bluuebunny/crossref_metadata_2025 huggingface dataset:
Enterocytozoon bieneusi Genotypes in Grazing Horses in China and their Zoonotic Transmission Potential
Authors: Qi Meng , Wang Rongjun , Wang Haiyan , Jian Fuchun , Li Junqiang , Zhao Jinfeng , Dong Haiju , Zhu Huili , Ning Changshen , Zhang Longxian
Published: February 2016

In present study, 262 fecal specimens were collected from 12 groups of grazing horses in the Xinjiang Uyghur Autonomous Region of China. The specimens were subjected to PCR and sequencing analyses of the ribosomal internal transcribed spacer (ITS). The overall prevalence of E. bieneusi in horses was 30.9% (81/262). No significant differences in prevalence were observed between horses of different ages or sexes. Nineteen genotypes were identified: 15 known genotypes (BEB6, CHG19, CM6, CM7, CM8, CS‐1, CS‐4, D, EpbA, EbpC, G, horse1, horse2, O, and Peru8) and four new genotypes (XJH1–XJH4). Six of these genotypes were previously detected in humans: BEB6, D, EbpA, EbpC, O, and Peru8. Genotype EbpC was the most prevalent (21/81), followed by EpbA (20/81), BEB6 (9/81), CM6 (4/81), horse1 (4/81), O (4/81), G (3/81), CHG19 (2/81), CM7 (2/81), horse2 (2/81), and XJH1 (2/81), whereas the remaining eight genotypes were seen in one specimen each. In a phylogenetic analysis, 14 genotypes (65/81, 80.2%), excluding genotypes BEB6, CM7, horse2, XJH1, and XJH4, belonged to group 1, which have zoonotic potential. The high diversity in the E. bieneusi genotypes and their zoonotic potential suggest that grazing horses are a potential source of zoonotic infection in humans.
The Glycerol‐3‐Phosphate Acyltransferase TbGAT is Dispensable for Viability and the Synthesis of Glycerolipids in Trypanosoma brucei
Authors: Patel Nipul , Pirani Karim A. , Zhu Tongtong , Cheung‐See‐Kit Melanie , Lee Sungsu , Chen Daniel G. , Zufferey Rachel
Published: February 2016

Glycerolipids are the main constituents of biological membranes in Trypanosoma brucei, which causes sleeping sickness in humans. Importantly, they occur as a structural component of the glycosylphosphatidylinositol lipid anchor of the abundant cell surface glycoproteins procyclin in procyclic forms and variant surface glycoprotein in bloodstream form, that play crucial roles for the development of the parasite in the insect vector and the mammalian host, respectively. The present work reports the characterization of the glycerol‐3‐phosphate acyltransferase TbGAT that initiates the biosynthesis of ester glycerolipids. TbGAT restored glycerol‐3‐phosphate acyltransferase activity when expressed in a Leishmania major deletion strain lacking this activity and exhibited preference for medium length, unsaturated fatty acyl‐CoAs. TbGAT localized to the endoplasmic reticulum membrane with its N‐terminal domain facing the cytosol. Despite that a TbGAT null mutant in T. brucei procyclic forms lacked glycerol‐3‐phosphate acyltransferase activity, it remained viable and exhibited similar growth rate as the wild type. TbGAT was dispensable for the biosynthesis of phosphatidylcholine, phosphatidylinositol, phosphatidylserine, and GPI‐anchored protein procyclin. However, the null mutant exhibited a slight decrease in phosphatidylethanolamine biosynthesis that was compensated with a modest increase in production of ether phosphatidylcholine. Our data suggest that an alternative initial acyltransferase takes over TbGAT's function in its absence.
A radiological study on intra‐ and extra‐cranial calcifications in adults with X‐linked hypophosphatemia and associations with other mineralizing enthesopathies and childhood medical treatment
Authors: Gjørup H. , Kjaer I. , Beck‐Nielsen S. S. , Poulsen M. R. , Haubek D.
Published: February 2016

Structured Abstract

Objectives

1) The objective of this study was to explore radiological signs of intracranial and nuchal ligament calcifications in adult patients with X‐linked hypophosphatemia (XLH) compared with controls and 2) to correlate signs of cranial calcifications in XLH patients with the presence of other extra‐cranial enthesopathies, with the severity of skeletal XLH impact and with medical treatment during childhood.

Setting and Sample Population

Lateral and postero‐anterior cephalograms from 36 adult XLH patients and 49 adult controls and X‐rays from spine, pelvis, knees and ankles from 31 of the 36 XLH patients.

Methods

Radiological signs of intracranial and nuchal ligament calcifications in XLH patients were compared with controls by Fischer's exact test. In XLH patients, the presence of cranial calcifications was correlated with the presence of other enthesopathies, with the severity of skeletal XLH impact and with medical treatment by Fischer's exact or chi‐squared test.

Results

Six (17%) XLH patients revealed major signs of intracranial calcifications. Nuchal ligament calcifications were common in XLH patients compared with controls (p = 0.018). Enthesopathy was present at 0–24 sites per XLH patient (median 2). Intracranial calcifications trended to correlate positively with vertebral enthesopathies (p = 0.059). Nuchal calcifications correlated positively with the severity of skeletal XLH impact (p = 0.040). Vertebral enthesopathies correlated negatively with medical treatment (p = 0.008).

