bluuebunny/crossref_metadata_2025 huggingface dataset:
Local adaptation along an environmental cline in a species with an inversion polymorphism
Authors: Wellenreuther M. , Rosenquist H. , Jaksons P. , Larson K. W.
Published: March 2017

Polymorphic inversions are ubiquitous across the animal kingdom and are frequently associated with clines in inversion frequencies across environmental gradients. Such clines are thought to result from selection favouring local adaptation; however, empirical tests are scarce. The seaweed fly Coelopa frigida has an α/β inversion polymorphism, and previous work demonstrated that the α inversion frequency declines from the North Sea to the Baltic Sea and is correlated with changes in tidal range, salinity, algal composition and wrackbed stability. Here, we explicitly test the hypothesis that populations of C. frigida along this cline are locally adapted by conducting a reciprocal transplant experiment of four populations along this cline to quantify survival. We found that survival varied significantly across treatments and detected a significant Location x Substrate interaction, indicating local adaptation. Survival models showed that flies from locations at both extremes had highest survival on their native substrates, demonstrating that local adaptation is present at the extremes of the cline. Survival at the two intermediate locations was, however, not elevated at the native substrates, suggesting that gene flow in intermediate habitats may override selection. Together, our results support the notion that population extremes of species with polymorphic inversions are often locally adapted, even when spatially close, consistent with the growing view that inversions can have direct and strong effects on the fitness of species.
Genetic population structure in an equatorial sparrow: roles for culture and geography
Authors: Danner J. E. , Fleischer R. C. , Danner R. M. , Moore I. T.
Published: March 2017

Female preference for local cultural traits has been proposed as a barrier to breeding among animal populations. As such, several studies have found correlations between male bird song dialects and population genetics over relatively large distances. To investigate whether female choice for local dialects could act as a barrier to breeding between nearby and contiguous populations, we tested whether variation in male song dialects explains genetic structure among eight populations of rufous‐collared sparrows (Zonotrichia capensis) in Ecuador. Our study sites lay along a transect, and adjacent study sites were separated by approximately 25 km, an order of magnitude less than previously examined for this and most other species. This transect crossed an Andean ridge and through the Quijos River Valley, both of which may be barriers to gene flow. Using a variance partitioning approach, we show that song dialect is important in explaining population genetics, independent of the geographic variables: distance, the river valley and the Andean Ridge. This result is consistent with the hypothesis that song acts as a barrier to breeding among populations in close proximity. In addition, songs of contiguous populations differed by the same degree or more than between two populations previously shown to exhibit female preference for local dialect, suggesting that birds from these populations would also breed preferentially with locals. As expected, all geographic variables (distance, the river valley and the Andean Ridge) also predicted population genetic structure. Our results have important implications for the understanding whether, and at what spatial scale, culture can affect population divergence.
Nanodiamonds and silicate minerals in ordinary chondrites as determined by micro‐Raman spectroscopy
Authors: Saikia Bhaskar J. , Parthasarathy Gopalakrishnarao , Borah Rashmi R.
Published: March 2017

We present here the Raman spectroscopic study of silicate and carbonaceous minerals in three ordinary chondrites with the aim to improve our understanding the impact process including the peak metamorphic pressures present in carbon‐bearing ordinary chondites. The characteristic Raman vibrational peaks of olivines, pyroxenes, and plagioclase have been determined on three ordinary chondrites from India, Dergaon (H5), Mahadevpur (H4/5), and Kamargaon (L6). The Raman spectra of these meteorite samples show the presence of nanodiamonds at 1334–1345 cm−1 and 1591–1619 cm−1. The full‐width at half maximum (FWHM) of Raman peaks for Mahadevpur and Dergaon reflect the nature of shock metamorphism in these meteorites. The frequency shift in Raman spectra might be because of shock effects during the formation of the diamond/graphite grains.
Shifting Gears: Triage and Traffic in Urban India
Authors: Solomon Harris
Published: March 2017

While studies of triage in clinical medical literature tend to focus on the knowledge required to carry out sorting, this article details the spatial features of triage. It is based on participation observation of traffic‐related injuries in a Mumbai hospital casualty ward. It pays close attention to movement, specifically to adjustments, which include moving bodies, changes in treatment priority, and interruptions in care. The article draws on several ethnographic cases of injury and its aftermath that gather and separate patients, kin, and bystanders, all while a triage medical authority is charged with sorting them out. I argue that attention must be paid to differences in movement, which can be overlooked if medical decision‐making is taken to be a static verdict. The explanatory significance of this distinction between adjustment and adjudication is a more nuanced understanding of triage as an iterative, spatial process.
Aspidistra cyathiflora var. bifolia and A. neglecta spp. nov. (Convallariaceae) from northern Vietnam
Authors: Nguyen Khang Sinh , Averyanov Leonid V. , Tillich H.‐J. , Pham Van The , Maisak Tatiana V. , Sam Ly Ngoc
Published: March 2017

