bluuebunny/crossref_metadata_2025 huggingface dataset:
Detrusor Underactivity: The Current Concept of the Pathophysiology
Authors: YOSHIDA Masaki , YAMAGUCHI Osamu
Published: August 2014

Based on evidence from available literature, we review the pathophysiology of detrusor underactivity (DU). DU is likely to be multifactorial. Aging reduces detrusor activity, but other concomitant causes may aggravate this condition, resulting in decrease of detrusor contractility. Impaired detrusor contractility has been regarded as a major etiologic factor of DU. However, a more complex pathology has been proposed. As contributing factors to DU, we discuss disturbances of the sensory afferent side of the micturition reflex, the central nervous system (CNS) and the efferent side of the reflex, including nerves and the detrusor muscle. Particularly, dysfunction of afferent nerves in the bladder and urethra may play a crucial role in the pathogenesis of DU. In addition, recent studies suggest that chronic bladder ischemia and resultant oxidative stress cause detrusor overactivity progressing to DU and inability to empty the bladder.
Sinus floor elevation utilizing the transalveolar approach
Authors: Pjetursson Bjarni E. , Lang Niklaus P.
Published: August 2014

A transalveolar approach for sinus floor elevation with subsequent placement of dental implants was first suggested by Tatum in 1986. In 1994, Summers described a different transalveolar approach using a set of tapered osteotomes with increasing diameters. The transalveolar approach of sinus floor elevation, also referred to as ‘osteotome sinus floor elevation’, the ‘Summers technique’ or the ‘Crestal approach’, may be considered as being more conservative and less invasive than the conventional lateral window approach. This is reflected by the fact that more than nine out of 10 patients who experienced the surgical procedure would be willing to undergo it again. The main indication for transalveolar sinus floor elevation is reduced residual bone height, which does not allow standard implant placement. Contraindications for transalveolar sinus floor elevation may be intra‐oral, local or medical. The surgical approach utilized over the last two decades is the technique described by Summers, with or without minor modifications. The surgical care after implant placement using the osteotome technique is similar to the surgical care after standard implant placement. The patients are usually advised to take antibiotic prophylaxis and to utilize antiseptic rinses. The main complications reported after performing a transalveolar sinus floor elevation were perforation of the Schneiderian membrane in 3.8% of patients and postoperative infections in 0.8% of patients. Other complications reported were postoperative hemorrhage, nasal bleeding, blocked nose, hematomas and benign paroxysmal positional vertigo. Whether it is necessary to use grafting material to maintain space for new bone formation after elevating the sinus membrane utilizing the osteotome technique is still controversial. Positive outcomes have been reported with and without using grafting material. A prospective study, evaluating both approaches, concluded that significantly more bone gain was seen when grafting material was used (4.1 mm mean bone gain compared with 1.7 mm when no grafting material was utilized). In a systematic review, including 19 studies reporting on 4388 implants inserted using the transalveolar sinus floor elevation technique, the 3‐year implant survival rate was 92.8% (95% confidence interval: 87.4–96.0%). Furthermore, a subject‐based analysis of the same material revealed an annual failure rate of 3.7%. Hence, one in 10 subjects experienced implant loss over 3 years. Several of the included studies demonstrated that transalveolar sinus floor elevation was most predictable when the residual alveolar bone height was ≥ 5 mm and the sinus floor anatomy was relatively flat.
Short implant in limited bone volume
Authors: Nisand David , Renouard Franck
Published: August 2014

Rehabilitation of severely resorbed jaws with dental implants remains a surgical and prosthetic challenge for clinicians. The purpose of this review was to evaluate the available data on short‐length implants and discuss their indications and limitations in daily clinical practice. A structured review of MEDLINE and a manual search were conducted. Thirty‐two case series devoted to short‐length implants, 14 reviews and 3 randomized controlled trials were identified. Of this group of papers, we can conclude that short‐length implants can be successfully used to support single and multiple fixed reconstructions in posterior atrophied jaws, even in those with increased crown‐to‐implant ratios. The use of short‐length implants allows treatment of patients who are unable to undergo complex surgical techniques for medical, anatomic or financial reasons. Moreover, the use of short‐length implants in daily clinical practice reduces the need for complex surgeries, thus reducing morbidity, cost and treatment time. The use of short implants promotes the new concept of stress‐minimizing surgery, allowing the surgeon to focus more on the correct three‐dimensional positioning of the implant.
Etiology and treatment of periapical lesions around dental implants
Authors: Temmerman Andy , Lefever David , Teughels Wim , Balshi Thomas J. , Balshi Stephen F. , Quirynen Marc
Published: August 2014

The widespread use of oral implants in recent years has resulted in various types of complications. One of those complications is the periapical implant lesion. Different factors have been proposed to play a role in the development and emergence of a periapical implant lesion. To date, there is no consensus on the etiology and therefore periapical lesions around dental implants are considered to have a multifactorial etiology. The diagnosis of an implant periapical lesion should be based on both clinical and radiological findings. Additionally, in order to apply the best treatment strategy the evolution of the lesion should be taken into account. The treatment of this kind of lesion, however, is still empiric. Data, primarily from case reports, seem to indicate that the removal of all granulation tissue is a first step to arrest the progression of the bone destruction. The removal of the apical part of the implant seems a valuable treatment strategy.
Implant therapy: 40 years of experience
Authors: Quirynen Marc , Herrera David , Teughels Wim , Sanz Mariano
Published: August 2014