Conclusion

More XLH patients than controls showed nuchal ligament calcifications, and some XLH patients showed intracranial calcifications. Severely affected XLH patients often had nuchal ligament calcifications. Medically treated XLH patients had few vertebral enthesopathies.
Characterization of Electrical Reconnection Following Pulmonary Vein Isolation Using First‐ and Second‐Generation Cryoballoon
Authors: KOEKTUERK BUELENT , YORGUN HIKMET , KOEKTUERK OEZLEM , TURAN CEM H. , KESKIN KERIM , SCHOETT MORITZ , TURAN RAMAZAN G. , GORR EDUARD , HOPPE CHRISTIAN , HORLITZ MARC
Published: February 2016

Background

Second‐generation cryoballoon (CB‐2) is associated with improved outcomes for pulmonary vein isolation (PVI) compared to first generation (CB‐1). However, data regarding the predictors of pulmonary vein (PV) electrical reconnection are limited. In this study, we aimed to characterize the predilection sites and predictors of reconnection in patients with recurrent atrial tachyarrhythmia (ATa) after PVI using CB‐1 and CB‐2.

Methods

A total of 59 patients (mean age: 62 ± 11 years and 66% male) with recurrent ATa after previous CB‐PVI, using either a 28‐mm CB‐1 or CB‐2, underwent repeat ablation. PV reisolation was performed by irrigated radiofrequency ablation using three‐dimensional electroanatomical mapping systems.

Results

Electrical PV reconnection was detected in 10 of 11 (91%) of CB‐1 patients compared to 41 of 48 (85%) of CB‐2 patients. Time to redo procedure after index CB‐1 was 8.9 ± 10.2 months and 11.2 ± 7.0 months in CB‐2. Bonus freeze was applied in all patients with CB‐1 and 41% of the patients with CB‐2. Superior quadrants of both superior PVs and inferior quadrants of the both inferior PVs exhibited higher predilection for conduction compared to other quadrants (P < 0.001). Multivariate binary logistic analysis revealed that right inferior PV (RIPV; odds ratio [OR]: 1.52, 95% confidence interval [CI]: 1.09–2.13, P = 0.014) and minimum temperature (OR: 1.09, 95% CI: 1.03–1.15, P = 0.004) were the independent predictors of electrical reconnection after CB‐2 ablation.

Conclusion

Conduction gaps after CB‐1 and CB‐2 were higher in inferior PVs compared to superior PVs. The RIPV and minimum CB temperature were independent predictors of PV electrical reconnection after CB‐2.
Neck Pain and Cervical Dystonia: Treatment Outcomes from CD PROBE (Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy)
Authors: Charles P. David , Manack Adams Aubrey , Davis Thomas , Bradley Kathryn , Schwartz Marc , Brin Mitchell F. , Patel Atul T.
Published: February 2016

Background

Pain is a prevailing feature of cervical dystonia (CD), the most common form of focal dystonia. This analysis examined pain relief after onabotulinumtoxinA treatment in CD subjects with moderate/severe pain from the Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy (CD PROBE).

Methods

CD PROBE was a prospective, multicenter, observational registry of CD subjects who were naïve to botulinum toxin (BoNT), new to physician, or had not received BoNT within ≥ 16 weeks if in a clinical trial. Subjects were eligible for 3 treatments, with variable session intervals. Descriptive and inferential statistics were utilized to evaluate the change in pain scores in the population with moderate/severe neck pain at baseline (Pain Numeric Rating Scale [PNRS] score 4 to 10).

Results

Of 1046 enrolled, 733 (70.7%) had moderate/severe neck pain at baseline. Postinjection pain questionnaire responses 4 to 6 weeks after each of the 3 treatments revealed that a majority of subjects (67.1%, 72.4%, and 76.4%) reported pain relief; mean time to pain relief was 7.1, 7.4, and 7.6 days. All pain scales showed significant improvements from baseline to final visit (all P < 0.0001): PNRS, mean 6.6 to 3.8; CD Impact Profile‐58 Pain and Discomfort subscale, mean 78.7 to 56.5; and Toronto Western Spasmodic Torticollis Rating Scale Pain subscale, mean 12.6 to 8.5. Multivariable regression models showed that initial pain score significantly contributed to the final pain score for all scales.

Conclusion

Results from this real‐world clinical registry indicate that a majority of CD subjects with moderate/severe neck pain experience significant relief following onabotulinumtoxinA treatment.
Continuity and Change in Social Policy
Authors: Béland Daniel , Powell Martin
Published: February 2016

While much has been written over the last two decades about social policy continuity and change, the literature is often fragmentary and imprecise, with little material exploring it in a systematic and rigorous manner. The objective of this article is to provide a critical reading of the recent literature, discussing concepts and issues such as paradigm shift, path dependence, punctuated equilibrium, ideational analysis and cumulative change (including conversion, layering and policy drift). It examines the degree and type of change, and explanations for change: the ‘how much, what type and why of change’. The article concludes with an overview of the contributions of this special issue of Social Policy & Administration devoted to the issues of policy continuity and change.
Policy Continuity and Change in Greek Social Policy in the Aftermath of the Sovereign Debt Crisis
Authors: Angelaki Marina
Published: February 2016

The extensive and radical reforms introduced in Greece's pension and health systems following the recent economic crisis provide a compelling case for the study of continuity and change in social policy. The article argues that a simple focus on retrenchment – as observed in pension and health in Greece in the aftermath of the crisis – provides only a partial understanding of the transformations taking place in the two sectors under study and their implications for the future structure of the two systems. While retrenchment has been the dominant feature associated with the fiscal consolidation effort undertaken in the context of the bailout agreements, other transformative processes have also taken place. In the case of pensions, a shift towards a more unified structure is observed, accompanied by a hesitant shift to a multi‐pillar system characterized by a reduction in public provision which is nonetheless not compensated by a strengthening of the second pillar. In the case of health, recent reforms attest to the gradual withering away of the public system through its shift to residualism. These changes have been made possible through the changes observed in the policy‐making process characterized by an unprecedented increase of the EU intrusiveness and the parallel decrease of the role and influence of social partners.
On Development of a Semimechanistic Wall Boiling Model
Authors: Das Saurish , Punekar Hemant
Published: February 2016

