bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Media for Use in Air Sampling To Detect Cultivable Bacteria and Fungi in the Pharmacy
Authors: Weissfeld Alice S. , Joseph Riya Augustin , Le Theresa V. , Trevino Ernest A. , Schaeffer M. Frances , Vance Paula H.
Published: August 2013

Current guidelines for air sampling for bacteria and fungi in compounding pharmacies require the use of a medium for each type of organism. U.S. Pharmacopeia (USP) chapter <797> (
http://www.pbm.va.gov/linksotherresources/docs/USP797PharmaceuticalCompoundingSterileCompounding.pdf
) calls for tryptic soy agar with polysorbate and lecithin (TSApl) for bacteria and malt extract agar (MEA) for fungi. In contrast, the Controlled Environment Testing Association (CETA), the professional organization for individuals who certify hoods and clean rooms, states in its 2012 certification application guide (
http://www.cetainternational.org/reference/CAG-009v3.pdf?sid=1267
) that a single-plate method is acceptable, implying that it is not always necessary to use an additional medium specifically for fungi. In this study, we reviewed 5.5 years of data from our laboratory to determine the utility of TSApl versus yeast malt extract agar (YMEA) for the isolation of fungi. Our findings, from 2,073 air samples obtained from compounding pharmacies, demonstrated that the YMEA yielded >2.5 times more fungal isolates than TSApl.
Rombencephalitis Caused by Francisella tularensis
Authors: Barbaz M. , Piau C. , Tadie J. M. , Pelloux I. , Kayal S. , Tattevin P. , Le Tulzo Y. , Revest M.
Published: August 2013

Common presentations of tularemia include pneumonia and ulceroglandular, oropharyngeal, or typhoidal disease. Neuromeningeal involvement is extremely rare. We report a case of a severe rhombencephalitis due to
Francisella tularensis
. Diagnosis was possible thanks to a very precise interview, and the patient dramatically improved after specific antibiotherapy.
Possible Involvement of Human Bocavirus 1 in the Death of a Middle-Aged Immunosuppressed Patient
Authors: Sadeghi Mohammadreza , Kantola Kalle , Finnegan Damian P. J. , McCaughey Conall , Hedman Lea , Söderlund-Venermo Maria , Hedman Klaus
Published: August 2013

An immunosuppressed 61-year-old man went to the hospital with fever, nonproductive cough, and increasing shortness of breath. The subject died 8 days later of respiratory complications. PCR of respiratory samples as well as a blood sample revealed exceptionally high DNA levels of the emerging pathogen, human bocavirus 1 (HBoV1), a recently found pathogen associated with respiratory symptoms in young children. We describe the clinical progression of the case and discuss the potential role of HBoV1 in the outcome.
Clinical Significance and Molecular Characterization of Nonsporulating Molds Isolated from the Respiratory Tracts of Bronchopulmonary Mycosis Patients with Special Reference to Basidiomycetes
Authors: Singh Pradeep Kumar , Kathuria Shallu , Agarwal Kshitij , Gaur Shailendra Nath , Meis Jacques F. , Chowdhary Anuradha
Published: August 2013

Nonsporulating molds (NSMs), especially basidiomycetes, have predominantly been reported as human pathogens responsible for allergic and invasive disease. Their conventional identification is problematic, as many isolates remain sterile in culture. Thus, inconclusive culture reports might adversely affect treatment decisions. The clinical significance of NSMs in pulmonary mycoses is poorly understood. We sequenced the internal transcribed spacer (ITS) region and D1/D2 domain of the larger subunit (LSU) of 52 NSMs isolated from respiratory specimens. The basidiomycetes were the predominant NSMs, of which
Schizophyllum commune
was the most common agent in allergic bronchopulmonary mycosis (ABPM), followed by
Ceriporia lacerata
in invasive fungal disease.
Porostereum spadiceum
,
Phanaerochaete stereoides
,
Neosartorya fischeri
, and
Marasmiellus palmivorus
were the other molds observed. Application of ITS and LSU region sequencing identified 92% of the isolates. The antifungal susceptibility data revealed that all basidiomycetes tested were susceptible to amphotericin B and resistant to caspofungin, fluconazole, and flucytosine. Except for 3 isolates of
S. commune
and a solitary isolate of
M. palmivorus
, all basidiomycetes had low MICs for itraconazole, posaconazole, and voriconazole. Basidiomycetes were isolated from patients with ABPM, invasive pulmonary mycosis/pneumonia, or fungal balls. In addition, the majority of the basidiomycetes were isolated from patients with chronic respiratory disorders who were sensitized to one of the basidiomycetous fungi and demonstrated precipitating antibodies against the incriminating fungi, indicating an indolent tissue reaction. Thus, isolation of basidiomycetes from the lower respiratory tract could be significant, and it is important to monitor these patients in order to prevent subsequent lung damage.
Combined Quantification of Pulmonary Pneumocystis jirovecii DNA and Serum (1→3)-β-
d
-Glucan for Differential Diagnosis of Pneumocystis Pneumonia and Pneumocystis Colonization
Authors: Damiani Céline , Le Gal Solène , Da Costa Cécilia , Virmaux Michèle , Nevez Gilles , Totet Anne
Published: August 2013

