bluuebunny/crossref_metadata_2025 huggingface dataset:
EGFR signaling is critical for maintaining the superficial layer of articular cartilage and preventing osteoarthritis initiation
Authors: Jia Haoruo , Ma Xiaoyuan , Tong Wei , Doyran Basak , Sun Zeyang , Wang Luqiang , Zhang Xianrong , Zhou Yilu , Badar Farid , Chandra Abhishek , Lu X. Lucas , Xia Yang , Han Lin , Enomoto-Iwamoto Motomi , Qin Ling
Published: November 2016

Significance

The uppermost superficial zone of articular cartilage plays multifaceted roles in maintaining cartilage structure, function, and mechanical properties and in preventing cartilage degeneration during osteoarthritis initiation. However, its regulation by growth factors and hormones is still largely unknown. Here we report that EGFR signaling is an important growth factor pathway that maintains superficial chondrocyte number, promotes boundary lubricant secretion and cartilage surface lubrication, and stimulates mechanical strength of articular cartilage. Reduction in EGFR activity leads to structurally, functionally, and mechanically compromised articular cartilage during development and drastically accelerates cartilage degeneration under normal and surgically induced osteoarthritis conditions. Thus, our studies strongly suggest that targeting cartilage surface EGFR signaling should be considered as a novel direction for osteoarthritis treatment.
β-Arrestin mediates the Frank–Starling mechanism of cardiac contractility
Authors: Abraham Dennis M. , Davis Robert T. , Warren Chad M. , Mao Lan , Wolska Beata M. , Solaro R. John , Rockman Howard A.
Published: November 2016

Significance

The Frank–Starling law of the heart describes the heart’s ability to enhance contractility in response to increased cardiac filling. This property is fundamental to how humans maintain cardiovascular function in response to changes in circulating blood volume, and is regulated by enhanced calcium sensitivity of myofilaments with biomechanical stretch. The mechanism of how biomechanical stretch leads to changes in the myofilament calcium sensitivity remains poorly understood. Using genetic and pharmacologic approaches, we show that β-arrestin and the angiotensin II type I receptor act as crucial molecular regulators of the Frank–Starling law of the heart. This work identifies β-arrestins as important regulators of this fundamental principle of cardiac contractility.
Geometry induced sequence of nanoscale Frank–Kasper and quasicrystal mesophases in giant surfactants
Authors: Yue Kan , Huang Mingjun , Marson Ryan L. , He Jinlin , Huang Jiahao , Zhou Zhe , Wang Jing , Liu Chang , Yan Xuesheng , Wu Kan , Guo Zaihong , Liu Hao , Zhang Wei , Ni Peihong , Wesdemiotis Chrys , Zhang Wen-Bin , Glotzer Sharon C. , Cheng Stephen Z. D.
Published: November 2016

Significance

How far can we push self-assembly toward unusual nanostructures? Frank–Kasper and quasicrystal phases represent unconventional phases of ordered spheroids originally identified in metal alloys. We report that Frank–Kasper and quasicrystal phases and their transition sequence are observed in one-component giant surfactants by introducing variations in molecular geometry. Both X-ray scattering and electron microscopy techniques are used to identify the self-assembled nanostructures. Combining molecular dynamics simulations, we attribute the appearance of these phases to molecular geometry as a result of tail number variation. Our findings lay the foundation for rational design of unconventional soft-matter phases and for exploiting them for unusual properties and functions.
Heterogeneous yet stable Vδ2
(+)
T-cell profiles define distinct cytotoxic effector potentials in healthy human individuals
Authors: Ryan Paul L. , Sumaria Nital , Holland Christopher J. , Bradford Claire M. , Izotova Natalia , Grandjean Capucine L. , Jawad Ali S. , Bergmeier Lesley A. , Pennington Daniel J.
Published: November 2016

Significance

A type of human white blood cell, known as the Vδ2
(+)
T cell, has shown promise in immunotherapies against a range of tumors. However, in recent clinical trials patient responses and clinical outcomes have been variable and unpredictable. To address this, we here reveal a significant variability in Vδ2
(+)
T-cell functional potential between individuals in the general population, which develops shortly after birth, is stable over time, and is manifested by differential mechanistic capacities to kill tumor targets. These results support personalized clinical approaches to identify patients with “Vδ2 profiles” that are compatible with killing of their particular tumor and suggest that tailored Vδ2-profile–specific activation protocols may maximize the chances of future treatment success.
Stretchable multichannel antennas in soft wireless optoelectronic implants for optogenetics
Authors: Park Sung Il , Shin Gunchul , McCall Jordan G. , Al-Hasani Ream , Norris Aaron , Xia Li , Brenner Daniel S. , Noh Kyung Nim , Bang Sang Yun , Bhatti Dionnet L. , Jang Kyung-In , Kang Seung-Kyun , Mickle Aaron D. , Dussor Gregory , Price Theodore J. , Gereau Robert W. , Bruchas Michael R. , Rogers John A.
Published: November 2016