To predict nucleate boiling, a novel semimechanistic wall boiling model is developed within a mixture multiphase flow framework available in ansys fluent. The mass transfer phenomenon is modeled using an evaporation–condensation model, and enhancement of wall-to-fluid heat transfer due to nucleate boiling is captured using a 1D empirical correlation, modified for 3D computational fluid dynamics (CFD) environment; hence this model can be used for a complex-shaped coolant passage. For a series of operating conditions, the present model is rigorously validated against available experimental data in which a 50% volume mixture of aqueous ethylene glycol was used as coolant. Subsequently, this model is applied to study boiling heat transfer for a typical automobile exhaust gas recirculation (EGR) cooler under a typical condition.
A New Stabilized Finite Element Formulation for Solving Radiative Transfer Equation
Authors: Zhang L. , Zhao J. M. , Liu L. H.
Published: February 2016

A new stabilized finite element formulation for solving radiative transfer equation is presented. It owns the salient feature of least-squares finite element method (LSFEM), i.e., free of the tuning parameter that appears in the streamline upwind/Petrov–Galerkin (SUPG) finite element method. The new finite element formulation is based on a second-order form of the radiative transfer equation. The second-order term will provide essential diffusion as the artificial diffusion introduced in traditional stabilized schemes to ensure stability. The performance of the new method was evaluated using challenging test cases featuring strong medium inhomogeneity and large gradient of radiative intensity field. It is demonstrated to be computationally efficient and capable of solving radiative heat transfer in strongly inhomogeneous media with even better accuracy than the LSFEM, and hence a promising alternative finite element formulation for solving complex radiative transfer problems.
Photon counting x‐ray imaging with K‐edge filtered x‐rays: A simulation study
Authors: Atak Haluk , Shikhaliev Polad M.
Published: February 2016

Purpose:

In photon counting (PC) x‐ray imaging and computed tomography (CT), the broad x‐ray spectrum can be split into two parts using an x‐ray filter with appropriate K‐edge energy, which can improve material decomposition. Recent experimental study has demonstrated substantial improvement in material decomposition with PC CT when K‐edge filtered x‐rays were used. The purpose of the current work was to conduct further investigations of the K‐edge filtration method using comprehensive simulation studies.

Methods:

The study was performed in the following aspects: (1) optimization of the K‐edge filter for a particular imaging configuration, (2) effects of the K‐edge filter parameters on material decomposition, (3) trade‐off between the energy bin separation, tube load, and beam quality with K‐edge filter, (4) image quality of general (unsubtracted) images when a K‐edge filter is used to improve dual energy (DE) subtracted images, and (5) improvements with K‐edge filtered x‐rays when PC detector has limited energy resolution. The PC x‐ray images of soft tissue phantoms with 15 and 30 cm thicknesses including iodine, CaCO3, and soft tissue contrast materials, were simulated. The signal to noise ratio (SNR) of the contrast elements was determined in general and material‐decomposed images using K‐edge filters with different atomic numbers and thicknesses. The effect of the filter atomic number and filter thickness on energy separation factor and SNR was determined. The boundary conditions for the tube load and halfvalue layer were determined when the K‐edge filters are used. The material‐decomposed images were also simulated using PC detector with limited energy resolution, and improvements with K‐edge filtered x‐rays were quantified.

Results:

The K‐edge filters with atomic numbers from 56 to 71 and K‐edge energies 37.4–63.4 keV, respectively, can be used for tube voltages from 60 to 150 kVp, respectively. For a particular tube voltage of 120 kVp, the Gd and Ho were the optimal filter materials to achieve highest SNR. For a particular K‐edge filter of Gd and tube voltage of 120 kVp, the filter thickness 0.6 mm provided maximum SNR for considered imaging applications. While K‐edge filtration improved SNR of CaCO3 and iodine by 41% and 36%, respectively, in DE subtracted images, it did not deteriorate SNR in general images. For x‐ray imaging with nonideal PC detector, the positive effect of the K‐edge filter was increased when FWHM energy resolution was degraded, and maximum improvement was at 60% FWHM.

Conclusions:

This study has shown that K‐edge filtered x‐rays can provide substantial improvements of material selective PC x‐ray and CT imaging for nearly all imaging applications using 60–150 kVp tube voltages. Potential limitations such as tube load, beam hardening, and availability of filter material were shown to not be critical.
Technical Note: FreeCT_wFBP: A robust, efficient, open‐source implementation of weighted filtered backprojection for helical, fan‐beam CT
Authors: Hoffman John , Young Stefano , Noo Frédéric , McNitt‐Gray Michael
Published: February 2016

Purpose:

With growing interest in quantitative imaging, radiomics, and CAD using CT imaging, the need to explore the impacts of acquisition and reconstruction parameters has grown. This usually requires extensive access to the scanner on which the data were acquired and its workflow is not designed for large‐scale reconstruction projects. Therefore, the authors have developed a freely available, open‐source software package implementing a common reconstruction method, weighted filtered backprojection (wFBP), for helical fan‐beam CT applications.

