bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Study of Scar Hyperplasia Formation Following Cleft Lip Wound Healing
Authors: Zhang Dai-zun , Liu Feng , Xiao Wen-lin , Cong Wen-wen
Published: January 2018

The purpose of this study was to observe the hyperplasia trend of scar after the cleft lip surgery in a rabbit animal model, and determine the time-point of the highest hypertrophic degree of scar after cleft lip repair. Forty New Zealand white rabbits from the same offspring were used to establish a cleft lip wound healing model using Millard surgery procedure. The scar volumes were measured and granulation tissues were observed visually in the 2, 3, 4, and 5 weeks after operation. The scar tissues were harvested at the indicated time-points. Immunohistochemical (IHC) and Western Blot analyses were performed to detect the expression level of α-smooth muscle actin (α-SMA) in the scar tissue. The scars shrunk and the volumes reduced at 3 to 4 weeks after surgery; however, at 5 weeks postsurgery, the volumes increased. IHC and Western blot analyses indicated the expression of α-SMA was significantly enhanced 3 to 4 weeks, but reduced in the 5 weeks after surgery. Overall, the degree of scar hyperplasia after cleft lip surgery in rabbits was normally distributed and the scarring was most severe in the 3 to 4 weeks after cleft lip surgery. The study confirms a novel animal model for the assessment of therapies for the treatment of scar hyperplasia of human cleft lip in future.
Giant Parapharyngeal Space Lipoma Extending to the Pterygoid Region (Anterior Skull Base)
Authors: Hakeem Arsheed H. , Hakeem Imtiyaz H. , Budharapu Abhishek , Wani Fozia Jeelani
Published: January 2018

Although lipoma is frequently seen in the head and neck region, but occurrence of the lipoma in the parapharyngeal space is rare. It is extremely rare for a parapharyngeal lipoma to extent to the pterygoid region (ie, anterior skull base). Management of giant parapharyngeal space lipoma with skull base extension and proximity to the vital neurovascular structures poses a challenge to surgeon. The authors report a patient with giant lipoma extending from the upper border of the clavicle to the pterygoid region. Complete excision was done using upper transverse cervical incision and pterygoid region was approached after removal of the ipsilateral submandibular gland. Surgery produced excellent cosmetic results with no functional impairment.
Functional Trajectories Before and After Major Surgery in Older Adults
Authors: Stabenau Hans F. , Becher Robert D. , Gahbauer Evelyne A. , Leo-Summers Linda , Allore Heather G. , Gill Thomas M.
Published: January 2018

Objectives:

We hypothesized that distinct sets of functional trajectories can be identified in the year before and after major surgery, with unique transition probabilities from pre to postsurgical functional trajectories, and that outcomes would be better among participants undergoing elective versus nonelective surgery.

Background:

Major surgery is common and can be highly morbid in older persons. The relationship between the course of disability (ie, functional trajectory) before and after surgery in older adults has not been well-studied for most operations.

Methods:

Prospective cohort study of 754 community-living persons 70 years or older. The analytic sample included 250 participants who underwent their first major surgery during the study period.

Results:

Before surgery, 4 functional trajectories were identified: no disability (n = 60, 24.0%), and mild (n = 84, 33.6%), moderate (n = 73, 29.2%), and severe (n = 33, 13.2%) disability. After surgery, 4 functional trajectories were identified: rapid (n = 39, 15.6%), gradual (n = 76, 30.4%), partial (n = 70, 28.0%), and little (n = 57, 22.8%) improvement. Rapid improvement was seen for n = 31 (51.7%) participants with no disability before surgery, but was uncommon among those with mild disability (n = 8, 9.5%) and was not observed in the moderate and severe trajectory groups. For participants with mild to moderate disability before surgery, gradual improvement (n = 46, 54.8%) and partial improvement (n = 36, 49.3%) were most common. Most participants with severe disability (n = 27, 81.8%) before surgery exhibited little improvement. Outcomes were better for participants undergoing elective versus nonelective surgery.

Conclusions:

Functional prognosis in the year after major surgery is highly dependent on premorbid function.
Trauma transitional care coordination: A mature system at work
Authors: Hall Erin C. , Tyrrell Rebecca L. , Doyle Karen E. , Scalea Thomas M. , Stein Deborah M.
Published: January 2018

BACKGROUND

We have previously demonstrated effectiveness of a Trauma Transitional Care Coordination (TTCC) Program in reducing 30-day readmission rates for trauma patients most at risk. With program maturation, we achieved improved readmission rates for specific patient populations.

METHODS

TTCC is a nursing driven program that supports patients at high risk for 30-day readmission. The TTCC interventions include calls to patients within 72 hours of discharge, complete medication reconciliation, coordination of medical appointments, and individualized problem solving. Account IDs were used to link TTCC patients with the Health Services Cost Review Commission database to collect data on statewide unplanned 30-day readmissions.

