bluuebunny/crossref_metadata_2025 huggingface dataset:
Grip on health: A complex systems approach to transform health care
Authors: van Wietmarschen Herman A. , Wortelboer Heleen M. , van der Greef Jan
Published: December 2016

This article addresses the urgent need for a transition in health care to deal with the increasing prevalence of chronic diseases and associated rapid rise of health care costs. Chronic diseases evolve and are predominantly related to lifestyle and environment. A shift is needed from a reductionist repair mode of thinking, toward a more integrated biopsychosocial way of thinking about health. The aim of this article is to discuss the opportunities that complexity science offer for transforming health care toward optimal treatment and prevention of chronic lifestyle diseases. Health and health care is discussed from a complexity science perspective. The benefits of concepts developed in the field of complexity science for stimulating transitions in health care are explored. Complexity science supports the elucidation of the essence of health processes. It provides a unique perspective on health with a focus on the relationships within networks of dynamically interacting factors and the emergence of health out of the organization of those relationships. Novel types of complexity science–based intervention strategies are being developed. The first application in practice is the integrated obesity treatment program currently piloted in the Netherlands, focusing on health awareness and healing relationships. Complexity science offers various theories and methods to capture the path toward unhealthy and healthy states, facilitating the development of a dynamic integrated biopsychosocial perspective on health. This perspective offers unique insights into health processes for patients and citizens. In addition, dynamic models driven by personal data provide simulations of health processes and the ability to detect transitions between health states. Such models are essential for aligning and reconnecting the many institutions and disciplines involved in the health care sector and evolve toward an integrated health care ecosystem.
In vivo study of viral haemorrhagic septicaemia virus and infectious pancreatic necrosis virus coexistence in Senegalese sole (Solea senegalensis)
Authors: López‐Vázquez C , Alonso M C , Dopazo C P , Bandín I
Published: December 2016

The effect of IPNV‐VHSV coinfection and superinfection on the mortality caused by both viruses in Senegalese sole has been analysed. No effect was observed after coinfection. However, a clear viral interference was recorded between a primary IPNV and a subsequent VHSV infection, which led to a survival increase in the infected sole of 50% points when compared with fish infected only with VHSV. The significantly higher Mx transcriptional values in the fish pre‐exposed to IPNV (at least at first days after superinfection) and the increased daily mortality when low Mx transcriptional levels were recorded suggest that Mx may be involved in the protective effect against VHSV infection. However, in fish subjected to VHSV primary/IPNV secondary infection, no interference was observed.
Prospective Life Cycle Assessment of Epitaxial Graphene Production at Different Manufacturing Scales and Maturity
Authors: Arvidsson Rickard , Molander Sverker
Published: December 2016

Epitaxial growth is a potential production process for the new material graphene, where it is grown on silicon carbide (SiC) wafers at high temperatures. We provide first estimates of the life cycle cumulative energy demand, climate change, terrestrial acidification, and eco‐toxicity of this production. For this purpose, we applied prospective life cycle assessment (LCA) for three production scenarios (lab, pilot, and an industrial scenario), which reflect different production scales and technological maturity. The functional unit was one square centimeter of graphene. Results show that the three scenarios have similar impacts, which goes against previous studies that have suggested a decrease with larger production scale and technological maturity. The reason for this result is the dominance of electricity use in the SiC wafer production for all impacts (>99% in the worst case, >76% in the best case). Only when assuming thinner SiC wafers in the industrial scenario is there a reduction in impacts by around a factor of 10. A surface‐area–based comparison to the life cycle energy use of graphene produced by chemical vapor deposition showed that epitaxial graphene was considerably more energy intensive—approximately a factor of 1,000. We recommend producers of epitaxial graphene to investigate the feasibility of thinner SiC wafers and use electricity based on wind, solar, or hydropower. The main methodological recommendation from the study is to achieve a temporal robustness of LCA studies of emerging technologies, which includes the consideration of different background systems and differences in production scale and technological maturity.
Increased Leptin and Leptin Receptor Expression in Dogs With Gallbladder Mucocele
Authors: Lee S. , Kweon O.‐K. , Kim W.H.
Published: December 2016

Background

Leptin and its receptor play a role in several disease processes such as pancreatitis and heart disease. However, their association with gallbladder mucocele (GBM) in dogs has not been reported.

Hypothesis/Objectives

To evaluate differences in the expression of leptin and leptin receptor between dogs with and without GBM.

Animals

Twenty‐five healthy dogs, including 9 laboratory beagle dogs, and 22 client‐owned dogs with GBM.

Methods

Serum leptin concentration was determined in blood samples of all dogs by ELISA. Canine gallbladder samples were collected from 9 dogs with GBM that underwent surgery for therapeutic purposes and from 9 healthy laboratory beagle dogs as a normal control group. Samples were analyzed for leptin and leptin receptor mRNA by real‐time polymerase chain reaction.

Results

Serum leptin concentration was significantly higher in dogs with GBM than in healthy dogs (medians of 7.03 and 2.18 ng/mL, respectively; P < .001). Patients with GBM that had undergone surgery had significantly higher serum leptin concentrations than those that had not (medians of 12.2 and 4.09 ng/mL, respectively; P = .001). However, no difference in serum leptin concentration was found between dogs with GBM with or without endocrinopathies. The mRNA expression levels of leptin and its receptor were significantly increased in the gallbladder tissues of dogs with GBM.

