bluuebunny/crossref_metadata_2025 huggingface dataset:
Melatonin ameliorates Angiotensin II‐induced vascular endothelial damage via its antioxidative properties
Authors: Nakao Tomoko , Morita Hiroyuki , Maemura Koji , Amiya Eisuke , Inajima Tsukasa , Saito Yuichiro , Watanabe Masafumi , Manabe Ichiro , Kurabayashi Masahiko , Nagai Ryozo , Komuro Issei
Published: June 2013

Melatonin is well known to have a beneficial effect on the cardiovascular system, but it remains to be elucidated whether melatonin has a therapeutic effect on the vascular damage induced by the potential vasoactive substance angiotensin II (Ang II). In this study, the effects of melatonin on Ang II‐induced vascular endothelial damage were investigated. In cultured vascular endothelial cells, Ang II stimulation increased ROS generation and inhibited eNOS phosphorylation (Ser1177), both of which were clearly restored by pretreatment with melatonin. The translocation of p47phox subunit of NADPH oxidase from the cytosol to plasma membrane was promoted in Ang II‐treated vascular endothelial cells, which was canceled by melatonin pretreatment. In Ang II‐infused rats, increased ROS generation in the aortic wall and impaired endothelial function of the aortic ring were observed, which were rescued by coadministration of melatonin. In vasculature, melatonin receptor agonist ramelteon had the antioxidative effect in the same manner as melatonin by itself. These findings suggest that melatonin directly ameliorates Ang II‐induced vascular endothelial damage partly via its antioxidative properties, providing with us the potential rationale for clinical application of melatonin to the prevention from cardiovascular diseases.
Melatonin inhibits visfatin‐induced inducible nitric oxide synthase expression and nitric oxide production in macrophages
Authors: Kang Young‐Soon , Kang Yong‐Gyu , Park Hyun‐Joo , Wee Hee‐Jun , Jang Hye‐Ock , Bae Moon‐Kyoung , Bae Soo‐Kyung
Published: June 2013

Aberrant expression of inducible nitric oxide synthase (iNOS) in macrophages, which has been reported to be suppressed by melatonin, has an important contribution in the development of pathological inflammation. Visfatin, an adipokine, regulates the expression of various inflammatory factors, leading to inflammation; however, the influence of visfatin on iNOS‐driven processes in macrophages is unclear. Here, we report the assessment of the role of visfatin in the regulation of iNOS gene expression in macrophages. Our data show that the levels of iNOS protein in peritoneal macrophages as well as nitric oxide (NO) in blood plasma were significantly lower after lipopolysaccharide treatment in visfatin+/− mice than those in the WT mice. In addition, visfatin increases iNOS mRNA and protein levels in RAW 264.7 cells, along with increasing production of NO. The enhancement of iNOS expression was prevented by treating the cells with inhibitors of the Janus kinase 2/signal transducers and activators of transcription 3 (JAK2/STAT3), nuclear factor (NF)‐κB, extracellular signal–regulated kinase 1/2, and c‐Jun N‐terminal kinase pathways. Our results also show that visfatin‐induced iNOS expression and NO production were significantly inhibited by melatonin, an effect that was closely associated with a reduction in phosphorylated JAK2/STAT3 levels and with the inhibition of p65 translocation into nucleus. In conclusion, our data show, for the first time, that melatonin suppresses visfatin‐induced iNOS upregulation in macrophages by inhibiting the STAT3 and NF‐κB pathways. Moreover, our data suggest that melatonin could be therapeutically useful for attenuating the development of visfatin–iNOS axis‐associated diseases.
Personal beliefs, learned resourcefulness, and adaptive functioning in depressed adults
Authors: Lai C. Y. , Zauszniewski J. A. , Tang T‐C. , Hou S‐Y. , Su S‐F. , Lai P. Y.
Published: June 2013

Accessible summary

Learned resourcefulness and personal beliefs are significant predictors of adaptive functioning.

The mediating effect of personal beliefs on the relationship between learned resourcefulness and adaptive functioning was validated in adults with depression.

The findings from this study may provide the basis for developing a useful nursing intervention constituting resourcefulness skills with positive personal beliefs to help patients with depression improve their ability to function well in their daily activities.

Research has shown that patients with depression have difficulty with performing daily tasks and meeting their own personal care needs. According to Beck's cognitive theory of depression, such deficits in adaptive functioning are affected by disturbances in specific personal beliefs that reflect the process of regulating cognitions. Rosenbaum's learned resourcefulness theory proposed that adaptive functioning is influenced by learned resourcefulness, while learned resourcefulness is associated with the process regulating cognitions. This study aims to test the mediating effect of personal beliefs on the relationship between resourcefulness and adaptive functioning. The study involved a cross‐sectional design. Participants consisted of 187 adults with depression in southern Taiwan. The data were collected through four instruments: Cognitive Triad Inventory, Self‐Control Schedule, modified Community Living Skills Scale, and a demographic questionnaire. Both resourcefulness and personal beliefs were significant predictors of adaptive functioning, and personal beliefs mediated the effect of learned resourcefulness on the adaptive functioning of the adults with depression. The results validate the role played by personal beliefs in effecting learned resourcefulness and adaptive functioning among adults with depression and provide direction for designing nursing interventions that consider personal beliefs when teaching resourcefulness skills to adults with depression.
Perceptions of parents and children regarding asthma management responsibilities
Authors: Ekim Ayfer , Ocakci Ayse Ferda
Published: June 2013

Purpose

The purpose of this study was to examine perceptions of children and parents regarding shared responsibilities for asthma management.

