bluuebunny/crossref_metadata_2025 huggingface dataset:
Connexin‐43 and aquaporin‐4 are markers of ageing‐related tau astrogliopathy (ARTAG)‐related astroglial response
Authors: Kovacs G. G. , Yousef A. , Kaindl S. , Lee V. M. , Trojanowski J. Q.
Published: July 2017

Aims

Ageing‐related tau astrogliopathy (ARTAG) appears in subependymal, subpial, perivascular, white matter (WM) and grey matter (GM) locations. Physical effects, blood–brain barrier dysfunction and blood‐ or vessel‐related factors have been considered as aetiology. As connexin‐43 (Cx43) and aquaporin‐4 (AQP4) are related to these, we hypothesized that their immunoreactivity (IR) varies with ARTAG in a location‐specific manner.

Methods

We performed a morphometric immunohistochemical study measuring the densities of IR of Cx43, AQP4, AT8 (phospho‐tau) and glial fibrillar acidic protein (GFAP). We analysed the amygdala and hippocampus in age‐matched cases with (n = 19) and without (n = 20) ARTAG in each of the locations it aggregates.

Results

We show a dramatic increase (>6‐fold; P < 0.01) of Cx43 density of IR in ARTAG cases correlating strongly with AT8 density of IR, irrespective of the presence of neuronal tau pathology or reactive gliosis measured by GFAP density of IR, in the GM. In contrast, AQP4 density of IR was increased only in the WM and GM, and was associated with increased AT8 density of IR only in WM and perivascular areas.

Discussion

Our study reveals distinctive astroglial responses in each of the locations associated with ARTAG. Our observations support the concept that factors related to brain‐fluid interfaces and water‐ion imbalances most likely play a role in the generation of ARTAG. As Cx43 is crucial for maintaining neuronal homeostasis, the ARTAG‐dependent increase of Cx43 density of IR suggests that the development of ARTAG in the GM most likely indicates an early response to the degeneration of neurons.
Vacuolar processing enzyme activates programmed cell death in the apical meristem inducing loss of apical dominance
Authors: Teper‐Bamnolker Paula , Buskila Yossi , Belausov Eduard , Wolf Dalia , Doron‐Faigenboim Adi , Ben‐Dor Shifra , Van der Hoorn Renier A.L. , Lers Amnon , Eshel Dani
Published: July 2017

The potato (Solanum tuberosum L.) tuber is a swollen underground stem that can sprout in an apical dominance (AD) pattern. Bromoethane (BE) induces loss of AD and the accumulation of vegetative vacuolar processing enzyme (S. tuberosum vacuolar processing enzyme [StVPE]) in the tuber apical meristem (TAM). Vacuolar processing enzyme activity, induced by BE, is followed by programmed cell death in the TAM. In this study, we found that the mature StVPE1 (mVPE) protein exhibits specific activity for caspase 1, but not caspase 3 substrates. Optimal activity of mVPE was achieved at acidic pH, consistent with localization of StVPE1 to the vacuole, at the edge of the TAM. Downregulation of StVPE1 by RNA interference resulted in reduced stem branching and retained AD in tubers treated with BE. Overexpression of StVPE1 fused to green fluorescent protein showed enhanced stem branching after BE treatment. Our data suggest that, following stress, induction of StVPE1 in the TAM induces AD loss and stem branching.
PARP‐1/PAR Activity in Cultured Human Lens Epithelial Cells Exposed to Two Levels of UVB Light
Authors: Cencer Caroline S. , Chintala Shravan K. , Townsend Tenira J. , Feldmann Daniel P. , Awrow Mirna A. , Putris Nahrain A. , Geno Mason E. , Donovan Maria G. , Giblin Frank J.
Published: July 2017

This study investigated poly(ADP‐ribose) polymerase‐1 (PARP‐1) activation in cultured human lens epithelial cells exposed to two levels of UVB light (312 nm peak wavelength), 0.014 and 0.14 J cm−2 (“low” and “high” dose, respectively). At the low dose, PARP‐1 and poly(ADP‐ribose) (PAR) polymers acted to repair DNA strand breaks rapidly with no subsequent major effects on either cell morphology or viability. However, following the high UVB dose, there was a dramatic second phase of PARP‐1 activation, 90 min later, which included a sudden reappearance of DNA strand breaks, bursts of reactive oxygen species (ROS) formation within both the mitochondria and nucleus, a translocation of PAR from the nucleus to the mitochondria and an ultimate 70% loss of cell viability occurring after 24 h. The results provide evidence for an important role for PARP‐1 in protecting the human lens epithelium against low levels of UVB light, and possibly participating in the triggering of cell death following exposure to toxic levels of radiation.
Successful use of digoxin‐specific immune Fab in the treatment of severeNerium oleandertoxicosis in a dog
Authors: Pao‐Franco Amaris , Hammond Tara N. , Weatherton Linda K. , DeClementi Camille , Forney Scott D.
Published: July 2017

Objective

To describe a case in which digoxin‐specific immune Fab was used successfully in a dog with severe oleander toxicosis secondary to ingesting plant material.

