bluuebunny/crossref_metadata_2025 huggingface dataset:
The 20-Year Public Health Impact and Direct Cost of Testosterone Deficiency in U.S. Men
Authors: Moskovic Daniel J. , Araujo Andre B. , Lipshultz Larry I. , Khera Mohit
Published: October 2012

Introduction

Testosterone deficiency (TD) imposes a substantial public health burden in the U.S. We modeled the costs associated with TD-related sequelae including cardiovascular disease (CVD), diabetes mellitus (DM), and osteoporosis-related fractures (ORFs).

Aim

To quantify the incremental cost burden imposed by TD's cardiometabolic sequelae.

Method

Incidence, prevalence, and mortality of these conditions were collected for men ages 45–74 from six national databases and large cross-sectional studies. Relative risk (RR) rates were determined for these sequelae in patients with T < 300 ng/dL. The prevalence of TD was determined for this cohort of men.

Main Outcome Measures

Adjusted incidence and prevalence were determined. Annual costs for the three TD-related sequelae were inflated at a real rate of 3% for 20 years.

Results

Actual and adjusted (normalized for T deficiency) rates of CVD, DM, and ORFs in U.S. men aged 45–74 assuming a TD prevalence of 13.4% were calculated. We determined that, over a 20-year period, T deficiency is projected to be involved in the development of approximately 1.3 million new cases of CVD, 1.1 million new cases of DM, and over 600,000 ORFs. In year 1, the attributed cost burden of these diseases was approximately $8.4 billion. Over the entire 20-year period, T deficiency may be directly responsible for approximately $190–$525 billion in inflation-adjusted U.S. health care expenditures.

Conclusion

TD may be a significant contributor to adverse public health. Further study is needed to definitively describe the whether TD is a modifiable risk factor for CVD, DM, and ORFs. This may represent an opportunity for nationwide public health initiatives aimed at preventive care.
Effect of Different Cornstarch Types in New Formulations of Gluten‐ and Lactose‐Free White Sauces with High Protein Content
Authors: Quiles Amparo , Llorca Empar , Hernández‐Carrión María , Hernando Isabel
Published: October 2012

Celiac disease is an immune response to ingestion of gluten in genetically susceptible individuals. As gluten is present in white sauces, the aim of this paper was to obtain new formulations of gluten‐ and lactose‐free sauces with high protein content. The microstructure and several sensory and physical properties were studied. The results showed white sauces maintained good stability and resistance to syneresis during storage. The sauces had a continuous phase consisting of components of starch granules released from gelatinized granules and soy protein, and a dispersed phase consisting of fat globules and swollen starch granules with high amylopectin content. The viscosity of the sauces seems to be related to the number and interaction of starch granules and size of the fat globules. Sensory evaluation revealed the best evaluated sauces were made with cross‐linked starches. Therefore, these starches are recommended for the formulation of gluten‐ and lactose‐free sauces with high protein content.

Practical Applications

It is estimated that around 1% of the population suffers from celiac disease. Many of the gluten‐free foods currently available are low quality and have a poor taste and mouthfeel. Sauces are an important part of the human diet. The standard ingredients of a white sauce are milk, oil, flour or starch, and salt. Starch can contain gluten if it is obtained from cereals such as wheat, barley and rye. Moreover, the use of dairy ingredients with high lactose content is unsuitable for celiacs because many also suffer from lactose intolerance. Therefore, it is important to study new formulations of gluten‐ and lactose‐free white sauces with high protein elaborated with different types of cornstarch in order to inform the industry and improve the quality of life of celiacs.
Effects of Linking a Soil‐Water‐Balance Model with a Groundwater‐Flow Model
Authors: Stanton Jennifer S. , Ryter Derek W. , Peterson Steven M.
Published: October 2012

A previously published regional groundwater‐flow model in north‐central Nebraska was sequentially linked with the recently developed soil‐water‐balance (SWB) model to analyze effects to groundwater‐flow model parameters and calibration results. The linked models provided a more detailed spatial and temporal distribution of simulated recharge based on hydrologic processes, improvement of simulated groundwater‐level changes and base flows at specific sites in agricultural areas, and a physically based assessment of the relative magnitude of recharge for grassland, nonirrigated cropland, and irrigated cropland areas. Root‐mean‐squared (RMS) differences between the simulated and estimated or measured target values for the previously published model and linked models were relatively similar and did not improve for all types of calibration targets. However, without any adjustment to the SWB‐generated recharge, the RMS difference between simulated and estimated base‐flow target values for the groundwater‐flow model was slightly smaller than for the previously published model, possibly indicating that the volume of recharge simulated by the SWB code was closer to actual hydrogeologic conditions than the previously published model provided. Groundwater‐level and base‐flow hydrographs showed that temporal patterns of simulated groundwater levels and base flows were more accurate for the linked models than for the previously published model at several sites, particularly in agricultural areas.
Evaluating the effects of common‐pool resource institutions and market forces on species richness and forest cover in Ecuadorian indigenous Kichwa communities
Authors: Oldekop Johan A. , Bebbington Anthony J. , Hennermann Karl , McMorrow Julia , Springate David A. , Torres Bolier , Truelove Nathan K. , Tysklind Niklas , Villamarín Santiago , Preziosi Richard F.
Published: October 2012

