bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic diagnosis and treatment of an isolated epithelioid trophoblastic tumor in recto‐uterine pouch
Authors: Jiang Fang , Xiang Yang , Guo Li‐na
Published: February 2018

A 30‐year‐old Chinese woman with irregular vaginal bleeding was admitted to our department. Serum β‐human chorionic gonadotropin (β‐hCG) was moderately elevated, and ultrasound and magnetic resonance imaging revealed an irregular, retro‐uterine lesion without intrauterine pregnancy. Ectopic pregnancy was the primary consideration, with trophoblastic tumor being another possibility. Laparoscopy revealed a 2 × 3 × 3 cm3 irregular, infiltrating, yellow‐white lesion in the left recto‐uterine pouch, which was completely resected without rectal damage. Final pathological/immunohistochemical analyses revealed an epithelial trophoblastic tumor (ETT) (Ki‐67 reactive index~45%). Postoperative recovery was smooth, and the patient received three chemotherapy courses (etoposide, methotrexate and actinomycin, alternating weekly with cyclophosphamide and vincristine) beginning 6 days postsurgery (β‐hCG = 46.4 mIU/mL). β‐hCG returned to an undetectable level after one chemotherapy course. Herein, we describe a rare case of isolated ETT that was difficult to differentiate from other pregnancy‐related diseases. Laparoscopy could be an effective, safe diagnostic method in select patients.
Infertility treatment strategy involving combined freeze‐all embryos and single vitrified‐warmed embryo transfer during hormonal replacement cycle for in vitro fertilization of women with hypogonadotropic hypogonadism
Authors: Kuroda Keiji , Ezoe Kenji , Kato Keiichi , Yabuuchi Akiko , Segawa Tomoya , Kobayashi Tamotsu , Ochiai Asako , Katoh Noriko , Takeda Satoru
Published: February 2018

Aim

Hypogonadotropic hypogonadism (HH) is a condition caused by the deficient secretion of pituitary gonadotropins, leading to diminished ovarian function. Several studies of in vitro fertilization (IVF) in women with HH revealed acceptable clinical pregnancy outcomes but high multiple pregnancy rates after multiple fresh embryo transfer (ET). The purpose of this study was to analyze the outcomes of combined freeze‐all embryos and single vitrified‐warmed ET in women with HH.

Methods

Of 91 infertile women with HH (basal luteinizing hormone and follicle‐stimulating hormone levels <2.0 mIU/mL), we excluded patients aged ≥40 years (n = 2) and women who preferred fresh ET (n = 10). Seventy‐nine women underwent 117 oocyte retrieval cycles and 135 vitrified‐warmed ET during hormone replacement (HR) cycles from 2008 to 2014 at the Kato Ladies Clinic and Juntendo University Hospital.

Results

In 26 single cleavage ET cycles, the rates of clinical pregnancy and live birth were 34.6% (9/26 ET) and 26.9% (7/26 ET), respectively. Regarding the outcomes after single vitrified‐warmed blastocyst transfer, clinical pregnancy and live birth rates were 65.1% (71/109 ET) and 50.5% (55/109 ET), respectively. Multiple conceptions and ovarian hyperstimulation syndrome did not occur in any of the women with HH.

Conclusion

Our results demonstrated that IVF followed by single vitrified‐warmed ET in adjusted endocrine milieu during the HR cycle is an effective fertility treatment for women with HH and decreases the incidence of complications, including multiple conceptions.
Credit portfolio selection with decaying contagion intensities
Authors: Bo Lijun , Capponi Agostino , Chen Peng‐Chu
Published: February 2018

We develop a fixed‐income portfolio framework capturing the exponential decay of contagious intensities between successive default events. We show that the value function of the control problem is the classical solution to a recursive system of second‐order uniformly parabolic Hamilton–Jacobi–Bellman partial differential equations. We analyze the interplay between risk premia, decay of default intensities, and their volatilities. Our comparative statics analysis finds that the investor chooses to go long only if he is capturing enough risk premia. If the default intensities deteriorate faster, the investor increases the size of his position if he goes short, or reduces the size of his position if he goes long.
On the Left and Right Ideological Divide: Historical Accounts and Contemporary Perspectives
Authors: Caprara Gian Vittorio , Vecchione Michele
Published: February 2018

Left and right are viewed as social constructs that serve to orient and to bind people to political choices over the last two centuries mostly within established Western liberal democracies. Their contents and functions, however, have not been invariant across polities but were largely shaped in accordance with the distinctive characteristics of societies and of political systems in which they operated. Thus, one can't avoid addressing left and right under an historical perspective to make sense of their different expressions and to better appreciate their functions. Recent findings have shown that individual differences in personality traits, basic values, and core political values account for a significant portion of preference for left and right across several polities. It has been argued that affinities between individual differences in personality and political preferences have developed over time under conditions of choice in which people's dispositions and value priorities could meet contingent political offers. Time and opportunities of free choice made possible the establishment of distinctive ideological identities that ultimately find their roots in people's personalities. Novel findings document the function that left and right still can play in predicting political preference and in summarizing political attitudes as stable social postures that account for the encounter of personality and politics.
The Contingent, Contextual Nature of the Relationship Between Needs for Security and Certainty and Political Preferences: Evidence and Implications
Authors: Federico Christopher M. , Malka Ariel
Published: February 2018

