bluuebunny/crossref_metadata_2025 huggingface dataset:
Intestinal Microbiota Transplantation for Patients With Inflammatory Bowel Disease Prevents Recurrence of C. difficile Infections but Not Recurrence of Gastrointestinal Symptoms
Authors: Chen Lea Ann
Published: December 2019

Intestinal microbiota transplantation (IMT) is an effective therapy for recurrent Clostridioides difficile infections in patients with inflammatory bowel disease (IBD). However, further research is needed to understand the safety of this procedure, particularly given the frequency of gastrointestinal symptoms and of IBD treatment escalation after IMT.
Leukocyte Apheresis Using a Fiber Filter Suppresses Colonic Injury Through Calcitonin Gene–Related Peptide Induction
Authors: Yamasaki Hiroshi , Mitsuyama Keiichi , Yoshioka Shinichiro , Kuwaki Kotaro , Yamauchi Ryosuke , Fukunaga Shuhei , Mori Atsushi , Tsuruta Osamu , Torimura Takuji
Published: December 2019

Background

The aim of this study was to address whether the therapeutic effect of leukocytapheresis (LCAP) depends on calcitonin gene– related peptide (CGRP) induction.

Methods

An HLA-B27 transgenic rat model was treated with an LCAP column. The effects of LCAP on clinical, endoscopic, and histologic disease activity, the colony-forming ability of colony-forming unit (CFU)–granulocyte macrophages (GMs), colonic blood flow, and tissue expression of tumor necrosis factor (TNF)–α and CGRP were examined. Changes in the effects of LCAP after pretreatment with the CGRP antagonist CGRP8–37 were also observed. A dextran sulfate sodium–induced colitis rat model included treatment with CGRP, and the effect was assessed based on clinical, endoscopic, and histologic disease activity, colonic blood flow, the colony-forming ability of CFU-GMs, and tissue expression of inflammatory cytokines and CGRP receptor families.

Results

LCAP improved disease activity, enhanced colonic blood flow, and induced the bone marrow colony-forming ability of CFU-GMs with an increase in CGRP mRNA levels. These effects were abolished by pretreatment with CGRP8–37. The administration of CGRP suppressed colitis, promoting colonic blood flow, inducing bone marrow–derived cells, downregulating inflammatory cytokines, and upregulating receptor activity–modifying protein–1. The mRNA and protein levels of inflammatory cytokines in lipopolysaccharide-stimulated mononuclear cells were also decreased after CGRP treatment.

Conclusions

The therapeutic effects of LCAP depend on CGRP induction. CGRP can effectively suppress colitis through the downregulation of inflammatory events and upregulation of protective events.
Analysis of the influencing mechanism of command-and-control instruments on adopting energy consumption monitoring technology in public buildings
Authors: Liu Xiaojun , Liu Xiaodan , Luo Xi , Wang Mengmeng , Wang Bojun
Published: December 2019

How can command-and-control instruments (CACs) influence consumers’ adoption of energy consumption monitoring technology (ECMT) in public buildings? We attempt to answer this question in an extended theory of planned behaviour in which CACs and energy-saving awareness (ESA) are introduced. Empirical data are collected by a questionnaire survey with 298 respondents, and structural equation modelling (SEM) is used to analyse the research model. The results indicate that ESA has a direct impact on consumers’ adoption of ECMT. The CACs have no direct effect on consumers’ adoption of ECMT but can indirectly affect consumers’ adoption of ECMT through three paths: CAC → ATT (attitudes) → BI (behavioural intention), CAC → ESA → BI and CAC → SN (subjective norm) → BI. Finally, suggestions are proposed, such as optimising the selection and combination of policy instruments, promoting the operation manager’s attitude towards ECMT to a more positive orientation, improving the ESA of the operation manager and providing more support for and pressure on the operation manager who has not adopted ECMT.
Co-culture of functionally enriched cancer stem-like cells and cancer-associated fibroblasts for single-cell whole transcriptome analysis
Authors: Chen Yu-Chih , Jung Seungwon , Zhang Zhixiong , Wicha Max S , Yoon Euisik
Published: December 2019

Considerable evidence suggests that breast cancer development and metastasis are driven by cancer stem-like cells (CSCs). Due to their unique role in tumor initiation, the interaction between CSCs and stromal cells is especially critical. In this work, we developed a platform to reliably isolate single cells in suspension and grow single-cell-derived spheres for functional enrichment of CSCs. The platform also allows adherent culture of stromal cells for cancer-stromal interaction. As a proof of concept, we grew SUM149 breast cancer cells and successfully formed single-cell-derived spheres. Cancer-associated fibroblasts (CAFs) as stromal cells were found to significantly enhance the formation and growth of cancer spheres, indicating elevated tumor-initiation potential. After on-chip culture for 14 days, we retrieved single-cell derived spheres with and without CAF co-culture for single-cell transcriptome sequencing. Whole transcriptome analysis highlights that CAF co-culture can boost cancer stemness especially ALDHhigh CSCs and alter epithelial/mesenchymal status. Single-cell resolution allows identification of individual CSCs and investigation of cancer cellular heterogeneity. Incorporating whole transcriptome sequencing data with public patient database, we discovered novel genes associated with cancer-CAF interaction and critical to patient survival. The preliminary works demonstrated a reliable platform for enrichment of CSCs and studies of cancer-stromal interaction.
Community-Based versus Statistical Targeting of Anti-Poverty Programs: Evidence from Burkina Faso
Authors: Hillebrecht Michael , Klonner Stefan , A Pacere Noraogo , Souares Aurélia
Published: December 2019

