bluuebunny/crossref_metadata_2025 huggingface dataset:
Elongation factor Tu on Escherichia coli isolated from urine of kidney stone patients promotes calcium oxalate crystal growth and aggregation
Authors: Amimanan Piyawan , Tavichakorntrakool Ratree , Fong-ngern Kedsarin , Sribenjalux Pipat , Lulitanond Aroonlug , Prasongwatana Vitoon , Wongkham Chaisiri , Boonsiri Patcharee , Umka Welbat Jariya , Thongboonkerd Visith
Published: June 2017

Escherichia coli is the most common bacterium isolated from urine and stone matrix of calcium oxalate (CaOx) stone formers. Whether it has pathogenic role(s) in kidney stone formation or is only entrapped inside the stone remains unclear. We thus evaluated differences between E. coli isolated from urine of patients with kidney stone (EUK) and that from patients with urinary tract infection (UTI) without stone (EUU). From 100 stone formers and 200 UTI patients, only four pairs of EUK/EUU isolates had identical antimicrobial susceptibility patterns. Proteomic analysis revealed nine common differentially expressed proteins. Among these, the greater level of elongation factor Tu (EF-Tu) in EUK was validated by Western blotting. Outer membrane vesicles (OMVs) derived from EUK had greater promoting activities on CaOx crystallization, crystal growth and aggregation as compared to those derived from EUU. Neutralizing the OMVs of EUK with monoclonal anti-EF-Tu antibody, not with an isotype antibody, significantly reduced all these OMVs-induced promoting effects. Moreover, immunofluorescence staining of EF-Tu on bacterial cell surface confirmed the greater expression of surface EF-Tu on EUK (vs. EUU). Our data indicate that surface EF-Tu and OMVs play significant roles in promoting activities of E. coli on CaOx crystallization, crystal growth and aggregation.
Identification of unique cardiolipin and monolysocardiolipin species in Acinetobacter baumannii
Authors: Lopalco Patrizia , Stahl Julia , Annese Cosimo , Averhoff Beate , Corcelli Angela
Published: June 2017

Acidic glycerophospholipids play an important role in determining the resistance of Gram-negative bacteria to stress conditions and antibiotics. Acinetobacter baumannii, an opportunistic human pathogen which is responsible for an increasing number of nosocomial infections, exhibits broad antibiotic resistances. Here lipids of A. baumannii have been analyzed by combined MALDI-TOF/MS and TLC analyses; in addition GC-MS analyses of fatty acid methyl esters released by methanolysis of membrane phospholipids have been performed. The main glycerophospholipids are phosphatidylethanolamine, phosphatidylglycerol, acyl-phosphatidylglycerol and cardiolipin together with monolysocardiolipin, a lysophospholipid only rarely detected in bacterial membranes. The major acyl chains in the phospholipids are C16:0 and C18:1, plus minor amounts of short chain fatty acids. The structures of the cardiolipin and monolysocardiolipin have been elucidated by post source decay mass spectrometry analysis. A large variety of cardiolipin and monolysocardiolipin species were found in A. baumannii. Similar lysocardiolipin levels were found in the two clinical strains A. baumannii ATCC19606﻿T﻿ and AYE whereas in the nonpathogenic strain Acinetobacter baylyi ADP1 lysocardiolipin levels were highly reduced.
The Complexity of Standing Postural Sway Associates with Future Falls in Community-Dwelling Older Adults: The MOBILIZE Boston Study
Authors: Zhou Junhong , Habtemariam Daniel , Iloputaife Ikechukwu , Lipsitz Lewis A. , Manor Brad
Published: June 2017

Standing postural control is complex, meaning that it is dependent upon numerous inputs interacting across multiple temporal-spatial scales. Diminished physiologic complexity of postural sway has been linked to reduced ability to adapt to stressors. We hypothesized that older adults with lower postural sway complexity would experience more falls in the future. 738 adults aged ≥70 years completed the Short Physical Performance Battery test (SPPB) test and assessments of single and dual-task standing postural control. Postural sway complexity was quantified using multiscale entropy. Falls were subsequently tracked for 48 months. Negative binomial regression demonstrated that older adults with lower postural sway complexity in both single and dual-task conditions had higher future fall rate (incident rate ratio (IRR) = 0.98, p = 0.02, 95% Confidence Limits (CL) = 0.96–0.99). Notably, participants in the lowest quintile of complexity during dual-task standing suffered 48% more falls during the four-year follow-up as compared to those in the highest quintile (IRR = 1.48, p = 0.01, 95% CL = 1.09–1.99). Conversely, traditional postural sway metrics or SPPB performance did not associate with future falls. As compared to traditional metrics, the degree of multi-scale complexity contained within standing postural sway-particularly during dual task conditions- appears to be a better predictor of future falls in older adults.
Far-field plasmonic coupling in 2-dimensional polycrystalline plasmonic arrays enables wide tunability with low-cost nanofabrication
Authors: Zhao Fusheng , Arnob Md Masud Parvez , Zenasni Oussama , Li Jingting , Shih Wei-Chuan
Published: June 2017

We report the experimental observation and numerical modeling study of far-field plasmonic coupling (FFPC) in 2-dimensional polycrystalline plasmonic arrays consisting of “single crystalline” domains of a random size and orientation.
Visceral adipose tissue activated macrophage content and inflammatory adipokine secretion is higher in pre-eclampsia than in healthy pregnancys
Authors: Huda Shahzya S. , Jordan Fiona , Bray Jack , Love Gillian , Payne Reba , Sattar Naveed , Freeman Dilys J.
Published: June 2017