Significance

Soft, multichannel antennas enable wireless, battery-free operation of fully implantable optoelectronic systems designed for use in studies of brain function. These systems support independent, remote control of multiple light-emitting diodes that inject into targeted regions of the deep brain, where they separately stimulate activity in genetically and spatially discrete neural circuits, via the use of the techniques of optogenetics. These capabilities represent significant advancements over alternative technology approaches for this important branch of neuroscience research. In vivo studies using optimized systems demonstrate wireless control of two different brain regions and distinct activation of subpopulations of neurons using separately activated light sources associated with these subdermal devices.
TNFα-stimulated gene-6 (TSG6) activates macrophage phenotype transition to prevent inflammatory lung injury
Authors: Mittal Manish , Tiruppathi Chinnaswamy , Nepal Saroj , Zhao You-Yang , Grzych Dagmara , Soni Dheeraj , Prockop Darwin J. , Malik Asrar B.
Published: November 2016

Significance

We found that TNFα-stimulated gene-6 (TSG6), a secreted 30-kDa immunomodulatory protein, resolved LPS-induced inflammatory lung injury by shifting macrophages from a proinflammatory to an anti-inflammatory phenotype. Macrophages from mice genetically deficient in TSG6 failed to transition, demonstrating the essential role of TSG6 in mediating macrophage plasticity. The finding that TSG6 induced the marked transition in anti-inflammatory macrophages lays the foundation for its therapeutic application.
Urban park soil microbiomes are a rich reservoir of natural product biosynthetic diversity
Authors: Charlop-Powers Zachary , Pregitzer Clara C. , Lemetre Christophe , Ternei Melinda A. , Maniko Jeffrey , Hover Bradley M. , Calle Paula Y. , McGuire Krista L. , Garbarino Jeanne , Forgione Helen M. , Charlop-Powers Sarah , Brady Sean F.
Published: November 2016

Significance

Bacterial natural products (NPs) have served as inspiration for many therapeutics. The hunt for new bioactive NPs has led to a global search for natural ecosystems from which bacteria can be cultured. Here, we used NP-focused metagenome sequencing to explore biosynthetic diversity in urban park soil of New York City. Our analyses reveal rich biosynthetic diversity in these microbiomes and predict that gene clusters encoding many clinically approved NPs families discovered using bacteria cultured from around the world are actually present in the soil microbiomes of a single city. Contrary to traditional NP discovery efforts that involve shallow explorations of diverse environments, our data suggest that a deeper exploration of local microbiomes may prove equally, if not, more productive.
Tau prions from Alzheimer’s disease and chronic traumatic encephalopathy patients propagate in cultured cells
Authors: Woerman Amanda L. , Aoyagi Atsushi , Patel Smita , Kazmi Sabeen A. , Lobach Iryna , Grinberg Lea T. , McKee Ann C. , Seeley William W. , Olson Steven H. , Prusiner Stanley B.
Published: November 2016

Significance

The progressive nature of neurodegenerative diseases is due to the spread of prions, misfolded infectious proteins, in the brain. In tauopathies, the protein tau misfolds, causing several diseases, including Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE). Here we created a panel of mammalian cell lines expressing a fragment of tau fused to yellow fluorescent protein. Each cell line selectively detects tau prions that are misfolded into self-propagating conformations; such cells permit identification of minute differences among tauopathies. For example, tau prions in AD and CTE are distinct from prions in other tauopathies such as Pick’s disease and progressive supranuclear palsy. These insights are likely to contribute to the development of future therapeutics.
Supramolecular PEGylation of biopharmaceuticals
Authors: Webber Matthew J. , Appel Eric A. , Vinciguerra Brittany , Cortinas Abel B. , Thapa Lavanya S. , Jhunjhunwala Siddharth , Isaacs Lyle , Langer Robert , Anderson Daniel G.
Published: November 2016

Significance

Pharmaceutical practice has transitioned away from small-molecule drugs to the use of biomolecules (peptides, proteins, and antibodies). Where formulation of small molecules focused primarily on solubility, biopharmaceuticals introduced an array of complications due to their more complex secondary and tertiary structures, contributing to concerns surrounding aggregation and denaturation over time in formulation. Here, we outline an approach using noncovalent supramolecular affinity to endow biopharmaceuticals with a polymer known to inhibit protein aggregation and improve solubility. This method stands in contrast to similar approaches to covalently graft the same polymer onto the protein, instead offering a broadly useful and modular formulation excipient that can be combined with authentic unmodified protein drugs to extend shelf life.
Zika virus cell tropism in the developing human brain and inhibition by azithromycin
Authors: Retallack Hanna , Di Lullo Elizabeth , Arias Carolina , Knopp Kristeene A. , Laurie Matthew T. , Sandoval-Espinosa Carmen , Mancia Leon Walter R. , Krencik Robert , Ullian Erik M. , Spatazza Julien , Pollen Alex A. , Mandel-Brehm Caleigh , Nowakowski Tomasz J. , Kriegstein Arnold R. , DeRisi Joseph L.
Published: November 2016

Significance

Zika virus (ZIKV) is a mosquito-borne flavivirus that has rapidly spread through the Americas and has been associated with fetal abnormalities, including microcephaly. To understand how microcephaly develops, it is important to identify which cell types of the developing brain are susceptible to infection. We use primary human tissue to show that radial glia and astrocytes are more susceptible to infection than neurons, a pattern that correlates with expression of a putative viral entry receptor, AXL. We also perform a screen of Food and Drug Administration-approved compounds, with an emphasis on drugs known to be safe in pregnancy. We identify an antibiotic, azithromycin, that reduces viral proliferation in glial cells, and compare its activity with daptomycin and sofosbuvir, two additional drugs with anti-ZIKV activity.
Adaptation of the short version of the Psychological Capital Questionnaire (PCQ-12) into Spanish / Adaptación al español de la versión reducida del Cuestionario de Capital Psicológico (PCQ-12)
Authors: León-Pérez José M. , Antino Mirko , León-Rubio José M.
Published: November 2016