RESULTS

Four hundred seventy-five patients were enrolled in the TTCC program from January 2014 to September 2016. Only 10.5% (n = 50) of TTCC enrollees were privately insured, 54.5% had Medicaid (n = 259), and 13.5% had Medicare (n = 64). Seventy-three percent had Health Services Cost Review Commission severity of injury ratings of 3 or 4 (maximum severity of injury = 4). The most common All Patient Refined Diagnosis Related Groups for participants were: lower-extremity procedures (n = 67, 14%); extensive abdominal/thoracic procedures (n = 40, 8.4%); musculoskeletal procedures (n = 37, 7.8%); complicated tracheostomy and upper extremity procedures (n = 29 each, 6.1%); infectious disease complications (n = 14, 2.9%); major chest/respiratory trauma, major small and large bowel procedures and vascular procedures (n = 13 each, 2.7%). The TTCC participants with lower-extremity injury, complicated tracheostomy, and bowel procedures had 6-point reduction (10% vs. 16%, p = 0.05), 11-point reduction (13% vs. 24%, p = 0.05), and 16-point reduction (11% vs. 27%, p = 0.05) in 30-day readmission rates, respectively, compared to those without TTCC.

CONCLUSION

Targeted outpatient support for high-risk patients can decrease 30-day readmission rates. As our TTCC program matured, we reduced 30-day readmission in patients with lower-extremity injury, complicated tracheostomy and bowel procedures. This represents over one million-dollar savings for the hospital per year through quality-based reimbursement.

LEVEL OF EVIDENCE

Therapeutic/care management, level III.
Older Adults With Metabolic Syndrome Present Lower Ankle-Brachial Index and Worse Functional Performance
Authors: Heubel Alessandro Domingues , Marques Terezinha Sasaki , Pessoa-Santos Bruna Varanda , Gimenes Camila , Arca Eduardo Aguilar , Martinelli Bruno , Barrile Silvia Regina
Published: January 2018

Background:

Metabolic syndrome (MetS) is a prevalent condition in the elderly and it is associated with a high risk of systemic atherosclerosis. The ankle-brachial index (ABI) is used to identify atherosclerotic obstructions in lower limbs, which might be associated with a decreased functional capacity due to blood flow limitation.

Objective:

This study aimed to investigate whether older adults with MetS present alterations in ABI values and whether these alterations are associated with impairments in functional performance.

Design:

Cross-sectional clinical study with a convenience sample.

Methods:

Older adults (>60 years) of both genders were divided into two groups: Control group (CG, n = 34)—patients without MetS, and MetS group (MetSG, n = 32)—patients with MetS. Both groups were subjected to the following evaluations: (1) ABI (Doppler method) and (2) 6-minute walk test (6MWT). Intergroup comparison was performed using the t test and the Mann-Whitney U test. The association between the ABI and the distance walked in the 6MWT was calculated by the Pearson correlation test. In all analyses, P < .05 was considered as significant.

Results:

When compared with CG, the MetSG group showed lower ABI (P = .007) and lower distance walked in 6MWT (P = .000). In the MetSG, a positive correlation was observed (r = 0.460; P = .008) between ABI values and the distance walked in 6MWT.

Conclusion:

Older adults with MetS present lower ABI, a measure considered a predictor for peripheral arterial obstructive processes. This result is associated with a poor functional performance, which can be due to a circulatory deficit in the lower limbs.
Pilot Study of Delayed ICOS/ICOS-L Blockade With αCD40 to Modulate Pathogenic Alloimmunity in a Primate Cardiac Allograft Model
Authors: O’Neill Natalie A. , Zhang Tianshu , Braileanu Gheorghe , Cheng Xiangfei , Hershfeld Alena , Sun Wenji , Reimann Keith A. , Dahi Sia , Kubicki Natalia , Hassanein Wessam , Laird Christopher , Cimeno Arielle , Azimzadeh Agnes M. , Pierson Richard N.
Published: January 2018

Background

Inducible costimulator (ICOS) is rapidly upregulated with T-cell stimulation and may represent an escape pathway for T-cell costimulation in the setting of CD40/CD154 costimulation blockade. Induction treatment exhibited no efficacy in a primate renal allograft model, but rodent transplant models suggest that the addition of delayed ICOS/ICOS-L blockade may prolong allograft survival and prevent chronic rejection. Here, we ask whether ICOS-Ig treatment, timed to anticipate ICOS upregulation, prolongs NHP cardiac allograft survival or attenuates pathogenic alloimmunity.

Methods

Cynomolgus monkey heterotopic cardiac allograft recipients were treated with αCD40 (2C10R4, d0-90) either alone or with the addition of delayed ICOS-Ig (d63-110).

Results

Median allograft survival was similar between ICOS-Ig + αCD40 (120 days, 120-125 days) and αCD40 (124 days, 89-178 days) treated animals, and delayed ICOS-Ig treatment did not prevent allograft rejection in animals with complete CD40 receptor coverage. Although CD4+ TEM cells were decreased in peripheral blood (115 ± 24) and mLNs (49 ± 1.9%) during ICOS-Ig treatment compared with monotherapy (214 ± 27%, P = 0.01; 72 ± 9.9%, P = 0.01, respectively), acute and chronic rejection scores and kinetics of alloAb elaboration were similar between groups.

Conclusions

Delayed ICOS-Ig treatment with the reagent tested is probably ineffective in modulating pathogenic primate alloimmunity in this model.
The epileptic encephalopathy jungle – from Dr West to the concepts of aetiology-related and developmental encephalopathies
Authors: Kalser Judith , Cross J Helen
Published: January 2018

Purpose of review

We aim to further disentangle the jungle of terminology of epileptic encephalopathy and provide some insights into the current understanding about the aetiology and pathophysiology of this process. We cover also the key features of epilepsy syndromes of infancy and childhood which are considered at high risk of developing an epileptic encephalopathy.