This paper continues the publication of new results of a successive investigation of the genus Aspidistra in Vietnam. It includes descriptions and illustrations of two new taxa discovered in northern Vietnam, A. cyathiflora Y. Wan & C.C. Huang var. bifolia Aver., Tillich & K.S. Nguyen and A. neglecta Aver., Tillich & K.S. Nguyen. Both plants are local endemics of karstic limestone areas in northern Vietnam. Data on ecology, phenology, tentative relations, distribution and expected conservation status are reported for all mentioned taxa.
Vismodegib Therapy for Basal Cell Carcinoma in an 8‐Year‐Old Chinese Boy with Xeroderma Pigmentosum
Authors: Fife Douglas , Laitinen Marko A. , Myers David J. , Landsteiner Pamela B.
Published: March 2017

Vismodegib is an oral inhibitor of the Hedgehog signaling pathway and has been used to treat basal cell carcinoma (BCC) in adults. This article reports clearance of a nodular BCC of the nasal tip in an 8‐year‐old boy with xeroderma pigmentosum (XP). BCC can pose therapeutic challenges when located in areas that are not amenable to traditional therapies such as Mohs micrographic surgery or topical agents. Vismodegib was used at a dose of 150 mg/day to treat the boy's BCC. After 4 months of therapy, we achieved complete clinical clearance. During 21 months of follow‐up, the patient's nose remained clinically clear of tumor. Vismodegib was successfully used to treat a child with XP and nodular BCC. Our goal in using vismodegib was tumor regression while avoiding cosmetic and functional disfigurement. Vismodegib was effective in clinically clearing the tumor, and the patient has shown no signs of recurrence. Further studies are warranted.
Immunohistochemical Staining of Pediatric Solitary Angiokeratomas
Authors: Prindaville Brea , Lawrence Hillary , Singh Vivekanand , Nopper Amy J. , Horii Kimberly A.
Published: March 2017

The precise etiology and subtype of vessels constituting angiokeratomas is poorly understood. We sought to characterize the vessels by studying prospero‐related homeobox gene‐1 and D2‐40 expression in 22 pediatric solitary angiokeratomas. Routine histologic examination demonstrated a mix of lymph‐containing vessels and erythrocyte‐filled small vessels. Our results suggest that angiokeratomas may in part be comprised of vessels with lymphatic differentiation.
Multidimensional Inequality Across Three Developed Countries
Authors: Rohde Nicholas , Guest Ross
Published: March 2017

This paper produces comparable estimates of multidimensional inequality for the U.S., Germany, and Australia. Two alternative approaches with differing interpretations are employed. The first method projects all facets of welfare onto a single variable which is then analyzed using standard univariate techniques. The second approach establishes equivalent‐income distributions thatwouldlead to an equalization of welfare, such that the difference between this counterfactual and the true income distribution can be measured. This difference is then interpreted as the degree of income redistribution required to offset welfare inequality. Using data on permanent incomes, health scores, years of education, and leisure times, we observe much higher levels of inequality in the U.S. than in Germany or Australia. Our results are highly statistically significant and hold over a large variety of weighting specifications.
Darwin in the Novels: Tolstoy's Evolving Literary Response
Authors: BERMAN ANNA A.
Published: March 2017

Although Tolstoy was deeply critical of Darwin in his notebooks, diaries, letters, and essays, his literary imagination was profoundly influenced by Darwinian theory. Tolstoy's major novels are Darwinian in form–modeling his ideals of gradual development, chance, and interconnectivity–while rejecting Darwin in their explicit discussions of his ideas. War and Peace is set in a pre‐Darwinian world where only the author, not the characters, has access to the new worldview opened up by ideas of evolution, natural selection and the struggle for existence. In this work, Darwinian ideas are manifest in the way Tolstoy conceived of the struggle of nations and individuals at the heart of the book and also in the “Second Epilogue,” where he references Darwin directly to help explain and justify his theory of history. Anna Karenina, by contrast, unfolds in the new Darwinian age, where both the characters, as well as the author, engage with Darwin's theories. His influence can be felt in the structuring worldview of the author, which emphasizes chance over teleology and interweaves multiple plotlines. However, the characters' own engagements with Darwin are designed to undermine his ideas, vindicating faith over the new scientific worldview. Anna embraces the “struggle for existence” as natural law and ends her life, while Levin turns away from Darwin and is saved from despair.
Shaler: in situ analysis of a fluvial sedimentary deposit on Mars
Authors: Edgar Lauren A. , Gupta Sanjeev , Rubin David M. , Lewis Kevin W. , Kocurek Gary A. , Anderson Ryan B. , Bell James F. , Dromart Gilles , Edgett Kenneth S. , Grotzinger John P. , Hardgrove Craig , Kah Linda C. , Leveille Richard , Malin Michael C. , Mangold Nicolas , Milliken Ralph E. , Minitti Michelle , Palucis Marisa , Rice Melissa , Rowland Scott K. , Schieber Juergen , Stack Kathryn M. , Sumner Dawn Y. , Wiens Roger C. , Williams Rebecca M. E. , Williams Amy J.
Published: March 2017

