bluuebunny/crossref_metadata_2025 huggingface dataset:
Pragmatic Contextualism
Authors: Pynn Geoff
Published: January 2015

Contextualism in epistemology has traditionally been understood as the view that “know” functions semantically like an indexical term, encoding different contents in contexts with different epistemic standards. But the indexical hypothesis about “know” faces a range of objections. This article explores an alternative version of contextualism on which “know” is a semantically stable term, and the truth‐conditional variability in knowledge claims is a matter of pragmatic enrichment. The central idea is that in contexts with stringent epistemic standards, knowledge claims are narrowed: “know” is used in such contexts to make assertions about particularly demanding types of knowledge. The resulting picture captures all of the intuitive data that motivate contextualism while sidestepping the controversial linguistic thesis at its heart. After developing the view, the article shows in detail how it avoids one influential linguistic objection to traditional contextualism concerning indirect speech reports, and then answers an objection concerning the unavailability of certain types of clarification speeches.
Last but not least: new insights into how FtsN triggers constriction during Escherichia coli cell division
Authors: Weiss David S.
Published: January 2015

The arrival of FtsN at the division site triggers synthesis of septal peptidoglycan and constriction of the cell envelope. New findings are changing our view of how this happens. Binding of FtsN's cytoplasmic domain to a protein named FtsA recruits a small amount of FtsN to the division site earlier than previously recognized. The ability of FtsA to interact with FtsN is regulated by the ZipA protein. The FtsN–FtsA interaction pushes FtsA into an ‘on’ conformation that activates the machinery for peptidoglycan synthesis. In addition, a small region of FtsN's periplasmic domain appears to interact with the FtsQLB complex, pushing it into an ‘on’ state that also triggers synthesis of peptidoglycan. Thus, FtsN allosterically activates peptidoglycan synthesis by two pathways, one in the cytoplasm and involving FtsA, and the other in the periplasm and involving FtsQLB.
Status, population trend and genetic structure of South American fur seals, Arctocephalus australis, in southwestern Atlantic waters
Authors: Crespo Enrique A. , Schiavini Adrián C. M. , García Néstor A. , Franco‐Trecu Valentina , Goodall R. Natalie P. , Rodríguez Diego , Stenghel Morgante João , de Oliveira Larissa Rosa
Published: January 2015

The South American fur seal (SAFS), Arctocephalus australis, was severely depleted during the 18th century. This work updates information on distribution, abundance, seasonal movements, and genetic structure along the southwestern South Atlantic. Its distribution in Argentine waters includes nineteen rookeries on the Patagonian coast, Isla de los Estados, and islets of the Beagle Channel. Censuses were carried out in rookeries from Isla Escondida to Isla de los Estados from 1996 to 2014. The largest concentrations are found in Chubut, (4,500–15,500 seals) and Isla de los Estados (4,500). Pups were recorded on Isla Escondida, Rasa, and Isla de los Estados. An increasing number of SAFS were recorded in northern Patagonia, including seals marked in Uruguay. Skin samples were taken from southern Brazil to Tierra del Fuego in order to evaluate population structure and demographic trends. Genetic results indicated no population subdivisions (Φst = −0.0292, Fst = −0.00716, P > 0.05). Bayesian skyline plots constructed for the entire data set indicated evidence of rapid population expansion discernible in Nef between the last 20,000 and 17,000 yr. Genetics results and observation data from marked fur seals support the hypothesis of ancient gene flow and a single Atlantic population. Therefore, SAFS should be managed under international and integrated conservation policies.
Efficacy of surgical transversus abdominis plane block for postoperative pain relief following abdominal surgery in pediatric patients
Authors: Lapmahapaisan Saowaphak , Tantemsapya Niramol , Aroonpruksakul Naiyana , Maisat Wiriya , Suraseranivongse Suwannee
Published: January 2015

Background

Transversus abdominis plane (TAP) block is a promising effective method for postoperative pain control after major abdominal surgery. Using a landmark technique, it is easily performed, but its popularity has decreased because of less efficacy due to inaccurate injection and the potential for intraperitoneal organ damage. Ultrasound‐guided TAP block provides better results and less complications, but it requires experienced operators. Surgically administered TAP (sTAP) block is a simple technique and may cause less complications. This study was aimed to determine the efficacy of sTAP on postoperative pain control in pediatric patients following a major abdominal surgery, compared with local anesthetic infiltration and no block.

Methods

This stratified, randomized controlled trial was conducted in pediatric patients, below the age of 15 years, who underwent non‐laparoscopic major abdominal surgery. Patients were allocated into three groups. The control group received no block; the LA group received 0.25% bupivacaine for local wound infiltration; and the sTAP group received 0.25% bupivacaine for TAP block performed by a surgeon before abdominal wall closure. Parameter records included the incidence of inadequate pain control, time to first analgesic, opioid requirement within 24 h, and complications of these techniques.