This study assessed a quantitative PCR (qPCR) assay for
Pneumocystis jirovecii
quantification in bronchoalveolar lavage (BAL) fluid samples combined with serum (1→3)-β-
d
-glucan (BG) level detection to distinguish
Pneumocystis
pneumonia (PCP) from pulmonary colonization with
P. jirovecii
. Forty-six patients for whom
P. jirovecii
was initially detected in BAL fluid samples were retrospectively enrolled. Based on clinical data and results of
P. jirovecii
detection, 17 and 29 patients were diagnosed with PCP and colonization, respectively. BAL fluid samples were reassayed using a qPCR assay targeting the mitochondrial large subunit rRNA gene. qPCR results and serum BG levels (from a Fungitell kit) were analyzed conjointly.
P. jirovecii
DNA copy numbers were significantly higher in the PCP group than in the colonization group (1.3 × 10
7
versus 3.4 × 10
3
copies/μl,
P
< 0.05). A lower cutoff value (1.6 × 10
3
copies/μl) achieving 100% sensitivity for PCP diagnosis and an upper cutoff value (2 × 10
4
copies/μl) achieving 100% specificity were determined. Applying these two values, 13/17 PCP patients and 19/29 colonized patients were correctly assigned to their patient groups. For the remaining 14 patients with
P. jirovecii
DNA copy numbers between the cutoff values, PCP and colonization could not be distinguished on the basis of qPCR results. Four of these patients who were initially assigned to the PCP group presented BG levels of ≥100 pg/ml. The other 10 patients, who were initially assigned to the colonization group, presented BG levels of <100 pg/ml. These results suggest that the combination of the qPCR assay, applying cutoff values of 1.6 × 10
3
and 2 × 10
4
copies/μl, and serum BG detection, applying a 100 pg/ml threshold, can differentiate PCP and colonization diagnoses.
Glycoprotein B Cleavage Is Important for Murid Herpesvirus 4 To Infect Myeloid Cells
Authors: Glauser Daniel L. , Milho Ricardo , Frederico Bruno , May Janet S. , Kratz Anne-Sophie , Gillet Laurent , Stevenson Philip G.
Published: August 2013

Glycoprotein B (gB) is a conserved herpesvirus virion component implicated in membrane fusion. As with many—but not all—herpesviruses, the gB of murid herpesvirus 4 (MuHV-4) is cleaved into disulfide-linked subunits, apparently by furin. Preventing gB cleavage for some herpesviruses causes minor infection deficits
in vitro
, but what the cleavage contributes to host colonization has been unclear. To address this, we mutated the furin cleavage site (R-R-K-R) of the MuHV-4 gB. Abolishing gB cleavage did not affect its expression levels, glycosylation, or antigenic conformation.
In vitro
, mutant viruses entered fibroblasts and epithelial cells normally but had a significant entry deficit in myeloid cells such as macrophages and bone marrow-derived dendritic cells. The deficit in myeloid cells was not due to reduced virion binding or endocytosis, suggesting that gB cleavage promotes infection at a postendocytic entry step, presumably viral membrane fusion.
In vivo
, viruses lacking gB cleavage showed reduced lytic spread in the lungs. Alveolar epithelial cell infection was normal, but alveolar macrophage infection was significantly reduced. Normal long-term latency in lymphoid tissue was established nonetheless.
Later Passages of Neural Progenitor Cells from Neonatal Brain Are More Permissive for Human Cytomegalovirus Infection
Authors: Pan Xing , Li Xiao-Jun , Liu Xi-Juan , Yuan Hui , Li Jia-Fu , Duan Ying-Liang , Ye Han-Qing , Fu Ya-Ru , Qiao Guan-Hua , Wu Cong-Cong , Yang Bo , Tian Xiao-Hui , Hu Kang-Hong , Miao Ling-Feng , Chen Xiao-Ling , Zheng Jun , Rayner Simon , Schwartz Philip H. , Britt William J. , Xu Jiang , Luo Min-Hua
Published: August 2013

Congenital human cytomegalovirus (HCMV) infection is the most frequent infectious cause of birth defects, primarily neurological disorders. Neural progenitor/stem cells (NPCs) are the major cell type in the subventricular zone and are susceptible to HCMV infection. In culture, the differentiation status of NPCs may change with passage, which in turn may alter susceptibility to virus infection. Previously, only early-passage (i.e., prior to passage 9) NPCs were studied and shown to be permissive to HCMV infection. In this study, NPC cultures derived at different gestational ages were evaluated after short (passages 3 to 6) and extended (passages 11 to 20)in vitropassages for biological and virological parameters (i.e., cell morphology, expression of NPC markers and HCMV receptors, viral entry efficiency, viral gene expression, virus-induced cytopathic effect, and release of infectious progeny). These parameters were not significantly influenced by the gestational age of the source tissues. However, extended-passage cultures showed evidence of initiation of differentiation, increased viral entry, and more efficient production of infectious progeny. These results confirm that NPCs are fully permissive for HCMV infection and that extended-passage NPCs initiate differentiation and are more permissive for HCMV infection. Later-passage NPCs being differentiated and more permissive for HCMV infection suggest that HCMV infection in fetal brain may cause more neural cell loss and give rise to severe neurological disabilities with advancing brain development.
Human Cytomegalovirus IE1 Protein Disrupts Interleukin-6 Signaling by Sequestering STAT3 in the Nucleus
Authors: Reitsma Justin M. , Sato Hiromi , Nevels Michael , Terhune Scott S. , Paulus Christina
Published: August 2013