Recent findings

The concept of ‘epileptic encephalopathy’ has progressively been elaborated by the International League Against Epilepsy according to growing clinical and laboratory evidence. It defines a process of neurological impairment caused by the epileptic activity itself and, therefore, potentially reversible with successful treatment, although to a variable extent. Epileptic activity interfering with neurogenesis, synaptogenesis, and normal network organization as well as triggering neuroinflammation are among the possible pathophysiological mechanisms leading to the neurological compromise. This differs from the newly introduced concept of ‘developmental encephalopathy’ which applies to where the epilepsy and developmental delay are both because of the underlying aetiology and aggressive antiepileptic treatment may not be helpful.

The understanding and use of correct terminology is crucial in clinical practice enabling appropriate expectations of antiepileptic treatment. Further research is needed to elucidate underlying pathophysiological mechanisms, define clear outcome predictors, and find new treatment targets.
Metagenomic analysis uncovers strong relationship between periodontal pathogens and vascular dysfunction in American Indian population
Authors: Vijay Kumar Prathik K , Gottlieb Roberta A. , Lindsay Suzanne , Delange Nicole , Penn Tanya E. , Calac Dan , Kelley Scott T.
Published: January 2018

Periodontal disease (PD) is a well-known risk factor for cardiovascular disease (CVD) but the casual relationship is unclear. American Indians/Alaskan Natives (AI/AN) have high rate of both PD and CVD and a better understanding of how PD might affect heart health would be particularly helpful in this population. In this study, we sequenced the bacterial biofilms of periodontal (gum) pockets and used metagenomic sequencing and vascular health measurements (immune cytokine profiles and vascular flow) to determine the relationship of microbial pathogens and CVD. Twelve subjects were sequenced before and after standard periodontal treatment. Other measures taken before and after treatment included a full dental screening; serum concentration of key immune cytokines from blood samples; lipid profiles from fasting venous blood; and plasma glucose concentrations. The non-invasive Laser Doppler Fluxmetry (LDF) procedure was conducted to measures the microvascular vasodilation. We found highly significant relationships between the total abundance of 4 periodontal pathogens,Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia and Treponema denticola, and the inflammatory cytokine interleukin 1 beta (IL-1β) (r=0.63; p=0.009) as well as with vascular flow post sodium nitroprusside (SNP) treatment (r=p=0.006). Two bacterial species that correlated most with IL-1β wereF. nucleatum and P. gingivalis. IL-1β has been strongly implicated as a causal factor in atherosclerosis and in periodontal bone loss. To our knowledge, this is the first direct link between abundance of specific periodontal pathogens and cardiovascular disease in humans, and suggests that these pathogens could be used as warning signs for cardiovascular risk.
The Chlamydia type III effector TarP alters the dynamics and organization of host cell focal adhesions
Authors: Pedrosa António T. , Murphy Korinn N. , Nogueira Ana T. , Brinkworth Amanda J. , Thwaites Tristan R. , Aaron Jesse , Chew Teng-Leong , Carabeo Rey A.
Published: January 2018

The human pathogen Chlamydia trachomatis targets epithelial cells lining the genital mucosa. We observed that infection of various cell types, including fibroblasts and epithelial cells resulted in the formation of unusually stable focal adhesions that resisted disassembly induced by the myosin II inhibitor, blebbistatin. Super-resolution microscopy revealed in infected cells the vertical displacement of paxillin and FAK from the signaling layer of focal adhesions; while vinculin remained in its normal position within the force transduction layer. The candidate type III effector TarP which localized to focal adhesions during infection and when expressed ectopically, was sufficient to mimic both the reorganization and blebbistatin-resistant phenotypes. These effects of TarP, including its localization to focal adhesions required interaction with the host protein vinculin through a specific domain at the C-terminus of TarP. The consequence of Chlamydia-stabilized focal adhesions was restricted cell motility and enhanced attachment to the extracellular matrix. Thus, via a novel mechanism, Chlamydia inserts TarP within focal adhesions to alter their organization and dynamics.
Generation of a novel growth-enhanced and reduced environmental impact transgenic pig strain
Authors: Zhang Xianwei , Li Zicong , Yang Huaqiang , Liu Dewu , Cai Gengyuan , Li Guoling , Mo Jianxin , Wang Dehua , Zhong Cuili , Wang Haoqiang , Sun Yue , Shi Junsong , Zheng Enqin , Meng Fanming , Zhang Mao , He Xiaoyan , Zhou Rong , Zhang Jian , Huang Miaorong , Zhang Ran , Li Ning , Zhe Fanming , Yang Jinzeng , Wu Zhenfang
Published: January 2018

In pig production, insufficient feed digestion causes excessive nutrients such as phosphorus and nitrogen, which are then released to the environment. To address the issue of environmental emissions, we have established transgenic pigs harboring a single-copy quad-cistronic transgene and simultaneously expressing three microbial enzymes, β-glucanase, xylanase, and phytase in the salivary glands. All the transgenic enzymes were successfully expressed, and the digestion of non-starch polysaccharides (NSPs) and phytate in the feedstuff was enhanced. Fecal nitrogen and phosphate outputs were reduced by 23%–46%, and growth rate improved by 23.4% (gilts) and 24.4% (boars) when the pigs were fed on a corn and soybean-based diet and high-NSP diet. The transgenic pigs showed a 11.5%– 14.5% improvement in feed conversion rate compared to the age-matched wild-type littermates. These findings indicate that transgenic pigs are promising resources for improving feed efficiency and reducing nutrient emissions to the environment.
Prediction of Accurate Binding Modes using Combination of classical and accelerated Molecular dynamics and Free Energy Perturbation Calculations: An Application to Toxicity Studies
Authors: Fratev Filip , Steinbrecher Thomas , Jónsdóttir Svava Ósk
Published: January 2018