Methods:

FreeCT_wFBP is a low‐dependency, GPU‐based reconstruction program utilizing c for the host code and Nvidia CUDA C for GPU code. The software is capable of reconstructing helical scans acquired with arbitrary pitch‐values, and sampling techniques such as flying focal spots and a quarter‐detector offset. In this work, the software has been described and evaluated for reconstruction speed, image quality, and accuracy. Speed was evaluated based on acquisitions of the ACR CT accreditation phantom under four different flying focal spot configurations. Image quality was assessed using the same phantom by evaluating CT number accuracy, uniformity, and contrast to noise ratio (CNR). Finally, reconstructed mass‐attenuation coefficient accuracy was evaluated using a simulated scan of a FORBILD thorax phantom and comparing reconstructed values to the known phantom values.

Results:

The average reconstruction time evaluated under all flying focal spot configurations was found to be 17.4 ± 1.0 s for a 512 row × 512 column × 32 slice volume. Reconstructions of the ACR phantom were found to meet all CT Accreditation Program criteria including CT number, CNR, and uniformity tests. Finally, reconstructed mass‐attenuation coefficient values of water within the FORBILD thorax phantom agreed with original phantom values to within 0.0001 mm2/g (0.01%).

Conclusions:

FreeCT_wFBP is a fast, highly configurable reconstruction package for third‐generation CT available under the GNU GPL. It shows good performance with both clinical and simulated data.
DATA CHECK: For innovation, no magic in 3% rule
Authors: Mervis Jeffrey
Published: February 2016

A venerable metric for measuring whether a country is spending enough on research takes some hits.
Arctic shipworm discovery alarms archaeologists
Authors: Kintisch Eli
Published: February 2016

Sunken log full of tunneling mollusks poses mystery.
A DNA topoisomerase VI–like complex initiates meiotic recombination
Authors: Vrielynck Nathalie , Chambon Aurélie , Vezon Daniel , Pereira Lucie , Chelysheva Liudmila , De Muyt Arnaud , Mézard Christine , Mayer Claudine , Grelon Mathilde
Published: February 2016

A partner protein for meiotic snip

Eukaryotes generate germ cells through meiotic recombination. This process initiates through breaks in genomic DNA catalyzed by the SPO11 protein. Vrielynck
et al.
and Robert
et al.
discover that SPO11, like topoisomerase VI enzymes, interacts with a partner protein (see the Perspective by Bouuaert and Keeney). This partner is required for proper meiotic recombination and is found in a wide range of eukaryotes, suggesting that it is a universal feature of the essential recombination step.

Science
, this issue p.
939
,
943
; see also p.
916
Evolution in the Anthropocene
Authors: Sarrazin François , Lecomte Jane
Published: February 2016

Taking account of the evolutionary effects of human actions is crucial for humans and nonhumans
Role of Clinicogenomics in Infectious Disease Diagnostics and Public Health Microbiology
Authors: Westblade Lars F. , van Belkum Alex , Grundhoff Adam , Weinstock George M. , Pamer Eric G. , Pallen Mark J. , Dunne W. Michael
Published: February 2016

Clinicogenomics is the exploitation of genome sequence data for diagnostic, therapeutic, and public health purposes. Central to this field is the high-throughput DNA sequencing of genomes and metagenomes. The role of clinicogenomics in infectious disease diagnostics and public health microbiology was the topic of discussion during a recent symposium (session 161) presented at the 115th general meeting of the American Society for Microbiology that was held in New Orleans, LA. What follows is a collection of the most salient and promising aspects from each presentation at the symposium.
Recovery of West Nile Virus Envelope Protein Domain III Chimeras with Altered Antigenicity and Mouse Virulence
Authors: McAuley Alexander J. , Torres Maricela , Plante Jessica A. , Huang Claire Y.-H. , Bente Dennis A. , Beasley David W. C.
Published: February 2016

Flaviviruses are positive-sense, single-stranded RNA viruses responsible for millions of human infections annually. The envelope (E) protein of flaviviruses comprises three structural domains, of which domain III (EIII) represents a discrete subunit. The EIII gene sequence typically encodes epitopes recognized by virus-specific, potently neutralizing antibodies, and EIII is believed to play a major role in receptor binding. In order to assess potential interactions between EIII and the remainder of the E protein and to assess the effects of EIII sequence substitutions on the antigenicity, growth, and virulence of a representative flavivirus, chimeric viruses were generated using the West Nile virus (WNV) infectious clone, into which EIIIs from nine flaviviruses with various levels of genetic diversity from WNV were substituted. Of the constructs tested, chimeras containing EIIIs from Koutango virus (KOUV), Japanese encephalitis virus (JEV), St. Louis encephalitis virus (SLEV), and Bagaza virus (BAGV) were successfully recovered. Characterization of the chimeras
in vitro
and
in vivo
revealed differences in growth and virulence between the viruses, with
in vivo
pathogenesis often not being correlated with
in vitro
growth. Taken together, the data demonstrate that substitutions of EIII can allow the generation of viable chimeric viruses with significantly altered antigenicity and virulence.