Targeting of governmental welfare programmes in low-income countries commonly relies on statistical procedures involving household-level data, while smaller-scale programmes often employ community-based targeting, where village communities themselves identify beneficiaries. Combining original data from community-based targeting exercises in Burkina Faso with a household survey we compare the targeting accuracy of community-based targeting with four common statistical targeting methods when the objective is to target consumption-poor households. We find that community-based targeting is substantially less accurate than statistical targeting in villages, while it is as accurate as the much more costly statistical methods in semi-urban areas. We show that this difference is due to differences in poverty concepts held by rural and urban communities. Its large cost advantage makes community-based targeting far more cost-effective than statistical targeting for common amounts of welfare programme benefits.
Assessing the Use of Wing Morphometrics to Identify Fall Armyworm (Lepidoptera: Noctuidae) Host Strains in Field Collections
Authors: Nagoshi Kira L , Allan Sandra A , Meagher Robert L
Published: December 2019

The fall armyworm (Spodoptera frugiperda) (J. E. Smith) (Lepidoptera: Noctuidae), a major agricultural pest in the Western Hemisphere, has recently become established in Africa and Asia. This highly polyphagous species has potential to economically harm multiple crops. Contributing to this host range are two fall armyworm populations historically called ‘host strains’ that differ in host specificity. Understanding behaviors of the two strains is crucial to effective management of this pest. A major difficulty in such studies is that strains have long been considered morphologically indistinguishable, with molecular markers the only reliable means of identification. However, studies of fall armyworm in Colombia reported strain differences in wing morphology sufficiently large to potentially provide a more economical alternative method to determine strain. This study tested whether a similar phenotypic difference was present in Florida populations using geometric morphometric analysis of 15 anatomical landmarks on forewings of 182 specimens from three habitats associated with different host plants. Principle component and linear discriminant analyses identified significant differences in wing size and shape in comparison of strains from different habitats, but not between strains within the same habitat. Data indicate that apparent strain distinctions in wing phenotype are most likely a secondary consequence of differences in developmental growth patterns on different host plants combined with strain-biased host choice. Furthermore, Florida specimens showed much larger phenotypic overlap than observed for strains from Colombia. Together these findings suggest that wing morphology is probably not a reliable indicator of strain identity in field populations where different host plants are available.
Flight Performance of Mamestra brassicae (Lepidoptera: Noctuidae) Under Different Biotic and Abiotic Conditions
Authors: Guo Jiang-Long , Li Xiao-Kang , Shen Xiu-Jing , Wang Meng-Lun , Wu Kong-Ming
Published: December 2019

Mamestra brassicae L. is an important, regionally migratory pest of vegetable crops in Europe and Asia. Its migratory activity contributes significantly to population outbreaks, causing severe crop yield losses. Because an in-depth understanding of flight performance is key to revealing migratory patterns, here we used a computer-linked flight mill and stroboscope to study the flight ability and wingbeat frequency (WBF) of M. brassicae in relation to sex, age, temperature, and relative humidity (RH). The results showed that age significantly affected the flight ability and WBF of M. brassicae, and 3-d-old individuals performed the strongest performance (total flight distance: 45.6 ± 2.5 km; total flight duration: 9.3 ± 0.3 h; WBF: 44.0 ± 0.5 Hz at 24°C and 75% RH). The age for optimal flight was considered to be 2–3 d old. Temperature and RH also significantly affected flight ability and WBF; flight was optimal from 23°C to 25°C and 64–75% RH. Because M. brassicae thus has great potential to undertake long-distance migration, better knowledge of its flight behavior and migration will help establish a pest forecasting and early-warning system.
Giraffe males have longer suckling bouts than females
Authors: Gloneková Markéta , Brandlová Karolína , Pluháček Jan
Published: December 2019

In polygynous mammals, females are expected to bias maternal investment in favor of male calves. The mother should invest more in males to enhance their reproductive success in adulthood, or the males require greater investment as they are bigger and stronger than females. In this study, we used nursing duration to compare the difference in the amount of maternal investment provided by females. We compared differences according to sex of the offspring and the influence of calves’ identification by sniffing, using captive giraffes (Giraffa camelopardalis) as a model. Since a high intensity of allonursing (nursing of a nonfilial calf) was reported in giraffes, we also focused on the difference between filial and nonfilial calves. We observed 22 nursing females and 47 suckling calves in four zoological gardens in the Czech Republic from 2007 to 2011. Nursing duration was longer for male calves than for female calves and for calves sniffed by the nursing female regardless whether the calves were filial or nonfilial. We conclude that male calves are more demanding for the amount of investment received and they are more successful in this effort than female calves. Since females provided investment in the same way to filial and nonfilial calves, selection for higher demand for investment by male than by female offspring should be important for their future development. Our results also demonstrate the importance of sniffing for the identification of the suckling calf by the female.
Severe Platelet Transfusion Refractoriness in Association with Antibodies Against CD36
Authors: Schmidt Amy E , Sahai Tanmay , Refaai Majed A , Sullivan Mia , Curtis Brian R
Published: December 2019

