bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluorescence Recovery Allows the Implementation of a Fluorescence Reporter Gene Platform Applicable for the Detection and Quantification of Horizontal Gene Transfer in Anoxic Environments
Authors: Pinilla-Redondo Rafael , Riber Leise , Sørensen Søren J.
Published: January 2018

The study of horizontal gene transfer (HGT) in microbial communities has been revolutionized by significant advances in cultivation-independent methods based on fluorescence reporter gene technologies. Recently, the combination of these novel approaches with flow cytometry has presented itself as one of the most powerful tools to study the spread of mobile genetic elements (MGEs) in the environment. However, the use of fluorescent markers, like green fluorescent protein (GFP) and mCherry, is limited by environmental constraints, such as oxygen availability and pH levels, that affect the correct maturation of their fluorophores. Few studies have characterized the effects of such environmental conditions in a systematic way, and the sheer amount of distinct protein variants requires each system to be examined in an individual fashion. The lack of efficient and reliable markers to monitor HGT in anaerobic environments, coupled to the abundance of ecologically and clinically relevant oxygen-deprived niches in which bacteria thrive, calls for the urgent development of suitable tools that permit its study. In an attempt to devise a process that allows the implementation of the mentioned dual-labeling system to anoxic milieus, the aerobic fluorescence recovery of mCherry and GFPmut3, as well as the effect of pH on their fluorescence intensities, was studied. The findings present a solution to an intrinsic problem that has long hampered the utilization of this system, highlight its pH limitations, and provide experimental tools that will help broaden its horizon of application to other fields.

IMPORTANCE
Many anaerobic environments, like the gastrointestinal tract, anaerobic digesters, and the interiors of dense biofilms, have been shown to be hotspots for horizontal gene transfer (HGT). Despite the increasing wealth of reports warning about the alarming spread of antibiotic resistance determinants, to date, HGT studies mainly rely on cultivation-based methods. Unfortunately, the relevance of these studies is often questionable, as only a minor fraction of bacteria can be cultivated. A recently developed approach to monitoring the fate of plasmids in microbial communities is based on a fluorescence dual-labeling system and allows the bypassing of cultivation. However, the fluorescent proteins on which it is founded are constrained by pH levels and by their strict dependence on oxygen for the maturation of their fluorophores. This study focused on the development and validation of an appropriate aerobic fluorescence recovery (AFR) method for this platform, as this embodies the missing technical link impeding its implementation in anoxic environments.
Draft Genome Sequence of the Filamentous Fungus
Hypoxylon pulicicidum
ATCC 74245
Authors: Nicholson Matthew J. , Van de Bittner Kyle C. , Ram Arvina , Bustamante Leyla Y. , Scott Barry , Parker Emily J.
Published: January 2018

Hypoxylon pulicicidum
strain MF5954 (ATCC 74245) (formerly classified as
Nodulisporium
sp.) is a filamentous fungal species known for its production of the secondary metabolite nodulisporic acid A. We present here the 41.5-Mb draft genome sequence for this organism.
Complete Genome Sequence ofEscherichia coliStrain WG5
Authors: Imamovic Lejla , Misiakou Maria-Anna , van der Helm Eric , Panagiotou Gianni , Muniesa Maite , Sommer Morten Otto Alexander
Published: January 2018

Escherichia colistrain WG5 is a widely used host for phage detection, including somatic coliphages employed as standard ISO method 10705-1 (2000). Here, we present the complete genome sequence of a commercialE. coliWG5 strain.
Draft Genome Sequence of the Fungus
Lecanicillium psalliotae
Strain HWLR35, Isolated from a Wheat Leaf Infected with Leaf Rust (Caused by
Puccinia triticina
)
Authors: Harm Gregory F. S. , Papanicolaou Alexie , Cuddy William S. , Park Robert F. , Moffitt Michelle C.
Published: January 2018

Lecanicillium psalliotae
is an entomopathogenic, mycoparasitical, and nematophagous fungus known to produce antibiotic and antifungal compounds. Here, we report the first 36-Mb draft genome sequence of
L. psalliotae
strain HWLR35. The draft genome contains 197 scaffolds and is predicted to have 11,009 protein-coding genes.
Genome Sequence of
Actinobacillus seminis
Strain ATCC 15768, a Reference Strain of Ovine Pathogens That Causes Infections in Reproductive Organs
Authors: Negrete-Abascal Erasmo , Montes-Garcia Fernando , Vaca-Pacheco Sergio , Leyto-Gil Abraham M. , Fragoso-Garcia Edgar , Carvente-Garcia Roberto , Perez-Agueros Sandra , Castelan-Sanchez Hugo G. , Garcia-Molina Alejandra , Villamar Tomas E. , Sánchez-Alonso Patricia , Vazquez-Cruz Candelario
Published: January 2018

The draft genome sequence of
Actinobacillus seminis
strain ATCC 15768 is reported here. The genome comprises 22 contigs corresponding to 2.36 Mb with 40.7% G+C content and contains several genes related to virulence, including a putative RTX protein.
Sick Note to Fit Note: one trust’s project to improve usage by hospital clinicians
Authors: Moran Amy , Mainwaring Cathryn , Keane Oliver , Sanctuary Thomas , Watson Kathryn , Lasoye Tunji
Published: January 2018

Introduction

In April 2010, the government introduced a new Statement of Fitness to Work or ’Fit Note' for patients requiring time off of work or adaptations to their work due to illness. Responsibility to issue these documents has shifted from primary to secondary care. Hospital clinicians are required to issue for inpatients and for outpatients where clinical responsibility has not been taken over by the general practitioner (GP). However, awareness of this change is lacking. Misdirecting patients to their GP for the sole purpose of receiving a ’Fit Note' is an unnecessary use of appointment time and negatively impacts on patients. King’s College Hospital NHS Trust receives a number of quality alerts from primary care regarding this issue.

