bluuebunny/crossref_metadata_2025 huggingface dataset:
The Clean Plate Club? Food Waste and Individual Responsibility
Authors: Matthes Erich Hatala , Matthes Jacelyn Hatala
Published: January 2018

This chapter offers an overview of both the empirical literature on food waste and philosophical work on the concept of waste. The chapter uses this background to argue that an overemphasis on responsibility for the reduction of individual food waste is misleading at best, and pernicious at worst, in combating the substantial problems that global food waste creates and exacerbates, including increased carbon emissions and hunger. While there would be benefits to widespread changes in individual habits surrounding food waste, they would be modest at best. Rather, civic engagement and political activism aimed at institutional reform that embeds concern with food waste in a broader fight for environmentally friendly policies should be prioritized in addressing these problems.
Food Choices and Moral Character
Authors: Nolfi Kate
Published: January 2018

This chapter argues that morally unreflective and non-deliberative actions and choices manifest an important dimension of people’s moral characters, one that has often been overlooked or underemphasized by philosophers. Many of the choices that people make and the actions that they perform in the course of eating are significantly dissociated from moral reflection and deliberation, and so a careful study thereof promises to help illuminate the connection between moral characters and all that people do in the absence of moral deliberation and reflection. In that spirit, this chapter explores how and why it makes sense to think that the way people eat manifests their moral characters, and then investigates what a person’s morally unreflective and non-deliberative food- and diet-related choices and actions may reveal about whether (and to what extent) the person is praiseworthy or admirable, qua moral agent.
The Etiquette of Eating
Authors: Stohr Karen
Published: January 2018

This chapter explores and defends the idea that the etiquette conventions governing dinner parties, whether formal or informal, have moral significance. Their significance derives from the way that they foster and facilitate shared moral aims. I draw on literary and philosophical sources to make this claim, beginning with Isak Dineson’s short story, “Babette’s Feast.” I employ the concept of ritual from Confucius and Xunzi, as well as Immanuel Kant’s detailed discussion of dinner parties in the Anthropology. Kant’s account, in particular, helps illuminate how properly conducted dinners can enhance our understanding and promote moral community among the people who attend. I conclude that dinner parties play an important role in the moral life, and that the etiquette conventions governing them derive their binding force from their contribution to that role.
Primary Cutaneous Spindle Cell Squamous Carcinoma Expressing Smooth Muscle Actin: Diagnostic Pitfalls
Authors: Ahmad Abdullahi , Chung Hye Jin , Bhawan Jag
Published: January 2018

Alpha smooth muscle actin (SMA) belongs to the actin proteins. It is a known immunohistochemical marker for tumors of mesenchymal origin. There have been reports of expression of SMA in certain epithelial malignancies in the head and neck and genital regions. In this study, the authors report a primary cutaneous spindle cell squamous carcinoma expressing SMA. Both high- and low-molecular-weight keratins and p63 were positive, and S100 protein, SOX10, MART-1/Melan-A, and muscle-specific actin stains were negative. This case highlights that an epithelial tumor could express a mesenchymal marker, thereby making the diagnosis problematic.
Cutaneous Angiosarcoma of the Eyelid Mimicking Morbihan Disease
Authors: Ferguson Donna C. , Mawn Louise A. , Al-Rohil Rami N.
Published: January 2018

Background:

Cutaneous angiosarcoma presents clinically in numerous ways, and can be mistaken for a different clinical entity, particularly when arising at unusual anatomic locations such as the eyelid.

Case Presentation:

A 57-year-old woman presented with a 1-year history of eyelid swelling. Concurrent imaging was also suggestive of an edematous process. Multiple superficial biopsies showed nonspecific dermal inflammation and interstitial edema. A diagnosis of Morbihan disease (chronic and idiopathic lymphedema of the eyelid) was rendered, and the patient was treated with compression and local therapy without clinical improvement. Three years after initial presentation, a diagnostic blepharoplasty was performed revealing a deep dermal vascular proliferation composed of anastomosing vascular channels with an atypical endothelial lining. A diagnosis of cutaneous angiosarcoma was ultimately made.

Conclusions:

This case illustrates a unique presentation of cutaneous angiosarcoma and the implications of different biopsy techniques in acquiring the correct diagnosis.
Single-Stage Breast Reconstruction Using an All-In-One Adjustable Expander/Implant
Authors: Azzi Alain J. , Zammit Dino , Lessard Lucie
Published: January 2018

Background:

When tissue expansion is necessary in breast reconstruction, a single-stage approach is possible using adjustable expander/implants, with or without the use of acellular dermal matrix. We aimed to present the senior author’s single-stage experience over a period of 12 years using combined expander/implants in breast reconstruction.

Methods:

This is a Single-institution, retrospective review of breast reconstruction with combined expander/implants from 2002 to 2014. Logistic regression was performed to evaluate the impact of multiple variables on long-term outcomes.

Results:

A total of 162 implants in 105 patients were included in this study. Mean follow-up time was 81.7 months (SD, ± 39.2; range, 15–151). Complication rates were as follows: 0.62% extrusion, 1.2% mastectomy flap necrosis, 1.2% hematoma, 1.9% dehiscence, 2.5% seroma, 4.9% infection, and 15.4% deflation. The following associations were identified by logistic regression: adjuvant radiotherapy and capsular contracture (P = 0.034), tumor size and deflation (P = 0014), and smoking history and infection (P = 0.013).

