bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Use of Ultrasound-Based Technology for Cargo Inspection
Authors: Álvarez-López Yuri , Martínez-Lorenzo José A.
Published: February 2016

A new guided wave imaging application for fast, low-cost ultrasound-based cargo scanning system is proposed. The ultimate goal is the detection of high-atomic-number, shielding containers used to diminish the radiological signature of nuclear threats. This ultrasonic technology has the potential to complement currently deployed X-ray-based radiographic systems, thus enhancing the probability of detecting nuclear threats. An array of ultrasonic transceivers can be attached to the metallic structure of the cargo to create a guided Lamb wave. Guided medium thickness and composition variation creates reflections whose placement can be revealed by means of an imaging algorithm. The knowledge of the reflection position provides information about the shielding metallic container location inside the cargo. Moreover, due to the low coupling between metallic and nonmetallic surfaces, only the footprint of metallic containers shows up in the imaging results, thus avoiding false positives from plastic or wooden assets. As imaging capabilities are degraded if working with dispersive Lamb wave modes, the operating frequency is tuned to provide a tradeoff between low dispersion and real-time image resolution. Reflected waves in the guided domain bounds may limit the performance of imaging methods for guided media. This contribution proposes a solution based on real-time Fourier domain analysis, where plane wave components can be filtered out, thus removing nondesired contributions from bounds. Several realistic examples, scaled due to limited calculation capabilities of the available computational resources, are presented in this work, showing the feasibility of the proposed method.
Dynamics of Cubic and Vibro-Impact Nonlinear Energy Sink: Analytical, Numerical, and Experimental Analysis
Authors: Li Tao , Seguy Sébastien , Berlioz Alain
Published: February 2016

This paper is devoted to study and compare dynamics of primary linear oscillator (LO) coupled to cubic and vibro-impact (VI) nonlinear energy sink (NES) under transient and periodic forcing. The classic analytical procedure combining the approach of invariant manifold and multiple scales is extended from the analysis of steady-state resonance to other regimes, especially strongly modulated response (SMR). A general equation governing the variation of motion along the slow invariant manifold (SIM) is obtained. Numerical results show its convenience to explain the transition from steady-state response to SMR and the characteristics of SMR for periodic forcing. Targeted energy transfer (TET) under transient forcing can also be well understood. Experimental results from LO coupled to VI NES under periodic forcing confirm the existence of SMR and its properties (e.g., chaotic). They also verify the feasibility of the general equation to explain complicated case like SMR in experiments.
On the Capability of Structural–Acoustical Fluid–Structure Interaction Simulations to Predict Natural Frequencies of Rotating Disklike Structures Submerged in a Heavy Fluid
Authors: Valentín David , Presas Alexandre , Egusquiza Eduard , Valero Carme
Published: February 2016

Predicting natural frequencies of rotating disklike structures submerged in water is of paramount importance in the field of hydraulic machinery, since the dynamic response of disks presents similarities to the dynamic response of pump-turbine runners. Well-known computational methods, such as structural-acoustical fluid–structure interaction (FSI) simulations, are perfectly capable to predict the added mass effects of standing submerged disks. However, the capability of these simulations to predict the effect of rotation in the natural frequencies of submerged disks has not been investigated. To obtain adequate results, the relationship between the disk rotation and the fluid rotation has to be introduced in the simulation model to consider the effects of the surrounding flow and the transmission within rotating and stationary frame. This procedure is explained and discussed in this technical brief comparing analytical, numerical, and experimental results.
Four billion people facing severe water scarcity
Authors: Mekonnen Mesfin M. , Hoekstra Arjen Y.
Published: February 2016

Global water scarcity assessment at a high spatial and temporal resolution, accounting for environmental flow requirements.
Spontaneous structural transition and crystal formation in minimal supramolecular polymer model
Authors: Fichman Galit , Guterman Tom , Damron Joshua , Adler-Abramovich Lihi , Schmidt Judith , Kesselman Ellina , Shimon Linda J. W. , Ramamoorthy Ayyalusamy , Talmon Yeshayahu , Gazit Ehud
Published: February 2016

A comprehensive minimalistic model for spontaneous structural transition that is governed by distinct molecular interactions.
MyShake: A smartphone seismic network for earthquake early warning and beyond
Authors: Kong Qingkai , Allen Richard M. , Schreier Louis , Kwon Young-Woo
Published: February 2016

MyShake is a crowdsourcing approach to earthquake early warning that harnesses the sensors in private smartphones.
Walls talk: Microbial biogeography of homes spanning urbanization
Authors: Ruiz-Calderon Jean F. , Cavallin Humberto , Song Se Jin , Novoselac Atila , Pericchi Luis R. , Hernandez Jean N. , Rios Rafael , Branch Oralee H. , Pereira Henrique , Paulino Luciana C. , Blaser Martin J. , Knight Rob , Dominguez-Bello Maria G.
Published: February 2016

