bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of visual Wulst cell responsiveness by imprinting causes stimulus-specific activation of rostral cells
Authors: Nakamori Tomoharu , Kato Tomomi , Sakagami Hiroyuki , Tanaka Kohichi , Ohki-Hamazaki Hiroko
Published: February 2017

Imprinting behaviour in chicks can be induced exclusively during a short period after hatching. During this period, visual information on the imprinting stimulus is conveyed to the visual Wulst (VW) in the telencephalon, which corresponds to the visual cortex of mammals, and then to the memory-storing region known as the intermediate medial mesopallium. These two regions are indispensable for imprinting. We previously showed that imprinting training altered the response pattern of the VW to the imprinting stimulus; however, the precise distribution of cells and the mechanism involved with this altered response remains unclear. Here we showed that a specific population of rostral VW cells responded to the imprinting stimulus by analysing the subcellular localization of Arc/arg3.1 transcripts in VW cells. GABAergic parvalbumin (PV) cells are abundant in the dorsal region of this area, and imprinting training doubled the number of activated PV-positive neurons. An injection of bicuculline, a GABA(A) receptor antagonist, in the dorsal VW disturbed the rostral distribution of responsive cells and thus resulted in a lack of imprinting. These results suggest that activated PV cells restrict VW cells response to dorsal area to form a specific imprinting pathway.
Widespread methane seepage along the continental margin off Svalbard - from Bjørnøya to Kongsfjorden
Authors: Mau S. , Römer M. , Torres M. E. , Bussmann I. , Pape T. , Damm E. , Geprägs P. , Wintersteller P. , Hsu C.-W. , Loher M. , Bohrmann G.
Published: February 2017

Numerous articles have recently reported on gas seepage offshore Svalbard, because the gas emission from these Arctic sediments was thought to result from gas hydrate dissociation, possibly triggered by anthropogenic ocean warming. We report on findings of a much broader seepage area, extending from 74° to 79°, where more than a thousand gas discharge sites were imaged as acoustic flares. The gas discharge occurs in water depths at and shallower than the upper edge of the gas hydrate stability zone and generates a dissolved methane plume that is hundreds of kilometer in length. Data collected in the summer of 2015 revealed that 0.02–7.7% of the dissolved methane was aerobically oxidized by microbes and a minor fraction (0.07%) was transferred to the atmosphere during periods of low wind speeds. Most flares were detected in the vicinity of the Hornsund Fracture Zone, leading us to postulate that the gas ascends along this fracture zone. The methane discharges on bathymetric highs characterized by sonic hard grounds, whereas glaciomarine and Holocene sediments in the troughs apparently limit seepage. The large scale seepage reported here is not caused by anthropogenic warming.
Enhanced Fenton-like Degradation of Trichloroethylene by Hydrogen Peroxide Activated with Nanoscale Zero Valent Iron Loaded on Biochar
Authors: Yan Jingchun , Qian Linbo , Gao Weiguo , Chen Yun , Ouyang Da , Chen Mengfang
Published: February 2017

Composite of nanoscale Zero Valent Iron (nZVI) loaded on Biochar (BC) was prepared and characterized as hydrogen peroxide (H2O2) activator for the degradation of trichloroethylene (TCE). nZVI is homogeneously loaded on lamellarly structured BC surfaces to form nZVI/BC with specific surface area (SBET) of 184.91 m2 g−1, which can efficiently activate H2O2 to achieve TCE degradation efficiency of 98.9% with TOC removal of 78.2% within 30 min under the conditions of 0.10 mmol L−1 TCE, 1.13 g L−1 nZVI/BC and 1.50 mmol L−1 H2O2. Test results from the Electron Spin Resonance (ESR) measurement and coumarin based fluorescent probe technology indicated that ∙OH radicals were the dominant species responsible for the degradation of TCE within the nZVI/BC-H2O2 system. Activation mechanism of the redox action of Fe2+/Fe3+ generated under both aerobic and anaerobic conditions from nZVI and single electron transfer process from BC surface bound C–OH to H2O2 promoted decomposition of H2O2 into ∙OH radicals was proposed.
Direct observation of the dynamics of single metal ions at the interface with solids in aqueous solutions
Authors: Ricci Maria , Trewby William , Cafolla Clodomiro , Voïtchovsky Kislon
Published: February 2017

