bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Activation of Staphylococcus aureus Heme Detoxification Machinery by Heme Analogues
Authors: Wakeman Catherine A. , Stauff Devin L. , Zhang Yaofang , Skaar Eric P.
Published: January 2014

The reactive nature of heme enables its use as an enzymatic cofactor while rendering excess heme toxic. The importance of heme detoxification machinery is highlighted by the presence of various types of these homeostatic systems in Gram-positive and Gram-negative microorganisms. A number of pathogens possess orthologs of the HssRS/HrtAB heme detoxification system, underscoring a potential role this system plays in the survival of bacteria in heme-rich environments such as the vertebrate host. In this work, we sought to determine the role of this system in protection against metalloporphyrin heme analogues identified by previous studies as antimicrobial agents. Our findings demonstrate that only toxic metalloporphyrins maximally activate expression of the
Staphylococcus aureus
heme detoxification system, suggesting that the sensing mechanism of HssRS might require a component of the associated toxicity rather than or in addition to the metalloporphyrin itself. We further establish that only a subset of toxic metalloporphyrins elicit the oxidative damage previously shown to be a significant component of heme toxicity whereas all toxic noniron metalloporphyrins inhibit bacterial respiration. Finally, we demonstrate that, despite the fact that toxic metalloporphyrin treatment induces expression of
S. aureus
heme detoxification machinery, the HrtAB heme export pump is unable to detoxify most of these molecules. The ineffectiveness of HrtAB against toxic heme analogues provides an explanation for their increased antimicrobial activity relative to heme. Additionally, these studies define the specificity of HssRS/HrtAB, which may provide future insight into the biochemical mechanisms of these systems.
Defining the Region of Bacillus subtilis SpoIIIJ That Is Essential for Its Sporulation-Specific Function
Authors: Geng Yanping , de Keyzer Jeanine , Scheffers Dirk-Jan , Driessen Arnold J. M.
Published: January 2014

Proteins of the YidC/OxaI/Alb3 family play a crucial role in the insertion, folding, and/or assembly of membrane proteins in prokaryotes and eukaryotes.
Bacillus subtilis
has two YidC-like proteins, denoted SpoIIIJ and YqjG. SpoIIIJ and YqjG are largely exchangeable in function, but SpoIIIJ has a unique role in sporulation, while YqjG stimulates competence development. To obtain more insight into the regions important for the sporulation specificity of SpoIIIJ, a series of SpoIIIJ/YqjG chimeras was constructed. These chimeras were tested for functionality during vegetative growth and for their ability to complement the sporulation defect of a
spoIIIJ
deletion strain. The data suggest an important role for the domain comprising transmembrane segment 2 (TMS2) and its flanking loops in sporulation specificity, with lesser contributions to specificity by TMS1 and TMS3.
The
ssbL
Gene Harbored by the ColV Plasmid of an Escherichia coli Neonatal Meningitis Strain Is an Auxiliary Virulence Factor Boosting the Production of Siderophores through the Shikimate Pathway
Authors: Lemaître Chloé , Bidet Philippe , Benoist Jean-François , Schlemmer Dimitri , Sobral Elsa , d'Humières Camille , Bonacorsi Stéphane
Published: January 2014

The ability to capture iron is a challenge for most bacteria. The neonatal meningitis
Escherichia coli
strain S88 possesses several iron uptake systems, notably including siderophores. Transcriptional analysis of the ColV plasmid pS88 has shown strong induction of a previously undescribed gene with low identity to three
E. coli
chromosomal genes encoding phospho-2-dehydro-3-deoxyheptonate aldolases involved in aromatic amino acid and catecholate/phenolate siderophore biosynthesis through the shikimate pathway. Here, we investigated the role of this gene,

ssbL
p

(
ssbL
carried on the plasmid), in siderophore biosynthesis and, consequently, in S88 virulence. We constructed an S88 mutant designated S88 Δ

ssbL
p

, which exhibited reduced growth under low-iron conditions compared to the wild-type strain. Liquid chromatography-mass spectroscopy analysis of culture supernatants showed that the mutant secreted significantly smaller amounts of enterobactin, salmochelin SX, and yersiniabactin than the wild-type strain. The mutant was also less virulent in a neonatal rat sepsis model, with significantly lower bacteremia and mortality. Supplementation with chorismate, the final product of the shikimate pathway, restored the wild-type phenotype
in vitro
. In a collection of human extraintestinal
E. coli
isolates, we found that
ssbL
was present only in strains harboring the
iro
locus, encoding salmochelins, and was located either on the chromosome or on plasmids. Acquisition of the
iro
locus has been accompanied by acquisition of the auxiliary gene
ssbL
, which boosts the metabolic pathway essential for catecholate/phenolate siderophore biosynthesis and could represent potential therapeutic targets.
RecD2 Helicase Limits Replication Fork Stress in Bacillus subtilis
Authors: Walsh Brian W. , Bolz Samantha A. , Wessel Sarah R. , Schroeder Jeremy W. , Keck James L. , Simmons Lyle A.
Published: January 2014