Case Summary

A 6‐year‐old intact female Rhodesian Ridgeback mixed breed dog was presented for severe oleander toxicosis and was refractory to all antiarrhythmic therapies and supportive care. Digoxin‐specific immune Fab was successful in treating this dog. The dog recovered but suffered ischemic injuries, the long‐term effects of which are unknown.

New or Unique Information Provided

This report describes the successful use of digoxin‐specific immune Fab in the treatment of oleander toxicosis in a dog, which has not previously been published in veterinary literature. Oleander poisoning can be associated with permanent cardiac arrhythmias due to the ischemic damage.
Harnessing electronic healthcare data for wound care research: Wound registry analytic guidelines for less‐biased analyses
Authors: Carter Marissa J.
Published: July 2017

Publications based on large healthcare databases that contain data pertaining to wound‐related outcomes are starting to appear more frequently. However, concern exists in regard to study design adequacy, the methodology used to minimize misclassifications, bias, and confounding, and lack of full reporting. The STROBE guidelines were published to encourage fuller reporting of observational studies and have now been extended using the RECORD statement to better document routinely collected healthcare data. In this paper, elements of the RECORD statement have been used to create guidelines for study design, cohort matching, reporting criteria, and analysis frameworks in regard to analyses of populations involving comparative effectiveness research. It is recommended that researchers present full data analysis with minimal inclusion and exclusion criteria and preplanned subgroups analyses rather than attempt to emulate randomized controlled trials, as patterns of product administration are likely to be vastly different to those using controlled trials; moreover, missing data are very common. Suggestions for creating better matched cohorts, classification of wound‐ and patient‐related variables, and a rationale for reporting at a minimum a particular set of benchmarks to better characterize wound care populations is also presented. Adherence to these guidelines would improve the credibility of studies and make comparisons between studies much easier. Finally, an adaptation of the Cochrane risk of bias tool is presented in connection with the proposed guidelines for systematic reviewers to assess these kinds of retrospective studies.
Healthy Skin Wins: A Glowing Pressure Ulcer Prevention Program That Can Guide Evidence‐Based Practice
Authors: Martin Donna , Albensi Lisa , Van Haute Stephanie , Froese Maria , Montgomery Mary , Lam Mavis , Gierys Kendra , Lajeunesse Rob , Guse Lorna , Basova Nataliya
Published: July 2017

Background

In 2013, an observational survey was conducted among 242 in‐patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence‐based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled “Healthy Skin Wins” with an online tutorial about PU prevention.

Aims

To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP.

Methods

This was a mixed methods study. A repeat observational survey discerned if the PUPP reduced PU prevalence. A pre‐test post‐test design was used to determine whether hospital staff's knowledge of PU prevention was enhanced by the online tutorial. Qualitative interviews were conducted with nurses, allied health professionals, and health care aides to explore staff's perspectives of the PUPP.

Results

A comparison of initial and repeat observational surveys (n = 239) identified a statistically significant reduction in the prevalence of PU to 7.53% (p < .001). The online tutorial enhanced staff knowledge level with a statistically significantly higher mean post‐test score (n = 80). Thirty‐five frontline staff shared their perspectives of the PUPP with “it's definitely a combination of everything” and “there's a disconnect between what's needed and what's available” as the main themes.

Conclusions

Incorporating evidence‐based PU prevention into clinical practice greatly reduced the prevalence of PUs among hospital in‐patients. Due to the small sample size for the pre‐test post‐test component, the effectiveness of the online tutorial in improving the knowledge level of PU prevention among hospital staff requires further research.

Linking Evidence to Action

Evidence‐based PU prevention strategies are facilitated by using a multidisciplinary approach. Educational tools about PU prevention must target all members of the healthcare team including healthcare aides, patients and families.
Toward Improving Quality of End‐of‐Life Care: Encoding Clinical Guidelines and Standing Orders Using the Omaha System
Authors: Slipka Allison F. , Monsen Karen A.
Published: July 2017

Background

End‐of‐life care (EOLC) relieves the suffering of millions of people around the globe each year. A growing body of hospice care research has led to the creation of several evidence‐based clinical guidelines for EOLC. As evidence for the effectiveness of timely EOLC swells, so does the increased need for efficient information exchange between disciplines and across the care continuum.

Aims

The purpose of this study was to investigate the feasibility of using the Omaha System as a framework for encoding interoperable evidence‐based EOL interventions with specified temporality for use across disciplines and settings.

Methods

Four evidence‐based clinical guidelines and one current set of hospice standing orders were encoded using the Omaha System Problem Classification Scheme and Intervention Scheme, as well as Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT). The resulting encoded guideline was entered on a Microsoft Excel spreadsheet and made available for public use on the Omaha System Guidelines website.

Results

The resulting EOLC guideline consisted of 153 interventions that may enable patients and their surrogates, clinicians, and ancillary providers to communicate interventions in a universally comprehensible way.

Linking Evidence to Action

Evidence‐based interventions from diverse disciplines involved in EOLC are described within this guideline using the Omaha System. Because the Omaha System and clinical guidelines are maintained in the public domain, encoding interventions is achievable by anyone with access to the Internet and basic Excel skills. Using the guideline as a documentation template customized for unique patient needs, clinicians can quantify and track patient care across the care continuum to ensure timely evidence‐based interventions.