Home microbes track space-use and reflect a decreasing exposure to environmental microbes due to urbanization.
Miniature high-throughput chemosensing of yield, ee, and absolute configuration from crude reaction mixtures
Authors: Bentley Keith W. , Zhang Peng , Wolf Christian
Published: February 2016

A molecular fluorescence/CD probe can be used for fast quantitative analysis of chiral compounds and asymmetric reactions.
An anticancer drug suppresses the primary nucleation reaction that initiates the production of the toxic Aβ42 aggregates linked with Alzheimer’s disease
Authors: Habchi Johnny , Arosio Paolo , Perni Michele , Costa Ana Rita , Yagi-Utsumi Maho , Joshi Priyanka , Chia Sean , Cohen Samuel I. A. , Müller Martin B. D. , Linse Sara , Nollen Ellen A. A. , Dobson Christopher M. , Knowles Tuomas P. J. , Vendruscolo Michele
Published: February 2016

An approved anticancer drug selectively targets the first step in the molecular cascade resulting in Alzheimer’s disease.
Direct observation of Σ7 domain boundary core structure in magnetic skyrmion lattice
Authors: Matsumoto Takao , So Yeong-Gi , Kohno Yuji , Sawada Hidetaka , Ikuhara Yuichi , Shibata Naoya
Published: February 2016

Advanced electron microscopy reveals a unique structural relaxation mechanism in a magnetic skyrmion domain boundary core.
Use of Metagenomic Shotgun Sequencing Technology To Detect Foodborne Pathogens within the Microbiome of the Beef Production Chain
Authors: Yang Xiang , Noyes Noelle R. , Doster Enrique , Martin Jennifer N. , Linke Lyndsey M. , Magnuson Roberta J. , Yang Hua , Geornaras Ifigenia , Woerner Dale R. , Jones Kenneth L. , Ruiz Jaime , Boucher Christina , Morley Paul S. , Belk Keith E.
Published: February 2016

Foodborne illnesses associated with pathogenic bacteria are a global public health and economic challenge. The diversity of microorganisms (pathogenic and nonpathogenic) that exists within the food and meat industries complicates efforts to understand pathogen ecology. Further, little is known about the interaction of pathogens within the microbiome throughout the meat production chain. Here, a metagenomic approach and shotgun sequencing technology were used as tools to detect pathogenic bacteria in environmental samples collected from the same groups of cattle at different longitudinal processing steps of the beef production chain: cattle entry to feedlot, exit from feedlot, cattle transport trucks, abattoir holding pens, and the end of the fabrication system. The log read counts classified as pathogens per million reads for
Salmonella enterica
,
Listeria monocytogenes
,
Escherichia coli
,
Staphylococcus aureus
,
Clostridium
spp. (
C. botulinum
and
C. perfringens
), and
Campylobacter
spp. (
C. jejuni
,
C. coli
, and
C. fetus
) decreased over subsequential processing steps. Furthermore, the normalized read counts for
S. enterica
,
E. coli
, and
C. botulinum
were greater in the final product than at the feedlots, indicating that the proportion of these bacteria increased (the effect on absolute numbers was unknown) within the remaining microbiome. From an ecological perspective, data indicated that shotgun metagenomics can be used to evaluate not only the microbiome but also shifts in pathogen populations during beef production. Nonetheless, there were several challenges in this analysis approach, one of the main ones being the identification of the specific pathogen from which the sequence reads originated, which makes this approach impractical for use in pathogen identification for regulatory and confirmation purposes.
Genetic Diversity of Campylobacter jejuni and Campylobacter coli Isolates from Conventional Broiler Flocks and the Impacts of Sampling Strategy and Laboratory Method
Authors: Vidal A. B. , Colles F. M. , Rodgers J. D. , McCarthy N. D. , Davies R. H. , Maiden M. C. J. , Clifton-Hadley F. A.
Published: February 2016

The genetic diversity of
Campylobacter jejuni
and
Campylobacter coli
isolates from commercial broiler farms was examined by multilocus sequence typing (MLST), with an assessment of the impact of the sample type and laboratory method on the genotypes of
Campylobacter
isolated. A total of 645
C. jejuni
and 106
C. coli
isolates were obtained from 32 flocks and 17 farms, with 47 sequence types (STs) identified. The
Campylobacter jejuni
isolates obtained by different sampling approaches and laboratory methods were very similar, with the same STs identified at similar frequencies, and had no major effect on the genetic profile of
Campylobacter
population in broiler flocks at the farm level. For
C. coli
, the results were more equivocal. While some STs were widely distributed within and among farms and flocks, analysis of molecular variance (AMOVA) revealed a high degree of genetic diversity among farms for
C. jejuni
, where farm effects accounted for 70.5% of variance, and among flocks from the same farm (9.9% of variance for
C. jejuni
and 64.1% for
C. coli
). These results show the complexity of the population structure of
Campylobacter
in broiler production and that commercial broiler farms provide an ecological niche for a wide diversity of genotypes. The genetic diversity of
C. jejuni
isolates among broiler farms should be taken into account when designing studies to understand
Campylobacter
populations in broiler production and the impact of interventions. We provide evidence that supports synthesis of studies on
C. jejuni
populations even when laboratory and sampling methods are not identical.
Activities of Secreted Aryl Alcohol Quinone Oxidoreductases from Pycnoporus cinnabarinus Provide Insights into Fungal Degradation of Plant Biomass
Authors: Mathieu Yann , Piumi Francois , Valli Richard , Aramburu Juan Carro , Ferreira Patricia , Faulds Craig B. , Record Eric
Published: February 2016