Implant placement has become a well‐established and highly successful therapy in the rehabilitation of partially and fully edentulous patients. The ‘original’ treatment protocol, which aimed to demonstrate implant ‘biocompatibility’ and the achievement of osseointegration, has evolved over the past 40 years into a broader treatment approach in which the esthetic and patient‐related objectives have become the main focus. This volume of Periodontology 2000 summarizes, via narrative reviews, the advantages and disadvantages of this evolution in implantology and offers recommendations on where and when to apply the new therapeutic protocols, without jeopardizing the outcome for the patient. It also discusses current treatments of the most common implant‐associated complications. Many of the implant innovations and new therapeutic protocols are supported by evidence‐based knowledge and have provided clear benefits for both the patient and the clinician.
Correcting for the bias caused by exposure measurement error in epidemiological studies
Authors: Fahey Michael T. , Forbes Andrew B. , Hodge Alison M.
Published: August 2014

An important goal of many epidemiological studies is to estimate the magnitude of association between an exposure and an outcome. Exposure measurement error causes bias in such estimates of association and can be substantial. In this article, we describe the problem of exposure measurement error and its effects. We show how a simple hand calculation, in conjunction with validation study data and a calibration equation, can be used to correct estimates for the bias caused by exposure measurement error. Correcting estimates of association for measurement error helps researchers appropriately assess effect size.
Australian Idiopathic Pulmonary Fibrosis Registry: Vital lessons from a national prospective collaborative project
Authors: Moodley Yuben , Goh Nicole , Glaspole Ian , Macansh Sacha , Walters E Haydn , Chapman Sally , Hopkins Peter , Reynolds Paul N , Zappala Christopher , Cooper Wendy , Mahar Annabelle , Ellis Samantha , McCormack Samuel , Darbishire William , Wood‐Baker Richard , Corte Tamera J. ,   Australian IPF Registry Steering Committee
Published: August 2014

There is little Australian epidemiologic data on idiopathic pulmonary fibrosis (IPF), a relatively uncommon but devastating disease. The vast geographic distances in Australia have been a major impediment for collaborative research into IPF. A collaborative national effort, the Australian IPF Registry, has been formed, launched and is recruiting successfully (n = 359, January 2014). Our experience provides unique insights for others wishing to set up IPF registries and in time for a global IPF registry.
Level of adherence to the GOLD strategy document for management of patients admitted to hospital with an acute exacerbation of COPD
Authors: Tang Clarice Y. , Taylor Nicholas F. , McDonald Christine F. , Blackstock Felicity C.
Published: August 2014

Background and objective

The Global initiative for chronic Obstructive Lung Disease (GOLD) strategy document has been available since 2001. Little is known about level of adherence to the GOLD document among hospital‐based health professionals assessing and managing inpatients admitted with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The primary aim of the study was to evaluate the level of adherence among health professionals to GOLD.

Methods

A retrospective audit of medical histories was completed on a random sample of 240 patients admitted to hospital with a primary diagnosis of AECOPD within a calendar year. The audit evaluated adherence to GOLD recommendations on appropriateness of hospital and intensive care unit admissions as well as pharmacological and non‐pharmacological management.

Results

High levels of adherence to indications for hospital admissions (97%), indications for intensive care unit admissions (100%) and prescription of bronchodilators (100%) were observed. However, antibiotics (45%) and oxygen therapy (68%) were over‐prescribed. Adherence to non‐pharmacological management was poor in areas such as smoking cessation (25%) and pulmonary rehabilitation referrals (16%). Patients admitted under the care of the respiratory team were more likely (odds ratio = 2.6, 95% confidence interval: 1.3–5.4) to be referred to pulmonary rehabilitation than patients admitted under the general medicine team.

Conclusions

Health professionals in the respiratory team had better adherence to GOLD as compared to health professionals in other teams. Nonetheless, pharmacological interventions were both appropriately prescribed and also over‐prescribed, whereas non‐pharmacological interventions were used rarely, suggesting a need for practice review in these areas.
Non‐eosinophilic Airway Hyper‐reactivity in Mice, Induced by IFN‐γ Producing CD4+ and CD8+ Lung T cells, is Responsive to Steroid Treatment
Authors: Stein J. , Maxeiner J. H. , Montermann E. , Höhn Y. , Raker V. , Taube C. , Sudowe S. , Reske‐Kunz A. B.
Published: August 2014

