bluuebunny/crossref_metadata_2025 huggingface dataset:
Low‐voltage areas detected by high‐density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation
Authors: Vlachos Konstantinos , Efremidis Michael , Letsas Konstantinos P. , Bazoukis George , Martin Ruairidh , Kalafateli Maria , Lioni Louiza , Georgopoulos Stamatis , Saplaouras Athanasios , Efremidis Theodore , Liu Tong , Valkanas Kosmas , Karamichalakis Nikolaos , Asvestas Dimitrios , Sideris Antonios
Published: September 2017

Introduction

We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high‐resolution and high‐spatial sampling.

Methods and results

We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high‐density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients. Criteria for an adequate left atrium (LA) shell were > 2,000 points. Each acquired point was classified according to the peak‐to‐peak bipolar voltage electrogram based on two criteria (criterion A: healthy > 0.8 mV, border zone: 0.4–0.8 mV and scarred: < 0.4 mV, criterion Β: healthy: > 0.5 mV, border zone: 0.25–0.5 mV and scarred: < 0.25 mV). The extent of low‐voltage area < 0.4 mV significantly predicted atrial tachyarrhythmia recurrence after the blanking period (P = 0.002). In univariate analysis, the presence of LA voltage areas < 0.4 mV more than 10% of the total surface area was the only significant predictor of arrhythmia recurrence. The analysis based on window B cutoff values failed to demonstrate any predictors of arrhythmia recurrence.

Conclusion

These data demonstrate that the existence of LA voltage areas < 0.4 mV more than 10% of the total LA surface area predicts arrhythmia recurrence following PVAI for paroxysmal AF.
Insights into the genetic structure of the rabbitfish Chimaera monstrosa (Holocephali) across the Atlantic‐Mediterranean transition zone
Authors: Catarino D. , Stanković D. , Menezes G. , Stefanni S.
Published: September 2017

A comparison of the genetic structure of Chimaera monstrosa populations from the Atlantic Ocean and the Mediterranean Sea was carried out using mitochondrial DNA analysis. Results indicate high and significant pairwise ΦST values with no shared haplotypes between the two areas. Furthermore, migration rate estimates suggested absence of gene flow between the two basins. These findings, coupled with the species vertical distribution, suggest that the shallow depth of the Strait of Gibraltar may act as a barrier limiting the dispersal capabilities of these populations, which likely became separated at the end of the middle Pleistocene.
A multipathogen selective enrichment broth for simultaneous growth of Salmonella enteria, Escherichia coli O157:H7, and Shigella flexneri
Authors: Suo Yujuan , Gao Shigang , Xie Yanping , Liu Yanhong , Qu Yang , Lin Ting , Zhou Changyan
Published: September 2017

Salmonella, Shigella, and Escherichia coli O157:H7 contaminate similar types of food and cause foodborne disease. The objective of this study was to develop a selective enrichment broth for simultaneous enrichment of Salmonella Enteritidis, E. coli O157:H7, and Shigella flexneri (SES) using Bile salt No. 3, potassium tellurite, novobiocin sodium, and lithium chloride as selective agents. Developed SES broth not only enriched both of the target pathogens to as high as 9 log10 CFU/ml after 24 hr incubation at 37 °C with 10–100 CFU/ml of inoculation concentration, but also could successfully support the simultaneous enrichment of target pathogens with similar growth rates and inhibit the growth of most nontarget bacteria effectively. The enrichment effect of SES was confirmed by artificial contamination test coupled with multiplex PCR. In summary, SES has been shown to be a promising multiplex selective enrichment broth for the detection of the three pathogens on a single‐assay platform.

Practical applications

It is different from traditional microbiological enrichment broths used in detecting Salmonella Enteritidis, Escherichia coli O157:H7, and Shigella flexneri, which limit the application of multipathogen detection in a single‐assay format. SES can be considered as an effective multipathogen selective enrichment broth for simultaneous growth of S. Enteritidis, E. coli O157:H7, and S. flexneri, and inhibit most of other common pathogens. In addition, SES combined with multi‐PCR could be directly used for the detection of the three pathogens in meat, which solved issues of no suitable enrichment broth, ensured detection accuracy, and saved detection time and cost.
Muscle Ultrasound As a Link to Muscle Quality and Frailty in the Clinic
Authors: Bartley Jenna M. , Studenski Stephanie A.
Published: September 2017

This editorial comments on the article by Borras et al.
When a Sinner Does a Good Deed: The Path‐Dependence of Reputation Repair
Authors: Shu Haibing , Wong Sonia Man‐Lai
Published: September 2017

This study examines how shareholders will interpret a socially desirable action taken by firms with a damaged corporate reputation status. We first explain theoretically why shareholders’ path‐dependent judgments of a tainted firm increase the likelihood of shareholders making less favourable judgments of the firm's socially desirable actions. We then test the theoretical predictions using a sample of Chinese listed firms that were sanctioned for securities fraud and subsequently made donations to the 2008 Sichuan earthquake relief funds. We find that the shareholders evaluate the donations made by fraud‐tainted firms less favourably than those made by firms that have not been sanctioned for fraud. Furthermore, the shareholders’ evaluations of the donations made by fraud‐tainted firms is less favourable if the firms have committed more serious fraud and undertaken fewer positive remedial actions in the post‐fraud period. Overall, our evidence demonstrates that shareholders’ path‐dependent judgments of fraud‐tainted firms constitute a major obstacle that constrains the effectiveness of reputation repair.
Under‐diagnosed chronic kidney disease in Jordanian adults: prevalence and correlates
Authors: Khalil Amani A. , Abed Mona A. , Ahmad Muayyad , Mansour Ayman Hamdan
Published: September 2017

Background

Jordan has no relevant database or registry by which chronic kidney disease (CKD) would be early identified. The purpose of the present study is to uncover the prevalence of CKD in a national sample of Jordanian patients at high risk and examine the association of CKD with demographic and clinical factors.