Methods

A trust-wide educational initiative was designed and implemented to increase staff awareness of Fit Notes and their correct usage in order to reduce the number of patients being misdirected to their GP to obtain one. Interventions included direct staff engagement, a trust-wide promotional campaign and creation of an electronic version of the document.

Results

Uptake of the electronic version of the Fit Note has steadily increased and there has been a fall in the number of quality alerts received by the trust. However, staff awareness on the whole remains low.

Conclusions

Patients being misdirected to their general practice for Fit Notes is an important issue and one on which the baseline level of awareness among hospital clinicians is low. Challenges during this intervention have been in penetrating a trust of this size and getting the message across to staff. However, digitising the Fit Note can help to increase its use.
Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon
Authors: Pharaon Shad K , Schoch Shawn , Marchand Lucas , Mirza Amer , Mayberry John
Published: January 2018

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.
Exploiting the full quantum crystallography
Authors: Massa Lou , Matta Chérif F.
Published: January 2018

Quantum crystallography (QCr) is a branch of crystallography aimed at obtaining the complete quantum mechanics of a crystal given its X-ray scattering data. The fundamental value of obtaining an electron density matrix that is N-representable is that it ensures consistency with an underlying properly antisymmetrized wavefunction, a requirement of quantum mechanical validity. However, X-ray crystallography has progressed in an impressive way for decades based only upon the electron density obtained from the X-ray scattering data without the imposition of the mathematical structure of quantum mechanics. Therefore, one may perhaps ask regarding N-representability “why bother?” It is the purpose of this article to answer such a question by succinctly describing the advantage that is opened by QCr.
De Broglie–Bohm interpretation of a Hořava–Lifshitz quantum cosmology model
Authors: Oliveira-Neto G. , Martins L. G. , Monerat G. A. , Corrêa Silva E. V.
Published: January 2018

In this paper, we consider the De Broglie–Bohm interpretation of a Hořava–Lifshitz quantum cosmology model in the presence of a radiation perfect fluid. We compute the Bohm’s trajectory for the scale factor and show that it never goes to zero. That result gives a strong indication that this model is free from singularities at the quantum level. We also compute the quantum potential. That quantity helps in understanding why the scale factor never vanishes.
In-Hand Grasping Pose Estimation Using Particle Filters in Combination with Haptic Rendering Models
Authors: Ding Yitao , Bonse Julian , Andre Robert , Thomas Ulrike
Published: January 2018

Specialized grippers used in the industry are often restricted to specific tasks and objects. However, with the development of dexterous grippers, such as humanoid hands, in-hand pose estimation becomes crucial for successful manipulations, since objects will change their pose during and after the grasping process. In this paper, we present a gripping system and describe a new pose estimation algorithm based on tactile sensory information in combination with haptic rendering models (HRMs). We use a 3-finger manipulator equipped with tactile force sensing elements. A particle filter processes the tactile measurements from these sensor elements to estimate the grasp pose of an object. The algorithm evaluates hypotheses of grasp poses by comparing tactile measurements and expected tactile information from CAD-based haptic renderings, where distance values between the sensor and 3D-model are converted to forces. Our approach compares the force distribution instead of absolute forces or distance values of each taxel. The haptic rendering models of the objects allow us to estimate the pose of soft deformable objects. In comparison to mesh-based approaches, our algorithm reduces the calculation complexity and recognizes ambiguous and geometrically impossible solutions.
Mining Overlapping Communities and Inner Role Assignments through Bayesian Mixed-Membership Models of Networks with Context-Dependent Interactions
Authors: Costa Gianni , Ortale Riccardo
Published: January 2018

Community discovery and role assignment have been recently integrated into an unsupervised approach for the exploratory analysis of overlapping communities and inner roles in networks. However, the formation of ties in these prototypical research efforts is not truly realistic, since it does not account for a fundamental aspect of link establishment in real-world networks, i.e., the explicative reasons that cause interactions among nodes. Such reasons can be interpreted as generic requirements of nodes, that are met by other nodes and essentially pertain both to the nodes themselves and to their interaction contexts (i.e., the respective communities and roles).

In this article, we present two new model-based machine-learning approaches, wherein community discovery and role assignment are seamlessly integrated and simultaneously performed through approximate posterior inference in Bayesian mixed-membership models of directed networks. The devised models account for the explicative reasons governing link establishment in terms of node-specific and contextual latent interaction factors. The former are inherently characteristic of nodes, while the latter are characterizations of nodes in the context of the individual communities and roles. The generative process of both models assigns nodes to communities with respective roles and connects them through directed links, which are probabilistically governed by their node-specific and contextual interaction factors. The difference between the proposed models lies in the exploitation of the contextual interaction factors. More precisely, in one model, the contextual interaction factors have the same impact on link generation. In the other model, the contextual interaction factors are weighted by the extent of involvement of the linked nodes in the respective communities and roles.