Conclusions:

Overall, 81% of breasts were successfully reconstructed in a single stage. Single-stage reconstruction using all-in-one expander/implants reduces costs by eliminating the need for a second procedure under general anesthesia and can achieve results comparable with other alloplastic reconstructions reported in the literature.
Technique for Preparing Ultrathin and Nanothin Descemet Stripping Automated Endothelial Keratoplasty Tissue
Authors: Cheung Albert Y. , Hou Joshua H. , Bedard Peter , Grimes Veronique , Buckman Natalie , Eslani Medi , Holland Edward J.
Published: January 2018

Purpose:

To describe and report outcomes of our single-pass microkeratome technique for preparation of ultrathin (UT, ≤100 μm) and nanothin (NT, ≤50 μm) Descemet stripping automated endothelial keratoplasty (DSAEK) grafts.

Methods:

To prepare NT-DSAEK grafts, a pachymetry nomogram specific to each technician and individual microkeratome head was developed based on accumulated precut and postcut pachymetry data from previous DSAEK grafts. Mean graft thickness as well as precut and postcut endothelial cell counts (ECCs) of NT-DSAEK, UT-DSAEK, and Descemet membrane endothelial keratoplasty (DMEK) grafts between July 2015 and July 2017 were calculated and compared statistically. Endothelial cell loss was evaluated using calcein AM stains and ImageJ analysis. Postcut graft thickness and rates of perforation/tissue loss for NT-DSAEK grafts between May and July 2017 were calculated to determine overall graft preparation success rates.

Results:

Mean postcut graft thickness for all grafts within the NT range was 41.0 ± 6.4 μm (range 26–50 μm). Mean ECC did not differ between NT-DSAEK, UT-DSAEK, and DMEK grafts (P = 0.759 and 0.633, respectively). The overall tissue loss rate from attempted NT-DSAEK was 4.8%. Excluding cases of perforation, the chance of achieving NT thickness was 60% and within the traditional UT range was 100%.

Conclusions:

We propose the term “NT-DSAEK” for grafts ≤50 μm. The described nomogram allows for standardized creation of NT grafts with a low tissue loss rate. This technique is safe and does not result in significant ECC loss compared with UT-DSAEK and DMEK grafts. Further studies are necessary to corroborate the postsurgical results of NT grafts.
Peer review in scholarly publishing part A: why do it?
Authors: Koshy Kiron , Fowler Alexander J. , Gundogan Buket , Agha Riaz A.
Published: January 2018

Peer review is a process whereby scientific experts evaluate a manuscript and provide feedback, offering a recommendation of whether the work is suitable for publication. In this article, we discuss the principles behind peer review and the different forms that it can take. We discuss the importance of peer reviewing, its drawbacks and the reasons an individual may want to become a peer reviewer.
Risk of Hepatitis B Virus Reactivation Among Patients Treated With Ledipasvir-Sofosbuvir for Hepatitis C Virus Infection
Authors: Yanny Beshoy T. , Latt Nyan L. , Saab Sammy , Han Steven , Choi Gina , Kramer Jason , Sahota Amandeep K.
Published: January 2018

Background:

Direct acting antiviral (DAA) agents are the standard of care for treatment of hepatitis C virus (HCV)–infected individuals. Hepatitis B virus (HBV) reactivation during HCV treatment has been reported, the incidence and clinical outcome remains unclear. The aim of our study is to examine the risk of HBV reactivation in actively infected or previously exposed patients during or after HCV treatment with DAAs.

Methods:

Adults with chronic HCV infection previously exposed or actively infected with HBV and treated with DAAs between December 2015 to 2016 were included. Electronic medical records were reviewed for HCV treatment dates, HCV treatment response, DAA used, HBV status, and concurrent HBV treatment. Primary end-point was to determine the risk of HBV reactivation during or up to 3 months after DAA treatment.

Results:

We identified 283 patients, and 100% of patients completed HCV treatment with ledipasvir-sofosbuvir. 93% had HCV genotype-1 of whom 91% achieved sustained viral response at 12 weeks posttreatment (SVR-12). In total, 7% had HCV genotype-4 who achieved SVR-12 of 84%. Mean (±SD) age was 59.7 (±7) years, and 58% were male. A total of 45% of patients had hepatitis B core antibody (HBcAb) positive and hepatitis B surface antigen (HBsAg) negative. In total, 55% of patients had a positive HBsAg before HCV DAA treatment. No HBV reactivation was encountered in the (HBcAb) positive HBsAg-negative cohort nor in the (HBsAg) positive group with 95% confidence interval (0-0.023) and (0-0.019), respectively.

Conclusion:

In our study of patients with HCV and isolated hepatitis B core or HBsAg positivity, no HCV patients treated with DAA experienced HBV reactivation.
Income Disparities in the Prevalence, Severity, and Costs of Co-occurring Chronic and Behavioral Health Conditions
Authors: Cunningham Peter J. , Green Tiffany L. , Braun Robert T.
Published: January 2018

Background:

Behavioral health problems usually co-occur along with physical health problems, resulting in higher health care costs. These co-occurring conditions are likely to be more prevalent and serious among low income patients, affecting both the quality and costs of care.

