bluuebunny/crossref_metadata_2025 huggingface dataset:
DOZ047.85: Percutaneous tracheostomy guided by endoscopy in pediatric patients
Authors: Urquizo M , Lobos P , Coraglia C , Mercado P , Gallegos D F
Published: June 2019

Objective

Tracheostomy is one of the most frequently performed surgical procedures in chronically ill pediatric patients and mechanical ventilatory assistance. This study presents our experience in percutaneous tracheostomy (PT) guided by endoscopy in children.

Methodology

A retrospective descriptive analysis was carried out in which the PT guided by endoscopy from December 2010 to October 2017 at Pediatric Surgery Service of the Hospital Italiano de Buenos Aires were considered. The variables analyzed were age, gender, basic pathology, tracheostomy indication, size of the cannula placed, surgical complications, and follow-up. At the same time, an updated bibliographical search on the subject was carried out. All the parents of the patients gave written consent.

Results and Discussion

A total of 50 PT guided by endoscopy were performed. The average age was 9.4 years (05–19 years). The male/female ratio was 1 (25 men, 25 women). The tracheostomy indications were prolonged orotracheal intubation (n: 41), lack of airway protection (n: 4), laryngomalacia (n: 2), difficult airway (n: 2), and laryngotracheal stenosis (n: 1). The endoscopic findings include glottic lesion, subglottic stenosis, vocal cord injury, and tracheal lesions by decubitus. There were no intraoperative complications. The average surgical time was 44 minutes (r: 10–60 min). The rate of postoperative complications was 6% (n: 3), among which were accidental decannulation, desaturation, and leakage. Distant complications such as tracheitis or granulomas occurred in 8% of patients (n: 4). The definitive decannulation was achieved in 19 patients in an average time of 15 days.

Conclusions

PT is feasible in children with a margin of safety comparable to tracheostomy by conventional technique. Simultaneous endoscopic vision is recommended for the control of complications during the procedure, in part because it offers firmness to the anterior wall of the trachea. At the same time it allows us to diagnose preexisting laryngotracheal lesions or anomalies. The size of the tracheostomy kit should be adjusted to the age of the patient to perform a safe tracheostomy. Due to the small diameter of the trachea and its weakness, it is not recommended by us to perform percutaneous tracheostomy in patients under 2 years of age.
DOZ047.89: Thoracoscopic (TS) management of early complications after esophageal atresia (EA) correction: single center experience
Authors: Andreetta M , Erculiani M , Leon F F , Gamba P
Published: June 2019

Background

Early complications and their surgical management after esophageal atresia (EA) correction aren’t largely described in the literature. Anastomotic stricture and anastomotic leakage are the most commonly described. Those, along with iatrogenic chylothorax, are safely managed with a conservative approach. Surgery is indicated for nonresponding cases and often carries major invasiveness. This study reports thoracoscopy use for EA complications at our center in a 2-year period (2017–2018).

Case Reports

Case 1, birth weight (BW) 1550 gr, presented respiratory difficulties 6 days after open surgery: chest X-ray revealed right diaphragmatic eventration probably due to phrenic nerve damage; Case 2 (BW 3420 gr) presented anastomotic dehiscence with salivary traces in drainage tube, 9 days after thoracoscopic (TS) repair with azygos vein sparing; Case 3 (BW 2530 gr) developed right chylothorax 13 days after right thoracotomy following primary TS left approach for dextrocardia (5 days after oral feeding was started) resistant to Octreotide treatment. All cases were successfully treated with TS technique. Case 1 underwent TS right diaphragmatic plication after an initial conservative approach. In case 2 we performed TS anastomosis revision with bovine pericardium patch apposition. Case 3 underwent right TS cruentation and glueing of the right costophrenic recess (6 weeks after surgery) for chylothorax persistence despite 22 days of Octreotide therapy. No intra- or postoperative complication occurred. A TS approach for EA repair is replacing open surgery, which is nowadays limited to selected neonates. The open technique seems to increase the risk of postoperative early complications, probably because thoracoscopy allows optimal anatomy visualization and minimal tissue handling. It is also postulated that TS azygos sparing may be a preventive factor against anastomotic leakage, even though it can be technically demanding. Furthermore, thoracoscopy can reduce invasiveness in the case of a diagnostic maneuver such as left anatomy exploration.

Conclusions

Early surgical complications after EA repair are rare, and can be safely treated with a TS approach, regardless of the primary surgical technique. If properly managed, they have good prognosis. Benefits of TS EA repair are widely known, and early reintervention for complications with this technique seems to be safe and justified in centers where neonatal MIS is the –first-choice approach.
Successful treatment of cardiac haemangiomas with oral propranolol: a case series of two patients
Authors: Polymerou Ioannis , Ojala Tiina , Bonou Pipina , Martelius Laura , Tzifa Aphrodite
Published: June 2019

Background

Cardiac haemangiomas are extremely rare tumours with equivocal surgical outcomes. Haemangiomas appearing on other sites of the body have been successfully treated with oral propranolol. To the best of our knowledge, such treatment has not been tried to date for cardiac location of haemangiomas.

Case summary

We report two cases of neonatal cardiac haemangiomas, and we describe their presentation and characteristics, as well as how these were successfully treated with oral propranolol, with complete regression of the tumours within the 1st year of life.