Conclusions

Clinical guidelines coded in the Omaha System can support the use of multidisciplinary evidence‐based interventions to improve quality of EOLC across settings and professions.
Population structure and attribution of human clinical Campylobacter jejuni isolates from central Europe to livestock and environmental sources
Authors: Kovac J. , Stessl B. , Čadež N. , Gruntar I. , Cimerman M. , Stingl K. , Lušicky M. , Ocepek M. , Wagner M. , Smole Možina S.
Published: July 2017

Campylobacter jejuni is among the most prevalent causes of human bacterial gastroenteritis worldwide. Domesticated animals and, especially, chicken meat are considered to be the main sources of infections. However, the contribution of surface waters and wildlife in C. jejuni transmission to humans is not well understood. We have evaluated the source attribution potential of a six‐gene multiplex PCR (mPCR) method coupled with STRUCTURE analysis on a set of 410 C. jejuni strains isolated from environment, livestock, food and humans in central Europe. Multiplex PCR fingerprints were analysed using Subclade prediction algorithm to classify them into six distinct mPCR clades. A subset of C. jejuni isolates (70%) was characterized by multilocus sequence typing (MLST) demonstrating 74% congruence between mPCR and MLST. The correspondence analysis of mPCR clades and sources of isolation indicated three distinct groups in the studied C. jejuni population—the first one associated with isolates from poultry, the second one with isolates from cattle, and the third one with isolates from the environment. The STRUCTURE analysis attributed 7.2% and 21.7% of human isolates to environmental sources based on MLST and mPCR fingerprints, respectively.
Myths and methodologies: Making sense of exercise mass and water balance
Authors: Cheuvront Samuel N. , Montain Scott J.
Published: July 2017

New Findings

What is the topic of this review?

There is a need to revisit the basic principles of exercise mass and water balance, the use of common equations and the practice of interpreting outcomes.

What advances does it highlight?

We propose use of the following equation as a way of simplifying exercise mass and water balance calculations in conditions where food is not consumed and waste is not excreted: ∆body mass − 0.20 g/kcal−1 = ∆body water. The relative efficacy of exercise drinking behaviours can be judged using the following equation: percentage dehydration = [(∆body mass − 0.20 g kcal−1)/starting body mass] × 100.

Changes in body mass occur because of flux in liquids, solids and gases. This knowledge is crucial for understanding metabolism, health and human water needs. In exercise science, corrections to observed changes in body mass to estimate water balance are inconsistently applied and often misinterpreted, particularly after prolonged exercise. Although acute body mass losses in response to exercise can represent a close surrogate for body water losses, the discordance between mass and water balance equivalence becomes increasingly inaccurate as more and more energy is expended. The purpose of this paper is briefly to clarify the roles that respiratory water loss, gas exchange and metabolic water production play in the correction of body mass changes for fluid balance determinations during prolonged exercise. Computations do not include waters of association with glycogen because any movement of water among body water compartments contributes nothing to water or mass flux from the body. Estimates of sweat loss from changes in body mass should adjust for non‐sweat losses when possible. We propose use of the following equation as a way of simplifying the study of exercise mass and water balance: ∆body mass − 0.20 g kcal−1 = ∆body water. This equation directly controls for the influence of energy expenditure on body mass balance and the approximate offsetting equivalence of respiratory water loss and metabolic water production on body water balance. The relative efficacy of exercise drinking behaviours can be judged using the following equation: percentage dehydration = [(∆body mass − 0.20 g kcal−1)/starting body mass] × 100.
On a Comprehensive Topological Analysis of Moore Spiegel Attractor
Authors: Ray Anirban , RoyChowdhury A.
Published: July 2017

A topological analysis of the attractor associated with the Moore–Spiegel nonlinear system is performed, following the basic idea laid down by Gilmore and Lefranc (2002, The Topology of Chaos, Wiley, Hoboken, NJ). Starting with the usual fixed point analysis and their stability, we proceed to study in detail the process of chaotic orbit extraction with the help of close return map. This is then used to construct the symbolic dynamics associated with it, which is helpful in understanding the sequential change taking place inside the attractor. In the next part, we show how to characterize the evolution of the attractor from its birth to the crisis by finding out the homoclinic orbit and the corresponding unstable manifold. In the concluding part of the paper, we show how all the pertinent information of the attractor can be encoded in the template, leading to the explicit realization of linking numbers and the relative rotation rates. In the concluding section, we have touched upon a new approach to chaotic dynamics, using the flow curvature manifold to display the relative positioning of the attractor in relation to the fixed points and the null lines.
Solid-State Infiltration of 6061-T6 Aluminum Alloy Into Carbon Fibers Via Friction Stir Welding
Authors: Franke Daniel J. , Morrow Justin D. , Zinn Michael R. , Pfefferkorn Frank E.
Published: July 2017

