bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of Fiscal Illusion: Lack of Information or Lack of Attention?
Authors: Baekgaard Martin , Serritzlew Søren , Blom‐Hansen Jens
Published: June 2016

According to fiscal illusion theory, voters misperceive fiscal parameters because of incomplete information. The costs of public services are underestimated, implying that if voters had full information, their support for public services would drop. The literature has focused on testing the implications of fiscal illusions, whereas the question why fiscal illusions occur at all has received less attention. According to the standard argument, individuals base their opinion of policy proposals on a valuation of benefits and costs. We formalize the standard argument and show that it is a special case of the attention model of fiscal illusion. In this model, opinion depends on the saliency of attributes of the proposal. We show that the attention model can better explain fiscal illusion by deriving competing hypotheses, which are tested in a survey experiment. We conclude that the mechanism behind fiscal illusion is attention and framing, not incomplete information.
Indirect selection for resistance to Stenocarpella maydis and Fusarium graminearum and the prospects of selecting for high‐yielding and resistant maize hybrids
Authors: Tembo Langa , Asea Godfrey , Gibson Paul T. , Okori Patrick
Published: June 2016

Stenocarpella maydis and Fusarium graminearum affect grain yield and quality as a result of mycotoxins produced. A negative association of yield with resistance to cob rots has been reported. The objectives of this study were therefore to investigate the influence of cob characteristics on the response to F. graminearum and S. maydis disease reaction and evaluate the prospects of direct selection for high‐yielding and resistant maize hybrids. In this study, the pathogens were directly introduced to the cob through toothpick inoculation. Correlation of husk cover to disease severity of each pathogen, separately toothpick inoculated, was significant (P < 0.01). However, the low r values (<0.45) of traits associated with the response to inoculation by S. maydis and F. graminearum imply that indirect selection would not be beneficial for obtaining the type of resistance shown under inoculation. Several hybrids combined good yields with at least moderate resistance to both pathogens.
Haploid differentiation in maize kernels based on fluorescence imaging
Authors: Boote Brett W. , Freppon Daniel J. , De La Fuente Gerald N. , Lübberstedt Thomas , Nikolau Basil J. , Smith Emily A.
Published: June 2016

A new fluorescence‐based method for inbred haploid differentiation in maize kernels was developed by utilizing the R1‐nj colour marker in combination with fluorescence microspectroscopy and imaging. Seven inbred lines with varying R1‐nj expression were used in this study. The fluorescence response of the diploid kernels at the embryonic dye spot was shown to simultaneously exhibit lower intensity and occur at a higher wavelength than the fluorescence of the dye‐lacking haploid embryos. Intensity and area thresholds were applied to fluorescence images to sort the haploids from mixed sample populations, and sorting efficiencies of greater than 80% were achieved in all seven inbred lines (with values greater than 90% for five lines). The potential for high‐throughput sorting when fluorescence imaging is combined with existing technologies for seed handling as well as high sorting efficiency may make fluorescence a viable and promising alternative to current sorting methods for some inbred lines.
Usefulness of an angioplasty balloon as selective bronchial blockade device after transbronchial cryobiopsy
Authors: Echevarria‐Uraga José Javier , Pérez‐Izquierdo Julio , García‐Garai Nerea , Gómez‐Jiménez Estíbaliz , Aramburu‐Ojembarrena Amaia , Tena‐Tudanca Luis , Miguélez‐Vidales José L. , Capelastegui‐Saiz Alberto
Published: June 2016

Background and objective

Transbronchial cryobiopsy (TBCB) is a technique in which frozen samples of lung are obtained using a probe inserted through a bronchoscope. We performed a retrospective study to assess the performance of the TBCB procedure complemented by segmental bronchial blockade using an angioplasty balloon, in terms of diagnostic yield and safety in diffuse parenchymal lung disease (DPLD).

Methods

Data from 100 patients with suspected DPLD (clinical and radiological findings), who underwent TBCB in our institution to establish a definitive diagnosis, were reviewed. In our institution, TBCB is monitored with fluoroscopy and performed under general anaesthesia by a multidisciplinary team (an anaesthesiologist, a pulmonologist and an interventional radiologist). In each patient, four samples were collected using a 2.4‐mm distal diameter cryoprobe. To control bleeding, the biopsied segmental bronchus was blocked with a 6‐mm diameter angioplasty balloon, inserted over a 0.035‐inch angled hydrophilic guidewire. After the cryoextraction, the balloon was inflated for 3 min intervals until bleeding stopped.

Results

Overall, 98% of samples had diagnostic value. In 85% of cases, DPLD was confirmed, while in 7%, cancer was diagnosed. Complications were observed in 16% of the patients: 13 patients developed moderate haemorrhage, and 3 developed pneumothorax.