Obesity increases pre-eclampsia (PE) risk. Adipose tissue inflammation may contribute to the clinical syndrome of PE. We compared adipose tissue macrophage infiltration and release of pro-inflammatory adipokines in PE and healthy pregnancy. Subcutaneous and visceral adipose tissue biopsies were collected from healthy (n=13) and PE (n=13) mothers. Basal and lipopolysaccharide (LPS) stimulated adipocyte TNFα, IL-6, CCL-2, and CRP release was measured. Adipose tissue cell densities of activated (cfms+) and total (CD68+) macrophages were determined. In PE only, visceral adipose tissue TNFα release was increased after LPS stimulation (57 [76] versus 81 [97] pg/ml/µg DNA, P=0.030). Basal TNFα release was negatively correlated insulin sensitivity of visceral adipocytes (r = −0.61, P=0.030) in PE. Visceral adipocyte IL-6 release was increased after LPS stimulation in PE only (566 [696] versus 852 [914] pg/ml/µg DNA, P=0.019). Visceral adipocyte CCL-2 basal (67 [61] versus 187 [219] pg/ml/µgDNA, P=0.049) and stimulated (46 [46] versus 224 [271] pg/ml/µg DNA, P=0.003) release was greater than in subcutaneous adipocytes in PE only. In PE, median TNF mRNA expression in visceral adipose tissue was higher than controls (1.94 [1.13–4.14] versus 0.8 [0.00–1.27] TNF/PPIA ratio, P=0.006). In visceral adipose tissue, CSF1R (a marker of activated macrophages) mRNA expression (24.8[11.0] versus 51.0[29.9] CSF1R/PPIA ratio, P=0.011) and activated (cfms+) macrophage count (6.7[2.6] versus 15.2[8.8] % cfms+/adipocyte, P=0.031) were higher in PE than in controls. In conclusion, our study demonstrates dysregulation of inflammatory pathways predominantly in visceral adipose tissue in PE. Inflammation of visceral adipose tissue may mediate many of the adverse metabolic effects associated with PE.
Smad7 protects against acute kidney injury by rescuing tubular epithelial cells from the G1 cell cycle arrest
Authors: Fu Sha , Tang Ying , Huang Xiao R. , Feng Min , Xu An P. , Lan Hui Y.
Published: June 2017

Smad7 plays a protective role in chronic kidney disease; however, its role in acute kidney injury (AKI) remains unexplored. Here, we report that Smad7 protects against AKI by rescuing the G1 cell cycle arrest of tubular epithelial cells (TECs) in ischemia/reperfusion-induced AKI in mice in which Smad7 gene is disrupted or restored locally into the kidney. In Smad7 gene knockout (KO) mice, more severe renal impairment including higher levels of serum creatinine and massive tubular necrosis was developed at 48 h after AKI. In contrast, restored renal Smad7 gene locally into the kidney of Smad7 KO mice protected against AKI by promoting TEC proliferation identified by PCNA+ and BrdU+ cells. Mechanistic studies revealed that worsen AKI in Smad7 KO mice was associated with a marked activation of TGF-β/Smad3-p21/p27 signaling and a loss of CDK2/cyclin E activities, thereby impairing TEC regeneration at the G1 cell cycle arrest. In contrast, restored Smad7 locally into the kidneys of Smad7 KO mice protected TECs from the G1 cell cycle arrest and promoted TEC G1/S transition via a CDK2/cyclin E-dependent mechanism. In conclusion, Smad7 plays a protective role in AKI. Blockade of TGF-β/Smad3-p21/p27-induced G1 cell cycle arrest may be a key mechanism by which Smad7 treatment inhibits AKI. Thus, Smad7 may be a novel therapeutic agent for AKI.
Technical and economic comparison between direct current and half‐wavelength transmission systems for very long distances
Authors: Samorodov German , Kandakov Simeon , Zilberman Samuil , Krasilnikova Tatyana , Tavares Maria Cristina , Machado Camilo , Li Qingmin
Published: June 2017

This study presents the results of technical and economic analysis of high‐voltage direct current (HVDC) transmission system and high‐voltage alternating current transmission system for bulk transmission over very long distances. The last is a point‐to‐point transmission that does not need reactive compensation and does not have intermediate substations, the half‐wavelength transmission (HWL). Special attention is paid to reliability and ways to meet the N  − 1 criteria regarding security and adequacy. Single‐circuit lines instead of double‐circuit ones are considered for economic and environmental reasons ensuring the same reliability when clearing the most frequent line‐to‐ground (or single‐pole) fault. For this, single‐circuit line with reserve phase for HWL and quadripolar single‐circuit line for HVDC are proposed. The analysed system considered Brazilian electrical system conditions: 6000 MW transmission over 2500 km. This study highlights the advantages of applying a reserve phase for HWLs and a third converter substation increase to cope with system security with minimum cost. It is shown that the single‐circuit HWL with reserve phase has an investment 30% lower than that for HVDC, resulting in a total yearly cost 15% lower.
Papierloses Krankenhaus: Klinik Nürtingen erhält IT-Zertifikat
Authors: Mau Jens
Published: June 2017