Methods

This is a cross‐sectional, correlational study that involved 540 outpatients at high risk for CKD. Demographic and clinical data were obtained in the period from September 2013 to March 2014. Prevalence of CKD was defined based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative Classification of CKD using estimated glomerular filtration rate. Associations of CKD and demographic and clinical factors were examined using bivariate analysis.

Results

The majority of the sample were females (64%), their mean age (±SD) was 55.0 ± 12.5 years, their mean eGFR (±SD) was 116.0 ± 47.5. One third of patients had eGFR of 23.5%, 5.4%, 0.7% and 0.7% which corresponds with mild, moderate, severe and very severe reduction in eGFR, respectively. Ageing, being male, unemployment, packs/years of smoking, co‐morbidities [hypertension (HTN), diabetes mellitus (DM) and cardiovascular disease] and low high density lipoprotein (HDL) correlated positively with development of CKD.

Conclusion

This study demonstrates a high rate of under‐diagnosed CKD among Jordanians. Several demographic and clinical factors are linked with the development of CKD. Policymakers and healthcare providers need to establish an evidence‐based practice project to prevent and screen for CKD in Jordan.
Does transparency reduce political corruption?
Authors: Strîmbu Octavian , González Patrick
Published: September 2017

Does a better monitoring of officials' actions (transparency) lower the incidence of corruption? Using a common agency game with imperfect information, we show that the answer depends on the measure of corruption that one uses. More transparency lowers the prevalence of corruption but raises the average bribe as it motivates the corruptor to bid more aggressively for the agent's favor. We show that transparency affects the prevalence of corruption at the margin through a competitive effect and an efficiency effect.
The effect of marine and Aral Sea water on the salinity tolerance of three Paramecium species (Ciliophora)
Authors: Smurov Alexey O. , Aladin Nikolai V. , Keyser Dietmar
Published: September 2017

The shift of salinity tolerant ranges in three species of ciliates Paramecium caudatum, P. primaurelia and P. jenningsi was studied in waters containing a composition of salts resembling those in the Aral Sea, in comparison with composition of salts in marine waters. The results indicate that the salt values of tolerant ranges are increasing in water with the Aral Sea composition. The ratio among values of tolerant ranges is described by a linear function. A similar ratio connecting the same tolerant ranges exists in ciliates, but leads to reliable values of tolerant ranges when expressed in terms of chlorine concentration. Thus, the connection between the tolerances of aquatic organisms obtained for water of marine composition and water of continental composition might be described by the equation , where Sm = tolerance of organisms in marine water, whereas Sk = tolerance of organisms in continental saline water. The term α indicates the portion of chlorine ion continental saline water, while β indicates the portion in marine water.
A randomized double‐blind placebo‐controlled crossover‐style trial of buspirone in functional dysphagia and ineffective esophageal motility
Authors: Aggarwal Nitin , Thota Prashanthi Nagavenkata , Lopez Rocio , Gabbard Scott
Published: September 2017

Background

Studies suggest that Ineffective Esophageal Motility (IEM) is the manometric correlate of Functional Dysphagia (FD). Currently, there is no accepted therapy for either condition. Buspirone is a serotonin modulating medication and has been shown to augment esophageal peristaltic amplitude in healthy volunteers. We aimed to determine if buspirone improves manometric parameters and symptoms in patients with overlapping IEM/FD.

Methods

We performed a prospective, double‐blind, placebo‐controlled, crossover‐style trial of 10 patients with IEM/FD. The study consisted of two 2‐week treatment arms with a 2‐week washout period. Outcomes measured at baseline, end of week 2, and week 6 include high resolution esophageal manometry (HREM), the Mayo Dysphagia Questionnaire‐14 (MDQ‐14), and the GERD‐HRQL.

Results

The mean age of our 10 patients was 53 ± 9 years and 70% were female. After treatment with buspirone, 30% of patients had normalization of IEM on manometry; however, there was 30% normalization in the placebo group as well. Comparing buspirone to placebo, there was no statistically significant difference in the HREM parameters measured. There was also no statistically significant difference in symptom outcomes for buspirone compared to placebo. Of note, patients had a statistically significant decrease in the total GERD‐HRQL total score when treated with placebo compared to baseline levels.