Non‐eosinophilic asthma is characterized by infiltration of neutrophils into the lung and variable responsiveness to glucocorticoids. The pathophysiological mechanisms have not been characterized in detail. Here, we present an experimental asthma model in mice associated with non‐eosinophilic airway inflammation and airway hyper‐responsiveness (AHR). For this, BALB/c mice were sensitized by biolistic DNA immunization with a plasmid encoding the model antigen β‐galactosidase (pFascin‐βGal mice). For comparison, eosinophilic airway inflammation was induced by subcutaneous injection of βGal protein (βGal mice). Intranasal challenge of mice in both groups induced AHR to a comparable extent as well as recruitment of inflammatory cells into the airways. In contrast to βGal mice, which exhibited extensive eosinophilic infiltration in the lung, goblet cell hyperplasia and polarization of CD4+ T cells into Th2 and Th17 cells, pFascin‐βGal mice showed considerable neutrophilia, but no goblet cell hyperplasia and a predominance of Th1 and Tc1 cells in the airways. Depletion studies in pFascin‐βGal mice revealed that CD4+ and CD8+ cells cooperated to induce maximum inflammation, but that neutrophilic infiltration was not a prerequisite for AHR induction. Treatment of pFascin‐βGal mice with dexamethasone before intranasal challenge did not affect neutrophilic infiltration, but significantly reduced AHR, infiltration of monocytes and lymphocytes as well as content of IFN‐γ in the bronchoalveolar fluid. Our results suggest that non‐eosinophilic asthma associated predominantly with Th1/Tc1 cells is susceptible to glucocorticoid treatment. pFascin‐βGal mice might represent a mouse model to study pathophysiological mechanisms proceeding in the subgroup of asthmatics with non‐eosinophilic asthma that respond to inhaled steroids.
Frequency and clinical outcomes of ESKAPE bacteremia in solid organ transplantation and the risk factors for mortality
Authors: Ye Q.F. , Zhao J. , Wan Q.Q. , Qiao B.B. , Zhou J.D.
Published: August 2014

Background

Although bacteremias caused by the 6 ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) have recently been highlighted as a serious complication in solid organ transplant (SOT), more information is urgently needed. We sought to investigate the frequency and clinical outcomes of ESKAPE bacteremia in SOT and determine the risk factors for mortality.

Methods

A retrospective analysis of bacteremia after SOT was reviewed. Risk factors for mortality caused by ESKAPE bacteremia were identified.

Results

Eighty‐four episodes of bacteremia were caused by ESKAPE strains. Of these strains, 41 were caused by resistant ESKAPE (rESKAPE) organisms. The only factor for bacteremia‐related mortality independently associated with ESKAPE was septic shock (odds ratio [OR] = 21.017, 95% confidence interval [CI] = 5.038–87.682, P < 0.001). The factors for bacteremia‐related mortality independently associated with rESKAPE bacteremia were septic shock (OR = 16.558, 95% CI = 6.620–104.668, P = 0.003) and age ≥40 years (OR = 7.521, 95% CI = 1.196–47.292, P = 0.031).

Conclusions

To improve the outcomes of transplantation, more effective therapeutic treatments are of paramount importance when older SOT recipients with bacteremia due to ESKAPE/rESKAPE organisms present with septic shock.
Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community‐acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines
Authors: Agweyu Ambrose , Kibore Minnie , Digolo Lina , Kosgei Caroline , Maina Virginia , Mugane Samson , Muma Sarah , Wachira John , Waiyego Mary , Maleche‐Obimbo Elizabeth
Published: August 2014

Objective

To determine the extent and pattern of treatment failure (TF) among children hospitalised with community‐acquired pneumonia at a large tertiary hospital in Kenya.

Methods

We followed up children aged 2–59 months with WHO‐defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre‐defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre‐defined clinical signs.

Results

We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4–5.1) and 12.4% (95% CI 7.9–18.4) for SP and 21.4% (95% CI 15.9–27) and 39.3% (95% CI 32.5–46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non‐adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non‐adherence to guideline‐recommended treatments for VSP tended to occur in children with altered consciousness (P < 0.001). Using propensity score matching to account for imbalance in the distribution of baseline clinical characteristics among children with VSP revealed no difference in TF between those treated with the guideline‐recommended regimen vs. more costly broad‐spectrum alternatives [risk difference 0.37 (95% CI −0.84 to 0.51)].

Conclusion

Before revising current pneumonia case management guidelines, standardised definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required.
Explaining Person Identification: An Inquiry Into the Tracking of Human Agents
Authors: Bullot Nicolas J.
Published: August 2014

To introduce the issue of the tracking and identification of human agents, I examine the ability of an agent (“a tracker”) to track a human person (“a target”) and distinguish this target from other individuals: The ability to perform person identification. First, I discuss influential mechanistic models of the perceptual recognition of human faces and people (the face‐recognition program). Such models propose detailed hypotheses about the parts and activities of the mental mechanisms that control the perceptual recognition of persons. However, models based on perceptual recognition are incomplete theories of person identification because they do not explain several identification behaviors that are fundamental to human social interactions (e.g., identifying unobservable persons and imposters). Furthermore, recognition‐based models tend to appeal to the controversial concept of the “identity” of a person without explaining what determines personal identity and persistence. To overcome these limitations, I propose to integrate the face‐recognition program into a broader causal‐historical theory of identification. The causal‐historical theory of identification complements models focused on perceptual recognition because it can account for the types of non‐perceptual identification overlooked by the face‐recognition program. Moreover, it can decompose the identification behaviors into tracking processes that succeed or fail to be sensitive to causal characteristics of a target. I illustrate these advantages with a discussion of the difference between the tracking of a person understood as either a causally continuous biological organism (organism‐based tracking) or a psychologically continuous mind (psychological tracking). Finally, I argue that the causal‐historical theory provides a theoretical framework for investigating the tracking of relations between a target and its contextual and historical attributes, such as a target's possessions.
Progression of plasma D‐dimer concentration and coagulopathies during hospitalization in horses with colic
Authors: Cesarini Carla , Monreal Luis , Armengou Lara , Delgado M. Ángeles , Ríos José , Jose‐Cunilleras Eduard
Published: August 2014

