasis. In the Senegal River Basin, there is evidence that prawn populations declined and schistosomiasis increased after completion of the Diama Dam. Restoring prawns to a water-access site upstream of the dam reduced snail density and reinfection rates in people. However, whether a similar cascade of effects (from dams to prawns to snails to human schistosomiasis) occurs elsewhere is unknown. Here, we examine large dams worldwide and identify where their catchments intersect with endemic schistosomiasis and the historical habitat ranges of large, migratory
Macrobrachium
spp. prawns. River prawn habitats are widespread, and we estimate that 277–385 million people live within schistosomiasis-endemic regions where river prawns are or were present (out of the 800 million people who are at risk of schistosomiasis). Using a published repository of schistosomiasis studies in sub-Saharan Africa, we compared infection before and after the construction of 14 large dams for people living in: (i) upstream catchments within historical habitats of native prawns, (ii) comparable undammed watersheds, and (iii) dammed catchments beyond the historical reach of migratory prawns. Damming was followed by greater increases in schistosomiasis within prawn habitats than outside prawn habitats. We estimate that one third to one half of the global population-at-risk of schistosomiasis could benefit from restoration of native prawns. Because dams block prawn migrations, our results suggest that prawn extirpation contributes to the sharp increase of schistosomiasis after damming, and points to prawn restoration as an ecological solution for reducing human disease.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.
Null expectations for disease dynamics in shrinking habitat: dilution or amplification?
Authors: Faust Christina L. , Dobson Andrew P. , Gottdenker Nicole , Bloomfield Laura S. P. , McCallum Hamish I. , Gillespie Thomas R. , Diuk-Wasser Maria , Plowright Raina K.
Published: April 2017

As biodiversity declines with anthropogenic land-use change, it is increasingly important to understand how changing biodiversity affects infectious disease risk. The dilution effect hypothesis, which points to decreases in biodiversity as critical to an increase in infection risk, has received considerable attention due to the allure of a win–win scenario for conservation and human well-being. Yet some empirical data suggest that the dilution effect is not a generalizable phenomenon. We explore the response of pathogen transmission dynamics to changes in biodiversity that are driven by habitat loss using an allometrically scaled multi-host model. With this model, we show that declining habitat, and thus declining biodiversity, can lead to either increasing or decreasing infectious-disease risk, measured as endemic prevalence. Whether larger habitats, and thus greater biodiversity, lead to a decrease (dilution effect) or increase (amplification effect) in infection prevalence depends upon the pathogen transmission mode and how host competence scales with body size. Dilution effects were detected for most frequency-transmitted pathogens and amplification effects were detected for density-dependent pathogens. Amplification effects were also observed over a particular range of habitat loss in frequency-dependent pathogens when we assumed that host competence was greatest in large-bodied species. By contrast, only amplification effects were observed for density-dependent pathogens; host competency only affected the magnitude of the effect. These models can be used to guide future empirical studies of biodiversity–disease relationships across gradients of habitat loss. The type of transmission, the relationship between host competence and community assembly, the identity of hosts contributing to transmission, and how transmission scales with area are essential factors to consider when elucidating the mechanisms driving disease risk in shrinking habitat.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications'.
Causal Evidence for Lateral Prefrontal Cortex Dynamics Supporting Cognitive Control
Authors: Nee Derek Evan , D’Esposito Mark
Published: April 2017