Discussion

Despite previous data demonstrating improved esophageal motility in healthy volunteers, our study shows no difference in terms of HREM parameters or symptom scores in IEM/FD patients treated with buspirone compared to placebo. Further research is necessary to identify novel agents for this condition.
Endoluminal weight loss and metabolic therapies: current and future techniques
Authors: Hill Christine , Khashab Mouen A. , Kalloo Anthony N. , Kumbhari Vivek
Published: September 2017

Obesity is a public health epidemic associated with a number of comorbidities, most notably type 2 diabetes and hypertension, as well as elevated all‐cause mortality. The treatment for obesity and its associated comorbidities has most recently expanded into the field of bariatric endoscopy. This field bridges a gap between lifestyle counseling with or without pharmaceutical treatment and the most effective treatment of obesity, bariatric surgery. Because of its minimally invasive nature, bariatric endoscopic therapy has the potential to appeal to the large sector of the obese population that resists surgery, as well as those early in the onset of obesity. To date, five endoscopic devices have been approved by the U.S. Food and Drug Administration for the treatment of obesity, and many more are in development, undergoing clinical trials, or being used around the world. Here, we present the current state of the field, highlight recent developments, and describe the clinical outcomes of these minimally invasive procedures in terms of weight loss, improvement in metabolic profile, and reduction in comorbidities.
Severe Mucha–Habermann‐Like Ulceronecrotic Skin Disease in T‐Cell Acute Lymphoblastic Leukemia Responsive to Basiliximab and Stem Cell Transplant
Authors: Orenstein Lauren A.V. , Coughlin Carrie. C. , Flynn Andrea T. , Pillai Vinodh , Boos Markus D. , Wertheim Gerald B. , Treat James R. , Teachey David T.
Published: September 2017

A 5‐year‐old girl with T‐cell acute lymphoblastic leukemia (T‐ALL) developed a progressive eruption of crusted papules and ulcerative plaques involving 80% of her body surface area with histopathology consistent with febrile ulceronecrotic Mucha–Habermann disease (FUMHD), although multiple specimens also contained clonal leukemic cells. Her skin disease was refractory to many classic treatments for FUMHD, including methotrexate, and became so severe that concern about superinfection prevented intensification of chemotherapy for her malignancy. The addition of basiliximab promoted gradual improvement of the skin, allowing for chemotherapy intensification and subsequent bone marrow transplantation, after which the eruption resolved completely. This report describes a severe case of FUMHD‐like eruption associated with clonal leukemic cells that improved with basiliximab, suggesting anti‐CD25 therapy as a novel treatment for ulceronecrotic skin disease in the setting of high interleukin‐2 levels.
Contracts to Promote Optimal Use of Optional Diagnostic Tests in Cancer Treatment
Authors: Ghamat Salar , Zaric Gregory S. , Pun Hubert
Published: September 2017

In this study, we examine performance‐based payment contracts to promote the optimal use of an optional diagnostic test for newly diagnosed cancer patients. Our work is inspired by three trends: tremendous increases in the cost of new, advanced cancer drugs; development of new diagnostic tests to allow physicians to tailor treatment to patients; and changes in healthcare funding models that reward quality care. We model the interaction between two parties—a healthcare payer and an oncologist, in which the oncologist has private information about patients’ characteristics (adverse selection) and the payer does not know whether the oncologist takes the optimal course of action (moral hazard). We show that, in the presence of information asymmetry, a healthcare payer should never incentivize an oncologist to use a diagnostic test for all patients, even if the diagnostic test is available for free. Moreover, although the oncologist has additional information about a patient's risk, he cannot always benefit from this private information. We also find that social welfare may not increase as a result of a decrease in the oncologist's concerns regarding the health outcome of patients. Finally, we show that it is not always socially optimal to make a diagnostic test compulsory even if such a policy can be implemented for free.
External liabilities, domestic institutions and banking crises in developing economies
Authors: Boukef Jlassi Nabila , Hamdi Helmi , Joyce Joseph P.
Published: September 2017

We investigate the impact of foreign equity and debt on the occurrence of banking crises in 61 lower income and middle income economies during the 1984 to 2010 period. We also focus on the effects of domestic institutions on banking crises and whether they mitigate or exacerbate the impact of the external liabilities. We find that FDI liabilities lower the probability of a crisis, while debt liabilities increase their incidence. However, institutions that lower financial or political risk partially offset the impact of debt liabilities, as does government stability. A decrease in investment risk directly reduces the incidence of banking crises.
Coping with Institutional Fragmentation? Competition and Convergence between Boundary Organizations in the Global Response to Polio
Authors: Holzscheiter Anna
Published: September 2017

This paper discusses competition and cooperation between boundary organizations (BOs) in the field of global health. It embeds its analysis of BOs in health in contemporary theories on institutional fragmentation and governance complexity, arguing that BOs in international politics have been a major driving force behind an often mind‐boggling complexity of actors, institutions, and rule systems relevant to many contemporary international issues or “regimes.” The paper argues that growing complexity of global governance structures generates new demands for BOs with regard to how they manage their interactions with other BOs. Accordingly, the framework suggested in this paper builds on a set of hypotheses that do not isolate factors at structural and agent level but rather capture the interplay of BOs and their organizational environment. The paper's empirical analysis investigates two BOs, the Global Polio Eradication Initiative and GAVI, the Vaccine Alliance, working in the field of polio eradication.
Characterization of the novel HLA‐A*02:07:10 allele by sequencing‐based typing
Authors: Zhang L.‐Q. , Zhou X.‐Y. , Xiao Y. , Cai J.‐P.
Published: September 2017