Discussion

Despite the rarity of cardiac haemangiomas, their presentation and complications could be dramatic with side-effects spanning from intracardiac space occupying phenomena to Kasabach–Merritt syndrome. Propranolol therapy, having been established for long now in the treatment of skin haemangiomas, should also be considered in cases of cardiac haemangiomas, particularly in the neonatal and infantile population.
Elastica degeneration and intimal hyperplasia lead to Contegra® conduit failure
Authors: Peivandi Armin Darius , Seiler Martina , Mueller Klaus-Michael , Martens Sven , Malec Edward , Asfour Boulos , Lueck Sabrina
Published: June 2019

OBJECTIVES

Currently, Contegra® grafts (processed bovine jugular vein conduits) are widely used for reconstructive surgery of the right ventricular outflow tract in patients with congenital heart disease (CHD). We analysed explanted Contegra conduits from 2 institutions histologically to get a possible hint at the underlying pathomechanisms of degenerative alterations and to find histological correlations of graft failure. Additionally, we compared the explants with a non-implanted processed graft and a native jugular vein obtained from a young bull.

METHODS

The explanted Contegra grafts were gathered during reoperations of 13 patients (male: n = 9, 69.2%; female: n = 4, 30.8%). After standardized histological preparation, samples were stained with dyes haematoxylin and eosin and Elastica van Gieson. Additionally, X-ray pictures revealed the extent of calcification and chelaplex (III)-descaling agent was used to decalcify selected explants.

RESULTS

Processing of the native jugular vein leads to tissue loosening and a loss of elastic fibres. For graft failure after implantation, 2 pathomechanisms were identified: original graft alteration as well as intimal hyperplasia. Elastica degeneration and rearrangement with interfibrillary matrix structures were the main developments observed within the graft itself. Intimal hyperplasia was characterized by fibrous tissue apposition, calcification and heterotopic ossification.

CONCLUSIONS

Regression of the elastic fibre network leads to rigidification of the conduit. In Contegra grafts, atherosclerosis-like changes can be considered the leading cause of graft stenosis and insufficiency. We conclude that both observed mechanisms lead to early reoperation in CHD patients.
A Single Dose of Dietary Nitrate Increases Maximal Knee Extensor Angular Velocity and Power in Healthy Older Men and Women
Authors: Coggan Andrew R , Hoffman Richard L , Gray Derrick A , Moorthi Ranjani N , Thomas Deepak P , Leibowitz Joshua L , Thies Dakkota , Peterson Linda R
Published: June 2019

Background

Aging results in reductions in maximal muscular strength, speed, and power, which often lead to functional limitations highly predictive of disability, institutionalization, and mortality in elderly adults. This may be partially due to reduced nitric oxide (NO) bioavailability. We, therefore, hypothesized that dietary nitrate (NO3−), a source of NO via the NO3− → nitrite (NO2−) → NO enterosalivary pathway, could increase muscle contractile function in older subjects.

Methods

Twelve healthy older (age 71 ± 5 years) men and women were studied using a randomized, double-blind, placebo-controlled, crossover design. After fasting overnight, subjects were tested 2 hours after ingesting beetroot juice containing or devoid of 13.4 ± 1.6 mmol NO3−. Plasma NO3− and NO2− and breath NO were measured periodically, and muscle function was determined using isokinetic dynamometry.

Results

N O 3 − ingestion increased (p < .001) plasma NO3−, plasma NO2−, and breath NO by 1,051% ± 433%, 138% ± 149%, and 111% ± 115%, respectively. Maximal velocity of knee extension increased (p < .01) by 10.9% ± 12.1%. Maximal knee extensor power increased (p < .05) by 4.4% ± 7.8%.

Conclusions

Acute dietary NO3− intake improves maximal knee extensor angular velocity and power in older individuals. These findings may have important implications for this population, in whom diminished muscle function can lead to functional limitations, dependence, and even premature death.
Viral DNA Loads in Various Blood Components of Patients With Epstein-Barr Virus–Positive T-Cell/Natural Killer Cell Lymphoproliferative Diseases
Authors: Kawada Jun-ichi , Kamiya Yasuko , Sawada Akihisa , Iwatsuki Keiji , Izutsu Koji , Torii Yuka , Kimura Hiroshi , Ito Yoshinori
Published: June 2019

To evaluate diagnostic values for Epstein-Barr virus (EBV) DNA loads in different blood components of patients with EBV-positive T-cell/natural killer cell lymphoproliferative diseases, EBV DNA loads were compared among disease categories in each blood component from 59 patients. Plasma viral loads were significantly higher in “active” disease in chronic active EBV infection. EBV DNA was not detected in the plasma from 7 patients in whom EBV DNA was detected in peripheral blood mononuclear cells and whole blood. Diagnostic cutoff values for whole blood EBV DNA loads of patients with chronic active EBV infection compared with those of infectious mononucleosis was 104.2 (15 800) IU/mL.
High relative reliability and responsiveness of the forgotten joint score-12 in patients with femoroacetabular impingement undergoing hip arthroscopic treatment. A prospective survey-based study
Authors: Bramming Ida Birgitte , Kierkegaard Signe , Lund Bent , Jakobsen Stig S , Mechlenburg Inger
Published: June 2019

