bluuebunny/crossref_metadata_2025 huggingface dataset:
A single heterologously expressed plant cellulose synthase isoform is sufficient for cellulose microfibril formation in vitro
Authors: Purushotham Pallinti , Cho Sung Hyun , Díaz-Moreno Sara M. , Kumar Manish , Nixon B. Tracy , Bulone Vincent , Zimmer Jochen
Published: September 2016

Significance

Cellulose is an abundant natural polymer synthesized primarily by vascular plants in which it forms the load-bearing component of the cell wall. It is a linear polymer of glucose molecules synthesized by membrane-embedded cellulose synthases that couple polymer synthesis with its secretion across the plasma membrane. Plants express multiple cellulose synthase isoforms that are organized into large macromolecular assemblies of varying composition that are likely responsible for aligning the cellulose strands into microfibrils. Here we show that recombinantly expressed and purified
Populus tremula
x
tremuloides
(hybrid aspen) cellulose synthase-8 is sufficient for cellulose biosynthesis and produces cellulose microfibrils in vitro. Our results demonstrate that no other plant-derived factors are required for cellulose microfibril biosynthesis.
Support vector machine applied to predict the zoonotic potential of
E. coli
O157 cattle isolates
Authors: Lupolova Nadejda , Dallman Timothy J. , Matthews Louise , Bono James L. , Gally David L.
Published: September 2016

Significance

Zoonotic infections with enterohemorrhagic
Escherchia coli
O157 have emerged as a serious threat to human health. Conventional sequence-based analyses indicate that most human infections originate from particular pathogenic lineages. In this study, we apply a machine-learning approach to complex pangenome information and predict the human infection potential of cattle
E. coli
O157 isolates. We demonstrate that only a small subset of bovine strains is likely to cause human disease, even within previously defined pathogenic lineages. The approach was tested across isolates from the United Kingdom and United States and verified with food and cattle isolates from outbreak investigations. This finding has important implications for targeting of control strategies in herds.
Mechanism of inhibition of the tumor suppressor Patched by Sonic Hedgehog
Authors: Tukachinsky Hanna , Petrov Kostadin , Watanabe Miyako , Salic Adrian
Published: September 2016

Significance

The Hedgehog-signaling pathway plays key roles in animal development and physiology. Insufficient Hedgehog signaling causes birth defects, whereas uncontrolled signaling is implicated in cancer. Signaling is triggered by the secreted protein, Sonic Hedgehog, which inhibits the membrane protein Patched1, leading to pathway activation. Despite its fundamental importance, we do not understand how Sonic Hedgehog inhibits Patched1. Here, we uncover a critical interaction between the fatty-acid–modified N-terminal portion of Sonic Hedgehog and Patched1, and we demonstrate that it is necessary and sufficient for Patched1 inhibition during Hedgehog signaling. This interaction explains impairment of a Sonic Hedgehog mutant causing a congenital brain malformation (holoprosencephaly) and oncogenic activity of Patched1 mutants responsible for a human cancer syndrome.
Whole-exome sequencing identifies multiple loss-of-function mutations of NF-κB pathway regulators in nasopharyngeal carcinoma
Authors: Zheng Hong , Dai Wei , Cheung Arthur Kwok Leung , Ko Josephine Mun Yee , Kan Rebecca , Wong Bonnie Wing Yan , Leong Merrin Man Long , Deng Mingdan , Kwok Tommy Chin Tung , Chan Jimmy Yu-Wai , Kwong Dora Lai-Wan , Lee Anne Wing-Mui , Ng Wai Tong , Ngan Roger Kai Cheong , Yau Chun Chung , Tung Stewart , Lee Victor Ho-fun , Lam Ka-On , Kwan Chung Kong , Li Wing Sum , Yau Stephen , Chan Kwok-Wah , Lung Maria Li
Published: September 2016

Significance

Host genetics, environmental factors, and EBV infection together contribute to nasopharyngeal carcinoma (NPC) development. A number of critical genetic and epigenetic events contributing to tumor development has been reported. However, the genomic alterations in NPC have not been completely deciphered. We used the whole-exome sequencing approach to study the somatic mutations in NPC, and an APOBEC-mediated mutagenesis signature was revealed. Importantly, multiple loss-of-function mutations in the NF-κB–negative regulators (NFKBIA,CYLD, andTNFAIP3) were discovered in NPC tumors, and we functionally confirmed that theNFKBIAloss-of-function mutations induce damaging effects on the WT proteins. Detection of these mutations emphasizes the critical role of NF-κB signaling in NPC tumorigenesis and provides perspectives for targeting this pathway in NPC treatment.
Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor
Authors: Shen Mei , Zhang Ning , Zheng Sanduo , Zhang Wen-Bo , Zhang Hai-Man , Lu Zekuan , Su Qian Peter , Sun Yujie , Ye Keqiong , Li Xiang-dong
Published: September 2016