Conclusion

Transbronchial cryobiopsy had a high diagnostic yield for DPLD. Performing the procedure under fluoroscopy guidance and using angioplasty balloon for selective bronchial blockade achieved a low rate of iatrogenic complications directly associated with the technique.
The Neotropical ‘polymorphic earless praying mantises’ – Part I: molecular phylogeny and revised higher‐level systematics (Insecta: Mantodea, Acanthopoidea)
Authors: RIVERA JULIO , SVENSON GAVIN J.
Published: June 2016

We perform phylogenetic analyses of the ‘polymorphic earless praying mantises’, a heterogeneous assemblage comprisingc.55% of mantodean diversity in the Neotropics. Bayesian and maximum‐likelihood were implemented on aDNAdataset of 9949 aligned nucleic acid characters comprising ten mitochondrial and nuclear genes. Our analyses largely resolved congruent relationships with high levels of support for higher‐level taxonomic groups, but revealed extensive inconsistencies between the resolved topology and morphology‐based classification systems. The polymorphic earless praying mantises, now granted superfamily status as the Acanthopoideastat. n.,comprises 8 families, 15 subfamilies and 18 tribes. Our newly revised organization required the following taxonomic changes: (i) Thespidaesensu n.,including subfamilies Pseudopogonogastrinaesubfam. n.,Pseudomiopteryginaesensu n.,Bantiinaesubfam. n.,Miobantiinaesensu n.and Thespinaesensu n.(tribes Musoniellinitrib. n.and Thespinisensu n.); (ii) Angelidaestat. n.etsensu n.; (iii) Coptopterygidaestat. n.; (iv) Liturgusidaesensu n.; (v) Photinaidaestat. n.,including Macromantinaestat. n.,Cardiopterinaestat. n.,Photiomantinaesubfam. n.and Photinainaesensu n.(tribes Microphotininitrib. n.,Orthoderellinistat. n.and Photinainisensu n.); (vi) Stenophyllidaestat. n.; (vii) Acontistidaestat. n.; and (viii) Acanthopidaesensu n.Our new system also resulted in the reassignment of various genera to new and existing higher‐level taxa, the exclusion of old world genera otherwise traditionally classified among the Thespidae, Liturgusidae and Angelidae, the confirmation ofStenophyllaWestwood as member of this clade, and the revalidation ofParadiabantiaPizastat. r.We provide diagnoses for all suprageneric taxa using external morphological characters and male genitalia. A key to higher‐level groups is provided. We incorporate egg case structural variation as a novel approach for taxon delineation.

This published work has been registered in ZooBank,http://zoobank.org/urn:lsid:zoobank.org:pub:29E37322‐30EB‐4F64‐80C9‐E2149B5B0195.
Tales of dracula ants: the evolutionary history of the ant subfamily Amblyoponinae (Hymenoptera: Formicidae)
Authors: WARD PHILIP S. , FISHER BRIAN L.
Published: June 2016

The ants in the subfamily Amblyoponinae are an old, relictual group with an unusual suite of morphological and behavioural features. Adult workers pierce the integument of their larvae to imbibe haemolymph, earning them the vernacular name ‘dracula ants’. We investigate the phylogeny of this group with a data set based on 54 ingroup taxa, 23 outgroups and 11 nuclear gene fragments (7.4 kb). We find that the genus Opamyrma has been misplaced in this subfamily: it is a member of the leptanilline clade and sister to all other extant Leptanillinae. Transfer of Opamyrma to Leptanillinae renders the Amblyoponinae monophyletic. The enigmatic Afrotropical genus Apomyrma is sister to all other amblyoponines, and the latter cleave into two distinct and well‐supported clades, here termed POA and XMMAS. The POA clade, containing Prionopelta, Onychomyrmex and Amblyopone, is well resolved internally, and its structure supports synonymy of the genus Concoctio under Prionopelta (syn.n.). The XMMAS clade comprises two well‐supported groups: (i) a predominantly Neotropical clade, for which we resurrect the genus name Fulakora (stat.r., stat.n.), with junior synonyms Paraprionopelta (syn.n.) and Ericapelta (syn.n.); and (ii) the remaining taxa, or ‘core XMMAS’, which are manifested in our study as a poorly resolved bush of about a dozen lineages, suggesting rapid radiation at the time of their origin. Most of these XMMAS lineages have been assigned to the catch‐all genus Stigmatomma, but the more distinctive elements have been treated as separate genera (Xymmer, Mystrium, Myopopone and Adetomyrma). Resolution of basal relationships in the core XMMAS clade and reconfiguration of ‘Stigmatomma’ to restore monophyly of all named genera will require more extensive genetic data and additional morphological analysis. However, the genus Bannapone can be synonymized under Stigmatomma (syn.n.) because it is embedded within a clade that contains S. denticulatum, the type species of Stigmatomma. Divergence dating analysis indicates that crown Amblyoponinae arose in the mid‐Cretaceous, about 107 Ma (95% highest probability density: 93–121 Ma). The POA and XMMAS clades have estimated crown ages of 47 and 73 Ma, respectively. The initial burst of diversification in the core XMMAS clade occurred in the Late Paleocene/Early Eocene (50–60 Ma). Ancestral range reconstruction suggests that amblyoponines originated in the Afrotropics, and dispersed to the Indo‐Malayan region and to the New World. During none of these dispersal events did the ants break out of their cryptobiotic lifestyle.
Cryoprecipitate AHF vs. fibrinogen concentrates for fibrinogen replacement in acquired bleeding patients – an economic evaluation
Authors: Okerberg C. K. , Williams L. A. , Kilgore M. L. , Kim C. H. , Marques M. B. , Schwartz J. , Pham H. P.
Published: June 2016

Background

Fibrinogen repletion in patients with acquired bleeding disorders can be accomplished by transfusing cryoprecipitate AHF (cryo) or fibrinogen concentrate (FC); thus, we undertook an economic evaluation from the transfusion service perspective regarding the use of cryo vs. FC in patients with acquired bleeding.