Objective

To assess the progression of plasma D‐dimer concentrations and coagulation status in horses with different types of colic.

Design

Prospective clinical observational study performed between March 2004 and September 2008.

Setting

Veterinary university teaching hospital.

Animals

Horses admitted and treated for colic and hospitalized for >48 hours were considered. Animals were classified by diagnosis into medical obstructive conditions (MO), surgical obstructive conditions (SO), inflammatory conditions, and ischemic lesions (IS).

Interventions

Three blood samples were obtained from each horse (admission, at 24–48 h [or after surgery] and upon discharge). For each sample, plasma D‐dimer concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and the presence of subclinical disseminated intravascular coagulation were determined.

Measurements and Main Results

When median plasma D‐dimer concentration values at admission and after 24–48 hours were compared, they were different but stable in horses with MO (1.29–1.95 nmol/L) and inflammatory conditions (5.70–6.69 nmol/L). However, 10‐fold and 5‐fold increases were observed, respectively, in SO (2.08 to 16.38 nmol/L) and IS (3.08 to 15.91 nmol/L) in the postoperative period. By 24–48 hours, the percentage of horses with coagulopathy increased in most groups (MO, 43 to 58%; SO, 50 to 96%, IS, 53 to 90%). By the time of discharge, 87% of horses with SO problems and 89% of horses with IS still had some form of coagulopathy documented.

Conclusions

Throughout hospitalization, horses with MO problems had less severe coagulopathy and lower plasmatic D‐dimer concentrations compared to other groups of horses. On admission, most horses with inflammatory conditions presented with coagulopathy. At 24–48 hours of hospitalization and following surgery, the hemostatic profile can differ markedly when compared to admission values.
Prevalence and risk factors for isolation of methicillin‐resistant Staphylococcus in dogs with keratitis
Authors: LoPinto Alexander J. , Mohammed Hussni O. , Ledbetter Eric C.
Published: August 2014

Objective

To determine the prevalence of, and risk factors for, methicillin‐resistant Staphylococcus (MRS) isolation in dogs with naturally acquired bacterial keratitis.

Procedures

All Staphylococcus spp. isolated from corneal samples of dogs with keratitis during a 2‐year period were evaluated for methicillin resistance by bacteriologic methods. Each MRS isolate was subjected to in vitro susceptibility testing for systemic and ocular antimicrobials. Nasal swabs for culture were collected from all dogs with MRS corneal isolation to evaluate for nasal carrier status. Potential risk factors for MRS isolation were investigated by medical record review and administration of an epidemiological survey to dog owners. Collected information characterizing animal, client, and environmental variables was analyzed for association with MRS isolation.

Results

Seventy‐one Staphylococcus spp. were isolated from seventy individual dogs with keratitis during the study period. Seventeen of the Staphylococcus isolates (23.9%) were methicillin resistant. The MRS isolates included Staphylococcus epidermidis (n = 10), Staphylococcus pseudintermedius (n = 6), and Staphylococcus aureus (n = 1). The MRS corneal isolates displayed extensive antimicrobial resistance. Four dogs (23.5%) with MRS corneal isolates had positive nasal cultures for MRS. Client occupation was significantly (P = 0.01) associated with MRS isolation, and dogs belonging to owners employed in veterinary or human healthcare fields were four times more likely to have MRS keratitis than dogs owned by clients with different professions. There were no significant associations between the other evaluated animal, client, and environmental factors.

Conclusions

Methicillin resistance is relatively common in Staphylococcus isolates from dogs with corneal infections, particularly among dogs belonging to healthcare workers.
High incidence of spontaneous cataracts in aging laboratory rabbits of an inbred strain
Authors: Peng Xuwen , Roshwalb Sara , Cooper Timothy K. , Zimmerman Heather , Christensen Neil D.
Published: August 2014

Objective

To investigate the occurrence of spontaneous cataracts in a breeding colony of the inbred EIII/JC strain of New Zealand White rabbits (Oryctolagus cuniculi) and the congenic strain of EIII/JC‐HLA‐A2.1transgenic rabbits.

Procedure

A retrospective study was conducted by collecting and analyzing data from clinical records for individual rabbits filed between January 2011 and October 2013.