Significance

Myosin-5a is a molecular motor that functions as a cargo transporter in cells. The motor function of myosin-5a is regulated by calcium via the calmodulin bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a. Here, we solve the crystal structure of a truncated myosin-5a containing the motor domain and the IQ1 complexed with calcium-bound calmodulin. Comparison of the structures of the IQ1 complexed with calmodulin with or without bound calcium reveals the calcium-induced conformational changes of calmodulin. We demonstrated that calmodulin continuously associates with the IQ1 during that calcium transition and that the IQ1 binding substantially changes the thermodynamic and kinetics of calcium transition in calmodulin. These findings provide insight into the mechanism by which calcium regulates myosin-5a.
Negotiating alignment in newspaper editorials
Authors: Breeze Ruth
Published: September 2016

Newspaper editorials are shaped by the need to negotiate alignment and rapport with a diverse readership. This is achieved partly through the resources of engagement (Martin and White 2005), that is, through the argumentative moves of disclaim, proclaim, entertain and attribute, by which dialogic relations with the reader are carefully modulated. One aspect of argumentation in editorials that has sometimes been overlooked is that of the concede-counter structure, by which the writer signals concurrence with the reader on a particular issue, only to counter this with a new argument that may wholly or partially refute the first one. Typically, leader writers signal this manoeuvre textually from the outset, indicating that they are setting up an argument in order to demolish it by means of specific lexical choices or patterns. Thus items such as “of course” or “naturally” are used to build up the first argument, with which the reader is understood to concur. This is generally followed by a turning point marked by “but”, “yet” or “though”, after which the counter-argument is presented. Corpus linguists have pointed out that the presence of this type of lexical patterning makes it possible to research argumentation in large volumes of text using corpus tools. This study contains an analysis of concede-counter patterns in a corpus consisting of all the editorials published in the Guardian newspaper in 2011. The distinctive patterns that emerge are described, with particular attention paid to patterns of alignment and disalignment that emerge, as well as the related use of concurrence in asides to the reader. The role of such patterns in structuring discourse is analysed, with a particular focus on their ideological dimension as a means of subtly aligning readers with a particular set of opinions.
Managing criticisms in US-based and Taiwan-based reality talent contests
Authors: Tang Chihsia
Published: September 2016

This research studied how English and Chinese speakers encode their criticisms in the media discourse, aiming to explore the correlation between the speakers’ applications of pragmalinguistic strategies and their sociocultural orientations. Criticisms analyzed in the present study were collected from evaluative communications elicited from the US-based talent competitionProject Runwayand the Taiwan-based talent competitionSuper Designer. The current analysis of the face attack act referred to Brown and Levinson’s politeness framework and face notion. The results showed different frequencies of criticizing strategies and redressive devices in the English and Chinese sub-corpora. In addition, the findings also manifested some cross-language variations in pragmalinguistic representation of the same criticizing strategy. The discrepancies were discussed from the perspective of context orientation of the American and Taiwanese societies, evidencing the strong linkage between the speakers’ communication patterns and the cultural norms of their social networks.
Categorization in talk
Authors: Hayashi Reiko
Published: September 2016

This article seeks to advance the usage-based discourse research that investigates meanings and processes of meaning construction in interaction by elaboratingan empirically grounded interdisciplinary model. The paradigmatic and sequential analysis employed here brings together linguistic discourse analysis with an ethnomethodological perspective, and presents an innovative take on category organization in talk,explaininghow to capture knowledge resources such as asymmetrical category contrast pairs in talk. In analyzing in detail the speaker’s taxonomy constructionin a sample conversation, the papersystematicallyexploresthefollowing two topicsrelated to the speaker: what category characteristic he is orientingto as a resource for his present talkandwhat socialmeaning the speaker’s taxonomizing isconsistentlycommunicatingin the flow of talk. The proposed model captures a color binary–used to categorize people–of the ‘colored’versus the ‘white’, entailed in theexpression ‘a so-called yellowcolored people’,and reveals that the category pair is used as an organizational device in the speaker’s argument.The paper claims that taxonomy analysis in sequence is useful to examine the selected words in relation to their semiotic resources.
Evaluation of a Long‐Term Predator Removal Program: Abundance and Population Dynamics of Invasive Northern Pike in the Yampa River, Colorado
Authors: Zelasko Koreen A. , Bestgen Kevin R. , Hawkins John A. , White Gary C.
Published: September 2016