Psychological capital (PsyCap) has been a topic of increasing interest in the last decade. However, there is a lack of validated instruments in Spanish to map PsyCap and its consequences for individuals’ well-being. Consequently, the goal of this study is to adapt the 12-item short version of the Psychological Capital Questionnaire (PCQ-12) to the Spanish context by analysing its internal consistency and reliability, factor solution and external validity. Results indicated that the PCQ-12 exhibited good Cronbach’s alpha (.87) and omega coefficient (.93) values in a sample from a vehicle inspection company ( n = 798). As expected, results also revealed that a second-order factor structure provided the best fit. Moreover, PsyCap is associated with increased job engagement (β = .579; R 2 adjusted = .333), decreased job burnout (β = −.409; R 2 adjusted = .166), and lower psychological distress (β = −.349; R 2 adjusted = .121) (all p < .01), which provided additional support for using the PCQ-12 in the Spanish context. Implications for theory and practice are discussed.
Quantitation using a stable isotope dilution assay (SIDA) and thresholds of taste-active pyroglutamyl decapeptide ethyl esters (PGDPEs) in sake
Authors: Hashizume Katsumi , Ito Toshiko , Igarashi Shinya
Published: November 2016

A stable isotope dilution assay (SIDA) for two taste-active pyroglutamyl decapeptide ethyl esters (PGDPE1; (pGlu)LFGPNVNPWCOOC2H5, PGDPE2; (pGlu)LFNPSTNPWCOOC2H5) in sake was developed using deuterated isotopes and high-resolution mass spectrometry. Recognition thresholds of PGDPEs in sake were estimated as 3.8 μg/L for PGDPE1 and 8.1 μg/L for PGDPE2, evaluated using 11 student panelists aged in their twenties. Quantitated concentrations in 18 commercial sake samples ranged from 0 to 27 μg/L for PGDPE1 and from 0 to 202 μg/L for PGDPE2. The maximum levels of PGDPE1 and PGDPE2 in the sake samples were approximately 8 and 25 times higher than the estimated recognition thresholds, respectively. The results indicated that PGDPEs may play significant sensory roles in the sake. The level of PGDPEs in unpasteurized sake samples decreased during storage for 50 days at 6 °C, suggesting PGDPEs may be enzymatically decomposed.
An equivalent spherical charge conversion (ESCC) approach for prediction of ground vibration due to blasting
Authors: Pal Roy Pijush
Published: November 2016

Peak particle velocity generated by cylindrically-charged blastholes fired at different delay detonators in surface blasting can be predicted with reasonable degree of certainty by an equivalent spherical charge conversion (ESCC) approach wherein the cylindrical charges are replaced by equivalent spherical charges. The validity of this conversion model has been tested through different predictive equations using experimental data of two opencast mines viz. Bhelatand Amalgamated Colliery and Joribahal Iron Ore Mine. In deriving these equations both maximum charge per delay and total charge fired in the round were considered separately. The results show that ESCC approach can be used as a reliable vibration prediction tool in surface blasting.
Exile and Petrarch’s Reinvention of Authorship
Authors: Hooper Laurence E.
Published: November 2016

This article demonstrates a systematic connection between the novelty of Petrarch’s authorship and his self-definition as an exile. Petrarch employs the unusual termexilium/esilioto substantiate his unprecedented claim that literature is a legally validofficium(civic role). Following Dante, Petrarch grounds his exilic authorship in the Christian discourse ofperegrinatio:life as pilgrimage through exile. But Petrarch’s newofficiumallows him a measure of control over literary creation that no prior Italian writer had enjoyed. This is especially true of the “Canzoniere,” Petrarch’s compilation of his vernacular lyrics, whose singularity functions as a proxy for its author’s selfhood.
Civic Piety and Patriotism: Patrician Humanists and Jews in Venice and Its Empire
Authors: Bowd Stephen
Published: November 2016

This article focuses on the contribution of anti-Jewish themes to political ideals and reality in the works of two leading Venetian patrician humanists — Ludovico Foscarini and Paolo Morosini. The article demonstrates that their literary attacks on Jews were shaped by classical, patristic, medieval, and humanist texts, and by the experience of service to the state. It also demonstrates that their work contributed to debates about the toleration of Jews in Venetian territory and can be linked to the humanist engagement with Judaism at a critical point for both phenomena in the fifteenth century.
Projecting Power: Cathedral Chapters and Public Rituals in Portugal, 1564–1650
Authors: Silva Hugo Ribeiro da
Published: November 2016

In the post-Tridentine period, conflicts in cathedrals revealed social dynamics that extended beyond the cathedral walls. Cathedral chapters had to deal with the competition of ecclesiastic as well as secular institutions, involving bishops, Inquisition officials, monks, and members of lay confraternities and city councils. All of them competed to preserve or advance their privileged place in a society of orders, and these rivalries often emerged in public ceremonies. Rituals thus provided a promising setting for power struggles. More than merely local episodes, these conflicts illustrate the rebalance of power in the sixteenth and seventeenth centuries that characterized the early modern state.
Acoustofluidic bacteria separation
Authors: Li Sixing , Ma Fen , Bachman Hunter , Cameron Craig E , Zeng Xiangqun , Huang Tony Jun
Published: November 2016

