bluuebunny/crossref_metadata_2025 huggingface dataset:
Flow and Heat Transfer Characteristics in Channels With Groove–Protrusions and Combination Effect With Ribs
Authors: Zheng Lu , Xie Yonghui , Zhang Di , Shi Haoning
Published: July 2015

Passive flow control and heat transfer enhancement technique has become an attractive method for device internal cooling with low resistance penalty. In the present paper, the flow and heat transfer characteristics in the small scale rectangular channel with different groove–protrusions are investigated numerically. Furthermore, the combination effect with ribs is studied. The numerical results show that on the groove side, the flow separation mainly occurs at the leading edge, and the reattachment mainly occurs at the trailing edge in accordance with the local Nusselt number distribution. On the protrusion side, the separation mainly occurs at the protrusion back porch and enhances the heat transfer at the leading edge of the downstream adjacent groove. The rectangle case provides the highest dimensionless heat transfer enhancement coefficient Nu/Nu0, dimensionless resistance coefficient f/f0, and thermal performance (TP) with the highest sensitivity of Re. When ribs are employed, the separation bubble sizes prominently decrease, especially inside the second and third grooves. The Nu/Nu0 values significantly increase when ribs are arranged, and the one-row case provides the highest heat transfer enhancement by ribs. Besides, the two-row case provides the highest Nu/Nu0 value without ribs, and the three-row case shows the lowest Nu/Nu0 value whether ribs are arranged or not.
Molecular overlap in the regulation of SK channels by small molecules and phosphoinositides
Authors: Zhang Miao , Meng Xuan-Yu , Zhang Ji-fang , Cui Meng , Logothetis Diomedes E.
Published: July 2015

NS309 enhances PIP
2
interactions and activity of SK channels.
Mini-ISES identifies promising carbafructopyranose-based salens for asymmetric catalysis: Tuning ligand shape via the anomeric effect
Authors: Karukurichi Kannan R. , Fei Xiang , Swyka Robert A. , Broussy Sylvain , Shen Weijun , Dey Sangeeta , Roy Sandip K. , Berkowitz David B.
Published: July 2015

Enzymes lead to the discovery of new, shape-tunable ligands for controlling catalytic chemistry.
A vanished history of skeletonization in Cambrian comb jellies
Authors: Ou Qiang , Xiao Shuhai , Han Jian , Sun Ge , Zhang Fang , Zhang Zhifei , Shu Degan
Published: July 2015

Early evolution of the basal animal phylum illuminated by sclerotized and armored ctenophore species from early Cambrian period.
The valence-fluctuating ground state of plutonium
Authors: Janoschek Marc , Das Pinaki , Chakrabarti Bismayan , Abernathy Douglas L. , Lumsden Mark D. , Lawrence John M. , Thompson Joe D. , Lander Gerard H. , Mitchell Jeremy N. , Richmond Scott , Ramos Mike , Trouw Frans , Zhu Jian-Xin , Haule Kristjan , Kotliar Gabriel , Bauer Eric D.
Published: July 2015

Determination of plutonium’s fluctuating electronic and magnetic ground state resolves long-standing “missing” magnetism puzzle.
Temperature-Dependent Galleria mellonella Mortality as a Result of Yersinia entomophaga Infection
Authors: Hurst Mark R. H. , Beattie Amy K. , Jones Sandra A. , Hsu Pei-Chun , Calder Joanne , van Koten Chikako
Published: July 2015

The bacterium
Yersinia entomophaga
is pathogenic to a range of insect species, with death typically occurring within 2 to 5 days of ingestion.
Per os
challenge of larvae of the greater wax moth (
Galleria mellonella
) confirmed that
Y. entomophaga
was virulent when fed to larvae held at 25°C but was avirulent when fed to larvae maintained at 37°C. At 25°C, a dose of ∼4 × 10
7
CFU per larva of a
Y. entomophaga
toxin complex (Yen-TC) deletion derivative, the
Y. entomophaga
ΔTC variant, resulted in 27% mortality. This low level of activity was restored to near-wild-type levels by augmentation of the diet with a sublethal dose of purified Yen-TC. Intrahemocoelic injection of ∼3
Y. entomophaga
or
Y. entomophaga
ΔTC cells per larva gave a 4-day median lethal dose, with similar levels of mortality observed at both 25 and 37°C. Following intrahemocoelic injection of a Yen-TC YenA1 green fluorescent protein fusion strain into larvae maintained at 25°C, the bacteria did not fluoresce until the population density reached 2 × 10
7
CFU ml
−1
of hemolymph. The observed cells also took an irregular form. When the larvae were maintained at 37°C, the cells were small and the observed fluorescence was sporadic and weak, being more consistent at a population density of ∼3 × 10
9
CFU ml
−1
of hemolymph. These findings provide further understanding of the pathobiology of
Y. entomophaga
in insects, showing that the bacterium gains direct access to the hemocoelic cavity, from where it rapidly multiplies to cause disease.
Rerouting Cellular Electron Flux To Increase the Rate of Biological Methane Production
Authors: Catlett Jennie L. , Ortiz Alicia M. , Buan Nicole R.
Published: July 2015