This paper characterizes the detailed sedimentology of a fluvial sandbody on Mars for the first time and interprets its depositional processes and palaeoenvironmental setting. Despite numerous orbital observations of fluvial landforms on the surface of Mars, ground‐based characterization of the sedimentology of such fluvial deposits has not previously been possible. Results from the NASA Mars Science Laboratory Curiosity rover provide an opportunity to reconstruct at fine scale the sedimentary architecture and palaeomorphology of a fluvial environment on Mars. This work describes the grain size, texture and sedimentary facies of the Shaler outcrop, reconstructs the bedding architecture, and analyses cross‐stratification to determine palaeocurrents. On the basis of bedset geometry and inclination, grain‐size distribution and bedform migration direction, this study concludes that the Shaler outcrop probably records the accretion of a fluvial barform. The majority of the outcrop consists of large‐scale trough cross‐bedding of coarse sand and granules. Palaeocurrent analyses and bedform reconstruction indicate that the beds were deposited by bedforms that migrated towards the north‐east, across the surface of a bar that migrated south‐east. Stacked cosets of dune cross‐bedding suggest aggradation of multiple bedforms, which provides evidence for short periods of sustained flow during Shaler deposition. However, local evidence for aeolian reworking and the presence of potential desiccation cracks within the outcrop suggest that fluvial deposition may have been intermittent. The uppermost strata at Shaler are distinct in terms of texture and chemistry and are inferred to record deposition from a different sediment dispersal system with a contrasting provenance. The outcrop as a whole is a testament to the availability of liquid water on the surface of Mars in its early history.
Is Contracting out of Public Services still the Great Panacea? A Systematic Review of Studies on Economic and Quality Effects from 2000 to 2014
Authors: Petersen Ole Helby , Hjelmar Ulf , Vrangbæk Karsten
Published: March 2017

This article presents the results of a systematic review of international studies on economic and quality effects of contracting out published in the period from 2000 to 2014. We conducted a comprehensive search of the literature and identified 49 relevant studies. There are three main findings of the systematic review: (1) cost savings documented in international contracting out literature have been decreasing over time; (2) cost savings have been much greater in technical services than in social services; and (3) economic effects have been twice as large in Anglo‐Saxon countries compared with other countries. With regard to measuring the effect of contracting out on service quality, which is a vital component of any service delivery arrangement, very few studies assess this issue in a comprehensive manner. There is also a significant lack of studies that include measures of transaction costs, thereby making it difficult to evaluate the impact of contracting out on overall cost‐effectiveness of public service delivery. We conclude that generalization of effects from contracting out should be made with caution and are likely to depend, among other things, on the transaction costs characteristics of the service, the market situation and the institutional/regulatory setting.
Service Users with Experience of Poverty as Institutional Entrepreneurs in Public Services in Belgium: An Institutional Theory Perspective on Policy Implementation
Authors: De Corte Joris , Roose Rudi , Bradt Lieve , Roets Griet
Published: March 2017

In this article, we report on a qualitative and interpretative research project in which we gained in‐depth knowledge about dynamics in ten federal public policy units in Belgium where a service user with experience of poverty was employed. Starting from an institutional theory perspective, it was argued that these service users with experience of poverty can possibly feature as institutional entrepreneurs or agents of change who initiate a critical reflection in the mindset of fellow social administrators about taken‐for‐granted practices, routines and rationales. In order to fulfill this ambition, we equally stressed that service users with experience of poverty should be able to perform two other roles as well: to provide direct support to citizens, especially those living in poverty during their contacts with a public policy unit, and to formulate concrete propositions to change some of the policy units' internal procedures. Our research findings reveal that these two roles provide a necessary breeding ground for further interaction and (in)formal dialogue between service users with experience of poverty and fellow social administrators about the quality and accessibility of service delivery. However, installing this shared responsibility proves to be a valuable but also gradual process, and we argue that it is therefore undesirable when service users with experience of poverty act as so‐called ‘heroes’ in changing these taken‐for‐granted institutional practices, routines and rationales.
Noninvasive fetal genotyping of paternally inherited alleles using targeted massively parallel sequencing in parentage testing cases
Authors: Yang Donggui , Liang Hao , Gao Yu , Lin Shaobin , He Zhiming , Gao Jun , Sun Hongyu , Li Qing , Ma Xiaoyan , Ou Xueling
Published: March 2017

BACKGROUND

Researchers have sought to develop a noninvasive protocol for paternity analysis that uses fetal cell‐free DNA (cfDNA) in maternal plasma. Massively parallel sequencing (MPS) is expected to overcome this challenge because it enables the analysis of millions of DNA molecules at a single‐base resolution.

STUDY DESIGN AND METHODS

Seven women were involved in prenatal paternity testing cases. Before conventional invasive procedures, cfDNA was isolated from maternal plasma. Fetal tissues were then collected, as were blood samples from the alleged fathers. A custom array was designed that targeted 1497 regions containing single‐nucleotide polymorphisms. These regions were massively parallel sequenced.