Design and Methods

The study included 72 children with asthma who were between the ages of 7 and 12 years and their parents. Asthma management responsibilities were assessed by the “Asthma Responsibility Questionnaire.”

Results

Disagreements occurred between parents and children on assuming responsibility. Children reported higher asthma management responsibility scores than reported by parents for them.

Practice Implications

It is important that nurses provide education and counseling to both children and their families to ensure that children take responsibility for disease management.
Commodity price shocks and inflation in a net oil‐importing economy
Authors: Misati Roseline Nyakerario , Nyamongo Esman Morekwa , Mwangi Isaac
Published: June 2013

The global economy experienced sharp spikes in food and oil prices in 2008–2009 and 2011 period. Oil prices and food price shocks are believed to have played a prominent role in the build‐up of persistent inflationary pressures in Kenya in the recent past. This study uses Granger causality and structural vector autoregressive (SVAR) methods to examine the dynamic linkages between commodity prices and both overall inflation and non‐food non‐fuel inflation. The study finds a significant role of oil and food prices in both measures of inflation. Specifically, the study reveals that food prices are more important than oil prices in explaining overall and non‐food non‐fuel inflation when both variables are considered in the same VAR framework. However, the effect of oil prices on inflation is more persistent than the effect of food prices. The paper also finds that the food and oil inflation effects have more significant influence on non‐food non‐fuel inflation than money supply growth rate and that oil price shocks immediately depreciate the exchange rate. Based on the results, the study recommends adoption of measures to reduce oil dependence, usage of targeted intervention rather than tax waivers during crisis periods, strengthening of supply response measures and a neutral monetary policy stance in the face of shocks unless they get entrenched in the non‐food non‐fuel inflation.
Role of co‐infection by Pectobacterium and Verticillium dahliae in the development of early dying and aerial stem rot of Russet Burbank potato
Authors: Dung J. K. S. , Johnson D. A. , Schroeder B. K.
Published: June 2013

Potato early dying (PED) is a disease complex primarily caused by the fungus Verticillium dahliae. Pectolytic bacteria in the genus Pectobacterium can also cause PED symptoms as well as aerial stem rot (ASR) of potato. Both pathogens can be present in potato production settings, but it is not entirely clear if additive or synergistic interactions occur during co‐infection of potato. The objective of this study was to determine if co‐infection by V. dahliae and Pectobacterium results in greater PED or ASR severity using a greenhouse assay and quantitative real‐time PCR to quantify pathogen levels in planta. PED symptoms caused by Pectobacterium carotovorum subsp. carotovorum isolate Ec101 or V. dahliae isolate 653 alone included wilt, chlorosis and senescence and were nearly indistinguishable. Pectobacterium wasabiae isolate PwO405 caused ASR symptoms including water‐soaked lesions and necrosis. Greater Pectobacterium levels were detected in plants inoculated with PwO405 compared to Ec101, suggesting that ASR can result in high Pectobacterium populations in potato stems. Significant additive or synergistic effects were not observed following co‐inoculation with these strains of V. dahliae and Pectobacterium. However, infection coefficients of V. dahliae and Ec101 were higher and premature senescence was greater in plants co‐inoculated with both pathogens compared to either pathogen alone in both trials, and V. dahliae levels were greater in basal stems of plants co‐inoculated with either Pectobacterium isolate. Overall, these results indicate that although co‐infection by Pectobacterium and V. dahliae does not always result in significant additive or synergistic interactions in potato, co‐infection can increase PED severity.
Efficient Bayesian Multivariate Surface Regression
Authors: Li Feng , Villani Mattias
Published: June 2013

Methods for choosing a fixed set of knot locations in additive spline models are fairly well established in the statistical literature. The curse of dimensionality makes it nontrivial to extend these methods to nonadditive surface models, especially when there are more than a couple of covariates. We propose a multivariate Gaussian surface regression model that combines both additive splines and interactive splines, and a highly efficient Markov chain Monte Carlo algorithm that updates all the knot locations jointly. We use shrinkage prior to avoid overfitting with different estimated shrinkage factors for the additive and surface part of the model, and also different shrinkage parameters for the different response variables. Simulated data and an application to firm leverage data show that the approach is computationally efficient, and that allowing for freely estimated knot locations can offer a substantial improvement in out‐of‐sample predictive performance.
How WM Load Influences Linguistic Processing in Adults: A Computational Model of Pronoun Interpretation in Discourse
Authors: van Rij Jacolien , van Rijn Hedderik , Hendriks Petra
Published: June 2013

This paper presents a study of the effect of working memory load on the interpretation of pronouns in different discourse contexts: stories with and without a topic shift. We discuss a computational model (in ACT‐R, Anderson, 2007) to explain how referring expressions are acquired and used. On the basis of simulations of this model, it is predicted that WM constraints only affect adults' pronoun resolution in stories with a topic shift, but not in stories without a topic shift. This latter prediction was tested in an experiment. The results of this experiment confirm that WM load reduces adults' sensitivity to discourse cues signaling a topic shift, thus influencing their interpretation of subsequent pronouns.
Long QT syndrome: beyond the causal mutation
Authors: Amin Ahmad S. , Pinto Yigal M. , Wilde Arthur A. M.
Published: June 2013