Die Medius Klinik Nürtingen hat als erste Einrichtung in Deutschland das Zertifikat EMRAM Stufe 6 erhalten, das den Digitalisierungsgrad eines Krankenhauses misst.
Qualifiziert in die Zukunft: Management nach Maß bei Sana
Authors: Schwarz Simone
Published: June 2017

Die Sana Kliniken AG schult in den nächsten vier Jahren mehr als 860 Funktions- und Stationsleitungen an allen Standorten. Ziel ist es, das mittlere Management in der Pflege passgenau für die Zukunft zu wappnen. Mehr hierzu im Interview mit Vorstandsmitglied Dr. Jens Schick und Martina Henke, Bereichsleiterin Unternehmensstrategie Pflege.
Revision Rhinoplasty: Retrospective Chart Review Analysis of Deformities and Surgical Maneuvers in Patients with Nasal Airway Obstruction—Five Years of Experience
Authors: Daskalakis Dimitrios , Patel Kalpesh , Goudakos John
Published: June 2017

Nasal airway obstruction is one of the most frequent causes of revision rhinoplasty in patients after previous rhinoplasty procedure. Purpose of this study is to present the deformities and the surgical maneuvers conducted in revision rhinoplasty patients with functional complaint, anatomical sites at risk, and potential prophylactic maneuvers. This study is a retrospective chart review analysis of 46 consecutive revision rhinoplasty procedures in patients with nasal airway obstruction. Inclusion criteria were at least one previous rhinoplasty and nasal airway obstruction as the epicenter of patients' complaint. Thorough clinical examination to certify the obstruction was performed. Deformities noted were separated in three categories according to functional, cosmetic, and combination of functional and cosmetic implications. Surgical maneuvers conducted were reviewed. Deformities found were checked for statistically significant coexistences. The average patient age was 34.9 years. The mean number of previous septorhinoplasties was 1.33. Nasal ventilation obstruction mainly caused either by septum deviation or nasal valve dysfunction was identified in 91.3% of our patients. Surgical maneuvers conducted included placement of grafts in 89.1% of all cases, septoplasty in 76.1%, lateral wall support in 47.8%, and placement of spreader grafts in 39.1% of patients. The average preoperative Nasal Obstruction Symptom Evaluation (NOSE) score was 61 ± 15 and it improved substantially, even from month 1, postoperatively. Owing to high prevalence of nasal airway obstruction after primary or secondary rhinoplasty, we conducted the first retrospective chart review study to identify the most common deformities in revision rhinoplasty patients with nasal airway obstruction and the appropriate surgical maneuvers to address them. Septum deviation and nasal valve dysfunction were the two pillars of nasal airway obstruction in those patients.
Nontraumatic Emergency of the Spine
Authors: Belloch Elena , Gallegos Paulina , Higueras Victoria , Taberner Esther , LLopis Eva
Published: June 2017

Nontraumatic spinal emergencies can have many different causes. Clinical symptoms may be nonspecific, and therefore radiology plays a key role in diagnosing and managing these patients. There is considerable time pressure in these situations because the development of irreversible myelopathy depends not only on the cause but also on the time elapsed between the start of compression and the decompression. To avoid structural cord damage, decompression should be done within 6 to 8 hours after the start of the compression. If patients still walk when the lesion is detected, they have a 90 to 100% chance of walking when the lesion is treated immediately.

Magnetic resonance imaging is the primary method for the evaluation of spinal emergencies. An appropriate fast protocol should be used, adding some special sequences depending on the clinical scenario.

In this review we use a simple anatomical approach that can be applied in an acute practical clinical setting, allowing an accurate differential diagnosis that will guide subsequent therapeutic actions. We highlight key radiologic features that will help nonspecialized radiologists make a precise diagnosis.
Decision Making: Osteoplasty, Ablation, or Combined Therapy for Spinal Metastases
Authors: Tutton Sean , Lea William
Published: June 2017

Metastatic disease involving the spine and pelvis is common, often resulting in significant pain and disability. Several percutaneous interventions have been described, including osteoplasty, ablation, and screw fixation, that when used alone or in combination can significantly reduce pain and disability from metastatic bone disease. Although it is possible to make a significant impact in patient care with basic principles and techniques, certain advanced techniques can extend the application of percutaneous interventions while minimizing morbidity.
Trauma Imaging of the Acute Cervical Spine
Authors: Berritto Daniela , Pinto Antonio , Michelin Paul , Demondion Xavier , Badr Sammy
Published: June 2017

Among patients admitted in emergency departments for acute cervical spine trauma, only a few have a confirmed and significant injury requiring surgical intervention. Imaging plays a key role in screening for unstable lesions that can be responsible for devastating neurologic complications or death. The complex anatomy of the cervical spine is associated with a wide spectrum of osseous and ligamentous pathologies. This review focuses on the imaging features of the main cervical spine fractures that can be encountered in emergency radiology.
Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis
Authors: Özdoğan Elif , Kaya Gülay , Özgün Nezir , Cansu Ali , Kalyoncu Mukaddes , Dilber Embiya , Şahin Sevim
Published: June 2017

Background Neurological involvement is common in hemolytic uremic syndrome (HUS), but each neurological symptom may be due to a variety of factors.

Objective We aimed to evaluate predisposing factors to the neurological symptoms in HUS.

Materials and Methods The 10-year follow-up data on HUS patients were retrospectively analyzed. Statistical comparisons were made across subgroups based on age and neurological symptoms.