The lateral prefrontal cortex (LPFC) is essential for higher-level cognition, but how interactions among LPFC areas support cognitive control has remained elusive. In previous work, dynamic causal modeling (DCM) of fMRI data revealed that demands on cognitive control elicited a convergence of influences towards mid LPFC. We proposed that these findings reflect the integration of abstract, rostral and concrete, caudal influences to inform context-appropriate action. Here, we provide a causal test of this model using continuous theta-burst transcranial magnetic stimulation (cTBS). cTBS was applied to caudal, mid, or rostral LPFC, as well as a control site in counterbalanced sessions. In most cases, behavioral modulations resulting from cTBS could be predicted based upon the direction of influences within the previously estimated DCM. However, inconsistent with our DCM, we found that cTBS to caudal LPFC impaired cognitive control processes presumed to involve rostral LPFC. Revising the original DCM with a pathway from caudal LPFC to rostral LPFC significantly improved the fitted DCM and accounted for the observed behavioral findings. These data provide causal evidence for LPFC dynamics supporting cognitive control and demonstrate the utility of combining DCM with causal manipulations to create, test, and refine models of cognition.
Extracellular Electron Transfer PowersEnterococcus faecalisBiofilm Metabolism
Authors: Keogh Damien , Lam Ling Ning , Doyle Lucinda E. , Matysik Artur , Pavagadhi Shruti , Umashankar Shivshankar , Dale Jennifer L. , Boothroyd Chris B. , Dunny Gary M. , Swarup Sanjay , Williams Rohan B. H. , Marsili Enrico , Kline Kimberly A.
Published: April 2017

Enterococci are important human commensals and significant opportunistic pathogens associated with endocarditis, urinary tract infections, wound and surgical site infections, and medical device associated infections. These infections often become chronic upon the formation of biofilm. The biofilm matrix establishes properties that distinguish this state from free-living bacterial cells and increase tolerance to antimicrobial interventions. The metabolic versatility of the Enterococci is reflected in the diversity and complexity of environments and communities in which they thrive. Understanding metabolic factors governing colonization and persistence in different host niches can reveal factors influencing the transition from commensal to opportunistic pathogen. Here, we report a new form of iron-dependent metabolism forEnterococcus faecaliswhere, in the absence of heme, respiration components can be utilised for extracellular electron transfer (EET). Iron augmentsE. faecalisbiofilm growth and generates alterations in biofilm matrix, cell spatial distribution, and biofilm matrix properties. We identify the genes involved in iron-augmented biofilm growth and show that it occurs by promoting EET to iron within biofilm.

Significance

Bacterial metabolic versatility is often key in dictating the outcome of host-pathogen interactions, yet determinants of metabolic shifts are difficult to resolve. The bacterial biofilm matrix provides the structural and functional support that distinguishes this state from free-living bacterial cells. Here, we show that the biofilm matrix provides access to resources necessary for metabolism and growth which are otherwise inaccessible in the planktonic state. Our data shows that in the absence of heme, components ofEnterococcus faecalisrespiration (l-lactate dehydrogenase and acetaldehyde dehydrogenase) may function as initiators of EET through the cytoplasmic membrane quinone pool and utilize matrix-associated iron to carry out EET. The presence of iron resources within the biofilm matrix leads to enhanced biofilm growth.
Dorsal anterior cingulate-midbrain ensemble as a reinforcement meta-learner
Authors: Silvetti Massimo , Vassena Eliana , Abrahamse Elger , Verguts Tom
Published: April 2017

The dorsal anterior cingulate cortex (dACC) is central in higher-order cognition and behavioural flexibility. The computational nature of this region, however, has remained elusive. Here we propose a new model – the Reinforcement Meta Learner (RML) – based on the bidirectional anatomical connections of the ACC with midbrain catecholamine nuclei (VTA and LC). In this circuit, dACC learns which actions are valuable and acts accordingly. Crucially, this mechanism is optimized by recurrent connectivity with the midbrain: Midbrain catecholamines provide modulatory signals to dACC, controlling its internal parameters (e.g. learning rate), while these parameter modulations are in turn optimized by dACC afferents to the midbrain. This closed-loop system generates emergent (i.e., homunculus-free) control and supports learning to solve hierarchical decision problems without having an intrinsic hierarchical structure itself. Further, it can be combined with other cortical modules to optimize the processing of these modules. We outline how the RML solves the current theoretical stalemate on dACC by assimilating various previous proposals on ACC functioning, and how it captures critical empirical findings from an unprecedented range of domains (stability/plasticity balance, effort processing, working memory, and higher-order classical and instrumental conditioning).
Modulation of Type IV pili phenotypic plasticity through a novel Chaperone-Usher system in Synechocystis sp.
Authors: Chandra Anchal , Joubert Lydia-Maria , Bhaya Devaki
Published: April 2017

