bluuebunny/crossref_metadata_2025 huggingface dataset:
Aromatic residues in RNase T stack with nucleobases to guide the sequence‐specific recognition and cleavage of nucleic acids
Authors: Duh Yulander , Hsiao Yu‐Yuan , Li Chia‐Lung , Huang Jason C. , Yuan Hanna S.
Published: September 2015

RNase T is a classical member of the DEDDh family of exonucleases with a unique sequence preference in that its 3′‐to‐5′ exonuclease activity is blocked by a 3′‐terminal dinucleotide CC in digesting both single‐stranded RNA and DNA. Our previous crystal structure analysis of RNase T‐DNA complexes show that four phenylalanine residues, F29, F77, F124, and F146, stack with the two 3′‐terminal nucleobases. To elucidate if the π–π stacking interactions between aromatic residues and nucleobases play a critical role in sequence‐specific protein–nucleic acid recognition, here we mutated two to four of the phenylalanine residues in RNase T to tryptophan (W mutants) and tyrosine (Y mutants). The Escherichia coli strains expressing either the W mutants or the Y mutants had slow growth phenotypes, suggesting that all of these mutants could not fully substitute the function of the wild‐type RNase T in vivo. DNA digestion assays revealed W mutants shared similar sequence specificity with wild‐type RNase T. However, the Y mutants exhibited altered sequence‐dependent activity, digesting ssDNA with both 3′‐end CC and GG sequences. Moreover, the W and Y mutants had reduced DNA‐binding activity and lower thermal stability as compared to wild‐type RNase T. Taken together, our results suggest that the four phenylalanine residues in RNase T not only play critical roles in sequence‐specific recognition, but also in overall protein stability. Our results provide the first evidence showing that the π−π stacking interactions between nucleobases and protein aromatic residues may guide the sequence‐specific activity for DNA and RNA enzymes.
Atypical effect of temperature tuning on the insertion of the catalytic iron−sulfur center in a recombinant [FeFe]‐hydrogenase
Authors: Morra Simone , Cordara Alessandro , Gilardi Gianfranco , Valetti Francesca
Published: September 2015

The expression of recombinant [FeFe]‐hydrogenases is an important step for the production of large amount of these enzymes for their exploitation in biotechnology and for the characterization of the protein‐metal cofactor interactions. The correct assembly of the organometallic catalytic site, named H‐cluster, requires a dedicated set of maturases that must be coexpressed in the microbial hosts or used for in vitro assembly of the active enzymes. In this work, the effect of the post‐induction temperature on the recombinant expression of CaHydA [FeFe]‐hydrogenase in E. coli is investigated. The results show a peculiar behavior: the enzyme expression is maximum at lower temperatures (20°C), while the specific activity of the purified CaHydA is higher at higher temperature (30°C), as a consequence of improved protein folding and active site incorporation.
Adaptive B‐spline neural network‐based vector control for a grid side converter in wind turbine‐DFIG systems
Authors: Setiawan Iwan , Priyadi Ardyono , Miyauchi Hajime , Purnomo Mauridhi Hery
Published: September 2015

This paper presents a novel control system design for the grid‐side converter of doubly fed induction generator wind power generation systems. The control method proposed in this work is a vector control based on adaptive B‐spline neural network by using a simple fixed‐gain stabilizing control topology. The adaptive control is designed both for inner current loops and an outer DC‐link voltage loop of the grid side converter control system. To guarantee the control stability, the weights updating rule for the B‐spline neural network is synthesized by utilizing Lyapunov's direct method. To verify the effectiveness of the proposed control system, extensive simulations are performed using MATLAB/Simulink. Based on the simulation results, it is concluded that the proposed controller has improved performance compared to an optimum proportional integral control system. It is also relatively robust against external disturbances and variations of the control parameters. © 2015 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Linking aptamer‐ligand binding and expression platform folding in riboswitches: prospects for mechanistic modeling and design
Authors: Aboul‐ela Fareed , Huang Wei , Abd Elrahman Maaly , Boyapati Vamsi , Li Pan
Published: September 2015

The power of riboswitches in regulation of bacterial metabolism derives from coupling of two characteristics: recognition and folding. Riboswitches contain aptamers, which function as biosensors. Upon detection of the signaling molecule, the riboswitch transduces the signal into a genetic decision. The genetic decision is coupled to refolding of the expression platform, which is distinct from, although overlapping with, the aptamer. Early biophysical studies of riboswitches focused on recognition of the ligand by the aptamer‐an important consideration for drug design. A mechanistic understanding of ligand‐induced riboswitch RNA folding can further enhance riboswitch ligand design, and inform efforts to tune and engineer riboswitches with novel properties. X‐ray structures of aptamer/ligand complexes point to mechanisms through which the ligand brings together distal strand segments to form a P1 helix. Transcriptional riboswitches must detect the ligand and form this P1 helix within the timescale of transcription. Depending on the cell's metabolic state and cellular environmental conditions, the folding and genetic outcome may therefore be affected by kinetics of ligand binding, RNA folding, and transcriptional pausing, among other factors. Although some studies of isolated riboswitch aptamers found homogeneous, prefolded conformations, experimental, and theoretical studies point to functional and structural heterogeneity for nascent transcripts. Recently it has been shown that some riboswitch segments, containing the aptamer and partial expression platforms, can form binding‐competent conformers that incorporate an incomplete aptamer secondary structure. Consideration of the free energy landscape for riboswitch RNA folding suggests models for how these conformers may act as transition states—facilitating rapid, ligand‐mediated aptamer folding. WIREs RNA 2015, 6:631–650. doi: 10.1002/wrna.1300