Hybrid welding/joining of lightweight metals to carbon fiber reinforced polymers (CFRPs) typically relies on the adhesive bond created when the molten polymer matrix hardens in contact with the metallic surface. It is hypothesized that these bonds can be improved upon by fully displacing the polymer and infiltrating the carbon fibers with the metallic constituent to create load-bearing fibers that bridge the two materials. Friction stir welding (FSW) holds potential to melt and displace the polymer matrix, plasticize the metal constituent, and force the plasticized metal to flow around the fibers. Preliminary investigations were performed by FSW in AA 6061-T6 plates sandwiched against dry carbon fiber bundles. The FSW process plasticizes the aluminum while applying pressure, forcing the material to flow around the fibers. Cross-sectional images of the samples were used to measure the distance of infiltration of the aluminum into the carbon fiber bed. A fiber infiltration model previously developed to describe the infiltration of carbon fibers with epoxy resins during resin transfer molding was applied to this solid-state infiltration situation, thus modeling the plasticized aluminum as a fluid with an effective viscosity. Promising agreement was seen between the measured distances of infiltration and the predicted distances of infiltration when using effective viscosity values predicted by computational fluid dynamics (CFD) simulations of FSW found in literature. This work indicates that the well-established epoxy infiltration model can form the basis of a model to describe solid-state infiltration of carbon fibers with a plasticized metal.
Tool Path Generation for Turbine Blades Machining With Twin Tool
Authors: Lu Dun , Liu Jun , Zhao Wanhua , Lu Bingheng , Wu Diaodiao , Song Dongdong , Xue Fei , Cheng Bing
Published: July 2017

Blades are essential parts used in thermal and nuclear power generation. Its machining precision is a vital factor that influences the efficiency and life of those industries. Blades are thin-walled parts, which could easily deform under cutting forces, and hence deteriorate the machining precision. In our previous work, a milling process with twin tool for blade is proposed, in which two tools are assigned to machine the basin and dorsal surfaces simultaneously. It is expected that the cutting forces acted on the basin and dorsal surfaces can be counteracted to reduce the deformation of the blade. In this study, a method of twin-tool paths generation is developed. The tool center points and tool axis vectors are generated with consideration of the cutting forces balance, the machine tool kinematics, the surface geometric precision, and the same number of tool paths on basin and dorsal surfaces. Virtual machining, finite element analysis, and trial cutting are carried out and verified that the method which is used for generating the twin-tool paths is successful. The basin and dorsal surfaces have the same number of tool paths and tool contact point coordinates, which guarantees that the two surfaces can be completely machined and can be machined and finished simultaneously. Furthermore, the cutting forces acted on the basin and dorsal surfaces can achieve the balance along the twin-tool paths. Therefore, the deformation of a blade caused by cutting force is obviously reduced compared with a conventional machining process with a single tool.
Energy Consumption of Feed Drive Systems Based on Workpiece Setting Position in Five-Axis Machining Center
Authors: Sato Ryuta , Shirase Keiichi , Hayashi Akio
Published: July 2017

Energy consumption of numerical control (NC) machine tools is one of the key issues in modern industrial field. This study focuses on reducing the energy consumed by a five-axis machining center by changing only the workpiece setting position. Previous studies show that the movements along each axis in five-axis machining centers depend on the workpiece setting position, regardless of whether the same operation is performed. In addition, the energy consumptions required for the movements are different along each axis. From these considerations, an optimum workpiece setting position that can minimize the energy consumed during these motions is assumed to exist. To verify this assumption, in this study, the energy consumed by the feed drive systems of an actual five-axis machining center is first measured and then estimated using the proposed model in this study. The model for estimating the energy consumption comprises the friction, motor, and amplifier losses along each axis. The total energy consumption can be estimated by adding the energy consumptions along each axis. The effect of the workpiece setting position on the energy consumption is investigated by employing the cone-frustum cutting motion with simultaneous five-axis motions. The energy consumption that depends on the workpiece setting position is first measured and then estimated. The results confirm that the proposed model can estimate the energy consumption accurately. Moreover, the energy consumption is confirmed to depend on the workpiece setting position; the minimum energy consumption is found to be 20% lower than the maximum one.
A
Discrete Control Lyapunov Function for Exponential Orbital Stabilization of the Simplest
Walker
Authors: Bhounsule Pranav
A. , Zamani Ali
Published: July 2017

In this paper, we demonstrate the application of a discrete control Lyapunov function (DCLF) for exponential orbital stabilization of the simplest walking model supplemented with an actuator between the legs. The Lyapunov function is defined as the square of the difference between the actual and nominal velocity of the unactuated stance leg at the midstance position (stance leg is normal to the ramp). The foot placement is controlled to ensure an exponential decay in the Lyapunov function. In essence, DCLF does foot placement control to regulate the midstance walking velocity between successive steps. The DCLF is able to enlarge the basin of attraction by an order of magnitude and to increase the average number of steps to failure by 2 orders of magnitude over passive dynamic walking. We compare DCLF with a one-step dead-beat controller (full correction of disturbance in a single step) and find that both controllers have similar robustness. The one-step dead-beat controller provides the fastest convergence to the limit cycle while using least amount of energy per unit step. However, the one-step dead-beat controller is more sensitive to modeling errors. We also compare the DCLF with an eigenvalue-based controller for the same rate of convergence. Both controllers yield identical robustness but the DCLF is more energy-efficient and requires lower maximum torque. Our results suggest that the DCLF controller with moderate rate of convergence provides good compromise between robustness, energy-efficiency, and sensitivity to modeling errors.
Functionally Graded Hollow Sphere With Piezoelectric Internal and External Layers Under Asymmetric Transient Thermomechanical Loads
Authors: Jabbari M. , Mousavi S. M. , Kiani M. A.
Published: July 2017