Research on the dispositional origins of political preferences is flourishing, and the primary conclusion drawn from this work is that stronger needs for security and certainty attract people to a broad‐based politically conservative ideology. Though this literature covers much ground, most integrative assessments of it have paid insufficient attention to the presence and implications of contingencies in the relationship between dispositional attributes and political attitudes. In this article, we review research showing that relationships between needs for security and certainty and political preferences vary considerably—sometimes to the point of directional shifts—on the basis of (1) issue domain and (2) contextual factors governing the content and volume of political discourse individuals are exposed to. On the basis of this evidence, we argue that relationships between dispositional attributes and political preferences vary in the extent to which they reflect an organic functional resonance between dispositions and preferences or identity‐expressive motivation to adopt a political attitude merely because it is discursively packaged with other need‐congruent attitudes. We contend that such a distinction is critical to gaining a realistic understanding of the origins and nature of ideological belief systems, and we consequently recommend an increased focus on issue‐based and contextual variation in relationships between dispositions and political preferences.
Authoritarianism, Affective Polarization, and Economic Ideology
Authors: Johnston Christopher D.
Published: February 2018

I consider two theories of affective polarization between Democrats and Republicans in the United States: (1) ideological divergence on size‐of‐government issues (Webster & Abramowitz, ) and (2) authoritarianism‐based partisan sorting (Hetherington & Weiler, ). I argue that these alternatives cannot be easily disentangled, because politically engaged citizens seek out and assimilate information about economic policy from elites who are perceived to share their core traits and cultural values. In this way, the economic preferences emphasized by the first view are partly endogenous to the worldview divide emphasized by the second. Elite position taking on economic issues may elicit strong emotions among citizens because it reliably signals a commitment to one worldview or the other. I review new and existing evidence for this claim in both observational survey data and two experimental studies. I also consider the broader implications of these results for the distribution of economic opinion across indicators of human capital.
The Nature of Party Categories in Two‐Party and Multiparty Systems
Authors: Nicholson Stephen P. , Carman Christopher J. , Coe Chelsea M. , Feeney Aidan , Fehér Balázs , Hayes Brett K. , Kam Christopher , Karp Jeffrey A. , Vaczi Gergo , Heit Evan
Published: February 2018

Categories are one of the primary ways by which people make sense of complex environments. For political environments, parties are especially useful categories. By simplifying political life, party categories enable people to make sense of politics. A fundamental characteristic of party categories is that they minimize perceived differences of members within a party (e.g., two Democrats) and maximize perceived differences between members of different parties (e.g., a Republican and a Democrat). In two‐party systems, politicians in leftist parties will often be perceived as highly differentiated from politicians in right‐wing parties. Yet, in multiparty systems there is greater complexity and potential for confusion since there are often multiple parties on the left and/or right. Spatial models of political competition predict that ideologically close neighboring parties will be perceived as similar, yet a categorical perspective holds that the public will perceive parties on the same side of the ideological divide to be dissimilar. In the present article, we review a research program investigating how political parties are treated as categories and present new data from seven democracies showing that people perceive parties to be highly differentiated regardless of where parties are located in ideological space.
Life Satisfaction, Income Comparisons and Individual Traits
Authors: Budría Santi , Ferrer‐I‐Carbonell Ada
Published: February 2018

People gain utility from occupying a higher ranked position in the income distribution of the reference group. This paper investigates whether these gains depend on an individual's set of personality and affective traits. Using the 2000 to 2013 waves of the German Socio‐economic Panel dataset (SOEP), a subjective question on Life Satisfaction, and three different measures of personal and affective traits, we find significant and robust differences across groups and conclude that traits determine the relationship between rank and life satisfaction. The heterogeneity on the importance of income comparisons is relevant, for example, when building economic models, predicting individuals' behavior, or making welfare judgments.
Minimum Wage: Does it Improve Welfare in Thailand?
Authors: del Carpio Ximena V. , Messina Julián , Sanz‐de‐Galdeano Anna
Published: February 2018

We study the causal impact of the minimum wage on labor market outcomes, household consumption, inequality and poverty in Thailand by relying on policy variation in minimum wages over time across provinces. We find that minimum‐wage increases have a large and significant impact on the likelihood of working in the uncovered sector among workers with elementary education. However, the impact is very small and insignificant among other labor market groups. In contrast, the minimum wage has large positive effects on the formal sector wages of low‐earning workers, such as the young, elderly and low educated. Increases in the minimum wage are associated with reductions in household poverty and consumption inequality at the bottom half of the distribution.
What Is Known about Punctuated Equilibrium Theory? And What Does That Tell Us about the Construction, Validation, and Replication of Knowledge in the Policy Sciences?
Authors: Kuhlmann Johanna , van der Heijden Jeroen
Published: February 2018