The forgotten joint score-12 (FJS-12) may be an advantageous questionnaire in young patients with high hip function and a low level of pain. We investigated the reliability and the responsiveness of the FJS-12 in patients with femoroacetabular impingement undergoing hip arthroscopic treatment. Fifty patients were included in the reliability study and 34 patients were included in the responsiveness study. Test–retest reliability was assessed with intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). Responsiveness was assessed from testing correlations between the FJS-12 and the Copenhagen Hip and Groin Outcome Score (HAGOS) of the change score, effect size (ES) and standardized response mean (SRM). Floor and ceiling effect were defined as present if the number of patients obtaining the maximum (100) and minimum score (0) exceeded 15%. The relative reliability was high (ICC = 0.9, 95% CI: 0.8–0.9) and the absolute reliability was low (SEM = 11, MDCindividual = 32, MDCgroup = 4.5). The responsiveness was high, and the change score was highly correlated with the subscale ‘pain’ from the HAGOS and moderately correlated with the subscale ‘ADL’. Furthermore, the FJS-12 exceeded or equalled the HAGOS subscales in ES and SRM. Below 15% of the patients scored the maximum or minimum score. The FJS-12 has high reliability, high responsiveness to change and shows no floor or ceiling effect.
Hybrid LWFA–PWFA staging as a beam energy and brightness transformer: conceptual design and simulations
Authors: Martinez de la Ossa A. , Assmann R. W. , Bussmann M. , Corde S. , Couperus Cabadağ J. P. , Debus A. , Döpp A. , Ferran Pousa A. , Gilljohann M. F. , Heinemann T. , Hidding B. , Irman A. , Karsch S. , Kononenko O. , Kurz T. , Osterhoff J. , Pausch R. , Schöbel S. , Schramm U.
Published: June 2019

We present a conceptual design for a hybrid laser-driven plasma wakefield accelerator (LWFA) to beam-driven plasma wakefield accelerator (PWFA). In this set-up, the output beams from an LWFA stage are used as input beams of a new PWFA stage. In the PWFA stage, a new witness beam of largely increased quality can be produced and accelerated to higher energies. The feasibility and the potential of this concept is shown through exemplary particle-in-cell simulations. In addition, preliminary simulation results for a proof-of-concept experiment in Helmholtz-Zentrum Dresden-Rossendorf (Germany) are shown.

This article is part of the Theo Murphy meeting issue ‘Directions in particle beam-driven plasma wakefield acceleration’.
Particle physics experiments based on the AWAKE acceleration scheme
Authors: Wing M.
Published: June 2019

New particle acceleration schemes open up exciting opportunities, potentially providing more compact or higher-energy accelerators. The AWAKE experiment at CERN is currently taking data to establish the method of proton-driven plasma wakefield acceleration. A second phase aims to demonstrate that bunches of about 10
9
electrons can be accelerated to high energy, preserving emittance and that the process is scalable with length. With this, an electron beam of

O

(50 GeV) could be available for new fixed-target or beam-dump experiments searching for the hidden sector, like dark photons. The rate of electrons on target could be increased by a factor of more than 1000 compared to that currently available, leading to a corresponding increase in sensitivity to new physics. Such a beam could also be brought into collision with a high-power laser and thereby probe the completely unmeasured region of strong fields at values of the Schwinger critical field. An ultimate goal is to produce an electron beam of

O

(3 TeV) and collide with an Large Hadron Collider proton beam. This very high-energy electron–proton collider would probe a new regime in which the structure of matter is completely unknown.

This article is part of the Theo Murphy meeting issue ‘Directions in particle beam-driven plasma wakefield acceleration’.
NON-RANDOM TIMING OF ECOLOGICAL SHIFTS ON CARIBBEAN CORAL REEFS SUGGESTS REGIONAL CAUSES OF CHANGE
Authors: Precht William F. , Aronson Richard B. , Gardner Toby A. , Gill Jennifer A. , Hawkins Julie P. , Hernández-Delgado Edwin A. , Jaap Walter C. , Mcclanahan Tim R. , Mcfield Melanie D. , Murdoch Thaddeus J.T. , Nugues Maggy M. , Roberts Callum M. , Schelten Christiane K. , Watkinson Andrew R. , Côté Isabelle M.
Published: June 2019