Results

Fifty‐four patients were recruited. There was no significant difference in the incidence of inadequate pain control (P = 0.589). The median time to first analgesic was 380 min in the sTAP group compared with 370 and 420 min in the LA and control groups, respectively (95%CI = 193–567, 121–619, and 0–1012; P = 0.632). The median dose of total opioid requirement (calculated as fentanyl‐equivalent dose) was 1.95, 2.05, and 2.04 μg·kg−1·24 h−1 in the sTAP, LA, and control groups, respectively (IQR = 0.65, 2.20; 0.59, 3.32; 0.38, 2.60; P = 0.723). No complications of sTAP block were detected.

Conclusions

There was no significant advantage of the sTAP block over local infiltration or no intervention for postoperative pain control in pediatric patients undergoing non‐laparoscopic major abdominal surgeries.
Low Pain Catastrophization and Disability Predict Successful Outcome to Radiofrequency Neurotomy in Individuals with Chronic Whiplash
Authors: Smith Ashley D. , Jull Gwendolen A. , Schneider Geoffrey M. , Frizzell Bevan , Hooper Robert A. , Sterling Michele M.
Published: January 2015

Objectives

Physical and psychological symptoms of individuals with chronic whiplash‐associated disorders (WAD) are modulated by successful treatment with cervical radiofrequency neurotomy (cRFN). However, not all individuals respond to cRFN, and it is unknown which clinical features predict successful response to cRFN.

Methods

This prospective cohort study investigated 53 individuals with chronic WAD (36 female, 17 male; mean age = 44.7 ± 10.9 (SD) years) who underwent cRFN. Predictor variables measured at baseline (prior to RFN) included self‐reported pain (VAS), disability (NDI), post‐traumatic stress symptoms (PDS), pain catastrophizing (PCS), and measures of sensory hypersensitivity (pressure and cold pain thresholds). The outcome measure was perceived Global Rating of Change (where scores ≥ 4 were classified as a successful response) 3 months post‐cRFN.

Results

Univariate logistic regression demonstrated that lower levels of disability and pain catastrophizing were associated with successful response of cRFN (both P < 0.05). Multivariable logistic regression demonstrated that low levels of pain catastrophizing and disability remained significant predictors of a successful response to cRFN (both P < 0.05).

Conclusions

Low levels of pain catastrophizing and disability independently predicted a successful response to cRFN in patients with chronic WAD.
An exploration of what service users value about early intervention in psychosis services
Authors: Barr Karen , Ormrod John , Dudley Robert
Published: January 2015

Objective

Given the potential severity of developing chronic mental health problems, particular attention has been paid to the first emergence of psychosis. Earlier detection is expected to lead to quicker access to the effective treatment that is necessary during the ‘critical period’ and is one of the main incentives for setting up early intervention in psychosis (EIP) services. EIP services have demonstrated good clinical outcomes since inception, but little is understood yet as to which specific element of EIP leads to these good outcomes. The aim of this research was to conduct an exploratory investigation of the elements that people experiencing a first episode of psychosis find most valuable about EIP treatment.

Design

The study employed a single group design and utilized Q‐methodology.

Method

20 people with first‐episode psychosis aged between 18 and 35 were recruited and asked what they valued most about EIP.

Results

Four separate factors were identified, which were interpreted and named as ‘therapeutic relationship’, ‘medical care’, ‘psychological interventions’, and ‘support, coping and recovery’. Three of the factors were consistent with a biopsychosocial approach of EIP that is recommended by expert professionals working in EIP services and Government guidance on service delivery.

Conclusions

The factor that accounted for the most variance is ‘therapeutic relationship’, highlighting the importance of non‐specific factors in mental health care and recovery from a first episode of psychosis.

Practitioner points

Service users reported that four main components of Early Intervention in Psychosis Services were helpful to them. These included a strong and effective therapeutic relationship, as well as medication, psychological therapies, and practical help and support.

Services are valued both for the quality of the therapeutic relationship but also for their ability to deliver meaningful and valued treatments in this context.
Clients’ experiences of formulation in cognitive behaviour therapy
Authors: Redhead Susannah , Johnstone Lucy , Nightingale Jim
Published: January 2015

Objectives

To explore clients’ experiences of formulation in cognitive behaviour therapy for depression and/or anxiety, as reported after the end of therapy.

Design

A qualitative study using inductive thematic analysis.

Method

Ten clients who had completed a course of cognitive behaviour therapy for depression and/or anxiety participated in semi‐structured interviews within a month of finishing therapy.

Results

Four overarching themes were identified: Formulation helps me to understand my problems; formulation leads to feeling understood and accepted; formulation leads to an emotional shift and formulation enables me to move forward.

Conclusions

Formulation is a powerful therapeutic tool that can be highly beneficial to clients, leading to an increased understanding of their difficulties, feeling understood and accepted and a sense of relief. The process of formulation can also result in distress, however, when associated with an increased awareness of the nature of one's difficulties, the implications of the formulation for one's sense of identity and being presented with a formulation that is perceived to be inaccurate. In some cases, this distress decreased during therapy, while for others, distress lasted beyond the end of therapy. Formulation enabled many participants to move forwards from their difficulties, leading them to feel empowered, helping them to cope, enabling them to talk more openly, in contrast to previous therapy which had not focused on formulation. Clinical implications indicate that formulation should be undertaken in a sensitive and collaborative way to maximize its benefits and minimize any possible negative effects.