This article is categorized under:

RNA Structure and Dynamics > Influence of RNA Structure in Biological Systems

RNA Interactions with Proteins and Other Molecules > Small Molecule–RNA Interactions

Regulatory RNAs/RNAi/Riboswitches > Riboswitches
Current aspects of auxin biosynthesis in plants
Authors: Kasahara Hiroyuki
Published: September 2015

Auxin is an important plant hormone essential for many aspects of plant growth and development. Indole-3-acetic acid (IAA) is the most studied auxin in plants, and its biosynthesis pathway has been investigated for over 70 years. Although the complete picture of auxin biosynthesis remains to be elucidated, remarkable progress has been made recently in understanding the mechanism of IAA biosynthesis. Genetic and biochemical studies demonstrate that IAA is mainly synthesized from l-tryptophan (Trp) via indole-3-pyruvate by two-step reactions in Arabidopsis. While IAA is also produced from Trp via indole-3-acetaldoxime in Arabidopsis, this pathway likely plays an auxiliary role in plants of the family Brassicaceae. Recent studies suggest that the Trp-independent pathway is not a major route for IAA biosynthesis, but they reveal an important role for a cytosolic indole synthase in this pathway. In this review, I summarize current views and future prospects of IAA biosynthesis research in plants.
Disinfection by‐products effect on swimmers oxidative stress and respiratory damage
Authors: Llana‐Belloch Salvador , Priego Quesada Jose Ignacio , Pérez‐Soriano Pedro , Lucas‐Cuevas Ángel G. , Salvador‐Pascual Andrea , Olaso‐González Gloria , Moliner‐Martinez Yolanda , Verdú‐Andres Jorge , Campins‐Falco Pilar , Gómez‐Cabrera M. Carmen
Published: September 2015

Disinfection by‐products (DBPs) are generated through the reaction of chlorine with organic and inorganic matter in indoor swimming pools. Different DBPs are present in indoor swimming pools. This study evaluated the effects of different chlorinated formations in oxidative stress and lung damage in 20 swimmers after 40 min of aerobic swimming in 3 indoor pools with different characteristics. Biological samples were collected to measure lung damage (serum‐surfactant‐associated proteins A and B), oxidative stress parameters (plasma protein carbonylation and malondialdehyde, and whole‐blood glutathione oxidation), and swimming exertion values (blood lactate) before and after exercise. Free chlorine and combined chlorine in water, and chlorine in air samples were determined in all the swimming pools. Chlorination as disinfection treatment led to the formation of chloramines in water samples, mainly mono‐ and dichloramine. However, free chlorine was the predominate species in ultraviolet‐treated swimming pool. Levels of total chlorine increased as a function of the swimming activity in chlorinated swimming pools. The lower quality of the installation resulted in a higher content of total chlorine, especially in air samples, and therefore a higher exposure of the swimmer to DBPs. However, the concentration level of chlorinated DBPs did not result in significant variation in serum‐surfactant‐associated proteins A and oxidative stress parameters in swimmers. In conclusion, the quality of the installation affected the DBPs concentration; however, it did not lead to lung epithelial damage and oxidative stress parameters in swimmers.
Assessment of patient engagement with a mobile application among service members in transition
Authors: Pavliscsak Holly , Little Jeanette R , Poropatich Ronald K , McVeigh Francis L , Tong James , Tillman Johnie S , Smith Challis H , Fonda Stephanie Jo
Published: September 2015

Objective: This article examines engagement with a mobile application (“mCare”) for wounded Service Members rehabilitating in their communities. Many had behavioral health problems, Traumatic Brain Injury (TBI), and/or post-traumatic stress disorder (PTS). The article also examines associations between Service Members’ background characteristics and their engagement with mCare.

Materials and Methods: This analysis included participants who received mCare ( n = 95) in a randomized controlled trial. mCare participants received status questionnaires daily for up to 36 weeks. Participant engagement encompasses exposure to mCare, percentage of questionnaires responded to, and response time. Participants were grouped by health status—that is, presence/absence of behavioral health problems, PTS, and/or TBI. Histograms and regression analyses examined engagement by participants’ health status and background characteristics.

Results: Exposure to mCare did not differ by health status. Participants usually responded to ≥60% of the questionnaires weekly, generally in ≤10 h; however, participants with behavioral health problems had several weeks with <50% response and the longest response times. Total questionnaires responded to and response time did not differ statistically by health status. Older age and higher General Well-Being Schedule scores were associated with greater and faster response.

Discussion: The sustained response to the questionnaires suggests engagement. Overall level of response surpassed trends reported for American’s usage of mobile applications. With a few exceptions, Service Members engaged with mCare irrespective of health status.