We develop MCMC algorithms implementing approximate posterior inference and parameter estimation within our models.

Finally, we conduct an intensive comparative experimentation, which demonstrates their superiority in community compactness and link prediction on various real-world and synthetic networks.
SRC
Authors: Duan Weiwei , Chiang Yao-Yi
Published: January 2018

Historical maps store abundant and valuable information about the evolution of natural features and human activities, such as changes in hydrography, the development of the railroad networks, and the expansion of human settlements. Such knowledge represents a unique resource that can be extremely useful for researchers in the social and natural sciences to better understand how human and environment have evolved over time. Fortunately, a large amount of historical maps have been scanned in high resolution by many organizations. For example, the United States Geological Survey (USGS) has scanned and released more than 200,000 historical maps in the TIFF format.
AutonomousGIS 2017 workshop report: the First ACM SIGSPATIAL International Workshop on High-Precision Maps and Intelligent Applications for Autonomous Vehicles (AutonomousGIS 2017)
Authors: Gao Song , Dai (David) Jing , He Gengen , Xu Yang , Chen Xin
Published: January 2018

Autonomous vehicles (aka self-driving cars) and their equipped intelligent systems are among the most exciting and innovative technologies in transportation. In order to operate safely, autonomous vehicles require high-precision geospatial datasets and maps, which contain significantly more detailed road information (such as lanes and signs) and the true ground (absolute accuracy) than those found in conventional geospatial resources for driving and navigation. With the integration with artificial intelligence, machine learning, data mining, image processing and other technologies, novel intelligent applications are fast growing. This workshop aims to bring both academic researchers and geospatial industry engineers together to present, discuss, and share the state-of-the-art scientific research and technology advancement on related fields for autonomous vehicles. The workshop participants will also have an opportunity to share their latest research works and brainstorm their visions of high-precision maps and development on future intelligent applications for autonomous vehicles.
Interaction strategies of blind ehealth and mhealth users
Authors: Sahasrabudhe Shrirang P.
Published: January 2018

Research lacks a comprehensive understanding of the interaction strategies of blind users in eHealth and mHealth interactions. Without this understanding, we cannot develop an accessible and usable eHealth and mHealth for blind users. Therefore, the objective of the proposed dissertation research is to understand blind users' interaction strategies in the context of their eHealth and mHealth interactions.
Interfering RNA against PKC-α inhibits TNF-α-induced IP3R1 expression and improves glomerular filtration rate in rats with fulminant hepatic failure
Authors: Wang Dong-Lei , Dai Wen-Ying , Wang Wen , Wen Ying , Zhou Ying , Zhao Yi-Tong , Wu Jian , Liu Pei
Published: January 2018

We have reported that tumor necrosis factor-α (TNF-α) is critical for reduction of glomerular filtration rate (GFR) in rats with fulminant hepatic failure (FHF). The present study aims to evaluate the underlying mechanisms of decreased GFR during acute hepatic failure. Rats with FHF induced by d-galactosamine plus lipopolysaccharide (GalN/LPS) were injected intravenously with recombinant lentivirus harboring short hairpin RNA against the protein kinase C-α ( PKC-α) gene (Lenti-shRNA-PKC-α). GFR, serum levels of aminotransferases, creatinine, urea nitrogen, potassium, sodium, chloride, TNF-α, and endothelin-1 (ET-1), as well as type 1 inositol 1,4,5-trisphosphate receptor (IP3R1) expression in renal tissue were assessed. The effects of PKC-α silencing on TNF-α-induced IP3R1, specificity protein 1 (SP-1), and c-Jun NH2-terminal kinase (JNK) expression, as well as cytosolic calcium content were determined in glomerular mesangial cell (GMCs) with RNAi against PKC-α. Renal IP3R1 overexpression was abrogated by pre-treatment with Lenti-shRNA-PKC-α. The PKC-α silence significantly improved the compromised GFR, reduced Cr levels, and reversed the decrease in glomerular inulin space and the increase in glomerular calcium content in GalN/LPS-exposed rats. TNF-α treatment increased expression of PKC-α, IP3R1, specificity protein 1 (SP-1), JNK, and p-JNK in GMCs and increased Ca2 + release and binding activity of SP-1 to the IP3R1 promoter. These effects were blocked by transfection of siRNA against the PKC-α gene, and the PKC-α gene silence also restored cytosolic Ca2+ concentration. RNAi targeting PKC-α inhibited TNF-α-induced IP3R1 overexpression and in turn improved compromised GFR in the development of acute kidney injury during FHF in rats.
Very small faces are easily discriminated under long and short exposure times
Authors: Gur Moshe
Published: January 2018