RESULTS

In these seven cases, the mean nonmaternal allele fractions in maternal plasma ranged from 3.22% to 6.17%. Setting the allele fraction cutoff of 2.5%, 300 to 491 loci were considered informative for paternal origin and no genetic incompatibilities with the alleged fathers were found. These results were concordant with those of conventional short tandem repeat genotyping. Validation results performed using fetal samples showed that sequencing noise was completely filtered out, and 78.35% to 99.19% of the paternal alleles were accurately genotyped. The fetal cfDNA concentrations ranged from 7.12% to 13.81%, and the overall sequencing error rates ranged from 0.40% to 0.93%.

CONCLUSION

In our study, we evaluate a straightforward method that can be used to identify paternal alleles based on analyses of paternal alleles and sequencing errors in maternal plasma. Our results support the notion that an MPS‐based method could be utilized in noninvasive fetal genotyping and prenatal paternity analyses.
Glyphosate resistance in common ragweed (Ambrosia artemisiifoliaL.) from Mississippi, USA
Authors: Nandula Vijay K. , Tehranchian Parsa , Bond Jason A. , Norsworthy Jason K. , Eubank Thomas W.
Published: March 2017

Glyphosate is one of the most commonly used broad‐spectrum herbicides over the last 40 years. Due to the widespread adoption of glyphosate‐resistant (GR) crop technology, especially corn, cotton and soybean, several weed species have evolved resistance to this herbicide. Research was conducted to confirm and characterize the magnitude and mechanism of glyphosate resistance in two GR common ragweed (
A

mbrosia artemisiifolia L.) biotypes from Mississippi, USA. A glyphosate‐susceptible (GS) biotype was included for comparison. The effective glyphosate dose to reduce the growth of the treated plants by 50% for the GR1, GR2 and GS biotypes was 0.58, 0.46 and 0.11 kg ae ha−1, respectively, indicating that the level of resistance was five and fourfold that of the GS biotype for GR1 and GR2, respectively. Studies using 14
C‐glyphosate have not indicated any difference in its absorption between the biotypes, but the GR1 and GR2 biotypes translocated more 14
C‐glyphosate, compared to the GS biotype. This difference in translocation within resistant biotypes is unique. There was no amino acid substitution at codon 106 that was detected by the 5‐enolpyruvylshikimate‐3‐phosphate synthase gene sequence analysis of the resistant and susceptible biotypes. Therefore, the mechanism of resistance to glyphosate in common ragweed biotypes from Mississippi is not related to a target site mutation or reduced absorption and/or translocation of glyphosate.
An Analysis of Preschool Teachers’ Sense of Efficacy: A Case of TRNC
Authors: Toran Mehmet
Published: March 2017

Determining the factors that affect teachers' competences has a decisive role in revealing the quality of teaching process. In this context, it is important to identify professional variables affecting the self-efficacy of preschool teachers. For this reason, it is aimed to investigate which professional variables influence preschool teachers' sense of efficacy. In the research, a descriptive research model was adopted. The working group of the study is composed of 191 preschool teachers participating in public nurseries and kindergartens in the TRNC, and also those participating to the research as a volunteer. The Professional Information Form and the Teacher’s Sense of Efficacy Scale were used as data collection tools in the study. Statistical analyses suitable for the analysis of the data were applied by applying the normality tests to the collected data. According to the findings obtained from the analysis made, except for the school type the preschool teachers graduated and the number of children, factors such as the graduated department, the place of residence, the duration of professional experience, the economic competence, and the educational environment were found to affect the self-efficacy of preschool teachers. As a result, it can be said that preschool teachers' self-efficacy is influenced by professional variables.
An Analytical Treatment of Buckling and Instability of Tensile Armors in Flexible Pipes
Authors: Sævik Svein , Thorsen Mats J.
Published: March 2017

The present paper addresses aspects related to local buckling and instability of tensile armors in flexible pipes. Analytical models for evaluating the tensile armor buckling capacity in both transverse (radial and lateral) directions are presented based on formulating the linearized differential equation describing transverse stability of the thin curved wire assuming no friction. Then analytical models for the ultimate capacity of the outer sheath and antibuckling tape are formulated and a combined criterion for radial instability is proposed based on considering radial buckling of the tensile armor, wire yield failure, and the ultimate capacity of the outer sheath and tape. Thereafter, a study is performed comparing the proposed models with test data and alternative models available in the literature.
Draft Genome Sequence of Lactobacillus plantarum MPL16, a Wakame-Utilizing Immunobiotic Strain Isolated from Swine Feces
Authors: Villena Julio , Saavedra Lucila , Hebert Elvira Maria , Suda Yoshihito , Masumizu Yuki , Albarracin Leonardo , Clua Patricia , Ikeda-Ohtsubo Wakako , Kitazawa Haruki
Published: March 2017

The genome of the immunomodulatory
Lactobacillus plantarum
MPL16, a strain able to ferment wakame (
Undaria pinnatifida
), is described here. The reads were assembled into contigs with a total size 3,278,495 bp. The genome information will be useful for further specific genetic studies of this strain that evaluate its immunomodulatory and biotechnological properties.
Complete Genome Sequence of a Wild-Type Measles Virus Isolated during a 2016 Winter Outbreak in a Refugee Settlement in Calais, France
Authors: Dina Julia , Hamel Justine , Antona Denise , Vabret Astrid
Published: March 2017