Practitioner points

Formulation can be highly beneficial for clients enabling them to move forwards from their difficulties.

It is important to be mindful of clients’ possible adverse reactions to the formulation, so that these can be resolved during therapy.

Formulation should be undertaken attentively sensitively and collaboratively to maximize its benefits and minimize negative effects.
Engineering soya bean seeds as a scalable platform to produce cyanovirin‐N, a non‐ARV microbicide against HIV
Authors: O'Keefe Barry R. , Murad André M. , Vianna Giovanni R. , Ramessar Koreen , Saucedo Carrie J. , Wilson Jennifer , Buckheit Karen W. , da Cunha Nicolau B. , Araújo Ana Claudia G. , Lacorte Cristiano C. , Madeira Luisa , McMahon James B. , Rech Elibio L.
Published: January 2015

There is an urgent need to provide effective anti‐HIV microbicides to resource‐poor areas worldwide. Some of the most promising microbicide candidates are biotherapeutics targeting viral entry. To provide biotherapeutics to poorer areas, it is vital to reduce the cost. Here, we report the production of biologically active recombinant cyanovirin‐N (rCV‐N), an antiviral protein, in genetically engineered soya bean seeds. Pure, biologically active rCV‐N was isolated with a yield of 350 μg/g of dry seed weight. The observed amino acid sequence of rCV‐N matched the expected sequence of native CV‐N, as did the mass of rCV‐N (11 009 Da). Purified rCV‐N from soya is active in anti‐HIV assays with an EC50 of 0.82–2.7 nM (compared to 0.45–1.8 nM for E. coli‐produced CV‐N). Standard industrial processing of soya bean seeds to harvest soya bean oil does not diminish the antiviral activity of recovered rCV‐N, allowing the use of industrial soya bean processing to generate both soya bean oil and a recombinant protein for anti‐HIV microbicide development.
Chromodomain, Helicase and DNA‐binding CHD1 protein, CHR5, are involved in establishing active chromatin state of seed maturation genes
Authors: Shen Yuan , Devic Martine , Lepiniec Loïc , Zhou Dao‐Xiu
Published: January 2015

Chromatin modification and remodelling are the basis for epigenetic regulation of gene expression. LEAFY COTYLEDON 1 (LEC1), LEAFY COTYLEDON 2 (LEC2), ABSCISIC ACID‐INSENSITIVE 3 (ABI3) and FUSCA3 (FUS3) are key regulators of embryo development and are repressed after seed maturation. The chromatin remodelling CHD3 protein PICKLE (PKL) is involved in the epigenetic silencing of the genes. However, the chromatin mechanism that establishes the active state of these genes during early embryo development is not clear. We show that the Arabidopsis CHD1‐related gene, CHR5, is activated during embryo development. Mutation of the gene reduced expression of LEC1, ABI3 and FUS3 in developing embryo and accumulation of seed storage proteins. Analysis of double mutants revealed an antagonistic function between CHR5 and PKL in embryo gene expression and seed storage protein accumulation, which likely acted on the promoter region of the genes. CHR5 was shown to be associated with the promoters of ABI3 and FUS3 and to be required to reduce nucleosome occupancy near the transcriptional start site. The results suggest that CHR5 is involved in establishing the active state of embryo regulatory genes by reducing nucleosomal barrier, which may be exploited to enhance seed protein production.
Epstein–Barr virus‐associated smooth muscle tumors in children following solid organ transplantation: A review
Authors: Jossen Jacqueline , Chu Jaime , Hotchkiss Hilary , Wistinghausen Birte , Iyer Kishore , Magid Margret , Kamath Amita , Roayaie Sasan , Arnon Ronen
Published: January 2015

EBV‐SMT are a rare entity following organ transplantation. Given the rarity of the tumor, there is no standard approach to diagnosis and treatment. A literature search identified 28 reported cases of EBV‐SMT in addition to our own experience with one case. The aim of this review is to summarize the existing data regarding pathogenesis, diagnosis, and treatment.
Creating a Bridge of Understanding between Two Worlds: Community‐Based Collaborative‐Action Research with Sudanese Refugee Women
Authors: Baird Martha B. , Domian Elaine Williams , Mulcahy Ellyn R. , Mabior Rebecca , Jemutai‐Tanui Gladys , Filippi Melissa K.
Published: January 2015

Objective

To explore the process of partnership between university researchers, students, and South Sudanese refugee women to address the health challenges associated with their resettlement transition to the United States.

Design and Sample

This qualitative study used a community‐based collaborative action research (CBCAR) framework in the design, collection, and analysis of the qualitative data. Twenty refugee women participated in this study.

Intervention

Five health education seminars followed by an audio‐recorded focus group were held over 9 months. A final focus group was held to confirm derived themes and develop an action plan.

Results

The partnership between the refugee women and researchers resulted in awareness of how power structures and differing expectations affected the process. The dialog in the focus groups provided an opportunity for refugee women to voice challenges to their health in resettlement. A pattern was recognized about how political and sociocultural events affected the process of CBCAR. Dialog and sharing differing worldviews and perspectives led to insights about ways to improve the health of the South Sudanese refugee community.