Acuity measures related to overall face size that can be perceived have not been studied quantitatively. Consequently, experimenters use a wide range of sizes (usually large) without always providing a rationale for their choices. I studied thresholds for face discrimination by presenting both long (500 ms)- and short (17, 33, 50 ms)-duration stimuli. Face width threshold for the long presentation was ~0.2°, and thresholds for the flashed stimuli ranged from ~0.3° for the 17-ms flash to ~0.23° for the 33- and 50-ms flashes. Such thresholds indicate that face stimuli used in physiological or psychophysical experiments are often too large to tap human fine spatial capabilities, and thus interpretations of such experiments should take into account face discrimination acuity. The 0.2° threshold found in this study is incompatible with the prevalent view that faces are represented by a population of specialized “face cells” because those cells do not respond to <1° stimuli and are optimally tuned to >4° faces. Also, the ability to discriminate small, high-spatial frequency flashed face stimuli is inconsistent with models suggesting that fixational drift transforms retinal spatial patterns into a temporal code. It seems therefore that the small image motions occurring during fixation do not disrupt our perception, because all relevant processing is over with before those motions can have significant effects.

NEW & NOTEWORTHY Although face perception is central to human behavior, the minimally perceived face size is not known. This study shows that humans can discriminate very small (~0.2°) faces. Furthermore, even when flashed for tens of milliseconds, ~0.25° faces can be discriminated. Such fine acuity should impact modeling of physiological mechanisms of face perception. The ability to discriminate flashed faces where there is almost no eye movement indicates that eye drift is not essential for visibility.
Subcutaneous Granulomatous Inflammation due to Basidiobolomycosis: Case Reports of 3 Patients in Buruli Ulcer Endemic Areas in Benin
Authors: Brun Luc V. C. , Roux Jean Jacques , Sopoh Ghislain E. , Aguiar Julia , Eddyani Miriam , Meyers Wayne M. , Stubbe Dirk , Akele Akpo Marie T. , Portaels Françoise , de Jong Bouke C.
Published: January 2018

Background. Basidiobolomycosis is a rare subcutaneous mycosis, which can be mistaken for several other diseases, such as soft tissue tumors, lymphoma, or Buruli ulcer in the preulcerative stage. Microbiological confirmation by PCR forBasidiobolus ranarumand culture yield the most specific diagnosis, yet they are not widely available in endemic areas and with varying sensitivity. A combination of histopathological findings, namely, granulomatous inflammation with giant cells, septate hyphal fragments, and the Splendore-Hoeppli phenomenon, can confirm basidiobolomycosis in patients presenting with painless, hard induration of soft tissue.Case Presentations. We report on three patients misdiagnosed as suffering from Buruli ulcer, who did not respond to Buruli treatment. Histopathological review of the tissue sections from these patients suggests basidiobolomycosis. All patients had been lost to follow-up, and none received antifungal therapy. On visiting the patients at their homes, two were reported to have died of unknown causes. The third patient was found alive and well and had experienced local spontaneous healing.Conclusion. Basidiobolomycosis is a rare subcutaneous fungal disease mimicking preulcerative Buruli ulcer. We stress the importance of the early recognition by clinicians and pathologists of this treatable disease, so patients can timely receive antifungal therapy.
Difference in Subjective Accessibility of On Demand Recall of Visual, Taste, and Olfactory Memories
Authors: Zach Petr , Zimmelová Petra , Mrzílková Jana , Kutová Martina
Published: January 2018

We present here significant difference in the evocation capability between sensory memories (visual, taste, and olfactory) throughout certain categories of the population. As object for this memory recall we selected French fries that are simple and generally known. From daily life we may intuitively feel that there is much better recall of the visual and auditory memory compared to the taste and olfactory ones. Our results in young (age 12–21 years) mostly females and some males show low capacity for smell and taste memory recall compared to far greater visual memory recall. This situation raises question whether we could train smell and taste memory recall so that it could become similar to visual or auditory ones. In our article we design technique of the volunteers training that could potentially lead to an increase in the capacity of their taste and olfactory memory recollection.
Nonlinear Regression with High-Dimensional Space Mapping for Blood Component Spectral Quantitative Analysis
Authors: Ma Xiaoyan , Zhang Yanbin , Cao Hui , Zhang Shiliang , Zhou Yan
Published: January 2018

Accurate and fast determination of blood component concentration is very essential for the efficient diagnosis of patients. This paper proposes a nonlinear regression method with high-dimensional space mapping for blood component spectral quantitative analysis. Kernels are introduced to map the input data into high-dimensional space for nonlinear regression. As the most famous kernel, Gaussian kernel is usually adopted by researchers. More kernels need to be studied for each kernel describes its own high-dimensional feature space mapping which affects regression performance. In this paper, eight kernels are used to discuss the influence of different space mapping to the blood component spectral quantitative analysis. Each kernel and corresponding parameters are assessed to build the optimal regression model. The proposed method is conducted on a real blood spectral data obtained from the uric acid determination. Results verify that the prediction errors of proposed models are more precise than the ones obtained by linear models. Support vector regression (SVR) provides better performance than partial least square (PLS) when combined with kernels. The local kernels are recommended according to the blood spectral data features. SVR with inverse multiquadric kernel has the best predictive performance that can be used for blood component spectral quantitative analysis.
Severe Hyperthyroidism Complicated by Agranulocytosis Treated with Therapeutic Plasma Exchange: Case Report and Review of the Literature
Authors: Garla Vishnu , Kovvuru Karthik , Ahuja Shradha , Palabindala Venkatataman , Malhotra Bharat , Abdul Salim Sohail
Published: January 2018