Measles outbreaks are regularly reported in European countries despite efforts to improve vaccination coverage. In January 2016, an outbreak occurred in a refugee settlement in Calais, France. We report here the complete genome sequence of a wild-type measles virus isolated from a health care worker (MVi/Calais. FRA/01.16) infected during this outbreak.
Draft Genome Sequence of Agrococcus baldri Strain Marseille-P2731
Authors: Afouda Pamela , Dubourg Gregory , Labas Noemie , Raoult Didier , Fournier Pierre-Edouard
Published: March 2017

Agrococcus baldri
strain Marseille-P2731 was isolated from a Siberian permafrost specimen dated around 10 million years. The 3,021,022-bp genome of strain Marseille-P2731, with a 71.82% G+C content, includes 2,844 protein-coding genes, 72 toxin/antitoxin modules, nine bacteriocin-encoding genes, and 1,266 genes associated with mobilome.
Draft Genome Sequence of a Novel
Coriobacteriaceae
sp. Strain, EMTCatB1, Reconstructed from the Metagenome of a Thermophilic Electromethanogenic Biocathode
Authors: Kobayashi Hajime , Fu Qian , Maeda Haruo , Sato Kozo
Published: March 2017

A draft genome of
Coriobacteriaceae
sp. strain EMTCatB1 was determined through taxonomic binning of a metagenome of a thermophilic biocathode actively catalyzing electromethanogenesis. This genome will provide information about the biocathode ecosystem, as well as the natural diversity of the
Coriobacteriaceae
family.
Whole-Genome Shotgun Sequencing of Cephalosporin-Resistant Salmonella enterica Serovar Typhi
Authors: Rodrigues Camilla , Kapil Arti , Sharma Anita , Devanga Ragupathi Naveen Kumar , Inbanathan Francis Yesurajan , Veeraraghavan Balaji , Kang Gagandeep
Published: March 2017

Typhoid is one of the leading causes of mortality in developing countries. Here, we report the draft genome sequences of four
Salmonella enterica
serovar Typhi strains isolated from bloodstream infections in a tertiary care hospital. The sequence data indicate genomes of ~4.5 Mb for all isolates, with one plasmid in each.
Complete Genome Sequence of Lactobacillus jensenii Strain SNUV360, a Probiotic for Treatment of Bacterial Vaginosis Isolated from the Vagina of a Healthy Korean Woman
Authors: Lee Sunghee , You Hyun Ju , Kwon Bomi , Ko GwangPyo
Published: March 2017

Lactobacillus jensenii
SNUV360 is a potential probiotic strain that shows antimicrobial activity for the treatment of bacterial vaginosis. Here, we present the complete genomic sequence of
L. jensenii
SNUV360, isolated from a vaginal sample from a healthy Korean woman. Analysis of the sequence may provide insight into its functional activity.
Draft Genome Sequence of a Multidrug-Resistant Nosocomial Serratia marcescens Strain That Persisted in a Hospital in Kemerovo, Russian Federation
Authors: Azarov Daniil , Goncharov Artemiy , Karaseva Alena , Brodina Tatyana , Lebedeva Ekaterina , Taranenko Irina , Feting Anna , Bakaev Michael , Brusina Elena , Zueva Lyudmila
Published: March 2017

Serratia marcescens
is a frequent cause of health care-associated infections and has led to multiple outbreaks. Here, we report the draft genome of a multidrug-resistant
S. marcescens
strain 189 which was isolated in 2012 as a predominant clone in a neonatal hospital in Kemerovo.
Necrotrophic Mycoparasites and Their Genomes
Authors: Karlsson Magnus , Atanasova Lea , Jensen Dan Funck , Zeilinger Susanne
Published: March 2017

Mycoparasitism is a lifestyle where one fungus establishes parasitic interactions with other fungi. Species of the genus
Trichoderma
together with
Clonostachys rosea
are among the most studied fungal mycoparasites. They have wide host ranges comprising several plant pathogens and are used for biological control of plant diseases.
Trichoderma
as well as
C. rosea
mycoparasites efficiently overgrow and kill their fungal prey by using infection structures and by applying lytic enzymes and toxic metabolites. Most of our knowledge on the putative signals and signaling pathways involved in prey recognition and activation of the mycoparasitic response is derived from studies with
Trichoderma
. These fungi rely on G-protein signaling, the cAMP pathway, and mitogen-activated protein kinase cascades during growth and development as well as during mycoparasitism. The signals being recognized by the mycoparasite may include surface molecules and surface properties as well as secondary metabolites and other small molecules released from the prey. Their exact nature, however, remains elusive so far. Recent genomics-based studies of mycoparasitic fungi of the order
Hypocreales
, i.e.,
Trichoderma
species,
C. rosea, Tolypocladium ophioglossoides
, and
Escovopsis weberi
, revealed not only several gene families with a mycoparasitism-related expansion of gene paralogue numbers, but also distinct differences between the different mycoparasites. We use this information to illustrate the biological principles and molecular basis of necrotrophic mycoparasitism and compare the mycoparasitic strategies of
Trichoderma
as a “model” mycoparasite with the behavior and special features of
C. rosea, T. ophioglossoides
, and
E. weberi
.
Miliary Tuberculosis
Authors: Sharma Surendra K. , Mohan Alladi
Published: March 2017