Platelet-transfusion refractoriness (PTR) is common in patients with hematological malignancies. The etiology of immune PTR is typically human leukocyte antigen (HLA) antibodies (Abs) from pregnancy or previous transfusion. Herein, we report PTR in the setting of induction chemotherapy for acute myelogenous leukemia (AML) from Abs against CD36/glycoprotein (GP)IV. A 66-year-old African American woman presented with anemia and thrombocytopenia. She was found to have transfusion-dependent AML, and a 7 + 3 regimen (7 days of standard-dose cytarabine and 3 days of an anthracycline antibiotic or an anthracenedione, most often daunorubicin) was initiated. The patient developed profound thrombocytopenia, with platelet nadir of 0 by day 13. The results of HLA antibody screening were negative. However, the results of a screening test for platelet-specific antibodies screen showed Abs against cluster of differentiation (CD)36. The platelets of the patient lacked expression of CD36, and DNA analysis showed mutations in the CD36 gene. HLA Ab–mediated PTR is common in patients with hematological malignancies. However, once HLA Abs are excluded, other less-frequent Abs should be considered, particularly in patient populations of Asian, African, or Middle Eastern descent.
Functional Movement Screen (FMS™) Scores and Demographics of US Army Pre-Ranger Candidates
Authors: Davis Joel D , Orr Robin , Knapik Joseph J , Harris Danny
Published: December 2019

Introduction

The United States Army Rangers are a unique population whose training requirements are intensive, and physically and mentally demanding. The Functional Movement Screen (FMS) is a movement screening tool designed to assess movement quality and asymmetries in movement with the potential to identify injury risk. This study was a descriptive, cross-sectional investigation examining associations between FMS scores and the various measures of health and performance of active duty soldiers in light infantry units who were involved in the U.S. Army Pre-Ranger Course (PRC).

Materials and Methods

Before the PRC, 491 male soldiers (mean age = 24.0 ± 3.8 years; mean height = 176.6 ± 7.2 cm; mean body mass = 80.2 ± 9.8 kg) completed a questionnaire which included items on self-assessed physical fitness, last Army physical fitness test (APFT) score, tobacco use, and injury history. The soldiers then completed the FMS, which consisted of seven movements and three clearing tests. From the FMS results, a determination of asymmetries (i.e., differences in FMS scores between the right and left side of the body) was made. Differences between groups were analyzed via an independent sample t-test, a one-way analysis of variance, or a chi-square as appropriate. Significance was set at 0.05 a priori.

Results

The average composite FMS score was 16.4 (±1.9) points. Soldiers reporting ≥290 APFT points achieved a higher FMS score than those reporting lower APFT scores (16.5 ± 2.0 vs 16.1 ± 2.0 points, P = 0.03). Soldiers reporting either tobacco use or a previous musculoskeletal injury had lower FMS scores than those not reporting these (tobacco: 16.1 ± 2.1 vs 16.5 ± 1.8 points, P = 0.02; injury: 16.0 ± 2.2 vs 16.6 ± 1.8 points, P < 0.01). FMS asymmetries were not related to APFT scores, tobacco use, or self-rated fitness. As self-rated fitness increased so did APFT scores.

Conclusions

Active duty soldiers of a light infantry division achieved FMS scores similar to other military populations tested, and the composite FMS score was related to higher APFT scores, absence of tobacco use, and absence of previous musculoskeletal injuries. Improving PRC candidate healthy habits through highlighting the negative associations between poorer fitness, cigarette tobacco use and movement quality, may reduce injury risk and increase PRC completion potential.
M51 ULX-7: superorbital periodicity and constraints on the neutron star magnetic field
Authors: Vasilopoulos G , Lander S K , Koliopanos F , Bailyn C D
Published: December 2019

In this work, we explore the applicability of standard theoretical models of accretion to the observed properties of M51 ULX-7. The spin-up rate and observed X-ray luminosity are evidence of a neutron star with a surface magnetic field of 2–7 × 1013 G, rotating near equilibrium. Analysis of the X-ray light curve of the system (Swift/XRT data) reveals the presence of a ∼39 d superorbital period. We argue that the superorbital periodicity is due to disc precession, and that material is accreted on to the neutron star at a constant rate throughout it. Moreover, by attributing this modulation to the free precession of the neutron star we estimate a surface magnetic field strength of 3–4 × 1013 G. The agreement of these two independent estimates provide strong constraints on the surface polar magnetic field strength of the NS.
The impact of the observed baryon distribution in haloes on the total matter power spectrum
Authors: Debackere Stijn N B , Schaye Joop , Hoekstra Henk
Published: December 2019