We compare conservation outcomes between a protected area (PA) and four indigenous common‐property regimes (CPRs) under differing degrees of market integration in the Ecuadorian Amazon. We first assess how market forces and common‐pool resource institutions governing processes of forest conversion affect biodiversity and forest cover, and whether institutions mitigate the effect of market forces. We then analyze how biodiversity and forest cover differ between a PA, and communities with different market access. Finally, we link biodiversity and forest cover changes within communities to differences in land‐use practices. While we show similar levels of forest cover and biodiversity between the PA and large CPRs with little access to local markets, institutions appear not to attenuate market effects on conservation outcomes in our case studies. We discuss results within a common‐property theory context and highlight the importance of disentangling how market integration, common‐pool resource institutions, and resource health interact over time.
Soft tissue injuries of the tarsocrural joint: A retrospective analysis of 30 cases evaluated arthroscopically
Authors: Barker W. H. J. , Smith M. R. W. , Minshall G. J. , Wright I. M.
Published: October 2012

Reasons for performing the study

Intra‐articular soft tissue injuries of the equine tarsocrural joint have been poorly defined.

Methods

All horses that underwent arthroscopic surgery of a tarsocrural joint over a 10 year period were identified. Those with primary intra‐articular soft tissue injuries were selected for inclusion and the cases evaluated retrospectively.

Results

Two hundred and eighty‐one horses underwent tarsocrural joint arthroscopy during the study period, 30 of which met the inclusion criteria (30 joints). A combination of soft tissue lesions was more common than injury to a single structure. Injuries involved the joint capsule (n = 25), collateral ligaments (n = 20), dorsal plica (n = 8) and open communication between the tarsocrural joint and extensor bundle (n = 7). Following arthroscopic surgery and rehabilitation, 81% of horses were able to return to their previous function.

Conclusion

Intra‐articular soft tissue injuries of the tarsocrural joint may be associated with localising clinical signs of inflammation. This series represented 11% of the total number of arthroscopic procedures undertaken on that joint in a single referral hospital. Arthroscopic surgery allows accurate definition of the injuries and facilitates lesion management. Case outcome following arthroscopic debridement and a subsequent period of rehabilitation is favourable.

Potential relevance

In lame horses with clinical signs localised to the tarsocrural joint, disrupted intra‐articular soft tissues should be considered in the list of differential diagnoses. Attending clinicians should consider arthroscopic evaluation in cases where primary intra‐articular soft tissue injuries are suspected to be causative.
Leaf Gas Exchange Characteristics of Jatropha as Affected by Nitrogen Supply, Leaf Age and Atmospheric Vapour Pressure Deficit
Authors: Rajaona A. M. , Brueck H. , Asch F.
Published: October 2012

Facing a steadily increasing world energy demand, jatropha, among other energy crops, has been reported to potentially contribute to biofuel production. A basic characterisation of plant responses to abiotic environmental factors is important for assessing the model‐assisted potential of this plant in view of the many agro‐ecological zones in which jatropha is presently cultivated. Two pot experiments and two field studies were used to record gas exchange parameters in response to light, nitrogen supply, atmospheric vapour pressure deficit (VPD), leaf age and time of measurements. Variation of N supply from 0 to 16 mm resulted in lower rates of photosynthesis (A) and stomatal conductance (gs) of treatment 0 mm N compared with other N levels, whereas the light compensation point (IC), quantum yield (QY) and dark respiration rates (Rd) were similar in all treatments. In the field, diurnal effects were evident with higher light‐saturated photosynthetic rate (Amax) and QY and lower IC and Rd in the morning than in the afternoon. Considering leaf age effects, fully expanded leaves had a lower Amax compared with expanding leaves and this variation in leaf gas exchange was not related to changes in the chlorophyll index value (SPAD) which steadily increased with leaf age. QY of field and greenhouse plants varied from 0.023 to 0.037 and was substantially lower than in C3 plants. A was positively correlated with gs in a hyperbolic function. A varied from 0.64 to 21.13 μmol m−2 s−1 and gs varied from 12 to 469 mmol m−2 s−1. With increasing VPD, gs decreased, but this response differed between the field experiments and the two pot experiments which contrasted each other distinctively. Applying the inverse logistic function of Webb (Ecological Modeling, 56 (1991), 81), the maximal stomatal conductance of jatropha was in the range of 382 mmol m−2 s−1 and gs is predicted to be close to zero at 5 kPa. These data altogether indicate that light absorption characteristics of single leaves and carbohydrate status parameters should be investigated further to explain the low QY and the pronounced diurnal variation.
Melatonin levels in periodontal health and disease
Authors: Almughrabi O. M. , Marzouk K. M. , Hasanato R. M. , Shafik S. S.
Published: October 2012

Background and Objective

The aim of this study was to measure melatonin levels in the gingival crevicular fluid and saliva of subjects with healthy periodontal tissues, plaque‐induced gingival inflammation, chronic periodontitis and aggressive periodontitis.

Material and Methods

A total of 70 subjects were examined and assigned to four groups: healthy periodontium (10 subjects); plaque‐induced gingival inflammation (20 subjects); chronic periodontitis (20 subjects); and aggressive periodontitis (20 subjects). Gingival crevicular fluid and saliva samples were collected from each subject and analyzed usingELISAs.