Miliary tuberculosis (TB) results from a massive lymphohematogenous dissemination of
Mycobacterium tuberculosis
bacilli and is characterized by tiny tubercles evident on gross pathology resembling millet seeds in size and appearance. The global HIV/AIDS pandemic and widespread use of immunosuppressive drugs and biologicals have altered the epidemiology of miliary TB. Considered to be predominantly a disease of infants and children in the pre-antibiotic era, miliary TB is increasingly being encountered in adults as well. The clinical manifestations of miliary TB are protean and nonspecific. Atypical clinical presentation often delays the diagnosis. Clinicians, therefore, should have a low threshold for suspecting miliary TB. Focused, systematic physical examination helps in identifying the organ system(s) involved, particularly early in TB meningitis, as this has therapeutic significance. Fundus examination for detecting choroid tubercles offers a valuable clinical clue for early diagnosis, as their presence is pathognomonic of miliary TB. Imaging modalities help in recognizing the miliary pattern, defining the extent of organ system involvement. Examination of sputum, body fluids, image-guided fine-needle aspiration cytology or biopsy from various organ sites, needle biopsy of the liver, bone marrow aspiration, and biopsy should be done to confirm the diagnosis. Cytopathological, histopathological, and molecular testing (e.g., Xpert MTB/RIF and line probe assay), mycobacterial culture, and drug susceptibility testing must be carried out as appropriate and feasible. Miliary TB is uniformly fatal if untreated; therefore, early initiation of specific anti-TB treatment can be lifesaving. Monitoring for complications, such as acute kidney injury, air leak syndromes, acute respiratory distress syndrome, adverse drug reactions such as drug-induced liver injury, and drug-drug interactions (especially in patients coinfected with HIV/AIDS), is warranted.
Flagellar Synchronization Is a Simple Alternative to Cell Cycle Synchronization for Ciliary and Flagellar Studies
Authors: Dutta Soumita , Avasthi Prachee
Published: March 2017

Cilia and flagella are highly conserved antenna-like organelles that found in nearly all mammalian cell types. They perform sensory and motile functions contributing to numerous physiological and developmental processes. Defects in their assembly and function are implicated in a wide range of human diseases ranging from retinal degeneration to cancer.
Chlamydomonas reinhardtii
is an algal model system for studying mammalian cilium formation and function. Here, we report a simple synchronization method that allows detection of small changes in ciliary length by minimizing variability in the population. We find that this method alters the key relationship between cell size and the amount of protein accumulated for flagellar growth. This provides a rapid alternative to traditional methods of cell synchronization for uncovering novel regulators of cilia.
Cooperation of Adhesin Alleles in
Salmonella
-Host Tropism
Authors: De Masi Leon , Yue Min , Hu Changmin , Rakov Alexey V. , Rankin Shelley C. , Schifferli Dieter M.
Published: March 2017

Salmonella enterica
remains a leading foodborne bacterial pathogen in the United States; infected livestock serve often as the source of contaminated food products. A study estimated that over a billion
Salmonella
gastroenteritis cases and up to 33 million typhoid cases occur annually worldwide, with 3.5 million deaths. Although many
Salmonella
strains with a broad host range present preferential associations with certain host species, it is not clear what determines the various levels of host adaptation. Here, causal properties of host associations were determined with allelic variants of three colonization factors of
S. enterica
serovar Newport, a most frequent zoonotic serovar. This is the first study that related not only individual but also a small group of host-associated gene variants with functional properties that cooperate to determine the level of host-adapted virulence. The detected associations should help to identify sources of
Salmonella
infections in both humans and animals.
Prevalence and Factors Associated with the Use of Acupuncture and Chinese Medicine: Results of a Nationally Representative Survey of 17161 Australian Women
Authors: Yang Lu , Adams Jon , Sibbritt David
Published: March 2017

Background

Traditional Chinese Medicine has considerable public support in Australia and elsewhere around the world; the literature suggests Chinese medicine (CM) and acupuncture are particularly popular.

Aim

To examine factors associated with CM/acupuncture use among young/middle-aged Australian women.

Methods

This research formed part of the Australian Longitudinal Study on Women's Health (ALSWH), a population-based cohort study. Data were obtained from the ‘young’ (34–39 years; n=8010) and ‘middle-aged’ (62–67 years; n=9151) ALSWH cohorts, who completed survey 6 (in 2012) and survey 7 (in 2013), respectively. Outcome measures included use of CM and visits to an acupuncturist in the previous 12 months. Predictive factors included demographic characteristics, and measures of health status (diagnosed chronic medical conditions) and health service utilisation. Statistical analyses included bivariate χ2 tests, two proportions Z-tests and backward stepwise multiple logistic regression modelling.