Aim. To present a case of Graves’ disease complicated by methimazole induced agranulocytosis treated with therapeutic plasma exchange (TPE) and review of the literature. Case Presentation. A 21-year-old patient with a history of Graves’ disease presented to the endocrine clinic. His history was significant for heat intolerance, weight loss, and tremors. Upon examination he had tachycardia, smooth goiter, thyroid bruit, and hyperactive reflexes. He was started on methimazole and metoprolol and thyroidectomy was to be done once his thyroid function tests normalized. On follow-up, the patient symptoms persisted. Complete blood count done showed a white blood cell count of 2100 (4000–11,000 cells/cu mm) with a neutrophil count of 400 cells/cu mm, consistent with neutropenia. He was admitted to the hospital and underwent 3 cycles of TPE and was also given filgrastim. He improved clinically and his thyroxine (T4) levels also came down. Thyroidectomy was done. He was discharged on levothyroxine for postsurgical hypothyroidism. Conclusion. Plasmapheresis may be useful in the treatment of hyperthyroidism. It works by removing protein bound hormones and also possibly inflammatory cytokines. Further studies are needed to clarify the role of various modalities of TPE in the treatment of hyperthyroidism.
Optical Design with Narrow-Band Imaging for a Capsule Endoscope
Authors: Yen Chih-Ta , Lai Zong-Wei , Lin Yu-Ting , Cheng Hsu-Chih
Published: January 2018

The study proposes narrow-band imaging (NBI) lens design of 415 nm and 540 nm of a capsule endoscope (CE). The researches show that in terms of the rate of accuracy in detecting and screening neoplastic and nonneoplastic intestinal lesions, the NBI system outperformed that of traditional endoscopes and rivaled that of chromoendoscopes. In the proposed NBI CE optical system, the simulation result shows the field of view (FOV) was 109.8°; the modulation transfer function (MTF) could achieve 12.5% at 285 lp/mm and 34.1% at 144 lp/mm. The relative illumination reaches more than 60%, and the system total length was less than 4 mm. Finally, this design provides high-quality images for a 300-megapixel 1/4″ CMOS image sensor with a pixel size of 1.75 μm.
Heterogeneity Signs on Noncontrast Computed Tomography Predict Hematoma Expansion after Intracerebral Hemorrhage: A Meta-Analysis
Authors: Zhang Danfeng , Chen Jigang , Xue Qiang , Du Bingying , Li Ya , Chen Tao , Jiang Ying , Hou Lijun , Dong Yan , Wang Junyu
Published: January 2018

Background and Purpose. Hematoma expansion (HE) is related to clinical deterioration after intracerebral hemorrhage (ICH) and noncontrast computed tomography (NCCT) signs are indicated as predictors for HE but with inconsistent conclusions. We aim to clarify the correlations of NCCT heterogeneity signs with HE by meta-analysis of related studies. Methods. PubMed, Embase, and Cochrane library were searched for eligible studies exploring the relationships between NCCT heterogeneity signs (hypodensity, mixed density, swirl sign, blend sign, and black hole sign) and HE. Poor outcome and mortality were considered as secondary outcomes. Odds ratio (OR) and its 95% confidence intervals (CIs) were selected as the effect size and combined using random effects model. Results. Fourteen studies were included, involving 3240 participants and 435 HEs. The summary results suggested statistically significant correlations of heterogeneity signs with HE (OR, 5.17; 95% CI, 3.72–7.19, P<0.001), poor outcome (OR, 3.60; 95% CI, 1.98–6.54, P<0.001), and mortality (OR, 4.64; 95%, 2.96–7.27, P<0.001). Conclusions. Our findings suggested that hematoma heterogeneity signs on NCCT were positively associated with the increased risk of HE, poor outcome, and mortality rate in ICH.
Pelvic Ultrasound Findings in Women with Obstetric Fistula: A Cross-Sectional Study of Cases and Controls
Authors: Wilkinson Jeffrey P. , Bengtson Angela M. , Chipungu Ennet , Pope Rachel J. , Makanani Bonus , Moyo Margaret , Mwale Mwawi , Tang Jennifer H.
Published: January 2018

Objective. Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods. This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18–45, prior pregnancy, and a uterus on ultrasound. Participants underwent endovaginal ultrasound with measurement of cervical dimensions. Comparisons were done using t-tests and Fisher's exact test. Among women with OF, linear regression was used to assess whether fistula stage was associated with cervical length. Results. We enrolled 98 cases and 12 controls. Women with OF had shorter cervical lengths (18.8 mm versus 27.3 mm, p < 0.01), as well as shorter anterior (7.0 mm versus 9.3 mm, p < 0.01) and posterior (9.5 mm versus 11.0 mm, p < 0.04) cervical stroma, compared to controls. Conclusion. Women with OF have shorter cervical lengths and anterior and posterior cervical stroma, when compared to women without OF. This may offer a partial explanation for subfertility and poor obstetric outcomes in OF patients. Additional studies to clarify the role of ultrasound in OF patients and prediction of future fertility are warranted.
Refractory Abdominal Pain in a Patient with Chronic Lymphocytic Leukemia: Be Wary of Acquired Angioedema due to C1 Esterase Inhibitor Deficiency
Authors: Abdulkareem Abdullateef , D’Souza Ryan S. , Mundorff Joshua , Shrestha Pragya , Shogbesan Oluwaseun , Donato Anthony
Published: January 2018

Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions. In this article, we present the case of a 62-year-old male with a history of recently diagnosed chronic lymphocytic leukemia (CLL) who presented to our hospital with recurrent abdominal pain, initially suspected to haveClostridium difficilecolitis and diverticulitis. He received a final diagnosis of acquired angioedema due to C1 esterase inhibitor deficiency due to concomitant symptoms of lip swelling, cutaneous nonpitting edema of his lower extremities, and complement level deficiencies. He received acute treatment with C1 esterase replacement and icatibant and was maintained on C1 esterase infusions. He also underwent chemotherapy for his underlying CLL and did not experience further recurrence of his angioedema.
Acquired Coagulopathy and Hemorrhage Secondary to Subcutaneous Heparin Prophylaxis
Authors: Sunseri Maria , Ahuja Tania , Wilcox Tanya , Green David
Published: January 2018

Unfractionated heparin and low-molecular-weight heparins are commonly used as thromboprophylaxis for hospitalized patients. Though generally considered safe at prophylactic doses, cases of catastrophic hemorrhage have been reported. The proposed mechanism involves bioaccumulation of heparin through saturation of the rapid-elimination pathway in its metabolism. We present an unusual case of an average-weight man with metastatic melanoma who suffered hemorrhage with syncope and end-organ damage while on prophylactic three times daily unfractionated heparin. Coagulation studies were consistent with heparin toxicity. Despite administration of protamine, the clearance of heparin was remarkably delayed, as demonstrated by serial coagulation studies. We review the suspected risk factors for heparin bioaccumulation and the emerging understanding of this unusual adverse event involving a nearly ubiquitous medication.
Autophagy Sustains Pancreatic Cancer Growth through Both Cell-Autonomous and Nonautonomous Mechanisms
Authors: Yang Annan , Herter-Sprie Grit , Zhang Haikuo , Lin Elaine Y. , Biancur Douglas , Wang Xiaoxu , Deng Jiehui , Hai Josephine , Yang Shenghong , Wong Kwok-Kin , Kimmelman Alec C.
Published: January 2018

Autophagy has been shown to be elevated in pancreatic ductal adenocarcinoma (PDAC), and its role in promoting established tumor growth has made it a promising therapeutic target. However, due to limitations of prior mouse models as well as the lack of potent and selective autophagy inhibitors, the ability to fully assess the mechanistic basis of how autophagy supports pancreatic cancer has been limited. To test the feasibility of treating PDAC using autophagy inhibition and further our understanding of the mechanisms of protumor effects of autophagy, we developed a mouse model that allowed the acute and reversible inhibition of autophagy. We observed that autophagy inhibition causes significant tumor regression in an autochthonous mouse model of PDAC. A detailed analysis of these effects indicated that the tumor regression was likely multifactorial, involving both tumor cell–intrinsic and host effects. Thus, our study supports that autophagy inhibition in PDAC may have future utility in the treatment of pancreatic cancer and illustrates the importance of assessing complex biological processes in relevant autochthonous models.

Significance: This work demonstrates that autophagy is critical pancreatic tumor maintenance through tumor cell–intrinsic and –extrinsic mechanisms. These results have direct clinical relevance to ongoing clinical trials as well as drug-development initiatives. Cancer Discov; 8(3); 276–87. ©2018 AACR.

See related commentary by Noguera-Ortega and Amaravadi, p. 266.

This article is highlighted in the In This Issue feature, p. 253
The Safety and Effectiveness of a Novel Annular Keratopigmentation Method: A Case Report
Authors: Ferrari Francis , van Haselen Robbert
Published: January 2018

Background: We investigated the safety and effectiveness of a novel aesthetic femtosecond-assisted annular keratopigmentation technique. Case Report: A 21-year-old female patient in good general and ophthalmological health with the wish to change the colour of her eyes was treated with a femtosecond-assisted annular keratopigmentation technique. Pigment was inserted in a channel in the cornea (external diameter 9.3 mm; internal diameter 5.5 mm) created with a femtosecond laser at a depth of 225 μm. Eight months post-operatively, there were no signs of leakage, diffusion, inflammation or any other detrimental effects on the cornea both objectively and subjectively. Conclusion: This procedure is a promising safe and effective option for those who want annular keratopigmentation for aesthetic reasons.
Thyroid Hormone Status in Overweight Children with Attention Deficit/Hyperactivity Disorder
Authors: Langrock Christian , Hebebrand Johannes , Radowksi Katharina , Hamelmann Eckard , Lücke Thomas , Holtmann Martin , Legenbauer Tanja , Schmidt Börge , Frank Mirjam , Jöckel Karl-Heinz , Reinehr Thomas
Published: January 2018