In the canonical STAT3 signaling pathway, binding of agonist to receptors activates Janus kinases that phosphorylate cytoplasmic STAT3 at tyrosine 705 (Y705). Phosphorylated STAT3 dimers accumulate in the nucleus and drive the expression of genes involved in inflammation, angiogenesis, invasion, and proliferation. Here, we demonstrate that human cytomegalovirus (HCMV) infection rapidly promotes nuclear localization of STAT3 in the absence of robust phosphorylation at Y705. Furthermore, infection disrupts interleukin-6 (IL-6)-induced phosphorylation of STAT3 and expression of a subset of IL-6-induced STAT3-regulated genes, including SOCS3. We show that the HCMV 72-kDa immediate-early 1 (IE1) protein associates with STAT3 and is necessary to localize STAT3 to the nucleus during infection. Furthermore, expression of IE1 is sufficient to disrupt IL-6-induced phosphorylation of STAT3, binding of STAT3 to the SOCS3 promoter, and SOCS3 gene expression. Finally, inhibition of STAT3 nuclear localization or STAT3 expression during infection is linked to diminished HCMV genome replication. Viral gene expression is also disrupted, with the greatest impact seen following viral DNA synthesis. Our study identifies IE1 as a new regulator of STAT3 intracellular localization and IL-6 signaling and points to an unanticipated role of STAT3 in HCMV infection.
Mice Lacking Functional STAT1 Are Highly Susceptible to Lethal Infection with Lassa Virus
Authors: Yun Nadezhda E. , Seregin Alexey V. , Walker David H. , Popov Vsevolod L. , Walker Aida G. , Smith Jeanon N. , Miller Milagros , de la Torre Juan C. , Smith Jennifer K. , Borisevich Viktoriya , Fair Joseph N. , Wauquier Nadia , Grant Donald S. , Bockarie Bayon , Bente Dennis , Paessler Slobodan
Published: August 2013

Lassa fever (LF) is a potentially lethal human disease that is caused by the arenavirus Lassa virus (LASV). Annually, around 300,000 infections with up to 10,000 deaths occur in regions of Lassa fever endemicity in West Africa. Here we demonstrate that mice lacking a functional STAT1 pathway are highly susceptible to infection with LASV and develop lethal disease with pathology similar to that reported in humans.
Host Species Barriers to Jaagsiekte Sheep Retrovirus Replication and Carcinogenesis
Authors: Caporale Marco , Martineau Henny , De las Heras Marcelo , Murgia Claudio , Huang Robert , Centorame Patrizia , Di Francesco Gabriella , Di Gialleonardo Luigina , Spencer Thomas E. , Griffiths David J. , Palmarini Massimo
Published: August 2013

Understanding the factors governing host species barriers to virus transmission has added significantly to our appreciation of virus pathogenesis. Jaagsiekte sheep retrovirus (JSRV) is the causative agent of ovine pulmonary adenocarcinoma (OPA), a transmissible lung cancer of sheep that has rarely been found in goats. In this study, in order to further clarify the pathogenesis of OPA, we investigated whether goats are resistant to JSRV replication and carcinogenesis. We found that JSRV induces lung tumors in goats with macroscopic and histopathological features that dramatically differ from those in sheep. However, the origins of the tumor cells in the two species are identical. Interestingly, in experimentally infected lambs and goat kids, we revealed major differences in the number of virus-infected cells at early stages of infection. These differences were not related to the number of available target cells for virus infection and cell transformation or the presence of a host-specific immune response toward JSRV. Indeed, we also found that goats possess transcriptionally active endogenous retroviruses (enJSRVs) that likely influence the host immune response toward the exogenous JSRV. Overall, these results suggest that goat cells, or at least those cells targeted for viral carcinogenesis, are not permissive to virus replication but can be transformed by JSRV.
Isolate-Specific Differences in the Conformational Dynamics and Antigenicity of HIV-1 gp120
Authors: Davenport Thaddeus M. , Guttman Miklos , Guo Wenjin , Cleveland Brad , Kahn Maria , Hu Shiu-Lok , Lee Kelly K.
Published: August 2013

The HIV-1 envelope glycoprotein (Env) mediates viral entry into host cells and is the sole target of neutralizing antibodies. Much of the sequence diversity in the HIV-1 genome is concentrated within Env, particularly within its gp120 surface subunit. While dramatic functional diversity exists among HIV-1 Env isolates—observable even in the context of monomeric gp120 proteins as differences in antigenicity and immunogenicity—we have little understanding of the structural features that distinguish Env isolates and lead to isolate-specific functional differences, as crystal structures of truncated gp120 “core” proteins from diverse isolates reveal a high level of structural conservation. Because gp120 proteins are used as prospective vaccine immunogens, it is critical to understand the structural factors that influence their reactivity with antibodies. Here, we studied four full-length, glycosylated gp120 monomers from diverse HIV-1 isolates by using small-angle X-ray scattering (SAXS) to probe the overall subunit morphology and hydrogen/deuterium-exchange with mass spectrometry (HDX-MS) to characterize the local structural order of each gp120. We observed that while the overall subunit architecture was similar among isolates by SAXS, dramatic isolate-specific differences in the conformational stability of gp120 were evident by HDX-MS. These differences persisted even with the CD4 receptor bound. Furthermore, surface plasmon resonance (SPR) and enzyme-linked immunosorbance assays (ELISAs) showed that disorder was associated with poorer recognition by antibodies targeting conserved conformational epitopes. These data provide additional insight into the structural determinants of gp120 antigenicity and suggest that conformational dynamics should be considered in the selection and design of optimized Env immunogens.
Identification of a Region in the Stalk Domain of the Nipah Virus Receptor Binding Protein That Is Critical for Fusion Activation
Authors: Talekar Aparna , DeVito Ilaria , Salah Zuhair , Palmer Samantha G. , Chattopadhyay Anasuya , Rose John K. , Xu Rui , Wilson Ian A. , Moscona Anne , Porotto Matteo
Published: August 2013