The Northern Pike Esox lucius is invasive in the upper Green and Yampa River basins of Colorado and Utah and impedes endangered fish recovery in the upper Colorado River basin. Mechanical removal was implemented in 2004, but Northern Pike population dynamics and removal efficacy were not well understood. We analyzed mark–recapture records from 8,929 individual Northern Pike captured during 2004–2010 from three reaches of the Yampa River: Hayden to Craig (upstream reach), South Beach–Little Yampa Canyon–Juniper (middle reach), and Maybell–Sunbeam (downstream reach), encompassing 175 river kilometers. Annual survival rates for Northern Pike of the mean TL (465 mm) were highest downstream (mean = 0.54; range = 0.36–0.71) and lowest upstream (mean = 0.25; range = 0.12–0.38). Annual abundance exhibited the opposite pattern, as it was highest upstream (annual range = 1,144–4,078 fish) and lowest downstream (range = 232–746 fish). After removal occurred each year, Northern Pike abundance increased annually by nearly 1,000% in the upstream reach, over 875% in the middle reach, and over 375% in the downstream reach due to recruitment and immigration. Resulting densities were 4–58 times higher than those for a native apex predator, the endangered Colorado Pikeminnow Ptychocheilus lucius. Northern Pike movement was mostly (90%) downstream and sometimes extensive, which may have promoted establishment of additional populations. Removal rates were inadequate to reduce Northern Pike abundance in the Yampa River because recruitment and immigration exceeded removal and mortality. Investigation of reproduction and recruitment, along with source management, spawning disruption, and increased removal, are needed to further reduce Northern Pike abundance and to aid recovery of native and endangered fishes. These findings underscore the need for sustained, comprehensive, and often costly removal efforts—including evaluation of their effects—in the face of the expanding distribution and abundance of invasive predator species.

Received April 16, 2015; accepted March 29, 2016Published online September 19, 2016
Production of high activity Aspergillus niger BCC4525 β-mannanase in Pichia pastoris and its application for mannooligosaccharides production from biomass hydrolysis
Authors: Harnpicharnchai Piyanun , Pinngoen Waraporn , Teanngam Wanwisa , Sornlake Warasirin , Sae-Tang Kittapong , Manitchotpisit Pennapa , Tanapongpipat Sutipa
Published: September 2016

A cDNA encoding β-mannanase was cloned from Aspergillus niger BCC4525 and expressed in Pichia pastoris KM71. The secreted enzyme hydrolyzed locust bean gum substrate with very high activity (1625 U/mL) and a relatively high kcat/Km (461 mg−1 s−1 mL). The enzyme is thermophilic and thermostable with an optimal temperature of 70 °C and 40% retention of endo-β-1,4-mannanase activity after preincubation at 70 °C. In addition, the enzyme exhibited broad pH stability with an optimal pH of 5.5. The recombinant enzyme hydrolyzes low-cost biomass, including palm kernel meal (PKM) and copra meal, to produce mannooligosaccharides, which is used as prebiotics to promote the growth of beneficial microflora in animals. An in vitro digestibility test simulating the gastrointestinal tract system of broilers suggested that the recombinant β-mannanase could effectively liberate reducing sugars from PKM-containing diet. These characteristics render this enzyme suitable for utilization as a feed additive to improve animal performance.
Final report on COOMET supplementary comparison of inductance at 10 mH and 100 mH at 1 kHz (COOMET.EM-S14)
Authors: Velychko O , Shevkun S
Published: September 2016

An inter-comparison of 10 mH and 100 mH inductance standards has taken place within the framework of COOMET. The inter-comparison, piloted by State Enterprise 'Ukrmetrteststandard'-UMTS (Ukraine), has involved four laboratories, including one who is a member of another regional metrological organization - EURAMET (GUM, Poland). The results presented in this report show that there are significant differences between some laboratory representations of the henry. However, the agreement demonstrated by the inter-comparison provides confidence in maintaining traceability for the henry.

KEY WORDS FOR SEARCH

Inter-comparison, inductance standard, traceability, regional metrological organization

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Key comparison SIM.EM.RF-K5b.CL: scattering coefficients by broad-band methods, 2 GHz–18 GHz — type N connector
Authors: Silva H , Monasterios G
Published: September 2016

The first key comparison in microwave frequencies within the SIM (Sistema Interamericano de Metrología) region has been carried out. The measurands were the S-parameters of 50 ohm coaxial devices with Type-N connectors and were measured at 2 GHz, 9 GHz and 18 GHz. SIM.EM.RF-K5b.CL was the identification assigned and it was based on a parent CCEM key comparison named CCEM.RF-K5b.CL. For this reason, the measurements standards and their nominal values were selected accordingly, i.e. two one-port devices (a matched and a mismatched load) to cover low and high reflection coefficients and two attenuators (3dB and 20 dB) to cover low and high transmission coefficients. This key comparison has met the need for ensuring traceability in high-frequency measurements across America by linking SIM's results to CCEM. Six NMIs have participated in this comparison which was piloted by the Instituto Nacional de Tecnología Industrial (Argentina). A linking method of multivariate values was proposed and implemented in order to allow the linking of 2-dimensional results.