Auxiliary activities family 3 subfamily 2 (AA3_2) from the CAZy database comprises various functions related to ligninolytic enzymes, such as fungal aryl alcohol oxidases (AAO) and glucose oxidases, both of which are flavoenzymes. The recent study of the
Pycnoporus cinnabarinus
CIRM BRFM 137 genome combined with its secretome revealed that four AA3_2 enzymes are secreted during biomass degradation. One of these AA3_2 enzymes, scf184803.g17, has recently been produced heterologously in
Aspergillus niger
. Based on the enzyme's activity and specificity, it was assigned to the glucose dehydrogenases (
P
.
cinnabarinus
GDH [
Pc
GDH]). Here, we analyze the distribution of the other three AA3_2 enzymes (scf185002.g8, scf184611.g7, and scf184746.g13) to assess their putative functions. These proteins showed the highest homology with aryl alcohol oxidase from
Pleurotus eryngii
. Biochemical characterization demonstrated that they were also flavoenzymes harboring flavin adenine dinucleotide (FAD) as a cofactor and able to oxidize a wide variety of phenolic and nonphenolic aryl alcohols and one aliphatic polyunsaturated primary alcohol. Though presenting homology with fungal AAOs, these enzymes exhibited greater efficiency in reducing electron acceptors (quinones and one artificial acceptor) than molecular oxygen and so were defined as aryl-alcohol:quinone oxidoreductases (AAQOs) with two enzymes possessing residual oxidase activity (
Pc
AAQO2 and
Pc
AAQO3). Structural comparison of
Pc
AAQO homology models with
P. eryngii
AAO demonstrated a wider substrate access channel connecting the active-site cavity to the solvent, explaining the absence of activity with molecular oxygen. Finally, the ability of
Pc
AAQOs to reduce radical intermediates generated by laccase from
P. cinnabarinus
was demonstrated, shedding light on the ligninolytic system of this fungus.
Systematic Mutational Analysis of Histidine Kinase Genes in the Nosocomial Pathogen Stenotrophomonas maltophilia Identifies BfmAK System Control of Biofilm Development
Authors: Zheng Liu , Wang Fang-Fang , Ren Bao-Zhen , Liu Wei , Liu Zhong , Qian Wei
Published: February 2016

The Gram-negative bacterium
Stenotrophomonas maltophilia
lives in diverse ecological niches. As a result of its formidable capabilities of forming biofilm and its resistance to multiple antibiotic agents, the bacterium is also a nosocomial pathogen of serious threat to the health of patients whose immune systems are suppressed or compromised. Besides the histidine kinase RpfC, the two-component signal transduction system (TCS), which is the canonical regulatory machinery used by most bacterial pathogens, has never been experimentally investigated in
S. maltophilia
. Here, we annotated 62 putative histidine kinase genes in the
S. maltophilia
genome and successfully obtained 51 mutants by systematical insertional inactivation. Phenotypic characterization identified a series of mutants with deficiencies in bacterial growth, swimming motility, and biofilm development. A TCS, named here BfmA-BfmK (Smlt4209-Smlt4208), was genetically confirmed to regulate biofilm formation in
S. maltophilia
. Together with interacting partner prediction and chromatin immunoprecipitation screens, six candidate promoter regions bound by BfmA
in vivo
were identified. We demonstrated that, among them, BfmA acts as a transcription factor that binds directly to the promoter regions of
bfmA-bfmK
and
Smlt0800
(
acoT
), a gene encoding an acyl coenzyme A thioesterase that is associated with biofilm development, and positively controls their transcription. Genome-scale mutational analyses of histidine kinase genes and functional dissection of BfmK-BfmA regulation in biofilm provide genetic information to support more in-depth studies on cellular signaling in
S. maltophilia
, in the context of developing novel approaches to fight this important bacterial pathogen.
Direct Comparison of Physical Properties of Bacillus subtilis NCIB 3610 and B-1 Biofilms
Authors: Kesel Sara , Grumbein Stefan , Gümperlein Ina , Tallawi Marwa , Marel Anna-Kristina , Lieleg Oliver , Opitz Madeleine
Published: February 2016