The dynamics of ions adsorbed at the surface of immersed charged solids plays a central role in countless natural and industrial processes such as crystal growth, heterogeneous catalysis, electrochemistry, or biological function. Electrokinetic measurements typically distinguish between a so-called Stern layer of ions and water molecules directly adsorbed on to the solid’s surface, and a diffuse layer of ions further away from the surface. Dynamics within the Stern layer remain poorly understood, largely owing to a lack of in-situ atomic-level insights. Here we follow the dynamics of single Rb+ and H3O+ ions at the surface of mica in water using high-resolution atomic force microscopy with 25 ms resolution. Our results suggest that single hydrated Rb+ions reside τ1 = 104 ± 5 ms at a given location, but this is dependent on the hydration state of the surface which evolves on a slower timescale of τ2 = 610 ± 30 ms depending on H3O+ adsorption. Increasing the liquid’s temperature from 5 °C to 65 °C predictably decreases the apparent glassiness of the interfacial water, but no clear effect on the ions’ dynamics was observed, indicating a diffusion-dominated process. These timescales are remarkably slow for individual monovalent ions and could have important implications for interfacial processes in electrolytes.
Antioxidant response is a protective mechanism against nutrient deprivation in C. elegans
Authors: Tao Jun , Wu Qin-Yi , Ma Yi-Cheng , Chen Yuan-Li , Zou Cheng-Gang
Published: February 2017

Animals often experience periods of nutrient deprivation; however, the molecular mechanisms by which animals survive starvation remain largely unknown. In the nematode Caenorhabditis elegans, the nuclear receptor DAF-12 acts as a dietary and environmental sensor to orchestrate diverse aspects of development, metabolism, and reproduction. Recently, we have reported that DAF-12 together with co-repressor DIN-1S is required for starvation tolerance by promoting fat mobilization. In this report, we found that genetic inactivation of the DAF-12 signaling promoted the production of reactive oxygen species (ROS) during starvation. ROS mediated systemic necrosis, thereby inducing organismal death. The DAF-12/DIN-1S complex up-regulated the expression of antioxidant genes during starvation. The antioxidant enzyme GST-4 in turn suppressed ROS formation, thereby conferring worm survival. Our findings highlight the importance of antioxidant response in starvation tolerance and provide a novel insight into multiple organisms survive and adapt to periods of nutrient deprivation.
Diversity-oriented synthesis and cytotoxic activity evaluation of biaryl-containing macrocycles
Authors: Pérez-Labrada Karell , Cruz-Mendoza Marco A. , Chávez-Riveros Alejandra , Hernández-Vázquez Eduardo , Torroba Tomás , Miranda Luis D.
Published: February 2017

Synthesis of biaryl-containing macrocycles has been carried out through a four-step approach comprising two Ugi four component reactions and a Suzuki–Miyaura macrocyclization.
Removal of ammonia from aqueous solutions by ligand exchange onto a Cu(ii)-loaded chelating resin: kinetics, equilibrium and thermodynamics
Authors: Chen Quanzhou , Zhou Kanggen , Chen Yan , Wang Aihe , Liu Fang
Published: February 2017

A poly ligand exchanger (PLE), Cu(ii)-loaded chelating resin (ammonia adsorption reagent, named AMAR) was prepared to efficiently remove ammonia from solutions by ligand exchange.
Piperazine-functionalized C60 and diiodine or iodine monochloride as components in forming supramolecular assemblies
Authors: Aghabali Amineh , Jun Sharon , Olmstead Marilyn M. , Balch Alan L.
Published: February 2017

Reaction of N(CH2CH2)2NC60 with iodine monochloride produced two materials: (ClIN(CH2CH2)2NICl)C60·2.3(CS2)·0.7(CH2Cl2) with two, nearly linear N–I–Cl units, or the salt, [(N(CH2CH2)2NH)C60+][ICl2−]·CS2.
C4-Ferrocenylsilyl-bridged and -substituted N-heterocyclic carbenes: complexation of germanium chloride
Authors: Wang Yuzhong , Hickox Hunter P. , Wei Pingrong , Robinson Gregory H.
Published: February 2017

C4-Ferrocenylsilyl-bridged and -substituted N-heterocyclic carbenes and their germanium chloride complexes have been prepared and characterized.
Yb14MgBi11: structure, thermoelectric properties and the effect of the structure on low lattice thermal conductivity
Authors: Hu Yufei , Kauzlarich Susan M.
Published: February 2017

This paper presents a new compound Yb14MgBi11and its thermoelectric properties, especially its extremely low lattice thermal conductivity.
Dual emissions from MnS clusters confined in the sodalite nanocage of a chalcogenide-based semiconductor zeolite
Authors: Hu Dandan , Zhang Yingying , Lin Jian , Hou Yike , Li Dongsheng , Wu Tao
Published: February 2017