Controlling the transition from a multicellular motile state to a sessile biofilm is an important eco-physiological decision for most prokaryotes, including cyanobacteria. Photosynthetic and bio geochemically significant cyanobacterium Synechocystis sp. PCC6803 (Syn6803) uses Type IV pili (TFP) for surface-associated motility and light-directed phototaxis. We report the identification of a novel Chaperone-Usher (CU) system in Syn6803 that regulate secretion of minor pilins as a means of stabilizing TFP morphology. These secreted minor-pilins aid in modifying TFP morphology to suit the adhesion state by forming cell to surface contacts when motility is not required. This morphotype is structurally distinct from TFP assembled during motile phase. We further demonstrate by examining mutants lacking either the CU system or the minor-pilins, which produce aberrant TFP, that are morphologically and functionally distinct from wild-type (WT). Thus, here we report that in Syn6803, CU system work independent of TFP biogenesis machinery unlike reported for other pathogenic bacterial systems and contributes to provide multifunctional plasticity to TFP. cAMP levels play an important role in controlling this switch. This phenotypic plasticity exhibited by the TFP, in response to cAMP levels would allow cells and cellular communities to adapt to rapidly fluctuating environments by dynamically transitioning between motile and sessile states.

Significance of this work

How cyanobacterial communities cope with fluctuating or extreme environments is crucial in understanding their role in global carbon and nitrogen cycles. This work addresses the key question: how do cyanobacteria modulate external appendages, called Type IV pili, to effectively switch between motile and sessile biofilm states? We demonstrate that cells transition between forming strong cell-surface interactions indispensable for biofilm formation to forming cell-cell interactions that allow for coordinated movement crucial for social motility by functional/ structural modification of same TFP appendage. The second messenger, cAMP and a Chaperone-Usher secretion are indispensible to achieve these structural modifications of TFP and control the complex phenotypic transition. We have uncovered a strategy that Syn6803 has evolved to deal with molecular decision-making under uncertainty, which we call phenotypic plasticity. Here we demonstrate how a single motility appendage can be structurally modified to attain two antagonistic functions in order to meet the fluctuating environmental demands.
Image Processing and Quality Control for the first 10,000 Brain Imaging Datasets from UK Biobank
Authors: Alfaro-Almagro Fidel , Jenkinson Mark , Bangerter Neal K. , Andersson Jesper L. R. , Griffanti Ludovica , Douaud Gwenaëlle , Sotiropoulos Stamatios N. , Jbabdi Saad , Hernandez-Fernandez Moises , Vallee Emmanuel , Vidaurre Diego , Webster Matthew , McCarthy Paul , Rorden Christopher , Daducci Alessandro , Alexander Daniel C. , Zhang Hui , Dragonu Iulius , Matthews Paul M. , Miller Karla L. , Smith Stephen M.
Published: April 2017

UK Biobank is a large-scale prospective epidemiological study with all data accessible to researchers worldwide. It is currently in the process of bringing back 100,000 of the original participants for brain, heart and body MRI, carotid ultrasound and low-dose bone/fat x-ray. The brain imaging component covers 6 modalities (T1, T2 FLAIR, susceptibility weighted MRI, Resting fMRI, Task fMRI and Diffusion MRI). Raw and processed data from the first 10,000 imaged subjects has recently been released for general research access. To help convert this data into useful summary information we have developed an automated processing and QC (Quality Control) pipeline that is available for use by other researchers. In this paper we describe the pipeline in detail, following a brief overview of UK Biobank brain imaging and the acquisition protocol. We also describe several quantitative investigations carried out as part of the development of both the imaging protocol and the processing pipeline.
Three isostructural solvates of a tetrahydrofurochromenone derivative
Authors: Sridhar Balasubramanian , Nanubolu Jagadeesh Babu , Ravikumar Krishnan , Karthik Govindaraju , Reddy Basi Venkata Subba
Published: April 2017