This article reviews how the Punctuated Equilibrium Theory (PET) has been applied in studies analyzing policy change. It builds on a systematic evidence synthesis of peer‐reviewed empirical literature that is based on the core readings by Frank R. Baumgartner and Bryan D. Jones. The article identifies trends in the geographical and policy focus of PET studies; maps, explores, and interrogates how core concepts of PET are applied in empirical analyses; and, finally, assesses the analytical and explanatory power of PET when applied to empirical phenomena. The article finds that PET studies have contributed a great deal to our knowledge on particular cases, but that more often than not PET is applied in a selective manner. The article deals with the implications of these findings for further theory development in policy analysis.
Band gap and strain engineering of pseudomorphic Ge1−x−ySixSny alloys on Ge and GaAs for photonic applications
Authors: Fernando Nalin S. , Carrasco Rigo A. , Hickey Ryan , Hart John , Hazbun Ramsey , Schoeche Stefan , Hilfiker James N. , Kolodzey James , Zollner Stefan
Published: February 2018

The authors report the compositional dependence of the direct and indirect band gaps of pseudomorphic Ge1−x−ySixSny alloys on Ge and GaAs with (001) surface orientation determined from deformation potential theory and spectroscopic ellipsometry measurements. The effects of alloying Ge with Si and Sn and the strain dependence of the band gaps at the Γ, Δ, and L conduction band minima are discussed. Deformation potential theory predicts an indirect to direct crossover in pseudomorphic Ge1−y−xSixSny alloys on Ge or GaAs only for very high Sn concentrations between 15% and 20%. No indirect to direct cross-over in pseudomorphic Ge1−ySny alloys (x = 0) on Ge or GaAs was found for practically approachable Sn compositions (y < 25%). The predictions for the compositional dependence of the E0, E1, and E1 + Δ1 band gaps were validated for pseudomorphic Ge1−ySny alloys on Ge using spectroscopic ellipsometry. The complex pseudodielectric functions of pseudomorphic Ge1−ySny alloys grown on Ge by molecular beam epitaxy were determined from Fourier transform infrared and ultraviolet-visible ellipsometry in the 0.1–6.6 eV energy range of Sn contents up to 11%, to investigate the compositional dependence of the band gaps. Critical point energies and related parameters were obtained by analyzing the second derivative spectra of the dielectric function of the Ge1−ySny epilayers. Sn composition, thickness, and strain of the Ge1−ySny epilayers on Ge were characterized by high resolution x-ray diffraction. The E0, E1, and E1 + Δ1 band gaps of pseudomorphic Ge1−ySny alloys on Ge obtained from ellipsometry are in good agreement with the theoretical predictions.
Deep-level defects in homoepitaxial p-type GaN
Authors: Nakano Yoshitaka
Published: February 2018

The author has investigated deep-level defects in homoepitaxial layers of p-type GaN with Mg doping concentrations of ∼1.4 × 1017 cm−3 grown by metal-organic chemical vapor deposition on GaN substrates. Five deep-level defects were revealed with their optical onsets at ∼1.80, ∼2.48, and ∼3.18 eV above the valence band and at ∼3.08 and ∼3.28 eV below the conduction band. The ∼1.80, ∼3.18, and ∼3.28 eV levels had high defect concentrations. In particular, the density of the ∼1.80 and ∼3.28 eV levels increased with decreasing depth, probably due to segregation of Mg toward the surface. These three deep-level defects are most likely associated with Ga vacancies, N vacancy-related compensating donors, and deep Mg acceptors, respectively.
Secondary ion formation on indium under nuclear and electronic sputtering conditions
Authors: Herder Matthias , Ernst Philipp , Breuer Lars , Bender Markus , Severin Daniel , Wucher Andreas
Published: February 2018

The electronic sputtering of indium under swift heavy ion bombardment is investigated using time of flight secondary ion mass spectrometry in combination with 157 nm laser postionization. Secondary ion and neutral mass spectra generated under the impact of 4.8 MeV/u 48Ca10+ ions are analyzed in order to determine the ionization probability of the emitted indium atoms, and the results are compared to those measured under nuclear sputtering conditions via bombardment by 5 keV Ar+ primary ions. The influence of surface contamination on the ionization probability is studied by comparing (1) a pristine surface covered by a native oxide layer, (2) a kilo-electron-volt sputter-cleaned surface, and (3) a controlled oxygen coverage established by dosing the precleaned surface with O2. It is found that the native oxide layer increases the ionization probability for both kilo-electron-volt and mega-electron-volt primary ions. In contrast, oxygen deposited on a sputter-cleaned surface results in the well-known matrix effect for kilo-electron-volt ions, but has no influence on the ionization probability for the mega-electron-volt ions. In the case of a thoroughly sputter-cleaned surface a four- to sevenfold higher ionization probability for indium atoms is found for 4.8 MeV/u 48Ca10+ as compared to 5 keV Ar+ bombardment.
Effect of auditory efferent time-constant duration on speech recognition in noise
Authors: Yasin Ifat , Liu Fangqi , Drga Vit , Demosthenous Andreas , Meddis Ray
Published: February 2018