KEY WORDS FOR SEARCH

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Dust evolution processes constrained by extinction curves in nearby galaxies
Authors: Hou Kuan-Chou , Hirashita Hiroyuki , Michałowski Michał J.
Published: September 2016

Extinction curves, especially those in the Milky Way (MW), the Large Magellanic Cloud (LMC), and the Small Magellanic Cloud (SMC), have provided us with a clue to the dust properties in the nearby Universe. We examine whether or not these extinction curves can be explained by well-known dust evolution processes. We treat the dust production in stellar ejecta, destruction in supernova shocks, dust growth by accretion and coagulation, and dust disruption by shattering. To make a survey of the large parameter space possible, we simplify the treatment of the grain size distribution evolution by adopting the “two-size approximation,” in which we divide the grain population into small (≲0.03 μm) and large (≳0.03 μm) grains. It is confirmed that the MW extinction curve can be reproduced in reasonable ranges for the time-scale of the above processes with a silicate–graphite mixture. This indicates that the MW extinction curve is a natural consequence of the dust evolution through the above processes. We also find that the same models fail to reproduce the SMC/LMC extinction curves. Nevertheless, this failure can be remedied by giving higher supernova destruction rates for small dust particles dust and considering amorphous carbon for carbonaceous dust; these modifications in fact fall in line with previous studies. Therefore, we conclude that the current dust evolution scenario composed of the aforementioned processes is successful in explaining the extinction curves. All the extinction curves favor efficient interstellar processing of dust, especially strong grain growth by accretion and coagulation.
Sex Differences in Methamphetamine Use and Dependence in a Thai Treatment Center
Authors: Rungnirundorn Teerayuth , Verachai Viroj , Gelernter Joel , Malison Robert T. , Kalayasiri Rasmon
Published: September 2016

Background and Objective:

Males and females who use methamphetamine (MA) differ in sociodemographics, MA diagnoses, comorbidities, and brain activity. The objective of this study was to investigate sex differences in the characteristics of MA use and dependence in patients at a Thai substance treatment center.

Methods:

Demographic, MA use, and diagnostic data for 782 MA users were obtained by using the Semi-Structured Assessment for Drug Dependence and Alcoholism—Thai version. Categorical comparisons of males (n = 413, 53%) and females (n = 369, 47%) were made by chi-square test. Factors significantly differentiating men and women with respect to MA-dependence were identified by logistic regression analysis controlling for demographic, diagnostic, and MA use variables.

Results:

Males admitted to residential drug treatment for MA use had an earlier age of onset for both MA use (17.7 ± 4.1 vs 19.7 ± 6.2 years; t = −5.3, P < 0.001) and dependence (20.4 ± 5.2 vs 22.2 ± 6.4 years; t = −3.6, P < 0.001). Females were more likely than males to be MA-dependent (79% vs 60%; χ
2
1 = 33.7, P < 0.001), and to experience MA withdrawal (65.3% vs 48.9%; χ
2
1 = 21.4, P < 0.001), withdrawal-related hypersomnia (77.2% vs 64.8%; χ
2
1 = 14.5, P < 0.001), fatigue (77.5% vs 70.3%; χ
2
1 = 5.2, P = 0.02), and psychomotor retardation (64.5% vs 57.0%; χ
2
1 = 4.5, P = 0.03). Similarly, females had heavier (eg, largest daily amount [χ
2
1 = 12.4, P < 0.001), more frequent (χ
2
1 = 5.1, P = 0.02]) and greater lifetime episodes of MA use (χ
2
1 = 24.1, P < 0.001) than males. After controlling for such variables by logistic regression, being female remained a significant factor influencing the occurrence of MA-dependence (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8–4.1, P < 0.001). Shared associated factors (or comorbidities) for MA-dependence in both sexes included nicotine dependence (in males: OR 4.1, 95% CI 2.4–7.0, P < 0.001; and in females: OR 2.4, 95% CI 1.3–4.4, P = 0.007), greater lifetime episodes of MA use (in males: OR 3.5, 95% CI 1.9–6.4, P < 0.001; and in females: OR 5.9, 95% CI 3.1–11.4, P < 0.001), and more frequent use (in males: OR 5.1, 95% CI 2.8–9.1, P < 0.001; and in females: OR 3.6, 95% CI 1.9–6.9, P < 0.001). Comorbid antisocial personality disorder predicted MA-dependence in males only (OR 3.7, 95% CI 1.6–8.6, P = 0.002).