Estimating the correct binding modes of ligands in protein-ligand complexes is not only crucial in the drug discovery process, but also for elucidating potential toxicity mechanisms. In the current paper, we discuss and demonstrate a computational modelling protocol using the combination of docking, classical (cMD) and accelerated (aMD) molecular dynamics and free energy perturbation (FEP+ protocol) for identification of the binding modes of selected perfluorocarboxyl acids (PFCAs) in the PPARγ nuclear receptor.

Initially, we employed both the regular and induced fit docking which failed to correctly predict the ligand binding modes and rank the compounds with respect to experimental free energies of binding, when they were docked into non-native X-ray structure. The cMD and aMD simulations identified the presence of multiple binding modes for these compounds, and the shorter chain PFCAs (C6-C8) continuously moved between a few energetically favourable binding conformations. These results demonstrate that the docking scoring function cannot rank compounds precisely in such cases, not due to its insufficiency, but because of the use of incorrect or only one unique bindings pose, neglecting the protein dynamics. Finally, based on MD predictions of binding conformations, the FEP+ sampling protocol was extended and then accurately reproduced experimental differences in the free energies. Thus, the preliminary MD simulations can also provide helpful information about correct set-up of the FEP+ calculations. These results show that the PFCAs binding modes were accurately predicted and the FEP+ protocol can be used to estimate free energies of binding of flexible molecules outside of typical drug-like compounds.

Our in silico workflow revealed the main characteristics of the PFCAs, which are week PPARγ partial agonists and illustrated the importance of specific ligand-residue interactions within the LBD. This work also suggests a common workflow for identification of ligand binding modes, ligand-protein dynamics description and relative free energy calculations.
Cell-type specific expression of oncogenic and tumor suppressive microRNAs in the human prostate and prostate cancer
Authors: Kumar Binod , Rosenberg Avi Z. , Choi Su Mi , Fox-Talbot Karen , De Marzo Angelo M. , Nonn Larisa , Brennen W. Nathaniel , Marchionni Luigi , Halushka Marc K. , Lupold Shawn E.
Published: January 2018

MiR-1 and miR-143 are frequently reduced in human prostate cancer (PCa), while miR-141 and miR-21 are frequently elevated. Consequently, these miRNAs have been studied as cell-autonomous tumor suppressors and oncogenes. However, the cell-type specificity of these miRNAs is not well defined in prostate tissue. Through two different microdissection techniques, and droplet digital RT-PCR, we quantified these miRNAs in the stroma and epithelium of radical prostatectomy specimens. In contrast to their purported roles as cell-autonomous tumor suppressors, we found miR-1 and miR-143 expression to be predominantly stromal. Conversely, miR-141 was predominantly epithelial. MiR-21 was detected in both stroma and epithelium. Strikingly, the levels of miR-1 and miR-143 were significantly reduced in tumor-associated stroma, but not tumor epithelium. Gene expression analyses in human cell lines, tissues, and prostate-derived stromal cultures support the cell-type selective expression of miR-1, miR-141, and miR-143. Analyses of the PCa Genome Atlas (TCGA-PRAD) showed a strong positive correlation between stromal markers and miR-1 and miR-143, and a strong negative correlation between stromal markers and miR-141. In these tumors, loss of miR-1 and gain of miR-21 was highly associated with biochemical recurrence. These data shed new light on stromal and epithelial miRNA expression in the PCa tumor microenvironment.
Irreversible temperature gating in trpv1 sheds light on channel activation
Authors: Sánchez-Moreno Ana , Guevara-Hernández Eduardo , Contreras-Cervera Ricardo , Rangel-Yescas Gisela , Ladrón-de-Guevara Ernesto , Rosenbaum Tamara , Islas León D.
Published: January 2018

Temperature activated TRP channels or thermoTRPs are among the only proteins that can directly convert temperature changes into changes in channel open probability. In spite of a wealth of information, including several experimentally determined structural models of TRP channels, the mechanism of temperature activation remains unknown. We have carefully characterized the repeated activation of TRPV1 by thermal stimuli and discovered a previously unknown inactivation process, which is irreversible. This inactivation is associated with specific conformational changes in the membrane proximal domain. We propose that this form of gating in TRPV1 channels is a consequence of the heat absorption process that leads to channel opening.
Drivers of the formation of e-loyalty towards tourism destinations
Authors: Parra-Lopez Eduardo , Martínez-González José Alberto , Chinea-Martin Angel
Published: January 2018

Purpose

The purpose of this paper is to determine the drivers of the formation of e-loyalty in a tourist destination, providing a model composed of variables that are under the control of the firm along with others that are not fully controllable by professionals.

Design/methodology/approach

The study was carried out with a sample of 497 subjects, university students and online consumers, and with the use of structural equations (partial least squares).

Findings

Results show that young people give a high valuation to all the variables used in the research. These results contribute to the literature on e-loyalty in tourism destinations and improve tourism loyalty in this population segment.