Methanogens are anaerobic archaea that grow by producing methane, a gas that is both an efficient renewable fuel and a potent greenhouse gas. We observed that overexpression of the cytoplasmic heterodisulfide reductase enzyme HdrABC increased the rate of methane production from methanol by 30% without affecting the growth rate relative to the parent strain. Hdr enzymes are essential in all known methane-producing archaea. They function as the terminal oxidases in the methanogen electron transport system by reducing the coenzyme M (2-mercaptoethane sulfonate) and coenzyme B (7-mercaptoheptanoylthreonine sulfonate) heterodisulfide, CoM-S-S-CoB, to regenerate the thiol-coenzymes for reuse. In
Methanosarcina acetivorans
, HdrABC expression caused an increased rate of methanogenesis and a decrease in metabolic efficiency on methylotrophic substrates. When acetate was the sole carbon and energy source, neither deletion nor overexpression of HdrABC had an effect on growth or methane production rates. These results suggest that in cells grown on methylated substrates, the cell compensates for energy losses due to expression of HdrABC with an increased rate of substrate turnover and that HdrABC lacks the appropriate electron donor in acetate-grown cells.
Fundamental Characteristics of Deep-UV Light-Emitting Diodes and Their Application To Control Foodborne Pathogens
Authors: Shin Joo-Yeon , Kim Soo-Ji , Kim Do-Kyun , Kang Dong-Hyun
Published: July 2015

Low-pressure mercury UV (LP-UV) lamps have long been used for bacterial inactivation, but due to certain disadvantages, such as the possibility of mercury leakage, deep-UV-C light-emitting diodes (DUV-LEDs) for disinfection have recently been of great interest as an alternative. Therefore, in this study, we examined the basic spectral properties of DUV-LEDs and the effects of UV-C irradiation for inactivating foodborne pathogens, including
Escherichia coli
O157:H7,
Salmonella enterica
serovar Typhimurium, and
Listeria monocytogenes
, on solid media, as well as in water. As the temperature increased, DUV-LED light intensity decreased slightly, whereas LP-UV lamps showed increasing intensity until they reached a peak at around 30°C. As the irradiation dosage and temperature increased,
E. coli
O157:H7 and
S
. Typhimurium experienced 5- to 6-log-unit reductions.
L. monocytogenes
was reduced by over 5 log units at a dose of 1.67 mJ/cm
2
. At 90% relative humidity (RH), only
E. coli
O157:H7 experienced inactivation significantly greater than at 30 and 60% RH. In a water treatment study involving a continuous system, 6.38-, 5.81-, and 3.47-log-unit reductions were achieved in
E. coli
O157:H7,
S
. Typhimurium, and
L. monocytogenes
, respectively, at 0.5 liter per minute (LPM) and 200 mW output power. The results of this study suggest that the use of DUV-LEDs may compensate for the drawbacks of using LP-UV lamps to inactivate foodborne pathogens.
Attenuation of Colitis by Lactobacillus casei BL23 Is Dependent on the Dairy Delivery Matrix
Authors: Lee Bokyung , Yin Xiaochen , Griffey Stephen M. , Marco Maria L.
Published: July 2015

The role of the food delivery matrix in probiotic performance in the intestine is not well understood. Because probiotics are often provided to consumers in dairy products, we investigated the contributions of milk to the health-benefiting performance ofLactobacillus caseiBL23 in a dextran sulfate sodium (DSS)-induced murine model of ulcerative colitis.L. caseiBL23 protected against the development of colitis when ingested in milk but not in a nutrient-free buffer simulating consumption as a nutritional supplement. Consumption of (acidified) milk alone also provided some protection against weight loss and intestinal inflammation but was not as effective asL. caseiand milk in combination. In contrast,L. caseimutants deficient in DltD (lipoteichoic acidd-alanine transfer protein) or RecA (recombinase A) were unable to protect against DSS-induced colitis, even when consumed in the presence of milk. Mice fed eitherL. caseior milk contained reduced quantities of colonic proinflammatory cytokines, indicating that theL. caseiDltD−and RecA−mutants as well asL. caseiBL23 in nutrient-free buffer were effective at modulating immune responses. However, there was not a direct correlation between colitis and quantities of these cytokines at the time of sacrifice. Identification of the cecal microbiota by 16S rRNA gene sequencing showed thatL. caseiin milk enriched forComamonadaceaeandBifidobacteriaceae; however, the consumption of neitherL. caseinor milk resulted in the restoration of the microbiota to resemble that of healthy animals. These findings strongly indicate that probiotic strain efficacy can be influenced by the food/supplement delivery matrix.
Host Avian Beta-Defensin and Toll-Like Receptor Responses of Pigeons following Infection with Pigeon Paramyxovirus Type 1
Authors: Li Yanyan , Xu Qianqian , Zhang Tingting , Gao Mengying , Wang Qiuling , Han Zongxi , Shao Yuhao , Ma Deying , Liu Shengwang
Published: July 2015

The high morbidity and mortality in pigeons caused by pigeon paramyxovirus type 1 (PPMV-1) highlights the need for new insights into the host immune response and novel treatment approaches. Host defense peptides (HDPs) are key components of the innate immune system. In this study, three novel avian β-defensins (AvBDs 2, 7, and 10) were characterized in pigeons and shown to possess direct antiviral activity against PPMV-1
in vitro
. In addition, we evaluated the mRNA expression of these AvBDs and other immune-related genes in tissues of 2-month-old infected pigeons at 3 and 7 days postinfection. We observed that the expression of AvBD2 in the cecal tonsil, lungs, and proventriculus, as well as the expression of AvBD10 in the spleen, lungs, proventriculus, and kidneys, was upregulated in infected pigeons. Similarly, the expression of both Toll-like receptor 3 (TLR3) and TLR7 was increased in the spleen, trachea, and proventriculus, while TLR15 expression was increased only in the lungs of infected pigeons. In addition, inducible nitric oxide synthase (iNOS) expression was upregulated in the spleen, the bursa of Fabricius, the trachea, and the proventriculus of infected pigeons. Furthermore, we observed a high correlation between the expression of AvBD2 and the expression of either TLR7 or TLR15, as well as between AvBD10 expression and either TLR3 or TLR7 expression in respective tissues. The results suggest that PPMV-1 infection can induce innate host responses characterized by the activation of TLRs, particularly TLR3 and TLR7, AvBDs (2 and 10), and iNOS in pigeons.
Neutral and Phospholipids of the Myxococcus xanthus Lipodome during Fruiting Body Formation and Germination
Authors: Ahrendt Tilman , Wolff Hendrik , Bode Helge B.
Published: July 2015