Conclusions:

The current study highlights both common (eg, nicotine dependence and severity of MA use) and sex-specific differences (eg, MA use/dependence characteristics and comorbidities), including sex itself, with respect to MA-dependence in a Thai treatment cohort.
New Setting of Neurally Adjusted Ventilatory Assist during Noninvasive Ventilation through a Helmet
Authors: Cammarota Gianmaria , Longhini Federico , Perucca Raffaella , Ronco Chiara , Colombo Davide , Messina Antonio , Vaschetto Rosanna , Navalesi Paolo
Published: September 2016

Background

Compared to pneumatically controlled pressure support (PSP), neurally adjusted ventilatory assist (NAVA) was proved to improve patient–ventilator interactions, while not affecting comfort, diaphragm electrical activity (EAdi), and arterial blood gases (ABGs). This study compares neurally controlled pressure support (PSN) with PSP and NAVA, delivered through two different helmets, in hypoxemic patients receiving noninvasive ventilation for prevention of extubation failure.

Methods

Fifteen patients underwent three (PSP, NAVA, and PSN) 30-min trials in random order with both helmets. Positive end-expiratory pressure was always set at 10 cm H2O. In PSP, the inspiratory support was set at 10 cm H2O above positive end-expiratory pressure. NAVA was adjusted to match peak EAdi (EAdipeak) during PSP. In PSN, the NAVA level was set at maximum matching the pressure delivered during PSP by limiting the upper pressure. The authors assessed patient comfort, EAdipeak, rates of pressurization (i.e., airway pressure-time product [PTP] of the first 300 and 500 ms after the initiation of patient effort, indexed to the ideal pressure–time products), and measured ABGs.

Results

PSN significantly increased comfort to (median [25 to 75% interquartile range]) 8 [7 to 8] and 9 [8 to 9] with standard and new helmets, respectively, as opposed to both PSP (5 [5 to 6] and 7 [6 to 7]) and NAVA (6 [5 to 7] and 7 [6 to 8]; P < 0.01 for all comparisons). Regardless of the interface, PSN also decreased EAdipeak (P < 0.01), while increasing PTP of the first 300 ms from the onset of patient effort, indexed to the ideal PTP (P < 0.01) and PTP of the first 500 ms from the onset of patient effort, indexed to the ideal PTP (P < 0.001). ABGs were not different among trials.

Conclusions

When delivering noninvasive ventilation by helmet, compared to PSP and NAVA, PSN improves comfort and patient–ventilator interactions, while not ABGs. (Anesthesiology 2016; 125:1181-9)
Long-term effects of exercise in postmenopausal women: 16-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)
Authors: Kemmler Wolfgang , Kohl Matthias , von Stengel Simon
Published: September 2016

Objective:

Multimorbidity related to menopause and/or increased age will put healthcare systems in western nations under ever-greater strain. Effective strategies to prevent diseases are thus of high priority and should be started earlier in life. The purpose of the study was to evaluate the long-term effect of exercise on different important health parameters in initially early postmenopausal women over a 16-year period.

Methods:

In 1998, 137 early postmenopausal women with osteopenia living in Erlangen-Nürnberg were included in the study. Eighty-six women joined the exercise group (EG) and conducted two supervised group and two home training sessions per week, whereas the control group (CG: n = 51) maintained their physical activity level. Primary outcome parameters were clinical overall fractures incidence; secondary study endpoint was Framingham study-based 10-year risk of coronary death/myocardial infarction and low back pain.

Results:

In 2014, 59 women of the EG and 46 women of the CG were included in the 16-year follow-up analysis. Framingham study-based 10-year risk of myocardial infarction/coronary death increased significantly (P < 0.001) in both groups; however, changes were significantly more favorable in the EG (5.00% ± 2.94% vs CG: 6.90% ± 3.98%; P = 0.02). The ratio for clinical “overall” fractures was 0.47 (95% CI: 0.24-0.92; P = 0.03), and thus significantly lower in the EG. Although we focused on a high-intensity exercise strategy, low back pain was favorably affected in the EG.

Conclusions:

Multipurpose exercise programs demonstrated beneficial effects on various relevant risk factors and diseases of menopause or/and increased age, and should thus be preferentially applied for primary or secondary prevention in postmenopausal women.
DISTINCTIVE WHITE FUNDUS LESIONS IN FAMILIAL EXUDATIVE VITREORETINOPATHY: A NEWLY CHARACTERIZED CLINICAL FEATURE
Authors: Johnson Brandon B. , Hubbard George B. , Mendoza Pia R. , Grossniklaus Hans E.
Published: September 2016

Purpose:

To report a novel clinical finding associated with familial exudative vitreoretinopathy in three patients using fundus photography, fluorescein angiography, and histopathology.

Methods:

Observational case series of three patients with familial exudative vitreoretinopathy, an ophthalmic examination with fundus photography, and fluorescein angiography were used to document clinical findings between January 2007 and January 2015. Surgical specimens from one case were examined using standard histopathologic techniques, as well as transmission electron microscopy and energy dispersive x-ray analysis.

Results:

Distinctive white preretinal granules were noted in all cases and were found to be extramacular in location. Histopathology in one case revealed the granules to be crystalline structures with a regular pattern evident on higher magnification. The chemical constitution was found to be carbon, oxygen, and fluorine.