The human auditory efferent system may play a role in improving speech-in-noise recognition with an associated range of time constants. Computational auditory models with efferent-inspired feedback demonstrate improved speech-in-noise recognition with long efferent time constants (2000 ms). This study used a similar model plus an Automatic Speech Recognition (ASR) system to investigate the role of shorter time constants. ASR speech recognition in noise improved with efferent feedback (compared to no-efferent feedback) for both short and long efferent time constants. For some signal-to-noise ratios, speech recognition in noise improved as efferent time constants were increased from 118 to 2000 ms.
Prediction Model for Antimalarial Activities of Hemozoin Inhibitors by Using Physicochemical Properties
Authors: Mosaddeque Farhana , Mizukami Shusaku , Kamel Mohamed Gomaa , Teklemichael Awet Alem , Dat Truong Van , Mizuta Satoshi , Toan Dinh Van , Ahmed Ali Mahmoud , Vuong Nguyen Lam , Elhady Mohamed Tamer , Giang Hoang Thi Nam , Dang Tran Ngoc , Fukuda Michiko , Huynh Lam K. , Tanaka Yoshimasa , Egan Timothy J. , Kaneko Osamu , Huy Nguyen Tien , Hirayama Kenji
Published: February 2018

The rapid spread of strains of malaria parasites that are resistant to several drugs has threatened global malaria control. Hence, the aim of this study was to predict the antimalarial activity of chemical compounds that possess anti-hemozoin-formation activity as a new means of antimalarial drug discovery. After the initial
in vitro
anti-hemozoin-formation high-throughput screening (HTS) of 9,600 compounds, a total of 224 hit compounds were identified as hemozoin inhibitors. These 224 compounds were tested for
in vitro
erythrocytic antimalarial activity at 10 μM by using chloroquine-mefloquine-sensitive
Plasmodium falciparum
strain 3D7A. Two independent experiments were conducted. The physicochemical properties of the active compounds were extracted from the ChemSpider and SciFinder databases. We analyzed the extracted data by using Bayesian model averaging (BMA). Our findings revealed that lower numbers of S atoms; lower distribution coefficient (log D) values at pH 3, 4, and 5; and higher predicted distribution coefficient (ACD log D) values at pH 7.4 had significant associations with antimalarial activity among compounds that possess anti-hemozoin-formation activity. The BMA model revealed an accuracy of 91.23%. We report new prediction models containing physicochemical properties that shed light on effective chemical groups for synthetic antimalarial compounds and help with
in silico
screening for novel antimalarial drugs.
Ecology and Biotechnological Potential of Bacteria Belonging to the Genus Pseudovibrio
Authors: Romano Stefano
Published: February 2018

Members of the genus
Pseudovibrio
have been isolated worldwide from a great variety of marine sources as both free-living and host-associated bacteria. So far, the available data depict a group of alphaproteobacteria characterized by a versatile metabolism, which allows them to use a variety of substrates to meet their carbon, nitrogen, sulfur, and phosphorous requirements. Additionally,
Pseudovibrio
-related bacteria have been shown to proliferate under extreme oligotrophic conditions, tolerate high heavy-metal concentrations, and metabolize potentially toxic compounds. Considering this versatility, it is not surprising that they have been detected from temperate to tropical regions and are often the most abundant isolates obtained from marine invertebrates. Such an association is particularly recurrent with marine sponges and corals, animals that play a key role in benthic marine systems. The data so far available indicate that these bacteria are mainly beneficial to the host, and besides being involved in major nutrient cycles, they could provide the host with both vitamins/cofactors and protection from potential pathogens via the synthesis of antimicrobial secondary metabolites. In fact, the biosynthetic abilities of
Pseudovibrio
spp. have been emerging in recent years, and both genomic and analytic studies have underlined how these organisms promise novel natural products of biotechnological value.
Structural Characterization and Directed Evolution of a Novel Acetyl Xylan Esterase Reveals Thermostability Determinants of the Carbohydrate Esterase 7 Family
Authors: Adesioye Fiyinfoluwa A. , Makhalanyane Thulani P. , Vikram Surendra , Sewell Bryan T. , Schubert Wolf-Dieter , Cowan Don A.
Published: February 2018

A hot desert hypolith metagenomic DNA sequence data set was screened
in silico
for genes annotated as acetyl xylan esterases (AcXEs). One of the genes identified encoded an ∼36-kDa protein (Axe1
NaM1
). The synthesized gene was cloned and expressed, and the resulting protein was purified. NaM1 was optimally active at pH 8.5 and 30°C and functionally stable at salt concentrations of up to 5 M. The specific activity and catalytic efficiency were 488.9 U mg
−1
and 3.26 × 10
6
M
−1
s
−1
, respectively. The crystal structure of wild-type NaM1 was solved at a resolution of 2.03 Å, and a comparison with the structures and models of more thermostable carbohydrate esterase 7 (CE7) family enzymes and variants of NaM1 from a directed evolution experiment suggests that reduced side-chain volume of protein core residues is relevant to the thermal stability of NaM1. Surprisingly, a single point mutation (N96S) not only resulted in a simultaneous improvement in thermal stability and catalytic efficiency but also increased the acyl moiety substrate range of NaM1.