Myxobacteria are well-known for their complex life cycle, including the formation of spore-filled fruiting bodies. The model organism
Myxococcus xanthus
exhibits a highly complex composition of neutral and phospholipids, including triacylglycerols (TAGs), diacylglycerols (DAGs), phosphatidylethanolamines (PEs), phosphatidylglycerols (PGs), cardiolipins (CLs), and sphingolipids, including ceramides (Cers) and ceramide phosphoinositols (Cer-PIs). In addition, ether lipids have been shown to be involved in development and signaling. In this work, we describe the lipid profile of
M. xanthus
during its entire life cycle, including spore germination. PEs, representing one of the major components of the bacterial membrane, decreased by about 85% during development from vegetative rods to round myxospores, while TAGs first accumulated up to 2-fold before they declined 48 h after the induction of sporulation. Presumably, membrane lipids are incorporated into TAG-containing lipid bodies, serving as an intermediary energy source for myxospore formation. The ceramides Cer(d-19:0/
iso
-17:0) and Cer(d-19:0/16:0) accumulated 6-fold and 3-fold, respectively, after 24 h of development, identifying them to be novel putative biomarkers for
M. xanthus
sporulation. The most abundant ether lipid, 1-
iso
-15:0-alkyl-2,3-di-
iso
-15:0-acyl glycerol (TG1), exhibited a lipid profile different from that of all TAGs during sporulation, reinforcing its signaling character. The absence of all these lipid profile changes in mutants during development supports the importance of lipids in myxobacterial development. During germination of myxospores, only the
de novo
biosynthesis of new cell membrane fatty acids was observed. The unexpected accumulation of TAGs also during germination might indicate a function of TAGs as intermediary storage lipids during this part of the life cycle as well.
A Modified Shuttle Plasmid Facilitates Expression of a Flavin Mononucleotide-Based Fluorescent Protein in Treponema denticola ATCC 35405
Authors: Godovikova Valentina , Goetting-Minesky M. Paula , Shin Jae M. , Kapila Yvonne L. , Rickard Alexander H. , Fenno J. Christopher
Published: July 2015

Oral pathogens, including
Treponema denticola
, initiate the dysregulation of tissue homeostasis that characterizes periodontitis. However, progress of research on the roles of
T. denticola
in microbe-host interactions and signaling, microbial communities, microbial physiology, and molecular evolution has been hampered by limitations in genetic methodologies. This is typified by an extremely low transformation efficiency and inability to transform the most widely studied
T. denticola
strain with shuttle plasmids. Previous studies have suggested that robust restriction-modification (R-M) systems in
T. denticola
contributed to these problems. To facilitate further molecular genetic analysis of
T. denticola
behavior, we optimized existing protocols such that shuttle plasmid transformation efficiency was increased by >100-fold over prior reports. Here, we report routine transformation of
T. denticola
ATCC 35405 with shuttle plasmids, independently of both plasmid methylation status and activity of the type II restriction endonuclease encoded by TDE0911. To validate the utility of this methodological advance, we demonstrated expression and activity in
T. denticola
of a flavin mononucleotide-based fluorescent protein (FbFP) that is active under anoxic conditions. Addition of routine plasmid-based fluorescence labeling to the
Treponema
toolset will enable more-rigorous and -detailed studies of the behavior of this organism.
YvoA and CcpA Repress the Expression of
chiB
in Bacillus thuringiensis
Authors: Jiang Kun , Li Li-na , Pan Jin-hua , Wang Ting-ting , Chen Yue-hua , Cai Jun
Published: July 2015

Bacillus thuringiensis
produces chitinases, which are involved in its antifungal activity and facilitate its insecticidal activity. In our recent work, we found that a 16-bp sequence,

dre
chiB

(AGACTTCGTGATGTCT), downstream of the minimal promoter region of the chitinase B gene (
chiB
) was a critical site for the inducible expression of
chiB
in
B. thuringiensis
Bti75. In this work, we show that a GntR family transcriptional regulator (named YvoA
Bt
), which is homologous to YvoA of
Bacillus subtilis
, can specifically bind to the

dre
chiB

oligonucleotide sequences
in vitro
by using electrophoretic mobility shift assays (EMSAs) and isothermal titration calorimetry (ITC) assays. The results of quantitative real-time reverse transcription-PCR (qRT-PCR) and Western blotting indicated that deletion of
yvoA
caused an ∼7.5-fold increase in the expression level of
chiB
. Furthermore, binding of purified YvoA
Bt
to its target DNA could be abolished by glucosamine-6-phosphate (GlcN-6-P). We also confirmed, in the presence of the phosphoprotein Hpr-Ser
45
-P, that purified CcpA
Bt
bound specifically to the promoter of
chiB
, which contains the “

cre
chiB

” sequence (ATAAAGCGTTTACA). According to the results of qRT-PCR and Western blotting, deletion of
ccpA
resulted in a 39-fold increase in the
chiB
expression level, and glucose no longer influenced the expression of
chiB
. We confirm that
chiB
is negatively controlled by both CcpA
Bt
and YvoA
Bt
in Bti75.
Dual-Color Monitoring Overcomes the Limitations of Single Bioluminescent Reporters in Fast-Growing Microbes and Reveals Phase-Dependent Protein Productivity during the Metabolic Rhythms of Saccharomyces cerevisiae
Authors: Krishnamoorthy Archana , Robertson J. Brian
Published: July 2015