Objective:

To examine the prevalence, severity, and health care costs of co-occurring chronic and behavioral health conditions among low income people compared with higher income people.

Methods:

Analysis of the 2011–2014 Medical Expenditure Panel Survey. Sample includes 146,000 persons aged 18–64 years. Regression analysis was used to examine how the combination of behavioral health conditions and chronic health conditions is associated with health care expenditures, and how this association differs by family income.

Results:

(1) Comorbid behavioral health problems are more prevalent and serious among low income people with chronic conditions compared with higher income people; (2) among patients with co-occurring chronic and behavioral problems, average annual spending is greater among the low income patients ($9472) compared with high income patients ($7457); (3) higher costs among low income patients with co-occurring conditions reflects their poorer mental and physical health, relative to higher income patients.

Conclusions:

For many low income people, comorbid behavioral problems need to be understood in the social context in which they live. Simply screening low income people for behavioral health problems may not be sufficient unless there is greater understanding of the mechanisms that both cause and exacerbate chronic and behavioral health problems in the low income population.
Reorganizing Care With the Implementation of Electronic Medical Records: A Time-Motion Study in the PICU*
Authors: Roumeliotis Nadia , Parisien Geneviève , Charette Sylvie , Arpin Elizabeth , Brunet Fabrice , Jouvet Philippe
Published: January 2018

Objectives:

To assess caregivers’ patient care time before and after the implementation of a reorganization of care plan with electronic medical records.

Design:

A prospective, observational, time-motion study.

Setting:

A level 3 PICU.

Participants:

Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008–2009) and after (2016) implementation of reorganization of care in 2013.

Interventions:

The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare).

Measurements and Main Results:

Time spent completing various work tasks was recorded by direct observation, and proportion of time in tasks was compared for each study period. A total of 153.7 hours was observed from 22 nurses and 14 orderlies. There was no significant difference in the proportion of nursing patient care time before (68.8% [interquartile range, 48–72%]) and after (55% [interquartile range, 51–57%]) (p = 0.11) the reorganization with electronic medical record. Direct patient care task time for nurses was increased from 27.0% (interquartile range, 30–37%) before to 34.7% (interquartile range, 33–75%) (p = 0.336) after, and indirect patient care tasks decreased from 33.6% (interquartile range, 23–41%) to 18.6% (interquartile range, 16–22%) (p = 0.036). Documentation time significantly increased from 14.5% (interquartile range, 12–22%) to 26.2% (interquartile range, 23–28%) (p = 0.032). Nursing productivity ratio improved from 28.3 to 26.0. A survey revealed that nursing staff was satisfied with the electronic medical record, although there was a concern for the maintenance of oral communication in the unit.

Conclusions:

The reorganization of care with the implementation of an ICU-specific electronic medical record in the PICU did not change total patient care provided but improved nursing productivity, resulting in improved efficiency. Documentation time was significantly increased, and concern over reduced oral communication arose, which should be a focus for future electronic improvement strategies.
Repeat Rapid Response Events in Children: Characteristics and Outcomes
Authors: Meulmester Kristen M. , Jaimon Nancy , Bavare Aarti C.
Published: January 2018

Objective:

We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes.

Design:

A 3-year retrospective study.

Setting:

High-volume tertiary academic pediatric hospital.

Patients:

All rapid response events were reviewed to identify repeat rapid response events.

Intervention:

None.

Measurements and Main Results:

Patient demographics, rapid response triggers, primary clinical diagnoses, illness acuity scores, medical interventions, transfers to ICU, occurrence of critical deterioration, and mortality were reviewed. We reviewed 146 patients with 309 rapid response events (146 initial rapid response and 163 repeat rapid response: 36% < 24 hr, 38% 24 hr to 7 d, and 26% > 7 d after initial rapid response). Median age was 3 years, and 60% were males. Eighty-five percentage of repeat rapid response occurred in medical complexity patients. The triggers for 71% of all repeat rapid response matched with those of initial rapid response. Transfer to ICU occurred in 69 (47%) of initial rapid response and 124 (76%) of repeat rapid response (p < 0.01). The median hospital stay was 11 and 30 days for previously healthy and medical complexity patients, respectively (p = 0.16). ICU readmission at repeat rapid response was associated with longer hospital stay (p < 0.01). Mortality during hospitalization occurred in 14% (all medically complex) of patients after repeat rapid response. Hospital mortality after rapid response is 4.4% per our center’s administrative data and 6.7% according to published multicenter data.

Conclusions:

Prevalence of medical complexity was high in patients with repeat rapid response compared with that reported for pediatric hospitalizations. Triggers between initial and repeat rapid response events correlated. Transfer to ICU was more likely after repeat rapid response and among repeat rapid response, events with ICU readmissions had a longer length of ICU and hospital stay. Mortality for the repeat rapid response cohort was higher than that for overall rapid responses in our center and per published reports from other centers.
Comparison of Laparoscopic and Open Pancreaticoduodenectomy for the Treatment of Nonpancreatic Periampullary Adenocarcinomas
Authors: Meng Ling-Wei , Cai Yun-Qiang , Li Yong-Bin , Cai He , Peng Bing
Published: January 2018

Background:

Laparoscopic pancreaticoduodenectomy (LPD), a surgical option for nonpancreatic periampullary adenocarcinoma (NPPA), is a complex procedure that has become increasing popular. However, there is no consensus as to whether this technique should be performed routinely. Our aim was to evaluate the outcomes of LPD compared with open pancreaticoduodenectomy (OPD).