Methods

We created a model comparing the cost of cryo vs. FC from the transfusion service perspective. A patient with acquired bleeding requiring fibrinogen replacement could receive either 15–20 cryo units or 3–4 g FC, consistent with the guidelines from the European Task Force for Advanced Bleeding Care in Trauma. All model parameters were estimated from institutional experiences and the medical literature. Additionally, a survey of US Transfusion Medicine fellowship directors was conducted.

Results

After adjusting for 28% wastage and technologist salary, cryo cost is $414/5‐unit pool. Depending on the dose, FC is more expensive by $976‐$1303. To be competitive with cryo, FC cost must decrease by 44% or be shown to save 0·25–0·66 ICU days. Of the 30 survey replies, 96·7% of US centres do not use FC for acquired bleeding with the top three reasons being cost (30%), off‐label usage (27%) and insufficient evidence for usage (20%). Only 47% are willing to pay more for FC, with $437/g as the median amount.

Conclusion

Fibrinogen concentrate is more expensive than cryo, even after adjusting for cryo wastage. To be economically competitive with cryo, FC must cost $414/g, or save on ICU length of stay, consistent with the survey's results.
The linear programming relaxation permutation symmetry group of an orthogonal array defining integer linear program
Authors: Arquette David M. , Bulutoglu Dursun A.
Published: June 2016

There is always a natural embedding of $S_{s}\wr S_{k}$ into the linear programming (LP) relaxation permutation symmetry group of an orthogonal array integer linear programming (ILP) formulation with equality constraints. The point of this paper is to prove that in the $2$-level, strength-$1$ case the LP relaxation permutation symmetry group of this formulation is isomorphic to $S_{2}\wr S_{k}$ for all $k$, and in the $2$-level, strength-$2$ case it is isomorphic to $S_{2}^{k}\rtimes S_{k+1}$ for $k\geqslant 4$. The strength-$2$ result reveals previously unknown permutation symmetries that cannot be captured by the natural embedding of $S_{2}\wr S_{k}$. We also conjecture a complete characterization of the LP relaxation permutation symmetry group of the ILP formulation.

Supplementary materials are available with this article.
Conformal image‐guided microbeam radiation therapy at the ESRF biomedical beamline ID17
Authors: Donzelli Mattia , Bräuer‐Krisch Elke , Nemoz Christian , Brochard Thierry , Oelfke Uwe
Published: June 2016

Purpose:

Upcoming veterinary trials in microbeam radiation therapy (MRT) demand for more advanced irradiation techniques than in preclinical research with small animals. The treatment of deep‐seated tumors in cats and dogs with MRT requires sophisticated irradiation geometries from multiple ports, which impose further efforts to spare the normal tissue surrounding the target.

Methods:

This work presents the development and benchmarking of a precise patient alignment protocol for MRT at the biomedical beamline ID17 of the European Synchrotron Radiation Facility (ESRF). The positioning of the patient prior to irradiation is verified by taking x‐ray projection images from different angles.

Results:

Using four external fiducial markers of 1.7  mm diameter and computed tomography‐based treatment planning, a target alignment error of less than 2  mm can be achieved with an angular deviation of less than 2∘. Minor improvements on the protocol and the use of smaller markers indicate that even a precision better than 1  mm is technically feasible. Detailed investigations concerning the imaging dose lead to the conclusion that doses for skull radiographs lie in the same range as dose reference levels for human head radiographs. A currently used online dose monitor for MRT has been proven to give reliable results for the imaging beam.

Conclusions:

The ESRF biomedical beamline ID17 is technically ready to apply conformal image‐guided MRT from multiple ports to large animals during future veterinary trials.
Effect of Foot Progression Angle and Lateral Wedge Insole on a Reduction in Knee Adduction Moment
Authors: Tokunaga Ken , Nakai Yuki , Matsumoto Ryo , Kiyama Ryoji , Kawada Masayuki , Ohwatashi Akihiko , Fukudome Kiyohiro , Ohshige Tadasu , Maeda Tetsuo
Published: June 2016

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle.
Leisure-Time and Occupational Physical Activity in Early and Late Adulthood in Relation to Later Life Physical Functioning
Authors: Kulmala Jenni , Ngandu Tiia , Pajala Satu , Lehtisalo Jenni , Levälahti Esko , Antikainen Riitta , Laatikainen Tiina , Oksa Heikki , Peltonen Markku , Rauramaa Rainer , Soininen Hilkka , Strandberg Timo , Tuomilehto Jaakko , Kivipelto Miia
Published: June 2016

Background:

Physical activity (PA) has beneficial effects on older age physical functioning, but longitudinal studies with follow-ups extending up to decades are few. We investigated the association between leisure-time PA (LTPA) and occupational PA (OPA) from early to late adulthood in relation to later life performance-based physical functioning.