Conclusions

CBCAR is a useful framework to address health concerns of a refugee community. Insights from this study provided a foundation for a future intervention research project with the refugee women.
Persistence of Toxoplasma gondii in the central nervous system: a fine‐tuned balance between the parasite, the brain and the immune system
Authors: Blanchard N. , Dunay I. R. , Schlüter D.
Published: January 2015

Upon infection of humans and animals with Toxoplasma gondii, the parasites persist as intraneuronal cysts that are controlled, but not eliminated by the immune system. In particular, intracerebral T cells are crucial in the control of T. gondii infection and are supported by essential functions from other leukocyte populations. Additionally, brain‐resident cells including astrocytes, microglia and neurons contribute to the intracerebral immune response by the production of cytokines, chemokines and expression of immunoregulatory cell surface molecules, such as major histocompatibility (MHC) antigens. However, the in vivo behaviour of these individual cell populations, specifically their interaction during cerebral toxoplasmosis, remains to be elucidated. We discuss here what is known about the function of T cells, recruited myeloid cells and brain‐resident cells, with particular emphasis on the potential cross‐regulation of these cell populations, in governing cerebral toxoplasmosis.
Biological and molecular variation amongst Australian Turnip mosaic virus isolates
Authors: Nyalugwe E. P. , Jones R. A. C. , Barbetti M. J. , Kehoe M. A.
Published: January 2015

Turnip mosaic virus (TuMV) causes crop losses worldwide. Eight Australian TuMV isolates originally obtained from five different species in two plant families were inoculated to 14 plant species belonging to four families to compare their host reactions. They differed considerably in virulence in Brassicaceae crop species and virus indicator hosts belonging to three other families. The isolates infected most Brassica species inoculated, but not Raphanus sativus, usually causing systemic mosaic symptoms, so they resembled TuMV biological host type [B]. Whole genome sequences of seven of the Australian isolates were obtained and had lengths of 9834 nucleotides (nt). When they were compared with 37 non‐recombinant TuMV genomes from other continents and another whole genome from Australia, six of them formed an Australian group within the overall world‐B phylogenetic grouping, while the remaining new genome sequence and the additional whole genome from Australia were part of the basal‐B grouping. When the seven new Australian genomes and the additional whole genome from Australia were subjected to recombination analysis, six different recombination events were found. Six genomes contained one or two recombination events each, but one was non‐recombinant. The non‐recombinant isolate was in the Australian grouping within the overall world‐B group while the remaining recombinant isolates were in the basal‐B and world‐B phylogenetic groups.
Rethinking the ‘mirroring’ hypothesis: implications for technological modularity, tacit coordination, and radical innovation
Authors: Hao Bin , Feng Yanan , Frigant Vincent
Published: January 2015

Studies of the ‘mirroring’ hypothesis have demonstrated the relationships between technological modularity and explicit coordination, yet little is known about the ‘mirroring’ relationship between technological modularity and tacit coordination, and how the ‘mirroring’ relationship may affect radical innovation. This paper contributes to the ‘mirroring’ hypothesis by identifying the interaction mechanisms embedded in and surrounded over the mirroring relationships. Using survey data of 121 high‐tech firms inChina, our study indicates that technological modularity enhances interfirm tacit coordination between module‐makers (‘mirroring’ hypothesis), and will also positively influence radical innovation (‘outcome’ hypothesis). Moreover, tacit coordination negatively moderates the impact of technological modularity on radical innovation (‘interaction’ hypothesis), indicating that the ‘mirroring’ relationship may offset the benefit obtained from modularization. It also suggests that, in a high‐technology industry in underdeveloped areas, tacit coordination could lead to exposure of hidden knowledge, thus lowering module‐makers' motivation for technology breakthrough.
Good news from Latin America and the Caribbean: national and international restoration networks are moving ahead
Authors: Echeverría Cristian , Smith‐Ramírez Cecilia , Aronson James , Barrera‐Cataño José I.
Published: January 2015

Degradation of ecosystems is ongoing in Latin America but there is also a strong upswing in conservation and restoration efforts. SIACRE – the Ibero‐American and Caribbean Society for Ecological Restoration – is playing a key role in coordinating and promoting this trend at international, national, and subnational levels. In October 2014, SIACRE members organized the first national seminar on ecological restoration in Chile, with participants representing both academic and non‐academic sectors. This seminar served as the catalyst for this essay and was an historic event at the national level. Much work has been underway in the science and practice of restoration in Chile, but until now it has been fragmented. This first national seminar enabled helped the principal strengths and challenges that Chile has and must face in the transdisciplinary domain of ecological restoration. Since 2004, various meetings have been organized in the region, in order to communicate the importance of restoration, especially in Mexico, Cuba, Colombia, Brazil, and more recently in Chile and Argentina. Here we trace the history of national and subnational restoration networks in Latin America and the Caribbean, and of SIACRE, and then outline some goals and challenges for the coming years.
Cohort study of a simple ‘Step‐Up’ regimen with the Asthma Control Test
Authors: Holt Shaun , Patel Mitesh , Montgomery Barney , Weatherall Mark , Beasley Richard
Published: January 2015