DNA helicases have important roles in genome maintenance. The RecD helicase has been well studied as a component of the heterotrimeric RecBCD helicase-nuclease enzyme important for double-strand break repair in
Escherichia coli
. Interestingly, many bacteria lack RecBC and instead contain a RecD2 helicase, which is not known to function as part of a larger complex. Depending on the organism studied, RecD2 has been shown to provide resistance to a broad range of DNA-damaging agents while also contributing to mismatch repair (MMR). Here we investigated the importance of
Bacillus subtilis
RecD2 helicase to genome integrity. We show that deletion of
recD2
confers a modest increase in the spontaneous mutation rate and that the mutational signature in Δ
recD2
cells is not consistent with an MMR defect, indicating a new function for RecD2 in
B. subtilis
. To further characterize the role of RecD2, we tested the deletion strain for sensitivity to DNA-damaging agents. We found that loss of RecD2 in
B. subtilis
sensitized cells to several DNA-damaging agents that can block or impair replication fork movement. Measurement of replication fork progression
in vivo
showed that forks collapse more frequently in Δ
recD2
cells, supporting the hypothesis that RecD2 is important for normal replication fork progression. Biochemical characterization of
B. subtilis
RecD2 showed that it is a 5′-3′ helicase and that it directly binds single-stranded DNA binding protein. Together, our results highlight novel roles for RecD2 in DNA replication which help to maintain replication fork integrity during normal growth and when forks encounter DNA damage.
Two Glycine Riboswitches Activate the Glycine Cleavage System Essential for Glycine Detoxification in Streptomyces griseus
Authors: Tezuka Takeaki , Ohnishi Yasuo
Published: January 2014

The glycine cleavage (GCV) system catalyzes the oxidative cleavage of glycine into CO
2
, NH
4
+
, and a methylene group, which is accepted by tetrahydrofolate (THF) to form
N
5
,
N
10
-methylene-THF.
Streptomyces griseus
contains
gcvP
and the
gcvT-gcvH
operon, which encode three intrinsic components of the GCV system. We identified the transcriptional start sites of
gcvTH
and
gcvP
and found putative glycine riboswitches in their 5′ untranslated regions (5′ UTRs). The ratios of the transcripts of the
gcvT
and
gcvP
coding sequences (CDSs) to those of the respective 5′ UTRs were significantly higher in the presence of glycine in the wild-type strain. However, the levels of
gcvT
and
gcvP
CDS transcripts were not increased by glycine in the respective 5′ UTR deletion mutants. A reporter gene assay showed that a transcriptional terminator exists in the 5′ UTR of
gcvTH
. Furthermore, by an in-line probing assay, we confirmed that glycine bound directly to the putative riboswitch RNAs. These results indicate that the
S. griseus
glycine riboswitches enhance transcriptional read-through to the downstream CDSs, like known glycine riboswitches in other bacteria. We examined the growth of three mutants in which either or both of the
gcvTH
and
gcvP
5′ UTRs were deleted. Like the wild-type strain, all mutants grew vigorously in a medium containing 0.9% glucose as a carbon source. However, the mutants showed severely restricted growth in a medium containing 0.9% glucose and 1% glycine, while the wild-type strain grew normally. This indicates that glycine has a growth-inhibitory effect and that the GCV system plays a critical role in glycine detoxification in
S. griseus
.
Ondansetron Combined with St36 (Zusanli) acupuncture point injection for postoperative vomiting
Authors: Chen Zi Y , Lin Ling , Wang Huan H , Zhou Yong , Yan Jian Q , Huang Yi L , Guo Qu L
Published: January 2014

Background

Ondansetron, sometimes combined with acustimulation at PC6 ( Neiguan), is commonly used for preventing postoperative nausea and vomiting, but PC6 is not the only point that can be used for this purpose.

Objectives

To evaluate the combined effects of ondansetron and ST36 ( Zusanli) acupuncture point injection on postoperative vomiting (POV) after laparoscopic surgery.

Methods

A randomised, patient and assessor-blinded, placebo-controlled clinical study was conducted. One hundred and sixty patients undergoing laparoscopic surgery were randomly assigned to one of four groups: (1) group P (placebo-control): intravenous normal saline+bilateral non-acupuncture point injection of vitamin B1 (n=40); (2) group O (ondansetron): intravenous ondansetron+bilateral ST36 sham injection (n=40); (3) group A (acupuncture point injection): intravenous normal saline+bilateral acupuncture point injection at ST36 of vitamin B1 (n=40); (4) group C (combination): intravenous ondansetron+bilateral acupuncture point injection at ST36 of vitamin B1 (n=40). Interventions were made on arrival at the postanaesthesia care unit. The primary outcome was the incidence of POV within 24 h after the operation. Secondary outcomes included severity of vomiting, incidence of rescue treatment, patients’ satisfaction and the first anal exsufflation time 24 h after the operation.

Results

The incidence of POV within 24 h postoperative period in each group was P 33%; O 11%, A 9% and C 6%. Outcomes for all intervention groups were significantly better than that for placebo (p<0.01). For the three interventions compared with placebo, the numbers needed to treat (NNTs) were O, NNT=5; A, NNT=5 and C, NNT=4. The secondary outcomes also demonstrated greater benefits of the combined regimen, with improvement seen in all the measures.

Conclusions

Ondansetron, acupuncture, and ondansetron and acupuncture combined are effective prophylaxis for POV.
Changes in the rates of weight and waist circumference gain in Australian adults over time: a longitudinal cohort study
Authors: Peeters Anna , Magliano Dianna J , Backholer Kathryn , Zimmet Paul , Shaw Jonathan E
Published: January 2014

Objective

To assess in a single cohort whether annual weight and waist circumference (WC) change has varied over time.

Design

Longitudinal cohort study with three surveys (1) 1999/2000; (2) 2004/2005 and (3) 2011/2012. Generalised linear mixed models with random effects were used to compare annualised weight and WC change between surveys 1 and 2 (period 1) with that between surveys 2 and 3 (period 2). Models were adjusted for age to analyse changes with time rather than age. Models were additionally adjusted for sex, education status, area-level socioeconomic disadvantage, ethnicity, body mass index, diabetes status and smoking status.