A new host–guest hybrid system with MnS clusters confined in a chalcogenide-based semiconductor zeolite was for the first time constructed and its photoluminescence (PL) properties were also investigated.
Synthesis of non-symmetric viologen-containing ditopic ligands and their Pd(ii)/Pt(ii)-directed self-assembly
Authors: Domarco Olaya , Neira Iago , Rama Tamara , Blanco-Gómez Arturo , García Marcos D. , Peinador Carlos , Quintela José M.
Published: February 2017

An improved method for the synthesis of non-symmetric viologen-containing ditopic ligands is presented, as well as their Pd(ii)/Pt(ii)-directed self-assembly into metallacyclic receptors.
Ligand-assisted palladium-catalyzed C–H alkenylation of aliphatic amines for the synthesis of functionalized pyrrolidines
Authors: He Chuan , Gaunt Matthew J.
Published: February 2017

The development of a ligand-assisted Pd-catalyzed C–H alkenylation of aliphatic amines is reported.
Les objectifs thérapeutiques de la philosophie FACE
Authors: Martin Domingo , Maté Amaia , Zabalegui Paula , Valenzuela Jaime
Published: February 2017

Introduction : La philosophie FACE (Functional and Cosmetic Excellence), se caractérise par la définition précise des objectifs de traitement : harmonie du visage, esthétique du sourire, santé parodontale, occlusion fonctionnelle, équilibre neuromusculaire et articulaire. Le but est d’établir une occlusion idéale dans un contexte d’harmonie faciale et d’équilibre articulaire. Matériels et méthodes : Les auteurs présentent tous les concepts de la philosophie FACE et les illustrent par la présentation d’un cas. Résultats : Tenir compte de l’ensemble de ces concepts accroît non seulement notre habilité diagnostique, mais également la qualité et la stabilité de nos résultats thérapeutiques. Discussion : Le but de la philosophie FACE est d’harmoniser le profil facial, l’alignement des dents, le parodonte, l’occlusion fonctionnelle, la fonction neuromusculaire et articulaire. L’évaluation et l’approche thérapeutique des décalages de la dimension verticale sont propres à cette philosophie.
Trouver un équilibre dans la communication pour la rendre claire, exhaustive, efficace. Par quels procédés ?
Authors: Bartala Michel
Published: February 2017

Introduction : La communication patient/praticien est un élément important dans l’acceptation des traitements. Depuis la loi Kouchner, le patient doit pouvoir donner un consentement libre et éclairé et être informé de l’ensemble des thérapeutiques possibles dans sa situation. Matériels et méthodes : Les praticiens ont aujourd’hui à leur disposition différents supports leur permettant de présenter de la façon la plus explicite les traitements envisagés. L’auteur les présente dans cet article. Discussion : La clé du succès reste encore pour les praticiens la construction d’une relation de confiance entre le soigné et le soignant.
Evaluating the economics of concentrate feeding decisions in grazing dairy cows
Authors: Ho C. K. M. , Heard J. W. , Wales W. J. , Jacobs J. L. , Doyle P. T. , Malcolm B.
Published: February 2017

Purchased concentrates are a significant variable cost of a dairy business. Farm economic theory states that feeding supplements will enable a dairy farmer to improve profit as long as the marginal revenue received from the milk produced exceeds the marginal cost of the supplement. To do this, the quantities of milk, milk protein and milk fat produced from a unit of concentrate added to the diet are needed. Recent research has compiled results from short-term concentrate feeding experiments conducted in Victoria over a 30-year period. Using these data, relationships for the response of milk production to cereal grain supplements in dairy cows grazing temperate pastures have been developed and shown to be a better predictor than previous relationships. These response functions were used in the present study to investigate the economics of tactical (short-term; weekly, monthly or seasonally) and strategic (medium- to longer-term) supplementary feeding decisions in a pasture-based system, including, specifically, how much concentrate should be fed in a particular farm situation, given a certain feed cost and milk price. In the present paper, the relevant production economics method is explained and applied to determine the amount of supplement to feed that will maximise the margin of total extra milk income minus the total cost of supplement, thereby adding the most to farm profit. Currently, when dairy farmers make decisions about how much more supplement to feed their herd, they are making implicit judgements about the extra milk, and other potential benefits, that they expect to result as well as what the milk will be worth. More finely tuned decisions about feeding supplements based on comparing marginal cost and marginal revenue would add more to farm profit than decisions based on other common criteria, such as feeding supplement for maximum milk production. While some farmers may already be feeding supplements close to the point where marginal cost equals marginal revenue, the formal method of marginal analysis reported here makes explicit what is done implicitly at present and tests farmers’ intuitive decision-making. More detailed information about the responses to supplements and the costs and benefits of feeding supplements under particular circumstances at different times through the lactation has the potential to enable better, more profitable decisions to be made about feeding cows and managing the whole farm.
Spatial distribution of grassland fires at the regional scale based on the MODIS active fire products
Authors: Zhang Zhengxiang , Feng Zhiqiang , Zhang Hongyan , Zhao Jianjun , Yu Shan , Du Wala
Published: February 2017