Conclusions and Clinical Importance

Dysregulation of leptin might be involved in the pathophysiology of GBM, and leptin concentrations might be associated with GBM severity.
Differential responses of native and exotic plant species to an invasive grass are driven by variation in biotic and abiotic factors
Authors: Stotz Gisela C. , Gianoli Ernesto , Patchell Melanie J. , Cahill James F.
Published: December 2016

Questions

The impact of invasive species on community structure and function varies, yet it is difficult to predict. Different hypotheses have been proposed to predict invasive species establishment and impact on resident communities, based on characteristics of the resident community and/or environmental conditions. Invasive species, however, interact with both native and exotic species. The interaction with exotic species is important, as it can result in secondary invasion or greater impact on native species. Smooth brome (Bromus inermis Leyss.) is a widely planted forage crop, but also a harmful invasive species in North American grasslands, yet little is known about the variability of its impact on resident communities. We ask (1) whether smooth brome has a consistent impact on community structure and function; (2) which biotic and abiotic conditions are associated with smooth brome's impact on resident communities; and (3) whether smooth brome has a similar impact on native and exotic species, and which biotic or abiotic conditions drive the interaction of smooth brome with native and exotic species.

Location

Eight grasslands throughout Alberta, Canada.

Methods

We used space‐for‐time substitutions to quantify smooth brome's impact on different aspects of community structure and function, and whether it varies depending on species richness, productivity, temperature, precipitation and variation in precipitation.

Results

Smooth brome had a consistent negative impact on community structure and function. However, the strength of the effect depended on aspects of the local community. Smooth brome impacts on species richness were higher in species‐rich areas, while impact on resident species biomass was larger in productive, warmer and more variable sites. In most sites the negative effect of smooth brome on species richness was higher for native species, compared to exotics. Impact on native and exotic species richness was larger in species‐rich and more variable sites, respectively.

Conclusions

Understanding and predicting smooth brome's impact on community structure and function can help managers prescribe management plans to reduce negative impacts of smooth brome on native communities. Predicting the interaction of smooth brome with exotic species may be just as important when planning management strategies, to avoid secondary invasion and/or the accumulation of exotic species.
Colonization in Mediterranean old‐fields: the role of dispersal and plant–plant interactions
Authors: García‐Cervigón Ana I. , Velázquez Eduardo , Wiegand Thorsten , Escudero Adrián , Olano José M.
Published: December 2016

Questions

How do the dominant species in a Mediterranean community (Juniperus sabina, Juniperus communis and Pinus sylvestris) colonize abandoned fields? At what rates? Does dispersal limitation shape species colonization patterns? Does J. sabina act as nurse plant for the other two species? If so, in which stages of development: seedlings and saplings or older individuals?

Location

Abandoned crop fields in the Alto Tajo Natural Park, central‐eastern Spain.

Methods

We mapped all individuals of the three species in three 4–14‐ha plots, and aged them using dendrochronology. Spatial patterns in 2000, 1980 and 1960 were reconstructed according to estimated ages in 2014. We used a battery of spatial point‐pattern analyses to evaluate dispersal in junipers, dispersal in pines, and the role of J. sabina as nurse plant for the other two species.

Results

Both junipers colonized earlier than pines, probably due to their more effective endozoochorous dispersal. Late‐coming pines, once established, expanded faster due to their higher seed productivity. Recent recruits of J. communis and P. sylvestris showed a random relationship with J. sabina canopies, whereas spatial patterns of older individuals in relation to J. sabina canopies ranged from attraction (plot 2 and marginally plot 1), suggesting facilitation, to repulsion in plot 3. These differences in spatial patterns between plots could be related to a shift in dominant herbivores, from sheep (plots 1 and 2) to red deer (plot 3).

Conclusions

Dispersal and plant–plant interactions drove colonization in Mediterranean old fields. The inclusion of a temporal perspective in the analysis of spatial patterns allowed the detection of shifting interactions between J. sabina and the other two species, depending on their life stage. This is a clear advance compared with the usual static analyses, as it provides additional clues to interpret the mechanisms and processes underlying their origin.
The role of nutrition in integrated early child development in the 21st century: contribution from the Maternal and Child Nutrition journal
Authors: Pérez‐Escamilla Rafael , Moran Victoria Hall
Published: December 2016

Even though it is widely recognized that early childhood development (ECD) is one of the most important predictors of future social capital and national productivity, the recently published ECD Lancet Series reports that about 250 million children under 5 years are at risk of not reaching their developmental potential, mainly as a result of poverty and social injustice. So why is this and what will it take to reverse this situation? The purpose of this special issue is to highlight important contributions from previously published articles in Maternal & Child Nutrition to the field of nutrition and ECD. The collection of papers presented in this special issue collectively indicates that although nutrition‐specific interventions are essential for child development, they are not sufficient by themselves for children to reach their full developmental potential. This is because ECD is influenced by many other factors besides nutrition, including hand washing/sanitation, parenting skills, psychosocial stimulation, and social protection. Future research should focus on mixed‐methods implementation science seeking to understand how best to translate evidence‐based integrated ECD packages into effective intersectoral policies and programs on a large scale. In addition to health and nutrition, these programs need to consider and include responsive parenting (including responsive feeding), learning stimulation, education, and social protection. Future studies should also address if and how childhood obesity affects human physical, socioemotional, and cognitive development.
Retropharyngeal calcific tendinitis presenting with neck pain and severe dysphagia: A case report
Authors: Madokoro Yuta , Mizuno Masayuki , Kato Daisuke , Toyoda Takanari , Okita Kenji , Matsukawa Noriyuki
Published: December 2016