Setting

The Australian Diabetes, Obesity and Lifestyle study (AusDiab)—a population-based, stratified-cluster survey of 11247 adults aged ≥25 years.

Participants

3351 Australian adults who attended each of three surveys and had complete measures of weight, WC and covariates.

Primary outcome measures

Weight and WC were measured at each survey. Change in weight and WC was annualised for comparison between the two periods.

Results

Mean weight and WC increased in both periods (0.34 kg/year, 0.43 cm/year period 1; 0.13 kg/year, 0.46 cm/year period 2). Annualised weight gain in period 2 was 0.11 kg/year (95% CI 0.06 to 0.15) less than period 1. Lesser annual weight gain between the two periods was not seen for those with greatest area-level socioeconomic disadvantage, or in men over the age of 55. In contrast, the annualised WC increase in period 2 was greater than period 1 (0.07 cm/year, 95% CI 0.01 to 0.12). The increase was greatest in men aged 55+ years and those with a greater area-level socioeconomic disadvantage.

Conclusions

Between 2004/2005 and 2011/2012, Australian adults in a national study continued to gain weight, but more slowly than 1999/2000–2004/2005. While weight gain may be slowing, this was not observed for older men or those in more disadvantaged groups, and the same cannot be said for WC.
Salt intake assessed by 24 h urinary sodium excretion in a random and opportunistic sample in Australia
Authors: Land Mary-Anne , Webster Jacqui , Christoforou Anthea , Praveen D , Jeffery Paul , Chalmers John , Smith Wayne , Woodward Mark , Barzi Federica , Nowson Caryl , Flood Victoria , Neal Bruce
Published: January 2014

Objective

The gold standard method for measuring population sodium intake is based on a 24 h urine collection carried out in a random population sample. However, because participant burden is high, response rates are typically low with less than one in four agreeing to provide specimens. At this low level of response it is possible that simply asking for volunteers would produce the same results.

Setting

Lithgow, New South Wales, Australia.

Participants

We randomly selected 2152 adults and obtained usable 24 h urine samples from 306 (response rate 16%). Specimens were also collected from a further 113 volunteers. Estimated salt consumption and the costs for each strategy were compared.

Results

The characteristics of the ‘random’ and ‘volunteer’ samples were moderately different in mean age 58 (SD 14.6 vs 49(17.7) years, respectively; p<0.001) as well as self-reported alcohol use, tobacco use, history of hypertension and prescription drug use (all p<0.04). Overall crude mean 24 h urinary salt excretion was 8.9(3.6) g/day in the random sample vs 8.5(3.3) g/day for the volunteers (p=0.42). Corresponding age-adjusted and sex-adjusted estimates were 9.2(3.3) and 8.8(3.4) g/day (p=0.29). Estimates for men 10.3(3.8) vs 9.6(3.3) g/day; (p=0.26) and women 7.6(3) vs 7.9(3.2) g/day; (p=0.43) were also similar for the two samples, as was salt excretion across age groups (p=0.72). The cost of obtaining each 24 h urine sample was two times greater for the random compared to volunteer samples ($A62 vs $A31).

Conclusions

The estimated salt consumption derived from the two samples was comparable and was not substantively different to estimates obtained from other surveys. In countries where salt is pervasive and cannot easily be avoided, estimates of consumption obtained from volunteer samples may be valid and less costly.
Patient- and surgeon-adjusted control charts for monitoring performance
Authors: Maruthappu Mahiben , Carty Matthew J , Lipsitz Stuart R , Wright John , Orgill Dennis , Duclos Antoine
Published: January 2014

Objectives

To determine whether an innovative graphical tool for accurate measurement of individual surgeon performance metrics, adjusted for both surgeon-specific and patient-specific factors, significantly alters interpretation of performance data.

Design

Retrospective analysis of all total knee replacements (TKRs) conducted at the host institution between 1996 and 2009. The database was randomly divided into training and testing datasets. Using multivariate generalised estimating equation regression models, the training dataset enabled generation of patient-risk and surgeon-experience adjustment factors. To simulate prospective monitoring of individual surgeon outcomes, the testing dataset was mapped on control charts. Weighted κ statistics were calculated to measure the agreement between patient-risk adjusted and fully adjusted control charts.

Setting

Tertiary care academic hospital.

Participants

All patients undergoing TKR at the host institution 1996–2009.

Main outcome measure

Operative efficiency.

Results

5313 procedures were analysed. Adjusted control charts were generated using a training dataset comprising 3756 procedures performed by 13 surgeons. The operative time gradually declined by 121 min with 25 years of experience (p<0.0001). Charts were tested by monitoring four other surgeons, performing an average of 389 procedures each. Adjustment for surgeon experience significantly altered the interpretation of operative efficiency (κ=0.29 (95% CI 0.11 to 0.47)), and enhanced assessment of a surgeon's improvement or diminishment in efficiency over time. Specifically, experience adjustment inverted the interpretation of surgeon efficiency from above average to below average, or from improving to declining performance.