Many bacteria form surface-attached communities known as biofilms. Due to the extreme resistance of these bacterial biofilms to antibiotics and mechanical stresses, biofilms are of growing interest not only in microbiology but also in medicine and industry. Previous studies have determined the extracellular polymeric substances present in the matrix of biofilms formed by
Bacillus subtilis
NCIB 3610. However, studies on the physical properties of biofilms formed by this strain are just emerging. In particular, quantitative data on the contributions of biofilm matrix biopolymers to these physical properties are lacking. Here, we quantitatively investigated three physical properties of
B. subtilis
NCIB 3610 biofilms: the surface roughness and stiffness and the bulk viscoelasticity of these biofilms. We show how specific biomolecules constituting the biofilm matrix formed by this strain contribute to those biofilm properties. In particular, we demonstrate that the surface roughness and surface elasticity of 1-day-old NCIB 3610 biofilms are strongly affected by the surface layer protein BslA. For a second strain,
B. subtilis
B-1, which forms biofilms containing mainly γ-polyglutamate, we found significantly different physical biofilm properties that are also differently affected by the commonly used antibacterial agent ethanol. We show that B-1 biofilms are protected from ethanol-induced changes in the biofilm's stiffness and that this protective effect can be transferred to NCIB 3610 biofilms by the sole addition of γ-polyglutamate to growing NCIB 3610 biofilms. Together, our results demonstrate the importance of specific biofilm matrix components for the distinct physical properties of
B. subtilis
biofilms.
SaxA-Mediated Isothiocyanate Metabolism in Phytopathogenic Pectobacteria
Authors: Welte Cornelia U. , Rosengarten Jamila F. , de Graaf Rob M. , Jetten Mike S. M.
Published: February 2016

Pectobacteria are devastating plant pathogens that infect a large variety of crops, including members of the family Brassicaceae. To infect cabbage crops, these plant pathogens need to overcome the plant's antibacterial defense mechanisms, where isothiocyanates are liberated by hydrolysis of glucosinolates. Here, we found that a
Pectobacterium
isolate from the gut of cabbage root fly larvae was particularly resistant to isothiocyanate and even seemed to benefit from the abundant
Brassica
root metabolite 2-phenylethyl isothiocyanate as a nitrogen source in an ecosystem where nitrogen is scarce. The
Pectobacterium
isolate harbored a naturally occurring mobile plasmid that contained a
sax
operon. We hypothesized that SaxA was the enzyme responsible for the breakdown of 2-phenylethyl isothiocyanate. Subsequently, we heterologously produced and purified the SaxA protein and characterized the recombinant enzyme. It hydrolyzed 2-phenylethyl isothiocyanate to yield the products carbonyl sulfide and phenylethylamine. It was also active toward another aromatic isothiocyanate but hardly toward aliphatic isothiocyanates. It belongs to the class B metal-dependent beta-lactamase fold protein family but was not, however, able to hydrolyze beta-lactam antibiotics. We discovered that several copies of the
saxA
gene are widespread in full and draft
Pectobacterium
genomes and therefore hypothesize that SaxA might be a new pathogenicity factor of the genus
Pectobacterium
, possibly compromising food preservation strategies using isothiocyanates.
Germs within Worms: Localization of Neorickettsia sp. within Life Cycle Stages of the Digenean Plagiorchis elegans
Authors: Greiman Stephen E. , Rikihisa Yasuko , Cain Jacob , Vaughan Jefferson A. , Tkach Vasyl V.
Published: February 2016

Neorickettsia
spp. are bacterial endosymbionts of parasitic flukes (
Digenea
) that also have the potential to infect and cause disease (e.g., Sennetsu fever) in the vertebrate hosts of the fluke. One of the largest gaps in our knowledge of
Neorickettsia
biology is the very limited information available regarding the localization of the bacterial endosymbiont within its digenean host. In this study, we used indirect immunofluorescence microscopy to visualize
Neorickettsia
sp. within several life cycle stages of the digenean
Plagiorchis elegans
. Individual sporocysts, cercariae, metacercariae, and adults of
P. elegans
naturally infected with
Neorickettsia
sp. were obtained from our laboratory-maintained life cycle, embedded, sectioned, and prepared for indirect immunofluorescence microscopy using anti-
Neorickettsia
risticii
horse serum as the primary antibody.
Neorickettsia
sp. was found within the tegument of sporocysts, throughout cercarial embryos (germ balls) and fully formed cercariae (within the sporocysts), throughout metacercariae, and within the tegument, parenchyma, vitellaria, uteri, testes, cirrus sacs, and eggs of adults. Interestingly,
Neorickettsia
sp. was not found within the ovarian tissue. This suggests that vertical transmission of
Neorickettsia
within adult digeneans occurs via the incorporation of infected vitelline cells into the egg rather than direct infection of the ooplasm of the oocyte, as has been described for other bacterial endosymbionts of invertebrates (e.g.,
Rickettsia
and
Wolbachia
).
Direct and Indirect Horizontal Transmission of the Antifungal Probiotic Bacterium Janthinobacterium lividum on Green Frog (Lithobates clamitans) Tadpoles
Authors: Rebollar Eria A. , Simonetti Stephen J. , Shoemaker William R. , Harris Reid N.
Published: February 2016