Methods:

The study involved 1260 people aged 60 to 79 years who took part in assessments of physical functioning (Short Physical Performance Battery [SPPB] test, 10-m maximal walking test, and grip strength test). Participants’ data on earlier life LTPA/OPA (age range 25 to 74 years) were received from the previous studies (average follow-up 13.4 years). Logistic, linear, and censored regression models were used to assess the associations between LTPA/OPA earlier in life and subsequent physical functioning.

Results:

A high level of LTPA earlier in life was associated with a lower risk of having difficulties on the SPPB test (odds ratio [OR]: 0.37; 95% confidence interval [CI], 0.24–0.58) and especially on the chair rise test (OR: 0.42; 95% CI, 0.27–0.64) in old age. Heavy manual work predicted difficulties on SPPB (OR: 1.91; 95% CI, 1.22–2.98) and the chair rise test (OR: 1.75; 95% CI, 1.14–2.69) and poorer walking speed (β = .10, P = .005).

Conclusions:

This study highlights the importance of LTPA on later life functioning, but also indicates the inverse effects that may be caused by heavy manual work.
Objectively Assessed Physical Activity and Associated Factors Among Adults in Peri-Urban and Rural Eastern Uganda: A Population-based Study
Authors: Kirunda Barbara Eva , Wamani Henry , Fadnes Lars Thore , Van den Broeck Jan , Tylleskär Thorkild
Published: June 2016

Background:

Data on physical inactivity, a known risk factor for noncommunicable diseases and its correlates in sub-Saharan Africa are almost absent. We assessed physical activity patterns and associated factors among adults.

Methods:

A populationbased study of 1208 adults was conducted in the Iganga-Mayuge Health and Demographic Surveillance Site, Uganda. Physical activity was assessed using a pedometer for 7 days. Physical inactivity was defined as a daily average of < 7500 steps while sedentary behavior was defined as a daily average of < 5000 steps. Logistic regression was conducted to identify factors associated with physical inactivity and sedentary behavior.

Results:

Of the 1208 participants, 18.8% were sedentary (10.6% of men; 26.9% of women, P < .001), 37.6% were physically inactive (28.5% of men; 46.6% of women, P < .001). Factors associated with sedentary behavior were being female, ≥ 65 years, peri-urban residence, being a domestic worker, formal employment and lower primary education. Factors associated with physical inactivity were being female, 55 to 64 years, ≥ 65 years, peri-urban residence, overweight and obesity.

Conclusions:

Sedentary behavior and physical inactivity were prevalent among the adult population. Targeted physical activity promotion interventions are needed.
Structure and torsional dynamics of the water octamer from THz laser spectroscopy near 215 μm
Authors: Cole William T. S. , Farrell James D. , Wales David J. , Saykally Richard J.
Published: June 2016

A close-up look at eight water molecules

A raindrop may look small, but it contains far too much water to model with the highest chemical precision. Theorists rely on studies of clusters with just a few molecules to enhance their understanding of the quantum-mechanical forces at play in the liquid. Cole
et al.
now report a high-resolution spectrum in the terahertz regime of the eight-membered cluster. By resolving 99 absorption lines associated with a collective torsional mode, the authors distinguish prolate and oblate isomers that are very similar in energy.

Science
, this issue p.
1194
Aligning statistical and scientific reasoning
Authors: Goodman Steven N.
Published: June 2016

Misunderstanding and misuse of statistical significance impede science
Metalenses at visible wavelengths: Diffraction-limited focusing and subwavelength resolution imaging
Authors: Khorasaninejad Mohammadreza , Chen Wei Ting , Devlin Robert C. , Oh Jaewon , Zhu Alexander Y. , Capasso Federico
Published: June 2016

Multifunction planar optics

Specially designed two-dimensional (2D) arrays of nanometer-scale metallic antennas, or metasurfaces, may allow bulky optical components to be shrunk down to a planar device structure. Khorasaninejad
et al.
show that arrays of nanoscale fins of TiO can function as high-end optical lenses. At just a fraction of the size of optical objectives, such planar devices could turn your phone camera or your contact lens into a compound microscope. Maguid
et al.
interleaved sparse 2D arrays of metal antennas to get multifunctional behavior from the one planar device structure (see the Perspective by Litchinitser). The enhanced functionality of such designed metasurfaces could be used in sensing applications or to increase the communication capacity of nanophotonic networks.