Results

The melatonin levels in both gingival crevicular fluid and saliva were lower in patients with chronic periodontitis (10.4 and 12.8 pg/mL, respectively) and aggressive periodontitis (8.4 and 8.8 pg/mL, respectively) than in patients with gingivitis (13.9 and 17.6 pg/mL, respectively) and in healthy subjects (16.6 and 22.9 pg/mL, respectively). The mean melatonin levels in both gingival crevicular fluid and saliva were statistically significantly higher in healthy patients compared with patients with chronic periodontitis and aggressive periodontitis; however, there was no significant difference in the plaque‐induced gingival inflammation between the study groups.

Conclusions

The melatonin levels in gingival crevicular fluid and saliva are decreased in diseased periodontal tissues, especially periodontitis. The melatonin level was lowest in the aggressive periodontitis group.
Low Body Mass Index Is Associated with a Positive Response during a Head‐Up Tilt Test
Authors: LUIZ LUZ LEIRIA TIAGO , BARCELLOS SÔNIA REGINA , MORAES MARIA ANTONIETA , LIMA GUSTAVO GLOTZ DE , KUS TERESA , BARBISAN JUAREZ NEHAUS
Published: October 2012

Background: To describe the association between body mass index (BMI) and a positive response during a head‐up tilt test (HUT) in patients referred for an investigation of syncope.

Methods: Observational study of patients referred for the diagnostic evaluation of syncope. Patients were divided into four groups according to their BMI: <18.5 kg/m2, 18.5–24.9 kg/m2, 25–29.9 kg/m2, and > 30 kg/m2.

Results: A total of 419 patients were evaluated. The mean age was 43 ± 22 years, and 62% were female. The prevalence of a positive tilt test was different between groups when stratified by BMI (P = 0.01), with a higher proportion of patients with positive tests among those with BMI <18.5 kg/m2 compared with other groups (P = 0.05). Multivariate analysis also showed that underweight patients had a 3.9 times higher risk for a positive HUT response (P = 0.01); additionally, the use of contraceptive drugs was associated with a protective effect during HUT (odds ratio: 0.35, confidence interval:0.19–0.45, P = 0.001).

Conclusion: In our sample, changes in BMI are associated with a positive response for HUT, and oral contraceptives seemed to protect against this response. Further studies are needed with larger numbers of patients to corroborate this finding.

(PACE 2013; 36:37–41)
ECG Criteria for Accurate Localization of Left Anterolateral and Posterolateral Accessory Pathways
Authors: MOSS JOSHUA D. , GERSTENFELD EDWARD P. , DEO RAJAT , HUTCHINSON MATHEW D. , CALLANS DAVID J. , MARCHLINSKI FRANCIS E. , DIXIT SANJAY
Published: October 2012

Background
: Left lateral accessory pathway (AP) location along the mitral annulus (MA) can influence ablation strategy, including choice of a transseptal or retrograde aortic approach and the use of deflectable sheaths and/or bidirectional catheters. We aimed to develop electrocardiographic (ECG) criteria to accurately localize a left lateral AP, hypothesizing that the relationship of QRS amplitudes in limb leads II and III could be used to differentiate left anterolateral (LAL) from left posterolateral (LPL) AP locations.

Methods
: The ECGs from patients who underwent ablation of a left‐sided AP between 2001 and 2008 were evaluated for the relationship of QRS amplitudes in limb leads II and III. A LAL‐AP was defined by successful ablation between 12 and 3 o’clock on the MA, as seen in left anterior oblique (LAO) fluoroscopic projection. A LPL‐AP was defined by successful ablation between 3 and 6 o’clock in the LAO projection.

Results
: In 249 consecutive patients undergoing AP ablation, 23 met the prespecified inclusion criteria: manifest preexcitation due to single AP, ablated successfully in a LAL or LPL location. The ratio of dominant QRS amplitude in lead II to lead III was ≥1 in 10/11 patients with LAL‐AP, compared with 3/12 patients with a LPL‐AP (P = 0.002). Using these criteria, two blinded reviewers predicted a LAL or LPL location with 87% accuracy and 100% interobserver agreement.

Conclusions
: We report new ECG criteria that can be used to accurately predict the anterior and posterior location of a left lateral AP. Such localization may facilitate procedural planning. (PACE 2012;35:1444–1450)
Succinate dehydrogenase assembly factor 2 is needed for assembly and activity of mitochondrial complex II and for normal root elongation in Arabidopsis
Authors: Huang Shaobai , Taylor Nicolas L. , Ströher Elke , Fenske Ricarda , Millar A. Harvey
Published: October 2012