Amphibian populations worldwide are being threatened by the disease chytridiomycosis, which is caused by
Batrachochytrium dendrobatidis
. To mitigate the effects of
B. dendrobatidis
, bioaugmentation of antifungal bacteria has been shown to be a promising strategy. One way to implement bioaugmentation is through indirect horizontal transmission, defined as the transfer of bacteria from a host to the environment and to another host. In addition, direct horizontal transmission among individuals can facilitate the spread of a probiotic in a population. In this study, we tested whether the antifungal bacterium
Janthinobacterium lividum
could be horizontally transferred, directly or indirectly, in a laboratory experiment using
Lithobates clamitans
tadpoles. We evaluated the ability of
J. lividum
to colonize the tadpoles' skin and to persist through time using culture-dependent and culture-independent techniques. We also tested whether the addition of
J. lividum
affected the skin community in
L. clamitans
tadpoles. We found that transmission occurred rapidly by direct and indirect horizontal transmission, but indirect transmission that included a potential substrate was more effective. Even though
J. lividum
colonized the skin, its relative abundance on the tadpole skin decreased over time. The inoculation of
J. lividum
did not significantly alter the skin bacterial diversity of
L. clamitans
tadpoles, which was dominated by
Pseudomonas
. Our results show that indirect horizontal transmission can be an effective bioaugmentation method. Future research is needed to determine the best conditions, including the presence of substrates, under which a probiotic can persist on the skin so that bioaugmentation becomes a successful strategy to mitigate chytridiomycosis.
Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease
Authors: Bouquet Jerome , Soloski Mark J. , Swei Andrea , Cheadle Chris , Federman Scot , Billaud Jean-Noel , Rebman Alison W. , Kabre Beniwende , Halpert Richard , Boorgula Meher , Aucott John N. , Chiu Charles Y.
Published: February 2016

Lyme disease is a tick-borne illness caused by the bacterium
Borrelia burgdorferi
, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls) enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs) in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the “window period” of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets.

IMPORTANCE
Lyme disease is the most common tick-borne infection in the United States, and some patients report lingering symptoms lasting months to years despite antibiotic treatment. To better understand the role of the human host response in acute Lyme disease and the development of post-treatment symptoms, we conducted the first longitudinal gene expression (transcriptome) study of patients enrolled at the time of diagnosis and followed up for up to 6 months after treatment. Importantly, we found that the gene expression signature of early Lyme disease is distinct from that of other acute infectious diseases and persists for at least 3 weeks following infection. This study also uncovered multiple previously undescribed pathways and genes that may be useful in the future as human host biomarkers for diagnosis and that constitute potential targets for the development of new therapies.
Electroacupuncture Relieves Labour Pain and Influences the Spinal Dynorphin/κ-Opioid Receptor System in Rats
Authors: Jiang Qiu-Yan , Wang Meng-Ying , Li Li , Mo Hai-Xia , Song Jin-Ling , Tang Qian-Li , Feng Xiao-Tao
Published: February 2016

Background

The dynorphin (DYN)/κ-opioid receptor (KOR) system plays a key role in the control of labour pain. Our previous clinical study reported that electroacupuncture (EA) provided intrapartum analgesia, but the underlying mechanisms of action have not been fully elucidated.

Aims

To observe the effect of EA on labour pain and to explore the underlying mechanisms of action in a rat model.

Methods

Copulation-confirmed pregnant rats (n=120) were given castor oil to induce labour. Rats remained untreated (control group, n=20) or received either meperidine (an opioid that is commonly used to treat labour pain, n=20) or EA at SP6, LI4, SP6+LI4 or SP10 (four groups, n=20 each). Labour pain was evaluated by the warm water tail-flick test. Serum DYN values were measured by ELISA. Protein and mRNA expression of prodynorphin (PDYN, the precursor protein of DYN) and KOR were analysed by Western blotting and real-time PCR, respectively.

Results

EA treatment at all acupuncture point combinations studied significantly relieved labour pain and increased serum DYN concentrations, to a degree similar to that achieved with meperidine. EA notably enhanced protein expression of KOR and PDYN and mRNA expression in the lumbar spinal cord but not in the cerebral cortex. The size of effect varied by EA group in the order: SP6>LI4>SP6+LI4>SP10 for all parameters measured, indicating differential effects relating to acupuncture point selection/combination.