Background: There is an ongoing discussion whether thyroid hormones are involved in the development and course of attention deficit/hyperactivity disorder (ADHD). Since obesity is associated with both higher thyroid-stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations and increased rates of ADHD, we hypothesized that overweight children with ADHD show higher TSH and fT3 concentrations compared to overweight children without ADHD. Methods: TSH, fT3, fT4, and leptin levels were analyzed in 230 children (60.9% boys, 9.3 ± 1.7 years old, 35.7% migration background). The children were divided into four groups (I = 26 overweight children with ADHD, II = 56 normal-weight children with ADHD, III = 66 overweight children without ADHD, and IV = 82 normal-weight children without ADHD). Severity of ADHD was determined by the parent version of the Connors 3® rating scales. Results: Overweight children with ADHD did not differ significantly from overweight children without ADHD with respect to TSH, fT3, or fT4 concentrations. Comparing the thyroid hormones between the four groups also demonstrated no significant differences for TSH and fT4 concentrations. fT3 concentrations were significantly higher in normal-weight children with ADHD compared to normal-weight children without ADHD. Inattention and hyperactivity/impulsivity scores were not significantly related to TSH or fT3 in multiple regression analyses adjusted for age, gender, and migration background. In these analyses, TSH was associated with BMI SDS (β coefficient 0.19 ± 0.12, p = 0.002) and leptin (exp[β coefficient] 1.87 ± 1.36, p < 0.001). fT3 (β coefficient 0.06 ± 0.05, p = 0.009) and leptin (exp[β coefficient] 1.17 ± 1.13, p = 0.009) were also associated with BMI SDS. Conclusions: Our findings confirm the relation between overweight and thyroid hormones but point against the hypothesis that thyroid hormones might link overweight and ADHD in children.
Language and Cognitive Impairment Associated with a Novel p.Cys63Arg Change in the MED13L Transcriptional Regulator
Authors: Jiménez-Romero Salud , Carrasco-Salas Pilar , Benítez-Burraco Antonio
Published: January 2018

Mutations in the MED13L gene, which encodes a subunit of a transcriptional regulatory complex, result in a complex phenotype entailing physical and cognitive anomalies. Deep language impairment has been reported in affected individuals, mostly in patients with copy number variations. We report on a child with a nonsynonymous p.Cys63Arg change in MED13L (chr12:116675396A>G, GRCh37) who exhibits profound language impairment in the expressive domain, cognitive delay, behavioral disturbances, and an autism-like phenotype. Because of the brain areas in which MED13L is expressed and because of the functional links between MED13L and the products of selected candidate genes for cognitive disorders involving language deficits, the proband's linguistic phenotype may result from changes in a functional network important for language development and evolution.
Phthirus pubis Infestation of the Eyelids Presenting as Chronic Blepharoconjunctivitis in a 6-Year-Old Girl: A Case Report
Authors: Dohvoma Viola Andin , Ebana Mvogo Steve Robert , Atangana Paul Jean Adrien , Nyasse Pamela , Epee Emilienne , Ebana Mvogo Côme
Published: January 2018

Purpose: To report the case of Phthirus pubis infestation of the eyelashes presenting as chronic blepharoconjunctivitis. Case Report: A 6-year-old girl presented with a 2-month history of blepharoconjunctivitis unresponsive to topical antibiotics in the left eye. Slit-lamp examination revealed the presence of nits and adult parasites on the eyelashes. Parasitological examination confirmed adult forms and nits of Phthirus pubis. There was no evidence of infestation elsewhere. Outcome was favourable with mechanical removal and application of petroleum jelly. Conclusion: Careful slit-lamp examination of the eyelashes should be done in all patients presenting with ocular irritation symptoms.
Prognostic Factors for Survival among Patients with Small Bowel Neuroendocrine Tumours Associated with Mesenteric Desmoplasia
Authors: Laskaratos Faidon Marios , Diamantopoulos Leonidas , Walker Martin , Walton Henry , Khalifa Mohamed , El-Khouly Fatima , Koffas Apostolos , Demetriou George , Caplin Martyn , Toumpanakis Christos , Mandair Dalvinder
Published: January 2018

Background: Small intestinal neuroendocrine tumours (SI NETs) represent 30–50% of small bowel neoplasms and are often associated with diverse fibrotic complications. Mesenteric fibrosis is a hallmark of SI NETs which may cause substantial morbidity and is considered an adverse feature. However, survival analyses in this group of patients are lacking. Methods: The aim of this retrospective study was to determine the overall survival (OS) and factors affecting prognosis in a large cohort of 147 patients with SI NETs and radiological evidence of mesenteric desmoplasia from our centre. The severity of desmoplasia was graded radiologically and its effect on OS and long-term complications was assessed. The median follow-up period was 82 months. Results: The median OS was 8.7 years (95% CI 6.8–9.9) with an overall 5-year survival of 71%. The univariate analysis demonstrated that an age >65 years, a liver tumour burden >50% of the hepatic parenchyma, carcinoid heart disease, chromogranin A levels >10 times the upper limit of normal, and urinary 5-hydroxyindoleacetic acid (5-HIAA) levels >5 times the upper limit of normal were poor prognosticators, while primary resection was associated with a longer OS. However, only an age >65 years and urinary 5-HIAA levels >10 times the upper limit of normal remained statistically significant after multivariate analysis. The severity of mesenteric desmoplasia did not seem to demonstrate a statistically significant relationship to OS or long-term outcomes. Conclusion: This study is the first comprehensive survival analysis of patients with SI NETs associated with mesenteric desmoplasia and has provided important and clinically relevant epidemiological data for this group of patients.
The Sonic Affordances of a System for Multitouch Manipulation of
Stereophonic Noise Spectra
Authors: Berndt Axel , Al-Kassab Nadia , Dachselt Raimund
Published: January 2018