Conclusion: Mobile health has the potential to increase the quantity and quality of patient-provider communications in a community-based, rehabilitation care setting, above that of standard care.
The changing trends and outcomes in renal replacement therapy: data from the ERA-EDTA Registry
Authors: Pippias Maria , Jager Kitty J. , Kramer Anneke , Leivestad Torbjørn , Sánchez Manuel Benítez , Caskey Fergus J. , Collart Frederic , Couchoud Cécile , Dekker Friedo W. , Finne Patrik , Fouque Denis , Heaf James G. , Hemmelder Marc H. , Kramar Reinhard , De Meester Johan , Noordzij Marlies , Palsson Runolfur , Pascual Julio , Zurriaga Oscar , Wanner Christoph , Stel Vianda S.
Published: September 2015

Background

This study examines the time trends in incidence, prevalence, patient and kidney allograft survival and causes of death (COD) in patients receiving renal replacement therapy (RRT) in Europe.

Methods

Eighteen national or regional renal registries providing data to the European Renal Association-European Dialysis and Transplant Association Registry between 1998 and 2011 were included. Incidence and prevalence time trends between 2001 and 2011 were studied with Joinpoint and Poisson regression. Patient and kidney allograft survival and COD between 1998 and 2011 were analysed using Kaplan–Meier and competing risk methods and Cox regression.

Results

From 2001 to 2008, the adjusted incidence of RRT rose by 1.1% (95% CI: 0.6, 1.7) annually to 131 per million population (pmp). During 2008–2011, the adjusted incidence fell by 2.2% (95% CI: −4.2, −0.2) annually to 125 pmp. This decline occurred predominantly in patients aged 45–64 years, 65–74 years and in the primary renal diseases diabetes mellitus type 1 and 2, renovascular disease and glomerulonephritis. Between 2001 and 2011, the overall adjusted prevalence increased from 724 to 1032 pmp (+3.3% annually, 95% CI: 2.8, 3.8). The adjusted 5-year patient survival on RRT improved between 1998–2002 and 2003–2007 [adjusted hazard ratio (HRa) 0.85, 95% CI: 0.84, 0.86]. Comparing these time periods, the risk of cardiovascular deaths fell by 25% (HRa 0.75, 95% CI: 0.74, 0.77). However the risk of malignant death rose by 9% (HRa 1.09, 95% CI: 1.03, 1.16) in patients ≥65 years.

Conclusion

This European study shows a declining RRT incidence, particularly in patients aged 45–64 years, 65–74 years and secondary to diabetic nephropathy. Encouragingly, the adjusted RRT patient survival continues to improve. The risk of cardiovascular death has decreased, though the risk of death from malignancy has increased in the older population.
Challenges in the Anesthetic and Intensive Care Management of Acute Ischemic Stroke
Authors: Kirkman Matthew A. , Lambden Simon , Smith Martin
Published: September 2015

Acute ischemic stroke (AIS) is a devastating condition with high morbidity and mortality. In the past 2 decades, the treatment of AIS has been revolutionized by the introduction of several interventions supported by class I evidence—care on a stroke unit, intravenous tissue plasminogen activator within 4.5 hours of stroke onset, aspirin commenced within 48 hours of stroke onset, and decompressive craniectomy for supratentorial malignant hemispheric cerebral infarction. There is new class I evidence also demonstrating benefits of endovascular therapy on functional outcomes in those with anterior circulation stroke. In addition, the importance of the careful management of key systemic physiological variables, including oxygenation, blood pressure, temperature, and serum glucose, has been appreciated. In line with this, the role of anesthesiologists and intensivists in managing AIS has increased. This review highlights the main challenges in the endovascular and intensive care management of AIS that, in part, result from the paucity of research focused on these areas. It also provides guidelines for the management of AIS based upon current evidence, and identifies areas for further research.
Lemierre Disease: A Case With Multilevel Epidural Abscess and Aggressive Neurological Weakness: Case Report and Literature Review
Authors: Sinatra Philip M. , Alander Dirk H.
Published: September 2015

Background:

Lemierre disease is a rare postanginal sepsis caused by the anaerobe Fusobacterium necrophorum. It is associated with a pharyngitis that progresses quickly to thrombophlebitis of the internal jugular vein and metastatic abscesses to pulmonary, soft tissue, articular, and organ systems. It is rarely associated with spinal epidural abscesses. Because of the increasing antibiotic resistance, its incidence is on the rise.

Methods:

A single-patient case report of an adolescent male who initially presented to our institution for bacteremia and febrile episodes. Over a 1-week course, he developed severe back pain and progressive lower extremity weakness. Advanced imaging revealed an epidural abscess spanning T2-L3 level with extension into the psoas and the paraspinal musculature. Acute management consisted of broad-spectrum intravenous (IV) antibiotics and hemilaminectomy decompression from T2 to L3. The patient completed a 6-week course of IV antibiotics and was followed for a 1-year time period with close clinical follow-up.