IMPORTANCE
The envelope (E) glycoprotein is the major protein present on the surface of flavivirus virions and is responsible for mediating virus binding and entry into target cells. Several viable West Nile virus (WNV) variants with chimeric E proteins in which the putative receptor-binding domain (EIII) sequences of other mosquito-borne flaviviruses were substituted in place of the WNV EIII were recovered, although the substitution of several more divergent EIII sequences was not tolerated. The differences in virulence and tissue tropism observed with the chimeric viruses indicate a significant role for this sequence in determining the pathogenesis of the virus within the mammalian host. Our studies demonstrate that these chimeras are viable and suggest that such recombinant viruses may be useful for investigation of domain-specific antibody responses and the more extensive definition of the contributions of EIII to the tropism and pathogenesis of WNV or other flaviviruses.
Nucleic Acid Binding by Mason-Pfizer Monkey Virus CA Promotes Virus Assembly and Genome Packaging
Authors: Füzik Tibor , Píchalová Růžena , Schur Florian K. M. , Strohalmová Karolína , Křížová Ivana , Hadravová Romana , Rumlová Michaela , Briggs John A. G. , Ulbrich Pavel , Ruml Tomáš
Published: February 2016

The Gag polyprotein of retroviruses drives immature virus assembly by forming hexameric protein lattices. The assembly is primarily mediated by protein-protein interactions between capsid (CA) domains and by interactions between nucleocapsid (NC) domains and RNA. Specific interactions between NC and the viral RNA are required for genome packaging. Previously reported cryoelectron microscopy analysis of immature Mason-Pfizer monkey virus (M-PMV) particles suggested that a basic region (residues RKK) in CA may serve as an additional binding site for nucleic acids. Here, we have introduced mutations into the RKK region in both bacterial and proviral M-PMV vectors and have assessed their impact on M-PMV assembly, structure, RNA binding, budding/release, nuclear trafficking, and infectivity using
in vitro
and
in vivo
systems. Our data indicate that the RKK region binds and structures nucleic acid that serves to promote virus particle assembly in the cytoplasm. Moreover, the RKK region appears to be important for recruitment of viral genomic RNA into Gag particles, and this function could be linked to changes in nuclear trafficking. Together these observations suggest that in M-PMV, direct interactions between CA and nucleic acid play important functions in the late stages of the viral life cycle.

IMPORTANCE
Assembly of retrovirus particles is driven by the Gag polyprotein, which can self-assemble to form virus particles and interact with RNA to recruit the viral genome into the particles. Generally, the capsid domains of Gag contribute to essential protein-protein interactions during assembly, while the nucleocapsid domain interacts with RNA. The interactions between the nucleocapsid domain and RNA are important both for identifying the genome and for self-assembly of Gag molecules. Here, we show that a region of basic residues in the capsid protein of the betaretrovirus Mason-Pfizer monkey virus (M-PMV) contributes to interaction of Gag with nucleic acid. This interaction appears to provide a critical scaffolding function that promotes assembly of virus particles in the cytoplasm. It is also crucial for packaging the viral genome and thus for infectivity. These data indicate that, surprisingly, interactions between the capsid domain and RNA play an important role in the assembly of M-PMV.
Chronic infection of a Brindley sacral nerve root stimulator
Authors: Bramall Alexa , Chaudhary Bednash , Ahmad Jamil , Shamji Mohammed F
Published: February 2016

The Finetech-Brindley sacral anterior root stimulator (SARS) is implanted for the treatment of bladder dysfunction following spinal cord injury (SCI) and has been successful in improving micturition in many patients with SCI. This case describes a 62-year-old man who presented with a chronicStaphylococcus aureusinfection of a Brindley SARS 26 years after implantation following a T5 American Spinal Injury Association A spinal cord injury (T5 ASIA A SCI). He presented with chronic sacral osteomyelitis with a history of periodic implant erosion through the skin. Following a series of interventions, definitive management involved removal of the intradural electrodes and epidural and intradural phlegmon, ligation of the thecal sac and flap reconstruction. In the case of delayed infection of a Brindley SARS, removal of the entire system should be considered, especially if extension of the infection to the intradural compartment is suspected.
Chronic inflammation masquerading as an appendiceal tumour with peritoneal metastasis: the challenge of diagnosis and the lessons learnt
Authors: Almerie Muhammad Qutayba , Culverwell Adam , Krishna Jyoti , Mahon Christopher
Published: February 2016

Advanced radiological imaging has largely replaced exploratory operations and has become an essential diagnostic tool clinicians routinely rely on. However, physicians are faced with a lot of radiological findings without histological proof, and assuming a more serious diagnosis may lead to unnecessary investigations and emotional stress for patients. We report an unusual presentation of chronic appendicitis with a synchronous peritoneal nodule on CT in a 76-year-old woman who presented with poor appetite, weight loss and a mass in the right iliac fossa. The coincidental finding of the nodule in addition to the suspicious appearance of the appendix raised concerns for primary appendiceal cancer with peritoneal metastasis. The case illustrates the patient's management and reflects on the learnt lessons with regard to careful use of invasive radiology-guided biopsies and interval imaging, as these could sometimes delay the diagnosis and management of a readily treatable disease.
Cost-efficiency of specialist inpatient rehabilitation for working-aged adults with complex neurological disabilities: a multicentre cohort analysis of a national clinical data set
Authors: Turner-Stokes Lynne , Williams Heather , Bill Alan , Bassett Paul , Sephton Keith
Published: February 2016

Objectives

To evaluate functional outcomes, care needs and cost-efficiency of specialist rehabilitation for a multicentre cohort of inpatients with complex neurological disability, comparing different diagnostic groups across 3 levels of dependency.

Design

A multicentre cohort analysis of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative (UKROC) national clinical database, 2010–2015.

Setting

All 62 specialist (levels 1 and 2) rehabilitation services in England.

Participants

Working-aged adults (16–65 years) with complex neurological disability. Inclusion criteria: all episodes with length of stay (LOS) 8–400 days and complete outcome measures recorded on admission and discharge. Total N=5739: acquired brain injury n=4182 (73%); spinal cord injury n=506 (9%); peripheral neurological conditions n=282 (5%); progressive conditions n=769 (13%).