HLA‐A*02:07:10 differs from HLA‐A*02:07:01 by one nucleotide substitution at position 117.
Identification of HLA‐B*58:01:21, a novel allele in a Korean individual
Authors: Lee J. H. , Choi H.‐J. , Kim S.‐H. , Shin M.‐G.
Published: September 2017

B*58:01:21 has a single nucleotide change, c.264A>G (ACA→ACG at codon 88) compared with B*58:01:01:01.
Characterization of the novel HLA‐DRB1*13:241 allele by sequencing‐based typing
Authors: Zhang L.‐Q. , Zhou X.‐Y. , Xiao Y. , Cai J.‐P.
Published: September 2017

HLA‐DRB1*13:241 differs from HLA‐DRB1*13:02:01 by one nucleotide substitution at position 335.
Cartografías de migración y desarraigo. Percepciones de una casa fantasma a través de la expresión artística.
Authors: Alfaro Buitrago Estefany
Published: September 2017

El presente artículo es producto de un proyecto de investigación-creación, que tuvo como propósito la indagación por la construcción de la noción de hogar partiendo de la experiencia vivida por mi familia materna en la vereda de Santa Helena y el municipio de Anzoátegui en el Tolima, en el período conocido como La Violencia. La investigación tuvo como eje central las memorias familiares, testimonios que daban cuenta de las consecuencias que conllevaba el abandono del territorio a causa de la guerra, entre ellas la pérdida del arraigo. A partir de estos relatos, se llevó a cabo una exploración plástica que se planteó como proceso de pensamiento que permitió entender cómo se daba la configuración del hogar en medio de la guerra, las tensiones existentes en las dinámicas de formación de los límites del territorio, y el desarraigo consecuencia de la imposibilidad de mantener esos límites.
La crisis del sistema de salud colombiano: una aproximación desde la legitimidad y la regulación
Authors: Suárez-Rozo Luisa Fernanda , Puerto-García Stephanie , Rodríguez-Moreno Lina María , Ramírez-Moreno Jaime
Published: September 2017

El objetivo fue determinar cuáles son las percepciones de distintos actores del sistema de salud colombiano sobre los problemas del sistema que están detrás de la crisis. Se realizó un estudio cualitativo a partir de entrevistas semiestructuradas y en profundidad con cuarenta agentes del sector salud, en Bogotá, Cali, Ibagué, Espinal y Calima-Darién. Los resultados mostraron que la corrupción, el incumplimiento de normas y los conflictos entre los intereses de diversos actores del sistema debilitan la legitimidad de este último, atomizan la cooperación y cohesión de los actores y fortalecen el interés particular. La polución normativa, la inconsistencia temporal de las normas y la información incompleta generan incertidumbre, confusión y desintegración en el interior del sistema, con lo cual contribuyen al desenvolvimiento de una crisis regulatoria con respecto a la cual se hace urgente recuperar espacios de toma de decisiones colectivas y concertadas que promuevan el diálogo y la superación de los intereses rentistas individualistas.
Stress Analysis-Driven Design of Bilayered Scaffolds for Tissue-Engineered Vascular Grafts
Authors: Szafron Jason M. , Breuer Christopher K. , Wang Yadong , Humphrey Jay D.
Published: September 2017

Continuing advances in the fabrication of scaffolds for tissue-engineered vascular grafts (TEVGs) are greatly expanding the scope of potential designs. Increasing recognition of the importance of local biomechanical cues for cell-mediated neotissue formation, neovessel growth, and subsequent remodeling is similarly influencing the design process. This study examines directly the potential effects of different combinations of key geometric and material properties of polymeric scaffolds on the initial mechanical state of an implanted graft into which cells are seeded or migrate. Toward this end, we developed a bilayered computational model that accounts for layer-specific thickness and stiffness as well as the potential to be residually stressed during fabrication or to swell during implantation. We found that, for realistic ranges of parameter values, the circumferential stress that would be presented to seeded or infiltrating cells is typically much lower than ideal, often by an order of magnitude. Indeed, accounting for layer-specific intrinsic swelling resulting from hydrophilicity or residual stresses not relieved via annealing revealed potentially large compressive stresses, which could lead to unintended cell phenotypes and associated maladaptive growth or, in extreme cases, graft failure. Metrics of global hemodynamics were also found to be inversely related to markers of a favorable local mechanobiological environment, suggesting a tradeoff in designs that seek mechanical homeostasis at a single scale. These findings highlight the importance of the initial mechanical state in tissue engineering scaffold design and the utility of computational modeling in reducing the experimental search space for future graft development and testing.
Transient Thermal Modeling of Ball Bearing Using Finite Element Method
Authors: Sibilli Thierry , Igie Uyioghosa
Published: September 2017