Conclusions

Adjustment for surgeon experience is necessary for accurate interpretation of metrics over the course of a surgeon's career. Patient-adjusted and surgeon-adjusted control charts provide an accurate method of monitoring individual operative efficiency.
Guidance on the effective use of upper gastrointestinal histopathology
Authors: Loughrey Maurice B , Johnston Brian T
Published: January 2014

Given the ever-increasing demand for upper gastrointestinal endoscopy, for diagnosis and surveillance, there is a need to consider when it is appropriate, and when it is not appropriate, to take an endoscopic biopsy for histological evaluation. In this article, we consider this in relation to each of the anatomical compartments encountered during oesophagogastroduodenoscopy, and in relation to the common clinical scenarios and endoscopic abnormalities encountered. There are clear indications to biopsy suspicious ulceration or mass lesions and for investigation of some inflammatory conditions, such as eosinophilic oesophagitis and coeliac disease. Increasing guidance is available on optimal biopsy sites and biopsy numbers to maximise yield from histology. Outside these areas, the endoscopist should consider whether biopsy of normal or abnormal appearing mucosa is likely to contribute to patient management, to ensure effective use of limited healthcare resources.
Cell cycle-related kinase mediates viral-host signalling to promote hepatitis B virus-associated hepatocarcinogenesis
Authors: Yu Zhuo , Gao Yue-Qiu , Feng Hai , Lee Ying-Ying , Li May S , Tian Yuan , Go Minnie Y Y , Yu Dae-Yeul , Cheung Yue-Sun , Lai Paul B S , Yu Jun , Wong Vincent W S , Sung Joseph J Y , Chan Henry L Y , Cheng Alfred S L
Published: January 2014

Background

Androgen receptor (AR) signalling contributes to male predominance in hepatocellular carcinoma (HCC), which is more pronounced in HBV-endemic areas. Cell cycle-related kinase (CCRK) is essential for AR-induced hepatocarcinogenesis but its molecular function in HBV-associated HCC remains obscure.

Objective

To determine the molecular function of CCRK in HBV-associated HCC.

Design

Transcriptional regulation was assessed by chromatin immunoprecipitation, promoter mutation and luciferase reporter assays. Hepatocellular proliferation and tumourigenesis were examined by colony formation, soft agar assays and using HBV X protein (HBx) transgenic mice with low-dose exposure to diethylnitrosamine. Protein expressions were examined in clinical samples and correlated with patient survival by log-rank Mantel–Cox test.

Results

Overexpression of CCRK, but not its kinase-defective mutant, activated β-catenin/T cell factor signalling through phosphorylation of glycogen synthase kinase-3β (GSK-3β) at Ser9, led to upregulation of AR transcriptional activity and, subsequently, expression of HBx. The viral transactivator in turn induced CCRK expression through enhanced AR signalling, thus forming a positive regulatory loop. RNA interference silencing of CCRK, which suppressed the CCRK/GSK-3β/β-catenin/AR regulatory loop, significantly suppressed HBx-induced hepatocellular proliferation (p=0.001) and transformation (p<0.001) and remarkably reduced >80% diethylnitrosamine-mediated hepatocarcinogenesis in HBx transgenic mice. Finally, patients with HBV-associated HCC with concordant overexpression of CCRK, GSK-3β phosphorylation at Ser9, active dephosphorylated β-catenin and AR phosphorylation at Ser81 had poorer overall (HR=31.26, p<0.0001) and disease-free (HR=3.60, p<0.01) survival rates.

Conclusions

Our findings highlight the critical role of CCRK in a self-reinforcing circuitry that regulates HBV-associated hepatocarcinogenesis. Further characterisation of this intricate viral-host signalling may provide new prognostic biomarkers and therapeutic targets for HCC treatment.
Do changes in objective and subjective family income predict change in children's diets over time? Unique insights using a longitudinal cohort study and fixed effects analysis
Authors: Skafida Valeria , Treanor Morag C
Published: January 2014

Background

While an association has been established between low income and poor diet using cross-sectional data, such analysis cannot account for confounding by unobserved characteristics correlated with income and diet, and changes in income and diet cannot be tracked over time. This paper, using longitudinal panel data, explores whether falls in objective and subjective family income predict deterioration in children's diets over time.

Methods

This paper uses panel data from the nationally representative birth cohort study Growing Up in Scotland. 3279 families have valid data on all dependent, independent and control variables for both time points. Dietary data were collected using maternal recall at sweeps 2 and 5 when the children were aged 22 and 58 months, respectively. Mothers reported on children's variety of consumption of vegetables, fruit and on the frequency of consumption of crisps, sweets and sugary drinks. The dietary variables were ordinal and were analysed using multivariate fixed effects ordinal logistic regression models.

Results

Controlling for time-varying confounders (children's food fussiness, maternal social class, maternal education, family composition, maternal employment) and for family and child time-invariant characteristics, moving from the highest to the lowest income band was linked to a smaller chance of increased fruit variety from 22 to 58 months (OR=0.42, 95% CI 0.21 to 0.82). Mothers who transitioned from ‘living very comfortably’ to ‘finding it very difficult’ to cope on current income had children who consumed fewer fruit varieties over time (OR=0.40, 95% CI 0.19 to 0.85), and who increased their frequency of consumption of crisps (OR=2.03, 95% CI 1.05 to 3.94) and sweets (OR=2.23, 95% CI 1.18 to 4.20).