Intervention

Specialist inpatient multidisciplinary rehabilitation.

Outcome measures

Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPDS/NPCNA). Functional independence: UK Functional Assessment Measure (UK Functional Independence Measure (FIM)+FAM). Cost-efficiency: (1) time taken to offset rehabilitation costs by savings in NPCNA-estimated costs of ongoing care, (2) FIM efficiency (FIM gain/LOS days), (3) FIM+FAM efficiency (FIM+FAM gain/LOS days). Patients were analysed in 3 groups of dependency.

Results

Mean LOS 90.1 (SD 66) days. All groups showed significant reduction in dependency between admission and discharge on all measures (paired t tests: p<0.001). Mean reduction in ‘weekly care costs’ was greatest in the high-dependency group at £760/week (95% CI 726 to 794)), compared with the medium-dependency (£408/week (95% CI 370 to 445)), and low-dependency (£130/week (95% CI 82 to 178)), groups. Despite longer LOS, time taken to offset the cost of rehabilitation was 14.2 (95% CI 9.9 to 18.8) months in the high-dependency group, compared with 22.3 (95% CI 16.9 to 29.2) months (medium dependency), and 27.7 (95% CI 15.9 to 39.7) months (low dependency). FIM efficiency appeared greatest in medium-dependency patients (0.54), compared with the low-dependency (0.37) and high-dependency (0.38) groups. Broadly similar patterns were seen across all 4 diagnostic groups.

Conclusions

Specialist rehabilitation can be highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients.
Development of the Chinese version of the Hospital Autonomy Questionnaire: a cross-sectional study in Guangdong Province
Authors: Liu Zifeng , Yuan Lianxiong , Huang Yixiang , Zhang Lingling , Luo Futian
Published: February 2016

Objective

We aimed to develop a questionnaire for quantitative evaluation of the autonomy of public hospitals in China.

Method

An extensive literature review was conducted to select possible items for inclusion in the questionnaire, which was then reviewed by 5 experts. After a two-round Delphi method, we distributed the questionnaire to 404 secondary and tertiary hospitals in Guangdong Province, China, and 379 completed questionnaires were collected. The final questionnaire was then developed on the basis of the results of exploratory and confirmatory factor analysis.

Results

Analysis suggested that all internal consistency reliabilities exceeded the minimum reliability standard of 0.70 for the α coefficient. The overall scale coefficient was 0.87, and 6 subscale coefficients were 0.92 (strategic management), 0.81 (budget and expenditure), 0.85 (financing), 0.75 (financing, medical management), 0.86 (human resources) and 0.86 (accountability). Correlation coefficients between and among items and their hypothesised subscales were higher than those with other subscales. The value of average variance extracted (AVE) was higher than 0.5, the value of construct reliability (CR) was higher than 0.7, and the square roots of the AVE of each subscale were larger than the correlation of the specific subscale with the other subscales, supporting the convergent and discriminant validity of the Chinese version of the Hospital Autonomy Questionnaire (CVHAQ). The model fit indices were all acceptable: χ2/df=1.73, Goodness of Fit Index (GFI) = 0.93, Adjusted Goodness of Fit Index (AGFI) = 0.91, Non-Normed Fit Index (NNFI) = 0.96, Comparative Fit Index (CFI) = 0.97, Root Mean Square Error of Approximation (RMSEA) = 0.04, Standardised Root Mean Square Residual (SRMR) = 0.07.

Conclusions

This study demonstrated the reliability and validity of a CVHAQ and provides a quantitative method for the assessment of hospital autonomy.
Prehospital and in-hospital use of healthcare resources in patients surviving acute coronary syndromes: an analysis of the EPICOR registry
Authors: Annemans Lieven , Danchin Nicolas , Van de Werf Frans , Pocock Stuart , Licour Muriel , Medina Jesús , Bueno Héctor
Published: February 2016

Objective

The aim of this report is to provide insight into real-world healthcare resource use (HCRU) during the critical management of patients surviving acute coronary syndromes (ACS), using data from EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) (NCT01171404).

Methods

EPICOR was a prospective, multinational, observational study that enrolled 10 568 ACS survivors from 555 hospitals in 20 countries in Europe and Latin America, between September 2010 and March 2011. HCRU was evaluated in patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation ACS (NSTE-ACS), with or without a history of cardiovascular disease (CVD). Multivariable analysis was performed to determine factors that affected resource use.

Results

Before hospitalisation, more patients with STEMI than with NSTE-ACS had their first ECG (44.1% vs 36.4%, p<0.0001) and received antithrombotic medication (26.6% vs 15.2%, p<0.0001). Patients with NSTE-ACS with prior CVD were less likely than those without to be catheterised (73.1% vs 82.8%, p<0.0001). More patients with STEMI than with NSTE-ACS had percutaneous coronary intervention (77.1% vs 54.9%, p<0.0001), but fewer underwent coronary artery bypass grafting (1.2% vs 3.7%, p<0.0001). Multivariable analysis showed that resource use, including length of hospital stay and coronary revascularisation, was significantly influenced by multiple factors, including ACS type, site characteristics and region (all p≤0.05).

Conclusions

In this large-scale, real-life study, findings were generally in line with clinical logic, although site characteristics and region still significantly affected resource use. Moreover, and unexpectedly, resource use tended to be slightly higher in patients without a history of CVD.