We herein describe a 45‐year‐old man with posterior neck pain and severe dysphagia secondary to retropharyngeal calcific tendinitis. Brain stem infarction as a result of vertebral artery dissection was suspected, but head magnetic resonance imaging showed no acute ischemic lesion. Sagittal T2‐weighted neck magnetic resonance imaging showed a retropharyngeal fluid collection from C2 to C8, and neck computed tomography showed calcification at the tendon of the longus colli muscle. Based on these characteristic imaging findings, retropharyngeal calcific tendinitis was diagnosed. Neurologists should remember that retropharyngeal calcific tendinitis can cause neck pain and severe dysphagia, and mimic brain stem infarction as a result of vertebral artery dissection.
Arabidopsis B‐cell lymphoma2 (Bcl‐2)‐associated athanogene 7 (BAG7)‐mediated heat tolerance requires translocation, sumoylation and binding to WRKY29
Authors: Li Yurong , Williams Brett , Dickman Martin
Published: December 2016

To cope with stress and increased accumulation of misfolded proteins, plants and animals use a survival pathway known as the unfolded protein response (UPR) that signals between the endoplasmic reticulum (ER) and the nucleus to maintain cell homeostasis via proper folding of proteins. B‐cell lymphoma2 (Bcl‐2)‐associated athanogene (BAG) proteins are an evolutionarily conserved family of co‐chaperones that are linked to disease states in mammals and responses to environmental stimuli (biotic and abiotic) in plants.

Molecular and physiological techniques were used to functionally characterize a newly identified branch of the UPR initiated by the ER‐localized co‐chaperone from Arabidopsis thaliana, AtBAG7.

AtBAG7 has functional roles in both the ER and the nucleus. Upon heat stress, AtBAG7 is sumoylated, proteolytically processed and translocated from the ER to the nucleus, where interaction with the WRKY29 transcription factor occurs. Sumoylation and translocation are required for the AtBAG7–WRKY29 interaction and subsequent stress tolerance. In the ER, AtBAG7 interacts with the ER‐localized transcription factor, AtbZIP28, and established UPR regulator, the AtBiP2 chaperone.

The results indicate that AtBAG7 plays a central regulatory role in the heat‐induced UPR pathway.
Nitrogen Limitation Adaptation (NLA) is involved in source‐to‐sink remobilization of nitrate by mediating the degradation of NRT1.7 in Arabidopsis
Authors: Liu Wenwen , Sun Qing , Wang Kai , Du Qingguo , Li Wen‐Xue
Published: December 2016

Recent studies on nitrate transporters (NRTs) have greatly increased our knowledge of the mechanisms regulating nitrogen (N) homeostasis in plants. However, an understanding of how these NRTs are regulated is still lacking.

The nitrogen limitation adaptation (nla) mutant is hypersensitive to N limitation. In the nla mutant, 15N‐nitrate spotted on old leaves preferentially accumulated in the youngest leaves. Analysis of leaf cross‐sections indicated that NLA expression was expressed in the sieve element and companion cell system. The results of bimolecular fluorescence complementation (BiFC), split‐ubiquitin yeast two‐hybrid and co‐immunoprecipitation (CoIP) assays demonstrated that NLA interacts with NRT1.7 in the plasma membrane.

The following findings suggest that NLA directs the ubiquitination of NRT1.7: the down‐regulation of NRT1.7 protein abundance in 35S::NLA/35S::Myc‐NRT1.7 double transgenic plants compared with 35S::Myc‐NRT1.7 transgenic plants; the up‐regulation of NRT1.7 protein abundance in the nla mutant compared with wild‐type plants; and the direct degradation of truncated NRT1.7 recombinant protein by NLA. Furthermore, analysis of NLA and NRT1.7 protein abundance in mirna827 knock‐out plants showed that N deficiency‐guided translational repression of NLA depends on miRNA827.

Our findings reveal that plants regulate source‐to‐sink remobilization of nitrate by the ubiquitin‐mediated post‐translational regulatory pathway.
Accommodation stimulus and response determinations with autorefractors
Authors: Atchison David A. , Varnas Saulius R.
Published: December 2016

Purpose

To develop equations for accommodation stimulus and accommodation response with autorefractors when the accommodation stimulus is produced by combinations of object distances and lenses placed in front of eyes, and to give worked examples using these equations.

Methods

Simple ray tracing was used to determine stimulus and response equations, taking into account the reference positions for targets, for refraction, and for autorefractor readings.

Results

Several examples applying equations are provided. Features of these examples include evaluating approximate calculations that have been used previously, demonstrating which equations should be used in different circumstances, how to substitute numbers into equations, how to deal with discrepancies between subjective and objective refraction, and how to deal with astigmatism. Problems associated with measuring accommodation response by placing lenses in front of the eye are discussed.

Conclusions

Accurate equations for accommodation stimulus and accommodation response for a range of accommodation stimuli in different setups have been developed.
Anterior and Posterior Instrumentation with Different Debridement and Grafting Procedures for Multi‐Level Contiguous Thoracic Spinal Tuberculosis
Authors: Cui Xu , Li Li‐tao , Ma Yuan‐zheng
Published: December 2016

Objective

To evaluate the clinical outcomes of anterior and posterior instrumentation with different debridement and graft fusion methods for multi‐level contiguous thoracic spinal tuberculosis.