Mitochondria complex II (succinate dehydrogenase, SDH) plays a central role in respiratory metabolism as a component of both the electron transport chain and the tricarboxylic acid cycle. We report the identification of an SDH assembly factor by analysis of T‐DNA insertions in At5g51040, a protein with unknown function that was identified by mass spectrometry analysis as a low abundance mitochondrial protein. This gene is co‐expressed with a number of genes encoding mitochondrial proteins, including SDH1‐1, and has low partial sequence similarity to human SDHAF2, a protein required for flavin‐adenine dinucleotide (FAD) insertion into SDH. In contrast to observations of other SDH deficient lines in Arabidopsis, the sdhaf2 line did not affect photosynthetic rate or stomatal conductance, but instead showed inhibition of primary root elongation with early lateral root emergence, presumably due to the low SDH activity caused by the reduced abundance of SDHAF2. Both roots and leaves showed succinate accumulation but different responses in the abundance of other organic acids and amino acids assayed. Isolated mitochondria showed lowered SDH1 protein abundance, lowered maximal SDH activity and less protein‐bound flavin‐adenine dinucleotide (FAD) at the molecular mass of SDH1 in the gel separation. The short root phenotype and SDH function of sdhaf2 was fully complemented by transformation with SDHAF2. Application of the SDH inhibitor, malonate, phenocopied the sdhaf2 root architecture in WT. Whole root respiratory assays showed no difference between WT and sdhaf2, but micro‐respirometry of the tips of roots clearly showed low oxygen consumption in sdhaf2 which could explain a metabolic deficit responsible for root tip growth.
Convex Estimators for Optimization of Kriging Model Problems
Authors: Hamza Karim , Shalaby Mohammed
Published: October 2012

This paper presents a framework for identification of the global optimum of Kriging models that have been tuned to approximate the response of some generic objective function and constraints. The framework is based on a branch and bound scheme for subdivision of the search space into hypercubes while constructing convex underestimators of the Kriging models. The convex underestimators, which are the key development in this paper, provide a relaxation of the original problem. The relaxed problem has two main features: (i) convex optimization algorithms such as sequential quadratic programming (SQP) are guaranteed to find the global optimum of the relaxed problem and (ii) objective value of the relaxed problem is a lower bound within a hypercube for the original (Kriging model) problem. As accuracy of the convex estimators improves with subdivision of a hypercube, termination of a branch happens when either: (i) solution of the relaxed problem within the hypercube is no better than current best solution of the original problem or (ii) best solution of the original problem and that of the relaxed problem are within tolerance limits. To assess the significance of the proposed framework, comparison studies against genetic algorithm (GA), particle swarm optimization (PSO), random multistart sequential quadratic programming (mSQP), and DIRECT are conducted. The studies include four standard nonlinear test functions and two design application problems of water desalination and vehicle crashworthiness. The studies show the proposed framework deterministically finding the optimum for all the test problems. Among the tested stochastic search techniques (GA, PSO, mSQP), mSQP had the best performance as it consistently found the optimum in less computational time than the proposed approach except on the water desalination problem. DIRECT deterministically found the optima for the nonlinear test functions, but completely failed to find it for the water desalination and vehicle crashworthiness problems.
Dielectric function of LaAlO3 from 0.8 to 6 eV between 77 and 700 K
Authors: Marie Nelson Cayla , Spies Maria , Abdallah Lina S. , Zollner Stefan , Xu Yun , Luo Hongmei
Published: October 2012

The authors used spectroscopic ellipsometry to determine the dielectric function and the refractive index of LaAlO3 as a function of photon energy from 0.8 to 6 eV between 77 and 700 K. The ellipsometric angles were acquired over a broad range of incidence angles with a computer-controlled Berek waveplate compensator and with zone-averaging of the adjustable polarizer. The data were corrected for surface effects, such as surface roughness or adsorbed overlayers. The authors report Tauc–Lorentz model parameters for LaAlO3 at 300 K. After annealing in UHV for 20 h, the surface layer thickness decreased from 15 Å to less than 1 Å. They speculate that the anneal causes surface modifications, such as the evaporation of adsorbed molecular layers (hydrocarbons or water) or surface vacancies, and that surface diffusion leads to a reduction of surface roughness. They have also measured the temperature-dependence of the refractive index at 1.96 eV between 77 and 700 K and given a theoretical explanation of its origin.
High resolution patterning on nonplanar substrates with large height variation using electron beam lithography
Authors: Ray Vishva , Aida Yukinori , Funakoshi Ryo , Kato Hitoshi , Pang Stella W.
Published: October 2012

High resolution patterning on nonplanar substrates with large height variation using electron beam lithography is reported. Using an automatic, high precision, noncontact laser probe microscope, a three-dimensional map of the nonplanar substrate to be patterned is obtained first. This data are converted to a format for the electron beam lithography system, which performs the write by adjusting the plane of electron beam focus based on the mapping data. As a proof of concept of this patterning scheme, three different kinds of nonplanar substrates were used including a tilted Si wafer for a uniform and unidirectional tilt, a planoconvex lens for a multidirectional tilt, and deep Si trenches with a step height variation. The patterning scheme was tested for resolution, field stitching accuracy, and field placement accuracy. The results of these tests are in very close agreement with typical results that are obtained for flat substrates with similar patterning conditions. For wafers with 10 mm tilt, 50 nm gratings show a line width variation of 18%, average field stitching error of 1.06 nm with a 3σ of 24.62 nm, and field placement error of 20.53 nm with a 3σ variation of 31.92 nm. The simplicity of this method and the fact that it can be applied for various nonplanar substrates with nanometer scale precision and over large areas open up a new avenue for the fabrication of devices based on nonplanar substrates.
Rapid Acceleration Leads to Rapid Weakening in Earthquake-Like Laboratory Experiments
Authors: Chang J. C. , Lockner D. A. , Reches Z.
Published: October 2012

Grinding Out Earthquake Physics

Simulating earthquakes in the lab produces events that are often orders of magnitude lower in energy than large, damaging earthquakes; thus, it is unclear how well the behavior along these simulated faults extrapolates to the physics of large earthquakes.