Conclusion:

Our case series represents the first description of white preretinal granules in association with familial exudative vitreoretinopathy. The authors have not seen these granules in other forms of retinopathy and their presence may aid in differentiating this disease from other entities.
EXUDATIVE RETINAL DETACHMENT CAUSED BY A CHOROIDAL NEOVASCULAR MEMBRANE IN HALLERMANN–STREIFF SYNDROME
Authors: AlAli Alaa , Bourgault Serge , Clark Ian , Lam Wai-Ching
Published: September 2016

Purpose:

To report a case of exudative retinal detachment caused by a choroidal neovascular membrane in Hallermann–Streiff syndrome.

Methods:

The authors report a 7-year-old white male with Hallermann–Streiff syndrome who developed exudative retinal detachments secondary to choroidal neovascular membrane that resolved after off-label use of intravitreal injections of bevacizumab 1.25 mg.

Conclusion:

Patients with Hallermann–Streiff syndrome and exudative retinal detachment present with choroidal neovascular membrane can respond well with intravitreal injections of anti-vascular endothelial growth factor.
Bisphosphonates and atypical femoral fractures
Authors: Adler Robert A.
Published: September 2016

Purpose of review

Bisphosphonates are used widely for the treatment of osteoporosis and prevention of fractures. Although generally well tolerated and effective, bisphosphonates (and denosumab, a newer antiresorptive agent) have been associated with unusual fractures of the femoral shaft.

Recent findings

New information about the incidence, pathophysiology, and management of atypical femoral fractures (AFFs) are reviewed. Histomorphometric studies have shown variable amounts of bone turnover suppression, but new studies suggest that healing near bone cracks may not occur in patients with AFF. Some studies suggest that hip and femur geometry make certain people more at risk for AFF. In some but not all studies, the risk of AFF appears to be related to duration of treatment. Thus, the benefit/risk ratio needs to be reassessed as bisphosphonate therapy is prolonged.

If we can better understand the pathogenesis of AFF, it may be possible to identify those patients at highest risk. In the meantime, clinicians must periodically assess risk for osteoporotic fracture versus risk for AFF in managing patients with osteoporosis.
Evolution of human oocyte cryopreservation: slow freezing versus vitrification
Authors: Levi-Setti Paolo Emanuele , Patrizio Pasquale , Scaravelli Giulia
Published: September 2016

Purpose of review

The purpose is to determine the efficiency and efficacy of oocyte cryopreservation by slow freezing versus vitrification, recent data collected from the Italian National Assisted Reproductive Technology Register during the period 2009–2014 will be presented and reviewed. The data on oocyte cryopreservation were also compared with the results obtained with embryo cryopreservation and relative IVF with fresh oocytes.

Recent findings

During the period 2009–2014 preservation of oocytes by vitrification had a significantly higher survival rate, implantation, and pregnancy rate than slow freezing; however, there are still large variations in success rates among centers in relation to the number of procedures performed.

Vitrification has now become the method of choice for oocyte cryopreservation because of better results than slow freezing, but still requires a more standardized utilization. The transfer of fresh or cryopreserved embryo still shows a statistically significant better performance than transfers with embryos obtained with cryopreserved oocytes. Only in a few centers with much experience in cryopreservation are the results between transfers of frozen embryos or embryos obtained from oocyte cryopreservation comparable.
Ethics of medical and nonmedical oocyte cryopreservation
Authors: Patrizio Pasquale , Molinari Emanuela , Caplan Arthur
Published: September 2016

Purpose of review

To assess the effectiveness and ethical dimensions of oocyte cryopreservation for both medical and social indications.

Recent findings

As more women are postponing motherhood for a variety of reasons, including lack of partner, for completing career plans and reaching financial stability, they are resorting to oocyte cryopreservation. To make informed choices, women rely on their primary care physicians (PCPs) for initial advice, but PCPs are not always fully prepared to discuss oocyte cryopreservation. Interestingly, there are mixed feelings among obstetricians/gynecologists on whether oocyte cryopreservation should be used for elective reasons, whereas it is fully supported for medical indications.

Oocyte vitrification has become an established procedure for safeguarding future reproductive chances for medical reasons, and its use is progressively expanding. There is an urgent need in preparing future PCPs and obstetricians/gynecologists as to how to initiate discussions with their patients about elective oocyte banking consistent with fully respecting patient autonomy so as to facilitate informed decisions.
Lessons Learned
Authors: Ziebert Carolyn , Klingbeil Carol , Schmitt Catherine A. , Stonek Alice V. , Totka Joan P. , Stelter Ashley , Schiffman Rachel F.
Published: September 2016

This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes.
Content Validation and Utility of a Critical Reflective Inquiry Assessment Tool
Authors: Asselin Marilyn E. , Fain James A.
Published: September 2016