Abstract  Congenital long QT syndrome (LQTS) is caused by single autosomal‐dominant mutations in a gene encoding for a cardiac ion channel or an accessory ion channel subunit. These single mutations can cause life‐threatening arrhythmias and sudden death in heterozygous mutation carriers. This recognition has been the basis for world‐wide staggering numbers of subjects and families counselled for LQTS and treated based on finding (putative) disease‐causing mutations. However, prophylactic treatment of patients is greatly hampered by the growing awareness that simple carriership of a mutation often fails to predict clinical outcome: many carriers never develop clinically relevant disease while others are severely affected at a young age. It is still largely elusive what determines this large variability in disease severity, where even within one pedigree, an identical mutation can cause life‐threatening arrhythmias in some carriers while in other carriers no disease becomes clinically manifested. This suggests that additional factors modify the clinical manifestations of a particular disease‐causing mutation. In this article, potential demographic, environmental and genetic factors are reviewed, which, in conjunction with a mutation, may modify the phenotype in LQTS, and thereby determine, at least partially, the large variability in disease severity.
Application of Code Case 2605 for Fatigue Evaluation of Vessels Made in 2.25Cr-1Mo-0.25V Steels Slightly Into Creep Range
Authors: Tereda Susumu
Published: June 2013

The current Section VIII Division 2 of ASME code permits only the method based on experience with comparable equipment of paragraph 5.5.2.2 to be used for the exemption from fatigue analysis when the design allowable stress is taken in the time dependent temperature range and the specified minimum tensile strength is greater than 552 MPa. In the case of 2.25Cr-1Mo-0.25V steels, the allowable stress of new Div.2 is higher than that of the old Div.2. Therefore, there are no experiences with comparable equipment. Code Case 2605-1 provides rules for fatigue evaluation of 2.25Cr-1Mo-0.25V steels at temperatures greater than 371 °C and equal to or less than 454 °C. An inelastic analysis including the effect of creep is required to be performed for all pressure parts according to Code Case 2605-1. There are six and more types of nozzles in each hydro-processing reactor. The inelastic analyses shall be performed for all types of nozzles. The simplified screening method for fatigue analyses and the simplified fatigue analysis procedure need to be developed because it takes much time to perform inelastic analyses. This paper provides sample analysis results for various types of nozzles and clarifies issue with respect to implementation of Code Case 2605-1. Then, a proposal for simplification and modification of Option 1 and Option 2 fatigue evaluation methods for nozzles of Code Case 2605-1 are proposed from these investigations.
Design and Development of a Modular Medical Simulation Prototype for Pediatric Spinal Detethering Surgeries
Authors: Bailey Joshua , Nair Kalyani , Macuk Alyssa , Frank Christopher , Patel Ankit , Lesniak Matthew , Lesle Edna , Morris Martin , Lin M. D. Julian
Published: June 2013

Medical simulation is a developing field used in the education of medical students, doctors, residents, and many other medical professionals. Despite emerging simulation tools, little has been done to address surgeries in congenital patients, specifically with regards to the spinal cord. The objective of this project was to design, fabricate, and functionally evaluate a medical simulator to address the challenge of teaching the spinal detethering surgical procedure to neurosurgery residents. This simulator was designed to mimic anatomical and physiological characteristics of the lower lumbar region. Pressure sensors were used to quantify the forces that were applied to the spinal cord during the surgical procedure and a LabVIEW program was developed to monitor the pressure profile. The simulator was functionally evaluated by six residents, one fellow, one doctor, and two medical students. A conclusive, quantitative method for scoring these surgeries has not yet been developed, however, the residents and medical students were able to compare their procedures with those of more experienced doctors and fellows via qualitative methods. Future developments will include incorporating quantitative scoring methods as well as noise elimination hardware into the design.
Elastic Stress Distribution in Layered Spherical Shells With Gaps Caused by Internal Pressure
Authors: Xu Shugen , Chen Chao
Published: June 2013

An interlayer gap is inevitable in layered spherical shells. Therefore, the classic formulae for the monobloc spherical shell can no longer be used. In this paper, the formulae for the elastic stress calculation of layered spherical shells were proposed and the difference between the proposed formulae and ASME formulae was clarified. Interlayer gaps induce stress redistribution and stress discontinuity in the layered spherical shell. The hoop stress in the inner wall surface becomes higher than that in the monobloc spherical shell, and the stress in the outer wall surface is lower. Calculation results obtained from the proposed formulae were compared to those obtained by the finite element method (FEM) and ASME formulae. It was shown that the results from the proposed formulae are in accordance with finite element results.
Experimental and Analytical Studies on the Effect of Excessive Loading on Fatigue Crack Propagation in Piping Materials
Authors: Yamaguchi Yoshihito , Katsuyama Jinya , Onizawa Kunio , Li Yinsheng , Yagawa Genki
Published: June 2013

The seismic design review guide in Japan was revised in September 2006 to address the occurrence of a large earthquake beyond the design basis. In addition, Japanese nuclear power plants (NPPs) experienced multiple large earthquakes, such as Niigata-ken Chuetsu-Oki Earthquake in 2007 and the Great East Japan Earthquake in 2011. Therefore, it is very important to assess the structural integrity of reactor piping under such a large earthquake when a crack exists in the piping. In this work, crack growth behavior after excessive loading during the large-scale earthquake were experimentally and analytically evaluated for carbon steel and austenitic stainless steel. Some cyclic loading patterns with increasing and decreasing load amplitudes and maximum loads were applied to fatigue crack growth test specimens. From the results, the retardation of crack growth rate was clearly observed after excessive loading. In addition, the applicability to the retardation effect of the modified Wheeler model was confirmed. It is also concluded that the retardation effect has little influence on the failure probability due to seismic loading using probabilistic fracture mechanics (PFM) analyses with the modified Wheeler model.
Estimated in Vivo Postnatal Surface Growth Patterns of the Ovine Main Pulmonary Artery and Ascending Aorta
Authors: Fata Bahar , Gottlieb Danielle , Mayer John E. , Sacks Michael S.
Published: June 2013