Methods

We retrospectively evaluated 81 patients with multi‐level contiguous thoracic spinal tuberculosis who underwent anterior or posterior instrumentation combined with different methods of debridement, decompression, and graft fusion from January 2002 to December 2012. All patients were divided into an anterior instrumentation group and a posterior instrumentation group. In the anterior instrumentation group, there were 39 patients who underwent transthoracic debridement. In the posterior instrumentation group, there were 34 patients who underwent trans‐costotransverse decompression and strut grafting with posterior instrumentation, and another 8 patients underwent combined anterior debridement and strut grafting with posterior instrumentation in a single‐stage or two‐stage procedure. The kyphotic angles were calculated from lateral spinal X‐rays using the modified Konstam method. The symptoms and signs of tuberculosis, fusion level, fusion time of the bone graft, average kyphosis angle, average correction, average loss of correction, and clinical complications were recorded. The average follow‐up period was 37 months (range, 17–72 months).

Results

The cohort consisted of 47 males and 34 females with an average age of 38 years. The mean durations of the operations were 3.5 ± 0.4 h in the anterior group and 4.0 ± 0.3 h in the posterior group (
P
< 0.05). The mean blood loss volumes during surgery were 450 ± 42 and 560 ± 51 mL for the anterior group and the posterior group, respectively (
P
< 0.01). The kyphotic deformities were corrected from 32.1° ± 10.3° to 10.2° ± 2.1° in the anterior group and from 33.8° ± 11.7° to 12.6° ± 2.7° in the posterior group (
P
< 0.01). The neurologic statuses of the 23 patients with preoperative neurologic deficits improved in each group. Fusion was confirmed radiographically at 5.4 ± 1.2 months (range, 4–12 months) in the anterior group and 5.6 ± 1.4 months (range, 4–13 months) in the posterior group (
P
> 0.05). Postoperative relapses were noted in 1 and 3 patients in the anterior and the posterior group, respectively.

Conclusion

Posterior instrumentation was more effective than anterior instrumentation in the correction of kyphosis and the maintenance of the correction. However, postoperative sinus formation was more frequent in patients who underwent a single‐stage posterior procedure.
Arthroscopic Retrieval of over 100 Loose Bodies in Shoulder Synovial Chondromatosis: A Case Report and Review of Literature
Authors: Raval Pradyumna , Vijayan Ashish , Jariwala Arpit
Published: December 2016

Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy. However, arthroscopy for loose body retrieval has gained popularity over the past two decades. Arthroscopic surgery is an extremely skilled procedure and there is a learning curve for operating in certain anatomical areas such as the shoulder. However, not only does an arthroscopy provide the surgeon with an excellent view of the shoulder but the patient also has a faster recovery. We report a rare case of shoulder synovial chondromatosis in which more than 100 loose bodies were successfully retrieved by an arthroscopy in an individual who had an excellent outcome post‐surgery, reaffirming our faith in the procedure. A detailed literature review of arthroscopic procedures is also presented.
Swimming attendance during childhood and development of asthma: Meta‐analysis
Authors: Valeriani Federica , Protano Carmela , Vitali Matteo , Romano Spica Vincenzo
Published: December 2016

Background

The association between asthma and swimming pool attendance has not been demonstrated and currently there are conflicting results. In order to clarify the association between asthma diagnosis in children and swimming pool attendance, and to assess the consistency of the available epidemiological studies, we completed a literature analysis on the relationship between the exposure to disinfection by‐products in indoor swimming pools during childhood and asthma diagnosis.

Methods

Following the Meta‐analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) criteria, a systematic review and meta‐analysis was performed by searching MEDLINE via PubMed, TOXNET, and Scopus databases (from inception to 20 April 2015) using the key word “Asthma” together with “swimming pool”, “disinfection by‐products”, “indoor air pollution” and “children”. Inclusion criteria were: English language, a complete analytic study design involving a cohort of children (0–16 years), a well‐defined definition of exposure, and the presence of data on effect and variance. Studies on in vivo, in vitro or professional and accidental exposure were excluded.

Results

After a screening process, seven reports (n = 5851 subjects) were included out of a total of 2928 references. The reported OR of the association between swimming pool attendance and asthma prevalence ranged from 0.58 to 2.30. The present meta‐analysis failed to identify a significant difference in asthma development between children attending swimming pools and controls (OR, 1.084; 95% CI: 0.89–1.31).

Conclusions

Swimming in childhood does not increase the likelihood of doctor‐diagnosed asthma. Based on this meta‐analysis review, the association of the disease with indoor pool attendance is still unclear.
40Ar/39Ar Geochronology of Volcanic and Intrusive Rocks in the Papandayan Metallic Prospect Area, West Java, Indonesia
Authors: Titisari Anastasia Dewi , Phillips David , Prayatna  , Setyaraharja Eko Purwanto
Published: December 2016