Science
, this issue pp.
1190
and
1202
; see also p.
1177
What does research reproducibility mean?
Authors: Goodman Steven N. , Fanelli Daniele , Ioannidis John P. A.
Published: June 2016

The language and conceptual framework of “research reproducibility” are nonstandard and unsettled across the sciences.
Streptococcus anginosus ("Streptococcus milleri"): the unrecognized pathogen
Authors: Ruoff K L
Published: June 2016

"Streptococcus milleri" is an unofficial name that has been applied to a group of streptococci which, although basically similar, show various hemolytic, serological, and physiological characteristics. The species name Streptococcus anginosus has recently been recognized as the approved name for these organisms. Streptococci known as "S. milleri" have been implicated as etiologic agents in a variety of serious purulent infections, but because of their heterogeneous characteristics, these organisms may be unrecognized or misidentified by clinical laboratorians. This review describes the bacteriological aspects of organisms known as "S. milleri," their clinical significance, and the problems encountered with their identification in the clinical laboratory.
Diagnostic deoxyribonucleic acid probes for infectious diseases
Authors: Tenover F C
Published: June 2016

Virtually all microorganisms contain some unique nucleotide sequences which can be the target of deoxyribonucleic acid probes. Probes have been used successfully to identify a wide variety of pathogens from the simple ribonucleic acid-containing polioviruses to the complex filarial worms Brugia malayi. Probe technology offers the clinical laboratory the potential both to extend the types of pathogens that can be readily identified and to reduce significantly the time associated with the identification of fastidious microorganisms. Over a dozen commercially prepared deoxyribonucleic acid probe tests are now available. This article explores the development of deoxyribonucleic acid probe tests and reviews the sensitivity, specificity, and predictive values of many of the diagnostic probes developed during the last several years. Prospects for newer, more sensitive detection systems for the products of hybridization reactions are also reviewed.
Haemophilus influenzae: antibiotic susceptibility
Authors: Needham C A
Published: June 2016

Ampicillin resistance was first reported among clinical isolates of Haemophilus influenzae in 1972. Reports of chloramphenicol resistance followed shortly thereafter. The principal mechanism of resistance to these two antibiotics is enzymatic. Although other mechanisms have been described, they are found in comparatively few strains. The genetic information for the inactivating enzymes is plasmid mediated and therefore readily transmissible to susceptible strains. Consequently, effective therapy for invasive disease caused by this pathogen has been seriously compromised. As antibiotic susceptibility became less predictable, in vitro testing became increasingly important. Unfortunately, the standardization of methods for laboratory testing has been slow and complicated by the fastidious nature of the organisms. This review traces the development of antibiotic resistance in H. influenzae, discusses the mechanisms which appear to be important in mediating resistance, explores newer antimicrobial agents which might be useful in the treatment of infection, and analyzes the various approaches to in vitro testing.
Current perspectives on the epidemiology and pathogenesis of clinically significant Vibrio spp
Authors: Janda J M , Powers C , Bryant R G , Abbott S L
Published: June 2016

Recent taxonomic advances have now implicated several different Vibrio species as human pathogens. While the most common clinical presentation of Vibrio infection continues to be gastroenteritis, an increasing number of extraintestinal infections are being reported, particularly in immunocompromised individuals. Detection of Vibrio infections requires a good clinical history and the use of appropriate isolation and identification procedures by the laboratory to confirm illnesses attributed to Vibrio species. Except for Vibrio cholerae O1 and Vibrio parahaemolyticus, there is little direct evidence linking the production of a myriad of cell-associated or extracellular factors produced by each species with human disease and pathogenesis. Many questions regarding pathogenic Vibrio species remain unanswered, including their frequency and distribution in environmental specimens (water, shellfish), infective doses, virulence potential of individual isolates, and markers associated with such strains.
Clinical laboratory applications of monoclonal antibodies
Authors: Payne W J , Marshall D L , Shockley R K , Martin W J
Published: June 2016

Monoclonal antibody (MAb) technology is well recognized as a significant development for producing specific serologic reagents to a wide variety of antigens in unlimited amounts. These reagents have provided the means for developing a number of highly specific and reproducible immunological assays for rapid and accurate diagnosis of an extensive list of diseases, including infectious diseases. The impact that MAbs have had in characterizing infectious disease pathogens, as well as their current and future applications for use in clinical microbiology laboratories, is reviewed. In addition, the advantages (and disadvantages) of the use of MAbs in a number of immunoassays, such as particle agglutination, radioimmunoassays, enzyme-linked immunosorbent assays, immunofluorescent-antibody assays, and immunohistology, are explored, including the use of these reagents in novel test system assays. Also, nucleic acid probe technology is compared with the use of MAbs from the perspective of their respective applications in the diagnosis of infectious disease agents. There is no question that hybridoma technology has the potential to alter significantly the methods currently used in most clinical microbiology laboratories.
Contemporary issues: diseases with a food vector
Authors: Archer D L , Young F E
Published: June 2016

