bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of aplastic anaemia with lower‐dose anti‐thymocyte globulin produces similar response rates and survival as per standard dose anti‐thymocyte globulin schedules
Authors: Scott A. , Morris K. , Butler J. , Mills A. K. , Kennedy G. A.
Published: July 2016

Background

Aplastic anaemia (AA) is a rare acquired bone marrow failure syndrome resulting from the immune‐mediated destruction of haemopoietic stem cells. For adults in whom first‐line haemopoietic progenitor cell transplantation is not feasible, combination anti‐thymocyte globulin (ATGAM) plus cyclosporine A is standard therapy; however, there are minimal data available regarding the optimal ATGAM dosage in terms of efficacy and survival.

Aims

Our institutions have historically used different dosing protocols of ATGAM in the treatment of AA. We aimed to review the outcome of AA patients treated with these protocols and compare them to the published literature.

Methods

We conducted a retrospective study of 31 adults who received first‐line ATGAM for AA and compared response rates and survival between cohorts who received standard (40 mg/kg/day D1–4) versus lower‐dose (15 mg/kg/day D1–5) ATGAM schedules.

Results

There were similar rates of response (64 vs 71%, P = 1.0), relapse (33 vs 33%, P = 1.0), transformation (14 vs 24%, P = 0.66) or infection (43 vs 47%, P = 1.0), respectively, between standard and lower‐dose cohorts. At a median follow up of 24 months, there was no statistical difference between standard and lower‐dose cohorts in either event‐free (42.2 vs 64.7%, P = 0.91) or overall survival (73.1 vs 88.2%, P = 0.75).

Conclusion

Our experience suggests that lower‐dose ATGAM at 15 mg/kg/day D1–5 as treatment of AA produces similar responses and outcomes as per standard‐dose ATGAM schedules. Prospective trials comparing ATGAM dose schedules in AA are warranted.
Lipopeptides: a novel antigen repertoire presented by major histocompatibility complex class I molecules
Authors: Morita Daisuke , Sugita Masahiko
Published: July 2016

Post‐translationally modified peptides, such as those containing either phosphorylated or O‐glycosylated serine/threonine residues, may be presented to cytotoxic T lymphocytes (CTLs) by MHC class I molecules. Most of these modified peptides are captured in the MHC class I groove in a similar manner to that for unmodified peptides. N‐Myristoylated 5‐mer lipopeptides have recently been identified as a novel chemical class of MHC class I‐presented antigens. The rhesus classical MHC class I allele, Mamu‐B*098, was found to be capable of binding N‐myristoylated lipopeptides and presenting them to CTLs. A high‐resolution X‐ray crystallographic analysis of the Mamu‐B*098:lipopeptide complex revealed that the myristic group as well as conserved C‐terminal serine residue of the lipopeptide ligand functioned as anchors, whereas the short stretch of three amino acid residues located in the middle of the lipopeptides was only exposed externally with the potential to interact directly with specific T‐cell receptors. Therefore, the modes of lipopeptide–ligand interactions with MHC class I and with T‐cell receptors are novel and fundamentally distinct from that for MHC class I‐presented peptides. Another lipopeptide‐presenting MHC class I allele has now been identified, leading us to the prediction that MHC class I molecules may be separated on a functional basis into two groups: one presenting long peptides and the other presenting short lipopeptides. Since the N‐myristoylation of viral proteins is often linked to pathogenesis, CTLs capable of sensing N‐myristoylation may serve to control pathogenic viruses, raising the possibility for the development of a new type of lipopeptide vaccine.
Better Late than Never? On the European Commission's Rule of Law Framework and its First Activation
Authors: Kochenov Dimitry , Pech Laurent
Published: July 2016

This article first offers an overview of the European Commission's Rule of Law Framework, which was adopted in March 2014. The mechanism's potential effectiveness and the Commission's reasoning to justify its first activation against Poland in January 2016, when it has failed to do so against Hungary, are subsequently analyzed. While the Commission should be commended for seeking to address increasing rule of law backsliding at Member State level, our main submission is that reliance on the Rule of Law Framework alone, if only because of its soft and discursive nature, will not remedy a situation where systemic violations of EU values form part of a governmental plan to set up an ‘illiberal’ regime.
Is furcation involvement affected by adjunctive systemic amoxicillin plus metronidazole? A clinical trials exploratory subanalysis
Authors: Eickholz Peter , Nickles Katrin , Koch Raphael , Harks Inga , Hoffmann Thomas , Kim Ti‐Sun , Kocher Thomas , Meyle Jörg , Kaner Doğan , Schlagenhauf Ulrich , Doering Stephan , Gravemeier Martina , Ehmke Benjamin
Published: July 2016

Objectives

Evaluation of the clinical effect of systemic amoxicillin and metronidazole adjunctively to mechanical debridement at furcation sites.

Material and Methods

This is an exploratory per‐protocol collective subanalysis from a prospective, randomized, double‐blind, multi‐centre trial (ClinicalTrials.gov NCT00707369) on the effect of adjunctive systemic amoxicillin 500 mg plus metronidazole 400 mg (3×/day, 7 days) use on furcation involvement in moderate to severe periodontitis. Outcome was the change in frequency of classes of furcation involvement after 27.5 months. Therapy comprised mechanical debridement in conjunction with antibiotic or placebo administration, and maintenance therapy at three months intervals.