This study presents new 40Ar/39Ar ages on the volcanic and intrusive rocks from the Papandayan metallic district in West Java, Indonesia. The vein system in the Arinem area, one of the prospective areas in the district, has been considered as an epithermal gold–silver–base metal deposit, however, no published age results are available for the host volcanic rocks in the district. The ages of these rocks are critical in terms of their association with mineralization and are important to understand the evolution of volcanism in the region, which has implications for mineral exploration in the district. 40Ar/39Ar plateau ages of two typical basalt and one andesite samples of the Jampang Formation volcanic rocks yielded ages of 11.65 ± 0.52 Ma, 18.15 ± 0.46 Ma and 7.69 ± 0.05 Ma, respectively. 40Ar/39Ar ages of three intrusive rock samples from Gunung Halang diorite, Gunung Lingga diorite, and Gunung Buligir fine‐grained quartz diorite yielded ages of 12.98 ± 0.20 Ma, 10.81 ± 0.15 Ma, and 7.37 ± 0.05 Ma, respectively. The age of the youngest fine‐grained diorite (Gunung Wayang dike) is 3.95 ± 0.03 Ma. An 40Ar/39Ar age obtained from adularia in the Arinem mineralized vein (18.30 ± 0.20 Ma) is older than the age of altered basalt sample of this study (11.65 ± 0.52 Ma) and the K–Ar illite ages of the Arinem vein (9.4 ± 0.3 Ma and 8.8 ± 0.3 Ma) which resulted from a previous study. The age results suggest that the Papandayan district may have experienced multiple hydrothermal and mineralization events. This study, therefore, provides crucial age data to support future mineral exploration in the district.
Digitalization, Street‐Level Bureaucracy and Welfare Users' Experiences
Authors: Hansen Hans‐Tore , Lundberg Kjetil , Syltevik Liv Johanne
Published: December 2016

Internet/web‐based forms of communication have increasingly been implemented by welfare agencies. However, there have been few studies of the experiences of welfare service users and the consequences of new technology for welfare service users. To what extent is the new technology adopted by the Norwegian Welfare and Labour Organization (NAV) used, and how do the users apply and experience the new possibilities? Do screen‐to‐screen encounters replace face‐to‐face encounters, and is this trend affected by age, gender, education or type of benefit? To answer these questions, we combine survey data, short‐term fieldwork in welfare reception areas and qualitative interviews with people receiving health and work‐related benefits. Our study indicates that screen‐to‐screen interaction in general does not replace face‐to‐face encounters, as many face‐to‐face encounters are related to screen communication. However, digital competence combined with life circumstances appears to be the source of a new divide between welfare service users.
Identification of 3 novel HLA‐B alleles: B*08:173, B*18:72:03 and B*53:05:02
Authors: Brunet L. , Bettens F. , Villard J. , Ferrari‐Lacraz S. , Buhler S.
Published: December 2016

A total of 3 novel human leukocyte antigen‐B (HLA‐B) alleles were detected by next generation sequencing and confirmed by monoallelic sequencing.
The EFSUMB website, a great source for ultrasound information and education
Authors: Dietrich Christoph F. , Rudd Lynne , Saftiou Adrian , Gilja Odd Helge
Published: December 2016

The aim of this updated EFSUMB-website guide is to introduce readers to EFSUMB’s wide ranging activities. The most recent are the guidelines on interventional ultrasound and intestinal ultrasound and updated CEUS Non-Liver and Elastography Liver Guidelines which can be freely downloaded. Hosting eBooks on our website is another new departure, most importantly the EFSUMB Course Book on Ultrasound available in a second edition as an eReader and an online Student Edition of the ECB. EFSUMB has been active with updating Guidelines; those mentioned above have all been revised or written in thelast two years. Webinars have been introduced and participation is possible online but can be reviewed later along with recent recordings of Euroson Schools. The EFSUMB Newsletter in the EJU promotes our activities and topical articles intended to reach all our members with the online version hosted on our website. The Case of the Month continues to be one of EFSUMB’s most visited sites and in the last few years has been translated into 14 different languages including Chinese. In conclusion, this article aims to provide an updated guide to the website educational sites of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB).
Acoustic Radiation Force Impulse (ARFI) Elastography for non‑invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: a systematic review and meta-analysis
Authors: Hu Xiangdong , Qiu Lanyan , Liu Dong , Qian Linxue
Published: December 2016

Aim: The purpose of the study was to assess the effect of Acoustic Radiation Force Impulse (ARFI) elastography in the diagnosis of liver fibrosis in chronic hepatitis B and C patients through Meta-analysis. Material and methods: Four databases (PubMed, the Cochrane Library, WanFang data, and CNKI) were searched. The key words were: (“ARFI” or “acoustic radiation force impulse”) combined with “liver fibrosis” and (“chronic hepatitis” or “HBV HCV”). Heterogeneity (I2) was assessed, and its source was analyzed through meta-regression. Results: 21 articles with 2,691 patients were included. The compositeSe=0.79 (95% CI: 0.76-0.83) and Sp=0.86 (95% CI: 0.85-0.88). ARFI elastography showed a better ability to evaluate higherstage liver fibrosis and liver cirrhosis (F=3 and F=4, respectively). For F≥3, Se=0.84 (95% CI: 0.80-0.88, I2=61.37), Sp=0.90 (95% CI: 0.86-0.92, I2=65.10), and AUROC=0.94 (95% CI: 0.91-0.95). Se and Sp and AUROC of F=4 were 0.86 (95% CI: 0.80-0.91, I2=70.67), 0.84 (95% CI: 0.80–0.88, I2=78.94) and 0.91 (95% CI: 0.89-0.94), respectively. Besides, the combined RFI values indicate that CHC patients had higher ARFI values especially in the F3 stage (1.87 [95% CI: 1.67-2.06] and 2.31[95% CI: 2.09-2.52] for CHB and CHC, respectively). Conclusion: ARFI elastography is accurate and reliable in the diagnosis of CHB- and CHC-induced liver fibrosis and is especially suitable for the evaluation of stages F≥3 and F=4. CHC patients manifest higher ARFI values than CHB patients especially in the F3 stage.
Objectively Measured Physical Activity During Physical Education and School Recess and Their Associations With Academic Performance in Youth: The UP&DOWN Study
Authors: Esteban-Cornejo Irene , Martinez-Gomez David , Garcia-Cervantes Laura , Ortega Francisco B. , Delgado-Alfonso Alvaro , Castro-Piñero José , Veiga Oscar L.
Published: December 2016

Background:

This study examined the associations of objectively measured physical activity in Physical Education and recess with academic performance in youth.