Abstract

Caribbean reefs have experienced unprecedented changes in the past four decades. Of great concern is the perceived widespread shift from coral to macroalgal dominance and the question of whether it represents a new, stable equilibrium for coral-reef communities. The primary causes of the shift -- grazing pressure (top-down), nutrient loading (bottom-up) or direct coral mortality (side-in) -- still remain somewhat controversial in the coral reef literature. We have attempted to tease out the relative importance of each of these causes. Four insights emerge from our analysis of an early regional dataset of information on the benthic composition of Caribbean reefs spanning the years 1977–2001. First, although three-quarters of reef sites have experienced coral declines concomitant with macroalgal increases, fewer than 10% of the more than 200 sites studied were dominated by macroalgae in 2001, by even the most conservative definition of dominance. Using relative dominance as the threshold, a total of 49 coral-to-macroalgae shifts were detected. This total represents ∼35% of all sites that were dominated by coral at the start of their monitoring periods. Four shifts (8.2%) occurred because of coral loss with no change in macroalgal cover, 15 (30.6%) occurred because of macroalgal gain without coral loss, and 30 (61.2%) occurred owing to concomitant coral decline and macroalgal increase. Second, the timing of shifts at the regional scale is most consistent with the side-in model of reef degradation, which invokes coral mortality as a precursor to macroalgal takeover, because more shifts occurred after regional coral-mortality events than expected by chance. Third, instantaneous observations taken at the start and end of the time-series for individual sites showed these reefs existed along a continuum of coral and macroalgal cover. The continuous, broadly negative relationship between coral and macroalgal cover suggests that in some cases coral-to-macroalgae phase shifts may be reversed by removing sources of perturbation or restoring critical components such as the herbivorous sea urchin Diadema antillarum to the system. The five instances in which macroalgal dominance was reversed corroborate the conclusion that macroalgal dominance is not a stable, alternative community state as has been commonly assumed. Fourth, the fact that the loss in regional coral cover and concomitant changes to the benthic community are related to punctuated, discrete events with known causes (i.e. coral disease and bleaching), lends credence to the hypothesis that coral reefs of the Caribbean have been under assault from climate-change-related maladies since the 1970s.
Deep data mining reveals variable abundance and distribution of microbial reproductive manipulators within and among diverse host species
Authors: Medina Paloma , Russell Shelbi L , Aswadhati Kavya , Corbett-Detig Russell
Published: June 2019

Bacterial symbionts that manipulate the reproduction of their hosts are important factors in invertebrate ecology and evolution. Studying the genomic and phenotypic diversity of reproductive manipulators can improve efforts to control infectious diseases and contribute to our understanding of host-symbiont evolution. Despite the vast genomic and phenotypic diversity of reproductive manipulators, only a handful of strains are used as biological control agents because little is known about the broad scale infection frequencies and densities of these bacteria in nature. Here we develop a data mining approach to quantify the number of arthropod and nematode host species infected withWolbachiaand other reproductive manipulators such asRickettsiaandSpiroplasma. Across the entire Sequence Read Archive (SRA) database, we found reproductive manipulators infected 2,083 arthropod and 119 nematode samples, representing 240 and 8 species, respectively. After accounting for sampling and infection frequency differences among species, we estimated thatWolbachiainfects approximately 44% of all arthropod species and 34% of all nematode species. In contrast, we estimated other reproductive manipulators infect 1-8% of arthropod and nematode species. Next, we explored another important biological parameter: the relative bacterial density, or titer, within hosts. We found variation in titer within and between arthropod species to be large, and that host species explains approximately 36% of variation in titer across our dataset. This suggests bacterial strain and/or host species plays a role in shaping bacterial densities within and between host species. By leveraging the model systemDrosophila melanogaster, we also found a number of host SNPs associated with titer in genes potentially relevant to host interactions withWolbachia, suggesting bacterial induced host genome evolution. Our study demonstrates that data mining is a powerful tool to understand host-symbiont co-evolution and opens an array of previously inaccessible questions for further analysis.
Spontaneous Mutations in HIV-1 Gag, protease, RT p66 in the first replication cycle and how they appear: Insights from anin vitroBSL2 assay on mutation rates and types
Authors: Yeo Joshua Yi , Koh Darius Wen-Shuo , Yap Ping , Goh Ghin-Ray , Gan Samuel Ken-En
Published: June 2019

While drug resistant mutations in HIV-1 is largely credited to its error prone HIV-1 RT, host proteins such as deaminases may also play a role generating mutations. Many HIV-1 RT mutationalin vitrostudies utilize reporter genes (LacZ) as template, leaving out the possible contribution of HIV codon usage and gene-specific effects. To address this gap, we studied HIV-1 RT mutation rates and bias on its own Gag, protease, and RT p66 genes in anin-vitroselection pressure free system. We found rare clinical mutations with a general avoidance of crucial functional sites in the background mutations rates for Gag, protease and RT p66 at 4.71 x 10−5, 6.03 x 10−5, and 7.09 x 10−5mutations/bp respectively. Gag and p66 genes showed a large number of ‘A to G’ hypermutations likely due to cellular adenosine deaminases. Comparisons with silently mutated p66 sequences showed an increase in mutation rates (1.88 x 10−4mutations/bp) and that ‘A to G’ mutations occurred in regions reminiscent of ADAR neighbour preferences. Mutational free energies by the ‘A to G’ mutations revealed an avoidance of destabilizing effects with the natural p66 gene codon usage providing barriers to ADAR effects. Our study demonstrates the importance of studying mutation emergence in HIV genes to understand how fast drug resistance can emerge, sometimes with contributions of host deaminases, providing transferable applications to how new viral diseases and drug resistances can emerge.
Transcriptome responses of intestinal epithelial cells induced by membrane vesicles ofListeria monocytogenesunveil novel insights into the host-pathogen cross talk
Authors: Karthikeyan Raman , Gayathri Pratapa , Gunasekaran Paramasamy , Jagannadham Medicharla V. , Rajendhran Jeyaprakash
Published: June 2019