Results

Thirteen cases (eight females and five males) of cataract were identified in a group of 51 EIII/JC inbred rabbits with a morbidity of 25.5%. The median age of the rabbits identified with unilateral or bilateral cataracts was 43 months in contrast to the median age of 23 months of the entire group of 51 rabbits. Additionally, seven cases (five females and two males) of cataracts were identified in a group of 21 EIII/JC‐HLA‐A2.1 transgenic rabbits. The EIII/JC‐HLA‐A2.1 transgenic rabbits showed similar morbidity (33.3%) and median age (41 months) for the development of cataracts as the EIII/JC rabbits. In both groups, none of the rabbits younger than 37 months developed cataracts while 13 (93%) of 14 EIII/JC rabbits aged 37–49 months and seven (63.6%) of 11 EIII/JC‐HLA‐A2.1 transgenic rabbits aged 37–43 months developed cataracts. In contrast, none of 78 outbred rabbits with a median age of 26 months (10–67 months) developed cataracts.

Conclusion

Results of this study indicate that the occurrence and high incidence of spontaneous cataracts in this inbred strain (EIII/JC) of rabbits were strictly age related and consistently transmitted through inbreeding.
Characteristic performance evaluation of a photon counting Si strip detector for low dose spectral breast CT imaging
Authors: Cho Hyo‐Min , Barber William C. , Ding Huanjun , Iwanczyk Jan S. , Molloi Sabee
Published: August 2014

Purpose:

The possible clinical applications which can be performed using a newly developed detector depend on the detectorˈs characteristic performance in a number of metrics including the dynamic range, resolution, uniformity, and stability. The authors have evaluated a prototype energy resolved fast photon counting x‐ray detector based on a silicon (Si) strip sensor used in an edge‐on geometry with an application specific integrated circuit to record the number of x‐rays and their energies at high flux and fast frame rates. The investigated detector was integrated with a dedicated breast spectral computed tomography (CT) system to make use of the detectorˈs high spatial and energy resolution and low noise performance under conditions suitable for clinical breast imaging. The aim of this article is to investigate the intrinsic characteristics of the detector, in terms of maximum output count rate, spatial and energy resolution, and noise performance of the imaging system.

Methods:

The maximum output count rate was obtained with a 50 W x‐ray tube with a maximum continuous output of 50 kVp at 1.0 mA. A109Cd source, with a characteristic x‐ray peak at 22 keV from Ag, was used to measure the energy resolution of the detector. The axial plane modulation transfer function (MTF) was measured using a 67 μm diameter tungsten wire. The two‐dimensional (2D) noise power spectrum (NPS) was measured using flat field images and noise equivalent quanta (NEQ) were calculated using the MTF and NPS results. The image quality parameters were studied as a function of various radiation doses and reconstruction filters. The one‐dimensional (1D) NPS was used to investigate the effect of electronic noise elimination by varying the minimum energy threshold.

Results:

A maximum output count rate of 100 million counts per second per square millimeter (cps/mm2) has been obtained (1 million cps per 100 × 100 μm pixel). The electrical noise floor was less than 4 keV. The energy resolution measured with the 22 keV photons from a 109Cd source was less than 9%. A reduction of image noise was shown in all the spatial frequencies in 1D NPS as a result of the elimination of the electronic noise. The spatial resolution was measured just above 5 line pairs per mm (lp/mm) where 10% of MTF corresponded to 5.4 mm−1. The 2D NPS and NEQ shows a low noise floor and a linear dependence on dose. The reconstruction filter choice affected both of the MTF and NPS results, but had a weak effect on the NEQ.

Conclusions:

The prototype energy resolved photon counting Si strip detector can offer superior imaging performance for dedicated breast CT as compared to a conventional energy‐integrating detector due to its high output count rate, high spatial and energy resolution, and low noise characteristics, which are essential characteristics for spectral breast CT imaging.
Technical Note: A method for improving the calibration reproducibility of an ionization chamber detector array
Authors: Goodall Simon , Morgan Steve
Published: August 2014

Purpose:

This paper describes an extension to a wide field calibration method implemented on a commercial detector array in order to improve the reproducibility of the calibration procedure.

Methods:

Following the standard array calibration procedure, two additional 10 × 10 cm exposures were acquired for each array axis with the detector array shifted by ±10 cm in the transverse or axial axes, or by ±10 cm in the positive or negative diagonal axes. These exposures were compared with a final baseline 10 × 10 cm exposure captured with the detector repositioned at the isocenter. The measurements were used to calculate a linear off‐axis correction gradient which was then applied to the stored calibration factors.

Results:

The mean coefficient of variation between five repeat calibrations was reduced from 4.17% to 0.48% and the maximum percentage error in individual calibration factors was reduced from 6.46% to 0.77%.