Results

Three hundred and forty‐five patients (175 placebo, 170 antibiotics) with 6576 furcation sites (class 0 2956; class I 2370; class II 886; class III 364) were examined (3472 placebo, 3104 antibiotics). Pocket reduction/attachment gain at the furcation sites was noticeably better after antibiotics (1.2/0.6 mm) than after placebo (0.7/0.2 mm) 27.5 months after therapy. However, most furcation degrees were unchanged (placebo 61.5%/antibiotics 62.2%), more sites improved than deteriorated (20.3%/18.2%, 22.1%/15.7% respectively) and no differences in the change of furcation degrees between treatments could be detected.

Conclusion

Compared to placebo, prescription of adjunctive systemic antibiotics failed to show clinically relevant benefit with regard to furcation class involvement.
Causality evaluation of bacterial species isolated from patients with community‐acquired lower leg cellulitis
Authors: Chaniotakis I. , Gartzonika C.G. , Gaitanis G. , Levidiotou‐Stefanou S. , Bassukas I.D.
Published: July 2016

Introduction

Lower leg cellulitis is a diffuse inflammation of the cutaneous connective tissue following invasion of microorganisms and with potential to recur. The causative agent is not routinely identified in clinical practice, and the empirical therapy initiated primarily targets the ‘conventional’ disease pathogens, Streptococcus pyogenes and Staphylococcus aureus.

Objective

To evaluate at case level, the role of bacterial species isolated from lesional skin in the pathogenesis of community‐acquired lower leg cellulitis.

Methods

Two sampling methods (superficial swab and biopsy) were applied to isolate bacterial species from 40 patients hospitalized for first (N = 24 cases) and recurrent (N = 16 patients) lower leg cellulitis episodes. Subsequently, a clinical‐laboratory heuristic algorithm was employed to interpret causality associations of isolated species with disease episodes at case level.

Results

In 37/40 cases (92.5%), at least one bacterial species was identified with either sampling method. The number of different species/specimen isolated from superficial swabs compared to punch biopsies was significantly more (P < 0.001). A causative agent was identified in 16 cases (40%); it was a ‘conventional’ pathogen in seven patients and strains belonging to one of six ‘non‐conventional’ pathogens in nine cases. There was no concordance in the spectrum of isolated pathogens with the two sampling methods (kappa‐index = 0.028). Another four species may have participated in five patients as co‐pathogens in mixed infections. There was also no difference in microbiological disease features between patients with first and recurrent cellulitis episodes.

Conclusions

The application of a clinical‐laboratory causality algorithm coupled with pooled culture results of more than one sampling methods in patients with lower leg cellulitis is anticipated to permit the identification of responsible bacterial species at case level and offer incentive for therapeutic intervention studies.
Regression in cutaneous melanoma: a comprehensive review from diagnosis to prognosis
Authors: Ribero S. , Moscarella E. , Ferrara G. , Piana S. , Argenziano G. , Longo C.
Published: July 2016

Histological regression in primary cutaneous melanoma occurs in 10–35% of cases. Although a large body of literature exists to suggest that histological regression serves very little purpose in predicting biologic behaviour with melanoma, recognizing the presence of regression at clinical and histological ground may still retain some value in grading melanoma aggressiveness. In the current review, a comprehensive overview of the main aspects of regression will be provided. Histologically, many classifications have been reported so far, but all of them only agreed on the presence of an infiltrate of lymphocytes admixed with pigment‐laden macrophages underlying an atrophic epidermis with flattened rete ridges. Upon dermoscopy, regression is also named Blue White Scar‐like areas and could be variably admixed with granularity or peppering. Almost fully regressed lesions represent a main diagnostic issue in dermoscopy, and thus, confocal microscopy can be of help to identify whether the tumour is melanocytic or not. The clinical utility of regression as a prognostic factor has been challenged recently. Nowadays, evidences showed that it is less likely associated to SLN metastases.
Fish composition and species richness in eastern South American coastal lagoons: additional support for the freshwater ecoregions of the world
Authors: Petry A. C. , Guimarães T. F. R. , Vasconcellos F. M. , Hartz S. M. , Becker F. G. , Rosa R. S. , Goyenola G. , Caramaschi E. P. , Díaz de Astarloa J. M. , Sarmento‐Soares L. M. , Vieira J. P. , Garcia A. M. , Teixeira de Mello F. , de Melo F. A. G. , Meerhoff M. , Attayde J. L. , Menezes R. F. , Mazzeo N. , Di Dario F.
Published: July 2016