Gas turbines are fitted with rolling element bearings, which transfer loads and supports the shafts. The interaction between the rotating and stationary parts in the bearing causes a conversion of some of the power into heat, influencing the thermal behavior of the entire bearing chamber. To improve thermal modeling of bearing chambers, this work focused on modeling of the heat generated and dissipated around the bearings, in terms of magnitude and location, and the interaction with the components/systems in the bearing chamber. A thermal network (TN) model and a finite element (FE) model of an experimental high-pressure shaft ball bearing and housing were generated and a comparison to test rig results have been conducted. Nevertheless, the purpose of the thermal matching process that focused on the FE model and experimental data is to provide a template for predicting temperatures and heat transfers for other bearing models. The result of the analysis shows that the predictions of the TN are considerate, despite the simplifications. However, lower relative errors were obtained in the FE model compared to the TN model. For both methods, the highest relative error is seen to occur during transient (acceleration and deceleration). This observation highlights the importance of boundary conditions and definitions: surrounding temperatures, heat split and the oil flow, influencing both the heat transfer and heat generation. These aspects, incorporated in the modeling and benchmarked with experimental data, can help facilitate other related cases where there is limited or no experimental data for validation.
New Methodology for the Identification of the Leakage Paths and Guidelines for the Design of Common Rail Injectors With Reduced Leakage
Authors: Ferrari A. , Mittica A. , Pizzo P. , Wu X. , Zhou H.
Published: September 2017

The static leakage of a common rail (CR) injector is the flow-rate that is recirculated from the injector when the pilot-stage is not actuated. It is a critical issue in the development of modern CR injectors, because it can limit the maximum rail pressure level. An experimental methodology for splitting the static leakage between the contributions that pertain to the different leakage paths has been developed and applied to an innovative solenoid injector for the Brazilian, Russian, Indian, and Chinese (BRIC) market. The weak point of this injector was the excessively high static leakage compared to solenoid injectors for the European and U.S. markets. The static leakage splitting procedure allowed the sources of this leakage to be determined and a newly designed prototype was manufactured on the basis of the outcomes of this analysis. The new prototype featured a significant reduction (up to 54%) in the static leakage, compared to the original injector, and its leakage performance was almost the same as the typical one of Euro 5 solenoid injectors. Finally, a finite element method (FEM) analysis has been carried out on the improved BRIC injector. Guidelines are provided for a more refined design of some critical pieces of the component internal layout in order to further reduce its static leakage.
Hot embossing of Au- and Pb-based alloys for x-ray grating fabrication
Authors: Romano Lucia , Vila-Comamala Joan , Schift Helmut , Stampanoni Marco , Jefimovs Konstantins
Published: September 2017

Grating-based X-ray phase-contrast interferometry has a high application impact in materials science and medicine for imaging of weakly absorbing (low Z) materials and soft tissues. For absorbing gratings, casting of highly X-ray absorbing metals, such as Au and Pb alloys, has proven to be a viable way to generate large area periodic high aspect ratio microstructures. In this paper, the authors review the grating fabrication strategy with a special focus on a novel approach of casting low temperature melting alloys (Au-Sn and Pb-based alloys) into Si grating templates using hot embossing. This process, similar to nanoimprint lithography, requires particular adjusting efforts of process parameters as a function of the metal alloy and the grating feature size. The transition between the solid and liquid state depends on the alloy phase diagram, the applied pressure can damage the high aspect ratio Si lamellas, and the microstructure of the solid metal can affect the grating structure. The authors demonstrate that metal casting by hot embossing can be used to fabricate gratings on a large area (up to 70 × 70 mm2) with an aspect ratio of up to 50:1 and a pitch in the range of 1–20 μm.
Minimizing open-loop piezoactuator nonlinearity artifacts in atomic force microscope measurements
Authors: Yen Chi-Fu , Sivasankar Sanjeevi
Published: September 2017

Atomic force microscopes (AFMs) are widely used to study molecular interactions with piconewton force sensitivity. In an AFM, interaction forces are measured by reflecting a laser beam off a cantilever onto a position sensitive detector and monitoring cantilever deflection. Precise measurements of interaction forces rely on accurately determining the optical lever sensitivity, i.e., the relationship between cantilever deflection and changes in detector voltage. The optical lever sensitivity is measured by pressing the cantilever against a hard substrate using a piezoactuator and recording the resulting change in detector voltage. However, nonlinearities in the motion of commonly used open-loop piezo actuators introduce significant errors in measured optical lever sensitivities. Here, the authors systematically characterize the effect of piezo actuator hysteresis and creep on errors in optical lever sensitivity and identify measurement conditions that minimize these errors.
Dopamine oxidation mediates mitochondrial and lysosomal dysfunction in Parkinson’s disease
Authors: Burbulla Lena F. , Song Pingping , Mazzulli Joseph R. , Zampese Enrico , Wong Yvette C. , Jeon Sohee , Santos David P. , Blanz Judith , Obermaier Carolin D. , Strojny Chelsee , Savas Jeffrey N. , Kiskinis Evangelos , Zhuang Xiaoxi , Krüger Rejko , Surmeier D. James , Krainc Dimitri
Published: September 2017

Human-derived neurons provide the answers

Pathways involved in energy metabolism and removal of cellular debris by lysosomes play an important role in protecting our brain from degeneration in Parkinson's disease. Burbulla
et al.
identified a toxic cascade of mitochondrial and lysosomal dysfunction in human neurons derived from patients with Parkinson's. The dysfunction was mediated by accumulation of oxidized dopamine and α-synuclein, but it was not found in Parkinson's mouse models, owing to species-specific differences in dopamine metabolism. Inherent species-specific differences between human and mouse neurons emphasize the value of studying human neurons to identify relevant targets for treatment of Parkinson's disease and related synucleinopathies.