Luciferase is a useful, noninvasive reporter of gene regulation that can be continuously monitored over long periods of time; however, its use is problematic in fast-growing microbes like bacteria and yeast because rapidly changing cell numbers and metabolic states also influence bioluminescence, thereby confounding the reporter's signal. Here we show that these problems can be overcome in the budding yeast
Saccharomyces cerevisiae
by simultaneously monitoring bioluminescence from two different colors of beetle luciferase, where one color (green) reports activity of a gene of interest, while a second color (red) is stably expressed and used to continuously normalize green bioluminescence for fluctuations in signal intensity that are unrelated to gene regulation. We use this dual-luciferase strategy in conjunction with a light-inducible promoter system to test whether different phases of yeast respiratory oscillations are more suitable for heterologous protein production than others. By using pulses of light to activate production of a green luciferase while normalizing signal variation to a red luciferase, we show that the early reductive phase of the yeast metabolic cycle produces more luciferase than other phases.
Unusual Biosynthesis and Structure of Locillomycins from Bacillus subtilis 916
Authors: Luo Chuping , Liu Xuehui , Zhou Xian , Guo Junyao , Truong John , Wang Xiaoyu , Zhou Huafei , Li Xiangqian , Chen Zhiyi
Published: July 2015

Three families of
Bacillus
cyclic lipopeptides—surfactins, iturins, and fengycins—have well-recognized potential uses in biotechnology and biopharmaceutical applications. This study outlines the isolation and characterization of locillomycins, a novel family of cyclic lipopeptides produced by
Bacillus subtilis
916. Elucidation of the locillomycin structure revealed several molecular features not observed in other
Bacillus
lipopeptides, including a unique nonapeptide sequence and macrocyclization. Locillomycins are active against bacteria and viruses. Biochemical analysis and gene deletion studies have supported the assignment of a 38-kb gene cluster as the locillomycin biosynthetic gene cluster. Interestingly, this gene cluster encodes 4 proteins (LocA, LocB, LocC, and LocD) that form a hexamodular nonribosomal peptide synthetase to biosynthesize cyclic nonapeptides. Genome analysis and the chemical structures of the end products indicated that the biosynthetic pathway exhibits two distinct features: (i) a nonlinear hexamodular assembly line, with three modules in the middle utilized twice and the first and last two modules used only once and (ii) several domains that are skipped or optionally selected.
Understanding the Linkage between Elevation and the Activated-Sludge Bacterial Community along a 3,600-Meter Elevation Gradient in China
Authors: Niu Lihua , Li Yi , Wang Peifang , Zhang Wenlong , Wang Chao , Wang Qing
Published: July 2015

To understand the relationship between elevation and bacterial communities in wastewater treatment plants (WWTPs), bacterial communities in 21 municipal WWTPs across China, located 9 to 3,660 m above sea level (masl), were investigated by 454 pyrosequencing. A threshold for the association of elevation with bacterial community richness and evenness was observed at approximately 1,200 masl. At lower elevations, both richness and evenness were not significantly associated with elevation. At higher elevations, significant declines with increased elevations were observed for community richness and evenness. The declining evenness trend at the phylum level was reflected by distinct trends in relative abundance for individual bacterial phyla.
Betaproteobacteria
,
Bacteroidetes
, and
Firmicutes
displayed significant increases, while most other phyla showed declines. Spearman correlation analysis indicated that the community richness and evenness at high elevations were more correlated with elevation than with any other single environmental variable. Redundancy analysis indicated that the contribution of elevation to community composition variances increased from 3% at lower elevations to 11% at higher elevations whereas the community composition variance at higher elevations remained much more explained by operational variables (39.2%) than by elevation. The influent total phosphorus concentration, food/microorganism ratio, and treatment process were the three shared dominant contributors to the community composition variance across the whole elevation gradient, followed by effluent ammonia nitrogen and temperature at higher elevations.
What's Inside That Seed We Brew? A New Approach To Mining the Coffee Microbiome
Authors: Vaughan Michael Joe , Mitchell Thomas , McSpadden Gardener Brian B.
Published: July 2015

Coffee is a critically important agricultural commodity for many tropical states and is a beverage enjoyed by millions of people worldwide. Recent concerns over the sustainability of coffee production have prompted investigations of the coffee microbiome as a tool to improve crop health and bean quality. This review synthesizes literature informing our knowledge of the coffee microbiome, with an emphasis on applications of fruit- and seed-associated microbes in coffee production and processing. A comprehensive inventory of microbial species cited in association with coffee fruits and seeds is presented as reference tool for researchers investigating coffee-microbe associations. It concludes with a discussion of the approaches and techniques that provide a path forward to improve our understanding of the coffee microbiome and its utility, as a whole and as individual components, to help ensure the future sustainability of coffee production.
Focused Directed Evolution of Aryl-Alcohol Oxidase in Saccharomyces cerevisiae by Using Chimeric Signal Peptides
Authors: Viña-Gonzalez Javier , Gonzalez-Perez David , Ferreira Patricia , Martinez Angel T. , Alcalde Miguel
Published: July 2015