Chang
et al.

(p.
101
; see the Perspective by

Shimamoto and Togo

) used a rotary apparatus that spins in tandem at high speeds with a disc-shaped rock sample, producing energies comparable to earthquakes of magnitudes 4 to 8. Experiments using both granite and dolomite samples suggest that the weakening of slip along faults during large earthquakes is a product of intense accelerations associated with the rupture event.
Are We Getting Closer to Valid Translational Models for Major Depression?
Authors: Berton Olivier , Hahn Chang-Gyu , Thase Michael E.
Published: October 2012

Advances in characterizing the neuropathology and functional dysconnectivity of depression and promising trials with emerging circuit-targeted and fast-onset therapeutics are providing unprecedented opportunities to gain deeper insight into the neurobiology of this devastating and pervasive disorder. Because of practical and ethical limitations to dissecting these mechanisms in humans, continued progress will critically depend on our ability to emulate aspects of depressive symptomatology and treatment response in nonhuman organisms. Although various experimental models are currently available, they often draw skepticism from both clinicians and basic research scientists. We review recent progress and highlight some of the best leads to diversify and improve discovery end points for preclinical depression research.
Earthquakes in the Lab
Authors: Shimamoto Toshihiko , Togo Tetsuhiro
Published: October 2012

Friction experiments using a flywheel-based apparatus can be used to simulate natural earthquakes.
Infusing Evolutionary Perspectives
Darwinian Agriculture
How Understanding Evolution Can Improve Agriculture

by R. Ford Denison

Princeton University Press, Princeton, NJ, 2012. 268 pp. $39.50, £27.95. ISBN 9780691139500.
Authors: Snow Allison A.
Published: October 2012

Questioning both the techno-centric approach of biotech and those who advocate blindly trying to mimic agriculture in nature's image, Denison argues that Darwinian insights are crucial to identify promising approaches to crop breeding and agricultural management.
They've Kept On Keeping On
Horseshoe Crabs and Velvet Worms
The Story of the Animals and Plants That Time Has Left Behind

by Richard Fortey

Knopf, New York, 2012. 374 pp. $28.95. ISBN 9780307263612.
Survivors
The Animals and Plants That Time Has Left Behind HarperCollins, London, 2011. £25. ISBN 9780007209866.
Authors: Sherratt Emma
Published: October 2012

Fortey introduces readers to well-worn organisms that, having endured all of the difficulties thrown at them over the ages, he refers to as "messengers from deep geological time."
Intestinal Wound Healing Requires a Wnt Balancing Act
Authors: Barrett Terrence A.
Published: October 2012

Control of wound healing via balancing signaling regulators may have implications for treating inflammatory bowel disease.
Supersolidity Shot Down by Its Own Discoverer
Authors: Cho Adrian
Published: October 2012

It now appears that the bizarre phenomenon of supersolidity—in which ultracold, highly pressurized solid helium supposedly flows through itself like a liquid without any viscosity—simply doesn't exist.
Utility Sacrificed for Speed, Supercomputer Critics Say
Authors: Normile Dennis
Published: October 2012

As Japan's K computer, which made headlines in June 2011 as the world's fastest supercomputer, is put to work on real-world problems, some scientific users say it was too narrowly built for speed.
Can We Make Our Brains More Plastic?
Authors: Vogel Gretchen
Published: October 2012

Neuroscientists have begun to understand a few of the factors that govern the flexibility of certain parts of the maturing brain, which may one day make it possible to rewire the adult brain.
Identification of Streptococcus intermedius Central Nervous System Infection by Use of PCR and Electrospray Ionization Mass Spectrometry
Authors: Bhatia Nisha S. , Farrell John J. , Sampath Rangarajan , Ranken Raymond , Rounds Megan A. , Ecker David J. , Bonomo Robert A.
Published: October 2012

We describe the utility of PCR and electrospray ionization with mass spectrometry (PCR/ESI-MS) of culture-negative cerebrospinal fluid (CSF) in order to identify Gram-positive cocci noted on a Gram stain of CSF from a previously healthy 26-year-old man with community-acquired pneumonia (CAP) and multiple brain abscesses. CSF samples were obtained 2 weeks apart, first by lumbar puncture and 2 weeks later from an external ventricular drain that was inserted into the right ventricle. Both CSF cultures were negative. A Gram stain of bronchoalveolar lavage (BAL) fluid was notable for many Gram-positive cocci (GPC), but cultures of BAL fluid and subcarinal lymph node biopsy tissue were negative. PCR/ESI-MS detected
Streptococcus intermedius
, a common cause of brain abscesses, in both CSF samples as well as in the fixed tissue from the biopsy. This unique case confirms
S. intermedius
pulmonary infection as the source of metastatic CNS infection and reveals the potential of PCR/ESI-MS to detect a streptococcal pathogen not captured by conventional cultures.
Comparison of SpectraCell RA Typing and Multilocus Sequence Typing for Extended-Spectrum-β-Lactamase-Producing Escherichia coli
Authors: Overdevest I. T. M. A. , Heck M. , van der Zwaluw K. , Willemsen I. , van de Ven J. , Verhulst C. , Kluytmans J. A. J. W.
Published: October 2012