Science
, this issue p.
1255
The condensin complex is a mechanochemical motor that translocates along DNA
Authors: Terakawa Tsuyoshi , Bisht Shveta , Eeftens Jorine M. , Dekker Cees , Haering Christian H. , Greene Eric C.
Published: September 2017

Condensin is a highly processive DNA motor

Condensin is thought to regulate genome architecture by creating DNA loops. Terakawa
et al.
used single-molecule imaging to show that yeast condensin is a highly processive mechanochemical motor capable of translocating along DNA (see the Perspective by Nasmyth). Their findings elucidate how the rapid ATP hydrolysis–dependent motor activity of condensin provides the driving forces necessary to support three-dimensional chromosome organization and compaction through a loop extrusion mechanism.

Science
, this issue p.
672
; see also p.
589
Fibril structure of amyloid-β(1–42) by cryo–electron microscopy
Authors: Gremer Lothar , Schölzel Daniel , Schenk Carla , Reinartz Elke , Labahn Jörg , Ravelli Raimond B. G. , Tusche Markus , Lopez-Iglesias Carmen , Hoyer Wolfgang , Heise Henrike , Willbold Dieter , Schröder Gunnar F.
Published: September 2017

Elucidating pathological fibril structure

Amyloid-β (Aβ) is a key pathological contributor to Alzheimer's disease. Gremer
et al.
used cryoelectron microscopy data to build a high-quality de novo atomic model of Aβ fibrils (see the Perspective by Pospich and Raunser). The complete structure reveals all 42 amino acids (including the entire N terminus) and provides a structural basis for understanding the effect of several disease-causing and disease-preventing mutations. The fibril consists of two intertwined protofilaments with an unexpected dimer interface that is different from those proposed previously. The structure has implications for the mechanism of fibril growth and will be an important stepping stone to rational drug design.

Science
, this issue p.
116
; see also p.
45
Genome Sequences of a Novel Picorna-Like Virus from Pacific Abalone (
Haliotis discus hannai
) in South Korea
Authors: Kim Jong-Oh , Lee Jong Kyu , Seo Yong Bae , Lim Han-Kyu , Kim Gun-Do
Published: September 2017

We report the draft genome sequences of a novel member of the
Picornavirales
isolated from Pacific abalone (
Haliotis discus hannai
). The full length of the assembled draft genome sequences, obtained by use of a next-generation sequencing technique, were 8,019 nucleotides, including an RNA-dependent RNA polymerase gene (5,088 nucleotides) and a capsid protein gene (2,553 nucleotides). This genome sequence will be useful for understanding viral disease of Pacific abalone.
Draft Genome Sequence of
Zobellia
sp. Strain OII3, Isolated from the Coastal Zone of the Baltic Sea
Authors: Harms Henrik , Poehlein Anja , Thürmer Andrea , König Gabriele M. , Schäberle Till F.
Published: September 2017

Zobellia
sp. strain OII3 was isolated from a marine environmental sample due to its heterotrophic lifestyle, i.e., using
Escherichia coli
cells as prey. It shows strong agar-lytic activity. The genome was assembled into 41 contigs with a total size of 5.4 Mb, revealing the genetic basis for natural product biosynthesis.
Survival of very preterm infants admitted to neonatal care in England 2008–2014: time trends and regional variation
Authors: Santhakumaran Shalini , Statnikov Yevgeniy , Gray Daniel , Battersby Cheryl , Ashby Deborah , Modi Neena
Published: September 2017

Objective

To analyse survival trends and regional variation for very preterm infants admitted to neonatal care.

Setting

All neonatal units in England.

Patients

Infants born at 22+0–31+6 weeks+daysgestational age (GA) over 2008–2014 and admitted to neonatal care; published data for admitted infants 22+0–25+6 weeks+days GA in 1995 and 2006, and for live births at 22+0–31+6 weeks+days GA in 2013.

Methods

We obtained data from the National Neonatal Research Database. We used logistic regression to model survival probability with birth weight, GA, sex, antenatal steroid exposure and multiple birth included in the risk adjustment model and calculated annualpercentage change (APC) for trends using joinpoint regression. We evaluated survival over a 20-year period for infants <26 weeks’ GA using additional published data from the EPICure studies.

Results

We identified 50 112 eligible infants. There was an increase in survival over 2008–2014 (2008: 88.0%; 2014: 91.3%; adjusted APC 0.46% (95% CI 0.30 to 0.62) p<0.001). The greatest improvement was at 22+0–23+6 weeks (APC 6.03% (95% CI 2.47 to 3.53) p=0.002). Improvement largely occurred in London and South of England (APC: London 1.26% (95% CI 0.60 to 1.96); South of England 1.09% (95% CI 0.36 to 1.82); Midlands and East of England 0.15% (95% CI −0.56 to 0.86); and North of England 0.26% (95% CI −0.54 to 1.07)). Survival at the earliest gestations improved at a similar rate over 1995–2014 (22+0–25+6 weeks, APC 2.73% (95% CI 2.35 to 3.12), p value for change=0.25).