Conclusions

The present study indicates that EA relieves labour pain, at least in part, by regulation of the spinal DYN/KOR system in a rat model.
Neuroregression as an initial manifestation in a toddler with acquired pernicious anaemia
Authors: Yoganathan Sangeetha , Thomas Maya Mary , Mathai Sarah , Ghosh Urmi
Published: February 2016

The aetiology spectrum for neuroregression in infants and toddlers is diverse. Vitamin B12deficiency-mediated neuroregression is less commonly considered as a differential. Prevalence of pernicious anaemia in the general population is 0.1% and is extremely rare in children. We describe a 35-month-old toddler with neuroregression, seizures, coarse tremors, bleating cry and neuropathy. His clinical symptomatology mimicked grey matter degenerative illness and infantile tremor syndrome, a nutritional deficiency-mediated movement disorder. His vitamin B12level was low and serum homocysteine level was elevated. Haematological manifestations were not overt and anti-intrinsic factor antibody was positive. With parenteral vitamin B12therapy, there was a dramatic response with clinical and laboratory translation. This report emphasises the need for a high index of suspicion and screening for markers of vitamin B12deficiency in all children with unexplained acute or subacute neuroregression, seizures and movement disorders as it is potentially reversible.
Patient safety: the landscape of the global research output and gender distribution
Authors: Schreiber Moritz , Klingelhöfer Doris , Groneberg David A , Brüggmann Doerthe
Published: February 2016

Objectives

Patient safety is a crucial issue in medicine. Its main objective is to reduce the number of deaths and health damages that are caused by preventable medical errors. To achieve this, it needs better health systems that make mistakes less likely and their effects less detrimental without blaming health workers for failures. Until now, there is no in-depth scientometric analysis on this issue that encompasses the interval between 1963 and 2014. Therefore, the aim of this study is to sketch a landscape of the past global research output on patient safety including the gender distribution of the medical discipline of patient safety by interpreting scientometric parameters. Additionally, respective future trends are to be outlined.

Setting

The Core Collection of the scientific database Web of Science was searched for publications with the search term ‘Patient Safety’ as title word that was focused on the corresponding medical discipline. The resulting data set was analysed by using the methodology implemented by the platform NewQIS. To visualise the geographical landscape, state-of-the-art techniques including density-equalising map projections were applied.

Results

4079 articles on patient safety were identified in the period from 1900 to 2014. Most articles were published in North America, the UK and Australia. In regard to the overall number of publications, the USA is the leading country, while the output ratio to the population of Switzerland was found to exhibit the best performance. With regard to the ratio of the number of publications to the Gross Domestic Product (GDP) per Capita, the USA remains the leading nation but countries like India and China with a low GDP and high population numbers are also profiting.

Conclusions

Though the topic is a global matter, the scientific output on patient safety is centred mainly in industrialised countries.
Association of the consumption of common food groups and beverages with mortality from cancer, ischaemic heart disease and diabetes mellitus in Serbia, 1991–2010: an ecological study
Authors: Ilic Milena , Ilic Irena , Stojanovic Goran , Zivanovic-Macuzic Ivana
Published: February 2016

Objectives

This paper reports association between mortality rates from cancer, ischaemic heart disease and diabetes mellitus and the consumption of common food groups and beverages in Serbia.

Design

In this ecological study, data on both mortality and the average annual consumption of common food groups and beverages per household's member were obtained from official data-collection sources. The multivariate linear regression analysis was used to determine the strength of the associations between consumption of common food groups and beverages and mortality rates.

Results

Markedly increasing trends of cancer, ischaemic heart disease and diabetes mellitus mortality rates were observed in Serbia in the period 1991–2010. Mortality rates from cancer were negatively associated with consumption of vegetable oil (p=0.005) and grains (p=0.001), and same was found for ischaemic heart disease (p=0.002 and 0.021, respectively), while consumption of other dairy products showed a significant positive association (p<0.001 and p=0.032, respectively). In men and women, mortality rates from diabetes mellitus showed a significant positive association with consumption of poultry (p=0.014 and 0.004, respectively). Consumption of beef and grains showed a significant negative association with cancer mortality rates in both genders (p=0.002 and p<0.001 in men, and p<0.001 and p=0.014 in women, respectively), while consumption of cheese was negatively associated only in men (p<0.001). Mortality from diabetes mellitus showed a significant positive association with consumption of animal fat and other dairy products only in women (p=0.003 and 0.046, respectively).

Conclusions

Association between unfavourable mortality trends from cancer, ischaemic heart disease and diabetes mellitus, and common food groups and beverages consumption was observed and should be assessed in future analytical epidemiological studies. Promotion of healthy diet is sorely needed in Serbia.
Can training non-physician clinicians/associate clinicians (NPCs/ACs) in emergency obstetric, neonatal care and clinical leadership make a difference to practice and help towards reductions in maternal and neonatal mortality in rural Tanzania? The ETATMBA project
Authors: Ellard David R , Shemdoe Aloisia , Mazuguni Festo , Mbaruku Godfrey , Davies David , Kihaile Paul , Pemba Senga , Bergström Staffan , Nyamtema Angelo , Mohamed Hamed-Mahfoudh , O'Hare Joseph Paul
Published: February 2016