Methods:

This cross-sectional study was conducted with 1,780 participants aged 6 to 18 years (863 girls). Physical activity was objectively measured by accelerometry and was also classified according to sex- and agespecific quartiles of physical activity intensities. Academic performance was assessed through school records.

Results:

Physical activity in physical education (PE) and recess was not associated with academic performance (β ranging from –0.038 to –0.003; all P > .05). Youth in the lowest quartile of physical activity in PE engaged in an average of 1.40 min of moderate-to-vigorous physical activity and those in the highest quartile engaged in 21.60 min (for recess: lowest quartile, 2.20 min; highest quartile, 11.15 min). There were no differences in academic performance between quartiles of physical activity in Physical Education and recess.

Conclusions:

Time spent at different physical activity intensities during PE and recess does not impair academic performance in youth.
A Physical Activity Intervention Program in School is Also Accompanied by Higher Leisure-Time Physical Activity: A Prospective Controlled 3-Year Study in 194 Prepubertal Children
Authors: Cronholm Felix , Rosengren Björn E. , Karlsson Caroline , Karlsson Magnus K.
Published: December 2016

Background:

The activity-stat theory infers that total physical activity (PA) in children is constant, independent of environmental interventions.

Methods:

We conducted a 3-year prospective population-based controlled PA intervention study including, at baseline, 7- to 9-year-old children (66 boys, 40 girls in the intervention and 50 boys, 38 girls in the control group). PA was increased in the intervention group from 60 to 200 minutes/week, while the controls maintained 60 minutes/week. We registered weekly duration of total PA and leisure-time PA and daily duration of sedentary activities, through questionnaires at baseline and 2 and 3 years after baseline.

Results:

Between intervention and control groups PA was similar before intervention start. After intervention start, total PA in both genders was increased during the entire period (P-values adjusted for age and Tanner stage at follow-up between 0.001 and 0.002). Duration of sedentary activities was unchanged with no group differences. Children in the intervention group changed their behavior so that they also achieved more leisure-time PA.

Conclusions:

A 3-year school-based PA intervention program in prepubertal children increases the duration of total PA without increasing the duration of sedentary activities, and the program seems to initiate more PA during leisure-time. Our results refute the activity-stat theory.
Azithromycin-Ciprofloxacin-Impregnated Urinary Catheters Avert Bacterial Colonization, Biofilm Formation, and Inflammation in a Murine Model of Foreign-Body-Associated Urinary Tract Infections Caused by Pseudomonas aeruginosa
Authors: Saini Hina , Vadekeetil Anitha , Chhibber Sanjay , Harjai Kusum
Published: December 2016

Pseudomonas aeruginosais a multifaceted pathogen causing a variety of biofilm-mediated infections, including catheter-associated urinary tract infections (CAUTIs). The high prevalence of CAUTIs in hospitals, their clinical manifestations, such as urethritis, cystitis, pyelonephritis, meningitis, urosepsis, and death, and the associated economic challenges underscore the need for management of these infections. Biomaterial modification of urinary catheters with two drugs seems an interesting approach to combat CAUTIs by inhibiting biofilm. Previously, we demonstrated thein vitroefficacy of urinary catheters impregnated with azithromycin (AZM) and ciprofloxacin (CIP) againstP. aeruginosa. Here, we report how these coated catheters impact the course of CAUTI induced byP. aeruginosain a murine model. CAUTI was established in female LACA mice with uncoated or AZM-CIP-coated silicone implants in the bladder, followed by transurethral inoculation of 108CFU/ml of biofilm cells ofP. aeruginosaPAO1. AZM-CIP-coated implants (i) prevented biofilm formation on the implant's surface (P≤ 0.01), (ii) restricted bacterial colonization in the bladder and kidney (P< 0.0001), (iii) averted bacteriuria (P< 0.0001), and (iv) exhibited no major histopathological changes for 28 days in comparison to uncoated implants, which showed persistent CAUTI. Antibiotic implants also overcame implant-mediated inflammation, as characterized by trivial levels of inflammatory markers such as malondialdehyde (P< 0.001), myeloperoxidase (P< 0.05), reactive oxygen species (P≤ 0.001), and reactive nitrogen intermediates (P< 0.01) in comparison to those in uncoated implants. Further, AZM-CIP-coated implants showed immunomodulation by manipulating the release of inflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and IL-10 to the benefit of the host. Overall, the study demonstrates long-termin vivoeffectiveness of AZM-CIP-impregnated catheters, which may possibly be a key to success in preventing CAUTIs.
Ciprofloxacin-Mediated Mutagenesis Is Suppressed by Subinhibitory Concentrations of Amikacin in Pseudomonas aeruginosa
Authors: Valencia Estela Ynés , Esposito Fernanda , Spira Beny , Blázquez Jesús , Galhardo Rodrigo S.
Published: December 2016