Results The neurological involvement rate was 37.5%. The female-to-male ratio increased in patients with neurological involvement (3.8 vs. 1.37). Regarding all HUS patients, hemoglobin levels were higher in patients with paresis. The rate of paresis was twofold higher in patients with a hemoglobin level above 11 g/dL (p < 0.05). In diarrhea-associated HUS patients, D-dimer and C-reactive protein levels were higher in patients with paresis, and leukocyte counts were higher in patients with seizures. Patients with altered consciousness had higher creatinine levels. The survival rate was significantly lower in patients with a reticulocyte percentage of less than 2% (50 vs. 100%).

Conclusion Results of our study indicate that neurological involvement depends on overall findings in HUS. A symptom-oriented approach, which is different from that employed in previous studies, reveals some clues to the pathogenesis and management of these patients.
Incidence of Sudden Unexpected Postnatal Collapse in the Therapeutic Hypothermia Era
Authors: Laudani Emanuela , Tubili Flavia , Calvani Maura , Bartolini Isabella , Donzelli Gianpaolo , Filippi Luca
Published: June 2017

Objective Hypothermia is considered the treatment of choice for newborns with hypoxic-ischemic encephalopathy. Even though currently no consensus exists regarding the opportunity to extend this treatment also to newborns with sudden unexpected postnatal collapse (SUPC), this treatment is frequently adopted. The aim of the study was to evaluate whether the availability of hypothermia also for collapsed newborns in a tertiary level center may impact the estimated incidence of SUPC.

Study Design A retrospective study was performed comparing the number of newborns admitted with the diagnosis of SUPC in the tertiary referral Neonatal intensive care unit of Florence in the period before (2008–2010) and after (2011–2014) the introduction of hypothermia treatment for newborns with SUPC.

Result After introducing active cooling also to newborns with SUPC, the number of newborns with SUPC admitted to our center augmented and, consequently, SUPC incidence apparently increased from 5.3 to 15.5/100,000 live births, even though this difference did not reach statistical significance (odds ratio = 0.340; 95% confidence interval = 0.071–1.639; p = 0.179).

Conclusion The apparent increase of SUPC incidence is probably related to a more effective centralization of newborns in our referral center but suggests that the real incidence of SUPC is probably significantly higher than currently estimated.
A Systematic Review of Mechanisms of Change in Body-Oriented Yoga in Major Depressive Disorders
Authors: Meister Klara , Juckel Georg
Published: June 2017

Introduction Despite empirical evidence for the efficacy of body-oriented yoga as add-on treatment for major depressive disorder (MDD), the specific mechanisms by which yoga leads to therapeutic changes remain unclear. By means of a systematic review, we evaluate how the field is progressing in its empirical investigation of mechanisms of change in yoga for MDD.

Methods To identify relevant studies, a systematic search was conducted.

Results The search produced 441 articles, of which 5 were included, that empirically examined 2 psychological mechanisms (mindfulness, rumination) and 3 biological mechanisms (vagal control, heart rate variability [HRV], brain-derived neurotrophic factor [BDNF], cortisol). 2 studies found that decreased rumination and 1 study that increased mindfulness was associated with the effect of yoga on treatment outcome. In addition, preliminary studies suggest that alterations in cortisol, BDNF, and HRV may play a role in how yoga exerts its clinical effect.

Discussion The results suggest that body-oriented yoga could work through some of the theoretically predicted mechanisms. However, there is a need for more rigorous designs that can assess greater levels of causal specificity.
Was there ever a “Female Gothic”?
Authors: Ledoux Ellen
Published: June 2017

This article examines the reception history of women-authored Gothic texts from the late eighteenth and early nineteenth century, arguing that the generic descriptor “Female Gothic” more accurately reflects the ideological goals of second-wave feminist literary criticism than the narratives of early women Gothic writers. While several critics have attempted to destabilize the term Female Gothic, its usage persists as a short-hand form to describe narratives in which distressed female heroines are imprisoned in the domestic sphere and threatened with extortion, rape and forced marriage. This essay asks why criticism clings to an understanding of this genre as one depicting female victimization despite overwhelming textual evidence that represents a much more complicated picture of women’s use and engagement with the Gothic mode. It is argued that the answer to this question rests in looking at how Gothic women’s writing was received in the early nineteenth century and how that reception history shaped the discursive strategies of second-wave feminist literary critics.
Morality in Plague Time: AIDS in Theological Perspective;

Lecture 1: Sickness and Sin
Authors: Meilaender Gilbert
Published: June 2017

The author is a professor of religion at Oberlin College in Oberlin, Ohio. He received his doctorate in philosophy from Princeton University and is the author of four hooks. These Luce Lectures on Religion and the Social Crisis were delivered by the author at Wake Forest University in April, 1988. The author wishes to thank the Department of Religion at Wake Forest for the invitation which provided the opportunity and the occasion to think about the topics treated in the lectures.
Longitudinal Form and the Human Conceptus
Authors: Fernandes Ashley K.
Published: June 2017

Human rights are not a privilege conferred by the government They are every human being's entitlement by virtue of his humanity. The right to life does not depend, and must not be declared to be contingent, on the pleasure of anyone else, not even a parent or sovereign … I have no new teaching for America. I seek only to recall you to faithfulness to what you once taught the world Your nation was founded on the proposition — very old as a moral precept, but startling and innovative as political insight — that human life is a gift of immeasurable worth, and that it deserves, always and everywhere, to be treated with the utmost dignity and respect