The interpretation of upcoming weak gravitational lensing surveys depends critically on our understanding of the matter power spectrum on scales $k \lt 10\, {h\, {\rm Mpc}^{-1}}$, where baryonic processes are important. We study the impact of galaxy formation processes on the matter power spectrum using a halo model that treats the stars and gas separately from the dark matter distribution. We use empirical constraints from X-ray observations (hot gas) and halo occupation distribution modelling (stars) for the baryons. Since X-ray observations cannot generally measure the hot gas content outside r500c, we vary the gas density profiles beyond this radius. Compared with dark matter only models, we find a total power suppression of $1\, {\mathrm{per\ cent}}$ ($5\, {\mathrm{per\ cent}}$) on scales $0.2\!-\!1\, {h\, {\rm Mpc}^{-1}}$ ($0.5\!-\!2\, {h\, {\rm Mpc}^{-1}}$), where lower baryon fractions result in stronger suppression. We show that groups of galaxies ($10^{13} \lt m_{\mathrm{500c}} / (h^{-1}\, \mathrm{M}_{\odot }) \lt 10^{14}$) dominate the total power at all scales $k \lesssim 10\, {h\, {\rm Mpc}^{-1}}$. We find that a halo mass bias of $30\, {\mathrm{per\ cent}}$ (similar to what is expected from the hydrostatic equilibrium assumption) results in an underestimation of the power suppression of up to $4\, {\mathrm{per\ cent}}$ at $k=1\, {h\, {\rm Mpc}^{-1}}$, illustrating the importance of measuring accurate halo masses. Contrary to work based on hydrodynamical simulations, our conclusion that baryonic effects can no longer be neglected is not subject to uncertainties associated with our poor understanding of feedback processes. Observationally, probing the outskirts of groups and clusters will provide the tightest constraints on the power suppression for $k \lesssim 1\, {h\, {\rm Mpc}^{-1}}$.
Subhalo destruction in the Apostle and Auriga simulations
Authors: Richings Jack , Frenk Carlos , Jenkins Adrian , Robertson Andrew , Fattahi Azadeh , Grand Robert J J , Navarro Julio , Pakmor Rüdiger , Gomez Facundo A , Marinacci Federico , Oman Kyle A
Published: December 2019

N-body simulations make unambiguous predictions for the abundance of substructures within dark matter haloes. However, the inclusion of baryons in the simulations changes the picture because processes associated with the presence of a large galaxy in the halo can destroy subhaloes and substantially alter the mass function and velocity distribution of subhaloes. We compare the effect of galaxy formation on subhalo populations in two state-of-the-art sets of hydrodynamical Λcold dark matter (ΛCDM) simulations of Milky Way mass haloes, Apostle and Auriga. We introduce a new method for tracking the orbits of subhaloes between simulation snapshots that gives accurate results down to a few kiloparsecs from the centre of the halo. Relative to a dark matter-only simulation, the abundance of subhaloes in Apostle is reduced by 50 per cent near the centre and by 10 per cent within r200. In Auriga, the corresponding numbers are 80 per cent and 40 per cent. The velocity distributions of subhaloes are also affected by the presence of the galaxy, much more so in Auriga than in Apostle. The differences on subhalo properties in the two simulations can be traced back to the mass of the central galaxies, which in Auriga are typically twice as massive as those in Apostle. We show that some of the results from previous studies are inaccurate due to systematic errors in the modelling of subhalo orbits near the centre of haloes.
Estimation of the jet inclination angle for the TDE Swift J1644+57
Authors: Chakraborty Sudip , Bhattacharyya Sudip , Chakraborty Chandrachur , Rao A R
Published: December 2019

An estimate of the jet inclination angle relative to the accreting black hole’s spin can be useful to probe the jet triggering mechanism and the disc–jet coupling. A tidal disruption event (TDE) of a star by a supermassive spinning black hole provides an excellent astrophysical laboratory to study the jet direction through the possibility of jet precession. In this work, we report a new method to constrain the jet inclination angle β and apply it to the well-sampled jetted TDE Swift J1644+57. This method involves X-ray data analysis and comparisons of jet models with broad properties of the observed X-ray dips, to estimate the upper limit of the extent of the contribution of a plausible jet precession to these X-ray dips. From this limit, we find that β is very likely to be less than ∼15° for Swift J1644+57. Such a well-constrained jet inclination angle could be useful to probe the jet physics. The main advantage of our method is that it does not need to assume an origin of the observed X-ray dips, and the conclusion does not depend on any particular type of jet precession (e.g. the one due to the Lense–Thirring effect) or any specific value of precession frequency or any particular jet model. These make this method reliable and applicable to other jetted TDEs, as well as to other jetted accreting systems.
A geometric probe of cosmology – I. Gravitational lensing time delays and quasar reverberation mapping
Authors: Ng Angela L H , Lewis Geraint F
Published: December 2019

We present a novel, purely geometric probe of cosmology based on measurements of differential time delays between images of strongly lensed quasars due to finite source effects. Our approach is solely dependent on cosmology via a ratio of angular diameter distances, the image separation, and the source size. It thereby entirely avoids the challenges of lens modelling that conventionally limit time delay cosmography, and instead entails the lensed reverberation mapping of the quasar broad-line region. We demonstrate that differential time delays are measurable with short-cadence spectroscopic monitoring of lensed quasars, through the timing of kinematically identified features within the broad emission lines. This provides a geometric determination of an angular diameter distance ratio complementary to standard probes, and as a result is a potentially powerful new method of constraining cosmology.
Evaluating washing and sifting methods for sampling gastropods in freshwater vegetation samples
Authors: Hobbs Christopher S , Harvey Christopher D
Published: December 2019