In this paper, an analytical method is developed to obtain the solution for the two-dimensional (2D) (r,θ) transient thermal and mechanical stresses in a hollow sphere made of functionally graded (FG) material and piezoelectric layers. The FGM properties vary continuously across the thickness, according to the power functions of radial direction. The temperature distribution as a function of radial and circumferential directions and time is obtained solving the energy equation, using the method of separation of variables and Legendre series. The Navier equations are solved analytically using the Legendre polynomials and the system of Euler differential equations.
Characterization of Welding-Induced Residual Stress Using Neutron Diffraction Technique
Authors: Clyde Zondi M. , Venter Andrew , Marais Deon , Bemont Clinton
Published: July 2017

Pressure vessels comprise critical plant equipment within industrial operations. The fact that the vessel operates under pressure, and may carry toxic, dangerous, or hazardous contents, necessitates that care is taken to ensure safety of humans operating it and the environment within which it operates. Residual stress developed during welding of pressure vessel structures can adversely affects fatigue life (mean stress effect) of such structure and lead to corrosion crack growth. The present study applies the neutron diffraction (ND) technique to formulate the stress field distribution of a nozzle-to-shell weld joint of a pressure vessel. A number of experiments are conducted using the submerged arc welding (SAW) process at various parametric combinations to develop a number of specimens with different stress profiles. It is shown that the hoop stresses close to the weld center line (WCL) are highly tensile and have values close to the yield strength of the material. The ideal parametric combination is also determined based on the results with lowest stresses. The results obtained in this study are congruent to the results of similar studies in the literature.
A Postassessment Test of 100,000 h Creep Rupture Strength of Grade 91 Steel at 600 °C
Authors: Maruyama K. , Sekido N. , Yoshimi K.
Published: July 2017

Predictions as to 105 h creep rupture strength of grade 91 steel have been made recently. The predicted values are examined with long-term creep rupture data of the steel. Three creep rupture databases were used in the predictions: data of tube products of grade 91 steel reported in National Institute for Materials Science (NIMS) Creep Data Sheet (NIMS T91 database), data of T91 steel collected in Japan, and data of grade 91 steel collected by an American Society of Mechanical Engineers (ASME) code committee. Short-term creep rupture data points were discarded by the following criteria for minimizing overestimation of the strength: selecting long-term data points with low activation energy (multiregion analysis), selecting data points crept at stresses lower than a half of proof stress (σ0.2/2 criterion), and selecting data points longer than 1000 h (cutoff time of 1000 h). In the case of NIMS T91 database, a time–temperature parameter (TTP) analysis of a dataset selected by multiregion analysis can properly describe the long-term data points and gives the creep rupture strength of 68 MPa at 600 °C. However, TTP analyses of datasets selected by σ0.2/2 criterion and cutoff time of 1000 h from the same database overestimate the data points and predict the strength over 80 MPa. Datasets selected by the same criterion from the three databases provide similar values of the strength. The different criteria for data selection have more substantial effects on predicted values of the strength of the steel than difference of the databases.
High thermal conductivity in electrostatically engineered amorphous polymers
Authors: Shanker Apoorv , Li Chen , Kim Gun-Ho , Gidley David , Pipe Kevin P. , Kim Jinsang
Published: July 2017

High thermal conductivity in amorphous polymer films via ionization-induced chain extension and stiffening, and dense packing.
Computational integration of nanoscale physical biomarkers and cognitive assessments for Alzheimer’s disease diagnosis and prognosis
Authors: Yue Tao , Jia Xinghua , Petrosino Jennifer , Sun Leming , Fan Zhen , Fine Jesse , Davis Rebecca , Galster Scott , Kuret Jeff , Scharre Douglas W. , Zhang Mingjun
Published: July 2017

Protein properties of AD patients can be computationally integrated with behavioral assessments for AD diagnosis and prognosis.
Eye motion triggered self-powered mechnosensational communication system using triboelectric nanogenerator
Authors: Pu Xianjie , Guo Hengyu , Chen Jie , Wang Xue , Xi Yi , Hu Chenguo , Wang Zhong Lin
Published: July 2017

A triboelectric eye blinking sensor with robustly high sensitivity achieves prominence as a human-machine interface.
Mycobacterium abscessus Displays Fitness for Fomite Transmission
Authors: Malcolm Kenneth C. , Caceres Silvia M. , Honda Jennifer R. , Davidson Rebecca M. , Epperson L. Elaine , Strong Michael , Chan Edward D. , Nick Jerry A.
Published: July 2017

Mycobacterium abscessus
is a rapidly growing nontuberculous mycobacterium (NTM) increasingly reported in soft tissue infections and chronic lung diseases, including cystic fibrosis. The environmental source of
M. abscessus
has not been definitively identified, but NTM have been detected in soil and water. To determine the potential of soil-derived
M. abscessus
as an infectious source, we explored the association, growth, and survival of
M. abscessus
with defined mineral particulates, including kaolin, halloysite, and silicone dioxide, and house dust as possible
M. abscessus
fomites.
M. abscessus
physically associated with particulates, and the growth of
M. abscessus
was enhanced in the presence of both kaolin and house dust.
M. abscessus
survived desiccation for 2 weeks but was not viable after 3 weeks. The rate of decline of
M. abscessus
viability during desiccation was reduced in the presence of house dust. The evidence for enhanced growth and survival of
M. abscessus
during alternating growth and drying periods suggests that dissemination could occur when in wet or dry environments. These studies are important to understand environmental survival and acquisition of NTM.