Conclusions

Continued national improvement in the survival of very preterm admissions masks important regional variation. Timely assessment of preterm survival is feasible using electronic records.
Modelling historical changes in the force-of-infection of Chagas disease to inform control and elimination programmes: application in Colombia
Authors: Cucunubá Zulma M , Nouvellet Pierre , Conteh Lesong , Vera Mauricio Javier , Angulo Victor Manuel , Dib Juan Carlos , Parra -Henao Gabriel Jaime , Basáñez María Gloria
Published: September 2017

Background

WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliaryTrypanosoma cruzitransmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.

Methods

Focusing on Colombia, all the available age-structured serological surveys (undertaken between 1995 and 2014) were searched and compiled. A total of 109 serosurveys were found, comprising 83 742 individuals from rural (indigenous and non-indigenous) and urban settings in 14 (out of 32) administrative units (departments). Estimates of the force-of-infection (FoI) were obtained by fitting and comparing three catalytic models using Bayesian methods to reconstruct temporal and spatial patterns over the course of three decades (between 1984 and 2014).

Results

Significant downward changes in the FoI were identified over the course of the three decades, and in some specific locations the predicted current seroprevalence in children aged 0–5 years is <1%. However, pronounced heterogeneity exists within departments, especially between indigenous, rural and urban settings, with the former exhibiting the highest FoI (up to 66 new infections/1000 people susceptible/year). The FoI in most of the indigenous settings remain unchanged during the three decades investigated. Current prevalence in adults in these 15 departments varies between 10% and 90% depending on the dynamics of historical exposure.

Conclusions

Assessing progress towards the control of Chagas disease requires quantifying the impact of historical exposure on current age-specific prevalence at subnational level. In Colombia, despite the evident progress, there is a marked heterogeneity indicating that in some areas the vector control interventions have not been effective, hindering the possibility of achieving interruption by 2020. A substantial burden of chronic cases remains even in locations where serological criteria for transmission interruption may have been achieved, therefore still demanding diagnosis and treatment interventions.
Effect of time and day of admission on hospital care quality for patients with chronic obstructive pulmonary disease exacerbation in England and Wales: single cohort study
Authors: Roberts Christopher Michael , Lowe Derek , Skipper Emma , Steiner Michael C , Jones Rupert , Gelder Colin , Hurst John R , Lowrey Gillian E , Thompson Catherine , Stone Robert A
Published: September 2017

Objective

To evaluate if observed increased weekend mortality was associated with poorer quality of care for patients admitted to hospital with chronic obstructive pulmonary disease (COPD) exacerbation.

Design

Prospective case ascertainment cohort study.

Setting

199 acute hospitals in England and Wales, UK.

Participants

Consecutive COPD admissions, excluding subsequent readmissions, from 1 February to 30 April 2014 of whom 13 414 cases were entered into the study.

Main outcomes

Process of care mapped to the National Institute for Health and Care Excellence clinical quality standards, access to specialist respiratory teams and facilities, mortality and length of stay, related to time and day of the week of admission.

Results

Mortality was higher for weekend admissions (unadjusted OR 1.20, 95% CI 1.00 to 1.43), and for case-mix adjusted weekend mortality when calculated for admissions Friday morning through to Monday night (adjusted OR 1.19, 95% CI 1.00 to 1.43). Median time to death was 6 days. Some clinical processes were poorer on Mondays and during normal working hours but not weekends or out of hours. Specialist respiratory care was less available and less prompt for Friday and Saturday admissions. Admission to a specialist ward or high dependency unit was less likely on a Saturday or Sunday.

Conclusions

Increased mortality observed in weekend admissions is not easily explained by deficiencies in early clinical guideline care. Further study of out-of-hospital factors, specialty care and deaths later in the admission are required if effective interventions are to be made to reduce variation by day of the week of admission.
Predictors of HIV virological failure and drug resistance in Chinese patients after 48 months of antiretroviral treatment, 2008–2012: a prospective cohort study
Authors: Kan Wei , Teng Tao , Liang Shujia , Ma Yanling , Tang Heng , Zuohela Tuerdi , Sun Guoqing , He Cui , Wall Kristin M , Marconi Vincent C , Liao Lingjie , Leng Xuebing , Liu Pengtao , Ruan Yuhua , Xing Hui , Shao Yiming
Published: September 2017

Objective

To explore factors associated with HIV virological failure (VF) and HIV drug resistance (HIVDR) among HIV-positive Chinese individuals 4 years after initiating first-line lamivudine-based antiretroviral treatment (ART) in 2008 at five sentinel sites.

Design

First-line ART initiators who were previously treatment naïve were selected using consecutive ID numbers from the 2008 National Surveillance Database into a prospective cohort study. Questionnaires and blood samples were collected in 2011 and 2012 to assess the outcomes of interest: VF (defined as viral load ≥1000 copies/mL) and HIVDR (defined as VF with genetic drug-resistant mutations). Questionnaires and data from National Surveillance Database assessed demographics and drug adherence data.