Materials and Methods:

From October 2010 to September 2015, 58 LPDs were performed to treat NPPA and were compared with 58 OPDs, which can theoretically be carried out by laparoscopic approach. Patients were also matched based on their demographic data and pathologic diagnosis. Demographic information, intraoperative and postoperative data, pathologic data, and follow-up evaluation data were collected at our center.

Results:

All patients had a median follow-up of 34 months (range, 8 to 60 mo). Overall median survival during the study between the groups was not different (P=0.760). No significant differences between the 2 groups were found in terms of patient demographics, short-term complications, pathologic outcomes, or tumor-node-metastasis stage. With regard to operative time, the LPD group was slightly longer than the OPD group (P<0.001). There were significant differences between groups in the time to the first passage of flatus and the time to oral intake (P<0.001). However, no differences were seen in blood loss, length of intensive care unit stay, node positive, or R0 resection between the laparoscopic and open groups.

Conclusions:

This study found that LPD is a feasible, safe, and effective method for the treatment of NPPA compared with OPD and may be a preferred method for surgeons to choose.
Signatures of host specialization and a recent transposable element burst in the dynamic one-speed genome of the fungal barley powdery mildew pathogen
Authors: Frantzeskakis Lamprinos , Kracher Barbara , Kusch Stefan , Yoshikawa-Maekawa Makoto , Bauer Saskia , Pedersen Carsten , Spanu Pietro D , Maekawa Takaki , Schulze-Lefert Paul , Panstruga Ralph
Published: January 2018

Powdery mildews are biotrophic pathogenic fungi infecting a number of economically important plants. The grass powdery mildew,Blumeria graminis,has become a model organism to study host specialization of obligate biotrophic fungal pathogens. We resolved the large-scale genomic architecture ofB. graminis forma specialis hordei (Bgh)to explore the potential influence of its genome organization on the co-evolutionary process with its host plant, barley(Hordeum vulgare).The near-chromosome level assemblies of theBghreference isolate DH14 and one of the most diversified isolates, RACE1, enabled a comparative analysis of these haploid genomes, which are highly enriched with transposable elements (TEs). We found largely retained genome synteny and gene repertoires, yet detected copy number variation (CNV) of secretion signal peptide-containing protein-coding genes (SPs) and locally disrupted synteny blocks. Genes coding for sequence-related SPs are often locally clustered, but neither theSPclusters nor TEs are enriched in specific genomic regions. Extended comparative analysis with different host-specificB. graminis formae specialesrevealed the existence of a core suite ofSPs,but also isolate-specificSPsets as well as congruence ofSPCNV and phylogenetic relationship. We further detected evidence for a recent, lineage-specific expansion of TEs in theBghgenome. The characteristics of theBghgenome (largely retained synteny, CNV ofSPgenes, recently proliferated TEs and a lack of compartmentalization) are consistent with a “one-speed” genome that differs in its architecture and (co-)evolutionary pattern from the “two-speed” genomes reported for several other filamentous phytopathogens.
Identification of an immune gene expression signature associated with favorable clinical features in Treg-enriched patient tumor samples
Authors: Givechian Kevin B. , Wnuk Kamil , Garner Chad , Benz Stephen , Garban Hermes , Rabizadeh Shahrooz , Niazi Kayvan , Soon-Shiong Patrick
Published: January 2018

Immune heterogeneity within the tumor microenvironment undoubtedly adds several layers of complexity to our understanding of drug sensitivity and patient prognosis across various cancer types. Within the tumor microenvironment, immunogenicity is a favorable clinical feature in part driven by the antitumor activity of CD8+ T cells. However, tumors often inhibit this antitumor activity by exploiting the suppressive function of Regulatory T cells (Tregs), thus suppressing the adaptive immune response. Despite the seemingly intuitive immunosuppressive biology of Tregs, prognostic studies have produced contradictory results regarding the relationship between Treg enrichment and survival. We therefore analyzed RNA-seq data of Treg-enriched tumor samples to derive a pan-cancer gene signature able to help reconcile the inconsistent results of Treg studies, by better understanding the variable clinical association of Tregs across alternative tumor contexts. We show that increased expression of a 32-gene signature in Treg-enriched tumor samples (n=135) is able to distinguish a cohort of patients associated with chemosensitivity and overall survival This cohort is also enriched for CD8+ T cell abundance, as well as the antitumor M1 macrophage subtype. With a subsequent validation in a larger TCGA pool of Treg-enriched patients (n = 626), our results reveal a gene signature able to produce unsupervised clusters of Treg-enriched patients, with one cluster of patients uniquely representative of an immunogenic tumor microenvironment. Ultimately, these results support the proposed gene signature as a putative biomarker to identify certain Treg-enriched patients with immunogenic tumors that are more likely to be associated with features of favorable clinical outcome.
Efficient production of erythroid, megakaryoid and myeloid cells, using single cell-derived iPSC colony differentiation
Authors: Hansen Marten , Varga Eszter , Aarts Cathelijn , Wust Tatjana , Kuijpers Taco , von Lindern Marieke , van den Akker Emile
Published: January 2018