Results

In total, 9.5% and 6.2% of women in the young and middle-aged cohorts, respectively, had consulted an acupuncturist, and 5.7% and 4.0%, respectively, had used CM. Young women with low iron levels and/or endometriosis were more likely to use CM and/or acupuncture. Middle-aged women with low iron levels and/or chronic fatigue syndrome (CFS) were more likely to use CM, while middle-aged women with arthritis and/or CFS were more likely to use acupuncture.

Conclusions

Women with chronic conditions (including arthritis, low iron, CFS and endometriosis) were associated with higher odds of CM/acupuncture use. There is a need for further research to examine the potential benefits of CM/acupuncture for these chronic illnesses.
Rheumatic fever with severe carditis: still prevalent in the South West Pacific
Authors: Nandra Taran Kaur , Wilson Nigel J , Artrip John , Pagis Bruno
Published: March 2017

Rheumatic heart disease (RHD) has a worldwide prevalence of 33 million cases and 270 000 deaths annually, making it the most common acquired heart disease in the world. There is a disparate global burden in developing countries. This case report aims to address the minimal RHD coverage by the international medical community. A Tahitian boy aged 10 years was diagnosed with advanced heart failure secondary to RHD at a local clinic. Previous, subtle symptoms of changes in handwriting and months of fever had gone unrecognised. Following a rapid referral to the nearest tertiary centre in New Zealand, urgent cardiac surgery took place. He returned home facing lifelong anticoagulation. This case highlights the RHD burden in Oceania, the limited access to paediatric cardiac services in countries where the RHD burden is greatest and the need for improved awareness of RHD by healthcare professionals, and the general public, in endemic areas.
Clinical characteristics associated with diagnostic delay of pulmonary embolism in primary care: a retrospective observational study
Authors: Hendriksen Janneke M T , Koster-van Ree Marleen , Morgenstern Marcus J , Oudega Ruud , Schutgens Roger E G , Moons Karel G M , Geersing Geert-Jan
Published: March 2017

Objectives

To evaluate the extent of delay in the diagnosis of pulmonary embolism (PE) in primary care, and to identify determinants that are associated with such diagnostic delay.

Design

Retrospective observational study.

Setting

6 primary care practices across the Netherlands.

Participants

Data from patients with an objectively confirmed diagnosis of PE (International Classification of Primary Care (ICPC) code K93) up to June 2015 were extracted from the electronic medical records. For all these PE events, we reviewed all consultations with their general practitioner (GP) and scored any signs and symptoms that could be attributed to PE in the 3 months prior to the event. Also, we documented actual comorbidity and the diagnosis considered initially.

Primary and secondary outcome measures

Delay was defined as a time gap of >7 days between the first potentially PE-related contact with the GP and the final PE diagnosis. Multivariable logistic regression analysis was performed to identify independent determinants for delay.

Results

In total, 180 incident PE cases were identified, of whom 128 patients had 1 or more potential PE-related contact with their GP within the 3 months prior to the diagnosis. Based on our definition, in 33 of these patients (26%), diagnostic delay was observed. Older age (age >75 years; OR 5.1 (95% CI 1.8 to 14.1)) and the absence of chest symptoms (ie, chest pain or pain on inspiration; OR 5.4 (95% CI 1.9 to 15.2)) were independent determinants for diagnostic delay. A respiratory tract infection prior to the PE diagnosis was reported in 13% of cases without delay, and in 33% of patients with delay (p=0.008).

Conclusions

Diagnostic delay of more than 7 days in the diagnosis of PE is common in primary care, especially in the elderly, and if chest symptoms, like pain on inspiration, are absent.
What proportion of patients with psychosis is willing to take part in research? A mental health electronic case register analysis
Authors: Patel Rashmi , Oduola Sherifat , Callard Felicity , Wykes Til , Broadbent Matthew , Stewart Robert , Craig Thomas K J , McGuire Philip
Published: March 2017

Objective

The proportion of people with mental health disorders who participate in clinical research studies is much smaller than for those with physical health disorders. It is sometimes assumed that this reflects an unwillingness to volunteer for mental health research studies. We examined this issue in a large sample of patients with psychosis.

Design

Cross-sectional study.

Setting

Anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM).

Participants

5787 adults diagnosed with a psychotic disorder.

Exposure

Whether approached prior to 1 September 2014 for consent to be approached about research participation.

Main outcome measures

Number of days spent in a psychiatric hospital, whether admitted to hospital compulsorily, and total score on the Health of the Nation Outcome Scale (HoNOS) between 1 September 2014 and 28 February 2015 with patient factors (age, gender, ethnicity, marital status and diagnosis) and treating clinical service as covariates.

Results

1187 patients (20.5% of the total sample) had been approached about research participation. Of those who were approached, 773 (65.1%) agreed to be contacted in future by researchers. Patients who had been approached had 2.3 fewer inpatient days (95% CI −4.4 to −0.3, p=0.03), were less likely to have had a compulsory admission (OR 0.65, 95% CI 0.50 to 0.84, p=0.001) and had a better HoNOS score (β coefficient −0.9, 95% CI −1.5 to −0.4, p=0.001) than those who had not. Among patients who were approached, there was no significant difference in clinical outcomes between those agreed to research contact and those who did not.