The relationships between fish composition, connectivity and morphometry of 103 lagoons in nine freshwater ecoregions (FEOW) between 2·83° S and 37·64° S were evaluated in order to detect possible congruence between the gradient of species richness and similarities of assemblage composition. Most lagoons included in the study were <2 km2, with a maximum of 3975 km2 in surface area. Combined surface area of all lagoons included in the study was 5411 km2. Number of species varied locally from one to 76. A multiple regression revealed that latitude, attributes of morphometry and connectivity, and sampling effort explained a large amount of variability in species richness. Lagoon area was a good predictor of species richness except in low latitude ecoregions, where lagoons are typically small‐sized and not affected by marine immigrants, and where non‐native fish species accounted for a significant portion of species richness. Relationships between species and area in small‐sized lagoons (<2 km2) is highly similar to the expected number in each ecoregion, with systems located between 18·27° S and 30·15° S attaining higher levels of species richness. Similarities in species composition within the primary, secondary and peripheral or marine divisions revealed strong continental biogeographic patterns only for species less tolerant or intolerant to salinity. Further support for the FEOW scheme in the eastern border of South America is therefore provided, and now includes ecotonal systems inhabited simultaneously by freshwater and marine species of fishes.
Freshwater fish faunas, habitats and conservation challenges in the Caribbean river basins of north‐western South America
Authors: Jiménez‐Segura L. F. , Galvis‐Vergara G. , Cala‐Cala P. , García‐Alzate C. A. , López‐Casas S. , Ríos‐Pulgarín M. I. , Arango G. A. , Mancera‐Rodríguez N. J. , Gutiérrez‐Bonilla F. , Álvarez‐León R.
Published: July 2016

The remarkable fish diversity in the Caribbean rivers of north‐western South America evolved under the influences of the dramatic environmental changes of neogene northern South America, including the Quechua Orogeny and Pleistocene climate oscillations. Although this region is not the richest in South America, endemism is very high. Fish assemblage structure is unique to each of the four aquatic systems identified (rivers, streams, floodplain lakes and reservoirs) and community dynamics are highly synchronized with the mono‐modal or bi‐modal flooding pulse of the rainy seasons. The highly seasonal multispecies fishery is based on migratory species. Freshwater fish conservation is a challenge for Colombian environmental institutions because the Caribbean trans‐Andean basins are the focus of the economic development of Colombian society, so management measures must be directed to protect aquatic habitat and their connectivity. These two management strategies are the only way for helping fish species conservation and sustainable fisheries.
Predicting 2‐Year Risk of Developing Pneumonia in Older Adults without Dementia
Authors: Jackson Michael L. , Walker Rod , Lee Sei , Larson Eric , Dublin Sascha
Published: July 2016

Objectives

To develop three prognostic indices of varying degree of required detail for 2‐year pneumonia risk in older adults.

Design

Retrospective cohort study.

Setting

Group Health (GH), an integrated healthcare delivery system.

Participants

Community‐dwelling dementia‐free individuals aged 65 and older who had been GH members for at least 2 years before start of follow‐up and were enrolled in the Adult Changes in Thought study (N = 3,375; development cohort, n = 2,250; validation cohort, n = 1,125.

Measurements

Potential pneumonia risk factors were identified from questionnaire data and interviewer assessments of functional status, medical history, smoking and alcohol use, cognitive function, personal care, and problem solving. Risk factors were also identified based on physical measures such as grip strength and gait speed and administrative database information on comorbid illnesses, laboratory tests, and prescriptions dispensed. Incident community‐acquired pneumonia was defined presumptively from administrative data and validated using medical record review.

Results

Participants (59% female) contributed 12,998 visits at which risk factors were assessed; 642 pneumonia events were observed during follow‐up. Age, sex, chronic obstructive pulmonary disease, congestive heart failure, body mass index, and use of inhaled or oral corticosteroids were critical predictors in all prognostic indices. A risk score based on these seven variables, information on which is commonly available in electronic medical records (EMRs), had equal or better performance (c‐index = 0.69 in the validation cohort) than scores including more‐detailed data such as functional status.

Conclusion

Data commonly available in EMRs can stratify older adults into groups with varying subsequent 2‐year pneumonia risk.
A potential relationship between skin hydration and stamp‐type microneedle intradermal hyaluronic acid injection in middle‐aged male face
Authors: Seok Joon , Hong Ji Yeon , Choi Sun Young , Park Kui Young , Kim Beom Joon
Published: July 2016

There is an increasing interest in skin rejuvenation using hyaluronic acid (HA) fillers beyond the improvement of deep wrinkles and volume deficiencies, which have been primary research foci in the past. We conducted a pilot study using a sample of six middle‐aged male subjects. Using an automatic intradermal injector with 0.020 mL of material contained in each injection point with a total of 100 points, 2 mL of non‐cross‐HA filler was injected into the entire face at every treatment session. We administered injections of HA for a total of three sessions per subject at 2‐week intervals and evaluated the results using a corneometer, TEWL, cutometer, measures of patient satisfaction, and the global aesthetic improvement scale (GAIS). Corneometer values increased steadily at each measurement, while the average value of TEWL increased in comparison with baseline after each application of the procedure. However, values returned to readings similar to those at 4 weeks after complete termination of the procedures. Cutometer values differed between the baseline and after procedures. All patients were assessed as “very much improved” or “much improved” according to GAIS, and all were pleased with the outcomes of treatment in terms of the enhancement of moisture, elasticity, and brightness.
Tele‐aesthetics in South Asia
Authors: Tian Brian
Published: July 2016

Background

Telemedicine is becoming increasingly popular. The best use for it is in the field of aesthetic dermatology – where conditions are not life‐threatening, and treatments can be topical and very safe.

Aims

In this study, we demonstrate that a simple store‐and‐forward telemedicine system can be applied safely to the field of aesthetic dermatology.