This prospective cohort study investigates whether simple guideline‐based asthma management using a ‘Step‐Up’ regimen with the Asthma Control Test score improves asthma control in patients with inadequately controlled asthma in primary care. Seventy out of ninety‐three (75%) participants achieved a score of >19 (good control), and the mean increase in Asthma Control Test score was 6.0 (95% confidence interval: 5.3–6.8), P < 0.001. The improvement was independent of baseline inhaled corticosteroid use.
“[L]abels of Themselves Condition Our Perceptions”: The DSM and the Diagnostic Sign of Schizophrenia
Authors: Flexer Michael J.
Published: January 2015

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has been partitioning mental illnesses into discrete disease entities for over 60 years. The diagnostic class of schizophrenia has undergone several different labels and some profound changes to its criteria over all these iterations. In trying to develop the least‐imperfect pragmatic description, the DSM has had to make several assumptions about the disease, and over the various iterations several critics – from within and without psychiatry – have increasingly felt that the APA have accepted their own assumptions as truth, creating a self‐justifying and self‐perpetuating ideology of schizophrenia. The latest edition, DSM‐5, has incorporated some of this criticism, but it is unclear whether the dominant ideology of the diagnostic labels will be over‐turned or will simply incorporate this challenge to its authority into its own “continuity myth” of ever‐improving diagnostic criteria.
Police Crime: The Criminal Behavior of Sworn Law Enforcement Officers
Authors: Stinson Philip Matthew
Published: January 2015

This essay examines the criminological conceptualizations and research on police crime, that is, the criminal behavior of sworn law enforcement officers. It starts with an overview of the conceptualization of police crime as it relates to organizational and scholarly perspectives of social deviance. Police deviance is often conceptualized to include various misconduct, corruption, and/or crime committed by police organizations and police officers. This essay focuses on police crime resulting in the arrest of a sworn law enforcement officer and is organized within a conceptual framework that incorporates five types of police crime: sex‐related police crime, alcohol‐related police crime, drug‐related police crime, violence‐related police crime, and profit‐motivated police crime.
Race, Gender, Hollywood: Representation in Cultural Production and Digital Media's Potential for Change
Authors: Erigha Maryann
Published: January 2015

Since its inception, the Hollywood industry has played an instrumental role in the mass dissemination of popular culture, both within the United States and globally. Yet, White men have almost exclusively created the narratives and myths that comprise Hollywood cultural production, while narratives by women and racial/ethnic minorities are fewer and less prominent. This article gives an overview of current research on racial and gender inequality in representation in the production of Hollywood film and television in the United States, with a focus on the contemporary era. Research on Hollywood cultural production points to a problematic trend of disadvantages in opportunities and outcomes facing women and racial/ethnic minorities, leading to the prevalence of stereotypes and a lack of diversity on‐screen. However, transformations in technology that alter the production and dissemination of media present the possibility of decreasing inequality for women and racial/ethnic minorities.
Risk factors for invasive mold diseases in allogeneic hematopoietic cell transplant recipients
Authors: Atalla A. , Garnica M. , Maiolino A. , Nucci M.
Published: January 2015

Background

The epidemiology of and risk factors for invasive mold disease (IMD) among allogeneic hematopoietic cell transplant (HCT) recipients may vary according to the region. In this study, we sought to evaluate risk factors for IMD in our patient population.

Methods

Between May 2007 and July 2009, all HCT recipients from 8 Brazilian centers were followed prospectively until 1 year post transplant. Cases of IMD were classified as early (before day +40) or late (after day +40). Patients with IMD (cases) were compared with controls (patients without IMD) using univariate and multivariate Cox regression analysis.

Results

Among 345 HCT recipients, 28 IMDs were diagnosed. Risk factors for early IMD were acute myeloid leukemia (hazard ratio [HR] 2.95, 95% confidence interval [95% CI] 1.13–7.68, P = 0.03) and transplant with a human leukocyte antigen‐mismatched donor (HR 3.38, 95% CI 1.18–9.68, P = 0.02), and for late IMD risk factors were lymphoma (HR 8.49, 95% CI 2.35–30.68, P = 0.001), cytomegalovirus reactivation (HR 5.51, 95% CI 1.15–26.47, P = 0.03), and neutropenia (HR 3.49, 95% CI 1.01–12.13, P = 0.049).

Conclusion

The variables identified in this study may help to define risk groups, and to tailor special preventive measures to patients at higher risk to develop IMD.
Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility
Authors: McNeil J.C. , Munoz F.M. , Hultén K.G. , Mason E.O. , Kaplan S.L.
Published: January 2015

Background

Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.

Design

An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.

Results

Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin‐and‐soft‐tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post‐transplant period (<1 month), all of which were bacteremia (P = 0.007) and all caused by methicillin‐susceptible S. aureus (MSSA). The majority of infections (90.2%) occurred in the late post‐transplant period (>6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.