Conclusions

The diets of young children in Scotland deteriorated between the ages of 2 and 5 years across the entire socioeconomic spectrum. Additionally, deterioration in subjective income predicted less healthy diets for children.
Correlation of clot imaging with endovascular recanalization in internal carotid artery terminus occlusion
Authors: Fujimoto Motoaki , Salamon Noriko , Takemoto Koichiro , Takao Hiroyuki , Song Ligang , Tateshima Satoshi , Viñuela Fernando
Published: January 2014

Background and purpose

In a swine stroke model we have previously demonstrated a high-intensity fluid attenuated inversion recovery (FLAIR) signal representing the erythrocyte component of the clot. We hypothesized that the intensity of the FLAIR clot signal in patients with acute stroke may predict the efficacy of recanalization by thrombectomy devices. In this study we compared the pretreatment FLAIR signal intensity of the clots in the distal internal carotid artery (ICA) and the degree of angiographic recanalization rate after mechanical thrombectomy.

Methods

25 consecutive acute stroke patients with ICA terminus (ICA-T) occlusion diagnosed with MRI at the UCLA Medical Center between 2002 and 2013 were retrospectively reviewed. The intensity of the FLAIR clot signal at the distal ICA was blindly compared with the angiographic recanalization status (successful recanalization defined as Thrombolysis In Cerebral Infarction (TICI) score of 2b–3) and non-successful recanalization as TICI score 0–2a) after endovascular treatment. Multivariate logistic regression analysis for successful recanalization was performed.

Results

Successful recanalization was achieved in 40% of patients (10/25) and showed a significantly higher FLAIR intensity (p=0.014). The cut-off value for clot intensity on the FLAIR sequence to predict recanalization was 0.7952, with 70% sensitivity and 80% specificity (95% CI 0.59 to 0.96) using a receiver operating characteristic curve. In multivariate logistic regression analysis, only a high FLAIR clot intensity (>0.7952) was associated with successful recanalization (OR 16.79; 95% CI 1.29 to 218.92; p=0.031).

Conclusions

High signal intensity on FLAIR clot imaging may predict successful recanalization after endovascular therapy for ICA-T occlusion.
Discharge disposition to skilled nursing facility after endovascular reperfusion therapy predicts a poor prognosis
Authors: Belagaje Samir R , Sun Chung-Huan J , Nogueira Raul G , Glenn Brenda A , Wuermser Lisa Ann , Patel Vishal , Frankel Michael R , Anderson Aaron M , Thomas Tommy T , Horn Christopher M , Gupta Rishi
Published: January 2014

Objective

We explore the impact of discharge disposition (independent rehabilitation facility (IRF) vs skilled nursing facility (SNF)) on 90 day outcomes in persons with stroke who received acute endovascular treatment.

Methods

Using a database from a single primary care stroke center, discharge disposition, National Institutes of Health Stroke Scale (NIHSS), Totaled Health Risks in Vascular Events (THRIVE), Houston Intra-Arterial Therapy 2 (HIAT-2), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores, and successful reperfusion were obtained. Univariate analysis was performed to assess predictors of good clinical outcome, as defined by 90 day modified Rankin Scale (mRS) scores ≤2. A binary logistic regression model was used to determine the impact of placement to an IRF versus an SNF on clinical outcomes.

Results

147 subjects were included in the analysis with a mean age of63±14 years and median NIHSS of 18 (IQR 14–21). Final infarct volumes, and modified APACHE II, THRIVE, and HIAT-2 scores were similar between those discharged to an IRF and those discharged to an SNF.However, their 90 day outcomes were significantly different, with far fewer patients at SNFs achieving good clinical outcomes (25% vs 46%; p=0.023). Disposition to SNF was significantly associated with a lower probability of achieving an mRS score of 0–2 at 90 days (OR = 0.337 (95% CI 0.12 to 0.94); p<0.04).

Conclusions

Subjects discharged to SNFs and IRFs after thrombectomy have similar medical and neurological severity at admission and similar final infarct volumes at discharge. Despite these similarities, patients discharged to an SNF had a significantly lower probability of achieving a good neurological outcome. These results have implications for future acute stroke trial design.
ASPECTS decay during inter-facility transfer predicts patient outcomes in endovascular reperfusion for ischemic stroke: a unique assessment of dynamic physiologic change over time
Authors: Sun Chung-Huan J , Connelly Kerrin , Nogueira Raul G , Glenn Brenda A , Zimmermann Susan , Anda Kim , Camp Deborah , Gaunt Susan , Pallard Herma , Eckenroth Michele , Frankel Michael R , Belagaje Samir R , Anderson Aaron M , Nahab Fadi , Yepes Manuel , Gupta Rishi
Published: January 2014

Background

Pretreatment Alberta Stroke Program Early CT Scores (ASPECTS) is associated with clinical outcomes. The rate of decline between subsequent images, however, may be more predictive of outcomes as it integrates time and physiology.

Methods

A cohort of patients transferred from six primary stroke centers and treated with intra-arterial therapy (IAT) was retrospectively studied. Absolute ASPECTS decay was defined as ((ASPECTSFirst CT—ASPECTSSecond CT)/hours elapsed between images). A logistic regression model was performed to determine if the rate of ASPECTS decay predicted good outcomes at 90 days (modified Rankin Scale score of 0–2).

Results

106 patients with a mean age of 66±14 years and a median National Institutes of Health Stroke Scale score of 19 (IQR 15–23) were analyzed. Median time between initial CT at the outside hospital to repeat CT at our facility was 2.7 h (IQR 2.0–3.6). Patients with good outcomes had lower rates of absolute ASPECTS decay compared with those who did not (0.14±0.23 score/h vs 0.49±0.39 score/h; p<0.001). In multivariable modeling, the absolute rate of ASPECTS decay (OR 0.043; 95% CI 0.004 to 0.471; p=0.01) was a stronger predictor of good patient outcome than static pretreatment ASPECTS obtained before IAT (OR 0.64; 95% CI 0.38 to 1.04; p=0.075). In practical terms, every 1 unit increase in ASPECTS decline per hour correlates with a 23-fold lower probability of a good outcome.