Hematopoietic differentiation of human induced pluripotent stem cells (iPSCs) provide opportunities not only for fundamental research and disease modelling/drug testing but also for large-scale production of blood effector cells for future clinical application. Although there are multiple ways to differentiate human iPSCs towards hematopoietic lineages, there is a need to develop reproducible and robust protocols. Here we introduce an efficient way to produce three major blood cell types using a standardized differentiation protocol that starts with a single hematopoietic initiation step. This system is feeder-free, avoids EB-formation, starts with a hematopoietic initiation step based on a novel single cell-derived iPSC colony differentiation and produces multi-potential progenitors within 8-10 days. Followed by lineage-specific growth factor supplementation these cells can be matured into well characterized erythroid, megakaryoid and myeloid cells with high-purity, without transcription factor overexpression or any kind of pre-purification step. This standardized differentiation system provides a simple platform to produce specific blood cells in a reproducible manner for hematopoietic development studies, disease modelling, drug testing and the potential for future therapeutic applications.

Highlights

Efficient hematopoietic differentiation from single cell-derived iPSC colonies

Reproducible feeder-free, monolayer differentiation system independent of iPSC line

Production of erythroid, megakaryoid and myeloid cells with high-purity

Platform for hematopoietic developmental research and future clinical application
RMalign: an RNA structural alignment tool based on a size independent scoring function
Authors: Zheng Jinfang , Xie Juan , Hong Xu , Liu Shiyong
Published: January 2018

RNA-protein 3D complex structure prediction is still challenging. Recently, a template-based approach PRIME is proposed in our team to build RNA-protein complex 3D structure models with a higher success rate than computational docking software. However, scoring function of RNA alignment algorithm SARA in PRIME is size-dependent, which limits its ability to detect templates in some cases. Herein, we developed a novel RNA 3D structural alignment approach RMalign, which is based on a size-independent scoring function RMscore. The parameter in RMscore is then optimized in randomly selected RNA pairs and phase transition points (from dissimilar to similar) are determined in another randomly selected RNA pairs. In tRNA benchmarking, the precision of RMscore is higher than that of SARAscore (0.8771 and 0.7766, respectively) with phase transition points. In balance-FSCOR benchmarking, RMalign performed as good as ESA-RNA with a non-normalized score measuring RNA structure similarity. In balance-x-FSCOR benchmarking, RMalign achieves much better than a state-of-the-art RNA 3D structural alignment approach SARA due to a size-independent scoring function. Taking the advantage of RMalign, we update our RNA-protein modeling approach PRIME to version 2.0. The PRIME2.0 significantly improves about 10% success rate than PRIME.

Author summary

RNA structures are important for RNA functions. With the increasing of RNA structures in PDB, RNA 3D structure alignment approaches have been developed. However, the scoring function which is used for measuring RNA structural similarity is still length dependent. This shortcoming limits its ability to detect RNA structure templates in modeling RNA structure or RNA-protein 3D complex structure. Thus, we developed a length independent scoring function RMscore to enhance the ability to detect RNA structure homologs. The benchmarking data shows that RMscore can distinct the similar and dissimilar RNA structure effectively. RMscore should be a useful scoring function in modeling RNA structures for the biological community. Based on RMscore, we develop an RNA 3D structure alignment RMalign. In both RNA structure and function classification benchmarking, RMalign obtains as good as or even better performance than the state-of-the-art approaches. With a length independent scoring function RMscore, RMalign should be useful for the modeling RNA structures. Based on above results, we update PRIME to PRIME2.0. We provide a more accurate RNA-protein 3D complex structure modeling tool PRIME2.0 which should be useful for the biological community.
HCMV glycoprotein B subunit vaccine efficacy was mediated by non-neutralizing antibody effector functions
Authors: Nelson Cody S. , Huffman Tori , de la Rosa Eduardo Cisneros , Xie Guanhua , Vandergrift Nathan , Pass Robert F. , Pollara Justin , Permar Sallie R.
Published: January 2018

Human cytomegalovirus (HCMV) is the most common congenital infection worldwide, frequently causing hearing loss and brain damage in afflicted infants. A vaccine to prevent maternal acquisition of HCMV during pregnancy is necessary to reduce the incidence of infant disease. The glycoprotein B (gB) + MF59 adjuvant subunit vaccine platform is the most successful HCMV vaccine tested to-date, demonstrating approximately 50% efficacy in preventing HCMV acquisition in phase II trials. However, the mechanism of vaccine protection remains unknown. Plasma from 33 gB/MF59 vaccinees at peak immunogenicity was tested for gB epitope specificity as well as neutralizing and non-neutralizing anti-HCMV effector functions, and compared to an HCMV-seropositive cohort. gB/MF59 vaccination elicited IgG responses with gB-binding magnitude and avidity comparable to natural infection. Additionally, IgG subclass distribution was similar with predominant IgG1 and IgG3 responses induced by gB vaccination and HCMV infection. However, vaccine-elicited antibodies exhibited limited neutralization of the autologous virus, negligible neutralization of multiple heterologous strains, and limited binding responses against gB structural motifs targeted by neutralizing antibodies including AD-1, AD-2, and Domain I. Interestingly, vaccinees had high-magnitude IgG responses against AD-3 linear epitopes, demonstrating immunodominance against this non-neutralizing, cytosolic region. Finally, vaccine-elicited IgG robustly bound trimeric, membrane-associated gB on the surface of transfected or HCMV-infected cells and mediated virion phagocytosis, though were poor mediators of NK cell activation. Altogether, these data suggest that non-neutralizing antibody functions, including virion phagocytosis, likely played a role in the observed 50% vaccine-mediated protection against HCMV acquisition.