Research limitations/implications

The main limitation of this research has been related to the number of variables and measurement indicators that, according to the literature review, influence e-loyalty. Finally, a balanced and statistically significant model has been developed that has practical utility and analyzes online purchase of tourism products from a process perspective that includes variables that are internal and external to the firm.

Practical implications

The study suggests that young people have a favourable attitude and predisposition towards e-commerce, which, in turn, favours firms’ efforts to promote consumption and loyalty within the framework of the model’s variables.

Originality/value

This research paper has important value by analysing the initiating variables to determine how e-loyalty can be managed in tourist destinations, in addition to analysing an important segment for future tourism development.
The development of neonatal nursing standards of practice for Cambodia: a Delphi study
Authors: Prak Manila , Wivatvanit Suvinee
Published: January 2018

Purpose

Cambodia has one of the highest death rates for children under five years of age in Southeast Asia. The high mortality rate of children under five years of age, especially the neonate is 35 per 1,000 for the period zero to four years. There are no neonatal nursing standards of practice to guide nurses providing neonatal nursing care. Some general guidelines are currently being implemented for both doctors and nurses. The Minister for Health officially launched the Cambodian Council of Nurses’ Guideline for the Standard of Nursing Care in December 2015. In the absence of specific neonatal nursing standards of practice, the purpose of this paper is to develop the Neonatal Nursing Standard of Practice for Cambodia.

Design/methodology/approach

The Delphi technique was selected as being appropriate for this study. The snowball with purposive sampling was used. The identified experts were located across Cambodia so the e-Delphi approach was considered appropriate and applicable according to the study context. Four experts preferred to be interviewed face-to-face, while 16 experts were confident to use e-mail to respond to the questionnaire in Round 1. In total, 19 experts provided responses via e-mail to the Rounds 2 and 3 questionnaires.

Findings

A Standard for Neonatal Nursing Practice for Cambodia which consists of ten standards was found as a result of this study: assessment, nursing diagnosis, planning, implementation, evaluation, ethics, evidence-based practice and research, health teaching and health promotion, continuing education, and communication.

Originality/value

All items and sub-items achieved consensus as either being at the most significant level and therefore, could be key indicators for neonatal nursing standards of practice. The results of this study can be incorporated into a focused discussion led by the Nursing and Midwifery Bureau of the Ministry of Health to develop national standards of practice for neonatal nurses in Cambodia.
Impact of a new simplified disability scoring system for adult patients with localized scleroderma
Authors: Okiyama Naoko , Asano Yoshihide , Hamaguchi Yasuhito , Jinnin Masatoshi , Motegi Sei‐ichiro , Koizumi Haruka , Hasegawa Minoru , Ishikawa Osamu , Sato Shinichi , Takehara Kazuhiko , Yamamoto Toshiyuki , Fujimoto Manabu , Ihn Hironobu
Published: January 2018

Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment.
Efficacy of Peracetic Acid in Inactivating Foodborne Pathogens on Fresh Produce Surface
Authors: Singh Prashant , Hung Yen‐Con , Qi Hang
Published: January 2018

Washing treatment with effective sanitizer is one of the critical steps in ensuring fresh produce safety. This study was to evaluate the efficacy of peracetic acid (PAA; VigorOx® 15 F&V), chlorine‐based sanitizers (acidic electrolyzed water [AEO], near neutral electrolyzed water and bleach), lactic acid, and deionized (DI) water to reduce Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella Typhimurium DT104 from fresh produce surfaces. A 5‐strain cocktail of E. coli O157:H7, L. monocytogenes, and S. Typhimurium DT104 was separately prepared and used for surface inoculation on produce samples (E. coli O157:H7 on romaine lettuce, lemons, tomatoes, and blueberries; L. monocytogenes on romaine lettuce and cantaloupe; S. Typhimurium DT104 on lemons, tomatoes, cantaloupe, and blueberries). PAA at 45, 85, and 100 mg/L; AEO, NNEO, and bleach at 100 mg/L of free chlorine; lactic acid at 2%; and DI water were used for washing inoculated produce in an automated produce washer for 5 min. In general, PAA at 100 mg/L achieved the highest microbial inactivation of E. coli O157:H7 (lettuce, lemon, tomato, and blueberry at 2.2, 5.7, 5.5, and 6.7 log CFU/g, respectively), S. Typhimurium DT104 (lemon, tomato, cantaloupe, blueberry at 5.4, 6.8, 4.5, and 5.9 log CFU/g, respectively), and L. monocytogenes (lettuce and cantaloupe at 2.4 and 4.4 log CFU/g, respectively). Efficacy of sanitizers on produce with coarse surface (for example, lettuce and cantaloupe) was lower than produce with smooth texture (lemon, tomato, and blueberry). Cross‐contamination of E. coli O157:H7 among romaine lettuce heads during simulated retail crisping process was greatly reduced by the application of PAA and NNEO.

Practical Application

NNEO and PAA showed high efficacy in foodborne pathogen removal from fresh produce. Produce surface texture plays an important role in pathogen removal. NNEO and PAA effectively prevented cross‐contamination during the crisping process.
Lipopolysaccharide‐induced maternal inflammation induces direct placental injury without alteration in placental blood flow and induces a secondary fetal intestinal injury that persists into adulthood
Authors: Fricke Erin M. , Elgin Timothy G. , Gong Huiyu , Reese Jeff , Gibson‐Corley Katherine N. , Weiss Robert M. , Zimmerman Kathy , Bowdler Noelle C. , Kalantera Karen M. , Mills David A. , Underwood Mark A. , McElroy Steven J.
Published: January 2018

Problem

Premature birth complicates 10%‐12% of deliveries. Infection and inflammation are the most common etiologies and are associated with increased offspring morbidity and mortality. We hypothesize that lipopolysaccharide (LPS)‐induced maternal inflammation causes direct placenta injury and subsequent injury to the fetal intestine.