European freshwater habitats are experiencing degradation and fragmentation, and this is causing population declines and range reductions in associated gastropod species. Accurate and time-efficient sampling methods are required for effective monitoring of such species, including Segmentina nitida, a priority species in the UK Biodiversity Action Plan. The diminutive size of S. nitida (adult shell width: 5–7 mm) and other small gastropods often makes them difficult to find among the vegetation in field samples. Here, we compare two sampling methods for gastropods from freshwater habitats with dense vegetation: a sift method where vegetation in a sample is examined by hand, and a wash method, where vegetation is washed in water that is then examined for gastropods. When sift and wash methods were compared for a single sample, there was no difference in the number of species detected with the two methods in all but 1 of 48 assessed samples. However, combining two wash steps and a sifting step yielded significantly more snail individuals and more S. nitida individuals. Though species richness as expressed by Menhinick’s index was significantly higher for the wash method compared to the sift method, index values for the two methods had a significant linear relationship. Splitting samples to assess each half with either wash or sift method indicated no significant difference in the number of species or number of individuals found with the two methods. The likelihood of detecting S. nitida in a sample and the number of S. nitida found was significantly higher for the wash method, and the wash method was significantly more time-efficient, saving c. 5 min per sample. We conclude that washing vegetation from freshwater samples without sifting through the vegetation by hand has the potential to accelerate surveys for freshwater gastropods and can increase the likelihood of detecting species of interest, especially S. nitida, without significantly affecting data accuracy. Further testing in various freshwater habitat conditions would allow wider use of this method in malacological and invertebrate studies.
Adapted formaldehyde gradient cross-linking protocol implicates human eIF3d and eIF3c, k and l subunits in the 43S and 48S pre-initiation complex assembly, respectively
Authors: Herrmannová Anna , Prilepskaja Terezie , Wagner Susan , Šikrová Darina , Zeman Jakub , Poncová Kristýna , Valášek Leoš Shivaya
Published: December 2019

One of the key roles of the 12-subunit eukaryotic translation initiation factor 3 (eIF3) is to promote the formation of the 43S and 48S pre-initiation complexes (PICs). However, particular contributions of its individual subunits to these two critical initiation reactions remained obscure. Here, we adapted formaldehyde gradient cross-linking protocol to translation studies and investigated the efficiency of the 43S and 48S PIC assembly in knockdowns of individual subunits of human eIF3 known to produce various partial subcomplexes. We revealed that eIF3d constitutes an important intermolecular bridge between eIF3 and the 40S subunit as its elimination from the eIF3 holocomplex severely compromised the 43S PIC assembly. Similarly, subunits eIF3a, c and e were found to represent an important binding force driving eIF3 binding to the 40S subunit. In addition, we demonstrated that eIF3c, and eIF3k and l subunits alter the efficiency of mRNA recruitment to 43S PICs in an opposite manner. Whereas the eIF3c knockdown reduces it, downregulation of eIF3k or eIF3l increases mRNA recruitment, suggesting that the latter subunits possess a regulatory potential. Altogether this study provides new insights into the role of human eIF3 in the initial assembly steps of the translational machinery.
Dynamics of the nucleosomal histone H3 N-terminal tail revealed by high precision single-molecule FRET
Authors: Lehmann Kathrin , Felekyan Suren , Kühnemuth Ralf , Dimura Mykola , Tóth Katalin , Seidel Claus A M , Langowski Jörg
Published: December 2019

Chromatin compaction and gene accessibility are orchestrated by assembly and disassembly of nucleosomes. Although the disassembly process was widely studied, little is known about the structure and dynamics of the disordered histone tails, which play a pivotal role for nucleosome integrity. This is a gap filling experimental FRET study from the perspective of the histone H3 N-terminal tail (H3NtT) of reconstituted mononucleosomes. By systematic variation of the labeling positions we monitored the motions of the H3NtT relative to the dyad axis and linker DNA. Single-molecule FRET unveiled that H3NtTs do not diffuse freely but follow the DNA motions with multiple interaction modes with certain permitted dynamic transitions in the μs to ms time range. We also demonstrate that the H3NtT can allosterically sense charge-modifying mutations within the histone core (helix α3 of histone H2A (R81E/R88E)) resulting in increased dynamic transitions and lower rate constants. Those results complement our earlier model on the NaCl induced nucleosome disassembly as changes in H3NtT configurations coincide with two major steps: unwrapping of one linker DNA and weakening of the internal DNA - histone interactions on the other side. This emphasizes the contribution of the H3NtT to the fine-tuned equilibrium between overall nucleosome stability and DNA accessibility.
A Bayesian Spatiotemporal Analysis of Pediatric Group A Streptococcal Infections
Authors: Wang Angela , Fine Andrew M , Buchanan Erin , Janko Mark , Nigrovic Lise E , Lantos Paul M
Published: December 2019

Background

Pharyngitis due to group A Streptococcus (GAS) is a common pediatric infection. Physicians might diagnose GAS pharyngitis more accurately when given biosurveillance information about GAS activity. The availability of geographic GAS testing data may be able to assist with real-time clinical decision-making for children with throat infections.

Methods

GAS rapid antigen testing data were obtained from the records of 6086 children at Boston Children’s Hospital and 8648 children at Duke University Medical Center. Records included children tested in outpatient, primary care settings. We constructed Bayesian generalized additive models, in which the outcome variable was the binary result of GAS testing, and predictor variables included smoothed functions of patient location data and both cyclic and longitudinal time data.

Results

We observed a small degree of geographic heterogeneity, but no convincing clusters of high risk. The probability of a positive test declined during the summer months.