Delineating the normal postnatal development of the pulmonary artery (PA) and ascending aorta (AA) can inform our understanding of congenital abnormalities, as well as pulmonary and systolic hypertension. We thus conducted the following study to delineate the PA and AA postnatal growth deformation characteristics in an ovine model. MR images were obtained from endoluminal surfaces of 11 animals whose ages ranged from 1.5 months/15.3 kg mass (very young) to 12 months/56.6 kg mass (adult). A bicubic Hermite finite element surface representation was developed for the each artery from each animal. Under the assumption that the relative locations of surface points were retained during growth, the individual animal surface fits were subsequently used to develop a method to estimate the time-evolving local effective surface growth (relative to the youngest measured animal) in the end-diastolic state. Results indicated that the spatial and temporal surface growth deformation patterns of both arteries, especially in the circumferential direction, were heterogeneous, leading to an increase in taper and increase in cross-sectional ellipticity of the PA. The longitudinal PA growth stretch of a large segment on the posterior wall reached 2.57 ± 0.078 (mean ± SD) at the adult stage. In contrast, the longitudinal growth of the AA was smaller and more uniform (1.80 ± 0.047). Interestingly, a region of the medial wall of both arteries where both arteries are in contact showed smaller circumferential growth stretches—specifically 1.12 ± 0.012 in the PA and 1.43 ± 0.071 in the AA at the adult stage. Overall, our results indicated that contact between the PA and AA resulted in increasing spatial heterogeneity in postnatal growth, with the PA demonstrating the greatest changes. Parametric studies using simplified geometric models of curved arteries during growth suggest that heterogeneous effective surface growth deformations must occur to account for the changes in measured arterial shapes during the postnatal growth period. This result suggests that these first results are a reasonable first-approximation to the actual effective growth patterns. Moreover, this study clearly underscores how functional growth of the PA and AA during postnatal maturation involves complex, local adaptations in tissue formation. Moreover, the present results will help to lay the basis for functional replacement by defining critical geometric metrics.
AKT Facilitates EGFR Trafficking and Degradation by Phosphorylating and Activating PIKfyve
Authors: Er Ekrem Emrah , Mendoza Michelle C. , Mackey Ashley M. , Rameh Lucia E. , Blenis John
Published: June 2013

Receptor tyrosine kinases limit their own activity by stimulating kinases that promote trafficking of the receptors to the lysosome.
The Griffithsin Dimer Is Required for High-Potency Inhibition of HIV-1: Evidence for Manipulation of the Structure of gp120 as Part of the Griffithsin Dimer Mechanism
Authors: Xue Jie , Hoorelbeke Bart , Kagiampakis Ioannis , Demeler Borries , Balzarini Jan , LiWang Patricia J.
Published: June 2013

Griffithsin (Grft) is a protein lectin derived from red algae that tightly binds the HIV envelope protein gp120 and effectively inhibits virus infection. This inhibition is due to the binding by Grft of high-mannose saccharides on the surface of gp120. Grft has been shown to be a tight dimer, but the role of the dimer in Grft's anti-HIV function has not been fully explored. To investigate the role of the Grft dimer in anti-HIV function, an obligate dimer of Grft was designed by expressing the protein with a peptide linker between the two subunits. This “Grft-linker-Grft” is a folded protein dimer, apparently nearly identical in structural properties to the wild-type protein. A “one-armed” obligate dimer was also designed (Grft-linker-Grft OneArm), with each of the three carbohydrate binding sites of one subunit mutated while the other subunit remained intact. While both constructed dimers retained the ability to bind gp120 and the viral surface, Grft-linker-Grft OneArm was 84- to 1,010-fold less able to inhibit HIV than wild-type Grft, while Grft-linker-Grft had near-wild-type antiviral potency. Furthermore, while the wild-type protein demonstrated the ability to alter the structure of gp120 by exposing the CD4 binding site, Grft-linker-Grft OneArm largely lost this ability. In experiments to investigate gp120 shedding, it was found that Grft has different effects on gp120 shedding for strains from subtype B and subtype C, and this might correlate with Grft function. Evidence is provided that the dimer form of Grft is critical to the function of this protein in HIV inhibition.
Klebsiella pneumoniae Sequence Type 11 from Companion Animals Bearing ArmA Methyltransferase, DHA-1 β-Lactamase, and QnrB4
Authors: Hidalgo Laura , Gutierrez Belen , Ovejero Cristina M. , Carrilero Laura , Matrat Stephanie , Saba Courage K. S. , Santos-Lopez Alfonso , Thomas-Lopez Daniel , Hoefer Andreas , Suarez Monica , Santurde Gloria , Martin-Espada Carmen , Gonzalez-Zorn Bruno
Published: June 2013