Conclusions

Patients with faster rates of ASPECTS decay during inter-facility transfers are associated with worse clinical outcomes. This value may reflect the rate of physiological infarct expansion and thus serve as a tool in patient selection for IAT.
Direct continuous measurement of draining vein pressure during Onyx embolization in a swine arteriovenous malformation model
Authors: Haussen Diogo C , Ashour Ramsey , Johnson Jeremiah N , Elhammady Mohamed Samy , Peterson Eric C , Cesar Liliana , Bowie Charles , Aziz-Sultan Mohammad Ali
Published: January 2014

Objective

Periprocedural intracranial hemorrhage secondary to intranidal flow redirection may develop after arteriovenous malformation (AVM) embolization. We hypothesized that continuous draining vein pressure monitoring may identify clinically relevant hemodynamic changes during devascularization. Our goal was to characterize the draining vein pressures in a swine rete mirabile AVM model during embolization with Onyx.

Methods

An acute swine AVM model was constructed in six animals. Baseline, transoperative and final AVM area measurements were used to determine the degree of AVM embolization. Continuous video recordings were captured at 10 s intervals of active embolization. Draining vein pressure, arterial feeder pressure and heart rate were continuously monitored.

Results

The baseline and post-embolization mean draining vein pressures were 49.8±17.2 and 33.0±11.7 mm Hg (p=0.01), mean arterial pressures were 79.8±19.4 and 79.6±25.2 mm Hg (p=0.94), mean transnidal pressures were 35.8±19.7 and 45.4±33.7 mm Hg (p=0.37) and mean heart rates were 81.1±11.9 and 83.1±12.8 bpm (p=0.38), respectively. The draining vein pressure was averaged according to the degree of AVM embolization and represented as a relative change compared with the baseline draining vein pressure, and the slopes were found to decrease in all cases (p=0.02). In half of the animals the draining vein pressure decreased progressively as the AVM was embolized. In the remaining animals the venous pressure only started to decline after the AVM had been devascularized by > 50%.

Conclusions

The draining vein pressure response during Onyx embolization in the swine AVM model is heterogeneous. Continuous draining vein pressure monitoring is feasible and may potentially identify clinically relevant hemodynamic changes during AVM embolization.
Republished: Unlocking the potential: longitudinal audit finds multifaceted education for general practice increases HIV testing and diagnosis
Authors: Pillay Timesh D , Mullineux Judith , Smith Colette J , Matthews Philippa
Published: January 2014

Background

This longitudinal study aimed to evaluate the impact of a multifaceted educational intervention (Sexual Health in Practice, SHIP) on general practice HIV testing rates in a high prevalence London area.

Intervention

SHIP offered training in sexual health clinical skills to general practitioners (GPs) and practice nurses (PNs) in Haringey. SHIP training aims to break down stigma in sexual health and provide sexual history and communication tools (e.g. differential diagnosis), and provides resources to practices (including condoms).

Design

Numbers of GP HIV tests were collected from laboratories for 24 months prior, 19 months during and 5 months after training. Attendance data and practice list sizes were obtained.

Results

39 of 51 practices had at least one trained individual. These ‘trained’ practices conducted an average 526 HIV tests p.a. before training began which rose to a projected 1556 p.a. (on the basis of the last 6 months of data). Testing rates of trained and untrained practices increased from 2.29 to 6.66 and 1.54 to 1.90 tests/1000 registered patients/year (p=0.0016 and p=0.5195) respectively. The rate of positive diagnosis was high in the trained group (18.0 and 16.7 positives/1000 tests before and after training began; p=0.7908). This equates to a rise from 9.5 to 22 new diagnoses p.a.

Conclusions

The training intervention has been found to significantly increase general practice HIV testing rates in the absence of financial incentives. Positivity rates are substantially higher than that found in pilots of screening in London, suggesting that the training nurtured and supplemented complex clinical skills.
Evaluation of the extent of ketamine-induced uropathy: the role of CT urography
Authors: Huang Li-Kuo , Wang Jia-Hwia , Shen Shu-Huei , Lin Alex T L , Chang Cheng-Yen
Published: January 2014

Background

With growing ketamine abuse, ketamine-induced uropathy (KIU) has become more prevalent in recent years. This research evaluates the presence, distribution and extent of KIU in the upper and lower urinary tracts by retrospectively reviewing CT urography (CTU) images.

Methods

Patients diagnosed with KIU who underwent CT scanning from 1 January 2006 to 31 December 2011 were recruited. The CT protocols included three-phase CTU in six patients, split-bolus CTU in 17, two-phase CT in one and unenhanced CT in three. The CT images were retrospectively reviewed by two radiologists.

Results

A total of 27 patients participated in this study. The common CT findings included diffuse bladder wall thickening (88.9%), small bladder volume (66.7%) and perivesical inflammation (44.4%). Twelve patients (44.4%) were diagnosed with hydronephrosis, including three patients with unilateral hydronephrosis and nine with bilateral hydronephrosis. Of these patients, nine had ureteral wall thickening (33.3%) and two (7.4%) had ureterovesical junction involvement (ie, they had hydronephrosis but no ureteral wall thickening). One patient had a ureteral obstruction because of a ureter stone. The correlation between upper urinary tract involvement and grading of the interstitial cystitis was statistically non-significant (p=0.33). Four patients (14.8%) had a vesicovaginal fistula which could be detected in the excretory phase only.