Membrane vesicles (MVs) serve as a vital source of virulence factors in many pathogenic organisms. The release of MVs byListeria monocytogenesis only recently recognized, but its role in the pathogenesis is poorly understood. Here, we investigated the role of MVs ofL. monocytogenesin virulence and host interactions. Proteomic analyses of whole cells and MVs ofL. monocytogeneswere performed using LC/MS/MS. A total of 1376 and 456 proteins were identified in theL. monocytogenescells and MVs, respectively. Also, we have found that MVs contains active pore-forming listeriolysin (LLO), internalin B (inlB), phosphatidylinositol-specific phospholipase C (PI-PLC-A). We have previously reported that MVs ofL. monocytogenescan infect and induce cytotoxicity in Caco-2 cells. In this study, we report the transcriptome response of Caco-2 cells upon infection with MVs as well asL. monocytogenes. In particular, we observed the up-regulation of autophagy-related genes in the early phase of infection with MVs. Transcription of inflammatory cytokines (CCL2, CXCL6, CXCL8, CXCL15, CXCL5, CXCL10) peaked at four h of infection. A large number of differentially expressed genes was associated with actin cytoskeleton rearrangement, autophagy, cell cycle arrest, and induction of oxidative stress. At a later time point, transcriptional programs generated upon infection with MVs point toward to evade innate immune signals, by modulating the expression of anti-inflammatory genes. KEGG pathway enrichment analysis revealed that MVs induce several signaling pathways such as PI3k-Akt signaling pathway, mitogen-activated protein kinase (MAPK) pathway, NOD-like receptor signaling pathway, cAMP signaling pathway, TNF, and NF-kB signaling pathway. Moreover, MVs induced the expression of cell cycle regulatory genes, which may result in the ability to prolong host cell survival, thus protecting the replicative niche forL. monocytogenes. Notably, we identified several non-coding RNAs (ncRNAs) are regulated during infection, suggesting that an early manipulation of the host gene expression may be essential forL. monocytogenespersistence and replication in host cells.
Human Endometrial Transcriptome and Progesterone Receptor Cistrome Reveal Important Pathways and Epithelial Regulators
Authors: Chi Ru-pin Alicia , Wang Tianyuan , Adams Nyssa , Wu San-pin , Young Steven L. , Spencer Thomas E. , DeMayo Francesco
Published: June 2019

Context

Poor uterine receptivity is one major factor leading to pregnancy loss and infertility. Understanding the molecular events governing successful implantation is hence critical in combating infertility.

Objective

To define PGR-regulated molecular mechanisms and epithelial roles in receptivity.

Design

RNA-seq and PGR-ChIP-seq were conducted in parallel to identify PGR-regulated pathways during the WOI in endometrium of fertile women.

Setting

Endometrial biopsies from the proliferative and mid-secretory phases were analyzed.

Patients or Other Participants

Participants were fertile, reproductive aged (18-37) women with normal cycle length; and without any history of dysmenorrhea, infertility, or irregular cycles. In total, 42 endometrial biopsies obtained from 42 women were analyzed in this study.

Interventions

There were no interventions during this study.

Main Outcome Measures

Here we measured the alterations in gene expression and PGR occupancy in the genome during the WOI, based on the hypothesis that PGR binds uterine chromatin cycle-dependently to regulate genes involved in uterine cell differentiation and function.

Results

653 genes were identified with regulated PGR binding and differential expression during the WOI. These were involved in regulating inflammatory response, xenobiotic metabolism, EMT, cell death, interleukin/STAT signaling, estrogen response, and MTORC1 response. Transcriptome of the epithelium identified 3,052 DEGs, of which 658 were uniquely regulated. Transcription factors IRF8 and MEF2C were found to be regulated in the epithelium during the WOI at the protein level, suggesting potentially important functions that are previously unrecognized.

Conclusion

PGR binds the genomic regions of genes regulating critical processes in uterine receptivity and function.

Précis

Using a combination of RNA-seq and PGR ChIP-seq, novel signaling pathways and epithelial regulators were identified in the endometrium of fertile women during the window of implantation.
In Depth Flow Inspection Using Dynamic Laser Speckle Temporal Statistics
Authors: Golberg Mark , Califa Ran , Polani Sagi , Garcia Javier , Zalevsky Zeev
Published: June 2019

We present novel optical approach based on statistical analysis of temporal laser speckle patterns for tissue in-depth flow characteristics. An ability to distinguish between Brownian motion of particles and laminar flow is well proved. The main steps in the post processing algorithm and the in-vivo and in-vitro experimental results are presented and demonstrated.
Cardiac contraction velocity has evolved to match heart rate with body size through variation in β-cardiac myosin sequence
Authors: Johnson Chloe A. , McGreig Jake E. , Vera Carlos D. , Mulvihill Dan P. , Ridout Martin , Leinwand Leslie A. , Wass Mark N. , Geeves Michael A.
Published: June 2019