Trial registration number

NCT01171404 (ClinicalTrials.gov).
Using remote sensing to understand Pinot noir vineyard variability in Ontario
Authors: Ledderhof David , Brown Ralph , Reynolds Andrew , Jollineau Marilyne
Published: February 2016

The study objective was to determine whether multispectral high spatial resolution airborne imagery could be used to segregate zones in Pinot noir vineyards to target highest quality fruit for premium winemaking. We hypothesized that remotely sensed data would be correlated with vine size and leaf water potential (ψ), and by extension with yield and berry composition. In 2008–2009, multispectral (blue, green, red, near-infrared) airborne images were acquired from four Ontario Pinot noir vineyards (four dates, 2008; three, 2009), with the final flight date near veraison. A process was developed to extract information from sentinel vine locations, and to calculate normalized difference vegetation index (NDVI). Data were extracted at 1 × 1, 3 × 3, and 5 × 5 pixel re-sampling rates to test for ideal image resolution. A method was developed to mask non-vine pixels to simplify qualitative assessment of images. The 3 × 3 pixel re-sampling provided most useful information. In 2008, 3 × 3 re-sampling NDVI correlated with (r-values; p < 0.0001): berry pH (−0.48), soluble solids (−0.43), vine size (0.46), anthocyanins (−0.65), colour (−0.58), and soil clay and sand content (−0.55, 0.55). In 2009, mean 3 × 3 re-sampling NDVI correlated with (r-values; p < 0.0001): anthocyanins (0.49), soil moisture (−0.89), and soil clay and silt content (−0.75, 0.83). No clear trends in correlations existed between vegetation indices vs. vine size, anthocyanins, phenolics, or soil moisture throughout the growing season in either vintage. Masked images proved effective for viewing spatial trends in airborne images without full data extraction. Qualitative similarities existed between maps of vineyard and grape composition variables vs. maps of extracted data and masked images. Remote sensing may be useful to determine colour or phenolic potential of grapes, in addition to vine water status, yield, and vine size. This study was unique by employing remote sensing in cover-cropped vineyards and thereafter using protocols for excluding spectral reflectance contributed by inter-row vegetation.
From Finite Automata to Regular Expressions and Back — A Summary on Descriptional Complexity
Authors: Gruber Hermann , Holzer Markus
Published: February 2016

The equivalence of finite automata and regular expressions dates back to the seminal paper of Kleene on events in nerve nets and finite automata from 1956. In the present paper we tour a fragment of the literature and summarize results on upper and lower bounds on the conversion of finite automata to regular expressions and vice versa. As an interesting special case also one-unambiguous regular expressions, a sort of a deterministic version of a regular expression, are considered. We also briefly recall the known bounds for the removal of spontaneous transitions (ε-transitions) on non-ε-free nondeter-ministic devices. Moreover, we report on recent results on the average case descriptional complexity bounds for the conversion of regular expressions to finite automata and new developments on the state elimination algorithm that converts finite automata to regular expressions.
SGK1 regulation by miR-466g in cortical collecting duct cells
Authors: Jacobs Mollie E. , Kathpalia Paru P. , Chen Yu , Thomas Sheela V. , Noonan Emily J. , Pao Alan C.
Published: February 2016

Micro-RNAs (miRNAs) are noncoding RNAs that bind target mRNA transcripts and modulate gene expression. In the cortical collecting duct (CCD), aldosterone stimulates the expression of genes that increase activity of the epithelial sodium channel (ENaC); in the early phase of aldosterone induction, one such gene is serum and glucocorticoid regulated kinase 1 (SGK1). We hypothesized that aldosterone regulates the expression of miRNAs in the early phase of induction to control the expression of target genes that stimulate ENaC activity. We treated mpkCCDc14cells with aldosterone or vehicle for 1 h and used a miRNA microarray to analyze differential miRNA expression. We identified miR-466g as a miRNA that decreased by 57% after 1 h of aldosterone treatment. Moreover, we identified a putative miR-466g binding site in the 3′-untranslated region of SGK1. We constructed an SGK1 3′-untranslated region luciferase reporter and found that cotransfection of miR-466g suppressed luciferase activity in human embryonic kidney-293 cells in a dose-dependent manner. Deletion or introduction of point mutations that disrupt the miR-466g target site attenuated miR-466g-directed suppression of luciferase activity. Finally, we generated stably transduced mpkCCDc14cell lines overexpressing miR-466g. Cells overexpressing miR-466g demonstrated 12.9-fold lower level of SGK1 mRNA compared with control cells after 6 h of aldosterone induction; moreover, cells overexpressing miR-466g exhibited 25% decrease in amiloride-sensitive current after 6 h of aldosterone induction and complete loss of amiloride-sensitive current after 24 h of aldosterone induction. Our findings implicate miR-466g as a novel early-phase aldosterone responsive miRNA that regulates SGK1 and ENaC in CCD cells.
Everything we always wanted to know about furosemide but were afraid to ask
Authors: Huang Xiaohua , Dorhout Mees Evert , Vos Pieter , Hamza Shereen , Braam Branko
Published: February 2016