Foodborne disease has become a contemporary issue. Several large, well-publicized outbreaks of foodborne disease have heightened public awareness that harmful microorganisms may be present in food and that chronic as well as acute disease may be caused by foodborne microbes. The field of food microbiology has likewise experienced a resurgence of interest. New tools, such as recombinant deoxyribonucleic acid technology and monoclonal antibody production, used to elucidate microbial virulence factors have facilitated identification of disease-causing microbes once thought to be harmless and demonstrated the complexity of individual virulence mechanisms previously considered to be well understood. Foodborne pathogens are also causing disease via some surprising food vectors, such as chopped, bottled garlic and sauteed onions. In addition to acute gastrointestinal disturbances, certain microorganisms may, through complex interactions with the human immune response, cause chronic diseases that affect several major organ systems. These microbes are serving as models in studies of molecular mimicry and genetic interrelatedness of procaryotes and eucaryotes. Other recently recognized attributes of foodborne microorganisms, such as the heat shock phenomenon and the possible nonculturability of some bacteria, may affect their ability to cause disease in humans. Because foodborne disease is a major cause of morbidity and mortality, the study of these diseases and their causative microorganisms presents a unique challenge to many professionals in the subdisciplines of microbiology, epidemiology, and clinical medicine.
Laboratory aspects of Lyme borreliosis
Authors: Barbour A G
Published: June 2016

Lyme borreliosis (Lyme disease), a common tick-borne disorder of people and domestic animals in North America and Europe, is caused by the spirochete Borrelia burgdorferi. Following the discovery and initial propagation of this agent in 1981 came revelations that other tick-associated infectious disorders are but different forms of Lyme borreliosis. A challenge for the clinician and microbiology laboratory is confirmation that a skin rash, a chronic meningitis, an episode of myocarditis, or an arthritic joint is the consequence of B. burgdorferi infection. The diagnosis of Lyme borreliosis may be established by (i) directly observing the spirochete in host fluid or tissue, (ii) recovering the etiologic spirochete from the patient in culture medium or indirectly through inoculation of laboratory animals, or (iii) carrying out serologic tests with the patient's serum or cerebrospinal fluid. The last method, while lacking in discriminatory power, is the most efficacious diagnostic assay for most laboratories at present.
Historical perspectives and identification of Neisseria and related species
Authors: Knapp J S
Published: June 2016

The pathogenic Neisseria spp., N. gonorrhoeae and N. meningitidis, have been studied extensively and rapid identification procedures have been designed to distinguish these species from the commensal Neisseria and related species that are normal flora of the oro- and nasopharynx. The commensal Neisseria spp. have been largely ignored except for isolated studies. It is important that we know about these species, however, because not only may some be misidentified as pathogenic species if identified with inappropriate procedures, but also they may occasionally be isolated from unusual sites and must be correctly identified to the species level for clinical purposes.
Toxic shock syndrome
Authors: Todd J K
Published: June 2016

In the past 10 years, we have learned much about TSS and S. aureus and its toxins. A number of important biologic principles have been reemphasized in this first decade of TSS research: S. aureus is a very complex organism, one not likely to yield quick answers; in vitro observations must always be confirmed in the patient; animal models may not always be reliable replicates of human disease; and epidemiologic associations cannot be equated with causation. Toxic shock is an intricate phenomenon with many interesting scientific facets. Unraveling its mysteries will undoubtedly teach us more about the complex interaction of patients and microorganisms.
Infection by verocytotoxin-producing Escherichia coli
Authors: Karmali M A
Published: June 2016

Verocytotoxin (VT)-producing Escherichia coli (VTEC) are a newly recognized group of enteric pathogens which are increasingly being recognized as common causes of diarrhea in some geographic settings. Outbreak studies indicate that most patients with VTEC infection develop mild uncomplicated diarrhea. However, a significant risk of two serious and potentially life-threatening complications, hemorrhagic colitis and the hemolytic uremic syndrome, makes VTEC infection a public health problem of serious concern. The main reservoirs of VTEC appear to be the intestinal tracts of animals, and foods of animal (especially bovine) origin are probably the principal sources for human infection. The term VT refers to a family of subunit exotoxins with high biological activity. Individual VTEC strains elaborate one or both of at least two serologically distinct, bacteriophage-mediated VTs (VT1 and VT2) which are closely related to Shiga toxin and are thus also referred to as Shiga-like toxins. The holotoxins bind to cells, via their B subunits, to a specific receptor which is probably the glycolipid, globotriosyl ceramide (Gb3). Binding is followed by internalization of the A subunit, which, after it is proteolytically nicked and reduced to the A1 fragment, inhibits protein synthesis in mammalian cells by inactivating 60S ribosomal subunits through selective structural modification of 28S ribosomal ribonucleic acid. The mechanism of VTEC diarrhea is still controversial, and the relative roles of locally acting VT and "attaching and effacing adherence" of VTEC to the mucosa have yet to be resolved. There is increasing evidence that hemolytic uremic syndrome and possibly hemorrhagic colitis result from the systemic action of VT on vascular endothelial cells. The role of antitoxic immunity in preventing the systemic complications of VTEC infection is being explored. Antibiotics appear to be contraindicated in the treatment of VTEC infection. The most common VTEC serotype associated with human disease is O157:H7, but over 50 different VT-positive O:H serotypes have now been identified. The best strategies for diagnosing human VTEC infection include testing for the presence of free VT in fecal filtrates and examining fecal cultures for VTEC by means of deoxyribonucleic acid probes that specify genes encoding VT1 and VT2. Both methods are currently confined to specialized laboratories and await commercial development for wider use. In the meantime, most laboratories should continue to screen for the most common human VTEC serotype, O157:H7, using a sorbitol-containing MacConkey medium.
Clinical and laboratory aspects of filariasis
Authors: Nanduri J , Kazura J W
Published: June 2016