IMPORTANCE
AcXEs belong to nine carbohydrate esterase families (CE1 to CE7, CE12, and CE16), of which CE7 enzymes possess a unique and narrow specificity for acetylated substrates. All structurally characterized members of this family are moderately to highly thermostable. The crystal structure of a novel, mesophilic CE7 AcXE (Axe1
NaM1
), from a soil metagenome, provides a basis for comparisons with thermostable CE7 enzymes. Using error-prone PCR and site-directed mutagenesis, we enhanced both the stability and activity of the mesophilic AcXE. With comparative structural analyses, we have also identified possible thermal stability determinants. These are valuable for understanding the thermal stability of enzymes within this family and as a guide for future protein engineering of CE7 and other α/β hydrolase enzymes.
Facile Arsenazo III-Based Assay for Monitoring Rare Earth Element Depletion from Cultivation Media for Methanotrophic and Methylotrophic Bacteria
Authors: Hogendoorn Carmen , Roszczenko-Jasińska Paula , Martinez-Gomez N. Cecilia , de Graaff Johann , Grassl Patrick , Pol Arjan , Op den Camp Huub J. M. , Daumann Lena J.
Published: February 2018

Recently, methanotrophic and methylotrophic bacteria were found to utilize rare earth elements (REEs). To monitor the REE content in culture media of these bacteria, we have developed a rapid screening method using the Arsenazo III (AS III) dye for spectrophotometric REE detection in the low μM (0.1 to 10 μM) range. We designed this assay to follow La
III
and Eu
III
depletion from the culture medium by the acidophilic verrucomicrobial methanotroph
Methylacidiphilum fumariolicum
strain SolV. The assay can also be modified to screen the uptake of other REEs, such as Pr
III
, or to monitor the depletion of La
III
from growth media in neutrophilic methylotrophs such as
Methylobacterium extorquens
strain AM1. The AS III assay presents a convenient and fast detection method for REE levels in culture media and is a sensitive alternative to inductively coupled plasma mass spectrometry (ICP-MS) or atomic absorption spectroscopy (AAS).

IMPORTANCE
REE-dependent bacterial metabolism is a quickly emerging field, and while the importance of REEs for both methanotrophic and methylotrophic bacteria is now firmly established, many important questions, such as how these insoluble elements are taken up into cells, are still unanswered. Here, an Arsenazo III dye-based assay has been developed for fast, specific, and sensitive determination of REE content in different culture media. This assay presents a useful tool for optimizing cultivation protocols, as well as for routine REE monitoring during bacterial growth without the need for specialized analytical instrumentation. Furthermore, this assay has the potential to promote the discovery of other REE-dependent microorganisms and can help to elucidate the mechanisms for acquisition of REEs by methanotrophic and methylotrophic bacteria.
A Natural Mouse Model for Neisseria Colonization
Authors: Ma Mancheong , Powell Daniel A. , Weyand Nathan J. , Rhodes Katherine A. , Rendón María A. , Frelinger Jeffrey A. , So Magdalene
Published: February 2018

Commensals are important for the proper functioning of multicellular organisms. How a commensal establishes persistent colonization of its host is little understood. Studies of this aspect of microbe-host interactions are impeded by the absence of an animal model. We have developed a natural small animal model for identifying host and commensal determinants of colonization and of the elusive process of persistence. Our system couples a commensal bacterium of wild mice,
Neisseria musculi
, with the laboratory mouse. The pairing of a mouse commensal with its natural host circumvents issues of host restriction. Studies are performed in the absence of antibiotics, hormones, invasive procedures, or genetic manipulation of the host. A single dose of
N. musculi
, administered orally, leads to long-term colonization of the oral cavity and gut. All mice are healthy. Susceptibility to colonization is determined by host genetics and innate immunity. For
N. musculi
, colonization requires the type IV pilus. Reagents and powerful tools are readily available for manipulating the laboratory mouse, allowing easy dissection of host determinants controlling colonization resistance.
N. musculi
is genetically related to human-dwelling commensal and pathogenic
Neisseria
and encodes host interaction factors and vaccine antigens of pathogenic
Neisseria
. Our system provides a natural approach for studying
Neisseria
-host interactions and is potentially useful for vaccine efficacy studies.
Increased Activity of Cystathionine β-Lyase Suppresses 2-Aminoacrylate Stress in Salmonella enterica
Authors: Ernst Dustin C. , Christopherson Melissa R. , Downs Diana M.
Published: February 2018

Reactive enamine stress caused by intracellular 2-aminoacrylate accumulation leads to pleiotropic growth defects in a variety of organisms. Members of the well-conserved RidA/YER057c/UK114 protein family prevent enamine stress by enhancing the breakdown of 2-aminoacrylate to pyruvate. In
Salmonella enterica
, disruption of RidA allows 2-aminoacrylate to accumulate and to inactivate a variety of pyridoxal 5′-phosphate-dependent enzymes by generating covalent bonds with the enzyme and/or cofactor. This study was initiated to identify mechanisms that can overcome 2-aminoacrylate stress in the absence of RidA. Multicopy suppressor analysis revealed that overproduction of the methionine biosynthesis enzyme cystathionine β-lyase (MetC) (EC 4.4.1.8) alleviated the pleiotropic consequences of 2-aminoacrylate stress in a
ridA
mutant strain. Degradation of cystathionine by MetC was not required for suppression of
ridA
phenotypes. The data support a model in which MetC acts on a noncystathionine substrate to generate a metabolite that reduces 2-aminoacrylate levels, representing a nonenzymatic mechanism of 2-aminoacrylate depletion.