IMPORTANCE
The environmental source of pulmonary
Mycobacterium abscessus
infections is not known. Fomites are nonliving carriers of infectious agents and may contribute to acquisition of
M. abscessus
. This study provides evidence that
M. abscessus
growth is enhanced in the presence of particulates, using kaolin, an abundant natural clay mineral, and house dust as experimental fomites. Moreover,
M. abscessus
survived desiccation for up to 2 weeks in the presence of house dust, kaolin, and several chemically defined mineral particulates; mycobacterial viability during extended periods of dessication was enhanced by the presence of house dust. The growth characteristics of
M. abscessus
with particulates suggest that a fomite mechanism of transmission may contribute to
M. abscessus
acquisition, which may lead to strategies to better control infections by
M. abscessus
and related organisms.
Metagenomic Analysis of Dairy Bacteriophages: Extraction Method and Pilot Study on Whey Samples Derived from Using Undefined and Defined Mesophilic Starter Cultures
Authors: Muhammed Musemma K. , Kot Witold , Neve Horst , Mahony Jennifer , Castro-Mejía Josué L. , Krych Lukasz , Hansen Lars H. , Nielsen Dennis S. , Sørensen Søren J. , Heller Knut J. , van Sinderen Douwe , Vogensen Finn K.
Published: July 2017

Despite being potentially highly useful for characterizing the biodiversity of phages, metagenomic studies are currently not available for dairy bacteriophages, partly due to the lack of a standard procedure for phage extraction. We optimized an extraction method that allows the removal of the bulk protein from whey and milk samples with losses of less than 50% of spiked phages. The protocol was applied to extract phages from whey in order to test the notion that members of
Lactococcus lactis
936 (now
Sk1virus
), P335, c2 (now
C2virus
) and
Leuconostoc
phage groups are the most frequently encountered in the dairy environment. The relative abundance and diversity of phages in eight and four whey mixtures from dairies using undefined mesophilic mixed-strain cultures containing
Lactococcus lactis
subsp.
lactis
biovar diacetylactis and
Leuconostoc
species (i.e., DL starter cultures) and defined cultures, respectively, were assessed. Results obtained from transmission electron microscopy and high-throughput sequence analyses revealed the dominance of
Lc. lactis
936 phages (order
Caudovirales
, family
Siphoviridae
) in dairies using undefined DL starter cultures and
Lc. lactis
c2 phages (order
Caudovirales
, family
Siphoviridae
) in dairies using defined cultures. The 936 and
Leuconostoc
phages demonstrated limited diversity. Possible coinduction of temperate P335 prophages and satellite phages in one of the whey mixtures was also observed.

IMPORTANCE
The method optimized in this study could provide an important basis for understanding the dynamics of the phage community (abundance, development, diversity, evolution, etc.) in dairies with different sizes, locations, and production strategies. It may also enable the discovery of previously unknown phages, which is crucial for the development of rapid molecular biology-based methods for phage burden surveillance systems. The dominance of only a few phage groups in the dairy environment signifies the depth of knowledge gained over the past decades, which served as the basis for designing current phage control strategies. The presence of a correlation between phages and the type of starter cultures being used in dairies might help to improve the selection and/or design of suitable, custom, and cost-efficient phage control strategies.
Fifteen-minute consultation: Monogenic forms of diabetes with onset after age 6 months
Authors: Dyer Emma M , Amin Rakesh
Published: July 2017

Monogenic forms of diabetes (historically known as Maturity Onset Diabetes of the Young (MODY)) are caused by single gene mutations inherited in an autosomal dominant fashion that result in reduced pancreatic beta cell function. Children with these forms of diabetes may be misdiagnosed as having type 1 or 2 diabetes, which has important implications for treatment, genetic counselling, screening of family members and prognosis. Useful tools now exist to aid in their diagnosis and management. Here, we attempt to outline the clinical features that will help the physician make the differentiation from other diabetes subtypes.
Obturator hernia: a rare cause of bowel obstruction
Authors: Rito CÃ¡tia Carreira , Travassos JosÃ© , PatrÃ­cio Joana , Duarte Ana Luisa
Published: July 2017