Seven
Klebsiella pneumoniae
isolates from dogs and cats in Spain were found to be highly resistant to aminoglycosides, and ArmA methyltransferase was responsible for this phenotype. All isolates were typed by multilocus sequence typing (MLST) as ST11, a human epidemic clone reported worldwide and associated with, among others, OXA-48 and NDM carbapenemases. In the seven strains,
armA
was borne by an IncR plasmid, pB1025, of 50 kb. The isolates were found to coproduce DHA-1 and SHV-11 β-lactamases, as well as the QnrB4 resistance determinant. This first report of the ArmA methyltransferase in pets illustrates their importance as a reservoir for human multidrug-resistant
K. pneumoniae
.
CTX-M-123, a Novel Hybrid of the CTX-M-1 and CTX-M-9 Group β-Lactamases Recovered from Escherichia coli Isolates in China
Authors: He Dandan , Partridge Sally R. , Shen Jianzhong , Zeng Zhenling , Liu Lanping , Rao Lili , Lv Luchao , Liu Jian-Hua
Published: June 2013

The chimeric
bla
CTX-M-123
gene was identified in two ceftazidime-resistant
Escherichia coli
isolates from animals in different Chinese provinces. Like other CTX-M-1/9 group hybrids (CTX-M-64 and CTX-M-132), the ends (amino acids 1 to 135 and 234 to 291) of CTX-M-123 match CTX-M-15 while the central part (122 to 241) matches CTX-M-14.
bla
CTX-M-123
is carried on related, but not identical, ∼90-kb IncI1 plasmids in the two isolates, and one isolate simultaneously carries the group 1
bla
CTX-M-55
gene on an additional IncI2 plasmid.
Epidemiology and Risk Factors for Isolation of Escherichia coli Producing CTX-M-Type Extended-Spectrum β-Lactamase in a Large U.S. Medical Center
Authors: Hayakawa Kayoko , Gattu Sureka , Marchaim Dror , Bhargava Ashish , Palla Mohan , Alshabani Khaled , Gudur Uma Mahesh , Pulluru Harish , Bathina Pradeep , Sundaragiri Pranathi Rao , Sarkar Moumita , Kakarlapudi Hari , Ramasamy Balaji , Nanjireddy Priyanka , Mohin Shah , Dasagi Meenakshi , Datla Satya , Kuchipudi Vamsi , Reddy Swetha , Shahani Shobha , Upputuri Vijaya , Marrey Satya , Gannamani Vedavyas , Madhanagopal Nandhini , Annangi Srinadh , Sudha Busani , Muppavarapu Kalyan Srinivas , Moshos Judy A. , Lephart Paul R. , Pogue Jason M. , Bush Karen , Kaye Keith S.
Published: June 2013

A case-case-control study was conducted to identify independent risk factors for recovery of
Escherichia coli
strains producing CTX-M-type extended-spectrum β-lactamases (CTX-M
E. coli
) within a large Southeastern Michigan medical center. Unique cases with isolation of ESBL-producing
E. coli
from February 2010 through July 2011 were analyzed by PCR for
bla
CTX-M
,
bla
TEM
, and
bla
SHV
genes. Patients with CTX-M
E. coli
were compared to patients with
E. coli
strains not producing CTX-M-type ESBLs (non-CTX-M
E. coli
) and uninfected controls. Of 575 patients with ESBL-producing
E. coli
, 491 (85.4%) isolates contained a CTX-M ESBL gene. A total of 319 (84.6%) patients with CTX-M
E. coli
(282 [74.8%] CTX-M-15 type) were compared to 58 (15.4%) non-CTX-M
E. coli
patients and to uninfected controls. Independent risk factors for CTX-M
E. coli
isolation compared to non-CTX-M
E. coli
included male gender, impaired consciousness, H2 blocker use, immunosuppression, and exposure to penicillins and/or trimethoprim-sulfamethoxazole. Compared to uninfected controls, independent risk factors for isolation of CTX-M
E. coli
included presence of a urinary catheter, previous urinary tract infection, exposure to oxyimino-cephalosporins, dependent functional status, non-home residence, and multiple comorbid conditions. Within 48 h of admission, community-acquired CTX-M
E. coli
(
n
= 51 [16%]) and non-CTX-M
E coli
(
n
= 11 [19%]) strains were isolated from patients with no recent health care contacts. CTX-M
E. coli
strains were more resistant to multiple antibiotics than non-CTX-M
E. coli
strains. CTX-M-encoding genes, especially
bla
CTX-M-15
type, represented the most common ESBL determinants from ESBL-producing
E. coli
, the majority of which were present upon admission. Septic patients with risk factors for isolation of CTX-M
E. coli
should be empirically treated with appropriate agents. Regional infection control efforts and judicious antibiotic use are needed to control the spread of these organisms.
Borrelia burgdorferi Linear Plasmid 28-3 Confers a Selective Advantage in an Experimental Mouse-Tick Infection Model
Authors: Dulebohn Daniel P. , Bestor Aaron , Rosa Patricia A.
Published: June 2013