Method of study

Pregnant C57Bl6 mice were injected intraperitoneally on day 15.5 with 100 μg/kg LPS or saline. Maternal serum, amniotic fluid, placental samples, and ileal samples of offspring were obtained assessed for inflammation and/or injury. Maternal placental ultrasounds were performed. Placental DNA was isolated for microbiome analysis.

Results

Maternal injection with LPS caused elevated IL‐1β, IL‐10, IL‐6, KC‐GRO, and TNF. Placental tissue showed increased IL‐1β, IL‐6, and KC‐GRO and decreased IL‐10, but no changes were observed in amniotic fluid. Placental histology demonstrated LPS‐induced increases in mineralization and necrosis, but no difference in placental blood flow. Most placentas had no detectable microbiome. Exposure to maternal LPS induced significant injury to the ilea of the offspring.

Conclusion

Lipopolysaccharide causes a maternal inflammatory response that is mirrored in the placenta. Placental histology demonstrates structural changes; however, placental blood flow is preserved. LPS also induces an indirect intestinal injury in the offspring that lasts beyond the neonatal period.
Intravitreal diclofenac for treatment of refractory uveitis‐associated cystoid macular oedema: A before and after clinical study
Authors: Kianersi Farzan , Rezaeian‐Ramsheh Abdolreza , Pourazizi Mohsen , Kianersi Hamidreza
Published: January 2018

Background

Cystoid macular oedema (CME) is one of the important complications of uveitis leading to irreversible blindness. Currently, there is no gold standard treatment for this condition. The aim of this study was to investigate the effects of single intravitreal diclofenac (IVD) injection on short‐term outcome of refractory uveitis‐associated CME.

Methods

This was a prospective clinical study on 16 consecutive patients (16 eyes) with refractory uveitis‐associated CME. Intravitreal injection of 500 μg/0.1 ml of diclofenac sodium was given to the patients. The clinical outcomes considered were best‐corrected visual acuity (BCVA) change and central macular thickness (CMT) changes in the pre‐ and postinjection periods. Follow‐up examinations were performed at 1 and 4 weeks after the injection.

Results

Age of the patients varied from 18 to 59 years (mean ± SD: 39.5 ± 13.2 years). Ten patients (62.5%) were females. Statistically significant differences were found in the decrease of mean BCVA (logMAR) (p = 0.043) and mean CMT (p = 0.003) during the study period. There was no significant difference in the intraocular pressure (IOP) increase at the end of the study (p = 0.94).

Conclusion

Intravitreal diclofenac (IVD) may be a promising treatment for refractory uveitis‐associated CME. Further clinical trials with a larger sample size should be conducted to confirm these findings and compare them with other treatments.
Diabetic retinopathy in type 1 diabetes patients in Western Norway
Authors: Jansson Ragnhild W. , Hufthammer Karl Ove , Krohn Jørgen
Published: January 2018

Purpose

To describe the prevalence of diabetic retinopathy (DR), associated risk factors and health‐related quality of life (HRQoL) in a population‐based cohort of patients with type 1 diabetes mellitus (DM1).

Methods

All patients underwent a general and ophthalmic examination including seven‐field stereo fundus photography for grading of DR and diabetic macular oedema (DMO). Kaplan‐Meier survival analyses were performed to evaluate disease progression in relation to diabetes duration, age and year of diabetes onset. HRQoL and its association with DR were assessed by the Medical Outcomes Study Short Form 36 (SF‐36) questionnaire.

Results

A total of 237 DM1 patients were included. Mean age at inclusion was 34 years (range, 4–75 years), and mean diabetes duration was 19 years (range, 5 months–63 years). A total of 145 patients (61%) had DR. Sixty‐two patients (26%) had mild, 39 (16%) moderate and 13 (5%) severe nonproliferative DR, while 31 (13%) had proliferative DR. The prevalence of DMO was 8%. The most important risk factors predicting severity of DR were diabetes duration (p < 0.0001) and HbA1c level (p < 0.0001). Neuropathy (p = 0.006), nephropathy (p = 0.004) and male gender (p = 0.02) were also significant predictors of DR. Compared to normative SF‐36 data, there was a linear trend of decreasing HRQoL with increasing severity of DR that was statistically significant for the four physical dimension scores.

Conclusion

The prevalence of DR in DM1 was largely within the range of previous reports. Diabetes duration, HbA1c level, neuropathy, nephropathy and male gender were all significant predictors of DR severity. The patients with more severe DR had lower HRQoL.
Anti‐inflammatory medication following cataract surgery: a randomized trial between preservative‐free dexamethasone, diclofenac and their combination
Authors: Ylinen Petteri , Holmström Emil , Laine Ilkka , Lindholm Juha‐Matti , Tuuminen Raimo
Published: January 2018

Purpose

To examine the anti‐inflammatory efficacy and tolerance between preservative‐free dexamethasone (DEX) and diclofenac (DICL) eye drops, and their combination following cataract surgery.