IMPORTANCE
RidA proteins are broadly conserved and have been demonstrated to deaminate 2-aminoacrylate and other enamines. 2-Aminoacrylate is generated as an obligatory intermediate in several pyridoxal 5′-phosphate-dependent reactions; if it accumulates, it damages cellular enzymes. This study identified a novel mechanism to eliminate 2-aminoacrylate stress that required the overproduction, but not the canonical activity, of cystathionine β-lyase. The data suggest that a metabolite-metabolite interaction is responsible for quenching 2-aminoacrylate, and they emphasize the need for emerging technologies to probe metabolism
in vivo
.
Treatment of HIV-Infected Individuals with the Histone Deacetylase Inhibitor Panobinostat Results in Increased Numbers of Regulatory T Cells and Limits
Ex Vivo
Lipopolysaccharide-Induced Inflammatory Responses
Authors: Brinkmann Christel Rothe , Højen Jesper Falkesgaard , Rasmussen Thomas Aagaard , Kjær Anne Sofie , Olesen Rikke , Denton Paul W. , Østergaard Lars , Ouyang Zhengyu , Lichterfeld Mathias , Yu Xu , Søgaard Ole Schmeltz , Dinarello Charles , Tolstrup Martin
Published: February 2018

The effect of treatment with histone deacetylase inhibitors on the immune system in HIV-infected individuals is not clear. Analysis of results from a clinical trial in which 15 HIV-infected individuals received 12 doses of panobinostat identified a significant impact on both T cell activation status and regulatory T cell suppressive marker expression and a reduced level of monocytic responsiveness to inflammatory stimuli. These changes were substantiated by global gene expression analysis. Collectively, the results suggest that panobinostat has multiple effects on innate and adaptive immune responses. Importantly, all the effects were transient, and further panobinostat treatment did not cause persistent long-term changes in gene expression patterns in HIV-infected individuals.
Does assistive technology contribute to social inclusion for people with intellectual disability? A systematic review protocol
Authors: Owuor John , Larkan Fiona , Kayabu Bonnix , Fitzgerald Geraldine , Sheaf Greg , Dinsmore John , McConkey Roy , Clarke Mike , MacLachlan Malcolm
Published: February 2018

Introduction

The aim of this review is to answer the following question:Does assistive technology contribute to social inclusion for people with intellectual disability?Previous research on assistive technology has focused on socioeconomic impacts such as education, employment and access to healthcare by people with intellectual disability. There is a need to consolidate evidence on the interaction between intellectual disability, assistive technology, community living and social inclusion.

Methods and analysis

The review will consider studies from all settings: geographical, socioeconomic and care (institutional and community care), published in English. Studies reported in other languages with abstracts in English will be included if they can be translated using Google Translate, otherwise such studies will be included in the appendix. The review will include both qualitative and quantitative studies. The intervention in this review refers to the use of assistive technology to promote community participation or interpersonal relationships (social inclusion) for people with intellectual disability. The outcomes will be behavioural and social benefits of using assistive technology by people with intellectual disability. Enhanced interpersonal relationships and community participation by people with intellectual disability. Data analysis will be in two phases. The first phase will involve analysis of individual study designs separately. The second phase will be narrative/thematic synthesis of all study groups.

Ethics

The review will not create any ethical or safety concerns.

Dissemination

At least one peer-reviewed article in a leading journal such as theBMJis planned. The findings will also be disseminated through a seminar session involving internal audience at Trinity College Dublin and within the Assistive Technologies for people with Intellectual Disability and Autism research programme.

PROSPERO registration number

CRD42017065447; Pre-results.
The cost of mental and physical health disability in childhood and adolescence to families in the UK: findings from a repeated cross-sectional survey using propensity score matching
Authors: Solmi Francesca , Melnychuk Mariya , Morris Stephen
Published: February 2018

Objective

In the UK, families of disabled children are entitled to receive disability benefits to help meet costs associated with caring for their child. Evidence of actual costs incurred is scant, especially for mental health disability. In this study, we aimed to quantify the cost of mental and physical health disability in childhood and adolescence to families in the UK using the concept of compensating variation (CV).

Design

Repeated cross-sectional survey.

Setting

The UK general population

Participants

85 212 children drawn from 8 waves of the Family Resources Survey.

Outcomes

Using propensity score matching we matched families with a disabled child to similar families without a disabled child and calculated the extra income the former require to achieve the same living standards as the latter, that is, their CV. We calculated the additional costs specifically associated with several definitions of mental health and physical health disability.