Methods and Materials

This was a prospective study was carried out in Singapore. A total of 102 patients filled up a medical questionnaire and submitted photographs via our online system. Upon submission, there was an independent doctor on the back‐end who would review their medical details and their photographs and make diagnoses and recommendations based on this information. There was another doctor who examined the patients face‐to‐face. Diagnoses made by the online doctor and by the face‐to‐face doctor were compared for congruency.

Results

A total of 358 diagnoses were made by the face‐to‐face doctor from 102 patients; 346 diagnoses were made by the teleconsultation doctor. For the purpose of this study, the diagnoses made by the FTFD were presumed to be correct. There was total agreement between both doctors in 342 diagnoses, giving a concordance rate of 95.5%. There were 12 missed diagnoses by the teleconsultation doctor and four discordant diagnoses.

Discussion

Our system demonstrates that a store‐and‐forward system enables our doctor to make accurate skin diagnoses. Our system was also able to detect dangerous conditions such as melanomas, skin cancers, actinic keratosis, and other dangerous diagnoses. There were discordant or missed diagnoses. This was mostly attributed to poor photograph quality.

Conclusion

Emerging telemedicine technologies should be rigorously evaluated before they become widely implemented. Any system of value must uphold certain principles. It has to be fundamentally sound, safe, and clearly beneficial to the patient. With current technological limitations, the best use of such a system would be in aesthetics.
Impact of preoperative defecation pattern on postoperative constipation for patients undergoing cardiac surgery
Authors: Iyigun Emine , Ayhan Hatice , Demircapar Aslı , Tastan Sevinc
Published: July 2016

Aims and objectives

To analyse the impact of preoperative defecation pattern on postoperative defecation pattern for patients undergoing cardiac surgery.

Background

Constipation is a neglected problem that occurs frequently after cardiac surgery.

Design

Descriptive study.

Method

The study sample comprised 102 patients who underwent cardiac surgery. A Descriptive Information Form, Rome III Diagnostic Criteria, Constipation Severity Instrument, Postoperative Defecation Pattern Evaluation Form and Bristol Stool Form Scale were used for data collection and analysis.

Results

The Constipation Severity Instrument scores of just over one‐third (37·2%) of the patients who were constipated prior to surgery were higher compared to those who were not constipated. Following cardiac surgery, 39·2% of patients developed constipation and 80% of these patients were constipated prior to cardiac surgery. The findings indicate a significantly high relationship between preoperative and postoperative defecation pattern (r = 0·71, p < 0·001).

Conclusion

Preoperative defecation pattern is a determining factor for the development of postoperative constipation for patients undergoing cardiac surgery.

Relevance to clinical practice

During the preoperative period, clinical nurses may evaluate the patients' defecation patterns using valid and reliable scales and follow the defecation of the patients, especially patients with defecation problems, during the postoperative period.
Prognostic value of bacterial infection in acute and chronic liver failure
Authors: Albillos Agustín , Martínez Javier
Published: July 2016

See Articles on Page 1133 and 1143
Divided Selves: Professional Role Distancing Among Law Students and New Lawyers in a Period of Market Crisis
Authors: Bliss John
Published: July 2016

In the terms of Erving Goffman's classic role-distancing analysis, newly admitted law students often aspire to an “embraced” lawyer role that directly expresses their personal and political values. Empirical research has suggested that during law school these students are instructed in an amoral and apolitical vision of professionalism. The literature has paid less attention to how students internally experience these norms within their continual processes of self-construction. This article takes an exploratory micro-dynamic look at professional identity formation drawing on longitudinal interviews and identity mapping with three student cohorts. Over the course of their legal education, students bound for large corporate law firms tended to report increasing professional role distancing. In contrast, students who pursued jobs in the public-interest sector tended to sustain a more proximate conception of professional identity, overlapping with racial, gender, political, and other centrally constitutive roles. The article concludes with normative and theoretical implications.
Variations in impact effects among IIIE iron meteorites
Authors: Breen John P. , Rubin Alan E. , Wasson John T.
Published: July 2016

Group‐IIIE iron meteorites can be ordered into four categories reflecting increasing degrees of shock alteration. Weakly shocked samples (Armanty, Colonia Obrera, Coopertown, Porto Alegre, Rhine Villa, Staunton, and Tanokami Mountain) have haxonite within plessite, unrecrystallized kamacite grains containing Neumann lines or possessing the ɛ structure, and sulfide inclusions typically consisting of polycrystalline troilite with daubréelite exsolution lamellae. The only moderately shocked sample is NWA 4704, in which haxonite has been partially decomposed to graphite; the majority of the kamacite in NWA 4704 is recrystallized, and its sulfide inclusions were partly melted. Strongly shocked samples (Cachiyuyal, Kokstad, and Paloduro) contain graphite and no haxonite, suggesting that pre‐existing haxonite fully decomposed. Also present in these rocks are recrystallized kamacite and melted troilite. Residual heat from the impact caused annealing and recrystallization of kamacite as well as the decomposition of haxonite into graphite. Severely shocked samples (Aliskerovo and Willow Creek) have sulfide‐rich assemblages consisting of fragmental and subhedral daubréelite crystals, 1–4 vol% spidery troilite filaments, and 30–50 vol% low‐Ni kamacite grains, some of which contain up to 6.0 wt% Co; haxonite in these inclusions has fully decomposed to graphite. The wide range of impact effects in IIIE irons is attributed to one or more major collision(s) on the parent asteroid that affected different group members to different extents depending on their proximity to the impact point.
Adaptive differentiation in floral traits in the presence of high gene flow in scarlet gilia (Ipomopsis aggregata)
Authors: Milano Elizabeth R. , Kenney Amanda M. , Juenger Thomas E.
Published: July 2016