— Mother Theresa of Calcutta (1994) 1
The class of the affine line is a zero divisor in the Grothendieck ring
Authors: Borisov Lev
Published: June 2017

We show that the class of the affine line is a zero divisor in the Grothendieck ring of algebraic varieties over complex numbers. The argument is based on the Pfaffian-Grassmannian double mirror correspondence.
Systematic analysis of Ca2+homeostasis inSaccharomyces cerevisiaebased on chemical-genetic interaction profiles
Authors: Ghanegolmohammadi Farzan , Yoshida Mitsunori , Ohnuki Shinsuke , Sukegawa Yuko , Okada Hiroki , Obara Keisuke , Kihara Akio , Suzuki Kuninori , Kojima Tetsuya , Yachie Nozomu , Hirata Dai , Ohya Yoshikazu
Published: June 2017

We investigated the global landscape of Ca2+homeostasis in budding yeast based on high-dimensional chemical-genetic interaction profiles. The morphological responses of 62 Ca2+-sensitive (cls) mutants were quantitatively analyzed with the image processing program CalMorph after exposure to a high concentration of Ca2+. After a generalized linear model was applied, an analysis of covariance model was used to detect significant Ca2+–cls interactions. We found that high-dimensional, morphological Ca2+–cls interactions were mixed with positive (86%) and negative (14%) chemical-genetic interactions, whereas one-dimensional fitness Ca2+–cls interactions were all negative in principle. Clustering analysis with the interaction profiles revealed nine distinct gene groups, six of which were functionally associated. In addition, characterization of Ca2+–cls interactions revealed that morphology-based negative interactions are unique signatures of sensitized cellular processes and pathways. Principal component analysis was used to discriminate between suppression and enhancement of the Ca2+-sensitive phenotypes triggered by inactivation of calcineurin, a Ca2+-dependent phosphatase. Finally, similarity of the interaction profiles was used to reveal a connected network among the Ca2+homeostasis units acting in different cellular compartments. Our analyses of high-dimensional chemical-genetic interaction profiles provide novel insights into the intracellular network of yeast Ca2+homeostasis.
Evaluating the Performance of a Relative Humidity-Based Warning System for Sooty Blotch and Flyspeck in Iowa
Authors: Rosli Hafizi , Mayfield Derrick A. , Batzer Jean C. , Dixon Philip M. , Zhang Wendong , Gleason Mark L.
Published: June 2017

A warning system for the sooty blotch and flyspeck (SBFS) fungal disease complex of apple, developed originally for use in the southeastern United States, was modified to provide more reliable assessment of SBFS risk in Iowa. Modeling results based on previous research in Iowa and Wisconsin had suggested replacing leaf wetness duration with cumulative hours of relative humidity (RH) ≥97% as the weather input to the SBFS warning system. The purpose of the present study was to evaluate the performance of a RH-based SBFS warning system, and to assess the potential economic benefits for its use in Iowa. The warning system was evaluated in two separate sets of trials—trial 1 during 2010 and 2011, and trial 2 during 2013–2015—using action thresholds based on cumulative hours of RH ≥97% and ≥90%, respectively, in conjunction with two different fungicide regimes. The warning system was compared with a traditional calendar-based system that specified spraying at predetermined intervals of 10 to 14 days. In trial 1, use of the RH ≥97% threshold caused substantial differences between two RH sensors in recording number of hours exceeding the threshold. When both RH thresholds were compared for 2013–2015, on average, RH ≥90% resulted in a 53% reduction in variation of cumulative hours between two identical RH sensors placed adjacent to each other in an apple tree canopy. Although both the SBFS warning system and the calendar-based system resulted in equivalent control of SBFS, the warning system required fewer fungicide sprays than the calendar-based system, with an average of 3.8 sprays per season (min = 2; max = 5) vs. 6.4 sprays per season (min = 5; max = 8), respectively. The two fungicide regimes provided equivalent SBFS control when used in conjunction with the warning system. A partial budget analysis showed that using the SBFS warning system with a threshold of RH ≥90% was cost effective for orchard sizes of >1 ha. The revised warning system has potential to become a valuable decision support tool for Midwest apple growers because it reduces fungicide costs while protecting apples as effectively as a calendar-based spray schedule. The next step toward implementation of the SBFS warning system in the North Central U.S. should be multiyear field testing in commercial orchards throughout the region.
Long-term Radiological and Clinical Outcomes After Using Bone Marrow Mesenchymal Stem Cells Concentrate Obtained With Selective Retention Cell Technology in Posterolateral Spinal Fusion
Authors: Yousef Mohamed Abdelhamid Ali , La Maida Giovanni Andrea , Misaggi Bernardo
Published: June 2017

Study Design.

Retrospective study.

Objective.

The aim of this study was to evaluate the long-term clinical and radiological outcomes of the use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology using Cellect with a particular collagen scaffold, Healos for posterolateral spinal fusion.

Summary of Background Data.

With the increasing rate of spinal fusion, the problem of pseudarthrosis, which contributes to recurrent pain with patient disability, is considered to be the most common cause of revision lumbar spine surgery. Intensive research is being carried out to develop an alternative source of bone grafting and improve the spinal fusion rate.