Human filarial infections afflict over 150 million persons worldwide and are major causes of morbidity in many developing countries. Onchocerca volvulus infection is a leading preventable cause of blindness, while bancroftian and brugian filariasis may produce lymphatic obstruction of the genitalia and extremities (elephantiasis). Definitive diagnosis of these helminthic infections currently depends on demonstration of microfilariae in host tissues, i.e., the skin in the case of O. volvulus and the bloodstream in the cases of Wuchereria bancrofti and Brugia malayi. Many investigations are now directed at developing specific and sensitive serum antigen assays that will allow diagnosis of active infection (i.e., presence of adult-stage parasites) in the absence of detectable microfilariae. With respect to the immunology of these parasitic infections, efforts are being directed at elucidating the role of T- and B-cell responses in the development of pathologic lesions and resistance to reinfection. These data as well as molecular biologic approaches to identify and study filarial molecules which are immunogenic are discussed. Finally, since treatment of filariases at present depends on antiparasitic drugs, the clinical indications and dosages of diethylcarbamazine and ivermectin are summarized.
Laboratory diagnosis of human chlamydial infections
Authors: Barnes R C
Published: June 2016

Chlamydia trachomatis is a human pathogen that causes ocular disease (trachoma and inclusion conjunctivitis), genital disease (cervicitis, urethritis, salpingitis, and lymphogranuloma venereum), and respiratory disease (infant pneumonitis). Respiratory chlamydioses also occur with infection by avian strains of C. psittaci or infection by the newly described TWAR agent. Diagnosis of most acute C. trachomatis infections relies on detection of the infecting agent by cell culture, fluorescent antibody, immunoassay, cytopathologic, or nucleic acid hybridization methods. Individual non-culture tests for C. trachomatis are less sensitive and specific than the best chlamydial cell culture system but offer the advantages of reduced technology and simple transport of clinical specimens. Currently available nonculture tests for C. trachomatis perform adequately as screening tests in populations in which the prevalence of infection is greater than 10%. A negative culture or nonculture test for C. trachomatis does not, however, exclude infection. The predictive value of a positive nonculture test may be unsatisfactory when populations of low infection prevalence are tested. Tests that detect antibody responses to chlamydial infection have limited utility in diagnosis of acute chlamydial infection because of the high prevalence of persistent antibody in healthy adults and the cross-reactivity due to infection by the highly prevalent C. trachomatis and TWAR agents. Assays for changes in antibody titer to the chlamydial genus antigen are used for the diagnosis of respiratory chlamydioses. A single serum sample that is negative for chlamydial antibody excludes the diagnosis of lymphogranuloma venereum.
Clinical and experimental aspects of viral myocarditis
Authors: Leslie K , Blay R , Haisch C , Lodge A , Weller A , Huber S
Published: June 2016

Picornaviruses are frequently implicated as the etiological agents of acute myocarditis. This association is based historically on serological evidence of rising antibody titers to specific pathogens and more recently on identification of viral genomic material in endocardial biopsy specimens through in situ hybridization. Only rarely is infectious virus isolated from either the patient or the heart during periods of maximum myocardial inflammation and injury. Thus, despite a probable viral etiology, much interest centers on the role of the immune system in cardiac damage and the likelihood that the infection triggers an autoimmune response to heart-specific antigens. Heart-reactive antibodies and T cells are found in most myocarditis patients, and immunosuppressive therapy has proven beneficial in many, though not all, cases. Furthermore, murine models of coxsackievirus group B type 3-induced myocarditis also demonstrate that virus infection initiates autoimmunity and that these autoimmune effectors are predominately responsible for tissue injury. How virus-host interactions overcome presumed self-tolerance to heart antigens is discussed, and evidence supporting various theories of virus-initiated autoimmunity and disease pathogenesis are delineated.
Rocky Mountain spotted fever: a disease in need of microbiological concern
Authors: Walker D H
Published: June 2016