Borrelia burgdorferi, the bacterium that causes Lyme disease, has a unique segmented genome consisting of numerous linear and circular plasmids and a linear chromosome. Many of these genetic elements have been found to encode factors critical forB. burgdorferito complete the infectious cycle. However, several plasmids remain poorly characterized, and their roles during infection withB. burgdorferihave not been elucidated. To more fully characterize the role of one of the four 28-kb linear plasmids, lp28-3, we generated strains specifically lacking lp28-3 and assayed the contribution of genes carried by lp28-3 toB. burgdorferiinfection. We found that lp28-3 does not carry any genes that are strictly required for infection of a mouse or tick and that lp28-3-deficient spirochetes are competent at causing a disseminated infection. Interestingly, spirochetes containing lp28-3 were at a selective advantage compared to lp28-3-deficient spirochetes when coinjected into a mouse, and this advantage was reflected in the population of spirochetes acquired by feeding ticks. Our data demonstrate that genes carried by lp28-3, although not essential, contribute to the fitness ofB. burgdorferiduring infection.
Induction of Rapid Cell Death by an Environmental Isolate of Legionella pneumophila in Mouse Macrophages
Authors: Tao Lili , Zhu Wenhan , Hu Bi-Jie , Qu Jie-Ming , Luo Zhao-Qing
Published: June 2013

Legionella pneumophila
, the etiological agent for Legionnaires' disease, is ubiquitous in the aqueous environment, where it replicates as an intracellular parasite of free-living protozoa. Our understanding of
L. pneumophila
pathogenicity is obtained mostly from study of derivatives of several clinical isolates, which employ almost identical virulent determinants to exploit host functions. To determine whether environmental
L. pneumophila
isolates interact similarly with the model host systems, we analyzed intracellular replication of several recently isolated such strains and found that these strains cannot productively grow in bone marrow-derived macrophages of A/J mice, which are permissive for all examined laboratory strains. By focusing on one strain called LPE509, we found that its deficiency in intracellular replication in primary A/J macrophages is not caused by the lack of important pathogenic determinants because this strain replicates proficiently in two protozoan hosts and the human macrophage U937 cell. We also found that in the early phase of infection, the trafficking of this strain in A/J macrophages is similar to that of JR32, a derivative of strain Philadelphia 1. Furthermore, infection of these cells by LPE509 caused extensive cell death in a process that requires the Dot/Icm type IV secretion system. Finally, we showed that the cell death is caused neither by the activation of the NAIP5/NLRC4 inflammasome nor by the recently described caspase 11-dependent pathway. Our results revealed that some environmental
L. pneumophila
strains are unable to overcome the defense conferred by primary macrophages from mice known to be permissive for laboratory
L. pneumophila
strains. These results also suggest the existence of a host immune surveillance mechanism differing from those currently known in responding to
L. pneumophila
infection.
Enhanced Susceptibility to Urinary Tract Infection in the Spinal Cord-Injured Host with Neurogenic Bladder
Authors: Balsara Zarine R. , Ross Sherry S. , Dolber Paul C. , Wiener John S. , Tang Yuping , Seed Patrick C.
Published: June 2013

Neurogenic bladder predisposes to recurrent urinary tract infections (UTI) and renal failure, and susceptibility is commonly ascribed to urinary stasis from elevated residual urine volumes.
Escherichia coli
UTI was modeled in the spinal cord-injured (SCI) rat with the hypothesis that SCI animals would require fewer bacteria to establish infection, have an exaggerated inflammatory response, and have delayed clearance of infection compared to normal-voiding controls. T10 SCI rats and controls had median infectious doses (ID
50
) of 10
2
and 10
5
CFU, respectively. Mean residual volumes in the SCI animals did not correlate with susceptibility to initiation of UTI or outcome. In the acute infection, control and SCI rats developed acute cystitis and pyelitis without acute differences in histopathological scores of inflammation. However,
in vivo
imaging of infected animals revealed persistently higher levels of bacteria in the SCI urine and bladders than were seen for controls over 2 weeks. Likewise, at 2 weeks, acute and chronic inflammatory infiltrates persisted in the bladders and kidneys of SCI rats, whereas inflammation largely resolved within the controls. Together these data demonstrate that SCI rats exhibit delayed clearance of infection and exaggerated inflammatory responses in bladders and kidneys; however, the severity of residual volumes does not predict increased susceptibility to UTI. These studies suggest that host-dependent mechanisms that are discrete from alterations in bladder physiology influence UTI susceptibility with the SCI-neurogenic bladder. This model will allow elucidation of SCI-neurogenic bladder-mediated changes in host response that yield UTI susceptibility and may lead to new preventative and therapeutic options.
Contributions of Environmental Signals and Conserved Residues to the Functions of Carbon Storage Regulator A of Borrelia burgdorferi
Authors: Karna S. L. Rajasekhar , Prabhu Rajesh G. , Lin Ying-Han , Miller Christine L. , Seshu J.
Published: June 2013

Carbon storage regulator A of
Borrelia burgdorferi
(CsrA
Bb
) contributes to vertebrate host-specific adaptation by modulating activation of the Rrp2-RpoN-RpoS pathway and is critical for infectivity. We hypothesized that the functions of CsrA
Bb
are dependent on environmental signals and on select residues. We analyzed the phenotype of

csrA
Bb

deletion and site-specific mutants to determine the conserved and pathogen-specific attributes of CsrA
Bb
. Levels of phosphate acetyltransferase (Pta) involved in conversion of acetyl phosphate to acetyl-coenzyme A (acetyl-CoA) and posttranscriptionally regulated by CsrA
Bb
in the

csrA
Bb

mutant were reduced from or similar to those in the control strains under unfed- or fed-tick conditions, respectively. Increased levels of supplemental acetate restored vertebrate host-responsive determinants in the