Significance

The CDC estimates that every hour, a child is born in the United States with permanent neurologic disability resulting from human cytomegalovirus (HCMV) infection – more than is caused by Down syndrome, fetal alcohol syndrome, and neural tube defects combined. A maternal vaccine to block transmission of HCMV to the developing fetus is a necessary intervention to prevent these adverse outcomes. The gB/MF59 vaccine is the most successful tested clinically to-date, achieving 50% reduction in HCMV acquisition. This manuscript establishes the function and epitope specificity of the humoral response stimulated by this vaccine that may explain the partial vaccine efficacy. Understanding the mechanism of gB/MF59-elicited protective immune responses will guide rational design and evaluation of the next generation of HCMV vaccines.
Crystal structures of tetrakis(pyridine-4-thioamide-κN)bis(thiocyanato-κN)cobalt(II) monohydrate and bis(pyridine-4-thioamide-κN)bis(thiocyanato-κN)zinc(II)
Authors: Neumann Tristan , Jess Inke , Näther Christian
Published: January 2018

Reaction of Co(NCS)2 and Zn(NCS)2 with 4-pyridinethioamide led to the formation of compounds with composition [Co(NCS)2(C6H6N2S)4]·H2O (1) and [Zn(NCS)2(C6H6N2S)2] (2), respectively. The asymmetric unit of compound 1, consists of one cobalt(II) cation, two thiocyanate anions, four 4-pyridinethioamide ligands and one water molecule whereas that of compound 2 comprises one zinc(II) cation that is located on a twofold rotation axis as well as one thiocyanate anion and one 4-pyridinethioamide ligand in general positions. In the structure of compound 1, the cobalt(II) cations are octahedrally coordinated by two terminal N-bonding thiocyanate anions and by the N atoms of four 4-pyridinethioamide ligands, resulting in discrete and slightly distorted octahedral complexes. These complexes are linked into a three-dimensional network via intermolecular N—H...S hydrogen bonding between the amino H atoms and the thiocyanate S atoms. From this arrangement, channels are formed in which the water molecules are embedded and linked to the host structure by intermolecular O—H...S and N—H...O hydrogen bonding. In the structure of compound 2, the zinc(II) cations are tetrahedrally coordinated by two N-bonding thiocyanate anions and the N atoms of two 4-pyridinethioamide ligands into discrete complexes. These complexes are likewise connected into a three-dimensional network by intermolecular N—H...S hydrogen bonding between the amino H atoms and the thioamide S atoms.
3-[6-(4-Methoxyphenyl)-2-methylpyrimidin-4-yl]-2-(4-methylpiperazin-1-yl)quinoline
Authors: Singh Vikram. D. , Anthal Sumati , Desai N. R. , Arunakumar D. B. , Sreenivasa S. , Kamni  , Kant Rajni
Published: January 2018

In the title compound, C26H27N5O, the piperazine ring adopts a chair conformation. The pyrimidine ring makes a dihedral angle of 1.5 (1)° with the methoxyphenyl ring and 33.1 (1)° with the quinoline ring system. In the crystal, molecules are consolidated in the crystal packing by weak C—H...π interactions and π–π stacking interactions.
Bis(4-aminophenylhydroxamato-κ2
O,O′)copper(II) methanol disolvate
Authors: Zhao Yansi , Chen Yanmei
Published: January 2018

In the title complex, [Cu(C7H7N2O2)2]·2CH3OH, the metal centre is coordinated by two 4-aminophenylhydroxamate bidentate ligands, in a distorted square-planar geometry. The asymmetric unit is completed by two methanol solvent molecules, which are involved in hydrogen bonding with N—H functionalities of the free hydroxamate groups. The crystal structure also features N—H...O bonds formed by the NH2 groups, and O—H...O hydrogen bonds with the methanol solvent molecules as donors.
Implementing the sustainable development goals at University level
Authors: Albareda-Tiana Silvia , Vidal-Raméntol Salvador , Fernández-Morilla Mónica
Published: January 2018

Purpose

The purpose of this case study is to explore the principles and practices of sustainable development (SD) in the university curriculum.

Design/methodology/approach

To explore the principles linked with the sustainable development goals (SDGs) and the learning and teaching practices in sustainability at the International University of Catalonia (Universitat Internacional de Catalunya, UIC, in Catalan), an empirical study was carried out by using a mixed methodology for data collection. Indicators related to SDGs found in the University curriculum (quantitative analysis) were measured using Excel, combined with in-depth semi-structured interviews to the deans of different faculties (qualitative study), which were analysed using Atlas.ti.