Bacterial separation from human blood samples can help with the identification of pathogenic bacteria for sepsis diagnosis. In this work, we report an acoustofluidic device for label-free bacterial separation from human blood samples. In particular, we exploit the acoustic radiation force generated from a tilted-angle standing surface acoustic wave (taSSAW) field to separate Escherichia coli from human blood cells based on their size difference. Flow cytometry analysis of the E. coli separated from red blood cells shows a purity of more than 96%. Moreover, the label-free electrochemical detection of the separated E. coli displays reduced non-specific signals due to the removal of blood cells. Our acoustofluidic bacterial separation platform has advantages such as label-free separation, high biocompatibility, flexibility, low cost, miniaturization, automation, and ease of in-line integration. The platform can be incorporated with an on-chip sensor to realize a point-of-care sepsis diagnostic device.
An image-based skeletal dosimetry model for the ICRP reference adult female—internal electron sources
Authors: O’Reilly Shannon E , DeWeese Lindsay S , Maynard Matthew R , Rajon Didier A , Wayson Michael B , Marshall Emily L , Bolch Wesley E
Published: November 2016

An image-based skeletal dosimetry model for internal electron sources was created for the ICRP-defined reference adult female. Many previous skeletal dosimetry models, which are still employed in commonly used internal dosimetry software, do not properly account for electron escape from trabecular spongiosa, electron cross-fire from cortical bone, and the impact of marrow cellularity on active marrow self-irradiation. Furthermore, these existing models do not employ the current ICRP definition of a 50 µm bone endosteum (or shallow marrow). Each of these limitations was addressed in the present study. Electron transport was completed to determine specific absorbed fractions to both active and shallow marrow of the skeletal regions of the University of Florida reference adult female. The skeletal macrostructure and microstructure were modeled separately. The bone macrostructure was based on the whole-body hybrid computational phantom of the UF series of reference models, while the bone microstructure was derived from microCT images of skeletal region samples taken from a 45 years-old female cadaver. The active and shallow marrow are typically adopted as surrogate tissue regions for the hematopoietic stem cells and osteoprogenitor cells, respectively. Source tissues included active marrow, inactive marrow, trabecular bone volume, trabecular bone surfaces, cortical bone volume, and cortical bone surfaces. Marrow cellularity was varied from 10 to 100 percent for active marrow self-irradiation. All other sources were run at the defined ICRP Publication 70 cellularity for each bone site. A total of 33 discrete electron energies, ranging from 1 keV to 10 MeV, were either simulated or analytically modeled. The method of combining skeletal macrostructure and microstructure absorbed fractions assessed using MCNPX electron transport was found to yield results similar to those determined with the PIRT model applied to the UF adult male skeletal dosimetry model. Calculated skeletal averaged absorbed fractions for each source-target combination were found to follow similar trends of more recent dosimetry models (image-based models) but did not follow results from skeletal models based upon assumptions of an infinite expanse of trabecular spongiosa.
SNP interaction pattern identifier (SIPI): an intensive search for SNP–SNP interaction patterns
Authors: Lin Hui-Yi , Chen Dung-Tsa , Huang Po-Yu , Liu Yung-Hsin , Ochoa Augusto , Zabaleta Jovanny , Mercante Donald E , Fang Zhide , Sellers Thomas A , Pow-Sang Julio M , Cheng Chia-Ho , Eeles Rosalind , Easton Doug , Kote-Jarai Zsofia , Amin Al Olama Ali , Benlloch Sara , Muir Kenneth , Giles Graham G , Wiklund Fredrik , Gronberg Henrik , Haiman Christopher A , Schleutker Johanna , Nordestgaard Børge G , Travis Ruth C , Hamdy Freddie , Pashayan Nora , Khaw Kay-Tee , Stanford Janet L , Blot William J , Thibodeau Stephen N , Maier Christiane , Kibel Adam S , Cybulski Cezary , Cannon-Albright Lisa , Brenner Hermann , Kaneva Radka , Batra Jyotsna , Teixeira Manuel R , Pandha Hardev , Lu Yong-Jie ,   the PRACTICAL Consortium, Park Jong Y
Published: November 2016

Motivation

Testing SNP–SNP interactions is considered as a key for overcoming bottlenecks of genetic association studies. However, related statistical methods for testing SNP–SNP interactions are underdeveloped.

Results

We propose the SNP Interaction Pattern Identifier (SIPI), which tests 45 biologically meaningful interaction patterns for a binary outcome. SIPI takes non-hierarchical models, inheritance modes and mode coding direction into consideration. The simulation results show that SIPI has higher power than MDR (Multifactor Dimensionality Reduction), AA_Full, Geno_Full (full interaction model with additive or genotypic mode) and SNPassoc in detecting interactions. Applying SIPI to the prostate cancer PRACTICAL consortium data with approximately 21 000 patients, the four SNP pairs in EGFR-EGFR, EGFR-MMP16 and EGFR-CSF1 were found to be associated with prostate cancer aggressiveness with the exact or similar pattern in the discovery and validation sets. A similar match for external validation of SNP–SNP interaction studies is suggested. We demonstrated that SIPI not only searches for more meaningful interaction patterns but can also overcome the unstable nature of interaction patterns.