Methods.

A retrospective review of hospital records was performed. Identified patients were contacted to have a clinical and radiological evaluation follow-up. Clinical outcome was evaluated using visual analog scales for the back pain (VAS), Oswestry Disability Index (ODI) scores, and quality of life (EQ-5D) questionnaire. Radiological outcome was evaluated by performing dynamic flexion/extension lateral views and calculation of segmental Cobb angle. Any implant-associated complication was reported. Computed tomography (CT) scans were also performed.

Results.

Twenty-one patients were included and all patients achieved successful fusion. The mean difference of the segmental Cobb angle was 0.48° (range 0.3°–0.7°). Computed tomography scans showed solid bilateral fusion with bridging bone (Grade I) in all patients, but solid unilateral fusion with bridging bone (Grade II) was detected for one patient at one level. Patients started to resume working activities within a mean period of 3.5 months. The VAS score for the residual back pain was 4.1 ± 2.1, whereas the ODI was 10.5 ± 5.6 points, and the mean disability index was 21.1%.

Conclusion.

The use of bone marrow mesenchymal stem cell concentrate obtained with selective cell retention technology could be considered as an effective means for augmenting spinal fusion.

Level of Evidence: 3
Rigor or Reliability and Validity in Qualitative Research: Perspectives, Strategies, Reconceptualization, and Recommendations
Authors: Cypress Brigitte S.
Published: June 2017

Issues are still raised even now in the 21st century by the persistent concern with achieving rigor in qualitative research. There is also a continuing debate about the analogous terms reliability and validity in naturalistic inquiries as opposed to quantitative investigations. This article presents the concept of rigor in qualitative research using a phenomenological study as an exemplar to further illustrate the process. Elaborating on epistemological and theoretical conceptualizations by Lincoln and Guba, strategies congruent with qualitative perspective for ensuring validity to establish the credibility of the study are described. A synthesis of the historical development of validity criteria evident in the literature during the years is explored. Recommendations are made for use of the term rigor instead of trustworthiness and the reconceptualization and renewed use of the concept of reliability and validity in qualitative research, that strategies for ensuring rigor must be built into the qualitative research process rather than evaluated only after the inquiry, and that qualitative researchers and students alike must be proactive and take responsibility in ensuring the rigor of a research study. The insights garnered here will move novice researchers and doctoral students to a better conceptual grasp of the complexity of reliability and validity and its ramifications for qualitative inquiry.
Part I: The Effects of Music for the Symptom Management of Anxiety, Pain, and Insomnia in Critically Ill Patients
Authors: Meghani Naheed , Tracy Mary Fran , Hadidi Niloufar Niakosari , Lindquist Ruth
Published: June 2017

Critical care environments are known for provoking anxiety, pain, and sleeplessness. Often, these symptoms are attributed to patients’ underlying physiological conditions; life-sustaining or life-prolonging treatments such as ventilators, invasive procedures, tubes, and monitoring lines; and noise and the fast-paced technological nature of the critical care environment. This, in turn, possibly increases length of stay and morbidity and challenges the recovery and healing of critically ill patients. Complementary therapies can be used as adjunctive therapies alongside pharmacological interventions and modalities. One complementary therapy with promise in critical care for improving symptoms of anxiety, pain, and sleeplessness is music. A review of current literature from Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and PubMed was conducted to examine the evidence for the use of this complementary therapy in critical care settings. This review presents the evidence on effectiveness of music for the symptom management of anxiety, pain, and insomnia in critically ill adult patients. The evidence from this review supports music in symptom management of pain, insomnia, and anxiety in critically ill patients. This review provides practice recommendations, generates dialog, and promotes future research. This review is part I of a 2-part series that focuses on evidence for use of music, aromatherapy and guided imagery for improving anxiety, pain, and sleeplessness of patients in critically ill patients.
Research Use of Nurses Working in the Critical Care Units: Barriers and Facilitators
Authors: Hweidi Issa M. , Tawalbeh Loai Issa , Al-hassan Musa A. , Alayadeh Razan M. , Al-Smadi Ahmed Mohammad
Published: June 2017

Background:

There is a distinct gap between theory and practice with respect to research use in clinical practice, particularly in critical care units, that could be related to the presence of a number of barriers that hinder the use of research findings.

Aims:

The aims of the study were to identify barriers and facilitators to research use as perceived by Jordanian nurses in critical care units and to examine the predictors of research use among those nurses.

Methods:

The study used a cross-sectional, correlational design. The self-administered “Barriers Scale” was introduced to 200 registered critical care nurses, using the drop-and-collect technique, between October and November 2015.

Results:

The results revealed that “nurse does not have time to read research at work” was the top ranked barrier that hinders research use (mean [SD], 3.45 [0.79]). The first 7 ranked barriers were related to the organizational subscale. Managerial support was the top perceived facilitator for research use. Only “attending special training courses in nursing research” was the significant predictor of research use and explained 59.1% of the variance in research use, t(190) = −3.93, P = .003. The most identified barriers toward research use revealed by the qualitative data include dominant routine nursing tasks, existence of gap between theory and practice, shortage of nursing staff, and public negative image about nursing profession. Participants suggested the importance of increasing organizational support and creating an organizational research culture to further promote research use in clinical nursing practice.