Paramyxoviruses, including the emerging lethal human Nipah virus (NiV) and the avian Newcastle disease virus (NDV), enter host cells through fusion of the viral and target cell membranes. For paramyxoviruses, membrane fusion is the result of the concerted action of two viral envelope glycoproteins: a receptor binding protein and a fusion protein (F). The NiV receptor binding protein (G) attaches to ephrin B2 or B3 on host cells, whereas the corresponding hemagglutinin-neuraminidase (HN) attachment protein of NDV interacts with sialic acid moieties on target cells through two regions of its globular domain. Receptor-bound G or HN via its stalk domain triggers F to undergo the conformational changes that render it competent to mediate fusion of the viral and cellular membranes. We show that chimeric proteins containing the NDV HN receptor binding regions and the NiV G stalk domain require a specific sequence at the connection between the head and the stalk to activate NiV F for fusion. Our findings are consistent with a general mechanism of paramyxovirus fusion activation in which the stalk domain of the receptor binding protein is responsible for F activation and a specific connecting region between the receptor binding globular head and the fusion-activating stalk domain is required for transmitting the fusion signal.
Hemagglutinin Stalk-Based Universal Vaccine Constructs Protect against Group 2 Influenza A Viruses
Authors: Margine I. , Krammer F. , Hai R. , Heaton N. S. , Tan G. S. , Andrews S. A. , Runstadler J. A. , Wilson P. C. , Albrecht R. A. , García-Sastre A. , Palese P.
Published: August 2013

Current influenza virus vaccines contain H1N1 (phylogenetic group 1 hemagglutinin), H3N2 (phylogenetic group 2 hemagglutinin), and influenza B virus components. These vaccines induce good protection against closely matched strains by predominantly eliciting antibodies against the membrane distal globular head domain of their respective viral hemagglutinins. This domain, however, undergoes rapid antigenic drift, allowing the virus to escape neutralizing antibody responses. The membrane proximal stalk domain of the hemagglutinin is much more conserved compared to the head domain. In recent years, a growing collection of antibodies that neutralize a broad range of influenza virus strains and subtypes by binding to this domain has been isolated. Here, we demonstrate that a vaccination strategy based on the stalk domain of the H3 hemagglutinin (group 2) induces in mice broadly neutralizing anti-stalk antibodies that are highly cross-reactive to heterologous H3, H10, H14, H15, and H7 (derived from the novel Chinese H7N9 virus) hemagglutinins. Furthermore, we demonstrate that these antibodies confer broad protection against influenza viruses expressing various group 2 hemagglutinins, including an H7 subtype. Through passive transfer experiments, we show that the protection is mediated mainly by neutralizing antibodies against the stalk domain. Our data suggest that, in mice, a vaccine strategy based on the hemagglutinin stalk domain can protect against viruses expressing divergent group 2 hemagglutinins.
Herpes Simplex Virus 1 Targets the Murine Olfactory Neuroepithelium for Host Entry
Authors: Shivkumar Maitreyi , Milho Ricardo , May Janet S. , Nicoll Michael P. , Efstathiou Stacey , Stevenson Philip G.
Published: August 2013

Herpes simplex virus 1 (HSV-1) is a ubiquitous and important human pathogen. It is known to persist in trigeminal ganglia (TG), but how it reaches this site has been difficult to determine, as viral transmission is sporadic, pathogenesis is complicated, and early infection is largely asymptomatic. We used mice to compare the most likely natural HSV-1 host entry routes: oral and nasal. Intranasal infection was 100-fold more efficient than oral and targeted predominantly the olfactory neuroepithelium. Live imaging of HSV-1-expressed luciferase showed infection progressing from the nose to the TG and then reemerging in the facial skin. The brain remained largely luciferase negative throughout. Infected cell tagging by viral Cre recombinase expression in floxed reporter gene mice showed nasal virus routinely reaching the TG and only rarely reaching the olfactory bulbs. Thus, HSV-1 spread from the olfactory neuroepithelium to the TG and reemerged peripherally without causing significant neurological disease. This recapitulation of typical clinical infection suggests that HSV-1 might sometimes also enter humans via the respiratory tract.
AIDS Alters the Commensal Plasma Virome
Authors: Li Linlin , Deng Xutao , Linsuwanon Piyada , Bangsberg David , Bwana Mwebesa Bosco , Hunt Peter , Martin Jeffrey N. , Deeks Steven G. , Delwart Eric
Published: August 2013

We compared the plasma viromes of HIV-infected subjects with low versus high CD4
+
T cell counts from the United States and Uganda by using deep sequencing and detected HIV, hepatitis C virus, hepatitis B virus, GB virus C, anellovirus, and human endogenous retrovirus (HERV) reads. An increase in the proportion of reads for anelloviruses, a family of highly prevalent and genetically diverse human viruses, was seen in subjects with AIDS from both countries. The proportion of endogenous human retrovirus reads was increased in AIDS subjects from Uganda but not the United States. Progression to AIDS is therefore associated with changes in the plasma concentration of commensal viruses.
Mosaic trisomy 13 and a sacral appendage
Authors: Pachajoa Harry , Meza Escobar Luis Enrique
Published: August 2013

Mosaic trisomy 13 occurs when there is a percentage of trisomic cells for an entire chromosome 13, while the remaining percentage of cells is euploid. The prevalence of this syndrome ranges from 1 in 10 000 to 1 in 20 000 births. Complete, partial or mosaic forms of this disorder can occur. The phenotype of mosaic trisomy 13 patients varies widely. Patients with mosaic trisomy 13 usually have a longer survival and a less severe phenotype compared to patients with complete trisomy 13. Genetic counselling is difficult due to the wide variation among the clinical manifestations of these patients. There have been 49 cases of mosaic trisomy 13 reported in the literature. We report the case of a patient with mosaic trisomy 13, a sacral appendage and a cleft lip and palate.
Patient with rheumatoid arthritis on methotrexate with multiple infecting organisms causing gastritis
Authors: Husney Robert , Privman Vladamir , Sepkowitz Douglas
Published: August 2013