Availability and Implementation

The SIPI software is freely available at http://publichealth.lsuhsc.edu/LinSoftware/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Risk Factors for Transmission of Middle East Respiratory Syndrome Coronavirus Infection During the 2015 Outbreak in South Korea
Authors: Kim Seung Woo , Park Jung Wan , Jung Hee-Dong , Yang Jeong-Sun , Park Yong-Shik , Lee Changhwan , Kim Kyung Min , Lee Keon-Joo , Kwon Donghyok , Hur Young Joo , Choi BoYoul , Ki Moran
Published: November 2016

Background.

Transmission heterogeneity was observed during the 2015 Korean outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Only 22 of 186 cases transmitted the infection, and 5 super-spreading events caused 150 transmissions. We investigated the risk factors for MERS-CoV transmission.

Methods.

Epidemiological reports were used to classify patients as nonspreaders, spreaders, or those associated with a super-spreading event (5 or more transmissions). Logistic regression analyses were used to evaluate the factors for MERS-CoV transmission.

Results.

Compared to nonspreaders, spreaders exhibited a longer interval from symptom onset to isolation (7 days vs 3 days) and more frequent pre-isolation pneumonia diagnoses (68.2% vs 17.1%). Spreaders also exhibited higher values for pre-isolation contacts (149 vs 17.5), pre-isolation hospitalization (68.2% vs 16.5%), and emergency room (ER) visits (50% vs 7.3%). Spreaders exhibited lower cycle thresholds for the upE and ORF1a genes (22.7 vs 27.2 and 23.7 vs 27.9, respectively). In multivariate analysis, transmission was independently associated with the cycle threshold (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.75–0.96) and pre-isolation hospitalization or ER visits (OR, 6.82; 95% CI, 2.06–22.84). The super-spreading events exhibited higher values for pre-isolation contacts (777 vs 78), pre-isolation ER visits (100% vs 35.3%), and doctor shopping (100% vs 47.1%) compared to non-super-spreading events.

Conclusions.

These findings indicate that transmission is determined by host infectivity and the number of contacts, whereas super-spreading events were determined by the number of contacts and hospital visits. These relationships highlight the importance of rapidly enforcing infection control measures to prevent outbreaks.
First Occurrence of Diabetes, Chronic Kidney Disease, and Hypertension Among North American HIV-Infected Adults, 2000–2013
Authors: Wong Cherise , Gange Stephen J. , Buchacz Kate , Moore Richard D. , Justice Amy C. , Horberg Michael A. , Gill M. John , Koethe John R. , Rebeiro Peter F. , Silverberg Michael J. , Palella Frank J. , Patel Pragna , Kitahata Mari M. , Crane Heidi M. , Abraham Alison G. , Samji Hasina , Napravnik Sonia , Ahmed Tareq , Thorne Jennifer E. , Bosch Ronald J. , Mayor Angel M. , Althoff Keri N. ,   for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
Published: November 2016

Background.

There remains concern regarding the occurrence of noncommunicable diseases (NCDs) among individuals aging with human immunodeficiency virus (HIV), but few studies have described whether disparities between demographic subgroups are present among individuals on antiretroviral therapy (ART) with access to care.

Methods.

We assessed the first documented occurrence of type 2 diabetes mellitus (DM), chronic kidney disease (CKD), and treated hypertension (HTN) by age, sex, and race within the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). HIV-infected adults (≥18 years) who initiated ART were observed for first NCD occurrence between 1 January 2000 and 31 December 2013. Cumulative incidences as of age 70 were estimated accounting for the competing risk of death; Poisson regression was used to compare rates of NCD occurrence by demographic subgroup.

Results.

We included >50000 persons with >250000 person-years of follow-up. Median follow-up was 4.7 (interquartile range, 2.4–8.1) years. Rates of first occurrence (per 100 person-years) were 1.2 for DM, 0.6 for CKD, and 2.6 for HTN. Relative to non-black women, the cumulative incidences were increased in black women (68% vs 51% for HTN, 52% vs 41% for DM, and 38% vs 35% for CKD; all P < .001); this disparity was also found among men (73% vs 60% for HTN, 44% vs 34% for DM, and 30% vs 25% for CKD; all P < .001).

Conclusions.

Racial disparities in the occurrence of DM, CKD, and HTN emphasize the need for prevention and treatment options for these HIV populations receiving care in North America.
Shared decision-making using personal health record technology: a scoping review at the crossroads
Authors: Davis Selena , Roudsari Abdul , Raworth Rebecca , Courtney Karen L , MacKay Lee
Published: November 2016

Objective. This scoping review aims to determine the size and scope of the published literature on shared decision-making (SDM) using personal health record (PHR) technology and to map the literature in terms of system design and outcomes.

Materials and Methods. Literature from Medline, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Engineering Village, and Web of Science (2005–2015) using the search terms “personal health records,” “shared decision making,” “patient-provider communication,” “decision aid,” and “decision support” was included. Articles (n = 38) addressed the efficacy or effectiveness of PHRs for SDM in engaging patients in self-care and decision-making or ways patients can be supported in SDM via PHR.

Results. Analysis resulted in an integrated SDM-PHR conceptual framework. An increased interest in SDM via PHR is apparent, with 55% of articles published within last 3 years. Sixty percent of the literature originates from the United States. Twenty-six articles address a particular clinical condition, with 10 focused on diabetes, and one-third offer empirical evidence of patient outcomes. The tethered and standalone PHR architectural types were most studied, while the interconnected PHR type was the focus of more recently published methodological approaches and discussion articles.