Results:

Blood cultures identified the infecting organism as F. necrophorum. The combination of IV antibiotics and acute hemilaminectomy decompression resulted in successful clearance of the infecting organism with normalization of inflammatory markers and cultures. The patient noted immediate and sustained neurological improvement, with return of full motor and sensory function. At the 1-year timepoint, the patient was able to return to sports and no sagittal/coronal imbalance was noted on radiographs.

Conclusions:

An aggressive case of Lemierre disease with extensive epidural abscess formation and neurological weakness was successfully managed with the combination of IV antibiotics and extensive hemilaminectomies for decompression. The patient exhibited no long-term sequela as a result of either the epidural abscess or of its treatment.

Level of Evidence:

Level V.
Sutureless Aortic Valve Replacement in the Setting of Triple-Valve Surgery
Authors: Mazine Amine , Vistarini Nicola , El-Hamamsy Ismail , Carrier Michel , Bouchard Denis , Demers Philippe
Published: September 2015

Sutureless aortic valve replacement is an emerging alternative to standard aortic valve replacement in high-risk surgical patients. We present our surgical technique for sutureless aortic valve replacement in patients undergoing triple-valve surgery. This procedure has been performed in six patients with excellent clinical and echocardiographic results. Despite some technical concerns, sutureless aortic valve replacement in the setting of triple-valve surgery is simple and reproducible.
The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study
Authors: Lozekoot Pieter W.J. , Gelsomino Sandro , Kwant Paul B. , Parise Orlando , Matteucci Francesco , de Jong Monique M.J. , Maessen Jos G. , Gründeman Paul F.
Published: September 2015

Objective

Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation.

Methods

The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures.

Results

Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis.

Conclusions

The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.
Rhizobium helianthi sp. nov., isolated from the rhizosphere of sunflower
Authors: Wei Xuexin , Yan Shouwei , Li Dai , Pang Huancheng , Li Yuyi , Zhang Jianli
Published: September 2015

A Gram-stain-negative, non-spore-forming, rod-shaped and aerobic bacterium, designated Xi19T, was isolated from a soil sample collected from the rhizosphere of sunflower (Helianthus annuus) in Wuyuan county of Inner Mongolia, China and was characterized taxonomically by using a polyphasic approach. Phylogenetic analysis based on 16S rRNA gene sequences indicated that the novel isolate was related to species of the genus Rhizobium, sharing the greatest 16S rRNA gene sequence similarity with Rhizobium rhizoryzae J3-AN59T (98.4 %), followed by Rhizobium pseudoryzae J3-A127T (97.4 %). There were low similarities ( < 91 %) between the atpD, recA and glnII gene sequences of the novel strain and those of members of the genus Rhizobium. DNA–DNA hybridization values between strain Xi19T and the most related strain Rhizobium rhizoryzae J3-AN59T were low. The major cellular fatty acids of strain Xi19T were C16 : 0, summed feature 8 (C18 : 1ω7c and/or C18 : 1ω6c) and C19 : 0 cyclo ω8c. Q-10 was identified as the predominant ubiquinone and the major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and phosphatidylcholine. The DNA G+C content of strain Xi19T was 60.2 mol%. On the basis of physiological and biochemical characteristics, coupled with genotypic data obtained in this work, strain Xi19T represents a novel species of the genus Rhizobium, for which the name Rhizobium helianthi is proposed. The type strain is Xi19T ( = CGMCC 1.12192T = KCTC 23879T).
Aliikangiella marina gen. nov., sp. nov., a marine bacterium from the culture broth of Picochlorum sp. 122, and proposal of Kangiellaceae fam. nov. in the order Oceanospirillales
Authors: Wang Guanghua , Tang Mingxing , Wu Huanlian , Dai Shikun , Li Tao , Chen Chenghao , He Hui , Fan Jiewei , Xiang Wenzhou , Li Xiang
Published: September 2015

A Gram-stain-negative, non-motile, non-spore-forming, long rod-shaped bacterium, designated strain GYP-15T, was isolated from the culture broth of a marine microalga,Picochlorumasp. 122. Phylogenetic analyses revealed that strain GYP-15Tshared 90.6 % 16S rRNA gene sequence similarity with its closest relative,Kangiella aquimarinaKCTC 12183T, and represents a distinct phylogenetic lineage in a robust clade consisting of GYP-15Tand members of the generaKangiellaandPleioneain the orderOceanospirillales. Chemotaxonomic and physiological characteristics, including major cellular fatty acids, NaCl tolerance and pattern of carbon source utilization, could also readily distinguish strain GYP-15Tfrom all established genera and species. Thus, it is concluded that strain GYP-15Trepresents a novel species of a new genus, for which the nameAliikangiella marinagen. nov., sp. nov. is proposed. The type strain ofAliikangiella marinais GYP-15T( = MCCC 1K01163T = KCTC 42667T). Based on phylogenetic results, 16S rRNA gene signature nucleotide pattern and some physiological characteristics, the three generaKangiella,PleioneaandAliikangiellaare proposed to make up a novel family,Kangiellaceaefam. nov., in the orderOceanospirillales.
Mapping phylogenetic trees to reveal distinct patterns of evolution
Authors: Kendall Michelle , Colijn Caroline
Published: September 2015