Aryl-alcohol oxidase (AAO) is an extracellular flavoprotein that supplies ligninolytic peroxidases with H
2
O
2
during natural wood decay. With a broad substrate specificity and highly stereoselective reaction mechanism, AAO is an attractive candidate for studies into organic synthesis and synthetic biology, and yet the lack of suitable heterologous expression systems has precluded its engineering by directed evolution. In this study, the native signal sequence of AAO from
Pleurotus eryngii
was replaced by those of the mating α-factor and the K
1
killer toxin, as well as different chimeras of both prepro-leaders in order to drive secretion in
Saccharomyces cerevisiae
. The secretion of these AAO constructs increased in the following order: preproα-AAO > preαproK-AAO > preKproα-AAO > preproK-AAO. The chimeric preαproK-AAO was subjected to focused-directed evolution with the aid of a dual screening assay based on the Fenton reaction. Random mutagenesis and DNA recombination was concentrated on two protein segments (Met[α1]-Val109 and Phe392-Gln566), and an array of improved variants was identified, among which the FX7 mutant (harboring the H91N mutation) showed a dramatic 96-fold improvement in total activity with secretion levels of 2 mg/liter. Analysis of the N-terminal sequence of the FX7 variant confirmed the correct processing of the preαproK hybrid peptide by the KEX2 protease. FX7 showed higher stability in terms of pH and temperature, whereas the pH activity profiles and the kinetic parameters were maintained. The Asn91 lies in the flavin attachment loop motif, and it is a highly conserved residue in all members of the GMC superfamily, except for
P. eryngii
and
P. pulmonarius
AAO. The
in vitro
involution of the enzyme by restoring the consensus ancestor Asn91 promoted AAO expression and stability.
Tools for ‘safety netting’ in common paediatric illnesses: a systematic review in emergency care
Authors: de Vos-Kerkhof Evelien , Geurts Dorien HF , Wiggers Mariska , Moll Henriette A , Oostenbrink Rianne
Published: July 2015

Context

Follow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician.

Objective

To systematically identify evaluated safety-netting strategies after ED discharge and to describe determinants of paediatric ED revisits.

Data sources

MEDLINE, Embase, CINAHL, Cochrane central, OvidSP, Web of Science, Google Scholar, PubMed.

Study selection

Studies of any design reporting on safety netting/follow-up after ED discharge and/or determinants of ED revisits for the total paediatric population or specifically for children with fever, dyspnoea and/or gastroenteritis. Outcomes included complicated course of disease after initial ED visit (eg, revisits, hospitalisation).

Data extraction

Two reviewers independently assessed studies for eligibility and study quality. As meta-analysis was not possible due to heterogeneity of studies, we performed a narrative synthesis of study results. A best-evidence synthesis was used to identify the level of evidence.

Results

We summarised 58 studies, 36% (21/58) were assessed as having low risk of bias. Limited evidence was observed for different strategies of safety netting, with educational interventions being mostly studied. Young children, a relevant medical history, infectious/respiratory symptoms or seizures and progression/persistence of symptoms were strongly associated with ED revisits. Gender, emergency crowding, physicians’ characteristics and diagnostic tests and/or therapeutic interventions at the index visit were not associated with revisits.

Conclusions

Within the heterogeneous available evidence, we identified a set of strong determinants of revisits that identify high-risk groups in need for safety netting in paediatric emergency care being related to age and clinical symptoms. Gaps remain on intervention studies concerning specific application of a uniform safety-netting strategy and its included time frame.
International comparison of sudden unexpected death in infancy rates using a newly proposed set of cause-of-death codes
Authors: Taylor Barry J , Garstang Joanna , Engelberts Adele , Obonai Toshimasa , Cote Aurore , Freemantle Jane , Vennemann Mechtild , Healey Matt , Sidebotham Peter , Mitchell Edwin A , Moon Rachel Y
Published: July 2015

Background

Comparing rates of sudden unexpected death in infancy (SUDI) in different countries and over time is difficult, as these deaths are certified differently in different countries, and, even within the same jurisdiction, changes in this death certification process have occurred over time.

Aims

To identify if International Classification of Diseases-10 (ICD-10) codes are being applied differently in different countries, and to develop a more robust tool for international comparison of these types of deaths.

Methods

Usage of six ICD-10 codes, which code for the majority of SUDI, was compared for the years 2002–2010 in eight high-income countries.

Results

There was a great variability in how each country codes SUDI. For example, the proportion of SUDI coded as sudden infant death syndrome (R95) ranged from 32.6% in Japan to 72.5% in Germany. The proportion of deaths coded as accidental suffocation and strangulation in bed (W75) ranged from 1.1% in Germany to 31.7% in New Zealand. Japan was the only country to consistently use the R96 code, with 44.8% of SUDI attributed to that code. The lowest, overall, SUDI rate was seen in the Netherlands (0.19/1000 live births (LB)), and the highest in New Zealand (1.00/1000 LB). SUDI accounted for one-third to half of postneonatal mortality in 2002–2010 for all of the countries except for the Netherlands.