Plant–pollinator interactions are thought to be major drivers of floral trait diversity. However, the relative importance of divergent pollinator‐mediated selection vs. neutral processes in floral character evolution has rarely been explored. We tested for adaptive floral trait evolution by comparing differentiation at neutral genetic loci to differentiation at quantitative floral traits in a putative Ipomopsis aggregata hybrid zone. Typical I. aggregata subsp. candida displays slender white tubular flowers that are typical of flowers pollinated by hawkmoths, and subsp. collina displays robust red tubular flowers typical of flowers pollinated by hummingbirds; yet, hybrid flower morphs are abundant across the East Slope of the Colorado Rockies. We estimated genetic differentiation (FST) for nuclear and chloroplast microsatellite loci and used a half‐sib design to calculate quantitative trait divergence (QST) from collection sites across the morphological hybrid zone. We found little evidence for population structure and estimated mean FST to be 0.032. QST values for several floral traits including corolla tube length and width, colour, and nectar volume were large and significantly greater than mean FST. We performed multivariate comparisons of neutral loci to genetic correlations within and between populations and found a strong signal for divergent selection, suggesting that specific combinations of floral display and reward traits may be the targets of selection. Our results show little support for historical subspecies categories, yet floral traits are more diverged than expected due to drift alone. Non‐neutral divergence for multivariate quantitative traits suggests that selection by pollinators is maintaining a correlation between display and reward traits.
A portrait of a sucker using landscape genetics: how colonization and life history undermine the idealized dendritic metapopulation
Authors: Salisbury Sarah J. , McCracken Gregory R. , Keefe Donald , Perry Robert , Ruzzante Daniel E.
Published: July 2016

Dendritic metapopulations have been attributed unique properties by in silico studies, including an elevated genetic diversity relative to a panmictic population of equal total size. These predictions have not been rigorously tested in nature, nor has there been full consideration of the interacting effects among contemporary landscape features, colonization history and life history traits of the target species. We tested for the effects of dendritic structure as well as the relative importance of life history, environmental barriers and historical colonization on the neutral genetic structure of a longnose sucker (Catostomus catostomus) metapopulation in the Kogaluk watershed of northern Labrador, Canada. Samples were collected from eight lakes, genotyped with 17 microsatellites, and aged using opercula. Lakes varied in differentiation, historical and contemporary connectivity, and life history traits. Isolation by distance was detected only by removing two highly genetically differentiated lakes, suggesting a lack of migration–drift equilibrium and the lingering influence of historical factors on genetic structure. Bayesian analyses supported colonization via the Kogaluk's headwaters. The historical concentration of genetic diversity in headwaters inferred by this result was supported by high historical and contemporary effective sizes of the headwater lake, T‐Bone. Alternatively, reduced allelic richness in headwaters confirmed the dendritic structure's influence on gene flow, but this did not translate to an elevated metapopulation effective size. A lack of equilibrium and upstream migration may have dampened the effects of dendritic structure. We suggest that interacting historical and contemporary factors prevent the achievement of the idealized traits of a dendritic metapopulation in nature.
Fungal keratitis due to Schizophyllum commune: an emerging pathogenic fungus
Authors: Reddy Ashok Kumar , Ashok Rangaiahgari , Majety Madhavi , Chitta Megharaj , Narayen Nitesh
Published: July 2016

Fungal keratitis due to Schizophyllum commune is very rare. In this study, we report the clinical and microbiological profile of five patients with fungal keratitis due to S. commune. Direct microscopic examination of corneal scrapings from all five patients showed septate branching hyaline fungal filaments. Similarly, in all five patients Sabouraud dextrose agar (SDA) plates inoculated with corneal scrapings showed white, cottony colonies on the second day of incubation. Lactophenol cotton blue stained wet preparation of 7‐day‐old colonies on SDA revealed clamp connections and no spores. The fungus was identified by its characteristic clamp connections, fan‐shaped bracket fruiting body with pinkish‐grey longitudinally split‐radiating gills. The phenotypic identification of one of the five isolates further conformed by ITS sequencing. Treatment outcome was available for two of the five patients; in these two patients, the keratitis resolved with topical natamycin.
Frequency, type and treatment of fungal pathogens in toenail onychomycosis in the central Alpine region of South Tyrol, northern Italy – a 10‐year retrospective study from 2004 to 2013
Authors: Gasser Julia , Pagani Elisabetta , Vittadello Fabio , Nobile Carla , Zampieri Pierfrancesco , Eisendle Klaus
Published: July 2016