Evolutionary relationships are described by phylogenetic trees, but a central barrier in many fields is the difficulty of interpreting data containing conflicting phylogenetic signals. Obtaining credible trees that capture the relationships present in complex data is one of the fundamental challenges in evolution today. We present a way to map trees which extracts distinct alternative evolutionary relationships embedded in data and resolves phylogenetic uncertainty. Our method reveals a remarkably distinct phylogenetic signature in the VP30 gene of Ebolavirus, indicating possible recombination with significant implications for vaccine development. Moving to higher organisms, we use our approach to detect alternative histories of the evolution of anole lizards. Our approach has the capacity to resolve key areas of uncertainty in the study of evolution, and to broaden the credibility and appeal of phylogenetic methods.
Selection on network dynamics drives differential rates of protein domain evolution
Authors: Mannakee Brian K. , Gutenkunst Ryan N.
Published: September 2015

The long-held principle that functionally important proteins evolve slowly has recently been challenged by studies in mice and yeast showing that the severity of a protein knockout only weakly predicts that protein’s rate of evolution. However, the relevance of these studies to evolutionary changes within proteins is unknown, because amino acid substitutions, unlike knockouts, often only slightly perturb protein activity. To quantify the phenotypic effect of small biochemical per-turbations, we developed an approach to use computational systems biology models to measure the influence of individual reaction rate constants on network dynamics. We show that this dynamical influence is predictive of protein domain evolutionary rate in vertebrates and yeast, even after controlling for expression level and breadth, network topology, and knockout effect. Thus, our results not only demonstrate the importance of protein domain function in determining evolutionary rate, but also the power of systems biology modeling to uncover unanticipated evolutionary forces.
Controlling type 2 diabetes mellitus with herbal medicines: A triple‐blind randomized clinical trial of efficacy and safety
Authors: Mirfeizi Mani , Mehdizadeh Tourzani Zahra , Mirfeizi Seyedeh Zahra , Asghari Jafarabadi Mohammad , Rezvani Hamid Reza , Afzali Monireh
Published: September 2015

Background

The use of alternative medicines is common in patients with diabetes mellitus. The primary aim of the present study was to determine the effects of cinnamon and Caucasian whortleberry (Vaccinium arctostaphylos L.) on blood glucose control, lipid profile and body mass index (BMI) in patients with type 2 diabetes (T2DM).

Methods

In all, 105 T2DM patients were recruited to the present randomized triple‐blinded clinical trial. Patients were randomly divided into three groups and administered either placebo, cinnamon or whortleberry supplements (1 g/day) for 90 days. Fasting blood glucose (FBG), serum insulin, lipid profiles, and HbA1c were measured before and after the study.

Results

There were no significant differences in baseline characteristics among the three groups. After treatment, FBG, 2‐h blood postprandial glucose and homeostasis model assessment of insulin resistance (HOMA‐IR) scores were significantly reduced in patients in the whortleberry group, but not in the placebo group. After treatment, there was a significant difference in BMI between the cinnamon and control groups (P = 0.02). There were no significant differences in any variables between the cinnamon and whortleberry groups (P>0.05 for all). In addition, there was a significant decrease in all indices of glucose control in all the cinnamon and whortleberry groups (P < 0.05).

Conclusions

There were no significant differences in blood glucose levels, insulin sensitivity or lipid profile among the three groups. However, the use of cinnamon and whortleberry in addition to conventional medical treatment is recommended to adjust weight and blood glucose levels in patients with T2DM, respectively.
Chlorhexidine‐induced anaphylaxis in surgical patients: a review of the literature
Authors: Sharp Gary , Green Sarah , Rose Michael
Published: September 2015

Background

Chlorhexidine (CHL) has antiseptic and disinfectant properties used to prevent hospital‐acquired infections. CHL‐induced anaphylaxis is poorly reported in surgical literature despite government warnings and growing recognition. The aim of this review is to increase awareness of CHL‐induced anaphylaxis in the surgical population.

Methods

Literature review of Embase, Medline, PubMed and the Cochrane library using ‘anaphylaxis (and) chlorhexidine’ search terms.

Results

Thirty‐six articles were published on surgical patients suffering anaphylaxis to CHL. Within these, seven patients had two proven separate anaphylactic reactions and one had three separate proven anaphylactic reactions. The most commonly affected speciality was urology. The majority occurred during elective procedures. A history of atopy was surprisingly uncommon as was bronchospasm. Six patients required active chest compressions and 39.71% of patients had their surgical procedure abandoned. Unplanned intensive care admissions occurred in 27.94%.

Discussion

In order to reduce abandoned procedures, unplanned intensive care unit admissions, morbidity and mortality associated with CHL‐induced anaphylaxis we recommend the following: rationalization of CHL‐containing products, greater vigilance regarding subtle symptoms of CHL allergy, appropriate investigation of these symptoms and a greater awareness of CHL‐containing products. Lastly, we outline the appropriate investigations and highlight the need for meticulous documentation in those who are CHL allergic.
Diagnostic value of hyperfibrinogenemia as a predictive factor for appendiceal perforation in acute appendicitis
Authors: Zhao Lingling , Feng Shaoguang , Huang Songsong , Tong Yulong , Chen Zhongliang , Wu Peng , Lai Xin‐He , Chen Xiaoming
Published: September 2015

Background

Acute appendicitis is one of the most common emergency requiring operation. As the first discovered coagulation factor, plasma fibrinogen frequently increases with inflammation due to the activation of coagulation. The aim of this retrospective study was to investigate the diagnostic value of hyperfibrinogenemia as a preoperative laboratory marker for appendiceal perforation in patients with acute appendicitis.