Conclusions

The proposed set of ICD-10 codes encompasses the codes used in different countries for most SUDI cases. Use of these codes will allow for better international comparisons and tracking of trends over time.
Role of probiotics VSL#3 in prevention of suspected sepsis in low birthweight infants in India: a randomised controlled trial
Authors: Sinha Anju , Gupta Subodh S , Chellani Harish , Maliye Chetna , Kumari Vidya , Arya Sugandha , Garg BS , Gaur Sunita Dixit , Gaind Rajni , Deotale Vijayshri , Taywade Manish , Prasad MS , Thavraj Vasantha , Mukherjee Ajit , Roy Malabika
Published: July 2015

Objectives

To assess the effect of the probiotic VSL#3 in prevention of neonatal sepsis in low birthweight (LBW) infants.

Design

Randomised, double-blind, placebo-controlled trial.

Setting

Community setting in rural India.

Participants

LBW infants aged 3–7 days.

Interventions

Infants were randomised to receive probiotic (VSL#3, 10 billion colony-forming units (cfu)) or placebo for 30 days, and were followed up for 2 months.

Main outcome measure

Possible serious bacterial infection (PSBI) as per the Integrated Management of Neonatal Childhood Illnesses algorithm, as diagnosed by fieldworkers/physicians.

Results

668 infants were randomised to VSL#3 and 672 to placebo. By intention-to-treat analysis, the risk of PSBI among infants in the overall population of LBW infants was not statistically significant (RR 0.79 (95% CI 0.56 to 1.03)). Probiotics reduced median days of hospitalisation (6 days vs 3 days in probiotics) (p=0.018) but not the risk of hospitalisation (RR 0.66 (95% CI 0.42 to 1.04). The onset of PSBI in 10% of infants occurred on the 40th day in the probiotics arm versus the 25th day in the control arm (p=0.063).

Conclusions

Daily supplementation of LBW infants with probiotics VSL#3 (10 billion cfu) for 30 days led to a non-significant 21% reduction in risk of neonatal sepsis. A larger study with sufficient power and a more specific primary end point is warranted to confirm the preventive effect of VSL#3 on neonatal sepsis in LBW infants.

Trial registration number

The study is registered at the Clinical Trial Registry of India (CTRI/2008/091/000049).
Effectiveness of a low-intensity telephone counselling intervention on an untreated metabolic syndrome detected by national population screening in Korea: a non-randomised study using regression discontinuity design
Authors: Yi Sang-Wook , Shin Soon-Ae , Lee Youn-Jung
Published: July 2015

Objective

Whether low-intensity telephone-counselling interventions can improve cardiometabolic risk factors in screen-detected people with metabolic syndrome (MetS) is unclear. The aim of this study was to evaluate the effectiveness of a low-intensity, telephone-counselling programme on MetS implemented by the National Health Insurance Service (NHIS) of Korea using regression discontinuity design.

Design

A nationwide non-randomised intervention study with a regression discontinuity design. A retrospective analysis using data from NHIS.

Setting

NHIS, Korea from January 2011 to June 2013.

Participants

5 378 558 beneficiaries with one or more MetS components by NHIS criteria detected by population screening were enrolled in the NHIS MetS Management Programme in 2012. Of these, 1 147 695 underwent annual follow-up examinations until June 2013 (‘control group’ which received control intervention, n=855 870; ‘eligible group’ which was eligible for counselling, n=291 825; ‘intervention group’ which participated in telephone counselling among eligible groups, n=23 968).

Main outcome measures

Absolute changes in MetS components, weight and body mass index (BMI) were analysed. Multiple regression analyses were applied using the analysis of covariance model (baseline measurements as covariates).

Results

Low-intensity telephone counselling was associated with decreased systolic BP (−0.85 mm Hg, 95% CI −1.02 to −0.68), decreased diastolic BP (−0.63 mm Hg, −95% CI −0.75 to −0.50), decreased triglyceride (−1.57 mg/dL, 95% CI −2.89 to −0.25), reduced waist circumference (−0.09 cm, 95% CI −0.16 to −0.02), reduced weight (−0.19 kg, 95% CI −0.24 to −0.15) and reduced BMI (−0.07 kg/m2, 95% CI −0.09 to −0.05), when comparing the intervention and control groups. When individuals with low high-density lipoprotein cholesterol were analysed, the intervention was also associated with increased HDL cholesterol (0.90 mg/dL, 95% CI 0.51 to 1.29).

Conclusions

Low-intensity telephone counselling programmes could yield improvements in the following year on blood pressure, lipid profiles, weight and body mass index in untreated patients detected at the population screening. However, the improvements may be very modest and the clinical relevance of these small improvements may be limited.
Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England
Authors: Kieslich Katharina , Littlejohns Peter
Published: July 2015

Introduction

Clinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels’ and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study combines these accounts and asks whether the decisions of those CCGs that adhere to elements of such accounts are perceived as fairer and more legitimate by key stakeholders. The study addresses the empirical gap arising from a lack of research on whether frameworks such as A4R hold what they promise. It aims to understand the criteria that feature in CCG decision-making. Finally, it examines the usefulness of a decision-making audit tool (DMAT) in identifying the process and content criteria that CCGs apply when making decisions.

Methods and analysis

The adherence of a sample of CCGs to criteria emerging from theories of fair priority setting will be examined using the DMAT developed by PL. The results will be triangulated with data from semistructured interviews with key stakeholders in the CCG sample to ascertain whether there is a correlation between those CCGs that performed well in the DMAT exercise and those whose decisions are perceived positively by interviewees. Descriptive statistical methods will be used to analyse the DMAT data. A combination of quantitative and qualitative content analysis methods will be used to analyse the interview transcripts.