A Critical Reflective Inquiry (CRI) Assessment Tool was developed based on the CRI Model to assess reflection in nursing practice. Experienced clinicians evaluated the CRI Assessment for clarity and relevance to the CRI Model and nursing practice utility. Content validity index was calculated for each item in the scale and then averaged across all items. The tool has potential in education and orientation for assessing the depth and focus of reflection and what is learned.
Making Research Delicious
Authors: Hayes Lane Susan , Serafica Reimund , Huffman Carolyn , Cuddy Alyssa
Published: September 2016

In the current healthcare environment, nurses must have a basic understanding of research to lead change and implement evidence-based practice. The purpose of this study was to evaluate the effectiveness of an educational intervention formulated on the framework of the Great American Cookie Experiment measuring nurses’ research knowledge, attitudes, and practice using mobile device gaming. This multisite quantitative study provides insight into promotion of research and information about best practices on innovative teaching strategies for nurses.
Improving Competence and Confidence With Evidence-Based Practice Among Nurses
Authors: Bissett Kim M. , Cvach Maria , White Kathleen M.
Published: September 2016

Evidence-based practice (EBP) is an integral part of quality patient care, reduction in practice variation, and increased nursing autonomy. Yet, EBP is not a consistent standard in many organizations. Although many barriers to EBP have been cited, this project focused on poor knowledge of the EBP process and a lack of available EBP mentors or experts. A bundled set of educational interventions to improve the EBP confidence and self-efficacy of nurses was developed and implemented. Comparison of pre/post data showed improvement in all categories and questions. Committee members expressed greater confidence with the process and comfort level with leading EBP projects following the intervention. The educational bundle used in this project can serve as a model for others looking to develop competent EBP mentors within their organization.
Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia
Authors: Hughes Linda , Adair Jean , Feng Feng , Maciejewski Stephanie , Sharma Harsha
Published: September 2016

BACKGROUND:

In the United States, fibromyalgia affects 2%–5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010.

PURPOSE:

The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia.

METHODS:

Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia.

RESULTS:

The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%).

CONCLUSION:

Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.
How Well Are Nurse Practitioners Prepared to Treat Common Musculoskeletal Conditions?
Authors: Benham A. J. , Geier Kathleen A.
Published: September 2016

BACKGROUND:

Musculoskeletal disorders affect a third of the U.S. population and are among the most prevalent, costly, and debilitating medical conditions. Basic familiarity with musculoskeletal conditions is essential for all primary care providers, including nurse practitioners (NPs).

PURPOSE:

The purpose of this study was: (1) to estimate the quantity of musculoskeletal education provided in NP programs; (2) to evaluate NPs' perceptions of their own confidence in providing musculoskeletal care versus other areas of primary care; and (3) to determine how well NPs score on a test of basic musculoskeletal knowledge.

METHODS:

An online self-reporting survey was conducted to evaluate NPs' knowledge, competence, and confidence in treating common musculoskeletal disorders.

RESULTS:

Most NPs receive fewer than 10 hours of musculoskeletal education, are subjectively less confident about their musculoskeletal skill set compared to other areas of primary care, and lack the basic knowledge to competently manage musculoskeletal problems in primary care.

CONCLUSION:

The findings of this study confirm earlier conclusions that, like our physician colleagues, the vast majority of nurse practitioners lack adequate preparation to manage common nonsurgical musculoskeletal problems.
Content-Area Framework for Conducting Family Meetings for Acutely Ill Psychiatric Patients
Authors: PON NATALIE C. , GORDON MOLLIE R. , COVERDALE JOHN , NGUYEN PHUONG T.
Published: September 2016

Family meetings are a critically important component of managing acutely psychiatrically ill patients, and learning how to conduct such a meeting is critically important in the training of psychiatrists. Because we found no published comprehensive tools that dealt with the biopsychosocial content areas to be covered in family meetings in acute psychiatric settings, we developed and present such a comprehensive tool that is based in part on a review of existing tools utilized by other disciplines. This article describes the specific steps involved in premeeting planning, the formal topic areas that might be canvassed during the meeting, and postmeeting documentation and debriefing. The general content areas for discussion during the meeting include the setting of goals and expectations, relevant history-gathering, assessment of the family’s understanding of the issues at stake, formal psychoeducation, and review of specific treatment strategies and clinical progress. The meeting may also include a discussion of resources available to the patient and family members and a review of issues related to the safety of the patient and others, management of early warning signs, and sensitive topics such as trauma, abuse, or violence that may play a role in the presentation or treatment of the patient to best translate established goals into a longer term plan of care. Implementation of this comprehensive and necessarily structured model should enhance the patient’s and family’s understanding of the issues at stake and should improve satisfaction, promote trust and an effective working alliance, and enhance the quality of the biopsychosocial care plan.
Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting
Authors: CAMPRODON-ROSANAS ESTER , BATLLE SANTIAGO , ESTRADA-PRAT XAVIER , ACEÑA-DÍAZ MARTA , PETRIZAN-ALEMAN ARAITZ , PUJALS ELENA , MARTIN-LÓPEZ LUIS M. , PÉREZ-SOLÁ VÍCTOR , RIBAS-FITÓ NÚRIA
Published: September 2016

Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time.
Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa
Authors: Rosenberg Molly S. , Gómez-Olivé Francesc X. , Rohr Julia K. , Houle Brian C. , Kabudula Chodziwadziwa W. , Wagner Ryan G. , Salomon Joshua A. , Kahn Kathleen , Berkman Lisa F. , Tollman Stephen M. , Bärnighausen Till
Published: September 2016

Objective:

To identify the unmet needs for HIV prevention among older adults in rural South Africa.

Methods:

We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age–sex standardization.

Results:

HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age–sex standardization.

Conclusions:

Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa.
Implementation and Operational Research: Active Referral of Children of HIV-Positive Adults Reveals High Prevalence of Undiagnosed HIV
Authors: Wagner Anjuli D. , Mugo Cyrus , Njuguna Irene N. , Maleche-Obimbo Elizabeth , Sherr Kenneth , Inwani Irene W. , Hughes James P. , Wamalwa Dalton C. , John-Stewart Grace C. , Slyker Jennifer A.
Published: September 2016

Objectives:

Few routine systems exist to test older, asymptomatic children for HIV. Testing all children in the population has high uptake but is inefficient, whereas testing only symptomatic children increases efficiency but misses opportunities to optimize outcomes. Testing children of HIV-infected adults in care may efficiently identify previously undiagnosed HIV-infected children before symptomatic disease.

Methods:

HIV-infected parents in HIV care in Nairobi, Kenya were systematically asked about their children's HIV status and testing history. Adults with untested children ≤12 years old were actively referred and offered the choice of pediatric HIV testing at home or clinic. Testing uptake and HIV prevalence were determined, as were bottlenecks in pediatric HIV testing cascade.

Results:

Of 10,426 HIV-infected adults interviewed, 8,287 reported having children, of whom 3,477 (42%) had children of unknown HIV status, and 611 (7%) had children ≤12 years of unknown HIV status. After implementation of active referral, the rate of pediatric HIV testing increased 3.8-fold from 3.5 to 13.6 children tested per month (Relative risk: 3.8, 95% confidence interval: 2.3 to 6.1). Of 611 eligible adults, 279 (48%) accepted referral and were screened, and 74 (14%) adults completed testing of 1 or more children. HIV prevalence among 108 tested children was 7.4% (95% confidence interval: 3.3 to 14.1%) and median age was 8 years (interquartile range: 2–11); 1 child was symptomatic at testing.

Conclusions:

Referring HIV-infected parents in care to have their children tested revealed many untested children and significantly increased the rate of pediatric testing; prevalence of HIV was high. However, despite increases in pediatric testing, most adults did not complete testing of their children.
Ultra–Low-Dose Ultrasound Molecular Imaging for the Detection of Angiogenesis in a Mouse Murine Tumor Model
Authors: Wang Shiying , Herbst Elizabeth B. , Mauldin F. William , Diakova Galina B. , Klibanov Alexander L. , Hossack John A.
Published: September 2016

Objectives

The objective of this study was to evaluate the minimum microbubble dose for ultrasound molecular imaging to achieve statistically significant detection of angiogenesis in a mouse model.

Materials and Methods

The preburst minus postburst method was implemented on a Verasonics ultrasound research scanner using a multiframe compounding pulse inversion imaging sequence. Biotinylated lipid (distearoyl phosphatidylcholine–based) microbubbles that were conjugated with antivascular endothelial growth factor 2 (VEGFR2) antibody (MBVEGFR2) or isotype control antibody (MBControl) were injected into mice carrying adenocarcinoma xenografts. Different injection doses ranging from 5 × 104 to 1 × 107 microbubbles per mouse were evaluated to determine the minimum diagnostically effective dose.

Results

The proposed imaging sequence was able to achieve statistically significant detection (P < 0.05, n = 5) of VEGFR2 in tumors with a minimum MBVEGFR2 injection dose of only 5 × 104 microbubbles per mouse (distearoyl phosphatidylcholine at 0.053 ng/g mouse body mass). Nonspecific adhesion of MBControl at the same injection dose was negligible. In addition, the targeted contrast ultrasound signal of MBVEGFR2 decreased with lower microbubble doses, whereas nonspecific adhesion of MBControl increased with higher microbubble doses.

Conclusions

The dose of 5 × 104 microbubbles per animal is now the lowest injection dose on record for ultrasound molecular imaging to achieve statistically significant detection of molecular targets in vivo. Findings in this study provide us with further guidance for future developments of clinically translatable ultrasound molecular imaging applications using a lower dose of microbubbles.