Materials and methods

We identified 455 patients (202 females, 253 males; mean age, 31.7 years) with histologically confirmed acute appendicitis who underwent laparoscopic or open appendectomy. Results of preoperative laboratory values and post‐operative histologic results were analysed retrospectively. A multivariate logistic regression model was performed to determine patient's age and laboratory tests associated with perforated appendicitis.

Result

Mean plasma fibrinogen level of all patients was 3.99 g/L (1.41 SD; range, 1.73–10.6 g/L; median, 3.69 g/L). Patients with appendiceal perforation had a mean fibrinogen level of 5.72 g/L (1.52 SD; range, 3.38–10.04 g/L; median, 5.28 g/L), which was significantly higher than those with nonperforated groups (P = 0.001). Multivariate analysis showed fibrinogen and D‐dimer were associated with perforation (P = 0.001, P = 0.014, respectively). Areas under the receiver operating characteristic curve of fibrinogen for discriminating acute perforated appendicitis from non‐perforated groups were larger than white blood cell and D‐dimer.

Conclusions

Hyperfibrinogenemia was common in patients with acute appendicitis and fibrinogen may be useful as a predictive factor for appendiceal perforation.
Non‐autonomous overgrowth by oncogenic niche cells: Cellular cooperation and competition in tumorigenesis
Authors: Enomoto Masato , Vaughen John , Igaki Tatsushi
Published: September 2015

Tumor progression is classically viewed as the Darwinian evolution of subclones that sequentially acquire genetic mutations and autonomously overproliferate. However, growing evidence suggests that tumor microenvironment and subclone heterogeneity contribute to non‐autonomous tumor progression. Recent Drosophila studies revealed a common mechanism by which clones of genetically altered cells trigger non‐autonomous overgrowth. Such “oncogenic niche cells” (ONCs) do not overgrow but instead stimulate neighbor overgrowth and metastasis. Establishment of ONCs depends on competition and cooperation between heterogeneous cell populations. This review characterizes diverse ONCs identified in Drosophila and describes the genetic basis of non‐autonomous tumor progression. Similar mechanisms may contribute to mammalian cancer progression and recurrence.
Utility of component analyses in subjects undergoing sublingual immunotherapy for peanut allergy
Authors: Burk C. M. , Kulis M. , Leung N. , Kim E. H. , Burks A. W. , Vickery B. P.
Published: September 2015

Background

Sublingual immunotherapy (SLIT) with peanut changes clinical and immune responses in most peanut‐allergic individuals, but the response is highly variable.

Objective

We sought to examine the component‐specific effects of peanut SLIT and determine whether peanut component testing could predict the outcome of a double‐blind, placebo‐controlled food challenge (DBPCFC) after 12 months of peanut SLIT.

Methods

We included 33 subjects who underwent peanut SLIT with a DBPCFC of 2500 mg of peanut protein performed after 12 months of therapy. Plasma samples from baseline and after 12 months of peanut SLIT were assayed using ImmunoCAP for IgE and IgG4 against whole peanut, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9.

Results

Following 12 months of SLIT, 10 subjects (30%) passed the DBPCFC without symptoms and were considered desensitized. Subjects that failed the DBPCFC tolerated a median of 460 mg peanut protein (range: 10–1710 mg). The desensitized group had significantly lower baseline levels of IgE against peanut (median 40.8 vs. 231 kUA/L, P = 0.0082), Ara h 2 (median 17 vs. 113 kUA/L, P = 0.0082), and Ara h 3 (median 0.3 vs. 8.5 kUA/L, P = 0.0396). ROC curves indicated that baseline IgE against peanut and Ara h 2 were equally effective at discriminating between the two groups (AUC = 0.7957, P = 0.007752 for both).

Conclusion and Clinical Relevance

In this cohort of subjects undergoing SLIT for peanut allergy, lower baseline levels of IgE against Ara h 2, Ara h 3, and peanut were associated with successful desensitization.
Early detection of psychosis: helpful or stigmatizing experience? A qualitative study
Authors: Uttinger Martina , Koranyi Susan , Papmeyer Martina , Fend Fabienne , Ittig Sarah , Studerus Erich , Ramyead Avinash , Simon Andor , Riecher‐Rössler Anita
Published: September 2015

Aim

Despite the large scientific debate concerning potential stigmatizing effects of identifying an individual as being in an at‐risk mental state (ARMS) for psychosis, studies investigating this topic from the subjective perspective of patients are rare. This study assesses whether ARMS individuals experience stigmatization and to what extent being informed about the ARMS is experienced as helpful or harmful.