TouchNoise is a multitouch interface for creative work with noise. It allows direct and indirect manipulation of sound particles, which are added together in a panning and frequency space. Based on the mechanics of a multiagent system and flocking algorithms, novel possibilities for the creation and modulation of noise and harmonic spectra are supported. TouchNoise underwent extensive revisions and extensions throughout a three-year, iterative development process. This article provides a comprehensive overview of the final TouchNoise concept and its approach to mapping and interaction, from which a variety of unique sonic capabilities derives. This article is based on our experiences with a fully functional prototype implementation, and focuses on the systematic exploration and discussion of these new sonic capabilities and corresponding playing techniques, which differ strongly from traditional synthesis interfaces.
On human consciousness: A mathematical perspective
Authors: Grindrod Peter
Published: January 2018

We consider the implications of the mathematical modeling and analysis of large modular neuron-to-neuron dynamical networks. We explain how the dynamical behavior of relatively small-scale strongly connected networks leads naturally to nonbinary information processing and thus to multiple hypothesis decision-making, even at the very lowest level of the brain’s architecture. In turn we build on these ideas to address some aspects of the hard problem of consciousness. These include how feelings might arise within an architecture with a foundational decision-making and classification layer of unit processors. We discuss how a proposed “dual hierarchy model,” made up from both externally perceived, physical elements of increasing complexity, and internally experienced, mental elements (which we argue are equivalent to feelings), may support aspects of a learning and evolving consciousness. We introduce the idea that a human brain ought to be able to reconjure subjective mental feelings at will, and thus these feelings cannot depend on internal chatter or internal instability-driven activity (patterns). An immediate consequence of this model, grounded in dynamical systems and nonbinary information processing, is that finite human brains must always be learning and forgetting and that any possible subjective internal feeling that might be fully idealized with a countable infinity of facets could never be learned completely a priori by zombies or automata. It may be experienced more and more fully by an evolving human brain (yet never in totality, not even in a lifetime). We argue that, within our model, the mental elements and thus internal modes (feelings) play a role akin to latent variables in processing and decision-making, and thus confer an evolutionary “fast-thinking” advantage.
Aphelenchoides spp. (Nematoda: Aphelenchida) and Panagrolaimus leperisini (Nematoda: Rhabditida) found associated with grass seeds in the Telperion Nature Reserve, South Africa
Authors: GIRGAN CHANTELLE , SWART ANTOINETTE , MARAIS MARIETTE , FOURIE HENDRIKA
Published: January 2018

As part of the South African Plant-Parasitic Nematode Survey (SAPPNS), an extensive nematode diversity survey was conducted in the Telperion Nature Reserve, Mpumalanga, South Africa. During this survey, samples of grass seeds were collected. Some of these seeds yielded specimens of the genera Aphelenchoides, Aphelenchus and Panagrolaimus. Identified species include Aphelenchoides africanus, A. besseyi, A. lichenicola, A. rutgersi, A. spicomucronatus and Panagrolaimus leperisini. Four of these species are new records for South Africa and the South African populations of these species are described in this paper.
A new fossil soldier beetle (Coleoptera, Cantharidae, Silinae) from Eocene Baltic amber
Authors: FANTI FABRIZIO , PANKOWSKI MICHAEL J.
Published: January 2018

A new genus and species of fossil soldier beetle Markus karenae gen. et sp. nov. is described and illustrated from Eocene Baltic amber. Its morphological characteristics place it in the taxonomic position of the subfamily Silinae. It is characterized by a particular lateral pronotal shape with two difform processes, pronotum slightly longer than wide, with a blunt and evident angle near the basal angles, anterior and posterior margins flat and with shallow punctation, and lateral margin strongly granulose and in relief. Furthermore, each of its legs has a claw with one acute tooth at the base, except for the posterior legs where the tooth appears to be blunt. The new taxon is morphologically compared with the other fossil representatives of Silinae from Baltic amber, and with extant Palearctic genera.
Emergency Medication Security Potassium Chloride as Floorstock Nurses and Drug Interaction Screening Medication Use Evaluations Enteral Samples Hospice and Oncology Care Plans Handwritten Labels Equipment Delivery Verification of Physician Licensure
Authors: Rich Darryl S.
Published: January 2018

This column addresses questions from readers about any issue, process, standard, or future direction of the Joint Commission, whether it relates to home care, the hospital, or other practice environment. The objective is to give you a better insight into the Joint Commission accreditation process in your own practice site. Any question is fair game.
Aminoglutethimide and Megestrol
Authors: Solimando Dominic A.
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.