Objectives

During late 2010, 36 trainees including 19 assistant medical officers (AMOs) 1 senior clinical officer (CO) and 16 nurse midwives/nurses were recruited from districts across rural Tanzania and invited to join the Enhancing Human Resources and Use of Appropriate Technologies for Maternal and Perinatal Survival in the sub-Saharan Africa (ETATMBA) training programme. The ETATMBA project was training associate clinicians (ACs) as advanced clinical leaders in emergency obstetric care. The trainees returned to health facilities across the country with the hope of being able to apply their new skills and knowledge. The main aim of this study was to explore the impact of the ETATMBA training on health outcomes including maternal and neonatal morbidity and mortality in their facilities. Secondly, to explore the challenges faced in working in these health facilities.

Design

The study is a pre-examination/postexamination of maternal and neonatal health indicators and a survey of health facilities in rural Tanzania. The facilities surveyed were those in which ETATMBA trainees were placed post-training. The maternal and neonatal indicators were collected for 2011 and 2013 and the survey of the facilities was in early 2014.

Results

16 of 17 facilities were surveyed. Maternal deaths show a non-significant downward trend over the 2 years (282–232 cases/100 000 live births). There were no significant differences in maternal, neonatal and birth complication variables across the time-points. The survey of facilities revealed shortages in key areas and some are a serious concern.

Conclusions

This study represents a snapshot of rural health facilities providing maternal and neonatal care in Tanzania. Enhancing knowledge, practical skills, and clinical leadership of ACs may have a positive impact on health outcomes. However, any impact may be confounded by the significant challenges in delivering a service in terms of resources. Thus, training may be beneficial, but it requires an infrastructure that supports it.
A qualitative process evaluation of training for non-physician clinicians/associate clinicians (NPCs/ACs) in emergency maternal, neonatal care and clinical leadership, impact on clinical services improvements in rural Tanzania: the ETATMBA project
Authors: Ellard David R , Shemdoe Aloisia , Mazuguni Festo , Mbaruku Godfrey , Davies David , Kihaile Paul , Pemba Senga , Bergström Staffan , Nyamtema Angelo , Mohamed Hamed-Mahfoudh , O'Hare Joseph Paul
Published: February 2016

Objectives

The Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in sub-Saharan Africa (ETATMBA) project is training non-physician clinicians as advanced clinical leaders in emergency maternal and newborn care in Tanzania and Malawi. The main aims of this process evaluation were to explore the implementation of the programme of training in Tanzania, how it was received, how or if the training has been implemented into practice and the challenges faced along the way.

Design

Qualitative interviews with trainees, trainers, district officers and others exploring the application of the training into practice.

Participants

During late 2010 and 2011, 36 trainees including 19 assistant medical officers one senior clinical officer and 16 nurse midwives/nurses (anaesthesia) were recruited from districts across rural Tanzania and invited to join the ETATMBA training programme.

Results

Trainees (n=36) completed the training returning to 17 facilities, two left and one died shortly after training. Of the remaining trainees, 27 were interviewed at their health facility. Training was well received and knowledge and skills were increased. There were a number of challenges faced by trainees, not least that their new skills could not be practised because the facilities they returned to were not upgraded. Nonetheless, there is evidence that the training is having an effect locally on health outcomes, like maternal and neonatal mortality, and the trainees are sharing their new knowledge and skills with others.

Conclusions

The outcome of this evaluation is encouraging but highlights that there are many ongoing challenges relating to infrastructure (including appropriate facilities, electricity and water) and the availability of basic supplies and drugs. This cadre of workers is a dedicated and valuable resource that can make a difference, which with better support could make a greater contribution to healthcare in the country.
Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project
Authors: Whop Lisa J , Diaz Abbey , Baade Peter , Garvey Gail , Cunningham Joan , Brotherton Julia M L , Canfell Karen , Valery Patricia C , O'Connell Dianne L , Taylor Catherine , Moore Suzanne P , Condon John R
Published: February 2016

Objective

To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates.

Setting/participants

A linked data set of women aged 20–69 in the Queensland Pap Smear Register (PSR; 1999–2011) and Queensland Cancer Registry (QCR; 1997–2010) formed the Initial Study Cohort. Two extracts (1995–2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20–69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2.

Outcome measures

The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared.

Results

There were 28 872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76 831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1 372 823 women (PSR n=1 374 401; QCR n=1955), and 5 062 118 records.

Conclusions

Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia.
Associations with fracture in patients with diabetes: a nested case–control study
Authors: Starup-Linde Jakob , Gregersen Søren , Vestergaard Peter
Published: February 2016

Objectives

Diabetes mellitus is associated with an increased risk of fractures, which is not fully explained by bone mineral density and common risk factors. The aim of this study is to investigate the association of medication and biochemical markers on the risk of fracture in a diabetes population.

Design and setting

A nested case–control study was conducted based on Danish diabetes patients from The Danish National Hospital Discharge Registry.