Discussion. The study reveals a scarcity of rigorous research on SDM via PHR. Research has focused on one or a few of the SDM elements and not on the intended complete process.

Conclusion. Just as PHR technology designed on an interconnected architecture has the potential to facilitate SDM, integrating the SDM process into PHR technology has the potential to drive PHR value.
Multiple Fungicide Resistance in Botrytis cinerea from Greenhouse Strawberries in Hubei Province, China
Authors: Fan F. , Hamada M. S. , Li N. , Li G. Q. , Luo C. X.
Published: November 2016

Two hundred and forty isolates of Botrytis cinerea were collected during the early summer of 2012 and 2013 from strawberry greenhouses in 10 locations in Hubei Province and examined for sensitivity to five fungicides, most of which were commonly used to control this fungus. High frequency of resistance to carbendazim (Car, 63.63%) and cyprodinil (Cyp, 42.42%) was detected. Boscalid-resistant (BosR) isolates were detected for the first time in China, whereas no fludioxonil-resistant isolates were identified. Dual resistance to carbendazim and diethofencarb (Die) was also detected. There were six phenotypes of resistance profile (i.e., CarRDieSBosSCypS, CarRDieRBosSCypS, CarRDieSBosSCypR, CarRDieSBosRCypS, CarRDieRBosSCypR, and CarRDieSBosRCypR). CarRDieSBosSCypS and CarRDieSBosSCypR were the most common phenotypes, occurring at eight and seven locations, respectively. After 10 successive transfers on fungicide-free potato dextrose agar, tested resistant isolates retained levels of resistance similar to or comparative with the initial generation, indicating the stability of these resistances. Fitness evaluations based on investigation of mycelial growth, osmotic sensitivity, sporulation in vitro and in vivo, and virulence revealed the uncompromising fitness in resistant isolates, except that decreased virulence was observed in BosR isolates. The molecular basis of carbendazim, diethofencarb, and boscalid resistance was investigated. Results showed that all 13 sequenced carbendazim-resistant isolates harbored the mutation E198V or E198A in the β-tubulin gene and the five isolates with dual resistance to carbendazim and diethofencarb showed the mutation E198K in the same gene. BosR isolates possessed the H272R mutation in succinate dehydrogenase subunit B gene. The results achieved in this study challenge the current management strategies for B. cinerea, which largely depend on applications of these fungicides.
The aeromedical physician assistant
Authors: Radi Joshua , Brisson Michael , Line Michael
Published: November 2016

The US Army aeromedical physician assistant (PA) serves aviation units in regards to crewmember medical readiness. All PAs are graduates of a 6-week flight surgeon course. They are responsible for conducting nearly 40% of the annual US Army flight physicals. This unique training and deployment illustrates the growing adaptability of PAs to assume a greater role in military medicine.
Allergen immunotherapy: an updated review of safety
Authors: James Christine , Bernstein David I.
Published: November 2016

Purpose of review

Allergen immunotherapy is the only modality that can modify the immune response upon exposure to aeroallergens and venom allergens. This review will update the allergist on recent studies evaluating safety of sublingual and subcutaneous allergen immunotherapy.

Recent findings

Multiple clinical trials and retrospective studies have been published evaluating overall safety of these therapies. The risk of systemic reactions with subcutaneous immunotherapy remains quite low, but near-fatal and fatal anaphylaxis does occur, requiring physicians to be aware of potential risks for such events. Sublingual immunotherapy has a high incidence of local site application reactions, but severe anaphylactic events are very uncommon.

Subcutaneous immunotherapy and sublingual immunotherapy are beneficial in treating allergic rhinitis and venom hypersensitivity but should be administered only by physicians familiar with potential risk factors and able to manage treatment-related local and systemic allergic reactions.
IgE and eosinophils as therapeutic targets in asthma
Authors: Patel Tanvi R. , Sur Sanjiv
Published: November 2016

Purpose of review

Asthma is a chronic inflammatory disorder characterized by reversible airflow obstruction, which is being more widely recognized as a broad-spectrum disease that encompasses multiple patient characteristics and pathophysiologic mechanisms. Suboptimal asthma control leads to increasing burden of healthcare costs and loss of productivity to society. Biologic therapies targeted at IgE and eosinophils can be used in poorly controlled allergic and eosinophilic asthma, respectively. The purpose of this review is to analyze the advancements in currently available biologic therapies targeted at IgE and eosinophils in asthma and to identify how these therapies may impact overall healthcare costs.

Recent findings

Omalizumab is an anti-IgE antibody that is approved for use of poorly controlled moderate-to-severe asthma. Many studies have confirmed that omalizumab not only improves quality of life and symptom scores, but also decreases urgent care and emergency department visits and hospitalizations. Dupilumab is a biologic agent targeted at Th2 cytokines, but indirectly impacts IgE and is an important biologic agent for atopic disease. Mepolizumab, reslizumab, and benralizumab target IL-5, a key cytokine for eosinophils. For patients with poorly controlled eosinophilic asthma, these biologic agents improve asthma symptoms, reduce exacerbations, and reduce emergency visits and hospitalizations.