Onychomycosis is one of the most common dermatological diseases, primarily caused by dermatophytes, and sometimes, also by yeast and moulds. This study aims to clarify the frequency of isolated pathogens from mycotic toenails in the reference centre of the central Alpine mountain region of South Tyrol, northern Italy. Age and gender differences, types of pathogens and initial therapy used were also investigated. This is a retrospective study from 2004 to 2013 on the files of all patients with suspected onychomycosis in whom a cultural pathogen detection was performed. A total of 1565 patients were studied (943 women; 622 men), with a median age of 55 years. Fungal pathogens could be detected by culture in 49.5%. Significantly more pathogens could be grown in men (63.8%) than in women (39.9%, P < 0.0001). The most common pathogens grown were dermatophytes (53.3%), especially T. rubrum and T. interdigitale, followed by moulds (24.7%) and yeast (22%). Therapies prescribed were topical in 64.2% and systemic in 35.8% of the cases. Topical treatment was more frequent in older patients (P < 0.05). In northern Italy, dermatophytes are the most common causative agents for onychomycosis. Fungal pathogens were more commonly found in men than in women and topical treatment was more frequent in older patients.
Current trends in candidemia and species distribution among adults: Candida glabrata surpasses C. albicans in diabetic patients and abdominal sources
Authors: Khatib Riad , Johnson Leonard B. , Fakih Mohamad G. , Riederer Kathleen , Briski Laurence
Published: July 2016

Candidemia rate and species distribution vary according to the type of patients, country of origin and antifungal prophylaxis use. To present current candidemia epidemiological trends. A retrospective examination of candidemia in adults (≥18 years‐old) hospitalised from 2007 to 2015. Cases were identified through the microbiology laboratory. Candida species were distinguished based on colony morphology and VITEK‐2 YBC cards, (bioMerieux, Durham, NC, USA). Patient characteristics, species distribution, source and outcome were assessed. We encountered 275 patients (294 episodes) with candidemia. The rate of candidemia dropped in 2010 (P = 0.003) without further decline. Nearly all cases (97.5%) were healthcare‐associated. C. albicans (n = 118) and C. glabrata (n = 77) proportions varied without a discernable trend. C. glabrata was more common in diabetics [52.9% vs. 32.0% (non‐diabetics); P = 0.004] and abdominal sources [53.3% vs. 35.5% (other sources); P = 0.03], especially gastric/duodenal foci [88.9% vs. 44.1% (other abdominal foci); P = 0.02]. All‐cause 30‐day mortality rate was 43.3% without changes over time or differences between C. albicans and C. glabrata. In conclusion, the candidemia rate remains stable after a decline in 2010. C. albicans remains the most common species but C. glabrata predominates in diabetics and abdominal sources. These findings suggest possible species‐related differences in colonisation dynamics or pathogenicity.
Fatigue: a distressing symptom for patients with irritable bowel syndrome
Authors: Frändemark Å. , Jakobsson Ung E. , Törnblom H. , Simrén M. , Jakobsson S.
Published: July 2016

Background

Fatigue is a frequent symptom in patients with irritable bowel syndrome (IBS), and is associated with poor quality of life. However, few studies have evaluated its impact on daily life or the perceived distress it can cause. Using a multi‐methods approach, this study describes the impact and manifestations of fatigue in patients with IBS and investigates the relationship between fatigue severity and illness‐related and health‐promoting factors.

Methods

A total of 160 patients with IBS completed self‐reported questionnaires assessing fatigue, gastrointestinal symptoms, psychological distress, and sense of coherence. Fatigue was assessed with the Fatigue Impact Scale, which also includes structured and open‐ended questions which were analyzed with a deductive qualitative analysis. Patients were classified as having severe, moderate, or mild fatigue based on frequency, distress and impact on daily life.

Key Results

The open‐ended questions revealed a multidimensional impact on life. Fatigue mainly interfered with the ability to perform physical activities, work, and domestic work, and the ability to interact socially. Decreased stamina was evident, along with strategies to limit the bodily consequences of tiredness. Severe fatigue was accompanied by more severe IBS symptoms, anxiety and depression and lower sense of coherence.

Conclusions & Inferences

Fatigue is a distressing symptom which occurs in a sizeable proportion of patients with IBS. It affects life in a multidimensional way, with poor bodily stamina being the most prominent feature. Fatigue, along with sense of coherence, depression and anxiety, needs to be assessed, confirmed and targeted for interventions.
The growth of vegetative and reproductive structures (leaves and silks) respond similarly to hydraulic cues in maize
Authors: Turc Olivier , Bouteillé Marie , Fuad‐Hassan Avan , Welcker Claude , Tardieu François
Published: July 2016

The elongation of styles and stigma (silks) of maize (Zea mays) flowers is rapid (1–3 mm h−1), occurs over a short period and plays a pivotal role in reproductive success in adverse environments.

Silk elongation rate was measured using displacement transducers in 350 plants of eight genotypes during eight experiments with varying evaporative demand and soil water status.

Measured time courses revealed that silk elongation rate closely followed changes in soil water status and evaporative demand, with day–night alternations similar to those in leaves. Day–night alternations were steeper with high than with low plant transpiration rate, manipulated via evaporative demand or by covering part of the leaf area. Half times of changes in silk elongation rate upon changes in evaporative demand or soil water status were 10–30 min, similar to those in leaves. The sensitivity of silk elongation rate to xylem water potential was genetically linked to that of leaf elongation rate. Lines greatly differed for these sensitivities.