Multilocus sequence typing (MLST) is one of the most reliable methods for typing of
Escherichia coli
, including extended-spectrum-β-lactamase-producing
E. coli
(ESBL-EC). We investigated the performance of a new typing method, SpectraCell RA (River Diagnostics, Madison, WI), in comparison on MLST on a well-defined collection of ESBL-EC isolates obtained from chicken meat and humans. Ninety-two ESBL-EC isolates obtained from meat and 59 ESBL-EC isolates obtained from human rectal swabs and clinical blood cultures were typed using MLST and SpectraCell RA. The sensitivity and specificity of SpectraCell RA were calculated, using MLST as a reference method. Subsequently, the results of SpectraCell RA were used to determine the relatedness of ESBL-EC isolates from chicken and humans. Using MLST as the gold standard, the performance of SpectraCell RA was evaluated for 3 different cutoff values: 0.99975, 0.99955, and 0.99935. Depending on the cutoff value, the sensitivity was mediocre to unacceptably low, with values of 9.4%, 43.9%, and 66.7%, respectively. When sensitivity increased, the specificity decreased rapidly, from 95.6% to 69.8% and 34.4%, respectively. Also, the number of clusters containing both human and meat samples varied from 0 (0.0%) to 14 (38.9%). Our study shows that SpectraCell RA is not a suitable typing method for ESBL-EC when evaluating relationships of ESBL-EC at the population level.
Lower-Sensitivity and Avidity Modifications of the Vitros Anti-HIV 1+2 Assay for Detection of Recent HIV Infections and Incidence Estimation
Authors: Keating Sheila M. , Hanson Debra , Lebedeva Mila , Laeyendecker Oliver , Ali-Napo N′ko L. , Owen S. Michele , Stramer Susan L. , Moore Richard D. , Norris Philip J. , Busch Michael P.
Published: October 2012

Recent-infection testing assays/algorithms (RITAs) have been developed to exploit the titer and avidity of HIV antibody evolution following seroconversion for incidence estimation. The Vitros Anti-HIV 1+2 assay (Ortho-Clinical Diagnostics) was approved by the FDA to detect HIV-1 and HIV-2 infections. We developed a less-sensitive (LS) and an avidity-modified version of this assay to detect recent HIV infection. Seroconversion panels (80 subjects, 416 samples) were tested to calculate the mean duration of recent infection (MDR) for these assays. A panel from known long-term (2+ years) HIV-infected subjects on highly active antiretroviral therapy (HAART) (
n
= 134) and subjects with low CD4 counts (AIDS patients [
n
= 140]) was used to measure the false-recent rate (FRR) of the assays. Using a signal-to-cutoff ratio of 20 and the LS-Vitros assay gave a RITA MDR of 215 days (95% confidence interval [95% CI], ±65 days) and using an avidity index (AI) of 0.6 gave an MDR of 170 days (±44 days), while a combination of the two assays yielded a MDR of 146 days (±38.6) and an FRR of 8%. Misclassifying subjects with known long-term infection as recently infected occurred in 14% of AIDS patients and 29% (95% CI, 22, 38) of HAART subjects and 3% (95% CI, 0.8, 7.2) and 42% (95% CI, 33, 51), respectively, for the LS- and avidity-modified Vitros assays, with a misclassification rate of 15% (95% CI, 11, 20) overall using a dual-assay algorithm. Both modified Vitros assays can be used to estimate the length of time since seroconversion and in calculations for HIV incidence. Like other RITAs, they are subject to high FRR in subjects on HAART or with AIDS.
Recovery of Bordetella pertussis from PCR-Positive Nasopharyngeal Samples Is Dependent on Bacterial Load
Authors: Vestrheim Didrik F. , Steinbakk Martin , Bjørnstad Martha L. , Moghaddam Amir , Reinton Nils , Dahl Mette L. , Grude Nils , Sandven Per
Published: October 2012

Viable
Bordetella pertussis
isolates are essential for surveillance purposes. We performed culture of 223 PCR-positive nasopharyngeal samples.
B. pertussis
was recovered from 45 (20.2%) of the samples. Growth was associated with a high bacterial load, as determined by PCR. Culture from PCR-positive samples is a feasible approach to recover
B. pertussis
isolates, and culture can be limited to samples with a high bacterial load.
Carriage of Neisseria lactamica in 1- to 29-Year-Old People in Burkina Faso: Epidemiology and Molecular Characterization
Authors: Kristiansen Paul A. , Diomandé Fabien , Ouédraogo Rasmata , Sanou Idrissa , Sangaré Lassana , Ouédraogo Abdoul-Salam , Ba Absatou Ky , Kandolo Denis , Dolan Thomas Jennifer , Clark Thomas A. , Préziosi Marie-Pierre , LaForce F. Marc , Caugant Dominique A.
Published: October 2012