An obturator hernia is a rare condition and an unusual cause of intestinal obstruction. With a challenging diagnosis, it has one of the highest mortality rates of all abdominal wall hernias. The authors present a case of an elderly woman with bowel obstruction secondary to an incarcerated obturator hernia. An 80-year-old woman presented at the emergency room with complaints for the last 2 days of nausea, vomiting, constipation and lower right abdominal pain that radiated down to the right medial thigh. Abdominal tenderness to deep palpation of the right iliac fossa and mildly distention were noted. A CT scan demonstrated bowel obstruction secondary to an incarcerated obturator hernia. The patient underwent emergency exploratory laparotomy. The incarcerated bowel was reduced and the defect was repaired with a plug of polypropylene mesh covered with peritoneum. The patient had an uneventful postoperative period and was discharged on the fifth postoperative day.
Thrombolytic therapy for the treatment of acute ischaemic stroke in adults with homozygous sickle cell disease
Authors: Majhadi Loubna , Calvet David , Rosso Charlotte , Bartolucci Pablo
Published: July 2017

Stroke is a significant cause of morbidity and mortality in patients with homozygous sickle cell disease (SCD). A specific large-vessel vasculopathy is often responsible for both haemorrhagic and ischaemic strokes in patients with SCD. Although intravenous thrombolysis has been considered as a therapeutic option for acute ischaemic strokes in SCD, its use remains debated because of an increased risk of spontaneous intracranial haemorrhage reported in this disease. This risk of haemorrhage is mainly supported by the presence of a Moyamoya syndrome often associated with the specific vasculopathy in patients with homozygous SCD. We report two cases of patients with homozygous SCD treated with intravenous thrombolysis for an acute ischaemic stroke without haemorrhagic transformation. Our cases suggest that reperfusion strategy in acute ischaemic stroke in patients with homozygous SCD can be considered once associated Moyamoya syndrome has been ruled out. An international registry would be of interest as these situations are rare.
Thalamic and cerebellar hypermetabolism and cortical hypometabolism during absence status epilepticus
Authors: Shimogori Kei , Doden Tadashi , Oguchi Kazuhiro , Hashimoto Takao
Published: July 2017

We report on a 17-year-old girl with absence status epilepticus who developed recurrent motionless confusional state and continuous generalised 3–4 Hz rhythmic delta waves on electroencephalogram (EEG). The patient had no history of absence, myoclonus or generalised convulsion. Her seizure was resistant to a combination of antiepileptic drugs including carbamazepine. Ictal positron emission tomography using [18F]fluorodeoxyglucose ([18F]FDG-PET) revealed hypermetabolism of the bilateral thalamus and cerebellum and hypometabolism of the frontal, parietal and posterior cingulate cortices. We diagnosed her seizure as absence status and obtained remission by changing medication. The findings of ictal metabolic alteration in previous studies and in our case confirm the pathogenic importance of the thalamus in absence status and that associated cortical deactivation and cerebellar activation may be related to the generation or maintenance of epileptic EEG discharges.
A case of deep infection after instrumentation in dorsal spinal surgery: the management with antibiotics and negative wound pressure without removal of fixation
Authors: Dobran Mauro , Mancini Fabrizio , Nasi Davide , Scerrati Massimo
Published: July 2017

Until today the role of spinal instrumentation in the presence of a wound infection has been widely discussed and recently many authors leave the hardware in place with appropriate antibiotic therapy. This is a case of a 65-year-old woman suffering from degenerative scoliosis and osteoporotic multiple vertebral collapses treated with posterior dorsolumbar stabilisation with screws and rods. Four months later, skin necrosis and infection appeared in the cranial wound with exposure of the rods. A surgical procedure of debridement of the infected tissue and package with a myocutaneous trapezius muscle flap was performed. One week after surgery, negative pressure wound therapy was started on the residual skin defect. The wound healed after 2 months. The aim of this case report is to focus on the utility of this method even in the case of hardware exposure and infection. This may help avoid removing instrumentation and creating instability.
Anterior, posterior and biomechanical parameters of cornea during pregnancy in healthy eyes: a cohort study
Authors: Naderan Mohammad , Jahanrad Ali
Published: July 2017

Background

To investigate the effect of pregnancy on anterior, posterior and biomechanical corneal parameters of healthy eyes.

Method

In this prospective cohort study, 70 pregnant participants with clinically healthy eyes underwent corneal topographic imaging evaluation by Pentacam and biomechanical assessment by Ocular Response Analyzer (ORA) before pregnancy, at the third trimester of pregnancy (34th week of pregnancy) and 12 months after delivery. The same number of age-matched non-pregnant females was evaluated at the corresponding appointments as the control group.

Results

Assessment of the tomographic, topographic and ORA measurements before pregnancy, at the third trimester of pregnancy and 12 months post partum revealed no statistically significant changes in anterior and posterior corneal flat, steep and mean keratometry, anterior and posterior elevation measurements, central and thinnest corneal thickness, corneal hysteresis, corneal resistance factor and intraocular pressure measurements (p>0.05, repeated measures analysis of variance (ANOVA)). All of the study parameters returned to their baseline levels 1 year after delivery. The ophthalmic parameters of the non-pregnant group remained significantly unchanged during the study period (p>0.05, all comparisons, repeated measures ANOVA). Moreover, no statistically significant differences were found between pregnant and non-pregnant groups in the second (34th week of pregnancy) and third (post partum) appointments (p>0.05, all comparisons, one-way ANOVA).