Conclusions:

Research use has not been widely implemented yet in Jordan because of various barriers. The organization-related barriers were the most influential. Factors hindering research use are multidimensional, and optimizing them should be a shared responsibility of nurse managers, researchers, clinicians, and academicians. Further initiatives are required to raise awareness of the importance of using evidence-based practice.
Targeting the S1P/S1PR1 axis mitigates cancer-induced bone pain and neuroinflammation
Authors: Grenald Shaness A. , Doyle Timothy M. , Zhang Hong , Slosky Lauren M. , Chen Zhoumou , Largent-Milnes Tally M. , Spiegel Sarah , Vanderah Todd W. , Salvemini Daniela
Published: June 2017

Metastatic bone pain is the single most common form of cancer pain and persists as a result of peripheral and central inflammatory, as well as neuropathic mechanisms. Here, we provide the first characterization of sphingolipid metabolism alterations in the spinal cord occurring during cancer-induced bone pain (CIBP). Following femoral arthrotomy and syngenic tumor implantation in mice, ceramides decreased with corresponding increases in sphingosine and the bioactive sphingolipid metabolite, sphingosine 1-phosphate (S1P). Intriguingly, de novo sphingolipid biosynthesis was increased as shown by the elevations of dihydro-ceramides and dihydro-S1P. We next identified the S1P receptor subtype 1 (S1PR1) as a novel target for therapeutic intervention. Intrathecal or systemic administration of the competitive and functional S1PR1 antagonists, TASP0277308 and FTY720/Fingolimod, respectively, attenuated cancer-induced spontaneous flinching and guarding. Inhibiting CIBP by systemic delivery of FTY720 did not result in antinociceptive tolerance over 7 days. FTY720 administration enhanced IL-10 in the lumbar ipsilateral spinal cord of CIBP animals and intrathecal injection of an IL-10 neutralizing antibody mitigated the ability of systemic FTY720 to reverse CIBP. FTY720 treatment was not associated with alterations in bone metabolism in vivo. Studies here identify a novel mechanism to inhibit bone cancer pain by blocking the actions of the bioactive metabolites S1P and dihydro-S1P in lumbar spinal cord induced by bone cancer and support potential fast-track clinical application of the FDA-approved drug, FTY720, as a therapeutic avenue for CIBP.
Post‐transplant Recurrent Bile Salt Export Pump Disease
Authors: Patel Kalyani R. , Harpavat Sanjiv , Finegold Milton , Eldin Karen , Hicks John , Firan Mihail , Keitel Verena , Kubitz Ralf , Wu Hao
Published: June 2017

Recurrent bile salt export pump (rBSEP) disease has been reported in progressive familial intrahepatic cholestasis type 2 (PFIC2) patients following liver transplantation (LT) and is often refractory to standard anti‐cellular rejection immunosuppressants. The mechanism of rBSEP disease is proposed to be a form of type II hypersensitivity reaction with de novo anti‐BSEP antibodies blocking the function of allograft BSEP. Utilization of C4d has not been evaluated in rBSEP. We describe a girl with 3 episodes of rBSEP with severe pruritus at 8.9, 10.3, and 11.0 years post‐LT, respectively. Patient's serum reacted with normal liver canaliculi by indirect immunofluorescence (IF), whereas patient's liver showed canalicular immunoglobulin G deposition. The histologic features of all 3 liver biopsies recapitulate PFIC2 with cholestatic giant cell hepatitis. Canalicular BSEP expression was not detected in areas of feathery degeneration by immunohistochemistry, but was retained in morphologically normal liver. By direct IF, C4d showed diffuse sinusoidal staining in the third biopsy. Patient responded well to rituximab with or without intravenous immunoglobulin with subsiding symptoms and normalization of serum bile acid levels. In conclusion, rBSEP disease should be considered in the differential diagnosis when evaluating for rejection in a PFIC2 patient post‐LT presenting with pruritus. A portion of liver core may be snap frozen in OCT medium for possible direct IF for C4d, that can serve as a surrogate marker for complement activation and antibody‐mediated graft dysfunction.
Intravenous Smart Pump Drug Library Compliance: A Descriptive Study of 44 Hospitals
Authors: Giuliano Karen K. , Su Wan-Ting , Degnan Daniel D. , Fitzgerald Kristy , Zink Richard J. , DeLaurentis Poching
Published: June 2017

Background

Although intravenous (IV) smart pumps with built-in dose-error reduction systems (DERS) can reduce IV medication administration error, most serious adverse events still occur during IV medication administration. Sources of error include overriding DERS and manually bypassing drug libraries and the DERS.

Methods

Our purpose was to use the Regenstrief National Center for Medical Device Informatics data set to better understand IV smart pump drug library and DERS compliance. Our sample consisted of 12 months of data from 7 hospital systems, 44 individual hospitals, and descriptive data from the American Hospital Directory (AHD) for 2015. The aims of the study were (1) to determine whether there are differences in IV smart pump drug library compliance between hospital systems and (2) to provide a broad descriptive overview of relevant trends related to IV smart pump compliance.

Results

For aim 1, we found 3 significant relationships among the 7 hospital systems: systems 3 (P < 0.001), 6 (P = 0.003), and 7 (P = 0.002) had significantly higher IV smart compliance as compared with system 4. For aim 2, the number of drug library profiles was positively correlated (P = 0.029) with IV smart pump compliance and the IV smart pump type used was significantly correlated (P = 0.013) with IV smart pump compliance.