Methods

A randomized, double‐blind, prospective single‐centre study with 189 eyes of 180 patients undergoing routine cataract surgery. Laser flare meter measurement and spectral‐domain optical coherence tomography imaging were conducted before surgery and at the 28‐day postoperative visit. Clinical characteristics, surgical parameters and assessment of postoperative symptoms were recorded.

Results

Preoperative flare was 9.0 ± 0.6 pu/ms and central retinal thickness (CRT) 269.6 ± 1.9 μm (mean ± SEM). On day 28, flare was 22.1 ± 2.9 pu/ms for DEX, 17.4 ± 2.5 pu/ms for DICL and 13.0 ± 1.6 pu/ms (p < 0.05) for their combination. Central retinal thickness (CRT) increase was 31.5 ± 8.8 μm for DEX, 6.0 ± 0.8 μm (p = 0.001) for DICL, and 3.5 ± 0.5 μm (p < 0.001) for their combination. The incidence of ocular symptoms related to the eye drops was 11% for DEX, 37% for DICL and 34% for their combination (p < 0.001). Clinically significant pseudophakic cystoid macular oedema (PCME) was observed in seven eyes which were all treated with DEX (p < 0.001).

Conclusion

Diclofenac (DICL), as well as the combination of DEX and DICL, were superior to DEX monotherapy in minimizing CRT change and the incidence of PCME. Combination medication showed no added value compared to DICL monotherapy in uneventful cataract surgery.
Long‐term uveal and capsular biocompatibility of a novel modular intraocular lens system
Authors: Ludlow Jason , Nguyen Jason , Aliancy Joah , Masino Bryan , Ha Larry , Werner Liliana , Mamalis Nick
Published: January 2018

Background

We evaluated the long‐term biocompatibility and safety of a new modular posterior chamber intraocular lens (IOL) system in rabbit eyes.

Methods

Seven New Zealand rabbits underwent bilateral phacoemulsification with placement of the modular IOL in OD and a control IOL (SA60AT) in OS. Slit‐lamp examinations were performed at postoperative weeks 1, 2, 3, 4, 6 and 8 and months 3 and 6. All rabbits were then sacrificed and eyes enucleated. The eyes were examined grossly from the Miyake–Apple view. Selected IOLs were explanted and underwent surface staining for implant cytology. All globes were then sectioned and processed for histopathological examination.

Results

The modular IOL remained stable in all seven rabbits through the entire follow‐up period. Biocompatibility was better than the control lens at six months postoperatively, on account of less extensive synechiae formation as assessed by slit‐lamp examination. At the six‐week examination, posterior capsule opacification (PCO) was significantly better in the test group (scored as 1.71 ± 0.8 versus 3.28 ± 0.48 in the control group, p = 0.0008). On gross examination with the Miyake–Apple view, Soemmering's ring formation was significantly better in the test group, (5.14 ± 1.57 versus 10.85 ± 1.95 in the control group, p = 0.002).

Conclusion

Previous studies showed that explantation/exchange of the modular system optic was safer and easier than with a standard IOL. The new modular IOL system has demonstrated better long‐term biocompatibility compared to the control lens at six months postoperatively in the rabbit model.
A SPATIAL MODEL OF CARTEL STABILITY: THE INFLUENCE OF PRODUCTION COST CONVEXITY
Authors: Andree Kai , Heywood John S. , Schwan Mike , Wang Zheng
Published: January 2018

We uniquely introduce convex production costs into a cartel model involving spatial price discrimination. We demonstrate that greater convexity improves cartel stability and that for sufficient convexity first best locations will be adopted. We show that allowing locations to vary over the game reduces cartel stability but that greater convexity continues to improve that stability. Moreover, when the degree of convexity does not support the first best collusive locations, other collusive locations exist that require less stability and these may either increase or decrease social welfare relative to competition. Critically, these locations that require less stability are more dispersed in sharp contrast to the known result assuming linear production costs.
Efficacy and safety of eslicarbazepine acetate versus controlled‐release carbamazepine monotherapy in newly diagnosed epilepsy: A phase III double‐blind, randomized, parallel‐group, multicenter study
Authors: Trinka Eugen , Ben‐Menachem Elinor , Kowacs Pedro A. , Elger Christian , Keller Birgit , Löffler Kurt , Rocha José Francisco , Soares‐da‐Silva Patrício
Published: January 2018

Objective

We assessed the efficacy and safety of once‐daily eslicarbazepine acetate in comparison with twice‐daily (BID) controlled‐release carbamazepine (carbamazepine‐CR) monotherapy in newly diagnosed focal epilepsy patients.

Methods

This randomized, double‐blind, noninferiority trial (NCT01162460) utilized a stepwise design with 3 dose levels. Patients who remained seizure‐free for the 26‐week evaluation period (level A: eslicarbazepine acetate 800 mg/carbamazepine‐CR 200 mg BID) entered a 6‐month maintenance period. If a seizure occurred during the evaluation period, patients were titrated to the next target level (level B: eslicarbazepine acetate 1200 mg/carbamazepine‐CR 400 mg BID, level C: eslicarbazepine acetate 1600 mg/carbamazepine‐CR 600 mg BID) and the evaluation period began again. The primary endpoint was the proportion of seizure‐free patients for 6 months after stabilization in the per protocol set. The predefined noninferiority criteria were −12% absolute and −20% relative difference between treatment groups.