Results

Families of a child with any mental health disability, regardless of the presence of physical health comorbidity, needed an additional £49.31 (95% CI: 21.95 to 76.67) and, for more severe disabilities, an additional £57.56 (95% CI: 17.69 to 97.44) per week to achieve the same living standards of families without a disabled child. This difference was greater for more deprived families, who needed between £59.28 (95% CI: 41.38 to 77.18) and £81.26 (95% CI: 53.35 to 109.38) more per week depending on the extent of mental health disability. Families of children with physical health disabilities, with or without mental health disabilities, required an additional £35.86 (95% CI: 13.77 to 57.96) per week, with economically deprived families requiring an extra £42.18 (95% CI: 26.38 to 57.97) per week.

Conclusions

Mental and physical health disabilities among children and adolescents were associated with high additional costs for the family, especially for those from deprived economic backgrounds. Means testing could help achieve a more equitable redistribution of disability benefit.
Longitudinal changes in oculomotor function in young adults with mild traumatic brain injury in Sweden: an exploratory prospective observational study
Authors: Matuseviciene Giedre , Johansson Jan , Möller Marika , Godbolt Alison K. , Pansell Tony , Deboussard Catharina Nygren
Published: February 2018

Objectives

To assess (1) whether visual disturbances can be demonstrated with objective measures more often in patients with mild traumatic brain injury (mTBI) than in orthopaedic controls and non-injured controls, (2) whether such objectively demonstrated disturbances change over time and (3) whether self-reported visual symptoms after mTBI correlate with objectively measurable changes in visuomotor performance.

Design

A prospective, controlled, observational study, with assessments planned 7–10 and 75–100 days after injury.

Setting

Emergency department of a general hospital in Sweden.

Participants

15 patients with mTBI, 15 patients with minor orthopaedic injury, 15 non-injured controls, aged 18–40 years.

Outcome measures

Visual examination, including assessment of visual acuity, accommodation, eye alignment, saccades and stereoacuity. Symptom assessment using Convergence Insufficiency Symptoms Survey (CISS) and Rivermead PostConcussion Symptoms Questionnaire.

Results

Assessments were performed 4–13 and 81–322 days after injury (extended time frames for logistical reasons). No statistically significant difference was found between the mTBI and control groups regarding saccade performance and stereoacuity at any time point. The accommodative amplitude was significantly lower in the mTBI group compared with non-injured controls at baseline. 6 out of 13 patients with mTBI had accommodative insufficiency at follow-up. Near point of convergence in the mTBI group was receded at baseline and improved statistically significantly at follow-up. At baseline, patients with mTBI had significantly higher CISS score than orthopaedic and non-injured controls. For patients with mTBI, the CISS score correlated with fusional vergence.

Conclusion

There were some transient measurable visual changes regarding convergence in patients with mTBI during the subacute period after the injury. Our findings of persistence of accommodative insufficiency in a considerable proportion of patients with mTBI suggest that this visual function should not be overlooked in clinical assessment.
Characteristics of medical disputes arising from dental practice in Guangzhou, China: an observational study
Authors: Liu Zifeng , Zhang Yong , Asante Joseph Obiri , Huang Yixiang , Wang Xin , Chen Lijin
Published: February 2018

Objectives

Doctor–patient conflict is a phenomenon that has become one of the major social problems affecting China’s medical system today. This study aimed to analyse the nature of medical dispute incidents arising from dental practice, discover the related factors that may have incited such disputes and explore measures whereby the incidents of patients’ conflicts towards dentists can be reduced.

Methods

A survey conducted in six public hospitals in Guangzhou, one of the largest cities in China, showed that more than two million patients received dental treatment between 2008 and 2012. χ2test and binary logistic regression analysis were used to identify statistically significant differences in incident rates.

Results

In a total of more than two million outpatients, 541 reported dental disputes and lodged complaints with the medical service centre. Male patients reported higher dispute rates than did females (χ2=9.74, P<0.01). Binary logistic regression analysis further showed that disputes developed into conflicts depending on five factors: patient gender, dental specialty, cause of dispute, mode of payment and resolution duration.

Conclusions

Gender, specialties, cause of dispute, mode of payment and resolution duration are associated with the incidence of dental conflicts, suggesting that medical quality is positively correlated to dental disputes, the coverage of stomatology in medical insurance should be expanded and detailed negotiation system should be developed for resolving dental disputes.
Training approaches for the deployment of a mechanical chest compression device: a randomised controlled manikin study
Authors: Couper Keith , Velho Rochelle M , Quinn Tom , Devrell Anne , Lall Ranjit , Orriss Barry , Yeung Joyce , Perkins Gavin D
Published: February 2018

Objectives

To evaluate the effect of training strategy on team deployment of a mechanical chest compression device.

Design

Randomised controlled manikin trial.

Setting

Large teaching hospital in the UK.

Participants

Twenty teams, each comprising three clinicians. Participating individuals were health professionals with intermediate or advanced resuscitation training.

Interventions

Teams were randomised in a 1:1 ratio to receive either standard mechanical chest compression device training or pit-crew device training. Training interventions lasted up to 1 h. Performance was measured immediately after training in a standardised simulated cardiac arrest scenario in which teams were required to deploy a mechanical chest compression device.

Primary and secondary outcome measures

Primary outcome was chest compression flow fraction in the minute preceding the first mechanical chest compression. Secondary outcomes included cardiopulmonary resuscitation quality and mechanical device deployment metrics, and non-technical skill performance. Outcomes were assessed using video recordings of the test scenario.