Furosemide is a widely used, potent natriuretic drug, which inhibits the Na+-K+-2Cl−cotransporter (NKCC)-2 in the ascending limb of the loop of Henle applied to reduce extracellular fluid volume expansion in heart and kidney disease. Undesirable consequences of furosemide, such as worsening of kidney function and unpredictable effects on sodium balance, led to this critical evaluation of how inhibition of NKCC affects renal and cardiovascular physiology. This evaluation reveals important knowledge gaps, involving furosemide as a drug, the function of NKCC2 (and NKCC1), and renal and systemic indirect effects of NKCC inhibition. Regarding renal effects, renal blood flow and glomerular filtration rate could become compromised by activation of tubuloglomerular feedback or by renin release, particularly if renal function is already compromised. Modulation of the intrarenal renin angiotensin system, however, is ill-defined. Regarding systemic effects, vasodilation followed by nonspecific NKCC inhibition and changes in venous compliance are not well understood. Repetitive administration of furosemide induces short-term (braking phenomenon, acute diuretic resistance) and long-term (chronic diuretic resistance) adaptations, of which the mechanisms are not well known. Modulation of NKCC2 expression and activity in kidney and heart failure is ill-defined. Lastly, furosemide's effects on cutaneous sodium stores and on uric acid levels could be beneficial or detrimental. Concluding, a considerable knowledge gap is identified regarding a potent drug with a relatively specific renal target, NKCC2, and renal and systemic actions. Resolving these questions would increase the understanding of NKCCs and their actions and improve rational use of furosemide in pathophysiology of fluid volume expansion.
In the absence of overt urothelial damage, chondroitinase ABC digestion of the GAG layer increases bladder permeability in ovariectomized female rats
Authors: Hurst Robert E. , Van Gordon Samuel , Tyler Karl , Kropp Bradley , Towner Rheal , Lin HsuehKung , Marentette John O. , McHowat Jane , Mohammedi Ehsan , Greenwood-Van Meerveld Beverley
Published: February 2016

Loss of integrity of the protective impermeability barrier in the urothelium has been identified as significant in bladder dysfunction. In this study, we tested the theory that the luminal layer of glycosaminoglycans (GAG) serves as an important component of barrier function. The peptide polycation protamine sulfate (PS), 1 mg/ml, was instilled intravesically for 10 min into rat bladders. Chondroitinase ABC (ChABC), 63 IU/ml, was instilled into an additional six rats for 30 min to digest the GAG layer. Unmanipulated controls and sham-injected controls were also performed. After 24 h, the rats were euthanized, the bladders were removed, and permeability was assessed in the Ussing chamber and by diffusion of FITC-labeled dextran (4 kDa) to measure macromolecular permeability. The status of tight junctions was assessed by immunofluorescence and electron microscopy. In control and sham treated rat bladders, the transepithelial electrical resistance were means of 2.5 ± 1.1 vs. 2.6 ± 1.1 vs 1.2 ± 0.5 and 1.01 ± 0.7 kΩ·cm2 in the PS-treated and ChABC-treated rat bladders ( P = 0.0016 and P = 0.0039, respectively). Similar differences were seen in dextran permeability. Histopathology showed a mild inflammation following PS treatment, but the ChABC-treated bladders were indistinguishable from controls. Tight junctions generally remained intact. ChABC digestion alone induced bladder permeability, confirming the importance of the GAG layer to bladder barrier function and supports that loss of the GAG layer seen in bladder biopsies of interstitial cystitis patients could be a significant factor producing symptoms for at least some interstitial cystitis/painful bladder syndrome patients.
Utilization of Waste Clay from Boron Production in Bituminous Geosynthetic Barrier (GBR-B) Production as Landfill Liner
Authors: Banar Müfide , Güney Yücel , Özkan Aysun , Günkaya Zerrin , Bayrakcı Eren , Ulutaş Derya
Published: February 2016

Bituminous geomembranes, one type of geosynthetics, include a hot bituminous mixture with mineral filler and reinforcement. In this study, boron production waste clay (CW) was used as filler to produce a geosynthetic barrier with bentonite, waste tire, and bitumen. Bentonite and waste tires were used as auxiliary fillers and bitumen as the binder. CW/bitumen, CW/bentonite/bitumen, and CW/waste tire/bitumen mixtures were prepared by using a laboratory mixer at 100°C. Hot mixtures were extruded into strips by using a lab-scale corotating twin screw extruder (L/D: 40) followed by die casting (2 mm × 100 mm). Glass fleece or nonwoven polyester was used as reinforcement material and while die casting, both sides of the reinforcement materials were covered with bituminous mixture. Thickness, mass per unit area, tensile strength, elongation at yield, and hydraulic conductivity were used to characterize the geomembranes. Among all geomembranes, nonwoven polyester covered with 30% bitumen-70% boron waste clay mixture (PK-BTM30CW70) was found to be the most promising in terms of structure and mechanical behaviour. After that, consequences of its exposure to distilled water (DW), municipal solid waste landfill leachate (L-MSW), and hazardous waste landfill leachate (L-HW) were examined to use for an innovative impermeable liner on solid waste landfills.
Laser-Based Obstacle Detection at Railway Level Crossings
Authors: Amaral Vítor , Marques Francisco , Lourenço André , Barata José , Santana Pedro
Published: February 2016

This paper presents a system for obstacle detection in railway level crossings from 3D point clouds acquired with tilting 2D laser scanners. Although large obstacles in railway level crossings are detectable with current solutions, the detection of small obstacles remains an open problem. By relying on a tilting laser scanner, the proposed system is able to acquire highly dense and accurate point clouds, enabling the detection of small obstacles, like rocks laying near the rail. During an offline training phase, the system learns a background model of the level crossing from a set of point clouds. Then, online, obstacles are detected as occupied space contrasting with the background model. To reduce the need for manual on-site calibration, the system automatically estimates the pose of the level crossing and railway with respect to the laser scanner. Experimental results show the ability of the system to successfully perform on a set of 41 point clouds acquired in an operational one-lane level crossing.