csrA
Bb

mutant to parental levels, indicating that both the levels of CsrA
Bb
and the acetyl phosphate and acetyl-CoA balance contribute to the activation of the Rrp2-RpoN-RpoS pathway. Site-specific replacement of 8 key residues of CsrA
Bb
(8S) with alanines resulted in increased levels of CsrA
Bb
and reduced levels of Pta and acetyl-CoA, while levels of RpoS, BosR, and other members of
rpoS
regulon were elevated. Truncation of 7 amino acids at the C terminus of CsrA
Bb
(7D) resulted in reduced

csrA
Bb

transcripts and posttranscriptionally reduced levels of FliW located upstream of CsrA
Bb
. Electrophoretic mobility shift assays revealed increased binding of 8S mutant protein to the CsrA binding box upstream of
pta
compared to the parental and 7D truncated protein. Two CsrA
Bb
binding sites were also identified upstream of
fliW
within the
flgK
coding sequence. These observations reveal conserved and unique functions of CsrA
Bb
that regulate adaptive gene expression in
B. burgdorferi
.
Characterization of Intracellular Growth Regulator
icgR
by Utilizing Transcriptomics To Identify Mediators of Pathogenesis in Shigella flexneri
Authors: Morris Carolyn R. , Grassel Christen L. , Redman Julia C. , Sahl Jason W. , Barry Eileen M. , Rasko David A.
Published: June 2013

Shigella
species Gram-negative bacteria which cause a diarrheal disease, known as shigellosis, by invading and destroying the colonic mucosa and inducing a robust inflammatory response. With no vaccine available, shigellosis annually kills over 600,000 children in developing countries. This study demonstrates the utility of combining high-throughput bioinformatic methods with
in vitro
and
in vivo
assays to provide new insights into pathogenesis. Comparisons of
in vivo
and
in vitro
gene expression identified genes associated with intracellular growth. Additional bioinformatics analyses identified genes that are present in
S. flexneri
isolates but not in the three other
Shigella
species. Comparison of these two analyses revealed nine genes that are differentially expressed during invasion and that are specific to
S. flexneri
. One gene, a DeoR family transcriptional regulator with decreased expression during invasion, was further characterized and is now designated
icgR
, for
i
ntra
c
ellular
g
rowth
r
egulator. Deletion of
icgR
caused no difference in growth
in vitro
but resulted in increased intracellular replication in HCT-8 cells. Further
in vitro
and
in vivo
studies using high-throughput sequencing of RNA transcripts (RNA-seq) of an isogenic Δ
icgR
mutant identified 34 genes that were upregulated under both growth conditions. This combined informatics and functional approach has allowed the characterization of a gene and pathway previously unknown in
Shigella
pathogenesis and provides a framework for further identification of novel virulence factors and regulatory pathways.
Resolution of an intracardiac mass with chemotherapy
Authors: Sidhu Manavjot S , Dellsperger Kevin C
Published: June 2013

Right atrial intracardiac tumours are uncommonly seen during echocardiography. Our patient presented with primary mediastinal large B-cell lymphoma with intracardiac involvement. The tumour was seen by echocardiography and the extent of the tumour was defined by CT scan of the chest. Following chemotherapy directed to her specific tumour cell type, there was complete resolution of the intracardiac mass.
Two rare forms of hepatocellular carcinoma metastases
Authors: Gentile Nicole M , McKenzie Kyle M , Hurt Ryan T
Published: June 2013

An 80-year-old man with known metastatic hepatocellular carcinoma, not on current treatment, was presented with bleeding gingival and penile masses. Bleeding from both sites was able to be controlled with local treatment and subsequent discontinuation of his clopidogrel. The gingival mass was biopsied and was found consistent with metastatic hepatocellular carcinoma. Owing to the concern of recurrent bleeding, the penile mass was not biopsied. Given the significant progression of his disease, the patient was discharged to hospice care.
Rapidly enlarging skin lesion on the lip
Authors: Vermaak Pieter V , Manushakian Jacob
Published: June 2013

Squamous cell carcinoma (SCC) is a malignant tumour arising from the keratinising cells of the epidermis. It is slow growing, locally invasive and has the potential to metastasise to other organs of the body. We report an unusual presentation of a rapidly enlarging, well-differentiated SCC on the upper lip of a 75-year-old woman. Rapidly enlarging skin lesions in specialised areas pose great challenges in its management. As the lesions increase in size, they eliminate first-line reconstructive options that can compromise functional and aesthetic outcomes. Accurate histological diagnosis prior to surgery is paramount, as it bears significance to the excision margins. Early, urgent referral to a specialist unit is essential and may avoid the need for more invasive procedures and associated morbidity.
Visual loss from scleritis in C-ANCA-positive microscopic polyangiitis
Authors: Alrashidi Salah , Yousef Yacoub A , Krema Hatem
Published: June 2013

Scleritis is an inflammation of the outer eye coating that manifests with redness and ocular pain, and tends to be more severe when associated with a systemic collagen disease. Antineutrophil cytoplasmic antibody (ANCA)-positive microscopic polyangiitis is an autoimmune, multisystem, chronic disease characterised by damage to the endothelial lining of small vessels, and can be associated with severe scleritis that necessitates early aggressive therapy to prevent severe ocular complications.
Unusual presentation and location pleural malignant mesothelioma
Authors: Kumar Anjan , Carcano Carolina , Hadeh Anas , Lilenbaum Rogerio
Published: June 2013