Findings

Several visions, difficulties and challenges were identified in this mixed-method study around the concept of sustainability, which allowed the authors to describe and portray a specific starting position in relation to the SDGs at the UIC.

Research limitations/implications

The presence of dimensions linked to the SDGs in the University curriculum were analysed by means of a quantitative study. However, global competences related to education for sustainable development were not studied.

Practical implications

Special emphasis was given to the challenges and opportunities for training future graduates and the whole University community in SD.

Originality/value

This paper shows a methodological exploration of the principles related to the SDGs and the learning and teaching practices in sustainability in higher education.
Delivering warmth by hand: customer responses to different formats of written communication
Authors: Ren Xingyao , Xia Lan , Du Jiangang
Published: January 2018

Purpose

The effect of different formats of message delivery has received little theoretical and empirical examination. This research focuses on the effect of written relational communication formats used by service providers. This study aims to answer three questions: Do different formats of written communications (i.e. handwriting and print) influence customer perceptions (i.e. feelings of warmth) of service firms? What are the mediators of these influences (i.e. perceived effort and psychological closeness)? And under what conditions do they occur (i.e. what is the contextual factor)?

Design/methodology/approach

One field study and three laboratory studies were conducted to provide a comprehensive understanding of the role of format in written communication.

Findings

Handwritten messages are more effective than print messages in building relationships in a service context because they elicit stronger feelings of warmth because of both the perception of greater effort and feelings of greater psychological closeness to the service provider. However, the presence of handwriting fails to deliver feelings of warmth when the quality of core services is low.

Practical implications

Service providers can effectively use handwritten communication to signal effort and create psychological closeness for relationship building with their key customers only when the quality of core services meets customer expectations.

Originality/value

First, the research differentiates the formats of written relational communication (handwritten vs print), and links communication formats with feelings of warmth, which is an important factor for impression and relationship formation in the practice of services marketing. Second, based on cognitive-experiential self-theory, this research demonstrates the dual mediators underlying the effect of handwriting (vs print) on warmth: perceived effort and psychological closeness. Third, it identifies the quality of core service as a boundary condition for the effect of handwritten communication.
Cassava flour slurry as a low‐cost alternative to commercially available gel for obstetrical ultrasound: a blinded non‐inferiority trial comparison of image quality
Authors: Aziz A , Dar P , Hughes F , Solorzano C , Muller MM , Salmon C , Salmon M , Benfield N
Published: January 2018

Objective

To evaluate the quality of ultrasound images obtained with cassava flour slurry (CFS) compared with conventional gel in order to determine objectively whether CFS could be a true low‐cost alternative.

Design

Blinded non‐inferiority trial.

Setting

Obstetrical ultrasound unit in an academic medical centre.

Population or Sample

Women with a singleton pregnancy, undergoing anatomy ultrasounds.

Methods

Thirty pregnant women had standard biometry measures obtained with CFS and conventional gel. Images were compared side‐by‐side in random order by two blinded sonologists and rated for image resolution, detail and total image quality using a 10‐cm visual analogue scale. Ratings were compared using paired t‐tests. Participant and sonographer experience was measured using five‐point Likert scales.

Main outcome measures

Image resolution, detail, and total image quality. Participant experience of gel regarding irritation, messiness, and ease of removal.

Results

We found no significant difference between perceived image quality obtained with CFS (mean = 6.2, SD = 1.2) and commercial gel (mean = 6.4, SD = 1.2) [t (28) = −1.1; P = 0.3]. Images were not rated significantly differently for either reviewer in any measure, any standardized image or any view of a specific anatomic structure. All five sonographers rated CFS as easy to obtain clear images and easy for patient and machine cleanup. Only one participant reported itching with CFS.

Conclusions

CFS produces comparable image quality to commercial ultrasound gel. The dissemination of these results and the simple CFS recipe could significantly increase access to ultrasound for screening, monitoring and diagnostic purposes in resource‐limited settings.

Funding

This study was internally funded by our department.

Tweetable abstract

Low‐cost homemade cassava flour slurry creates images equal to commercial ultrasound gel, improving access.
Respiratory complications of anaesthesia
Authors: Mills G. H.
Published: January 2018

Postoperative pulmonary complications are a major determinant of outcome for patients and consume huge resources within hospital, particularly in critical care. Prediction and anticipation of postoperative pulmonary complications are vital for patient selection and, in some cases, for informed patient consent. Being able to assess the likelihood of postoperative pulmonary complications also allows research into methods to reduce them by allowing allocation of patients to the appropriate arms of research trials. Some patients have pre‐operative characteristics or belong to patient groups such as those with chronic obstructive pulmonary disease or obstructive sleep apnoea, where techniques and evidence‐based guidance to avoid or reduce complications are becoming established. Intra‐operative ventilation and the use of lung‐protective ventilation may be helpful during major surgery, but studies looking at reduced tidal volumes, recruitment and levels of positive end‐expiratory pressure, have this far only led to a degree of consensus in terms of tidal volume, although parameters that predispose to postoperative pulmonary complications are becoming clearer. Optimal postoperative care in terms of analgesia, positioning, physiotherapy and mobilisation is another developing area. Techniques such as continuous positive airways pressure, non‐invasive ventilation and high‐flow nasal humidified oxygen appear to show some benefit, but the exact roles, pressures and timings of each are currently being explored. Much remains to be researched and developed into evidence‐based practice.
Peripheral nerve injury arising in anaesthesia practice
Authors: Hewson D. W. , Bedforth N. M. , Hardman J. G.
Published: January 2018