Neisseria lactamica
is a true commensal bacterium occupying the same ecological niche as the pathogenic
Neisseria meningitidis
, which is responsible for outbreaks and large epidemics, especially in sub-Saharan Africa. To better understand the epidemiology of
N. lactamica
in Africa and its relationship to
N. meningitidis
, we studied
N. lactamica
carriage in 1- to 29-year-old people living in three districts of Burkina Faso from 2009 to 2011.
N. lactamica
was detected in 18.2% of 45,847 oropharyngeal samples. Carriage prevalence was highest among the 2-year-olds (40.1%) and decreased with age. Overall prevalence was higher for males (19.1%) than females (17.5%) (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.04 to 1.18), while among the 18- to 29-year-olds, carriage prevalence was significantly higher in women (9.1%) than in men (3.9%) (OR, 2.49; 95% CI, 1.94 to 3.19). Carriage prevalence of
N. lactamica
was remarkably homogeneous in the three districts of Burkina Faso and stable over time, in comparison with carriage of
N. meningitidis
(P. A. Kristiansen et al., Clin. Vaccine Immunol. 18:435–443, 2011). There was no significant seasonal variation of
N. lactamica
carriage and no significant change in carriage prevalence after introduction of the serogroup A meningococcal conjugate vaccine, MenAfriVac. Multilocus sequence typing was performed on a selection of 142 isolates. The genetic diversity was high, as we identified 62 different genotypes, of which 56 were new. The epidemiology of
N. lactamica
carriage and the molecular characteristics of carried isolates were similar to those reported from industrialized countries, in contrast to the particularities of
N. meningitidis
carriage and disease epidemiology in Burkina Faso.
First Isolation of Dietzia cinnamea from a Dog Bite Wound in an Adult Patient
Authors: Hirvonen Jari J. , Lepistö Inari , Mero Sointu , Kaukoranta Suvi-Sirkku
Published: October 2012

We report the first case of deep-wound colonization by
Dietzia cinnamea
in a patient who had been bitten by a dog.
Swab Protocol for Rapid Laboratory Diagnosis of Cutaneous Anthrax
Authors: Dauphin Leslie A. , Marston Chung K. , Bhullar Vinod , Baker Daniel , Rahman Mahmudur , Hossain M. Jahangir , Chakraborty Apurba , Khan Salah Uddin , Hoffmaster Alex R.
Published: October 2012

The clinical laboratory diagnosis of cutaneous anthrax is generally established by conventional microbiological methods, such as culture and directly straining smears of clinical specimens. However, these methods rely on recovery of viable
Bacillus anthracis
cells from swabs of cutaneous lesions and often yield negative results. This study developed a rapid protocol for detection of
B. anthracis
on clinical swabs. Three types of swabs, flocked-nylon, rayon, and polyester, were evaluated by 3 extraction methods, the swab extraction tube system (SETS), sonication, and vortex. Swabs were spiked with virulent
B. anthracis
cells, and the methods were compared for their efficiency over time by culture and real-time PCR. Viability testing indicated that the SETS yielded greater recovery of
B. anthracis
from 1-day-old swabs; however, reduced viability was consistent for the 3 extraction methods after 7 days and nonviability was consistent by 28 days. Real-time PCR analysis showed that the PCR amplification was not impacted by time for any swab extraction method and that the SETS method provided the lowest limit of detection. When evaluated using lesion swabs from cutaneous anthrax outbreaks, the SETS yielded culture-negative, PCR-positive results. This study demonstrated that swab extraction methods differ in their efficiency of recovery of viable
B. anthracis
cells. Furthermore, the results indicated that culture is not reliable for isolation of
B. anthracis
from swabs at ≥7 days. Thus, we recommend the use of the SETS method with subsequent testing by culture and real-time PCR for diagnosis of cutaneous anthrax from clinical swabs of cutaneous lesions.
Similarity and Divergence of Phylogenies, Antimicrobial Susceptibilities, and Virulence Factor Profiles of Escherichia coli Isolates Causing Recurrent Urinary Tract Infections That Persist or Result from Reinfection
Authors: Luo Yanping , Ma Yanning , Zhao Qiang , Wang Leili , Guo Ling , Ye Liyan , Zhang Youjiang , Yang Jiyong
Published: October 2012

In order to obtain a better molecular understanding of recurrent urinary tract infection (RUTI), we collected 75 cases with repeatedly occurring uncomplicated UTI. The genetic relationships among uropathogenic
Escherichia coli
(UPEC) isolates were analyzed by pulsed-field gel electrophoresis. While 39 (52%) of the RUTI cases were defined as “persistence” of the same strain as the primary infecting strain, 36 (48%) were characterized by “reinfection” with a new strain that is different from the primary strain. We then examined the antimicrobial susceptibilities and phylogenetic backgrounds of 39 persistence and 86 reinfection UPEC isolates, and screened 44 virulence factor (VF) genes. We found that isolates had significant differences in the following: placement in phylogenetic group B2 (41% versus 21%;
P
= 0.0193) and the presence of adhesin genes
iha
(49% versus 28%;
P
= 0.0233) and
papG
allele
I
′ (51% versus 24%;
P
= 0.003), iron uptake genes
fyuA
(85% versus 58%;
P
= 0.0037),
irp-2
(87% versus 65%;
P
= 0.0109), and
iutA
(87% versus 58%;
P
= 0.0014), and an aggregate VF score (median, 11 versus 9;
P
= 0.0030). In addition, 41% of persistence strains harbored three adhesin genes simultaneously, whereas 22% of reinfection isolates did (
P
= 0.0289). Moreover, 59% versus 29% (
P
= 0.0014) of persistence and reinfection isolates contained seven types of iron uptake genes. Taken together, the antimicrobial susceptibilities of UPEC isolates had little effect on the RUTI. Compared with reinfection strains, persistence UPEC isolates exhibited higher VF scores and carried more VF genes than may be involved in the development and progression of RUTI.
Use of Clustered Regularly Interspaced Short Palindromic Repeat Sequence Polymorphisms for Specific Detection of Enterohemorrhagic Escherichia coli Strains of Serotypes O26:H11, O45:H2, O103:H2, O111:H8, O121:H19, O145:H28, and O157:H7 by Real-Time PCR
Authors: Delannoy Sabine , Beutin Lothar , Fach Patrick
Published: October 2012