Pleural malignant mesothelioma is an uncommon tumour of the thorax. We report two cases: a patient with atypically isolated location of the tumour at the right hilum and a young female patient. The histopathological and radiological features are reviewed with reference to relevant literature.
Abdominal pain and collapse in the emergency department
Authors: Green Adam , Bowman-Burns Carley , Cumberbatch Gary
Published: June 2013

Rupture of a splenic artery aneurysm is a rare but life-threatening presentation to the emergency department. This case demonstrates the importance of swift resuscitation and the benefit of bedside imaging in a highly unstable patient. The definitive management of this condition in patients who are refractory to resuscitative attempts is immediate surgery with the diagnosis often only confirmed at laparotomy.
Uncontrollable haemorrhage following dabigatran prophylaxis
Authors: Sandhu Pavandeep Singh , Wilson Caroline , Dalton Emily , Bogdanov Alexey
Published: June 2013

An 88-year-old man, on dabigatran anticoagulation after a total hip replacement 1 week before admission, presented with acute abdominal pain associated with malaena and haematemesis. After examination and investigation, he was found to have a perforated viscus and underwent laparotomy. The perforation was surgically repaired, but the patient suffered from a massive haemorrhage during the operation, requiring intensive care admission postoperatively. The patient subsequently deteriorated despite aggressive treatment and died several days later.
ISOKINETIC STRENGTH AND RATIO OF PROFESSIONAL FOOTBALL PLAYERS IN UAE
Authors: Ghrairi Mourad , Chomier Philippe , Khelifa Maher , Ferret Jean Marcel
Published: June 2013

Numerous research studies examined muscles strength among professional football players worldwide. However, little or no research studies exist on this issue with relation to Arabian Gulf players. Therefore, the purpose of this study was to provide reference data for peak isokinetic muscle strength and ratio of hamstring and quadriceps in professional Emirati footballers. The study was conducted within Alshabab Football Club (AFC) of Dubai, one of twelve clubs evolving then in the United Arab Emirates (UAE) professional football league. As part of AFC's 2011–2012 preseason program, 36 professional footballers underwent an isokinetic assessment. Peak Torque and Ratio of left and right thigh muscles, i.e. quadriceps and hamstrings, were assessed using a Cybex Norm machine following a standardized protocol at 3 different speeds, namely 60, 180, and 240°/s. The results for the right thigh showed that the maximum peak torque at the speed of 60°/sec was 195.77 N.m. for the quadriceps and 173.2 N.m for the Hamstring. For the left thigh, the values were 193.3 N.m for the quadriceps and 171.6 N.m for the hamstrings. As our main focus was to assess the balance of the thigh muscles, the recorded average ratio hamstrings/quadriceps was 95.6 for the right thigh and 94.4 for the left one. In comparison with the available literature in other professional football leagues, the obtained values indicate that the Emirati player is characterized with a lack of strength and thigh muscles imbalance. Data obtained in this study was used to educate players and football technicians on the need to rigorously strength train to reach the ideal muscle profile as observed in reputed professional football leagues. The obtained values were also used as a reference for the prevention and rehabilitation of muscle injuries.
ARTHOSCOPIC REDUCTION AND FIXATION OF FRACTURES OF THE GREATER HUMERAL TUBEROSITY IN ATHLETES: A CASE SERIES
Authors: Tsikouris Georgios , Intzirtis Panagiotis , Zampiakis Emmanouil , Plessas Sotirios , Taprantzis Loukas , Kourougenis Panayiotis , Tsikouris Dimitrios , Tsikouris Lefteris
Published: June 2013

Background

Arthroscopy is nowadays a well-establish method to treat a wide range of injuries and overuse syndromes of the shoulder. The role of arthroscopy is extremely important for the treatment of soft-tissue injuries and specific-type fractures of the shoulder.

Aim

to estimate the applicability of shoulder arthroscopy as an effective method for the treatment of fractures of the greater tuberosity in athletes.

Patients–Methods

Twelve athletes (six professional–six recreational, four skiers–two horse riders–two motorcycle racers–one cyclist–one football player–one hardle jumper–one judoka, eight males-four females) with a mean age of 29 (20–45) years, sustaining an avulsion fracture of the greater humeral tuberosity were treated arthroscopically over a 5-year period. Nine were managed acutely and three as malunion and rotator cuff dysfunction cases. For the imaging evaluation, standard plain radiographs (anteroposterior and axillary views), CT scans (with 3D reconstruction) and MRI were performed. In three patients the fragment dislocation was found ≤5 mm, in four was 6–10 mm and in two was more than 10 mm. Anchors were used to fix the avulsed fragment. In nine patients, accompanying soft-tissue lesions (seven rotator cuff tears and two Bankart lesions) were recognized and properly treated. Postoperatively a shoulder abduction brace 30° was applied for six weeks and a careful rehabilitation plan was utilized. Passive external rotation exercises were started immediately.

Results

During the follow up period no major complication was observed. Radiographic outcome was assessed on plain X-rays. No patient developed non-union. All patients achieved UCLA scores over 30 at six months. Professionals returned to practicing at 10–12 weeks with customized programs. All athletes returned to their pre-operative activity level with no residual pain.

Discussion

The investigation of indications of shoulder arthroscopy is a continuous process. Surgical familiarity is important to perform advanced techniques in shoulder arthroscopy. Arthroscopic treatment of minimally displaced greater tuberosity fractures should be considered for athletes or people who perform overhead activities.

Conclusions

Arthroscopic treatment of fractures of the greater humeral tuberosity can offer excellent functional results and permits the treatment of concomitant critical lesions.