Poorly controlled severe asthma affects a small portion of patients with asthma in the United States and yet it accounts for large portion of healthcare utilization. Biological therapies in poorly controlled severe persistent asthma have been identified to reduce healthcare utilization, including emergency visits and hospitalizations. Biologic agents have a clear beneficial role in the management of severe asthma, and further evaluations should be continued in identifying optimal patient characteristics for the various agents and overall benefit toward healthcare utilization and cost.
Management of scoliosis associated with neurofibromatosis
Authors: Patel Priyank M. , Bhojraj Shekhar , Nagad Premik
Published: November 2016

Scoliosis is the most common skeletal deformity seen in patients with neurofibromatosis type 1. It is classified based on dystrophic features seen on imaging. Classification is important for deciding on the management options. Nondystrophic curves can be treated similar to idiopathic curves. Conservatively treated curves should be monitored for curve modulation. Dystrophic curves should be managed surgically with 360-degree fusion. Special attention should be focused on fusion as the rate of pseudoarthrosis is higher in these curves. To get good results and avoid neurologic complications, screening of the whole spine is mandatory to identify associated bony and intraspinal anomalies that may be missed when focusing on the main curve.
Assessment of Clinical Alarms Influencing Nurses’ Perceptions of Alarm Fatigue
Authors: Petersen Emalie M. , Costanzo Cindy L.
Published: November 2016

Background:

Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm management is a multifaceted problem that affects all health care organizations and clinical staff, especially those in critical care units. Ultimately, the lack of knowledge regarding nurses’ perceptions to alarm management and alarm fatigue creates patient safety chiasms.

Objectives:

The purpose of this quality improvement project was to understand nurses’ perceptions of alarm fatigue (utilizing the Healthcare Technology Foundation’s Clinical Alarms Committee Survey) while implementing interventions that improve patient safety.

Methods:

The design of this qualitative study is an electronically distributed survey to 31 nurses who work in critical care. The Healthcare Technology Foundation clinical alarms survey has 36 questions with various answering strategies distributed (with permission) via e-mail access by BlueQ through Creighton University.

Results:

Twenty-six respondents (n = 26) completed the survey, with 42% being intensive care unit nurses and 58% being progressive care unit nurses. The majority of nurses (n = 23, 88%) agreed that nuisance alarms occur frequently and disrupt patient care (n = 25, 96%). A lack of standardized method was noted to alarm management and parameter changes. Multiple patterns emerged that initiated the need for further examination and improvement.

Discussion:

Following the survey, themes emerged, and changes were implemented including the following: an alarm management policy was created, tools were provided to staff for easy usage, staff were educated using hands-on practice at an annual training summit, and sustainability was created through continuation of alarm management assessment and improvement.
Structural and Histologic Eyelid Changes Associated with 6 Months of Topical Bimatoprost in the Rabbit
Authors: Kent Tiffany L. , Custer Philip L.
Published: November 2016

Purpose:

To determine the periorbital effects of daily 0.03% bimatoprost in New Zealand white (NZW) rabbits.

Materials and Methods:

NZW rabbits were treated with daily 0.03% bimatoprost, artificial tears, or left untreated. Following 3 and 6 months of treatment, eyelid measurements were obtained for both upper and lower eyelid distraction, as well as canthus-to-canthus measurements. Once complete, subjects were humanely euthanized and eyelid tissue was utilized for histology. Hematoxylin and eosin staining, along with Verhoeff Van Giesen staining was performed on paraffin-embedded sections. Tissue was also stained with mActin antibodies as a marker for fibroblast activity.

Results:

Daily, topical 0.03% bimatoprost induced eyelid tightening and shortening the NZW rabbit. These findings were most striking at the 6-month timepoint, suggesting a temporal component to these induced changes. Histologically, eyelid tissue demonstrated thinning in bimatoprost-treated eyelids compared with those receiving artificial tears. Slightly increased mActin and Verhoeff Van Giesen staining was observed, suggesting increased fibroblast activity and elastin production in prostaglandin analogs–treated eyelids.

Conclusions:

These findings suggest that eyelid tissue thins and tightens over time, following daily administration of 0.03% bimatoprost in the NZW rabbit. These findings are similar to what has been observed in human patients.
Intraocular Pressure Measurements After Descemet Membrane Endothelial Keratoplasty
Authors: Maier Anna-Karina , Gundlach Enken , Pahlitzsch Milena , Gonnermann Johannes , Corkhill Caitlin , Bertelmann Eckart , Joussen Antonia M. , Klamann Matthias K.J. , Torun Necip
Published: November 2016

Purpose:

Intraocular pressure (IOP) elevation occurs regularly after Descemet membrane endothelial keratoplasty (DMEK). This study evaluated the effect of central corneal thickness (CCT) on the IOP after DMEK.

Patients and Methods:

This prospective study recorded the IOP of 46 eyes from 46 patients preoperatively, and then 1 and 3 months after DMEK. IOP measurement was performed by noncontact pneumatic tonometry (NCT), iCare, Goldmann applanation tonometry (GAT), and dynamic contour tonometry (DCT). CCT was analyzed by anterior-segment optical coherence tomography.