Conclusions

About two-thirds of patients with psychotic disorders were willing to be contacted about participation in research. The patients who were approached had better clinical outcomes than those who were not, suggesting that clinicians were more likely to approach patients who were less unwell.
Simplified Mortality Score for the Intensive Care Unit (SMS-ICU): protocol for the development and validation of a bedside clinical prediction rule
Authors: Granholm Anders , Perner Anders , Krag Mette , Hjortrup Peter Buhl , Haase Nicolai , Holst Lars Broksø , Marker Søren , Collet Marie Oxenbøll , Jensen Aksel Karl Georg , Møller Morten Hylander
Published: March 2017

Introduction

Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU).

Methods and analysis

During the first phase of the study, we will develop and internally validate a clinical prediction rule that predicts 90-day mortality on ICU admission. The development sample will comprise 4247 adult critically ill patients acutely admitted to the ICU, enrolled in 5 contemporary high-quality ICU studies/trials. The score will be developed using binary logistic regression analysis with backward stepwise elimination of candidate variables, and subsequently be converted into a point-based clinical prediction rule. The general performance, discrimination and calibration of the score will be evaluated, and the score will be internally validated using bootstrapping. During the second phase of the study, the score will be externally validated in a fully independent sample consisting of 3350 patients included in the ongoing Stress Ulcer Prophylaxis in the Intensive Care Unit trial. We will compare the performance of the SMS-ICU to that of existing scores.

Ethics and dissemination

We will use data from patients enrolled in studies/trials already approved by the relevant ethical committees and this study requires no further permissions. The results will be reported in accordance with the Transparent Reporting of multivariate prediction models for Individual Prognosis Or Diagnosis (TRIPOD) statement, and submitted to a peer-reviewed journal.
Increased household financial strain, the Great Recession and child health—findings from the UK Millennium Cohort Study
Authors: McKenna Caoimhe , Law Catherine , Pearce Anna
Published: March 2017

Background

There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the ‘Great Recession’ many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health.

Methods

We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the ‘Great Recession’. Three measures of increased FS were defined; ‘became income poor’ (self-reported household income dropped below the ‘poverty line’ between T1 and T2); ‘developed difficulty managing’ (parental report of being ‘financially comfortable’ at T1 and finding it ‘difficult to manage’ at T2); ‘felt worse off’ (parental report of feeling financially ‘worse off’ at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2.

Results

Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line.

Conclusions

FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor.
Improving reconciliation following medical injury: a qualitative study of responses to patient safety incidents in New Zealand
Authors: Moore Jennifer , Mello Michelle M
Published: March 2017

Background

Despite the investment in exploring patient-centred alternatives to medical malpractice in New Zealand (NZ), the UK and the USA, patients' experiences with these processes are not well understood. We sought to explore factors that facilitate and impede reconciliation following patient safety incidents and identify recommendations for strengthening institution-led alternatives to malpractice litigation.

Methods

We conducted semistructured interviews with 62 patients injured by healthcare in NZ, administrators of 12 public hospitals, 5 lawyers specialising in Accident Compensation Corporation (ACC) claims and 3 ACC staff. NZ was chosen as the research site because it has replaced medical malpractice litigation with a no-fault scheme. Thematic analysis was used to identify key themes from interview transcripts.

Results

Interview responses converged on five elements of the reconciliation process that were important: (1) ask, rather than assume, what patients and families need from the process and recognise that, for many patients, being heard is important and should occur early in the reconciliation process; (2) support timely, sincere, culturally appropriate and meaningful apologies, avoiding forced or tokenistic quasi-apologies; (3) choose words that promote reconciliation; (4) include the people who patients want involved in the reconciliation discussion, including practitioners involved in the harm event; and (5) engage the support of lawyers and patient relations staff as appropriate.

Discussion

Policymakers and healthcare institutions are keenly interested in non-litigation approaches to resolving malpractice incidents. Interviewing participants involved in patient safety incident reconciliation processes suggests that healthcare institutions should not view apology as a substitute for other remedial actions; use flexible guidelines that distil best-practice principles, ensuring that steps are not missed, while not prescribing a ‘one size fits all’ communication approach.
Stability analysis and control models for rumor spreading in online social networks
Authors: Jiang Ping , Yan Xiangbin
Published: March 2017

This paper establishes a novel Susceptible-Infected-Removed (SIR) rumor spreading model for online social networks (OSNs). The model utilizes the node degree to describe the dynamic changes of the number of rumor spreaders and it can be regarded as an extension of the traditional SIR model. Stability analysis of the model reveals that the spreader in social networks has a basic reproduction number. If the basic reproduction number is less than 1, then rumors will disappear. Otherwise, rumors will persist. According to this result, we can predict the trend of rumor spreading. Then we propose an immune-structure SIR model to explore the control method of rumor spreading. Stability analysis and numerical simulation of the model indicate that immunizing susceptible individual is an effective method to control rumors. Further, the immune-structure model explains that the network structure decides the choice of immune methods. Our findings offer some new insights to control the spread of rumors on OSNs.