Participants

The cases of the study were diabetes patients with a fracture (n=24 349), and controls were diabetes patients with no fracture (n=132 349). A total of 2627 diabetes patients were available for an analysis of patient characteristics, comorbidities, biochemical parameters and drug usage.

Results

Age (OR=1.02, 95% CI 1.01 to 1.04), diabetes duration (OR=1.06, 95% CI 1.02 to 1.09), a diagnosis of previous fracture (OR=2.20, 95% CI 1.55 to 3.11), an alcohol-related diagnosis (OR=2.94, 95% CI 1.76 to 4.91), total cholesterol level (OR=2.50, 95% CI 1.20 to 5.21) and the usage of antiepileptics (OR=2.12, 95% CI 1.39 to 3.59) all increased the odds of fracture. Low-density lipoprotein cholesterol levels decreased the odds of fracture (OR =0.34, 95% CI 0.16 to 0.74), where the level of 3.04–5.96 mmol/L was optimal with regard to fracture risk.

Conclusions

Low-density lipoprotein cholesterol may improve our understanding of fractures in diabetes patients, and it may be added to current fracture risk models in diabetes patients.
Active play exercise intervention in children with asthma: a PILOT STUDY
Authors: Westergren Thomas , Fegran Liv , Nilsen Tonje , Haraldstad Kristin , Kittang Ole Bjørn , Berntsen Sveinung
Published: February 2016

Objective

Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and children's perceptions of participating.

Methods

6 children with asthma (4 boys, 2 girls) aged 10–12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing.

Findings

The average attendance rate was 90%. Intensity ≥80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation.

Conclusions

The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL.
Preventing avoidable incidents leading to a presentation to the emergency department (ED) by older adults with cognitive impairment: protocol for a scoping review
Authors: Provencher Véronique , Généreux Mélissa , Gagnon-Roy Mireille , Veillette Nathalie , Egan Mary , Sirois Marie-Josée , Lacasse Francis , Rose Kathy , Stocco Stéphanie
Published: February 2016

Introduction

Older adults with cognitive impairment represent a large portion (21–42%) of people (65+) who consult at an emergency department (ED). Because this sub-group is at higher risk for hospitalisation and mortality following an ED visit, awareness about ‘avoidable’ incidents should be increased in order to prevent presentations to the ED due to such incidents. This study aims to synthetise the actual knowledge related to ‘avoidable’ incidents (ie, traumatic injuries, poisoning and other consequences of external causes) (WHO, 2016) leading to ED presentations in older people with cognitive impairment.

Methodology and analysis

A scoping review will be performed. Scientific and grey literature (1996–2016) will be searched using a combination of key words pertaining to avoidable incidents, ED presentations, older adults and cognitive impairment. A variety of databases (MEDLINE, CINAHL, Ageline, SCOPUS, ProQuest Dissertations/theses, EBM Reviews, Healthstar), online library catalogues, governmental websites and published statistics will be examined. Included sources will pertain to community-dwelling older adults presenting to the ED as a result of an avoidable incident, with the main focus on those with cognitive impairment. Data (eg, type, frequency, severity, circumstances of incidents, preventive measures) will be extracted and analysed using a thematic chart and content analysis.

Discussion and dissemination

This scoping review will provide a picture of the actual knowledge on the subject and identify knowledge gaps in existing literature to be filled by future primary researches. Findings will help stakeholders to develop programmes in order to promote safe and healthy environments and behaviours aimed at reducing avoidable incidents in seniors, especially those with cognitive impairment.
Effect of the rate of chest compression familiarised in previous training on the depth of chest compression during metronome-guided cardiopulmonary resuscitation: a randomised crossover trial
Authors: Bae Jinkun , Chung Tae Nyoung , Je Sang Mo
Published: February 2016

Objectives

To assess how the quality of metronome-guided cardiopulmonary resuscitation (CPR) was affected by the chest compression rate familiarised by training before the performance and to determine a possible mechanism for any effect shown.

Design

Prospective crossover trial of a simulated, one-person, chest-compression-only CPR.

Setting

Participants were recruited from a medical school and two paramedic schools of South Korea.

Participants

42 senior students of a medical school and two paramedic schools were enrolled but five dropped out due to physical restraints.

Intervention

Senior medical and paramedic students performed 1 min of metronome-guided CPR with chest compressions only at a speed of 120 compressions/min after training for chest compression with three different rates (100, 120 and 140 compressions/min). Friedman's test was used to compare average compression depths based on the different rates used during training.

Results

Average compression depths were significantly different according to the rate used in training (p<0.001). A post hoc analysis showed that average compression depths were significantly different between trials after training at a speed of 100 compressions/min and those at speeds of 120 and 140 compressions/min (both p<0.001).

Conclusions

The depth of chest compression during metronome-guided CPR is affected by the relative difference between the rate of metronome guidance and the chest compression rate practised in previous training.