Ethics and dissemination

Full ethics approval was received by the King's College London Biomedical Sciences, Dentistry, Medicine and Natural and Mathematical Sciences Research Ethics Subcommittee. The results of the study will be disseminated through publications in peer review journals.
Qualitative approach to patient-reported outcomes in oncology: protocol of a French study
Authors: Orri Massimiliano , Sibeoni Jordan , Labey Mathilde , Bousquet Guilhem , Verneuil Laurence , Revah-Levy Anne
Published: July 2015

Introduction

The past decade has been characterised by movement from a doctor-centred to a patient-centred approach to treatment outcomes, in which doctors try to see the illness through their patients’ eyes. Patients, family members and doctors are the three participants in cancer care, but their perspectives about what have been helpful during cancer treatment have never simultaneously and explicitly compared in the same qualitative study. The aim of this study project is to explore patients’ perspectives about the care they receive, as well as families’ and doctors’ perspectives about what have been helpful for the patient. These three points of view will be compared and contrasted in order to analyse the convergences and divergences in these perspectives.

Methods and analysis

This is a national multicentre qualitative study. Participants will be constituted by three different subsamples: (1) patients with cancer (skin, breast, urological and lung cancers), (2) their relatives, and (3) their referring physicians. Recruitment will follow the purposive sample technique, and the final sample size will be determined by data saturation. Data will be collected through open-ended semistructured interviews and independently analysed with NVivo V.10 software by three researchers according to the principles of Interpretative Phenomenological Analysis.

Ethics and dissemination

The research protocol received approval from the University Paris Descartes review board (IRB number: 20140600001072), and participants will provide written consent. To the best of our knowledge, this is the first study to focus on the simultaneous exploration of the separate points of view of patients, families and doctors about the care received during the cancer care journey. We expect that our findings will help to improve communication and relationships between doctors, patients and families. Comparison of these three points of view will provide information about the convergences and divergences of these perspectives and how to address the needs of all three groups.
Quality of life and coping strategies among immigrant women living with pain in Denmark: a qualitative study
Authors: Michaëlis Camilla , Kristiansen Maria , Norredam Marie
Published: July 2015

Objective

To examine quality of life and coping strategies among immigrant women living with chronic pain.

Design

Qualitative content analysis based on in-depth semistructured interviews.

Setting

A clinic specifically targeting immigrants at a larger university hospital in Copenhagen, Denmark.

Participants

Non-western female immigrant patients suffering from chronic pain (n=13).

Main outcome measures

Experiences of the impact of chronic pain on quality of life.

Results

Chronic pain was perceived to have an extensive, adverse effect on all aspects of quality of life, including physical health, mental well-being and social relations. This included the ability to maintain activities of daily living and the ability to work. Chronic pain was further experienced as a cause of emotional distress, depression and altered personalities, which all had great consequences on women's social interactions, causing change and loss of social relations. A variety of coping strategies were used to cope with the pain, manage its consequences, and restore a level of health that would enable women to function and fulfil social roles. Many participants coped with the pain by altering everyday life, keeping daily activities to a minimum and taking pain-killing drugs, offering temporary relief. Seeking healthcare was another coping strategy used as an active means to assert agency and as a temporary distraction from pain. However, accessing healthcare also involved a risk of disagreement and disappointments.

Conclusions

Chronic pain had a severe negative impact on quality of life and necessitated alterations in everyday life and active health-seeking strategies. Implications for practice imply a need for a more holistic approach to immigrant women with chronic pain, including a family-centred approach. Further research is needed to explore similarities or differences in and between populations with diverse ethnic, socioeconomic and psychosocial backgrounds, and to assess how ethnicity and culture might influence the experiences of chronic pain.
Diet quality and adherence to a healthy diet in Japanese male workers with untreated hypertension
Authors: Kanauchi Masao , Kanauchi Kimiko
Published: July 2015

Objectives

As Japanese societies rapidly undergo westernisation, the prevalence of hypertension is increasing. We investigated the association between dietary quality and the prevalence of untreated hypertension in Japanese male workers.

Design and methods

We conducted a cross-sectional study of 433 male workers who completed a brief food frequency questionnaire. Adherence to the WHO-based Healthy Diet Indicator (HDI), the American Heart Association 2006 Diet and Lifestyle Recommendations, the Dietary Approaches to Stop Hypertension (DASH) diet, and Mediterranean-style diet was assessed using four adherence indexes (HDI score, AI-84 score, DASH score and MED score). Hypertension classes were classified into three categories: non-hypertension, untreated hypertension and treated hypertension (ie, taking antihypertensive medication).

Results

The prevalence of untreated hypertension and treated hypertension was 22.4% and 8.5%, respectively. Patients with untreated hypertension had significantly lower HDI and AI-84 scores compared with non-hypertension. DASH and MED scores across the three hypertension classes were comparable. After adjusting for age, energy intake, smoking habit, alcohol drinking, physical activity and salt intake, a low adherence to HDI and a lowest quartile of AI-84 score were associated with a significantly higher prevalence of untreated hypertension, with an OR of 3.33 (95% CI 1.39 to 7.94, p=0.007) and 2.23 (1.09 to 4.53, p=0.027), respectively.

Conclusions

A lower dietary quality was associated with increased prevalence of untreated hypertension in Japanese male workers. Our findings support a potential beneficial impact of nutritional assessment using diet qualities.
Impact of the angulus biopsy for the detection of gastric preneoplastic conditions and gastric cancer risk assessment
Authors: Varbanova M , Wex T , Jechorek D , Röhl FW , Langner C , Selgrad M , Malfertheiner P
Published: July 2015

Background

Gastric atrophy and intestinal metaplasia (IM) are preneoplastic conditions in the development of gastric cancer. Histopathological assessment is based on the updated Sydney system and superordinate staging systems, operative link on gastritis assessment (OLGA) and operative link on gastritis assessment using IM (OLGIM), all requiring a biopsy from theincisura angularis(angulus).