Conclusions

S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post‐transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection.
Disseminated adenovirus disease in heart transplant recipient presenting with conjunctivitis
Authors: Bruminhent J. , Athas D.M. , Hess B.D. , Flomenberg P.
Published: January 2015

We report a 65‐year‐old heart transplant recipient who presented with conjunctivitis, likely acquired from a family member who worked at a daycare center during an outbreak of conjunctivitis. He developed a severe adenoviral pneumonitis, which was successfully treated with intravenous cidofovir combined with a reduction of immunosuppression.
How do I implement a more restrictive transfusion trigger of hemoglobin level of 7 g/dL at my hospital?
Authors: Boral Leonard I. , Bernard Andrew , Hjorth Todd , Davenport Daniel , Zhang Daoping , MacIvor Duncan C.
Published: January 2015

Background

The red blood cell (RBC) transfusion trigger is a major driver of transfusion practice and affects health care costs and in some instances patient outcomes. Reducing the transfusion threshold will decrease RBC utilization and hospital costs.

Study Design and Methods

The hospital transfusion committee, endorsed by the medical staff executive committee, developed an educational program for physicians, nurses, and blood bank staff focusing on the scientific basis for a transfusion trigger of hemoglobin (Hb) of 7 g/dL rather than 8 g/dL as well as a program to discourage the routine 2‐unit RBC transfusion. RBC transfusion practice review was performed and those physicians transfusing outside of the new variables were questioned as to the necessity for the transfusion.

Results

A total of 4492 RBC units were saved and 662 patients were not transfused over the three fiscal years (FYs), 2010, 2011, and 2012, compared to 2009 baseline. Direct cost savings over 3 years with a transfusion trigger of Hb of 7 g/dL was $943,320. If activity‐based costing is used, the savings may have reached as high as $5,314,036. The number of single‐unit RBC transfusions increased steadily over the course of the study while the number of 2‐unit transfusions remained relatively stable over the three FYs 2010 to 2012.

Conclusion

A Hb level of 7 g/dL is the transfusion threshold which is being adopted by many hospitals. Institutional culture change to a Hb level of 7 g/dL can be implemented with the right champion when endorsed by upper echelon medical leadership and hospital administration.
Firm Heterogeneity, Endogenous Quality, and Traded Goods Prices
Authors: Bekkers Eddy
Published: January 2015

A model with endogenous quality and firm heterogeneity is developed. Firms can invest in quality, and quality investment is relatively skill intensive. The model is used to account for two findings in the empirical literature on traded goods prices, lacking a formal explanation in the theoretical literature thus far. First, the model provides a theoretical explanation for Schott's (Quarterly Journal of Economics 2004, 119, 647) empirical finding that relatively skill‐abundant countries export higher priced goods. Firms in these countries invest more in quality and therefore sell higher quality, higher priced goods. Second, the opposite effects of importer market size on traded goods prices at the firm level (positive) and at the aggregate level (negative) identified in the empirical literature can be explained with the model. In a larger market, the incentive to invest in quality is larger for each firm, leading to higher firm‐level prices. Due to a selection effect, also less productive firms selling goods of lower quality can export to larger markets, implying lower aggregate prices.
The Product Space Revisited: China's Trade Profile
Authors: Ferrarini Benno , Scaramozzino Pasquale
Published: January 2015

The concept of product space has encountered broad interest within the development community, as an analytical tool against which to assess countries’ potential to diversify their production and export structures. It has received far less attention in the economics literature, and its assumptions and building blocks have not been put under scrutiny. This paper assesses whether exclusive reliance on export data in product space analysis may limit its value as a tool assessing country capabilities. Reliance on net trade flows—to account for horizontal intra‐industry trade—and on unit values—to capture within‐product differentiation—changes the features of the product space. Based on a highly detailed data set of both trade value and volume and spanning over 144 countries, the amended product space put forth in this paper shows that China has indeed expanded its trade profile to now occupy also product areas that are typically associated with higher‐income countries. However, China's remarkable success in expanding horizontally within the product space is strongly qualified by the introduction of the vertical dimension, which shows the country to be occupying mostly the low‐unit value segment of product categories, more akin to the typical trade profile of a developing country.
Firm Heterogeneity and FDI in Distribution Services
Authors: Tanaka Kiyoyasu
Published: January 2015

Distribution services play a large role in intermediating production and consumption across borders. Using firm‐level data on Japanese multinationals in wholesale and retail sectors, this study examines FDI decisions of distribution firms for local distribution services at the extensive and intensive margin. Consistent with the model of heterogeneous firms on multinational production, I find that more productive multinationals are more likely than less productive multinationals to enter a larger number of markets, to penetrate less attractive markets and to generate larger sales per each market. While these findings are consistent with previous evidence on manufacturing multinationals, I find some distinctive determinants of FDI in distribution services.
Preoperative findings and visual outcome associated with retinal reattachment surgery in dogs: 217 cases (275 eyes)
Authors: Spatola Ronald A. , Nadelstein Brad , Leber Andrea C. , Berdoulay Andrew
Published: January 2015

Objective

Report the correlation of pre‐operative findings with visual outcome in dogs undergoing retinal reattachment surgery for giant retinal tears.