Results

536 individuals with HIV were analysed; the 4-year risk of VF was 63 (11.8%) and HIVDR was 27 (5.0%). Female participants initiating stavudine (D4T)-based regimens were more susceptible to both VF (adjusted OR (aOR)=2.5, 95% CI 1 to 6.1, p=0.04) and HIVDR (aOR=3.6, 95% CI 1 to 12.6, p=0.05) versus zidovudine-based regimens. Male participants missing doses in past month were more susceptible to both VF (aOR=2.8, 95% CI 1.1 to 7, p=0.03) and HIVDR (aOR=9.7, 95% CI 2.1 to 44.1, p<0.01). Participants of non-Han nationality were of increased risk for HIVDR (aOR from 4.8 to 12.2, p<0.05) and non-Han men were at increased risk for VF (aOR=2.9, 95% CI 1.1 to 7.3, p=0.02). All 27 participants detected with HIVDR had non-nucleoside reverse-transcriptase inhibitor mutations, 21 (77.8%) also had nucleoside reverse-transcriptase inhibitor mutations, and no protease inhibitor mutations were detected.

Conclusions

Our findings suggest successful treatment outcomes at 4 years for roughly 90% of patients. We suggest conducting further study on whether and when to change ART regimen for women initiated with D4T-based regimen, and reinforcing adherence counselling for men. Increased VF and HIVDR risk among non-Han minorities warrants further exploration, and ethnic minorities may be an important group to tailor adherence-focused interventions.
What is the test-retest reliability of the Malay version of the Hypertension Self-Care Profile self efficacy assessment tool? A validation study in primary care
Authors: Seow Kai Cong , Mohamed Yusoff Diana , Koh Yi Ling Eileen , Tan Ngiap Chuan
Published: September 2017

Objectives

Self-efficacy and self-care measures are key attributes to optimal control of essential hypertension. Self-efficacy can be measured by the Hypertension Self-Care Profile (HTN-SCP) tool but its utility is dependent on the literacy and understanding of the subjects. A Malay version of the HTN-SCP Tool was developed to assess self-efficacy of Malay-literate patients with hypertension in the multi-ethnic Asian population in Singapore. The study aimed to determine the test-retest reliability of this tool which has been translated in Malay language.

Methods and Material

145 Malay-literate patients, aged 41-70 years, with essential hypertension were recruited in a polyclinic (primary care clinic) in Singapore. Forty-three percent of them completed both the first and second HTN SCP tool online, with a period of two weeks in between. The Cronbach’s alpha and Intra-class correlation coefficient (ICC) were computed to assess its test-retest reliability and internal consistency.

Results

The Cronbach’s alpha/ICC for “Behavior” (0.851/0.664)), “Motivation” (0.928/0.655) and “Self-efficacy” (0.945/0.682) domains showed high internal consistency, fair to good reliability and stability. No floor or ceiling effect was found for the "behavior" and "motivation" domains. However, the borderline ceiling effect (15.2) for "self-efficacy" suggested limited discriminating power of the tool for patients with high self-efficacy. Positive association was shown between the HTN-SCP score and reported self-care measures but it was not statistically significant.

Conclusion

Overall, the translated HTN-SCP tool showed satisfactory test-retest reliability and internal consistency amongst the Malay-literate study population. Further research is needed for its application in general practice to identify patients with low self-efficacy for possible intervention.
Effects of cerebral near-infrared spectroscopy on the outcome of patients undergoing cardiac surgery: a systematic review of randomised trials
Authors: Serraino Giuseppe Filiberto , Murphy Gavin J
Published: September 2017

Objectives

Goal-directed optimisation of cerebral oxygenation using near-infrared spectroscopy (NIRS) during cardiopulmonary bypass is widely used. We tested the hypotheses that the use of NIRS cerebral oximetry results in reductions in cerebral injury (neurocognitive function, serum biomarkers), injury to other organs including the heart and brain, transfusion rates, mortality and resource use.

Design

Systematic review and meta-analysis.

Setting

Tertiary cardiac surgery centres in North America, Europe and Asia.

Participants

A search of Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature Plus from inception to November 2016 identified 10 randomised trials, enrolling a total of 1466 patients, all in adult cardiac surgery.

Interventions

NIRS-based algorithms designed to optimise cerebral oxygenation versus standard care (non-NIRS-based) protocols in cardiac surgery patients during cardiopulmonary bypass.

Outcome measures

Mortality, organ injury affecting the brain, heart and kidneys, red cell transfusion and resource use.

Results

Two of the 10 trials identified in the literature search were considered at low risk of bias. Random-effects meta-analysis demonstrated similar mortality (risk ratio (RR) 0.76, 95% CI 0.30 to 1.96), major morbidity including stroke (RR 1. 08, 95% CI 0.40 to 2.91), red cell transfusion and resource use in NIRS-treated patients and controls, with little or no heterogeneity. Grades of Recommendation, Assessment, Development and Evaluation of the quality of the evidence was low or very low for all of the outcomes assessed.

Conclusions

The results of this systematic review did not support the hypotheses that cerebral NIRS-based algorithms have clinical benefits in cardiac surgery.

Trial registration number

PROSPERO CRD42015027696.