Results:

Mean IOPs as measured by NCT, iCare, GAT, and DCT, respectively, were 14.3, 11.6, 12.7, and 16.0 mm Hg preoperatively; 13.1, 12.6, 12.7, and 16.0 mm Hg after 1 month; and 14.7, 14.5, 12.9, and 17.7 mm Hg after 3 months. There was a correlation of IOP measurements between GAT and NCT (P=0.119), GAT and iCare (P=0.892), and iCare and NCT (P=0.081) after 1 month and between iCare and NCT (P=0.702) after 3 months. Although GAT recorded approximately stable IOP values, NCT, iCare, and DCT tended to measure a higher IOP postoperatively than preoperatively. Preoperatively, correlations between IOP and CCT were not statistically significant for any measurement technique. After 3 months, the IOP measured by NCT and iCare correlated significantly with CCT (P=0.003, 0.041).

Conclusions:

Correlation between the different measurement techniques was poor and showed a broad distribution of limits of agreement. Therefore, a change between the 4 techniques during follow-up is not recommended. Nevertheless, all techniques detected the IOP elevation during follow-up, requiring therapy.
Do Years of Experience With Electronic Health Records Matter for Productivity in Community Health Centers?
Authors: Frogner Bianca K. , Wu Xiaoli , Ku Leighton , Pittman Patricia , Masselink Leah E.
Published: November 2016

This study investigated how years of experience with an electronic health record (EHR) related to productivity in community health centers (CHCs). Using data from the 2012 Uniform Data System, we regressed average annual medical visits, weighted for service intensity, as a function of full-time equivalent medical staff controlling for CHC size and location. Physician productivity significantly improved. Although the productivity of all other staff types was not significantly different by years of EHR experience, the trends showed lower productivity among nurses and other medical staff in CHCs with fewer years of EHR experience versus more years of experience.
Interference Reduction and Common Mode Rejection in Electrocardiograph Signal by Removing the Ground Electrode
Authors: Hamza Nabil , Khriji Lazhar , Tourki Rached
Published: November 2016

Rejection of common mode voltages in biosignals is a crucial issue specially in acquiring electrocardiograph (ECG) signal susceptible to a significant interference due to the surrounding sources of noise. The identification and minimization of these common voltages and sources of interference are necessary to acquire such signal because its level is low (few millivolts) compared with these undesirable common voltages generated by the surrounding environment. We investigate different sources of interference and common voltages coupled to an ECG signal and analyze techniques to reject and mitigate their effects. We propose the elimination of the ground electrode and study its efficiency to reduce common-mode voltages and improve the rejection ratio of the bioamplifier. We provide a qualitative ECG signal acquisition with a sophisticated analog front-end architecture, resulting in an accurate ECG signal detection and an improved common-mode and isolation-mode rejection.
Another Look at Decision Matrices for Device Selection
Authors: Hyman William A.
Published: November 2016

The purchase of a medical device from among several candidates is a common undertaking in which clinical engineering will hopefully play an important role. Inherent to this process is a comparison across multiple variables or attributes of the devices and an assessment of which device is best overall. Similar comparisons may occur in choosing service options or other support functions such as connectivity solutions or cyber security. Depending on the number of variables and the number of options, this type of comparison can be relatively easy or it may involve trade-offs in which one device appears superior in 1 or more areas but a different one is superior in different areas. Making a rational decision, explaining it, and defending it in such a situation can be difficult. A structured decision-making process can simplify (but perhaps over simplify) this kind of selection. One such method is described here.
Patient Evaluation of a Novel Prosthetic Foot with Hydraulic Ankle Aimed at Persons with Amputation with Lower Activity Levels
Authors: Moore Raymond
Published: November 2016

Introduction

Since their release, prosthetic feet with integrated hydraulic ankle units have proved a popular prescription choice among individuals with amputation, as quantified in previous studies. Since the release of the Avalon foot, a new design specifically aimed at less active individuals with amputation, all the patients prescribed this foot within our clinic have been asked to trial and then evaluate it using the Seattle Prosthesis Evaluation Questionnaire.

Materials and Methods

Fourteen established K2 activity level patients with amputation were asked to evaluate their existing prosthetic foot using the Seattle Prosthesis Evaluation Questionnaire before beginning a trial of the new Avalon foot for a period of 4 weeks. The Avalon foot was then evaluated using the same tool after this trial.

Results

The results showed the patients recorded an improvement in all the domains evaluated. There were significant improvements noted in both the overall prosthetic satisfaction and in the patients' overall gait satisfaction.

Conclusions

The results showed a marked improvement in the patients' perception of their prosthesis when using the Avalon foot, and further studies including gait analysis are warranted to help in our understanding of this.
Measuring Harm in Health Care
Authors: Walsh Kathleen E. , Harik Polina , Mazor Kathleen M. , Perfetto Deborah , Anatchkova Milena , Biggins Colleen , Wagner Joann , Schoettker Pamela J. , Firneno Cassandra , Klugman Robert , Tjia Jennifer
Published: November 2016

Objective:

The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care–associated harm in clinical practice improvement and research.

Methods:

A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care–associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability.

Results:

Pharmacists were slightly more precise and consistent in their ratings than either physicians or nurses. For example, to achieve high reliability of 0.83, 3 physicians could be replaced by 2 pharmacists without loss in precision of measurement. If only 1 rater was available for rating, ∼5% of the reviews for severe harm would have been incorrectly categorized. Reliability was greatly improved with 2 reviewers.

Conclusions:

We identified factors that influence the reliability of clinician reviews of health care–associated harm. Our novel use of generalizability analyses improved our understanding of how differences affect reliability. This approach was useful in optimizing resource utilization when selecting raters to assess harm and may have similar applications in other settings in health care.