Methods

Eleven ARMS individuals, currently participating in the follow‐up assessments of the prospective Basel Früherkennung von Psychosen (FePsy; English: Early Detection of Psychosis) study, were interviewed in detail using a semistructured qualitative interview developed for this purpose. Data were analysed using Interpretative Phenomenological Analysis.

Results

Most individuals experiencing first symptoms reported sensing that there was ‘something wrong with them’ and felt in need of help. They were relieved that a specific term was assigned to their symptoms. The support received from the early detection centre was generally experienced as helpful. Many patients reported stigmatization and discrimination that appeared to be the result of altered behaviour and social withdrawal due to the prepsychotic symptoms they experienced prior to contact with the early detection clinic.

Conclusions

The results suggest that early detection services help individuals cope with symptoms and potential stigmatization rather than enhancing or causing the latter. More emphasis should be put on the subjective experiences of those concerned when debating the advantages and disadvantages of early detection with regard to stigma. There was no evidence for increased perceived stigma and discrimination as a result of receiving information about the ARMS.
Changes in triglyceride levels in ultra‐high risk for psychosis individuals treated with omega‐3 fatty acids
Authors: Mossaheb Nilufar , Papageorgiou Konstantinos , Schäfer Miriam R. , Becker Jana , Schloegelhofer Monika , Amminger G. Paul
Published: September 2015

Aim

The aim of this analysis was to assess changes in lipid parameters, specifically in triglyceride (TG) levels, in a population at ultra‐high risk (UHR) for psychosis treated with ω‐3 polyunsaturated fatty acids (PUFAs) versus placebo.

Methods

Data were derived from a randomized, double‐blind, placebo‐controlled trial conducted at an early psychosis unit. Eighty‐one individuals, aged 13–25 years, at UHR for psychosis participated in a 12‐week intervention trial of 1.2 g/day of ω‐3 PUFAs (n = 41) versus placebo (n = 40). Lipid and C‐reactive protein levels were collected at baseline and after 12 weeks.

Results

Between‐group comparisons showed no significant difference in TG levels after the intervention. However, in individuals with baseline TG levels above 150 mg dL−1 there was a significant mean TG reduction of 67.29 (SD 42.54; P = 0.006) in the ω‐3 group (n = 7).

Conclusion

In this sample of UHR individuals, a 12‐week intervention with ω‐3 PUFAs was effective in reducing previously elevated TG levels. This might introduce the possibility of altering the lipid profile and thus the risk of cardiovascular morbidity of UHR individuals.
Early intervention services in psychosis: from evidence to wide implementation
Authors: Csillag Claudio , Nordentoft Merete , Mizuno Masafumi , Jones Peter B. , Killackey Eóin , Taylor Matthew , Chen Eric , Kane John , McDaid David
Published: September 2015

Aim

Early intervention (EI) in psychosis is a comprehensive and evidence‐based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme fidelity, challenges for its widespread dissemination and economic perspectives related to it.

Methods

This paper is a narrative review about the evidence supporting EI and the challenges to its widespread dissemination.

Results

In spite of evidence of a wide range of benefits, widespread dissemination has been slow, and even currently implemented programmes might be threatened. This reflects in part the shortcomings of mental health care in general, such as low priority for funding, stigma and structural problems. Successful examples of advocacy, mobilization and destigmatization campaigns have overcome these difficulties.

Conclusions

Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost‐effectiveness, but not all stakeholders beyond mental health administrators are aware of this. Positive impacts of EI programmes on excess unemployment and tax forgone suggest that social affairs and labour ministries – and not only health ministries – could be more involved in governance of mental health issues; ministries of justice and education are other sector stakeholders than can benefit. Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives.
Efficacy of air polishing for the non‐surgical treatment of peri‐implant diseases: a systematic review
Authors: Schwarz Frank , Becker Kathrin , Renvert Stefan
Published: September 2015

Focused Question

In patients suffering from peri‐implant diseases, what is the efficacy of air polishing on changing signs of inflammation compared with control treatments (i.e. alternative measures for plaque removal with or without adjunctive antiseptic and/ or antibiotic therapy)?

Material & Methods

After electronic database and hand search, 10 full‐text articles were independently screened by two reviewers. Finally, a total of five studies (six publications) fulfilled the inclusion criteria. The weighted mean difference (WMD) [p; 95% CI] in bleeding on probing‐ (BOP) (primary outcome) and probing pocket depth‐ (PD) reductions was estimated using a random effect model.

Results

All studies reported on residual BOP scores after therapy. A narrative data synthesis did not reveal any major improvement of bleeding index/ BOP or disease resolution following air polishing over mechanical debridement at mucositis sites. At peri‐implantitis sites, WMD in BOP reduction between test and control (mechanical debridement with or without local antiseptic therapy, Er:YAG laser) groups was −23.83% [p = 0.048; 95% CI (−47.47, −0.20)] favouring air polishing over control measures.