Results

In relation to the primary outcome of chest compression flow fraction in the minute preceding the first mechanical chest compression, we found that pit-crew training was not superior to standard training (0.76 (95% CI 0.73 to 0.79) vs 0.77 (95% CI 0.73 to 0.82), mean difference −0.01 (95% CI −0.06 to 0.03), P=0.572). There was also no difference between groups in performance in relation to any secondary outcome.

Conclusions

Pit-crew training, compared with standard training, did not improve team deployment of a mechanical chest device in a simulated cardiac arrest scenario.

Trial registration number

ISRCTN43049287; Pre-results.
Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study
Authors: Wehberg Sonja , Guldberg Rikke , Gradel Kim Oren , Kesmodel Ulrik Schiøler , Munk Lis , Andersson Charlotte Brix , Jølving Line Riis , Nielsen Jan , Nørgård Bente Mertz
Published: February 2018

Objectives

The aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions.

Design

Historical registry-based cohort study.

Settings and participants

The study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included.

Primary and secondary outcome measures

We estimated (1) OR of elective and emergency CS adjusted for several risk factors, for example, body mass index, parity, age and size of maternity unit and (2) risk-adjusted proportions of elective and emergency CS to evaluate between-hospital variation.

Results

The CS proportion was stable at 20%–21%, but showed wide variation between units, even in adjusted models. Large units performed significantly more elective CSs than smaller units, and the risk of emergency CS was significantly reduced compared with smaller units. Many of the included risk factors were found to influence the risk of CS. The most important risk factors were breech presentation and previous CS. Four units performed more CSs and one unit fewer CSs than expected.

Conclusion

The main risk factors for elective CS were breech presentation and previous CS; for emergency CS they were breech presentation and cephalopelvic disproportion. The proportions of CS were stable during the study period. We found variation in risk-adjusted CS between hospitals in Denmark. Although exhaustive models were applied, the results indicated the presence of systematic variation between hospital units, which was unexpected in a small, well-regulated country such as Denmark.
‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia
Authors: Obermair Helena M , Dodd Rachael H , Bonner Carissa , Jansen Jesse , McCaffery Kirsten
Published: February 2018

Objectives

The incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18–69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25–74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, ‘Stop May 1st Changes to Pap Smears—Save Women’s Lives’, opposing the changes, which received over 70 000 signatures and almost 20 000 comments.

Methods

Content analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February–March 2017.

Results

Nineteen codes were identified, reflecting four themes: (1) valuing women’s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women’s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted.

Conclusions

Screening changes within this selected group were perceived as threatening women’s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes.
Epidemiological and clinical features of human metapneumovirus in hospitalised paediatric patients with acute respiratory illness: a cross-sectional study in Southern China, from 2013 to 2016
Authors: Zhang Ling , Liu Wenkuan , Liu Donglan , Chen Dehui , Tan Weiping , Qiu Shuyan , Xu Duo , Li Xiao , Liu Tiantian , Zhou Rong
Published: February 2018

Objectives

Human metapneumovirus (HMPV) is one of the most important respiratory viral pathogens affecting infants and children worldwide. Our study describes the epidemiological and clinical characteristics of HMPV present in patients hospitalised with acute respiratory illness (ARI) in Guangzhou, Southern China.

Study design

A cross-sectional study.

Setting

Two tertiary hospitals in Guangzhou.

Participants and methods

Throat swabs were collected over a 3-year period from 5133 paediatric patients (≤14 years) hospitalised with ARI. Patients who are HMPV positive with clinical presentations (101/103) were recorded for further analysis.

Results

Of the 5133 patients included in the study, 103 (2.0%) were positive for HMPV. HMPV was more prevalent in children ≤5 years (2.2%, 98/4399) compared with older children (>5–14 years) (0.7%, 5/734) (P=0.004). Two seasonal HMPV peaks were observed each year and mainly occurred in spring and early summer. Overall, 18.4% (19/103) of patients who are HMPV positive were codetected with other pathogens, most frequently respiratory syncytial virus (36.8%, 7/19). Patients who are HMPV positive presented with a wide spectrum of clinical features, including cough (100.0%, 101/101), abnormal pulmonary breath sound (91.1%, 92/101), fever (88.1%, 89/101), expectoration (77.2%, 78/101), coryza (50.5%, 51/101) and wheezing (46.5%, 47/101). The main diagnosis of patients who are HMPV positive was bronchopneumonia (66.7%, 56/84). Fever (≥38˚C) (91.6%, 76/83) was detected more often in patients with only HMPV detected than in patients with HMPV plus other pathogen(s) detected (72.2%, 13/18) (P=0.037), whereas diarrhoea was more common in patients with HMPV plus other pathogen(s) detected (22.2%, 4/18), compared with patients with HMPV only (3.6%, 3/83) (P=0.018).

Conclusions

HMPV is an important respiratory pathogen in children with ARI in Guangzhou, particularly in children ≤5 years old. HMPV has a seasonal variation. Bronchopneumonia is a major diagnosis in patients who are HMPV positive.