These results are consistent with a common hydraulic control of expansive growth in vegetative and reproductive structures upon changes in environmental conditions via a close connection with the xylem water potential. They have important implications for breeding, modelling and phenotyping.
Social support in the workplace between teleworkers, office‐based colleagues and supervisors
Authors: Collins Alison M. , Hislop Donald , Cartwright Susan
Published: July 2016

This paper draws upon the findings of qualitative interviews carried out with teleworkers, their office‐based colleagues and supervisory staff of a teleworking initiative introduced by a UK public sector local authority to explore workplace social support relationships. Our study found differences between office‐based and permanent teleworking staff in terms of social support. For teleworkers relationships at work are complex, with social support networks being established prior to working at home. By working from home, teleworkers were able to develop greater social support relationships with some colleagues, predominantly other teleworkers, while at the same time allowing them to distance themselves from negative work relationships. Overall, a social disconnection developed between teleworkers and office‐based staff. In contrast social support was more important for office‐based workers, who valued co‐worker relationships with other office‐based staff.
Skills in the green economy: recycling promises in the UK e‐waste management sector
Authors: Bozkurt Ödül , Stowell Alison
Published: July 2016

In advanced economies the ‘greening’ of the economy is widely seen as promising extensive job creation and upskilling, alongside its other benefits. In popular and policy rhetoric, the growing importance of ‘green skills’ is asserted frequently. This study critically examines these claims within the context of the electronic waste management sector in the United Kingdom. Drawing on the cases of a non‐profit organisation and a small private enterprise in North West England, we observe that despite government support for developing skills in e‐waste, both the development and utilisation of skills remain minimal. Critically, the relatively more skill‐intensive process of reuse is substantially less profitable than recycling and resource capture. The study concludes by noting that the expectations from the green economy for high‐quality jobs need to be assessed within the context of similar, misplaced celebrations of previous transformations of work to avoid recycling the same promises.
Status of and problems concerning neonatal resuscitation in Japan in 2015
Authors: Kunikata Tetsuya , Morita Kayo , Sakurai Hayato , Kakei Hiroko , Honda Masakazu , Wada Masaki , Kawasaki Hidenori , Tamura Masanori
Published: July 2016

Background

The International Liaison Committee on Resuscitation (ILCOR) published Consensus 2015 in October 2015. Thereafter, the Japanese version of neonatal cardiopulmonary resuscitation programs was revised. Prior to the revision, we re‐conducted questionnaire surveys in three types of medical facilities in January 2015.

Methods

Targeted groups included (i) 277 training hospitals authorized by the Japanese Society of Perinatal/Neonatal Medicine for training of physicians specialized in perinatal care (neonatology) in January 2015 (training hospitals; response rate, 70.8%); (ii) 459 obstetric hospitals/clinics (response rate, 63.6%); and (iii) 453 midwife clinics (response rate, 60.9%). The survey included systems of neonatal resuscitation, medical equipment and practices, and education systems. The results were compared with that of similar surveys conducted in 2005, 2010 and 2013.

Results

Almost all results were generally improved compared with past surveys. In training hospitals, however, the use of oxygen blenders or manometers was not widespread. Only 35% of institutions used continuous positive airway pressure systems frequently, and expert neonatal resuscitation doctors attended all deliveries in only 6% of training centers. In addition, only 71% of training hospitals had brain therapeutic hypothermia facilities. Not all obstetric hospitals/clinics prepared pulse oximeters, and only a few used manometers frequently. Some midwife clinics did not keep warming equipment, and few midwife clinics were equipped with pulse oximeters. In addition, some midwife clinics did not prepare ventilation bags (masks).

Conclusions

The equipment in Japanese delivery rooms is variable. Further efforts need to be made in the distribution of neonatal resuscitation devices and the dissemination of techniques.
Efficiency of pyramiding of three quantitative resistance loci to apple scab
Authors: Laloi G. , Vergne E. , Durel C. E. , Le Cam B. , Caffier V.
Published: July 2016

Quantitative plant resistance is supposed to be more durable than qualitative resistance for the control of plant diseases. However, it has been experimentally shown that erosion of quantitative resistance can occur. Cumulation of quantitative resistance loci (QRLs) in the same cultivar is considered to improve the efficiency and durability of quantitative resistance, but the choice of QRLs to be combined is of crucial importance. This study investigated whether the combination of QRLs acting on different stages of pathogen development could improve the efficiency of resistance in the apple scab pathosystem. The efficiencies of three QRLs were evaluated against 10 isolates of Venturia inaequalis and the stages of pathogen development that were affected by the QRLs were defined microscopically. A gain in the efficiency of resistance was observed when QRLs were pyramided compared to when they acted alone. Thanks to the combined effects of the individual QRLs, the pyramiding of the three QRLs hindered fungal development at different stages: before the penetration of the plant cuticule, after the penetration with hypersensitivity reaction, and during the colonization and asexual reproduction. These effects were dependent on the V. inaequalis isolates. These results suggest that the gain in efficiency of resistance by pyramiding may derive from the combination of different and complementary molecular mechanisms underlying QRLs. Thus, the resistance achieved from pyramiding such a combination of QRLs should be durable.
Examining habituation of the startle reflex with the reinforcement sensitivity theory of personality
Authors: Blanch Angel , Aluja Anton , Blanco Eduardo , Balada Ferran
Published: July 2016