Conclusions

Future work should include geographic data about school catchments to identify whether GAS transmission clusters within schools.
The impact of long-term biologics/target therapy on bone mineral density in rheumatoid arthritis: a propensity score-matched analysis
Authors: Chen Jia-Feng , Hsu Chung-Yuan , Yu Shan-Fu , Ko Chi-Hua , Chiu Wen-Chan , Lai Han-Ming , Chen Ying-Chou , Su Yu-Jih , Cheng Tien-Tsai
Published: December 2019

Objectives

To investigate changes in BMD in RA patients receiving 3-year biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) or conventional synthetic DMARD (csDMARD).

Methods

Patients with RA were recruited from September 2014 until March 2019. Clinical characteristics, BMD and evidence of fragility fractures at enrolment were documented. Participants were treated according to the National Institute for Health and Care Excellence (NICE) guidelines over a 3-year observation period. Repeated BMD was measured at the end of the study period. Participants were grouped into those receiving b/tsDMARD or csDMARD and by propensity score matching (1:2).

Results

A total of 388 participants completed the 3-year follow-up. After propensity score matching, 92 and 184 participants were allocated to the b/tsDMARD (Group I) and csDMARD (Group II), respectively. After 3 years, BMD remained stable at the femoral neck (FN), hip (total) (TH) and lumbar vertebra (L1-4) (P =0.09, 0.15, 0.87) in Group I. However, BMD decreased significantly in Group II (P=0.045, <0.001, 0.004) at corresponding sites. Participants receiving combined b/tsDMARD and anti-osteoporosis therapy experienced a greater BMD preserving effect than other subgroups.

Conclusion

Long-term b/tsDMARDs therapy had protective effects on bone loss for patients with RA. Patients receiving concomitant anti-osteoporosis therapy and b/tsDMARDs therapy experienced the greatest BMD preserving effect.
Systemic sclerosis myocarditis has unique clinical, histological and prognostic features: a comparative histological analysis
Authors: De Luca Giacomo , Campochiaro Corrado , De Santis Maria , Sartorelli Silvia , Peretto Giovanni , Sala Simone , Canestrari Giovanni , De Lorenzis Enrico , Basso Cristina , Rizzo Stefania , Thiene Gaetano , Palmisano Anna , Esposito Antonio , Selmi Carlo , Gremese Elisa , Della Bella Paolo , Dagna Lorenzo , Bosello Silvia Laura
Published: December 2019

Objective

To outline the clinical, histological and prognostic features of systemic sclerosis (SSc) endomyocardial biopsy-proven myocarditis with respect to those of diverse endomyocardial biopsy-proven virus-negative myocarditis (VNM).

Methods

We retrospectively analysed data from three cohorts of endomyocardial biopsy-proven myocarditis: SSc-related VNM (SSc-VNM); isolated VNM (i-VNM); and VNM related to other systemic autoimmune diseases (a-VNM). The degree of myocardial fibrosis was expressed as relative percentage and fibrotic score (0–3). Clinical data, cardiac enzymes, echocardiogram, 24 h ECG Holter and cardiac magnetic resonance were obtained at baseline and during follow-up. Non-parametric tests were used.

Results

We enrolled 12 SSc-VNM [11 females, mean age 49.3 (14.2) years; seven diffuse-SSc, five early-SSc], 12 i-VNM [12 females, mean age 47.7 (10.8) years] and 10 a-VNM [four females, mean age 48.4 (16.3) years] patients. SSc patients had higher degrees of myocardial fibrosis as assessed by both percentage [SSc-VNM: 44.8 (18.8)%; a-VNM: 28.6 (16.5)%; i-VNM: 24.9 (10.3)%; P = 0.019] and score [SSc-VNM: 2.3 (0.8); a-VNM: 1.4 (1.1); i-VNM: 1.2 (0.7); P = 0.002]. Myocardial fibrosis directly correlated with skin score (r = 0.625, P = 0.03) and number of ventricular ectopic beats on 24 h ECG Holter in SSc patients (r = 0.756, P = 0.01). Dyspnoea class was higher at presentation in SSc-VNM patients (P = 0.041) and we found heart failure only in SSc patients (25%) (P = 0.05). At cardiac magnetic resonance, myocardial oedema was nearly undetectable in SSc-VNM patients compared with others (P = 0.02). All patients received immunosuppressive treatment. The number of patients who died during follow-up due to cardiac complications was significantly higher in SSc-VNM patients (50%), as compared with a-VNM (0%) and i-VNM (8.3%) patients (P = 0.006). Patients who died during follow-up had higher degrees of myocardial fibrosis [52.2 (11.6)% vs 27.5 (12.9)%, P = 0.024; fibrotic score: 2.83 (0.41) vs 1.4 (0.9), P < 0.001].