Conclusions

Our findings support that there are differences in IV smart pump compliance both within and between hospital systems and that IV smart pump type and the number of drug library profiles may be influencing factors. Further research is required to more accurately identify the impact of these factors in this very important area of patient safety.
Factors Associated With Global Variability in Electroconvulsive Therapy Utilization
Authors: Rakita Uros , Bingham Kathleen , Fung Kenneth , Giacobbe Peter
Published: June 2017

Objectives

The aims of this study were to investigate the social and economic factors that contribute to global variability in electroconvulsive therapy (ECT) utilization and to contrast these to the factors associated with antidepressant medication rates.

Methods

Rates of ECT and antidepressant utilization across nations and data on health, social, and economic indices were obtained from multiple international organizations including the World Health Organization and the Organization for Economic Co-operation and Development, as well as from the published literature. To assess whether relationships exist between selected indices and each of the outcome measures, a correlational analysis was conducted using Pearson correlation coefficients. Those that were significant at a level of P < 0.05 in the correlation analysis were selected for entry into the multivariate analyses. Selected predictor variables were entered into a stepwise multiple regression models for ECT and antidepressant utilization rates separately.

Results

A stepwise multiple regression analysis indicated that government expenditure on mental health was the only significant contributor to the model, explaining 34.2% of global variation in ECT use worldwide. Human Development Index was the only variable found to be significantly correlated with global antidepressant utilization, accounting for 71% of the variation in global antidepressant utilization.

Conclusions

These findings suggest that across the globe ECT but not antidepressant medication utilization is associated with the degree to which a nation financially invests in mental health care for its citizens.
A new fossil dolphinDilophodelphis fordyceiprovides insight into the evolution of supraorbital crests in Platanistoidea (Mammalia, Cetacea)
Authors: Boersma Alexandra T. , McCurry Matthew R. , Pyenson Nicholas D.
Published: June 2017

Many odontocete groups have developed enlarged facial crests, although these crests differ in topography, composition and function. The most elaborate crests occur in the South Asian river dolphin (Platanista gangetica), in which they rise dorsally as delicate, pneumatized wings anterior of the facial bones. Their position wrapping around the melon suggests their involvement in sound propagation for echolocation. To better understand the origin of crests in this lineage, we examined facial crests among fossil and living Platanistoidea, including a new taxon,Dilophodelphis fordycei, nov. gen. and sp., described herein, from the Early Miocene Astoria Formation of Oregon, USA. We measured the physical extent and thickness of platanistoid crests, categorized their relative position and used computed tomography scans to examine their internal morphology and relative bone density. Integrating these traits in a phylogenetic context, we determined that the onset of crest elaboration or enlargement and the evolution of crest pneumatization among the platanistoids were separate events, with crest enlargement beginning in the Oligocene. However, we find no evidence for pneumatization until possibly the Early Miocene, although certainly by the Middle Miocene. Such an evolutionary context, including data from the fossil record, should inform modelling efforts that seek to understand the diversity of sound generation morphology in Odontoceti.
BioSharing: Harnessing Metadata Standards for the Data Commons
Authors: Sansone Susanna-Assunta , Gonzalez-Beltran Alejandra , Rocca-Serra Philippe , McQuilton Peter , Izzo Massimiliano , Lister Allyson , Thurston Milo
Published: June 2017

The use of community-driven metadata standards, such as minimal information guidelines, terminologies, formats/models, is essential to ensure that data and other digital research outputs are Findable, Accessible, Interoperable, and Reusable, according to the FAIR principles. As with other types of digital assets, metadata standards also need be FAIR. Their discoverability and accessibility is ensured by BioSharing, the most comprehensive resource of metadata standards, interlinked to data repositories and policies, available in the life, environmental and biomedical sciences. With its growing content, endorsements, and collaborative network, BioSharing is part of a larger ecosystem of interoperable resources. Here we describe some of the activities under the USA National Institutes of Health (NIH)’s Big Data to Knowledge (BD2K) Initiative, illustrating how we track the evolution and use of metadata standards and work to connect them to indexes and annotation tools.
Foresight is required to enforce sustainability under time-delayed biodiversity loss
Authors: Lafuite A.-S. , de Mazancourt C. , Loreau M.
Published: June 2017

Natural habitat loss and fragmentation generate a time-delayed loss of species and associated ecosystem services. Since social-ecological systems (SESs) depend on a range of ecosystem services, lagged ecological dynamics may affect their long-term sustainability. Here, we investigate the role of consumption changes in sustainability enforcement, under a time-delayed ecological feedback on agricultural production. We use a stylized model that couples the dynamics of biodiversity, technology, human demography and compliance to a social norm prescribing sustainable consumption. Compliance to the sustainable norm reduces both the consumption footprint and the vulnerability of SESs to transient overshoot-and-collapse population crises. We show that the timing and interaction between social, demographic and ecological feedbacks govern the transient and long-term dynamics of the system. A sufficient level of social pressure (e.g. disapproval) applied on the unsustainable consumers leads to the stable coexistence of unsustainable and sustainable or mixed equilibria, where both defectors and conformers coexist. Under bistability conditions, increasing time delays reduces the basin of attraction of the mixed equilibrium, thus resulting in abrupt regime shifts towards unsustainable pathways. Given recent evidence of large ecological relaxation rates, such results call for farsightedness and a better understanding of lag effects when studying the sustainability of coupled SESs.