Procedures

Retrospective analysis of dogs that underwent pars plana vitrectomy (PPV) with silicone oil (SiO) tamponade and endolaser retinopexy at one institution. Recorded parameters included signalment, etiology, and duration of retinal detachment, observable retinal tissue architecture, visual reflexes, lens status, presurgical aqueous flare, visual status postoperatively, and complications.

Results

Two hundred and seventeen patients (275 eyes) were included. Common etiologies of detachment were primary vitreoretinal disease (50.5%), lens surgery (35.3%), and hypermature cataracts (6.2%). Immediate postoperative anatomic success was noted in 98% of operated eyes. Maintenance or return of vision was noted in 74.2% of patients (72% of eyes) through the last known follow‐up, with return of vision on average 18.5 days postoperatively. In those eyes that regained vision, 71.7% had retained vision at the last known recheck examination, with an average follow‐up time of 550 days. Pre‐operative findings correlated with postoperative vision included presence of a dazzle reflex, presence of a menace response, and retinal tissue architecture. The most common complications included migration of SiO into the anterior chamber (49.4%), corneal ulceration (25.7%), glaucoma (25.7%), and cataract formation (24.5%).

Conclusion

Giant retinal tears in dogs can be successfully managed viaPPVwith SiO tamponade and endolaser retinopexy. Vision was maintained in the majority of cases with long‐term follow‐up. Patient history and thorough ophthalmic examination with attention to retinal tissue architecture are important in assessing surgical candidacy.
Normalizing dysfunctional purine metabolism accelerates diabetic wound healing
Authors: Weinstein Andrew L. , Lalezarzadeh Frank D. , Soares Marc A. , Saadeh Pierre B. , Ceradini Daniel J.
Published: January 2015

Diabetic patients exhibit dysfunction of the normal wound healing process, leading to local ischemia by vascular occlusive disease as well as sustained increases in the proinflammatory cytokines and overproduction of reactive oxygen species (ROS). Of the many sources of ROS, the enzyme xanthine oxidase (XO) has been linked to overproduction of ROS in diabetic environment, and studies have shown that treatment with XO inhibitors decreases XO overactivity and XO‐generated ROS. This study evaluates the role of XO in the diabetic wound and the impact of specifically inhibiting its activity on wound healing. Treatment of diabetic wounds with siXDH (xanthine dehydrogenase siRNA) decreased XDH mRNA expression by 51.6%, XO activity by 35.9%, ROS levels by 78.1%, pathologic wound burden by 31.5%, and accelerated wound healing by 7 days (23.3%). Polymerase chain reaction analysis showed that increased XO activity in wild‐type wound may be due to XDH to XO conversion and/or XO phosphorylation, but not to gene transcription, whereas increased XO activity in diabetic wounds may also be from gene transcription. These results suggest that XO may be responsible for large proportion of elevated oxidative stress in the diabetic wound environment and that normalizing the metabolic activity of XO using targeted delivery of siXDH may decrease overproduction of ROS and accelerate wound healing in diabetic patients.
Hybrids of Shigatoxigenic and Enterotoxigenic Escherichia coli (STEC/ETEC) Among Human and Animal Isolates in Finland
Authors: Nyholm O. , Heinikainen S. , Pelkonen S. , Hallanvuo S. , Haukka K. , Siitonen A.
Published: January 2015

Diarrhoeagenic Escherichia coli (DEC) cause serious foodborne infections in humans. Total of 450 Shigatoxigenic E. coli (STEC) strains isolated from humans, animals and environment in Finland were examined by multiplex PCR targeting the virulence genes of various DEC pathogroups simultaneously. One per cent (3/291) of the human STEC and 14% (22/159) of the animal and environmental STEC had genes typically present in enterotoxigenic E. coli (ETEC). The strains possessed genes encoding both Shiga toxin 1 and/or 2 (stx1 and/or stx2) and ETEC‐specific heat‐stable (ST) enterotoxin Ia (estIa). The identified stx subtypes were stx1a, stx1c, stx2a, stx2d and stx2g. The three human STEC/ETEC strains were isolated from the patients with haemolytic uraemic syndrome and diarrhoea and from an asymptomatic carrier. The animal STEC/ETEC strains were isolated from cattle and moose. The human and animal STEC/ETEC strains belonged to 11 serotypes, of which O2:H27, O15:H16, O101:H‐, O128:H8 and O141:H8 have previously been described to be associated with human disease. Identification of multiple virulence genes offers further information for assessing the virulence potential of STEC and other DEC. The emergence of novel hybrid pathogens should be taken into account in the patient care and epidemiological surveillance.
Mixed motivic sheaves (and weights for them) exist if ‘ordinary’ mixed motives do
Authors: Bondarko Mikhail V.
Published: January 2015