Results

Eight hundred fifteen patients were randomly assigned; 785 (388 in the eslicarbazepine acetate group and 397 in the carbamazepine‐CR group) were included in the per protocol set, and 813 (401 in the eslicarbazepine acetate group and 412 in the carbamazepine‐CR group) were included in the full analysis set for the primary analysis. Overall, 71.1% of eslicarbazepine acetate–treated patients and 75.6% of carbamazepine‐CR–treated patients were seizure‐free for ≥6 months at the last evaluated dose (average risk difference = −4.28%, 95% confidence interval [CI] = −10.30 to 1.74; relative risk difference = −5.87%, 95% CI = −13.50 to 2.44) in the per protocol set. Rates of treatment‐emergent adverse events were similar between groups for patients in the safety set. Noninferiority was also demonstrated in the full analysis set, as 70.8% of patients with eslicarbazepine acetate and 74.0% with carbamazepine‐CR were seizure‐free at the last evaluated dose (average risk difference = −3.07, 95% CI = −9.04 to 2.89).

Significance

Treatment with eslicarbazepine acetate was noninferior to BID carbamazepine‐CR. With its once‐daily formulation, eslicarbazepine acetate provides a useful option for first‐line monotherapy for adults with newly diagnosed epilepsy and focal onset seizures.
Cyclic cryogenic pretreatments influencing the mechanical properties of a bulk glassy Zr‐based alloy
Authors: Grell D. , Dabrock F. , Kerscher E.
Published: January 2018

In this study, cryogenic thermal cycling was applied to bulk glassy Zr52.5Cu17.9Al10Ni14.6Ti5 (Vitreloy 105) bending samples. After that, significantly improved plasticity and better fatigue properties at three‐point bending as well as higher impact toughness were measured in dependence of the duration and the cooling rate of the thermal cycling process. This improved material behaviour is caused by reinforced shear banding, visible in scanning electron microscopy at the side faces of the specimens after fracture. A comprehensive analysis of the fracture surfaces of both quasi‐static and cyclic bent specimens revealed intense crack propagation along major shear bands and increased fatigue fracture regions, respectively. It is supposed that there is a structural rejuvenation due to the local variations of the thermal expansion coefficients within the multicomponent alloy affecting the mechanical properties.
Robust Small Area Estimation under Spatial Non‐stationarity
Authors: Baldermann Claudia , Salvati Nicola , Schmid Timo
Published: January 2018

The effective use of spatial information in a regression‐based approach to small area estimation is an important practical issue. One approach to account for geographic information is by extending the linear mixed model to allow for spatially correlated random area effects. An alternative is to include the spatial information by a non‐parametric mixed models. Another option is geographic weighted regression where the model coefficients vary spatially across the geography of interest. Although these approaches are useful for estimating small area means efficiently under strict parametric assumptions, they can be sensitive to outliers. In this paper, we propose robust extensions of the geographically weighted empirical best linear unbiased predictor. In particular, we introduce robust projective and predictive estimators under spatial non‐stationarity. Mean squared error estimation is performed by two analytic approaches that account for the spatial structure in the data. Model‐based simulations show that the methodology proposed often leads to more efficient estimators. Furthermore, the analytic mean squared error estimators introduced have appealing properties in terms of stability and bias. Finally, we demonstrate in the application that the new methodology is a good choice for producing estimates for average rent prices of apartments in urban planning areas in Berlin.
Decentralization and Firm Investments: Evidence from China
Authors: Pan Xiaofei , Wu Yiping , Wu Huihang
Published: January 2018

Taking advantage of decentralization reform that enlarges the authority of county government in China, we construct a quasi‐experiment. Using a large sample of Chinese firms, we show that after the implementation of decentralization reform, firms located in decentralized counties experienced a significant increase in investment expenditure compared with other firms. We also find that after the decentralization reform, state owned enterprises (SOEs) experienced greater increase in investment expenditure on average compared with non‐SOEs, and that, within non‐SOEs, collective firms have an even larger increase in investments, followed by foreign firms and private firms. Further analysis shows that the influence of decentralization reform was more significant in more developed markets, and that the increased investment was associated with improved productivity, which was more pronounced in SOEs. These results are robust to an alternative sample and endogeneity issues. Overall, these findings support the view that decentralization reform improves government efficiency and creates positive externalities, thereby encouraging firms to invest.
High trait emotional intelligence in men: Beneficial for perceived stress levels but disadvantageous for the physiological response to acute stressors?
Authors: Thomas Laura Isabell , Fuchs Reinhard , Klaperski Sandra
Published: January 2018

This study examined the relationship between trait emotional intelligence (EI) and stress in 110 male employees. Particularly, the association between trait EI and perceived chronic stress, occupational stress, and the physiological stress response was examined. Trait EI, perceived chronic stress, and occupational stress levels were assessed via questionnaires. The physiological stress response was measured by means of salivary free cortisol and heart rate variability (HRV) in response to the Trier Social Stress Test for Groups. Consistent with previous findings, men with high trait EI showed significantly lower perceived chronic and occupational stress levels than men with low trait EI. However, men with high trait EI also showed significantly higher cortisol reactivity than their low trait EI counterparts. Similarly, HRV in men with high trait EI appeared to be lower than in men with low trait EI but HRV differences between groups were not significant. Our findings suggest that trait EI might play a critical role in the stress regulation process but due to the cross‐sectional design of the study no causal conclusions can be drawn. Experimental studies need to explore further whether and how trait EI affects psychological and physiological stress responses.