Conclusions

While glycine powder air polishing is as effective as the control treatments at mucositis sites, it may improve the efficacy of non‐surgical treatment of peri‐implantitis over the control measures investigated. A complete disease resolution was commonly not obtained.
Occurrence and risk indicators of medication‐related osteonecrosis of the jaw after dental extraction: a systematic review and meta‐analysis
Authors: Gaudin Elise , Seidel Laurence , Bacevic Miljana , Rompen Eric , Lambert France
Published: September 2015

Aims

The primary objective was to assess the occurrence rate of Medication‐Related OsteoNecrosis of the Jaw (MRONJ) after dental extraction in patients treated with Antiresorptive Drugs (ARD) for OsteoPorosis (OP) or for oncological reasons. The secondary objective was to compare the extraction techniques regarding the occurrence of MRONJ.

Materials and Methods

A systematic search in PubMed/MEDLINE, EMBASE and LILACS databases was performed. Prospective studies considering human patients treated with ARD and providing information regarding the occurrence of MRONJ after dental extraction were selected. Meta‐analysis for incidence of MRONJ at the patient level was performed. The effect of administration route and surgical technique on MRONJ was evaluated.

Results

The risk of MRONJ after dental extraction was significantly higher in patients treated with ARD for oncological reasons (3.2%) than in those treated with per os ARD for OP (0.15%) (p < 0.0001). Dental extraction performed with adjusted extraction protocols decreased significantly MRONJ development. Potential risk indicators such as concomitant medications and pre‐existing osteomyelitis were identified.

Conclusion

The risk of MRONJ after dental extraction in patients treated with ARD exists, especially in patients treated for oncologic reasons. This risk tends to decrease with adjusted extraction protocols.
The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo‐controlled clinical trials
Authors: Asserin Jérome , Lati Elian , Shioya Toshiaki , Prawitt Janne
Published: September 2015

Background

Skin dryness and an accelerated fragmentation of the collagen network in the dermis are hallmarks of skin aging. Nutrition is a key factor influencing skin health and consequently its appearance. A wide range of dietary supplements is offered to improve skin health. Collagen peptides are used as a bioactive ingredient in nutricosmetic products and have been shown in preclinical studies to improve skin barrier function, to induce the synthesis of collagen and hyaluronic acid, and to promote fibroblast growth and migration. Our aim was to investigate the effect of oral supplementation with specific collagen peptides on skin hydration and the dermal collagen network in a clinical setting.

Methods

Two placebo‐controlled clinical trials were run to assess the effect of a daily oral supplementation with collagen peptides on skin hydration by corneometry, on collagen density by high‐resolution ultrasound and on collagen fragmentation by reflectance confocal microscopy. Human skin explants were used to study extracellular matrix components in the presence of collagen peptides ex vivo.

Results

Oral collagen peptide supplementation significantly increased skin hydration after 8 weeks of intake. The collagen density in the dermis significantly increased and the fragmentation of the dermal collagen network significantly decreased already after 4 weeks of supplementation. Both effects persisted after 12 weeks. Ex vivo experiments demonstrated that collagen peptides induce collagen as well as glycosaminoglycan production, offering a mechanistic explanation for the observed clinical effects.

Conclusion

The oral supplementation with collagen peptides is efficacious to improve hallmarks of skin aging.
Clinical effect of azithromycin as an adjunct to non‐surgical treatment of chronic periodontitis: a meta‐analysis of randomized controlled clinical trials
Authors: Zhang Z. , Zheng Y. , Bian X.
Published: September 2015

The results of recent published studies focusing on the effect of azithromycin as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis are inconsistent. We conducted a meta‐analysis of randomized controlled clinical trials to examine the effect of azithromycin combined with SRP on periodontal clinical parameters as compared to SRP alone. An electronic search was carried out on Pubmed, Embase and the Cochrane Central Register of Controlled Trials from their earliest records through December 28, 2014 to identify studies that met pre‐stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Data were extracted independently by two authors. Either a fixed‐ or random‐effects model was used to calculate the overall effect sizes of azithromycin on probing depth, attachment level (AL) and bleeding on probing (BOP). Heterogeneity was evaluated using the Q test and I2 statistic. Publication bias was evaluated by Begg's test and Egger's test. A total of 14 trials were included in the meta‐analysis. Compared with SRP alone, locally delivered azithromycin plus SRP statistically significantly reduced probing depth by 0.99 mm (95% CI 0.42–1.57) and increased AL by 1.12 mm (95% CI 0.31–1.92). In addition, systemically administered azithromycin plus SRP statistically significantly reduced probing depth by 0.21 mm (95% CI 0.12–0.29), BOP by 4.50% (95% CI 1.45–7.56) and increased AL by 0.23 mm (95% CI 0.07–0.39). Sensitivity analysis yielded similar results. No evidence of publication bias was observed. The additional benefit of systemic azithromycin was shown at the initially deep probing depth sites, but not at shallow or moderate sites. The overall effect sizes of systemic azithromycin showed a tendency to decrease with time, and meta‐regression analysis suggested a negative relation between the length of follow‐up and net change in probing depth (r = −0.05, p = 0.02). This meta‐analysis provides further evidence that azithromycin used as an adjunct to SRP significantly improves the efficacy of non‐surgical periodontal therapy on reducing probing depth, BOP and improving AL, particularly at the initially deep probing depth sites.