A 70-year-old man with a medical history of rheumatoid arthritis on methotrexate 2.5 mg every other day was being followed for cytomegalovirus (CMV) gastritis andHelicobacter pyloriinfection, who was also found to have adrenal masses bilaterally. A CT showed a 1 cm left adrenal nodule along with a 2.5 cm right adrenal mass suspicious for malignancy. A positron emission tomography showed metabolic activity in his adrenals that was non-specific (could be seen in benign as well as malignant lesions). The patient was started on valganciclovir 900 mg daily for 30 days. Following treatment the patient showed marked clinical improvement with a weight gain of 9 lbs and a complete resolution of his epigastric pain. A repeat oesophagogastroduodenoscopy performed with biopsy returned negative for CMV. A repeat CT abdomen to assess the adrenals was performed 2 weeks after completion of valganciclovir. His adrenal nodules had decreased significantly in size, with his left adrenal gland nodules measuring 1 cm and now his right adrenal gland nodule measuring 1 cm.
Two cases of rare benign mucosal lesions of the stomach
Authors: Agrawal Komal , Soubam Parkinson Singh , Vaiphei Kim
Published: August 2013

Gastric lipomas are rare benign mesenchymal tumours comprising 3.2% of all gastrointestinal lipomas. Most patients are asymptomatic and the symptoms depend on the size and location of the mass. The patient may present with bleeding due to ulceration of the overlying mucosa, rarely obstruction and intussusception. We present two such rare mass lesions of the stomach presenting with bleeding symptoms.
A left atrial mass in a patient with atrial fibrillation and previous renal cancer
Authors: Mahmood Muhammad Muzaffar , Wynn Nu Nu , Sanderson Steven , Junejo Shahid
Published: August 2013

A 73-year-old man underwent a surveillance CT following a laparoscopic radical nephrectomy for left-sided renal cell carcinoma 3 years earlier. He had atrial fibrillation. CT identified a large left atrial mass. The differential diagnosis of this mass was thrombus, primary cardiac tumour or cardiac metastasis secondary to his previous renal cell carcinoma. Location, size and appearance of the mass on echocardiogram were unusual for a left atrial thrombus; however, following surgical removal pathological examination confirmed this as an organised thrombus. A brief discussion on diagnostic evaluation of a left atrial mass follows the case report.
Femoral artery rupture during total hip arthroplasty
Authors: Kakwani Rajeshkumar , Duggan John , Muller Scott
Published: August 2013

Vascular injuries are an uncommon but significant complication of total hip arthroplasty. We present a case of femoral artery rupture through an atherosclerotic plaque during primary total hip arthroplasty and a review of the published literature. The early recognition and prompt treatment of this complication can reduce the mortality and morbidity associated with this injury.
Spontaneous splenic rupture in a patient with small-cell lung cancer
Authors: Fernandes Lígia Rodrigues , Lares dos Santos Cláudia , Costa Filipa , Barata F
Published: August 2013

We report a case of a 66-year-old male patient presented to our pneumology ward with the diagnosis of neutropenic pneumonia. Therapy with granulocyte colony stimulating factors (G-CSF) and intravenous antibiotics was initiated as usual in this condition. The unexpected and acute onset of left-sided abdominal pain and sings of hypovolemic shock led us to a challenging diagnosis, rarely considered in non-traumatic patients. After pathological evaluation of the spleen, spontaneous splenic rupture due to G-CSF was our final diagnosis.
‘Mend the bend’: a report of two cases of labial dilacerated and palatal dilacerated crown
Authors: Avinash A , Dubey Alok , Khandelwal Vishal , Nayak Prathibha Anand
Published: August 2013

Dilaceration is the result of a developmental anomaly in which there has been an abrupt change in the axial inclination between the crown and the root of a tooth. Crown dilaceration of permanent tooth occurs due to the non-axial displacement of the already formed hard tissue portion of the developing crown at an angle to their longitudinal axis due to trauma to the primary predecessors. Thus endo-aesthetic management of such teeth helps in maintaining morphology as well as aesthetics in a growing child. This article depicts two cases of severely dilacerated crown.
Acute central retinal vein occlusion following episode of myopericarditis in an adolescent patient
Authors: Desai Ankit , Saxena Sandeep , Akduman Levent
Published: August 2013

A 15-year-old African-American boy presented with unilateral decrease in vision following an episode of myopericarditis. His ocular examination was significant for diffuse retinal oedema and intraretinal haemorrhages. He was diagnosed with a central retinal vein occlusion and was referred to rheumatology for further evaluation following negative hypercoaguable studies. He was later found to have systemic lupus erythematous. Approximately 8 months after presentation, the patient's vision improved and remained stable at 20/40.
Examination of acetabular labral tear: a continued diagnostic challenge
Authors: Reiman Michael P , Mather Richard C , Hash Thomas W , Cook Chad E
Published: August 2013