Heart rate and the maximum velocity of contraction of striated muscle are inversely related to species size. As mammals evolve to different sizes, adaptations are required such as slower contracting heart and skeletal muscles. Analysis of the motor domain of β-myosin from 67 mammals from two clades identifies 14 sites, out of 800, strongly associated with body mass (p<0.01) but not with the clade (p>0.05). Nine of these sites were mutated in the human β-myosin to make it resemble the rat sequence. Biochemical analysis revealed that the rat-human β-myosin chimera functioned like the native rat myosin with a two fold increase in both motility and in the rate of ADP release from the actin.myosin cross-bridge (the step that limits contraction velocity). Both clades use the same small set of amino acids to adjust contraction velocity, suggesting a limited number of ways in which velocity can be manipulated.
Strategizing in English hospitals: accounting, practical coping and strategic intent
Authors: Begkos Christos , Llewellyn Sue , Walshe Kieran
Published: June 2019

Purpose

The purpose of this paper is to investigate the intricate ways in which accounting is implicated in the unfolding of strategizing in a pluralistic setting. The authors treat strategizing as a practical coping mechanism which begins in response to a problem and unfolds over time into an episode. This approach enables the authors to explore strategizing pathways and the ways they can mobilise accounting to advance from practical coping to explicit strategic intent.

Design/methodology/approach

The authors conducted semi-structured interviews with Clinical Directors, Business Managers and Finance personnel at three NHS hospitals. Documents were also collected, such as business cases and financial reports. The authors employed theories on strategizing agency, episodes and practical coping to select examples of strategizing and indicate how strategizing is constructed and performed. The authors present the results of this qualitative analysis in three strategizing narratives.

Findings

The analysis highlights how Clinical Directors’ strategizing with accounting, in response to their financial problems, can take on contesting, conforming and circumventing modes. As the strategizing pathway unfolds, accounting acts as an obligatory passage point through which Clinical Directors pursue their strategic intent. Along each pathway the authors identify, first, where practical coping takes on a clear strategic intent and, second, whether this emergent strategy proves efficacious.

Originality/value

The authors contribute to the nascent body of accounting and strategizing studies through seeing strategizing with accounting, not as the formulation of explicit organisational strategy as “done” in board rooms and strategy meetings, but as an impromptu response to a critical financial problem within a localised organisational setting. In response to a problem, actors may realise their immanent strategizing through their engagement with accounting practices.
Adaptive motion planning framework by learning from demonstration
Authors: Li Xiao , Cheng Hongtai , Liang Xiaoxiao
Published: June 2019

Purpose

Learning from demonstration (LfD) provides an intuitive way for non-expert persons to teach robots new skills. However, the learned motion is typically fixed for a given scenario, which brings serious adaptiveness problem for robots operating in the unstructured environment, such as avoiding an obstacle which is not presented during original demonstrations. Therefore, the robot should be able to learn and execute new behaviors to accommodate the changing environment. To achieve this goal, this paper aims to propose an improved LfD method which is enhanced by an adaptive motion planning technique.

Design/methodology/approach

The LfD is based on GMM/GMR method, which can transform original off-line demonstrations into a compressed probabilistic model and recover robot motion based on the distributions. The central idea of this paper is to reshape the probabilistic model according to on-line observation, which is realized by the process of re-sampling, data partition, data reorganization and motion re-planning. The re-planned motions are not unique. A criterion is proposed to evaluate the fitness of each motion and optimize among the candidates.

Findings

The proposed method is implemented in a robotic rope disentangling task. The results show that the robot is able to complete its task while avoiding randomly distributed obstacles and thereby verify the effectiveness of the proposed method. The main contributions of the proposed method are avoiding unforeseen obstacles in the unstructured environment and maintaining crucial aspects of the motion which guarantee to accomplish a skill/task successfully.

Originality/value

Traditional methods are intrinsically based on motion planning technique and treat the off-line training data asa prioriprobability. The paper proposes a novel data-driven solution to achieve motion planning for LfD. When the environment changes, the off-line training data are revised according to external constraints and reorganized to generate new motion. Compared to traditional methods, the novel data-driven solution is concise and efficient.
Developing specific involvement strategies within a psychologically informed planned environment: a service evaluation
Authors: Greenacre Karine , Paez Rebecca
Published: June 2019

Purpose

The purpose of this paper is to apply current understanding of service user involvement (SUI) to forensic practice with reference to the benefits and drawbacks. Specifically, it discusses models of SUI and their application to a psychologically informed planned environment (PIPE) located in a Category C male prison.

Design/methodology/approach

Drawing upon residents’ experiences, the evaluation reflects on the contribution of cultural, environmental and political factors to the success or failure of SUI within the PIPE service.

Findings

The evaluation will review current systems and explore ways of improving and strengthening strategies by referring to the “whole systems approach” to SUI (Wright, 2006).

Originality/value

The evaluation makes recommendations for local and national SUI within PIPE services.
SEC approves amendments to the NYSE’s substantial stockholder issuance rule and 20 per cent rule for shareholder approval of certain private offerings
Authors: Hoffman Justin , Dworaczyk Jude
Published: June 2019

Purpose

To explain recent amendments by the US Securities and Exchange Commission (the SEC) to Sections 312.03(b) relating to issuances of securities to substantial stockholders (the Substantial Stockholder Issuance Rule) and 312.03(c) (the 20 Per cent Rule) of the New York Stock Exchange’s (the NYSE) Listed Company Manual to change the definition of “market value” for purposes of the 20 Per cent Rule and eliminate the requirement for shareholder approval of certain private issuances at a price less than book value but greater than market value.