We explored the genetic diversity of the clustered regularly interspaced short palindromic repeat (CRISPR) regions of enterohemorrhagic
Escherichia coli
(EHEC) to design simplex real-time PCR assays for each of the seven most important EHEC serotypes worldwide. A panel of 958
E. coli
strains investigated for their CRISPR loci by high-throughput real-time PCR showed that CRISPR polymorphisms in
E. coli
strongly correlated with both O:H serotypes and the presence of EHEC virulence factors (
stx
and
eae
genes). The CRISPR sequences chosen for simplex real-time PCR amplification of EHEC strains belonging to the top 7 EHEC serogroups differentiated clearly between EHEC and non-EHEC strains. Specificity estimates for the CRISPR PCR assays varied from 97.5% to 100%. Sensitivity estimates for the assays ranged from 95.7% to 100%. The assays targeting EHEC O145:H28, O103:H2, and O45:H2 displayed 100% sensitivity. The combined usage of two simplex PCR assays targeting different sequences of the O26 CRISPR locus allowed detection of EHEC O26:H11 with 100% sensitivity. By combining two simplex PCR assays targeting different sequences of the EHEC O157 CRISPR locus, EHEC O157:H7 was detected with 99.56% sensitivity. EHEC O111:H8 and EHEC O121:H19 were detected with 95.9% and 95.7% sensitivity, respectively. This study demonstrates that the identification of EHEC serotype-specific CRISPR sequences is more specific than the mere identification of O-antigen gene sequences, as is used in current PCR protocols for detection of EHEC strains.
Atypical H-Type Bovine Spongiform Encephalopathy in a Cow Born after the Reinforced Feed Ban on Meat-and-Bone Meal in Europe
Authors: Guldimann Claudia , Gsponer Michaela , Drögemüller Cord , Oevermann Anna , Seuberlich Torsten
Published: October 2012

The significance of atypical bovine spongiform encephalopathies (BSE) in cattle for controlling the BSE epidemic is poorly understood. Here we report a case of atypical H-type BSE in a cow born after the implementation of the reinforced feed ban in Europe. This supports an etiology of H-type BSE unrelated to that of classical BSE.
Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia, 2006–2007: a cross-sectional study
Authors: Brennan Sharon Lee , Stanford Tyman , Wluka Anita E , Page Richard S , Graves Stephen E , Kotowicz Mark A , Nicholson Geoffrey C , Pasco Julie A
Published: October 2012

Objectives

There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006–2007.

Design

Cross-sectional.

Setting

BSD, South-eastern Victoria, Australia

Participants

All patients who underwent a TKR for OA, 2006–2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion.

Primary outcome measure

Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands.

Results

Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006–2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70–79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles.

Conclusions

Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.
DIRAC OPERATOR ON COMPLEX MANIFOLDS AND SUPERSYMMETRIC QUANTUM MECHANICS
Authors: IVANOV E. A. , SMILGA A. V.
Published: October 2012

We explore a simple [Formula: see text] supersymmetric quantum mechanics (SQM) model describing the motion over complex manifolds in external gauge fields. The nilpotent supercharge Q of the model can be interpreted as a (twisted) exterior holomorphic derivative, such that the model realizes the twisted Dolbeault complex. The sum [Formula: see text] can be interpreted as the Dirac operator: the standard Dirac operator if the manifold is Kähler and the Dirac operator involving certain particular extra torsions for a generic complex manifold. Focusing on the Kähler case, we give new simple physical proofs of the two mathematical facts: (i) the equivalence of the twisted Dirac and twisted Dolbeault complexes and (ii) the Atiyah–Singer theorem.
Knowledge Sharing Differences Between Engineering Functional Teams: An Empirical Investigation
Authors: Lin I-Ching , Seidel Rainer , Shekar Aruna , Shahbazpour Mehdi , Howell David
Published: October 2012

Studies on organisations have indicated the significance of acknowledging subcultures across an organisation. It is therefore important to consider dedicated Knowledge Management (KM) strategies for different "entities" within each ontology level to suit their unique characteristics. However, a review of the literature indicates that this concept so far appears to have only been applied down to departmental level. There is little research exploring the next level down, to whether or not different "teams" require different KM strategies to remain competitive. In order to answer this question, this research explores what differences there are between teams in the context of KM by using a case study of a medium-sized high-tech manufacturer in New Zealand. Different KM practices between homogeneous teams of design engineers from different technical disciplines within the same department were investigated. The findings confirmed that in the context of KM, teams within a department do not always behave homogeneously. Four factors that caused different tacit knowledge sharing practices between the functional teams in the Engineering Department of the case company were identified: The nature of the technical discipline, team resources, departmental structure design and team culture. Based on these findings, a KM approach defining a specific KM strategy for each team was then proposed. This approach provides managers with an alternative perspective on KM implementation, which may help mitigate the high failure rate of KM among businesses reported in the literature.