Conclusion

SSc has unique clinical and histological features, as it tends to present more frequently with heart failure and a higher dyspnoea class and to show higher degrees of myocardial fibrosis. These specific features are paralleled by a worse cardiac prognosis.
Non-structural carbohydrate pools not linked to hydraulic strategies or carbon supply in tree saplings during severe drought and subsequent recovery
Authors: Kannenberg Steven A , Phillips Richard P
Published: December 2019

Non-structural carbohydrate (NSC) pools fluctuate based on the interplay between photosynthesis, demand from various carbon (C) sinks and tree hydraulic status. Thus, it has been hypothesized that tree species with isohydric stomatal control (i.e., trees that close stomata rapidly in response to drought) rely heavily on NSC pools to sustain metabolism, which can lead to negative physiological consequences such as C depletion. Here, we seek to use a species’ degree of isohydry or anisohydry as a conceptual framework for understanding the interrelations between photosynthetic C supply, hydraulic damage and fluctuations in NSC pools. We conducted a 6-week experimental drought, followed by a 6-week recovery period, in a greenhouse on seven tree species that span the spectrum from isohydric to anisohydric. Throughout the experiment, we measured photosynthesis, hydraulic damage and NSC pools. Non-structural carbohydrate pools were remarkably stable across species and tissues—even highly isohydric species that drastically reduced C assimilation were able to maintain stored C. Despite these static NSC pools, we still inferred an important role for stored C during drought, as most species converted starches into sugars during water stress (and back again post-drought). Finally, we did not observe any linkages between C supply, hydraulic damage and NSC pools, indicating that NSC was maintained independent of variation in photosynthesis and hydraulic function. Our results advance the idea that C depletion is a rare phenomenon due to either active maintenance of NSC pools or sink limitation, and thus question the hypothesis that reductions in C assimilation necessarily lead to C depletion.
Time to Surgery and Patient Mortality in Geriatric Acetabular Fractures
Authors: Glogovac Georgina , Le Theodore Toan , Archdeacon Michael T.
Published: December 2019

Objectives:

To determine whether surgical intervention within 48 hours of injury results in decreased mortality in geriatric patients who have sustained acetabular fractures.

Design:

Retrospective case series.

Setting:

University Level 1 Trauma Center.

Patients/Participants:

One hundred eighty-three patients 65 years of age and older who were operatively treated for acetabular fractures between 2002 and 2017. The average age was 76 years.

Intervention:

Operative fixation of acetabular fracture.

Main Outcome Measurements:

Chi square tests were used to compare 30-day, 6-month, and 1-year mortality after operative intervention between patients treated within 48 hours and after 48 hours. A Cox proportional hazard model was used to determine predictors of mortality.

Results:

The overall 1-year morality was 15%. When patients were grouped by time to surgery (fracture fixation within 48 hours or after 48 hours), there were no statistically significant differences in 30-day, 6-month, or 1-year mortality between groups. In addition, there were no statistically significant differences in age, sex, mechanism of injury, fracture pattern, Charlson comorbidity index, length of hospital stay, presence of deep vein thrombosis, or quality of reduction. In the final multivariate Cox regression model of survival, increasing age was associated with a significantly increased hazard of death with a hazard ratio (HR) of 1.09 (95% confidence interval, 1.05–1.13) per year of age (P < 0.001). Patient sex, mechanism of injury, fracture pattern, estimated blood loss, and Charlson comorbidity index were not significant predictors of mortality.

Conclusion:

In contrast to the clear mortality benefits of early surgical intervention in geriatric patients with proximal femur fractures, the results of our study suggest that surgical intervention after 48 hours of injury is not associated with increased mortality rates in geriatric patients with acetabular fractures. Increased mortality was independently associated with advancing age. Sex, mechanism of injury, and facture pattern were not associated with mortality. Time to surgery in geriatric patients with acetabular fractures should be determined on an individual basis.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Do seizures compromise correction maintenance after spinal fusion in cerebral palsy scoliosis?
Authors: Abousamra Oussama , Sullivan Brian T. , Shah Suken A. , Yaszay Burt , Samdani Amer F. , Cahill Patrick J. , Newton Peter O. , Sponseller Paul D.
Published: December 2019

Seizure disorder in cerebral palsy (CP) has been described as a risk factor for postoperative complications after posterior spinal fusion. However, the effect of seizures on the maintenance of curve correction has not been reported. The aim of this study is to investigate associations between seizure history and maintenance of curve correction after posterior spinal fusion in children with CP. We analyzed records of 201 children with CP who underwent posterior spinal fusion with two-year follow-up. Patients were classified as having no seizures (31%); controlled seizures (54%); or poorly controlled seizures (PCS, 15%). Perioperative data, radiographic measurements, and complications were compared between groups. Groups were similar in operative time, estimated blood loss, and rates of deep wound infection and implant-related complications. The PCS group had a higher rate of respiratory complications (27%) than the no seizures (10%; P = 0.03) and controlled seizures (12%; P = 0.04) groups. Controlled seizures and PCS groups had longer ICU stays than the no seizures group (P= 0.02 and P= 0.04). Major coronal curve and pelvic obliquity were corrected significantly in all groups, and correction was maintained at 2 years. Loss of correction during follow-up was similar between groups. Although seizures were associated with longer ICU stays and more respiratory complications, there was no association between seizure history and loss of curve correction at two years of follow-up after CP scoliosis surgery.
Functional Elbow Range of Motion in Children and Adolescents
Authors: Valone Lindsey C. , Waites Cameron , Tartarilla Ashley B. , Whited Amy , Sugimoto Dai , Bae Donald S. , Bauer Andrea S.
Published: December 2019

Background:

The functional elbow range of motion in children and adolescents has not been previously reported. In adults, a functional motion arc of 30 to 130 degrees of elbow flexion and 50 degrees of pronation to 50 degrees of supination is well established. Contemporary tasks such as cellular phone use and keyboarding require greater elbow flexion and pronation than the functional motion arc. Whether or not this is true in children has yet to be established. We hypothesize that to perform functional and contemporary tasks, children and adolescents use a greater range of elbow motion and forearm rotation as compared with adults.