Acetabular labrum tears (ALT) are present in 22–55% of individuals with hip or groin pain. Tears can occur as a result of trauma or degeneration and are markedly associated with femoral acetabular morphological variations. An ALT can lead to biomechanical deficiencies and a loss of stability to the coxafemoral joint due to the labrum serving as a stabilising structure of this joint. The diagnosis of ALT is complex and multidimensional. Although tremendous improvements in diagnostic utility for ALT have occurred in the past 25 years, there are few patient history, clinical examination and special test findings that are unique to the condition. Imaging methods such as MRI, CT and ultrasonography have demonstrated reasonable accuracy, but not at a level that allows use as a stand-alone measure. Outcomes measures that focus on functional limitation or that are used to measure recovery should envelop the complexities of the condition and be captured using both self-report and physical performance measures. Only when patient history, objective testing, clinical examination special testing and imaging are combined can a clinician fully elucidate the multidimensional diagnosis of ALT.
How to treat Guyon's canal syndrome? Results from the European HANDGUIDE study: a multidisciplinary treatment guideline
Authors: Hoogvliet P , Coert J H , Fridén J , Huisstede B M A ,   the European HANDGUIDE group
Published: August 2013

Background

Although Guyon's canal syndrome is not highly prevalent, a considerable knowledge of anatomy is needed to localise and treat the pathology. Data on the effectiveness of interventions for this disorder are lacking.

Objective

To achieve consensus on a multidisciplinary treatment guideline for this disorder based on experts’ opinions.

Methods

A European Delphi consensus strategy was initiated. In total, 35 experts (hand surgeons/hand therapists selected by the national member associations of their European federations and Physical Medicine and Rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis and a feedback report.

Results

After three Delphi rounds, consensus was achieved on the description, symptoms and diagnosis of Guyon's canal syndrome. The experts agreed that patients with this disorder should always receive instructions and that these instructions should be combined with another form of treatment. Instructions combined with splinting or with surgery were considered as suitable treatment options. Details on the use of instructions, splinting and surgery were described. Main factors for selecting one of the aforementioned treatment options were identified: severity and duration of the syndrome and previous treatments given. A relation between the severity/duration and choice of therapy was indicated by the experts and reported in the guideline.

Conclusions

Although this disorder is less prevalent and not easy to diagnose, this guideline may contribute to better insight into and treatment of Guyon's canal syndrome.
Fit and healthy Paralympians—medical care guidelines for disabled athletes: a study of the injuries and illnesses incurred by the Polish Paralympic team in Beijing 2008 and London 2012
Authors: Gawroński Wojciech , Sobiecka Joanna , Malesza Jacek
Published: August 2013

Background

Successful performance in Paralympic Games (PGs) requires continuous monitoring of the athletes’ health and optimal medical care.

Objective

To present the health status and disability category of Polish athletes at the Beijing and London PGs, as well as to compare the injuries and illnesses incurred during both PGs in view of the more stringent healthcare guidelines implemented before London.

Methods

The preparticipation examination (PPE) involved general medical/orthopaedic examination, ECG, blood and urine tests. The mandatory periodic health evaluation (PHE) introduced before London comprised general medical/orthopaedic/dental examination, anthropometric measurement, ECG, stress test, laryngological and ophthalmological consultations, and blood and urine tests. The incidence rate (IR) for all injuries/illnesses with 95% CI, incidence proportion and exposure data (athlete-days) were calculated.

Results

There were 91 Polish Paralympians in Beijing and 100 in London. Medical consultations decreased from 151 to 74 (injuries: 57 vs 24 and illnesses: 94 vs 50). In both PGs, respiratory tract infections (RTIs) were the most frequent: IR increased from 15.2 in Beijing to 18.1 in London/1000 athlete-days (95% CI 9.7 to 20.7 vs 11.5 to 24.7). In both PGs, most injuries/illnesses concerned Paralympians with spinal cord injuries. The PPE before both PGs confirmed the disability type according to the general medical classification and revealed no health-related contraindications. Only 6.6% of athletes before Beijing but 100% before London had undergone the multispecialist PHE.

Conclusions

In both PGs, illnesses were more frequent than injuries. RTIs presented a serious problem. Some groups of disabled athletes are at an increased risk of injury/illness. The more stringent medical care guidelines before London may have caused staggeringly better results.
A pilot randomised controlled trial of a preconsultation web-based intervention to improve the care quality and clinical outcomes of diabetes outpatients (DIAT)
Authors: Frost Julia , Anderson Rob , Argyle Catherine , Daly Mark , Harris-Golesworthy Faith , Harris Jim , Gibson Andy , Ingram Wendy , Pinkney Jon , Ukoumunne Obioha C , Vaidya Bijay , Vickery Jane , Britten Nicky
Published: August 2013

Introduction

Diabetes is a chronic condition associated with many long-term complications. People with diabetes need to actively manage their condition, which can be complex. In consultations with healthcare professionals, patients receive advice about their diabetes but do not always discuss things which concern them, perhaps because of the perceived limited time or embarrassment. We want to test a ‘preconsultation’ intervention in which the patient is supported by a healthcare assistant to complete a web-based intervention aimed at producing an agenda to help them identify important areas for discussion in the consultation. Use of this agenda may enable the patient to play a more active role in that consultation and consequently become more confident, and hence more successful, in managing their condition.

Methods and analysis

In this pilot randomised controlled trial, 120 people with diabetes will be randomised with equal allocation to receive the intervention or usual clinical care. The primary outcome is reduction in glycosylated haemoglobin(HbA1c). Secondary outcomes are patient-reported communication, enablement, self-care activity, diabetes-dependent quality of life, empowerment, satisfaction, health-related quality of life and resource use. The aim of the pilot study was to estimate parameters to inform the design of the definitive trial. Follow-up on quantitative outcomes will be at 3 and 6 months. A nested qualitative study will collect data on the patients’ experiences of producing an agenda. Resource use data and medication use will also be collected via a review of medical records for a sample of participants.