Resistance to antibiotics is a global health problem. Activation of the SOS response, and the subsequent elevation in mutagenesis, contributes to the appearance of resistance mutations. Among currently used drugs, quinolones are the most potent inducers of the SOS response. In the present study, we show that amikacin inhibits ciprofloxacin-mediated SOS induction and mutagenesis in
Pseudomonas aeruginosa
.
PER-8, a Novel Extended-Spectrum β-Lactamase PER Variant, from an Acinetobacter baumannii Clinical Isolate in Nepal
Authors: Tada Tatsuya , Shrestha Shovita , Shimada Kayo , Ohara Hiroshi , Sherchand Jeevan B. , Pokhrel Bharat M. , Kirikae Teruo
Published: December 2016

A novel PER-type extended-spectrum β-lactamase, PER-8, was identified in an
Acinetobacter baumannii
clinical isolate obtained in Nepal. The amino acid sequence of PER-8 has a substitution at position 39 (Gly to Glu) compared with that of PER-7. The
k
cat
/

K
m

ratio of PER-8 for aztreonam was lower than that of PER-7, while the
k
cat
/

K
m

ratio of PER-8 for imipenem was higher than that of PER-7. The genomic environment surrounding
bla
PER-8
was
intI1 bla
PSE-1
qacEDI sulI
IS
CR1-bla
PER-8
gts sulI orfX
on a 100-kb plasmid.
Assessment of the Plasmodium falciparum Preerythrocytic Antigen UIS3 as a Potential Candidate for a Malaria Vaccine
Authors: Longley Rhea J. , Halbroth Benedict R. , Salman Ahmed M. , Ewer Katie J. , Hodgson Susanne H. , Janse Chris J. , Khan Shahid M. , Hill Adrian V. S. , Spencer Alexandra J.
Published: December 2016

Efforts are under way to improve the efficacy of subunit malaria vaccines through assessments of new adjuvants, vaccination platforms, and antigens. In this study, we further assessed the
Plasmodium falciparum
antigen upregulated in infective sporozoites 3 (PfUIS3) as a vaccine candidate. PfUIS3 was expressed in the viral vectors chimpanzee adenovirus 63 (ChAd63) and modified vaccinia virus Ankara (MVA) and used to immunize mice in a prime-boost regimen. We previously demonstrated that this regimen could provide partial protection against challenge with chimeric
P. berghei
parasites expressing PfUIS3. We now show that ChAd63-MVA PfUIS3 can also provide partial cross-species protection against challenge with wild-type
P. berghei
parasites. We also show that PfUIS3-specific cellular memory responses could be recalled in human volunteers exposed to
P. falciparum
parasites in a controlled human malaria infection study. When ChAd63-MVA PfUIS3 was coadministered with the vaccine candidate
P. falciparum
thrombospondin-related adhesion protein (PfTRAP) expressed in the ChAd63-MVA system, there was no significant change in immunogenicity to either vaccine. However, when mice were challenged with double chimeric
P. berghei
-
P. falciparum
parasites expressing both PfUIS3 and PfTRAP, vaccine efficacy was improved to 100% sterile protection. This synergistic effect was evident only when the two vaccines were mixed and administered at the same site. We have therefore demonstrated that vaccination with PfUIS3 can induce a consistent delay in patent parasitemia across mouse strains and against chimeric parasites expressing PfUIS3 as well as wild-type
P. berghei
; when this vaccine is combined with another partially protective regimen (ChAd63-MVA PfTRAP), complete protection is induced.
The Carbohydrate Lectin Receptor Dectin-1 Mediates the Immune Response to Exserohilum rostratum
Authors: Reedy Jennifer L. , Negoro Paige E. , Feliu Marianela , Lord Allison K. , Khan Nida S. , Lukason Dan P. , Wiederhold Nathan P. , Tam Jenny M. , Mansour Michael K. , Patterson Thomas F. , Vyas Jatin M.
Published: December 2016

Dematiaceous molds are found ubiquitously in the environment and cause a wide spectrum of human disease, including infections associated with high rates of mortality. Despite this, the mechanism of the innate immune response has been less well studied, although it is key in the clearance of fungal pathogens. Here, we focus on
Exserohilum rostratum
, a dematiaceous mold that caused 753 infections during a multistate outbreak due to injection of contaminated methylprednisolone. We show that macrophages are incapable of phagocytosing
Exserohilum
. Despite a lack of phagocytosis, macrophage production of tumor necrosis factor alpha is triggered by hyphae but not spores and depends upon Dectin-1, a C-type lectin receptor. Dectin-1 is specifically recruited to the macrophage-hyphal interface but not the macrophage-spore interface due to differences in carbohydrate antigen expression between these two fungal forms. Corticosteroid and antifungal therapy perturb this response, resulting in decreased cytokine production.
In vivo
soft tissue infection in wild-type mice demonstrated that
Exserohilum
provokes robust neutrophilic and granulomatous inflammation capable of thwarting fungal growth. However, coadministration of methylprednisolone acetate results in robust hyphal tissue invasion and a significant reduction in immune cell recruitment. Our results suggest that Dectin-1 is crucial for macrophage recognition and the macrophage response to
Exserohilum
and that corticosteroids potently attenuate the immune response to this pathogen.
Copper Is a Host Effector Mobilized to Urine during Urinary Tract Infection To Impair Bacterial Colonization
Authors: Hyre Amanda N. , Kavanagh Kylie , Kock Nancy D. , Donati George L. , Subashchandrabose Sargurunathan
Published: December 2016