Methods:

Twenty-eight subjects performed 8 functional tasks and 4 contemporary tasks. Kinematic data were captured using a 3-dimensional motion analysis system as previously described. Mean and SD was collected for elbow flexion, extension, pronation, and supination. Unpaired t tests were performed to compare elbow kinematics of children 6- to 11-year-old (n=14) to that of adolescents 12- to 17-year-old (n=14), with a significance criterion of P-value <0.05.

Results:

The mean arc of motion to achieve functional tasks was 28 to 146 degrees of elbow extension/flexion and 54 degrees of supination to 65 degrees of pronation. Contemporary tasks utilized 40 to 148 degrees of elbow extension/flexion and 49 degrees of supination to 65 degrees of pronation. A greater supination/pronation arc (107 degrees) and greater elbow flexion (148 degrees) were used to bring a cellular phone to the ear, whereas greater pronation (65 degrees) was used to type on a keyboard. Statistically significant differences were observed between children and adolescents in each of the 12 tasks, with the exception of using a fork.

Conclusions:

A motion arc of 30 to 130 degrees of elbow flexion and 50 to 50 degrees of pronation/supination is sufficient to achieve most positional and functional tasks in children and adolescents. However, specific contemporary tasks such as the use of a cellular phone and typing on a keyboard utilize more elbow flexion and pronation. Awareness of greater use of flexion and pronation to achieve contemporary tasks may help guide surgeons in the care of patients with posttraumatic elbow and forearm deformities and contractures.

Level of Evidence:

Level II—investigation of a diagnostic test.
Normative Values for Capital Femoral Epiphyseal Extension of the Developing Hip Based on Age, Sex, and Oxford Bone Age
Authors: Marshall Danielle C. , Morris William Z. , Liu Raymond W.
Published: December 2019

Background:

Recent evidence suggests that increasing capital femoral epiphyseal extension may be an adaptive response that underlies the development of most cam morphology, whereas slipped capital femoral epiphysis is associated with its deficiency. However, there is an absence of rigorous data on the normal development of epiphyseal extension in the hip joint in modern adolescents. The aim of this study was to establish normative values for anterior and superior epiphyseal extension in a normal adolescent control population.

Methods:

A total of 210 pediatric subjects (420 hips) between the ages of 8 and 17 years old at the time of presentation who received pelvic radiographs were retrospectively reviewed. Basic demographic data were collected. All subjects with underlying hip pathology were excluded. Epiphyseal extension ratio (EER) was measured, defined as the ratio of extension of the capital femoral epiphysis down the femoral neck relative to the diameter of the femoral head. Superior EER was measured on the anterioposterior view and anterior EER on the frog-leg lateral view bilaterally. Skeletal maturity was graded based on Oxford bone age (OBA) at the proximal femur.

Results:

The superior EER increased from 0.63±0.05 at age 8 to 0.80±0.05 at age 17. The anterior EER similarly increased from 0.56±0.06 at age 8 to 0.74±0.05 at age 17. The superior and anterior EERs increased with age in a linear fashion for males (r=0.80 and 0.75, respectively) and females (r=0.67 and 0.65) through physeal closure. When subjects were standardized by the OBA stage of the femoral head, females and males showed no statistical difference at OBA stages 6, 7 or 8.

Conclusions:

Superior and anterior EER increased throughout adolescent development until physeal closure. When controlling for skeletal maturity, there were no significant differences between sexes. This normative data may help guide future management and research of slipped capital femoral epiphysis and cam morphology.

Level of Evidence:

Level II, Diagnostic.
Association of Knee Pain and Crouch Gait in Individuals With Cerebral Palsy
Authors: Pelrine Eliza , Novacheck Tom , Boyer Elizabeth
Published: December 2019

Background:

Crouch gait (ie, excessive knee flexion) is commonly seen in patients with cerebral palsy (CP) and has been inconsistently linked with knee pain. The definitive cause of knee pain is unknown, but may result from increased joint forces due to crouch gait kinematics. Our purpose was to determine whether knee pain is positively associated with knee flexion in gait among a large sample of ambulatory individuals with CP. We hypothesized that knee pain prevalence would increase as knee flexion increased.

Methods:

In this retrospective study, pain questionnaire and 3-dimensional gait analysis data from 2015 to 2018 were extracted from the medical records of individuals with CP who had a clinical gait analysis. The pain questionnaire asked caregivers/patients to indicate the location of pain and when it occurs. A multivariate logistic regression was performed with minimum knee flexion in stance, patella alta, age, and sex as predictors of knee pain.

Results:

Among the 729 participants included in the analysis, 147 reported knee pain (20.1%). The odds of knee pain were not associated with minimum knee flexion in stance or sex. However, the odds of knee pain increased 73.2% when patella alta was present (P=0.008) and tended to increase 2.2% as age increased (P=0.059).

Conclusions:

The data suggest that there is not a meaningful association between crouch gait and knee pain. Having patella alta was associated with pain. Further studies that use validated pain questionnaires are needed to understand the multifactorial etiology of knee pain within ambulatory individuals with CP.

Level of Evidence:

Level III—case-control study.