Conclusions:

The reproducibility of the calibration factors of an ionization chamber array was increased by capturing a baseline exposure and two further off‐axis readings per calibration axis.
The role of the duty factor in ultrasound-mediated cardiac stimulation
Authors: Coiado Olivia C. , O'Brien William D.
Published: August 2014

The role of the duty factor (DF) in ultrasound-mediated cardiac stimulation is studied. Five 3-month-old female rats were exposed transthoracically to 3.5-MHz ultrasonic pulses of 2.0-MPa peak rarefactional pressure amplitude, variable DF, and variable pulse repetition frequency. A change in the heart rate was not observed following the 0.25%-DF sequence. A decrease of ∼4% in the heart rate was observed following the 0.50%-DF and 1.00%-DF sequences. Outcomes suggest a possible DF threshold for cardiac pacing.
The Development of a Framework to Capture Perceptions of Sport Organizations Legitimacy
Authors: Lock Daniel , Filo Kevin , Kunkel Thilo , Skinner James L.
Published: August 2014

In this manuscript, we use Bitektine’s (2011) theory of organizational social judgments to develop a framework to Capture Perceptions of Organizational Legitimacy (CPOL). We outline a three-stage framework as a method to measure the perceived dimensions on which constituents scrutinize a sport organization’s legitimacy. In stage one of the framework, we defined the organizational context of a nonprofit sport organization in Sydney, Australia to establish the classification, purpose, and relationship of the focal entity to its constituents. In stage two, we distributed a qualitative questionnaire (N = 279) to identify the perceived dimensions on which constituents scrutinized organizational action. In stage 3 we distributed a quantitative questionnaire (N = 860) to test six perceived dimensions, which emerged during stage two of the CPOL framework. The six dimensions explained 63% of respondents’ overall organizational judgment, providing support for the CPOL framework as a context-driven process to measure constituent perceptions of the legitimacy of sport organizations.
Pseudo–three-dimensional maps of the diffuse interstellar band at 862 nm
Authors: Kos Janez , Zwitter Tomaž , Wyse Rosemary , Bienaymé Olivier , Binney James , Bland-Hawthorn Joss , Freeman Kenneth , Gibson Brad K. , Gilmore Gerry , Grebel Eva K. , Helmi Amina , Kordopatis Georges , Munari Ulisse , Navarro Julio , Parker Quentin , Reid Warren A. , Seabroke George , Sharma Sanjib , Siebert Arnaud , Siviero Alessandro , Steinmetz Matthias , Watson Fred G. , Williams Mary E. K.
Published: August 2014

Clues to a mystery with RAVE results

An unknown interloper systematically picks off light from galactic sources, snatching at specific wavelengths ranging from the ultraviolet to the infrared. The cause of what astronomers term diffuse interstellar bands (DIBs) still evades identification. Kos
et al.
combined nearly 500,000 stellar spectra from the RAVE survey to make a telling map that may clue us in further. This pseudo–three-dimensional map shows the distribution of the carrier that absorbs light at 862 nm, and it closely follows a separate map of interstellar dust, but with a significantly larger scale height in the Galactic plane. Though this is only one DIB of many, this analysis sets a path for the future study of others.

Science
, this issue p.
791
The evolution of flexible parenting
Authors: Royle Nick J. , Russell Andrew F. , Wilson Alastair J.
Published: August 2014

Parenting behaviors, such as the provisioning of food by parents to offspring, are known to be highly responsive to changes in environment. However, we currently know little about how such flexibility affects the ways in which parenting is adapted and evolves in response to environmental variation. This is because few studies quantify how individuals vary in their response to changing environments, especially social environments created by other individuals with which parents interact. Social environmental factors differ from nonsocial factors, such as food availability, because parents and offspring both contribute and respond to the social environment they experience. This interdependence leads to the coevolution of flexible behaviors involved in parenting, which could, paradoxically, constrain the ability of individuals to rapidly adapt to changes in their nonsocial environment.
Programmable self-assembly in a thousand-robot swarm
Authors: Rubenstein Michael , Cornejo Alejandro , Nagpal Radhika
Published: August 2014

Large-scale robotic self-assembly

When individuals swarm, they must somehow communicate to direct collective motion. Swarms of robots need to deal with outliers, such as robots that move more slowly than the rest. Rubenstein
et al.
created a large swarm of programmed robots that can form collaborations using only local information. The robots could communicate only with nearby members, within about three times their diameter. They were able to assemble into complex preprogrammed shapes. If the robots' formation hit snags when they bumped into one another or because of an outlier, additional algorithms guided them to rectify their collective movements.

Science
, this issue p.
795
Electronic structure of the oxygen-evolving complex in photosystem II prior to O-O bond formation
Authors: Cox Nicholas , Retegan Marius , Neese Frank , Pantazis Dimitrios A. , Boussac Alain , Lubitz Wolfgang
Published: August 2014

Setting the stage for release of oxygen

Plants transform water into the oxygen we breathe using a protein-bound cluster of four manganese (Mn) ions and a calcium ion. Cox
et al.
now establish the precise electronic structure in that cluster immediately before formation of the O-O bond (see the Perspective by Britt and Oyala). Using the technique of electron paramagnetic resonance spectroscopy, they confirm a hypothesis that all four Mn ions are octahedrally coordinated and in the 4+ oxidation state. Such clues to the efficiency of the photosynthetic process, so essential to life on Earth, may also facilitate the development of artificial waters-plitting catalysts.