Conclusions

Upper urinary tract involvement is common in patients with KIU. CTU might aid evaluation of the extent of KIU and prompt adequate management.
Factors that trigger emergency physicians to contact a poison centre: findings from a Swiss study
Authors: Schurter David , Rauber-Lüthy Christine , Jahns Maximilian , Haberkern Monika , Kupferschmidt Hugo , Exadaktylos Aristomenis , Eriksson Urs , Ceschi Alessandro
Published: January 2014

Objective

Poison centres offer rapid and comprehensive support for emergency physicians managing poisoned patients. This study investigates institutional, case-specific and poisoning-specific factors which influence the decision of emergency physicians to contact a poison centre.

Methods

Retrospective, consecutive review of all poisoning-related admissions to the emergency departments (EDs) of a primary care hospital and a university hospital-based tertiary referral centre during 2007. Corresponding poison centre consultations were extracted from the poison centre database. Data were matched and analysed by logistic regression and generalised linear mixed models.

Results

545 poisonings were treated in the participating EDs (350 (64.2%) in the tertiary care centre, 195 (35.8%) in the primary care hospital). The poison centre was consulted in 62 (11.4%) cases (38 (61.3%) by the tertiary care centre and 24 (38.7%) by the primary care hospital). Factors significantly associated with poison centre consultation included gender (female vs male) (OR 2.99; 95% CI 1.69 to 5.29; p<0.001), number of ingested substances (>1 vs 1) (OR 2.84; 95% CI 1.65 to 4.9; p<0.001) and situation (accidental vs intentional) (OR 2.76; 95% CI 1.05 to 7.25; p=0.039). In contrast, age, medical history and hospital size did not influence poison centre consultation. Poison centre consultation was significantly higher during the week, and significantly less during night shifts. The poison centre was consulted significantly more when patients were admitted to intensive care units (OR 5.81; 95% CI 3.25 to 10.37; p<0.001). Asymptomatic and severe versus mild cases were associated with more frequent consultation (OR 4.48; 95% CI 1.78 to 11.26; p=0.001 and OR 2.76; 95% CI 1.42 to 5.38; p=0.003).

Conclusions

We found low rates of poison centre consultation by emergency physicians. It appears that intensive care unit admission and other factors reflecting either complexity or uncertainty of the clinical situation are the strongest predictors for poison centre consultation. Hospital size did not influence referral behaviour.
The microbial ecology of flowers: an emerging frontier in phyllosphere research
Authors: Aleklett Kristin , Hart Miranda , Shade Ashley
Published: January 2014

Though we are learning more about the diversity, dynamics, and importance of phyllosphere microbiota, we have only modest knowledge about the microorganisms that specifically inhabit flowers. Due to their ephemerality and exquisite anatomy, flowers provide unique habitats to microorganisms, including a range of distinct microscale niches. Here, we review the recent literature concerning community composition and diversity in the flower microbiota, the spatial and temporal community dynamics, and the interactions between flower microbes, their plant hosts, and pollinators. We conclude with future directions for improving our understanding of this emerging frontier in phyllosphere microbial ecology.
Using mark–recapture information to validate and assess age and growth of long-lived fish species
Authors: Hamel Martin J. , Koch Jeff D. , Steffensen Kirk D. , Pegg Mark A. , Hammen Jeremy J. , Rugg Mathew L.
Published: January 2014

Long-lived species from marine and freshwater environments have experienced declines linked to anthropogenic effects such as overexploitation, dam construction, and habitat modification. An understanding of the age structure and the associated dynamics determined from these data for long-lived species is critical for both perseverance of at-risk species and maintenance of exploited species. We used pallid sturgeon (Scaphirhynchus albus) to evaluate the efficacy of mark–recapture data from known-age, hatchery-reared fish (ages 1 to 7) to corroborate age and growth estimates obtained from sectioned pectoral fin rays. Accuracy of age estimates from known-age fish was 13%, whereas 72% of estimates were within 2 years of the true age. Annual growth was significantly different between estimated growth (back-calculated) and actual observations of tagged pallid sturgeon. Age for pallid sturgeon of any given size was estimated with parameters derived from mark–recapture data, and the predicted length-at-age relation was similar to observations from known individuals. In instances where age determination for all ages of interest cannot be verified, mark–recapture appears to be a viable solution for examining growth and has shown promise as a tool for estimating ages in long-lived species with calcified structures that are difficult to read.
Do social mating systems limit maternal immune investment in shorebirds?
Authors: Edwards D.B. , Haring M. , Gilchrist H.G. , Schulte-Hostedde A.I.
Published: January 2014

Across mating systems, females differ in the amount of resources they invest in offspring. For example, polyandrous females invest in acquiring multiple matings rather than providing parental care. We examined how the amount of maternal immune investment, measured as immunoglobulin Y and lysozyme activity in eggs, was influenced by female role across three social mating systems (polyandry, polygyny, and monogamy) in shorebirds. We predicted that polyandry should impose the greatest costs on the ability to provision eggs and monogamy, where females receive benefits from biparentality, the least. Contrary to our predictions, levels of maternally derived egg immune constituents were consistently high across measures in the polyandrous species and low in the monogamous species. Our results may support a link with pace-of-life where developmental costs are greater than the energetic costs of provisioning eggs, and (or) a role for sexual selection acting on maternal immune investment.
Critical thermal maximum (CTmax) and hematology of shortnose sturgeons (Acipenser brevirostrum) acclimated to three temperatures
Authors: Zhang Yueyang , Kieffer James D.
Published: January 2014