Urinary tract infection (UTI) is a major global infectious disease affecting millions of people annually. Human urinary copper (Cu) content is elevated during UTI caused by uropathogenic
Escherichia coli
(UPEC). UPEC upregulates the expression of Cu efflux genes during clinical UTI in patients as an adaptive response to host-derived Cu. Whether Cu is mobilized to urine as a host response to UTI and its role in protection against UTI remain unresolved. To address these questions, we tested the hypothesis that Cu is a host effector mobilized to urine during UTI to limit bacterial growth. Our results reveal that Cu is mobilized to urine during UTI caused by the major uropathogens
Proteus mirabilis
and
Klebsiella pneumoniae
, in addition to UPEC, in humans. Ceruloplasmin, a Cu-containing ferroxidase, is found at higher levels in UTI urine than in healthy control urine and serves as the molecular source of urinary Cu during UTI. Our results demonstrate that ceruloplasmin decreases the bioavailability of iron in urine by a transferrin-dependent mechanism. Experimental UTI with UPEC in nonhuman primates recapitulates the increased urinary Cu content observed during clinical UTI. Furthermore, Cu-deficient mice are highly colonized by UPEC, indicating that Cu is involved in the limiting of bacterial growth within the urinary tract. Collectively, our results indicate that Cu is a host effector that is involved in protection against pathogen colonization of the urinary tract. Because urinary Cu levels are amenable to modulation, augmentation of the Cu-based host defense against UTI represents a novel approach to limiting bacterial colonization during UTI.
Polynucleotide Phosphorylase, RNase E/G, and YbeY Are Involved in the Maturation of 4.5S RNA in Corynebacterium glutamicum
Authors: Maeda Tomoya , Tanaka Yuya , Wachi Masaaki , Inui Masayuki
Published: December 2016

Corynebacterium glutamicum
has been applied for the industrial production of various metabolites, such as amino acids. To understand the biosynthesis of the membrane protein in this bacterium, we investigated the process of signal recognition particle (SRP) assembly. SRP is found in all three domains of life and plays an important role in the membrane insertion of proteins. SRP RNA is initially transcribed as precursor molecules; however, relatively little is known about its maturation. In
C. glutamicum
, SRP consists of the Ffh protein and 4.5S RNA lacking an Alu domain. In this study, we found that 3′-to-5′ exoribonuclease, polynucleotide phosphorylase (PNPase), and two endo-type RNases, RNase E/G and YbeY, are involved in the 3′ maturation of 4.5S RNA in
C. glutamicum
. The mature form of 4.5S RNA was inefficiently formed in Δ
rneG
Δ
pnp
mutant cells, suggesting the existence of an alternative pathway for the 3′ maturation of 4.5S RNA. Primer extension analysis also revealed that the 5′ mature end of 4.5S RNA corresponds to that of the transcriptional start site. Immunoprecipitated Ffh protein contained immature 4.5S RNA in Δ
pnp
, Δ
rneG
, and Δ
ybeY
mutants, suggesting that 4.5S RNA precursors can interact with Ffh. These results imply that the maturation of 4.5S RNA can be performed in the 4.5S RNA-Ffh complex.

IMPORTANCE
Overproduction of a membrane protein, such as a transporter, is useful for engineering of strains of
Corynebacterium glutamicum
, which is a workhorse of amino acid production. To understand membrane protein biogenesis in this bacterium, we investigated the process of signal recognition particle (SRP) assembly. SRP contains the Ffh protein and SRP RNA and plays an important role in the membrane insertion of proteins. Although SRP RNA is highly conserved among the three domains of life, relatively little is known about its maturation. We show that PNPase, RNase E/G, and YbeY are involved in the 3′ maturation of the SRP RNA (4.5S RNA) in this bacterium. This indicates that 3′ end processing in this organism is different from that in other bacteria, such as
Escherichia coli
.
Comparative Genome Analysis and Global Phylogeny of the Toxin Variant Clostridium difficile PCR Ribotype 017 Reveals the Evolution of Two Independent Sublineages
Authors: Cairns M. D. , Preston M. D. , Hall C. L. , Gerding D. N. , Hawkey P. M. , Kato H. , Kim H. , Kuijper E. J. , Lawley T. D. , Pituch H. , Reid S. , Kullin B. , Riley T. V. , Solomon K. , Tsai P. J. , Weese J. S. , Stabler R. A. , Wren B. W.
Published: December 2016

The diarrheal pathogen
Clostridium difficile
consists of at least six distinct evolutionary lineages. The RT017 lineage is anomalous, as strains only express toxin B, compared to strains from other lineages that produce toxins A and B and, occasionally, binary toxin. Historically, RT017 initially was reported in Asia but now has been reported worldwide. We used whole-genome sequencing and phylogenetic analysis to investigate the patterns of global spread and population structure of 277 RT017 isolates from animal and human origins from six continents, isolated between 1990 and 2013. We reveal two distinct evenly split sublineages (SL1 and SL2) of
C. difficile
RT017 that contain multiple independent clonal expansions. All 24 animal isolates were contained within SL1 along with human isolates, suggesting potential transmission between animals and humans. Genetic analyses revealed an overrepresentation of antibiotic resistance genes. Phylogeographic analyses show a North American origin for RT017, as has been found for the recently emerged epidemic RT027 lineage. Despite having only one toxin, RT017 strains have evolved in parallel from at least two independent sources and can readily transmit between continents.