Science
, this issue p.
804
; see also p.
736
Sequential histone-modifying activities determine the robustness of transdifferentiation
Authors: Zuryn Steven , Ahier Arnaud , Portoso Manuela , White Esther Redhouse , Morin Marie-Charlotte , Margueron Raphaël , Jarriault Sophie
Published: August 2014

Epigenetics direct transdifferentiation

To make an entire animal, many and varied cell types form and interact. Some of these differentiated cells take a U-turn and can de-differentiate or transdifferentiate to another cell fate. Although relatively rare in nature, Zuryn
et al.
followed such a program in the tiny roundworm
Caenorhabditis elegans
, where a rectal cell–to–motor neuron conversion is seen. Transcription factors with conserved roles in cell plasticity and terminal fate selection partner up with specific histone-modifying enzymes in discrete steps to specify separate sequential phases of cell identity.

Science
, this issue p.
826
Replace contamination, not the pipes
Authors: Rauch Wolfgang , Kleidorfer Manfred
Published: August 2014

Rethinking water treatment additives can have synergistic benefits for urban water management systems

[Also see Report by

Pikaar
et al.

]
Mother of all lodes
Authors: Stone Richard
Published: August 2014

The United States is putting scientific boots on the ground in Afghanistan to assess its mineral riches.
Mutational Analysis of Pneumocystis jirovecii Dihydropteroate Synthase and Dihydrofolate Reductase Genes in HIV-Infected Patients in China
Authors: Deng Xilong , Zhuo Li , Lan Yun , Dai Zhaoxia , Chen Wan-shan , Cai Weiping , Kovacs Joseph A. , Ma Liang , Tang Xiaoping
Published: August 2014

We investigated
Pneumocystis jirovecii
dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) genes for mutations in 25 Chinese HIV-infected patients with
P. jirovecii
pneumonia. We identified DHPS mutations in 3 (12%) patients and DHFR mutations in 1 (4%) patient. The prevalence of DHPS and DHFR mutations in China remains low, as it does in other developing countries.
Two Cases of Bacteriemia Caused by Nontoxigenic, Non-O1, Non-O139 Vibrio cholerae Isolates in Ho Chi Minh City, Vietnam
Authors: Lan Nguyen Phu Huong , Nga Tran Vu Thieu , Yen Nguyen Thi Thu , Dung Le Thi , Tuyen Ha Thanh , Campbell James I. , Whitehorn Jamie , Thwaites Guy , Chau Nguyen Van Vinh , Baker Stephen
Published: August 2014

The toxigenic bacterium
Vibrio cholerae
belonging to the O1 and O139 serogroups is commonly associated with epidemic diarrhea in tropical settings; other diseases caused by this environmental pathogen are seldom identified. Here we report two unassociated cases of nonfatal, nontoxigenic
V. cholerae
non-O1, non-O139 bacteremia in patients with comorbidities in Ho Chi Minh City, Vietnam, that occurred within a 4-week period.
Equine Viperin Restricts Equine Infectious Anemia Virus Replication by Inhibiting the Production and/or Release of Viral Gag, Env, and Receptor via Distortion of the Endoplasmic Reticulum
Authors: Tang Yan-Dong , Na Lei , Zhu Chun-Hui , Shen Nan , Yang Fei , Fu Xian-Qiu , Wang Yu-Hong , Fu Li-Hua , Wang Jia-Yi , Lin Yue-Zhi , Wang Xue-Feng , Wang Xiaojun , Zhou Jian-Hua , Li Cheng-Yao
Published: August 2014

Viperin is an endoplasmic reticulum (ER)-associated multifunctional protein that regulates virus replication and possesses broad antiviral activity. In many cases, viperin interferes with the trafficking and budding of viral structural proteins by distorting the membrane transportation system. The lentivirus equine infectious anemia virus (EIAV) has been studied extensively. In this study, we examined the restrictive effect of equine viperin (eViperin) on EIAV replication and investigated the possible molecular basis of this restriction to obtain insights into the effect of this cellular factor on retroviruses. We demonstrated that EIAV infection of primary equine monocyte-derived macrophages (eMDMs) upregulated the expression of eViperin. The overexpression of eViperin significantly inhibited the replication of EIAV in eMDMs, and knockdown of eViperin transcription enhanced the replication of EIAV in eMDMs by approximately 45.8%. Further experiments indicated that eViperin restricts EIAV at multiple steps of viral replication. The overexpression of eViperin inhibited EIAV Gag release. Both the α-helix domain and radical S-adenosylmethionine (SAM) domain were required for this activity. However, the essential motifs in SAM were different from those reported for the inhibition of HIV-1 Gag by human viperin. Furthermore, eViperin disrupted the synthesis of both EIAV Env and receptor, which consequently inhibited viral production and entry, respectively, and this disruption was dependent on the eViperin α-helix domain. Using immunofluorescence assays and electron microscopy, we demonstrated that the α-helix domain is responsible for the distortion of the endoplasmic reticulum (ER). Finally, EIAV did not exhibit counteracting eViperin at the protein level.