Conclusion

Our findings may suggest a physiological nature for ocular changes during pregnancy that these changes return to baseline values after delivery. The differences between tomographic, topographic and biomechanical corneal parameters before pregnancy, during pregnancy and post partum were not statistically or clinically significant.
A comprehensive strength testing protocol offers no clinical value in predicting risk of hamstring injury: a prospective cohort study of 413 professional football players
Authors: van Dyk Nicol , Bahr Roald , Burnett Angus F , Whiteley Rod , Bakken Arnhild , Mosler Andrea , Farooq Abdulaziz , Witvrouw Erik
Published: July 2017

Background

Hamstring injuries remain prevalent across a number of professional sports. In football, the incidence has even increased by 4% per year at the Champions League level over the last decade. The role of muscle strength or strength ratios and their association with risk of hamstring injury remain restricted by small sample sizes and inconclusive results.

Purpose

The purpose of this study is to identify risk factors for hamstring injury in professional football players in an adequately powered, prospective cohort study. Using both established (isokinetic) and novel (eccentric hamstring test device) measures of muscle strength, we aimed to investigate the relationship between these strength characteristics over the entire range of motion with risk of hamstring injury.

Methods

All teams (n=18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included isokinetic strength, Nordic hamstring exercise strength and dynamic hamstring: quadriceps ratios.

Results

Of the 413 players included (68.2% of all league players), 66 suffered a hamstring injury over the two seasons. Only isokinetic quadriceps concentric at 300°/s (adjusted for bodyweight) was associated with risk of hamstring injury when considered categorically. Age, body mass and playing position were also associated with risk of hamstring injury. None of the other 23 strength variables examined were found to be associated with hamstring injury.

Conclusion

The clinical value of isolated strength testing is limited, and its use in musculoskeletal screening to predict future hamstring injury is unfounded.
Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: A prospective study of 11274 athletes from 207 countries
Authors: Soligard Torbjørn , Steffen Kathrin , Palmer Debbie , Alonso Juan Manuel , Bahr Roald , Lopes Alexandre Dias , Dvorak Jiri , Grant Marie-Elaine , Meeuwisse Willem , Mountjoy Margo , Pena Costa Leonardo Oliveira , Salmina Natalia , Budgett Richard , Engebretsen Lars
Published: July 2017

Objective

To describe the pattern of injuries and illnesses sustained during the Games of the XXXI Olympiad, hosted by Rio de Janeiro from 5 to 21 August 2016.

Methods

We recorded the daily incidence of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Rio 2016 medical staff.

Results

In total, 11 274 athletes (5089 women, 45%; 6185 men, 55%) from 207 NOCs participated in the study. NOC and Rio 2016 medical staff reported 1101 injuries and 651 illnesses, equalling 9.8 injuries and 5.4 illnesses per 100 athletes over the 17-day period. Altogether, 8% of the athletes incurred at least one injury and 5% at least one illness. The injury incidence was highest in BMX cycling (38% of the athletes injured), boxing (30%), mountain bike cycling (24%), taekwondo (24%), water polo (19%) and rugby (19%), and lowest in canoe slalom, rowing, shooting, archery, swimming, golf and table tennis (0%–3%). Of the 1101 injuries recorded, 40% and 20% were estimated to lead to ≥1 and >7 days of absence from sport, respectively. Women suffered 40% more illnesses than men. Illness was generally less common than injury, with the highest incidence recorded in diving (12%), open-water marathon (12%), sailing (12%), canoe slalom (11%), equestrian (11%) and synchronised swimming (10%). Illnesses were also less severe; 18% were expected to result in time loss. Of the illnesses, 47% affected the respiratory system and 21% the gastrointestinal system. The anticipated problem of infections in the Rio Olympic Games did not materialise, as the proportion of athletes with infectious diseases mirrored that of recent Olympic Games (3%).

Conclusion

Overall, 8% of the athletes incurred at least one injury during the Olympic Games, and 5% an illness, which is slightly lower than in the Olympic Summer Games of 2008 and 2012.
Gender bias in under-five mortality in low/middle-income countries
Authors: Costa Janaína Calu , da Silva Inacio Crochemore Mohnsam , Victora Cesar Gomes
Published: July 2017

Introduction

Due to biological reasons, boys are more likely to die than girls. The detection of gender bias requires knowing the expected relation between male and female mortality rates at different levels of overall mortality, in the absence of discrimination. Our objective was to compare two approaches aimed at assessing excess female under-five mortality rate (U5MR) in low/middle-income countries.

Methods

We compared the two approaches using data from 60 Demographic and Health Surveys (2005–2014). The prescriptive approach compares observed mortality rates with historical patterns in Western societies where gender discrimination was assumed to be low or absent. The descriptive approach is derived from global estimates of all countries with available data, including those affected by gender bias.

Results

The prescriptive approach showed significant excess female U5MR in 20 countries, compared with only one country according to the descriptive approach. Nevertheless, both models showed similar country rankings. The 13 countries with the highest and the 10 countries with the lowest rankings were the same according to both approaches. Differences in excess female mortality among world regions were significant, but not among country income groups.

Conclusion

Both methods are useful for monitoring time trends, detecting gender-based inequalities and identifying and addressing its causes. The prescriptive approach seems to be more sensitive in the identification of gender bias, but needs to be updated using data from populations with current-day structures of causes of death.