Ethics and dissemination

Approval was granted by the NHS Research Ethics Committee North West—Preston (13/NW/0123). Dissemination will include publication of quantitative and qualitative findings, and experience of public involvement in peer-reviewed journals. Results will also be disseminated to trial participants via workshops led by lay coapplicants.

Trial Registration

ISRCTN75070242.
Predicting human papillomavirus vaccination behaviour among adolescent girls in England: results from a prospective survey
Authors: Bowyer Harriet L , Forster Alice S , Marlow Laura A V , Waller Jo
Published: August 2013

Background

To maximise the benefits of human papillomavirus (HPV) vaccination, uptake needs to be high. We examined psychosocial predictors of HPV vaccine uptake and the association between vaccine intention and uptake 1 year later in adolescent girls (aged 16–17 years) in England.

Method

Adolescent girls in the catch-up cohort were recruited from colleges in the South East of England in 2009 and 2010. Participants completed a questionnaire 6 months before (n=606) and 6 months after (n=214) being offered the vaccine, which assessed vaccine intention, vaccine uptake, demographics and attitudes based on the Health Belief Model and Theory of Planned Behaviour.

Results

A number of demographic and psychological factors, including intention, showed associations with vaccine uptake in uni-variable analyses. In multi-variable analyses, only ethnicity was independently associated with vaccine uptake. Participants from Black or ‘Other’ ethnic backgrounds were less likely to have received the HPV vaccine than White participants.

Conclusions

More research is needed to help understand variation in vaccine coverage between ethnic groups.
Hounsfield unit value and clot length in the acutely occluded vessel and time required to achieve thrombectomy, complications and outcome
Authors: Spiotta Alejandro M , Vargas Jan , Hawk Harris , Turner Raymond , Chaudry M Imran , Battenhouse Holly , Turk Aquilla S
Published: August 2013

Introduction

Intra-arterial therapy for acute ischemic stroke (AIS) now has an established role. We investigated if Hounsfield Units (HU) quantification on non-contrast CT is associated with ease and efficacy of mechanical thrombectomy and outcomes.

Methods

We retrospectively studied a prospectively maintained database of cases of AIS given intra-arterial therapy between May 2008 and August 2012. Functional outcome was assessed by 90-day follow-up modified Rankin Scale (mRS). Patients were dichotomized based on time to recanalization. HU were calculated on head CT and thrombus location and length were determined on CT angiography. Simple linear regression was used to analyze the association between clot length, average HU and other clinical variables.

Results

141 patients were included. There was no difference in clot length or average HU among patients with good recanalization achieved within 1 h and those in which the procedures extended beyond 1 h. There was no relationship between clot length or density and recanalization. The thrombus length and density were not significantly different between patients with procedural complications and those without. Neither the presence of post-procedure intracranial hemorrhage nor the 90-day mRS was associated with thrombus length or density.

Conclusions

We have not found any significant associations between either thrombus length or density and likelihood of recanalization, time to achieve recanalization, intraprocedural complications, postprocedural hemorrhage or functional outcome at 90 days. These results do not support a predictive value for thrombus quantification in the evaluation of AIS.
The Villain Team-Up or howTrichomonas vaginalisand bacterial vaginosis alter innate immunity in concert
Authors: Fichorova Raina N , Buck Olivia R , Yamamoto Hidemi S , Fashemi Titilayo , Dawood Hassan Y , Fashemi Bisiayo , Hayes Gary R , Beach David H , Takagi Yuko , Delaney Mary L , Nibert Max L , Singh Bibhuti N , Onderdonk Andrew B
Published: August 2013

Objectives

Complex interactions of vaginal microorganisms with the genital tract epithelium shape mucosal innate immunity, which holds the key to sexual and reproductive health. Bacterial vaginosis (BV), a microbiome-disturbance syndrome prevalent in reproductive-age women, occurs commonly in concert with trichomoniasis, and both are associated with increased risk of adverse reproductive outcomes and viral infections, largely attributable to inflammation. To investigate the causative relationships among inflammation, BV and trichomoniasis, we established a model of human cervicovaginal epithelial cells colonised by vaginalLactobacillusisolates, dominant in healthy women, and common BV species (Atopobium vaginae,Gardnerella vaginalisandPrevotella bivia).

Methods

Colonised epithelia were infected withTrichomonas vaginalis(TV) or exposed to purified TV virulence factors (membrane lipophosphoglycan (LPG), its ceramide-phosphoinositol-glycan core (CPI-GC) or the endosymbiont Trichomonas vaginalis virus (TVV)), followed by assessment of bacterial colony-forming units, the mucosal anti-inflammatory microbicide secretory leucocyte protease inhibitor (SLPI), and chemokines that drive pro-inflammatory, antigen-presenting and T cells.

Results

TV reduced colonisation byLactobacillusbut not by BV species, which were found inside epithelial cells. TV increased interleukin (IL)-8 and suppressed SLPI, likely via LPG/CPI-GC, and upregulated IL-8 and RANTES, likely via TVV as suggested by use of purified pathogenic determinants. BV speciesA vaginaeandG vaginalisinduced IL-8 and RANTES, and also amplified the pro-inflammatory responses to both LPG/CPI-GC and TVV, whereasP biviasuppressed the TV/TVV-induced chemokines.