Design/methodology/approach

This article provides background on the purpose and policy behind the Substantial Stockholder Issuance Rule and the 20 Per cent Rule and summarizes the provisions of each rule, both before and after the recent SEC amendments thereto. This article then highlights the most important changes to the Substantial Stockholder Issuance Rule and the 20 Per cent Rule and explains the implications thereof for NYSE-listed issuers.

Findings

The amended Substantial Stockholder Issuance Rule and the 20 Per cent Rule provide NYSE-listed issuers greater flexibility in structuring transactions involving private placements of equity and will likely reduce the number of such transactions requiring a shareholder vote.

Originality/value

Practical guidance from experienced corporate finance and capital markets lawyers.
Mergers in higher education institutions: a proposal of a novel conceptual model
Authors: Sułkowski Łukasz , Fijałkowska Justyna , Dzimińska Małgorzata
Published: June 2019

Purpose

The macroeconomic changes as well as the challenges facing universities nowadays result in the transfer and adaptation of various concepts and organizational methods from enterprises to universities. One of such solutions is mergers. Even though there are a very large number of practical examples of university mergers in the world, at the same time there is a shortage of frameworks that would help manage mergers. The purpose of this paper is to present key areas of focus in HEIs’ consolidation processes and the creation of the conceptual model of the universities’ mergers.

Design/methodology/approach

In this paper synthesis, the inductive approach for model development and case study description were used. The analysis and findings were based on the systematic literature review taken out from management and public policy areas. The new public management and public value governance approaches as well as strategic and process theories of mergers were applied. The descriptive approach to management was used as well.

Findings

Formulation of a Conceptual Model of Universities’ Mergers and ten principles of effective management of universities’ mergers that cover the entire process, from planning, through implementation, to integration.

Research limitations/implications

There is a need to verify the proposed inductive model of universities’ mergers through further qualitative and mixed-methods research studies.

Practical implications

The paper offers a significant opportunity for practical application of the presented content, because it indicates how the know-how from one (business) sector can be valuable for the future of another sector (the over-fragmented sector of higher education).

Originality/value

This study presents the key areas of focus in HEIs’ consolidation processes and proposes a novel Conceptual Model of Universities’ Mergers. It concludes with the principles of effective management of universities’ mergers.
Diagnostic accuracy of procalcitonin for the early diagnosis of anastomotic leakage after colorectal surgery: a meta‐analysis
Authors: Su'a Bruce , Tutone Senitila , MacFater Wiremu , Barazanchi Ahmed , Xia Weisi , Zeng Irene , Hill Andrew G.
Published: June 2019

Background

Anastomotic leakage (AL) is a dreaded complication following colorectal surgery. Procalcitonin is one of many biomarkers studied and research has suggested that it has improved accuracy for the diagnosis of AL compared with other inflammatory biomarkers such as C‐reactive protein. This meta‐analysis was conducted to evaluate the accuracy of procalcitonin in the early diagnosis of AL following colorectal surgery.

Methods

MEDLINE, Embase and PubMed were searched for studies evaluating procalcitonin in the context of AL following colorectal surgery in the elective setting. The literature was reviewed using the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) statement. Quality of the studies was assessed using the Quality Assessment Diagnostic Accuracy Studies (QUADAS)‐2 tool. Meta analyses were conducted using area under the receiver operating characteristic curves for day 3, 4 and 5 post‐surgery as a diagnostic test to detect AL.

Results

A total of eight studies were analysed. Results showed that the highest diagnostic accuracy for procalcitonin is on day 5 post surgery. The reported optimal cut‐off values ranged from 0.25 to 680 ng/mL from postoperative day 3 to 5, with reported negative predictive values ranging from 95% to 100%, and positive predictive values of up to 34%. The highest area under the receiver operating characteristic curve was 0.88 on postoperative day 5.

Conclusion

Procalcitonin is a useful negative test for AL following elective colorectal surgery. However, as an isolated test, it is not useful in detecting AL.
Single‐strain regression analysis evaluating disc potencies of flumequine and enrofloxacin for testing Aeromonas sobria and Vibrio anguillarum
Authors: Kronvall Göran , Baron Sandrine , Larvor Emeline , Rudas–Villarreal Casandra , Hobson Jonathan , Smith Peter
Published: June 2019

Two quite different disc contents are used for antimicrobial susceptibility testing of two fluoroquinolone drugs, flumequine and enrofloxacin, in the disc diffusion test, 30 and 5 µg, respectively. Using the SRA method, single‐strain regression analysis, we studied the impact of disc content when testing two relevant bacterial species, Aeromonas sobria and Vibrio anguillarum. There were no major differences between the antimicrobial regression lines for the two species. Wild‐type strains produced acceptable zones of inhibition over a wide range of disc contents. The flumequine 30 µg disc should be lowered in its drug content. No rational reasons for choosing so different disc contents for the two antimicrobials were apparent. At present, the choice of disc content for new antimicrobials are outside the realm of clinical microbiologists. It is recommended that reference authorities, such as EUCAST, CLSI and USCAST, are consulted for the choice of disc contents in the future.
Isolation of antibiotic‐resistant gram‐negative organisms from donor respiratory culture does not impact non‐lung solid organ recipient management
Authors: Benamu Esther , Pereira Marcus R. , Taimur Sarah , Jacobs Samantha E. , Friedman Amy L. , Jenkins Stephen G. , Herold Betsy C. , Pellett Madan Rebecca
Published: June 2019

Background

Multidrug‐resistant (MDR) and extensively drug‐resistant (XDR) gram‐negative bacteria may be transmitted from organ donors to solid organ transplant recipients and are associated with poor outcomes post‐transplant.