In this article, we will discuss the pathophysiology of peripheral nerve injury in anaesthetic practice, including factors which increase the susceptibility of nerves to damage. We will describe a practical and evidence‐based approach to the management of suspected peripheral nerve injury and will go on to discuss major nerve injury patterns relating to intra‐operative positioning and to peripheral nerve blockade. We will review the evidence surrounding particular strategies to reduce the incidence of peripheral nerve injury during nerve blockade, including nerve localisation methods, timing of blocks, needle techniques and design, injection pressure‐monitoring and local anaesthetic and adjunct choice.
What to do when complications occur
Authors: Cruikshanks A. , Bryden D. C.
Published: January 2018

Adverse events and complications, even if minor, can result in considerable negative effects on patients, including loss of life. They can also have an impact on the healthcare workers involved. Offering an apology to a patient who has suffered a complication is necessary, and is not an admission of fault. In England and Wales, there are also statutory obligations of candour in cases of more severe notifiable events. Local and national systems exist for incident reporting, with a strong emphasis on learning from events and sharing of best practice. Complaints may arise from poor management of a patient's complications, and in situations where there is a clear breach of a professional duty that has resulted in patient harm, negligence may be deemed to have occurred. National Health Service Resolution focuses on learning from events to help reduce the growth in litigation and emphasises that discussions should be timely, include appropriate explanation and information, and provide ongoing support and, if necessary, continuity of care.
Expanding the phenotype of SLC25A42‐associated mitochondrial encephalomyopathy
Authors: Almannai M. , Alasmari A. , Alqasmi A. , Faqeih E. , Al Mutairi F. , Alotaibi M. , Samman M.M. , Eyaid W. , Aljadhai Y.I. , Shamseldin H.E. , Craigen W. , Alkuraya F.S.
Published: January 2018

SLC25A42 gene encodes an inner mitochondrial membrane protein that imports Coenzyme A into the mitochondrial matrix. A mutation in this gene was recently reported in a subject born to consanguineous parents who presented with mitochondrial myopathy with muscle weakness and lactic acidosis. In this report, we present 12 additional individuals with the same founder mutation who presented with variable manifestations ranging from asymptomatic lactic acidosis to a severe phenotype characterized by developmental regression and epilepsy. Our report confirms the link between SLC25A42 and mitochondrial disease in humans, and suggests that pathogenic variants in SLC25A42 should be interpreted with the understanding that the associated phenotype may be highly variable.
EAST GERMAN WRITERS, THE PUBLIC SPHERE, AND THE 1956 WRITERS' CONGRESS
Authors: Brockmann Stephen
Published: January 2018

This article examines the debates surrounding the 1956 Writers' Congress in East Germany as part of a complex and conflicted process of negotiation and contestation between writers, institutions, the East German government, and the Socialist Unity Party (SED) in a year that witnessed, initially, widespread efforts at liberalisation in much of the socialist world (the USSR, Poland, and Hungary, as well as the GDR) and, subsequently, a crackdown on dissent (especially in Hungary and the GDR). The article shows that there was considerable dispute in the run‐up to the congress, as well as during the congress itself and in its aftermath. The goal is to demonstrate that the 1956 Writers' Congress was more contested than is sometimes believed, and that, on a larger scale, East German literary life in the 1950s was less conformist than its critics have sometimes claimed.
GÜNTER WALLRAFF'S BUNDESWEHR DIARIES AND THE MAKING OF A CONTROVERSIAL FIGURE
Authors: Plowman Andrew
Published: January 2018

Günter Wallraff's diaries of his conscription to the Bundeswehr and his belated conscientious objection (1964) were his first publication. He republished them several times in revised form throughout a controversial career extending from industrial reportage in Wir brauchen dich (1966) to his impersonation of a Turkish ‘guest worker’ in Ganz unten (1985). This article examines how successive versions of Wallraff's text engaged with evolving debates about conscription and conscientious objection in the FRG for different readers; and it explores how Wallraff drew upon his diaries as a narrative about the origins of his methods at the same time as he revised them in line with current concerns. A first version in the magazine twen in 1964 provided future conscripts with information about conscription and objection following scandal around the abuse of conscripts. Against the background of 1968, his ‘Protokoll aus der Bundeswehr’ (1970) encouraged serving conscripts to emulate his refusal and constructed Wallraff as a ‘participant observer’ after controversy around his methods. His diaries also supported a shift towards satirical impersonation in his work, and in 1992 Mein Tagebuch aus der Bundeswehr offered a definitive version with a view to the text's literary status and legacy. Wallraff's Bundeswehr diaries are a fascinating historical and literary document of controversies around the Bundeswehr in Germany and central to the process in which he fashioned himself as a critical figure.