Rocky Mountain spotted fever, a life-threatening tick-transmitted infection, is the most prevalent rickettsiosis in the United States. This zoonosis is firmly entrenched in the tick host, which maintains the rickettsiae in nature by transovarian transmission. Although the incidence of disease fluctuates in various regions and nationwide, the problems of a deceptively difficult clinical diagnosis and little microbiologic diagnostic effort persist. Many empiric antibiotic regimens lack antirickettsial activity. There is neither an effective vaccine nor a generally available assay that is diagnostic during the early stages of illness, when treatment is most effective. Microbiology laboratories that offer only the archaic retrospective Weil-Felix serologic tests should review the needs of their patients. Research microbiologists who tackle these challenging organisms have an array of questions to address regarding rickettsial surface composition, structure-function analysis, and pathogenic and immune mechanisms, as well as laboratory diagnosis.
Immunopathology of Schistosoma mansoni infection
Authors: Boros D L
Published: June 2016

Schistosomiasis mansoni is a chronic helminthic disease that affects about 100 million people in the tropics. The worms have a life span of 5 to 10 years, and they live in the mesenteric veins of the host. Lightly infected individuals are asymptomatic or manifest mild intestinal symptoms. Heavily infected individuals often develop severe morbidity with hepatosplenomegaly, sometimes with a fatal outcome. Morbidity is attributed to the strong humoral and T-cell-mediated host immune responses developed to a variety of parasite antigens and expressed as tissue inflammations. The immunopathology includes dermatitis, immune complex-mediated kidney disease, and, chiefly, T-cell-mediated granuloma formation and fibrosis around disseminated parasite eggs. This review describes the mechanisms of induction and expression of immunopathology in infected persons and experimental animals. Immunoregulatory mechanisms that modulate the enhanced immune responses and may ameliorate excessive morbidity are discussed.
Classification and identification of the viridans streptococci
Authors: Coykendall A L
Published: June 2016

This review traces the history of the human, nonhemolytic, or viridans, streptococci and describes improvements in their taxonomy wrought by study of their biochemical profiles and analysis of their nucleic acids. The goal was to define species on the basis of genetic relationships and to describe these species by their phenotypic characteristics so that they can be easily identified. This method has resulted in the division of some species. Streptococcus mutans has been divided into four species, two of which are common in humans. Three more mutans group species are indigenous to animals. Conversely, S. constellatus, S. intermedius, and "S. milleri" have been combined under S. anginosus. S. mitis (or "S. mitior") can be well-defined and includes S. sanguis II. There is genetic heterogeneity within S. sanguis, but the species is usually easy to identify. There is also some heterogeneity in S. bovis, but most human isolates are genetically related. Discussions of the taxonomy of these species are accompanied by descriptions of the characteristics by which these streptococci can be identified. Among these species are potential pathogens which should be suspected in cases of endocarditis and purulent infections of liver, brain, and other tissues.
The life and times of the Enterococcus
Authors: Murray B E
Published: June 2016

Enterococci are important human pathogens that are increasingly resistant to antimicrobial agents. These organisms were previously considered part of the genus Streptococcus but have recently been reclassified into their own genus, called Enterococcus. To date, 12 species pathogenic for humans have been described, including the most common human isolates, Enterococcus faecalis and E. faecium. Enterococci cause between 5 and 15% of cases of endocarditis, which is best treated by the combination of a cell wall-active agent (such as penicillin or vancomycin, neither of which alone is usually bactericidal) and an aminoglycoside to which the organism is not highly resistant; this characteristically results in a synergistic bactericidal effect. High-level resistance (MIC, greater than or equal to 2,000 micrograms/ml) to the aminoglycoside eliminates the expected bactericidal effect, and such resistance has now been described for all aminoglycosides. Enterococci can also cause urinary tract infections; intraabdominal, pelvic, and wound infections; superinfections (particularly in patients receiving expanded-spectrum cephalosporins); and bacteremias (often together with other organisms). They are now the third most common organism seen in nosocomial infections. For most of these infections, single-drug therapy, most often with penicillin, ampicillin, or vancomycin, is adequate. Enterococci have a large number of both inherent and acquired resistance traits, including resistance to cephalosporins, clindamycin, tetracycline, and penicillinase-resistant penicillins such as oxacillin, among others. The most recent resistance traits reported are penicillinase resistance (apparently acquired from staphylococci) and vancomycin resistance, both of which can be transferred to other enterococci. It appears likely that we will soon be faced with increasing numbers of enterococci for which there is no adequate therapy.
Transport of viral specimens
Authors: Johnson F B
Published: June 2016

The diagnosis of viral infections by culture relies on the collection of proper specimens, proper care to protect the virus in the specimens from environmental damage, and use of an adequate transport system to maintain virus activity. Collection of specimens with swabs that are toxic to either virus or cell culture should be avoided. A variety of transport media have been formulated, beginning with early bacteriological transport media. Certain swab-tube combinations have proven to be both effective and convenient. Of the liquid transport media, sucrose-based and broth-based media appear to be the most widely accepted and used. Studies on virus stability show that most viruses tested are sufficiently stable in transport media to withstand a transport time of 1 to 3 days. Some viruses may withstand longer transport times. In many cases, it is not necessary to store virus specimens in a refrigerator or send them to the laboratory on wet ice or frozen on dry ice. However, the specimen should not be exposed to environmental extremes. Modern viral transport media allow for more effective use of viral culture and culture enhancement techniques for the diagnosis of human viral infections.