Aim

To determine the value of the angulus biopsy for the detection of preneoplastic conditions and cancer risk evaluation using OLGA and OLGIM prospectively.

Methods

Biopsies from antrum (2), angulus (1) and corpus (2) were obtained from 213 patients (age 19–94 years, median 54 years, female to male ratio 138:75) undergoing upper endoscopy. Histological assessment according to the updated Sydney system, OLGA and OLGIM staging was performed by gastrointestinal pathologists. Statistical analysis used exact confidence limits for dichotomous variables and repeated measurement analysis of variance.

Results

8% of the cases with atrophic gastritis and 3% with IM (17 vs 6/213) would have been missed without the angulus biopsy. More patients were diagnosed with a preneoplastic condition when the angulus biopsy was considered (13.1%, CI 8.9% to 18.4%), but the grade of atrophy, if present at both sides, did not vary significantly in angulus and antrum. OLGA and OLGIM scores dropped significantly when recalculated without the angulus (difference in means±SD 0.131±0.402 and 0.075±0.313, respectively). The impact on the identification of high-risk stages is limited.

Conclusions

The angulus biopsy adds to the detection of mild gastric atrophy in particular. It allows identifying a small additional number of patients with high-risk gastritis.
Twist predicts poor outcome of patients with astrocytic glioma
Authors: Nordfors Kristiina , Haapasalo Joonas , Mäkelä Katri , Granberg Kirsi J , Nykter Matti , Korja Miikka , Paavonen Timo , Haapasalo Hannu , Soini Ylermi
Published: July 2015

Aims and methods

Epithelial-mesenchymal transition (EMT) has previously been linked to glioma invasion and progression. To determine whether EMT regulators, Twist and Zeb1, had clinical significance in astrocytic gliomas, the association of Twist and Zeb1 with clinicopathological and molecular factors was studied in 269 astrocytoma samples.

Results

Twist and Zeb1 were widely expressed in astrocytic gliomas, but the expression of the former did not correlate with that of the latter. Stronger Twist expression levels were associated with higher WHO grades (p=0.001), whereas Zeb1 did not correlate with WHO grades. We found no association between Twist and proliferation activity (Ki67/MIB-1), p53 status, epidermal growth factor receptor (EGFR) amplification or neural cell adhesion molecule (NCAM) expression. There was no significant difference in Twist or Zeb1 expression when primary and secondary gliomas were analysed. Tumours with high Twist expression wereIDH1negative (p=0.009). High hypoxia-inducible factor-1α expression correlated significantly with positive Twist expression (p<0.001), whereas it was not associated with Zeb1 expression. Zeb1 expression did not correlate with proliferation, EGFR orIDH1. Nevertheless, we did find a correlation between high Zeb1 expression and low p53 expression levels (p=0.027). Positive NCAM expression was significantly associated with Zeb1 positivity (p=0.022). Zeb1 had no association with patient survival, whereas positive Twist expression predicted poor survival for patients in both univariate (p<0.001) and multivariable analyses (p=0.027).

Conclusions

EMT regulators, Twist and Zeb1, are common features of infiltrating astrocytomas, and Twist is upregulated in glioblastomas in particular. Twist may be a novel marker for poor prognosis in glioma patients.
Weight change and its determinants in Portuguese adult women: a longitudinal analysis in the EPIPorto cohort
Authors: Henriques Ana , Severo Milton , Alves Luís , Barros Henrique , Azevedo Ana
Published: July 2015

Background

We aimed to characterise between-women and within-women weight change in adult women, and to assess the association of sociodemographic, reproductive and lifestyle characteristics with the variations.

Methods

This study comprised 1040 adult women from a population-based cohort of adults from Porto, Portugal, assembled in 1999–2003 and re-evaluated in 2005–2008 (median follow-up 5 years). A mixed-effects model for longitudinal analysis of body weight was fitted, with random intercepts and random slopes. Multivariate-adjusted coefficients with 95% CIs were computed for the determinants of weight at baseline and weight change between visits.

Results

There was an average crude increase of 0.11 kg of measured weight per calendar year (95% CI 0.05 to 0.17). In a multivariate model, despite not explaining differences in weight between women at baseline, years of fertile life were associated with individual weight change: −0.34 kg/year for women with up to 21 years of fertile life, whereas after that, weight increased progressively more with increasing fertile time (21.1–34 years: −0.34 kg+0.42 kg=0.08 kg; 34.1–41 years: −0.34 kg+0.46 kg=0.12 kg) up to 0.44 kg/year above 41 years. Height, age, education, marital status, residential neighbourhood deprivation, number of children delivered and use of oral contraceptives, influenced interindividual weight variation at baseline, but did not influence weight change from baseline to follow-up.

Conclusions

Cross-sectional determinants of weight and those of weight change over time are vary. Reproductive factors play important roles in explaining both differences among women as well as in individual weight change over time.
Finite Groups of Spencer Height ≤ 3
Authors: Guo Wenbin , Andreeva Dina P. , Skiba Alexander N.
Published: July 2015

In this paper, we describe the finite groups G in which every maximal chain M3 < M2 < M1 < M0 =G contains a proper subnormal subgroup of G.