Quantifying a species thermal tolerance is critical to assessing biological impacts of anticipated increases in temperature (e.g., climate change). Although many studies have documented the critical thermal maximum (CTmax) of fish, there is a paucity of research on thermal biology of sturgeon. The shortnose sturgeon (Acipenser brevirostrum LeSueur, 1818) is a threatened species that exists along the eastern coast of North America. They can be exposed to temperatures ranging from freezing to above 25 °C. Using a heating rate of 6 °C/h, CTmaxand the associated hematological responses of shortnose sturgeon acclimated to 10, 15, and 20 °C were determined. There was a significant positive relationship between CTmaxand body mass, and CTmaxincreased significantly with increases in acclimation temperature (Ta). In general, hematology of thermally stressed fish was modified relative to control (nonstressed) fish. Hematocrit, plasma lactate, and plasma Na+and Cl–of fish were all significantly influenced by thermal stress and Ta. Glucose and K+were only significantly influenced by thermal stress. Future studies should address the importance of other stressors, such as salinity and toxicants, on thermal relationships of sturgeon.
THE PHYSICS OF QUANTUM INFORMATION: COMPLEMENTARITY, UNCERTAINTY, AND ENTANGLEMENT
Authors: RENES JOSEPH M.
Published: January 2014

Complementarity is one of the central mysteries of quantum mechanics, dramatically illustrated by the wave-particle duality in Young's double-slit experiment, and famously regarded by Feynman as "impossible, absolutely impossible to describe classically, [and] which has in it the heart of quantum mechanics" (emphasis original).1 The overarching goal of this thesis is to demonstrate that complementarity is also at the heart of quantum information theory, that it allows us to make (some) sense of just what information "quantum information" refers to, and that it is useful in understanding and constructing quantum information processing protocols.
OUTPUT ENTANGLEMENT IN A FOUR-LEVEL CORRELATED EMISSION LASER
Authors: PING YUNXIA , ZHANG CHAOMIN , WANG MINGXIA , WANG SHAN
Published: January 2014

The continuous-variable (CV) entanglement of the output fields is investigated in a four-level correlated emission laser system. The atomic coherence is introduced using two external classical driving fields. Based on the input–output theory, it is shown that the output entanglement and the entangled photons of the system can be achievable under certain conditions. Moreover, it is found that the two-mode entanglement has a close relation with the intensities of two external driving fields.
SOLVING ION CHANNEL KINETICS WITH THE QuB SOFTWARE
Authors: NICOLAI CHRISTOPHER , SACHS FREDERICK
Published: January 2014

The ability to record the currents from single ion channels led to the need to extract the underlying kinetic model from such data. This inverse hidden Markov problem is difficult but led to the creation of a software suite called QuB utilizing likelihood optimization. This review presents the software. The software is open source and, in addition to solving kinetic models, has many generic database operations including report generation with publishable graphics, function fitting and scripting for new and repeated processing and AD/DA I/O. The core algorithms allow for constraints such as fixed rates or maintaining detailed balance in the model. All rate constants can be driven by a stimulus and the system can analyze nonstationary data. QuB also can analyze the kinetics of multichannel data where individual events cannot be discriminated, but the fitting algorithms utilize the signal variance as well as the mean to fit models. QuB can be applied to any data appropriately modeled with Markov kinetics and has been utilized to solve ion channels but also the movement of motor proteins, the sleep cycles in mice, and physics processes.

[Formula: see text]Special Issue Comment: This is a review about the software QuB that can extract a model from the trajectory. It is connected with the review about treatments when solving single molecules,60 and the reviews about enzymes.61,62
THE OPERATION OF VEGA/CHARA: FROM THE SCIENTIFIC IDEA TO THE FINAL PRODUCTS
Authors: LIGI R. , MOURARD D. , NARDETTO N. , CLAUSSE J.-M.
Published: January 2014

We describe the data flow in the operation of the VEGA/CHARA instrument. After a brief summary of the main characteristics and scientific objectives of the VEGA instrument, we explain the standard procedure from the scientific idea up to the execution of the observation. Then, we describe the different steps done after the observation, from the raw data to the archives and the final products. Many tools are used and we show how the Virtual Observatory principles have been implemented for the interoperability of these software and databases.
JOUVENCE OF FLUOR: UPGRADES OF A FIBER BEAM COMBINER AT THE CHARA ARRAY
Authors: SCOTT N. J. , MILLAN-GABET R. , LHOMÉ E. , TEN BRUMMELAAR T. A. , COUDÉ DU FORESTO V. , STURMANN J. , STURMANN L.
Published: January 2014

The FLUOR (Fiber Linked Unit for Optical Recombination) interferometric beam combiner located at the CHARA Array on Mt. Wilson, California has recently undergone a program of major upgrades known as Jouvence of FLUOR (JouFLU). These upgrades seek to improve the precision, use, and observing efficiency of FLUOR as well as introduce new modes of operation. A Fourier Transform Spectrograph (FTS) mode and a spectral dispersion mode have been added to improve calibration and data collection. New mechanized stages and new cameras have been added to FLUOR for alignment and pupil plane imaging. Entirely new control/command software has been written for FLUOR which brings it into compliance with CHARA software standards. This allows for continued software upgrades and full remote operation capability. The new JouFLU instrument is now operating on sky and is expected to achieve accurate interferometric visibility amplitude measurements with 0.1 to 0.3% precision.