IMPORTANCE
In previous studies, viperin was indicated as restricting virus replications primarily by the inhibition of virus budding. Here, we show that viperin may have multiple antiviral mechanisms, including the reduction of EIAV Gag budding and Env expression, and these activities are dependent on different viperin domains. We especially demonstrate that the overexpression of viperin inhibits EIAV entry by decreasing the level of virus receptor. Therefore, viperin restriction of viruses is determined largely by the dependence of virus on the cellular membrane transportation system.
The N Terminus of the Influenza B Virus Nucleoprotein Is Essential for Virus Viability, Nuclear Localization, and Optimal Transcription and Replication of the Viral Genome
Authors: Sherry Lee , Smith Matt , Davidson Sophie , Jackson David
Published: August 2014

The nucleoprotein (NP) of influenza viruses is a multifunctional protein with essential roles throughout viral replication. Despite influenza A and B viruses belonging to separate genera of the
Orthomyxoviridae
family, their NP proteins share a relatively high level of sequence conservation. However, NP of influenza B viruses (BNP) contains an evolutionarily conserved N-terminal 50-amino-acid extension that is absent from NP of influenza A viruses. There is conflicting evidence as to the functions of the BNP N-terminal extension; however, this has never been assessed in the context of viral infection. We have used reverse genetics to assess the significance of this region on the functions of BNP and virus viability. The truncation of more than three amino acids prevented virus recovery, suggesting that the N-terminal extension is essential for virus viability. Mutational analysis indicated that multiple regions of the protein are involved in the nuclear localization of BNP, with the entire N-terminal extension required for this to function efficiently. Viruses containing mutations in the first 10 residues of BNP demonstrated few differences in nuclear localization; however, the viruses exhibited significant reductions in viral mRNA transcription and genome replication, resulting in significantly attenuated phenotypes. Mutations introduced to ablate a previously reported nuclear localization signal also resulted in a significant decrease in mRNA production during early stages of viral replication. Overall, our results demonstrate that the N-terminal extension of BNP is essential to virus viability not only for directing nuclear localization of BNP but also for regulating viral mRNA transcription and genome replication.

IMPORTANCE
The multifunctional NP of influenza viruses has roles throughout the viral replication cycle; therefore, it is essential for virus viability. Despite high levels of homology between the NP of influenza A and B viruses, the NP of influenza B virus contains an evolutionarily conserved 50-amino-acid N-terminal extension that is absent from the NP of influenza A viruses. In this study, we show that this N-terminal extension is essential for virus viability, and we confirm and expand upon recent findings that this region of BNP is required for nuclear localization of the protein. Furthermore, we demonstrate for the first time that the N terminus of BNP is involved in regulating viral mRNA transcription and replication of the viral genome. As the NP of influenza A virus lacks this N-terminal extension, these viruses may have evolved separate mechanisms to regulate these processes.
Chronic cutaneous chest wall fistula and gallstone empyema due to retained gallstones
Authors: Gaster Richard S , Berger Aaron J , Ahmadi-Kashani Mastaneh , Shrager Joseph B , Lee Gordon K
Published: August 2014

We report a case of a 72-year-old man who presented with a persistent pleural effusion and painful abscess in the right lower chest wall 6 months following a laparoscopic cholecystectomy. The patient subsequently developed a chronic cutaneous chest wall fistula requiring a large resection and complex closure. The complication was likely secondary to intraoperative spillage of gallstones. While previous reports describe gallstone spillage in the abdominal cavity as benign, this case illustrates that stones left in the abdominal cavity can potentially lead to significant morbidity. Therefore, stones should be diligently removed from the abdominal cavity when spillage occurs. In addition, it is important that operative notes reflect the occurrence of stone spillage so stones may be suspected when a patient presents with an abdominal or thoracic infection following a cholecystectomy.
Camden active spaces: Does the construction of active school playgrounds influence children's physical activity levels? A longitudinal quasi-experiment protocol
Authors: Smith Lee , Kipps Courtney , Aggio Daniel , Fox Paul , Robinson Nigel , Trend Verena , Munnery Suzie , Kelly Barry , Hamer Mark
Published: August 2014

Introduction

Physical activity is essential for every facet of children's health. However, physical activity levels in British children are low. The school environment is a promising setting to increase children's physical activity but limited empirical evidence exists on how a change in the outdoor physical school environment influences physical activity behaviour. The London Borough of Camden is redesigning seven existing school playgrounds to engage children to become more physically active. The primary aim of this project is to evaluate the impact of the redesigned playgrounds on children's physical activity, well-being and physical function/fitness.

Method and analysis

This project will use a longitudinal quasi-experimental design. Seven experimental schools and one control school will take part. One baseline data collection session and two follow-ups will be carried out. Between baseline and follow-up, the experimental school playgrounds will be redesigned. At baseline, a series of fitness tests, anthropometric and questionnaire measurements, and 7-day objective physical activity monitoring (Actigraph accelerometer) will be carried out on children (aged 5–16 years). This will be repeated at follow-up. Changes in overall physical activity levels and levels during different times of the day (eg, school breaks) will be examined. Multilevel regression modelling will be used to analyse the data.

Ethics and dissemination

The results of this study will be disseminated through peer-review publications and scientific presentations. Ethical approval was obtained through the University College London Research Ethics Committee (Reference number: 4400/002).