Methods

We reported the prevalence of MDR/XDR gram‐negative respiratory colonization among 702 deceased organ donors in the New York City area from 2011 to 2014 and performed chart reviews for a subset of recipients to determine whether donor respiratory culture results were predictive of subsequent recipient infection or used to guide post‐transplant antimicrobial therapy.

Results

Fifty donors (7% of the cohort) had MDR or XDR gram‐negative bacteria isolated from endotracheal aspirate or bronchoalveolar lavage culture. Organs from these 50 donors were transplanted into 120 recipients; chart review was performed for 89 of these recipients (38 kidney, 32 liver, 11 heart, 6 kidney/pancreas, 1 liver/kidney, 1 lung). None of the 89 recipients of organs from donors with MDR/XDR gram‐negative respiratory colonization were reported to have a donor‐derived infection post‐transplant, and chart review for the 88 non‐lung recipients indicated that peri‐transplant antibiotics were not adjusted specifically for donor respiratory culture results.

Conclusion

These results suggest that donor respiratory culture results are not predictive of post‐transplant infection in non‐lung recipients and are unlikely to impact post‐transplant management.
Bilateral adnexal masses in a perimenopausal female
Authors: Kaur Gurwinder , Gupta Parikshaa , Elangovan Arun , Kapoor Rakesh , Jain Vanita , Rajwanshi Arvind
Published: June 2019

Small cell carcinoma of the ovary is an extremely rare ovarian malignancy with an aggressive clinical course. Establishing an early and accurate clinical diagnosis is challenging, owing to the rarity and non‐specific clinical presentations. We present a case of small cell carcinoma of the ovary in a perimenopausal female, diagnosed on fine needle aspiration cytology and confirmed by immunocytochemistry.
Stress response as implemented by hibernating ribosomes: a structural overview
Authors: Matzov Donna , Bashan Anat , Yap Mee‐Ngan F. , Yonath Ada
Published: June 2019

Protein synthesis is one of the most energy demanding cellular processes. The ability to regulate protein synthesis is essential for cells under normal as well as stress conditions, such as nutrient deficiencies. One mechanism for protein synthesis suppression is the dimerization of ribosomes into hibernation complexes. In most cells, this process is promoted by the hibernating promoting factor (HPF) and in a small group of Gram‐negative bacteria (γ‐proteobacteria), the dimer formation is induced by a shorter version of HPF (HPFshort) and by an additional protein, the ribosome modulation factor. In most bacteria, the product of this process is the 100S ribosome complex. Recent advances in cryogenic electron microscopy methods resulted in an abundance of detailed structures of near atomic resolutions 100S complexes that allow for a better understanding of the dimerization process and the way it inhibits protein synthesis. As ribosomal dimerization is vital for cell survival, this process is an attractive target for the development of novel antimicrobial substances that might inhibit or stabilize the complex formation. As different dimerization processes exist among bacteria, including pathogens, this process may provide the basis for species‐specific design of antimicrobial agents. Here, we review in detail the various dimerization mechanisms and discuss how they affect the overall dimer structures of the bacterial ribosomes.
Genes on the edge: A framework to detect genetic diversity imperiled by climate change
Authors: Carvalho Sílvia Benoliel , Torres João , Tarroso Pedro , Velo‐Antón Guillermo
Published: June 2019

Ongoing global warming is disrupting several ecological and evolutionary processes, spanning different levels of biological organization. Species are expected to shift their ranges as a response to climate change, with relevant implications to peripheral populations at the trailing and leading edges. Several studies have analyzed the exposure of species to climate change but few have explored exposure at the intraspecific level. We introduce a framework to forecast exposure to climate change at the intraspecific level. We build on existing methods by combining correlative species distribution models, a model of species range dynamics, and a model of phylogeographic interpolation. We demonstrate the framework by applying it to 20 Iberian amphibian and reptile species. Our aims were to: (a) identify which species and intraspecific lineages will be most exposed to future climate change; (b) test if nucleotide diversity at the edges of species ranges are significantly higher or lower than on the overall range; and (c) analyze if areas of higher species gain, loss, and turnover coincide with those predicted for lineages richness and nucleotide diversity. We found that about 80% of the studied species are predicted to contract their range. Within each species, some lineages were predicted to contract their range, while others were predicted to maintain or expand it. Therefore, estimating the impacts of climate change at the species level only can underestimate losses at the intraspecific level. Some species had significant high amount of nucleotide at the trailing or leading edge, or both, but we did not find a consistent pattern across species. Spatial patterns of species richness, gain, loss, and turnover were fairly concurrent with lineages richness and nucleotide diversity. Our results support the need for increased attention to intraspecific diversity regarding monitoring and conservation strategies under climate change.