The goal of this paper is to prove that if certain ‘standard’ conjectures on motives over algebraically closed fields hold, then over any ‘reasonable’ scheme $S$ there exists a motivic$t$-structure for the category $\text{DM}_{c}(S)$ of relative Voevodsky’s motives (to be more precise, for the Beilinson motives described by Cisinski and Deglise). If $S$ is of finite type over a field, then the heart of this $t$-structure (the category of mixed motivic sheaves over $S$) is endowed with a weight filtration with semisimple factors. We also prove a certain ‘motivic decomposition theorem’ (assuming the conjectures mentioned) and characterize semisimple motivic sheaves over $S$ in terms of those over its residue fields. Our main tool is the theory of weight structures. We actually prove somewhat more than the existence of a weight filtration for mixed motivic sheaves: we prove that the motivic $t$-structure is transversal to the Chow weight structure for $\text{DM}_{c}(S)$ (that was introduced previously by Hébert and the author). We also deduce several properties of mixed motivic sheaves from this fact. Our reasoning relies on the degeneration of Chow weight spectral sequences for ‘perverse étale homology’ (which we prove unconditionally); this statement also yields the existence of the Chow weight filtration for such (co)homology that is strictly restricted by (‘motivic’) morphisms.
Oscillatory blood pressure response to the onset of cycling exercise in men: role of group III/IV muscle afferents
Authors: Barbosa Thales C. , Fernandes Igor A. , Magalhães‐Jr Nisval , Cavalcanti Ismar L. , Secher Niels H. , Nóbrega Antonio C. L. , Vianna Lauro C.
Published: January 2015

New Findings

What is the central question of this study?

Neural feedback from group III/IV muscle afferents has a key role in regulation of cardiovascular responses to exercise. Blood pressure oscillates in the first seconds of dynamic exercise, but the contribution of muscle afferent feedback to this pattern is unclear.

What is the main finding and its importance?

We demonstrate that attenuation of group III/IV muscle afferent feedback by spinal fentanyl impairs the pressor response after 10 s of moderate leg cycling exercise, but this afferent feedback does not appear to be necessary for induction of the oscillatory pattern of blood pressure at the onset of exercise.

We investigated whether attenuation of the central projections of group III/IV skeletal muscle afferents via lumbar intrathecal administration of the μ‐opioid receptor agonist fentanyl affects the oscillatory blood pressure (BP) response to the onset of dynamic exercise. Eight healthy, recreationally active men (28 ± 3 years old) performed 40 s of cycling at 80 W (60 r.p.m.) before (control) and after fentanyl administration, while heart rate, stroke volume, cardiac output, systolic, mean and diastolic BP and total vascular conductance were continuously monitored. Sytolic and mean BP responses to cycling included an initial increase (from 0 to 3 s), followed by a transient decrease below resting levels (from 3 to 10 s) and then a sustained increase (>10 s). In the presence of fentanyl, systolic and mean BP responses closely matched those in control conditions in the first 10 s, but were blunted thereafter (P < 0.05). In contrast, fentanyl did not modify the heart rate, stroke volume, cardiac output, diastolic BP or total vascular conductance responses to 40 s of cycling (P > 0.05). These findings suggest that during moderate leg cycling exercise the muscle afferents contribute to the BP response after ∼10 s, but that they do not appear to be implicated in the oscillation of BP at the onset of exercise.
Spontaneously hypertensive rats have more orexin neurons in their medial hypothalamus than normotensive rats
Authors: Clifford Liam , Dampney Bruno W. , Carrive Pascal
Published: January 2015

New Findings

What is the central question of this study?

Blockade of orexin receptors reduces blood pressure in spontaneously hypertensive rats (SHRs) but not in normotensive Wistar–Kyoto (WKY) rats, suggesting that upregulation of orexin signalling underlies the hypertensive phenotype of the SHR. However, it is not known what causes this upregulation.

What is the main finding and its importance?

Using orexin immunolabelling, we show that SHRs have 20% more orexin neurons than normotensive WKY and Wistar rats in the medial hypothalamus, which is a good match to their blood pressure phenotype. In contrast, there is no such match for the orexin neurons of the lateral hypothalamus. Essential hypertension may be linked to an increase in orexin neurons in the medial hypothalamus.

The neuropeptide orexin contributes to the regulation of blood pressure as part of its role in the control of arousal during wakefulness and motivated behaviour (including responses to psychological stress). Recent work shows that pharmacological blockade of orexin receptors reduces blood pressure in spontaneously hypertensive rats (SHRs) but not in normotensive Wistar–Kyoto (WKY) rats. It is not clear why orexin signalling is upregulated in the SHR, but one possibility is that these animals have more orexin neurons than their normotensive WKY and Wistar relatives. To test this possibility, SHRs, WKY and Wistar male rats (6–16 weeks old) were killed, perfused and their brains sectioned and immunolabelled for orexin A. Labelled neurons were plotted and counted in the six best labelled hemisections (120 μm apart) of each brain. There were significantly more orexin neurons (+20%) in the medial hypothalamus (medial to fornix) of SHRs compared with WKY and Wistar rats (126 ± 4 versus106 ± 5 and 104 ± 5 per hemisection, respectively,P < 0.05), which matches well the blood pressure phenotypes. In contrast, counts in the lateral hypothalamus did not match the blood pressure phenotypes (69 ± 2 versus50 ± 3 and 76 ± 4, respectively). The results support the idea that orexin signalling is upregulated in the SHR and suggest that this is due, at least in part, to a greater number of orexin neurons in the medial hypothalamus. These medial orexin neurons, which are also involved in hyperarousal and stress responses, may contribute to the development of essential hypertension.