The habituation of the acoustic startle reflex (ASR) was examined concerning individual differences in sensitivity to punishment (PUN) and sensitivity to reward (REW), within the general framework of the reinforcement sensitivity theory (RST) of personality. Two hypotheses derived from the RST were evaluated: the separable subsystems hypothesis and the joint subsystems hypothesis. In addition, we examined the direction of the relationship of PUN and REW with the habituation of the ASR. A habituation segment of electromyography recordings of the orbicularis oculi was assessed with an unconditional latent curve model. In accordance with the RST hypotheses, the relationship of PUN and REW on the habituation process was assessed with two conditional latent curve models. There was higher support for the separable subsystems hypothesis. In addition, PUN and REW related with the habituation trajectory of the ASR in the expected directions. Higher levels of PUN and lower levels of REW related with a slower habituation of the ASR, whereas lower levels of PUN and higher levels of REW related with a faster habituation of the ASR.
Temporal adverbs in thekiezdeutschleft periphery: Combining late merge with deaccentuation for v3
Authors: te Velde John R.
Published: July 2016

This investigation of verb‐third (V3) constructions inKiezdeutsch, consisting of a temporal adverb (TA) and a subject left of the finite verb, aims to shed light on the syntax and prosody of the West Germanic left periphery. I show that two pieces of evidence from V3‐structures support the hypothesis that this left periphery has two syntactic properties: i) aTPthat is the final projection when a temporal adverb is merged late and does not induce verb raising out ofTP, creating the V3‐structure, and ii) deaccentuation: the lack of pitch accent on any of the pre‐finite verb elements. This analysis requires two terminal finite verb positions in the left periphery. If we includeKiezdeutschin the family of West Germanic languages – for which there is ample independent evidence – we must conclude, as supported also by the presence of other V3‐structures elsewhere in this family, as well as by the prosody requirements of these V3‐structures, that all members of this family have the same options in the left periphery asKiezdeutsch. The only difference betweenKiezdeutschand the others – which also allow V3‐structures but always with at least one pitch accent – is the V3‐structure with temporal adverbs inKiezdeutschin which two constituents are allowed left of the finite verb, but no pitch accent. In this way a single prosodic phrase can be created consisting of theTA, pronominal subject and the finite verb.
The H3 chaperone function of NASP is conserved in Arabidopsis
Authors: Maksimov Vladimir , Nakamura Miyuki , Wildhaber Thomas , Nanni Paolo , Ramström Margareta , Bergquist Jonas , Hennig Lars
Published: July 2016

Histones are abundant cellular proteins but, if not incorporated into chromatin, they are usually bound by histone chaperones. Here, we identify Arabidopsis NASP as a chaperone for histones H3.1 and H3.3. NASP interacts in vitro with monomeric H3.1 and H3.3 as well as with histone H3.1–H4 and H3.3–H4 dimers. However, NASP does not bind to monomeric H4. NASP shifts the equilibrium between histone dimers and tetramers towards tetramers but does not interact with tetramers in vitro. Arabidopsis NASP promotes [H3–H4]2 tetrasome formation, possibly by providing preassembled histone tetramers. However, NASP does not promote disassembly of in vitro preassembled tetrasomes. In contrast to its mammalian homolog, Arabidopsis NASP is a predominantly nuclear protein. In vivo, NASP binds mainly monomeric H3.1 and H3.3. Pulldown experiments indicated that NASP may also interact with the histone chaperone MSI1 and a HSC70 heat shock protein.
Altered expression of the bZIP transcription factor DRINK ME affects growth and reproductive development in Arabidopsis thaliana
Authors: Lozano‐Sotomayor Paulina , Chávez Montes Ricardo A. , Silvestre‐Vañó Marina , Herrera‐Ubaldo Humberto , Greco Raffaella , Pablo‐Villa Jeanneth , Galliani Bianca M. , Diaz‐Ramirez David , Weemen Mieke , Boutilier Kim , Pereira Andy , Colombo Lucia , Madueño Francisco , Marsch‐Martínez Nayelli , de Folter Stefan
Published: July 2016

Here we describe an uncharacterized gene that negatively influences Arabidopsis growth and reproductive development. DRINK ME (DKM; bZIP30) is a member of the bZIP transcription factor family, and is expressed in meristematic tissues such as the inflorescence meristem (IM), floral meristem (FM), and carpel margin meristem (CMM). Altered DKM expression affects meristematic tissues and reproductive organ development, including the gynoecium, which is the female reproductive structure and is determinant for fertility and sexual reproduction. A microarray analysis indicates that DKM overexpression affects the expression of cell cycle, cell wall, organ initiation, cell elongation, hormone homeostasis, and meristem activity genes. Furthermore, DKM can interact in yeast and in planta with proteins involved in shoot apical meristem maintenance such as WUSCHEL, KNAT1/BP, KNAT2 and JAIBA, and with proteins involved in medial tissue development in the gynoecium such as HECATE, BELL1 and NGATHA1. Taken together, our results highlight the relevance of DKM as a negative modulator of Arabidopsis growth and reproductive development.