Isostructurality is more likely to occur in multicomponent systems. In this context, three closely related solvates were crystallized, namely, benzene (C27H21BrO6·C6H6), toluene (C27H21BrO6·C7H8) and xylene (C27H21BrO6·C8H10) with methyl 3a-acetyl-3-(4-bromophenyl)-4-oxo-1-phenyl-3,3a,4,9b-tetrahydro-1H-furo[3,4-c]chromene-1-carboxylate, and their crystal structures determined. All three structures belong to the same space group (P\overline{1}) and display similar unit-cell dimensions and conformations, as well as isostructural crystal packings. The isostructurality is confirmed by unit-cell and isostructural similarity indices. In each solvate, weak C—H...O and C—H...π interactions extend the molecules into two-dimensional networks, which are further linked by C—H...Br and Br...Br interactions into three-dimensional networks. The conformation of the core molecule is predominantly responsible for governing the isostructurality.
Crystal structure and photoluminescence properties of a new monomeric copper(II) complex: bis(3-{[(3-hydroxypropyl)imino]methyl}-4-nitrophenolato-κ3
O,N,O′)copper(II)
Authors: Kocak Cagdas , Oylumluoglu Gorkem , Donmez Adem , Coban M. Burak , Erkarslan Ugur , Aygun Muhittin , Kara Hulya
Published: April 2017

Copper(II)–Schiff base complexes have attracted extensive interest due to their structural, electronic, magnetic and luminescence properties. The title novel monomeric CuII complex, [Cu(C10H11N2O4)2], has been synthesized by the reaction of 3-{[(3-hydroxypropyl)imino]methyl}-4-nitrophenol (H2
L) and copper(II) acetate monohydrate in methanol, and was characterized by elemental analysis, UV and IR spectroscopies, single-crystal X-ray diffraction analysis and a photoluminescence study. The CuII atom is located on a centre of inversion and is coordinated by two imine N atoms, two phenoxy O atoms in a mutual trans disposition and two hydroxy O atoms in axial positions, forming an elongated octahedral geometry. In the crystal, intermolecular O—H...O hydrogen bonds link the molecules to form a one-dimensional chain structure and π–π contacts also connect the molecules to form a three-dimensional structure. The solid-state photoluminescence properties of the complex and free H2
L have been investigated at room temperature in the visible region. When the complex and H2
L are excited under UV light at 349 nm, the complex displays a strong green emission at 520 nm and H2
L displays a blue emission at 480 nm.
Outsourcing/offshoring insights: going beyond reshoring to rightshoring
Authors: Tate Wendy L. , Bals Lydia
Published: April 2017

Purpose

The last decades have seen manufacturing and services offshoring on the rise, often motivated by low prices and without consideration of other important criteria such as additional cost measures and risk. With wages in former low-cost countries and automation/robotization increasing, these decisions are increasingly contested. Re-evaluations of “shoring” decisions inherently create a need to re-examine theoretical and academic contributions to this rapidly changing phenomenon. Therefore, the special issue sought manuscripts that added to the exciting and dynamic body of knowledge on “rightshoring”. The paper aims to discuss this issue.

Design/methodology/approach

The paper starts out by delimiting outsourcing/insourcing and offshoring/reshoring as part of a conceptual “rightshoring” framework to establish a common terminology and context for the insights gathered in the special issue. It illustrates that “shoring” options can be classified along geographical and governance dimensions.