Conclusions

These molecular host–parasite–endosymbiont–bacteria interactions explain epidemiological associations and suggest a revised paradigm for restoring vaginal immunity and preventing BV/TV-attributable inflammatory sequelae in women.
Density functional theory periodic slab calculations of adsorption and dissociation of H2O on the Cu2O(110):CuO surface
Authors: Saraireh Sherin A. , Altarawneh Mohammednoor
Published: August 2013

Interaction of water with Cu2O has many prominent industrial and environmental applications. This study represents detailed density-functional theory calculations investigating the adsorption of a water molecule on a Cu2O(110):CuO surface; one of the two most stable Cu2O surfaces under practical catalytic conditions of temperatures and pressures. We report herein structural geometries and binding energies for all plausible molecular and dissociative interaction of H2O with the surface. The water molecule is found to interact weakly with the Cu2O(110):CuO surface, forming several vertical and flat orientations where the latter was found to offer the most preferred site with a binding energy at 0.389 eV. Dissociation of a water molecule on this surface is found to incur a modest endothermcity of 0.71 eV.
AN UPDATED ANALYSIS ON THE RISE OF THE HADRONIC TOTAL CROSS-SECTION AT THE LHC ENERGY REGION
Authors: MENON M. J. , SILVA P. V. R. G.
Published: August 2013

A forward amplitude analysis on pp and [Formula: see text] elastic scattering above 5 GeV is presented. The dataset includes the recent high-precision TOTEM measurements of the pp total and elastic (integrated) cross-sections at 7 TeV and 8 TeV. Following previous works, the leading high-energy contribution for the total cross-section (σ tot ) is parametrized as ln γ(s/sh), where γ and sh are free real fit parameters. Singly-subtracted derivative dispersion relations are used to connect σ tot and the rho parameter (ρ) in an analytical way. Different fit procedures are considered, including individual fits to σ tot data, global fits to σ tot and ρ data, constrained and unconstrained data reductions. The results favor a rise of the σ tot faster than the log-squared bound by Froissart and Martin at the LHC energy region. The parametrization for σ tot is extended to fit the elastic cross-section (σ el ) data with satisfactory results. The analysis indicates an asymptotic ratio σ el /σ tot consistent with 1/3 (as already obtained in a previous work). A critical discussion on the correlation, practical role and physical implications of the parameters γ and sh is presented. The discussion confronts the 2002 prediction of σ tot by the COMPETE Collaboration and the recent result by the Particle Data Group (2012 edition of the Review of Particle Physics). Some conjectures on possible implications of a fast rise of the proton–proton total cross-section at the highest energies are also presented.
SIMULATION OF HYDROGEN ADSORPTION IN MOLECULAR SIEVES
Authors: DAI WEI , XU JIA-JING
Published: August 2013

The grand canonical Monte Carlo (GCMC) technique is used to investigate the adsorption capacity of hydrogen in AlPO4and AFT molecular sieves. Results show that the hydrogen storage capacities of AlPO4and AFT are 513 m3/g and 475 m3/g respectively at 77 K and 10 MPa. By applying Dubinin–Astakhov (DA) micropore analysis method, it is found that the apertures of AlPO4-18 zeolite mainly distribute in the range of 8–25 Å, and the apertures of AFT zeolite mainly distribute in the range of 10–28 Å. AlPO4-18 zeolite contains more micropores, which enhance the adsorption energy and enable the hydrogen to arise capillary condensation. It proves that, the microlization of the pore structure will facilitate the adsorption of hydrogen.
MAGNETIC PHASE DIAGRAM OF THE HUBBARD MODEL ON THE AB2 CHAIN
Authors: NASCIMENTO A. C. , SOUZA ANDRE M. C.
Published: August 2013

In this paper, a complete investigation of the magnetic properties of the Hubbard model on the AB2 chain is presented. We evaluate the magnetic phase diagram as a function of the electron–electron interaction and band filling by using the Green's function method within the Hartree–Fock approximation. Our results are in agreement with Lieb's theorem and the system shows ferromagnetic, ferrimagnetic, and paramagnetic phases.
HOLOGRAMS OF FLAT SPACE
Authors: BAGCHI ARJUN , GRUMILLER DANIEL
Published: August 2013

The holographic principle has a concrete realization in the Anti-de Sitter/Conformal Field Theory (AdS/CFT) correspondence. If this principle is a true fact about quantum gravity then it must also hold beyond AdS/CFT. In this paper, we address specifically holographic field theory duals of gravitational theories in asymptotically flat spacetimes. We present some evidence of our recent conjecture that three-dimensional (3d) conformal Chern–Simons gravity (CSG) with flat space boundary conditions is dual to an extremal CFT.
ON THE DYNAMICS OF A BEAM PARTIALLY SUPPORTED BY AN ELASTIC FOUNDATION: AN EXACT SOLUTION-SET
Authors: CAZZANI ANTONIO
Published: August 2013

Free vibrations of straight beams which are partially supported by an elastic foundation are analyzed. For the sake of simplicity, only the Euler–Bernoulli beam model coupled with a Winkler-type elastic foundation is considered.

This structural system can be used to study, in a rather accurate way, the dynamic response of partially embedded piles (like those used for telecommunications) when dealing with the problem of identifying their mechanical properties during operative conditions.

The study makes clear that different kinds of vibration modes may occur in the part of the beam which is supported by the continuous elastic foundation: indeed apart from the classical modes, corresponding to the dynamics of a free beam, it is possible to have vibration modes which are similar to the static deflection of a beam on an elastic support or even corresponding to rigid-body modes. For the same beam it is shown that transition between these vibration modes can appear when switching from the fundamental natural frequency to subsequent ones. This effect is the focus of the presented numerical examples.

In particular, the analytic expression of the transcendental functions governing the vibration modes, and of the coefficients of the eigenfunctions for all occurring cases, are given here — to the best of the author's knowledge — for the first time.

From the practical point of view, the reported results allow to define a suitable range of the elastic stiffness parameter such that the behavior of a partially supported beam can be conveniently approximated with that of a single-span beam, having one built-in end and the other free.