Findings

Both the geographical and governance dimensions are part of the rightshoring decision which is an important conceptual foundation for this special issue, as it invited insightful pieces on all of these phenomena (e.g. outsourcing, insourcing, offshoring, reshoring), acknowledging that these decisions are embedded in the same context – firms making governance and location decisions. Therefore, papers 1-4 primarily focus on offshoring, whereas paper 5 focuses on insourcing and paper 6 on reshoring. Their main findings are summarized in Table II.

Research limitations/implications

Suggestions for future research out of the six papers are summarized in Table III. There is ample opportunity to further shed light on these suggestions as well as to cover parts of the “rightshoring” framework presented, that remain less covered here (e.g. insourcing and/or reshoring).

Practical implications

The array of potential “rightshoring” options fosters clarity about the phenomena studied and their implications. The main practical implications of the six papers are summarized in Table II.

Originality/value

The overall conceptual framework highlights the positioning of the final papers included into the special issue and provides guidance to scholars and managers alike.
The nexus between health workers’ emotional intelligence and job performance
Authors: Asiamah Nestor
Published: April 2017

Purpose

This study aims to examine the effect of health workers’ emotional intelligence (EI) on job performance (JP), with potential confounding variables controlled for. The confounding variables introduced are gender, education, tenure and level of access to in-service training.

Design/methodology/approach

A cross-sectional quantitative research design was used in this study. A self-reported questionnaire was used to collect data from 1,163 health professionals, who were selected using the simple random sampling method. Confirmatory factor analysis (CFA) was used to test a framework of hypotheses.

Findings

The resulting CFA model is of a good fit at 5 per cent significance level [chi-square (χ2) = 1.492; p = 0.222]. Moreover, the study finds that EI significantly predicts JP among health workers after controlling for the lurking variables.

Originality/value

Though several studies have confirmed that EI makes a significant positive effect on health workers’ JP, none of them controlled for potential confounding variables. For this reason, the effect detected in previous studies could include the influence of lurking variables and is consequently spurious. Apart from contributing to extant literature, this study controls for these lurking variables in an attempt to enhance the value of empirical evidence that supports the relevance of EI to health-care performance.
Exploring the role of CSR as national responsibility
Authors: Al Yammahi Kamal , Guruswamy Mohan
Published: April 2017

Purpose

This paper aims to consolidate the constructs of national responsibility (NR) and corporate social responsibility (CSR) in the context of corporate responsibilities. The paper traces the historical evolution of the concepts of NR and CSR with a discussion on bridging CSR with NR. The aim of this paper is to develop an understanding of the potential of CSR to support NR.

Design/methodology/approach

This paper reviews the historical evolution of the CSR and NR concepts to identify how CSR can be integrated and focused towards supporting NR.

Findings

NR needs partnership and support from the corporate and commercial world to direct its efforts towards effective implementation of CSR to ensure NR.

Practical implications

The paper offers the implications for the development of a powerful CSR, its relation with NR and how the linkage should be developed at an organizational level.

Originality/value

This research paper fulfils the need to study the role of CSR in supporting the NR at a corporate level.
Low-intensity conflict in multinational corporations
Authors: Lauring Jakob , Andersen Poul Houman , Storgaard Marianne , Kragh Hanne
Published: April 2017

Purpose

This paper aims to identify antecedents for, and consequences of, low-intensity inter-unit conflict in multinational corporations (MNCs). Inter-unit conflict in MNCs is an important and well-researched theme. However, while most studies have focused on open conflict acknowledged by both parties, much less research has dealt with low-intensity conflicts. Still, low-intensity conflicts can be highly damaging – not least because they are rarely resolved.

Design/methodology/approach

The authors used a qualitative approach to understanding low-intensity conflict relying on 170 interviews in four Danish MNCs.

Findings

They describe consequences of low-intensity conflict and identify three types of actions by headquarters’ representatives that could lead to the development of low-intensity conflicts, namely, ignoring, bypassing and educating.

Originality/value

Very few studies have dealt with low-intensity conflict – not least in international business research. The authors argue that the study of low-intensity conflict in MNCs can provide relevant, novel knowledge of MNC functioning.