Grassland fires are major disturbances to ecosystems and economies around the world. Therefore, research on the spatial patterns of grassland fires is important for understanding the dynamics of fire occurrence and providing evidence for fire prevention and management. One of the problems in grassland fire risk analysis is that historically observed fire data are generally in the point format, with imprecise positions, whereas other influencing factors are often expressed in continuous areal units. To minimise the influences of inaccurate locations and grid size, density estimates can be produced using kernel density estimation (KDE) – a nonparametric statistical method for estimating probability densities. This method has been widely used to convert historical fire data into continuous surfaces. In this study, KDE was applied to grassland fire events in the eastern Inner Mongolia of China, based on Moderate Resolution Imaging Spectroradiometer (MODIS) Terra and Aqua daily active fire data from 2001 to 2014. The bandwidth choice was based on the mean random distance method. Annual and seasonal kernel density maps were produced, showing that the spatial patterns of grassland fire events remained temporally consistent. These results were used to create grassland fire risk zones on the basis of the mean density values in the study area. Grassland fire prevention and planning may focus on high-risk areas identified using this method.
Can Largemouth Bass Transplanted from an Unexploited Population Genetically Contribute to an Active Fishery? A Test Case for Genetic Management of Exploited Fish Populations
Authors: Hessenauer Jan-Michael , Vokoun Jason , Welsh Amy , Davis Justin , Jacobs Robert , O’ Donnell Eileen
Published: February 2017

Recreational fishing is one of the most popular outdoor activities in the world, resulting in substantial effects on recreational fish stocks. Recent studies have found that recreational angling may drive fisheries-induced evolution, resulting in changes in the size, behavior, and physiology of exploited recreational stocks. Traditional harvest-based management of recreational fisheries may be unable to mitigate these changes, especially with the rise of catch-and-release practices for many fisheries. We explored the potential to genetically manage exploited fisheries by introducing individuals from unexploited populations as a means to mitigate selection from recreational angling. We stocked 77 individuals from an unexploited population of Largemouth Bass Micropterus salmoides and 79 individuals from an exploited population into a third water body (with an active fishery) and evaluated the extent to which each group of stocked fish contributed to fall age-0 recruits. Fifty-four percent of the sampled age-0 Largemouth Bass with reliable parentage were hybrids of stocked and resident parents. Individuals from the exploited and unexploited populations contributed to the age-0 sample in proportion to their initial abundances. No sex-biased contribution was detected between the exploited and unexploited individuals stocked into the pond, although the largest females had the highest contribution to the age-0 sample. Age-0 fish originating from hybridization between unexploited and resident parents had significantly higher condition than age-0 recruits originating from two resident parents. We conclude that individuals from unexploited populations can successfully reproduce in an exploited system and that genetic management may be a feasible option for mitigating the effects of recreational fisheries-induced evolution.

Received January 12, 2016; accepted October 28, 2016 Published online February 23, 2017
Distinct populations of inflammatory fibroblasts and myofibroblasts in pancreatic cancer
Authors: Öhlund Daniel , Handly-Santana Abram , Biffi Giulia , Elyada Ela , Almeida Ana S. , Ponz-Sarvise Mariano , Corbo Vincenzo , Oni Tobiloba E. , Hearn Stephen A. , Lee Eun Jung , Chio Iok In Christine , Hwang Chang-Il , Tiriac Hervé , Baker Lindsey A. , Engle Dannielle D. , Feig Christine , Kultti Anne , Egeblad Mikala , Fearon Douglas T. , Crawford James M. , Clevers Hans , Park Youngkyu , Tuveson David A.
Published: February 2017

Pancreatic stellate cells (PSCs) differentiate into cancer-associated fibroblasts (CAFs) that produce desmoplastic stroma, thereby modulating disease progression and therapeutic response in pancreatic ductal adenocarcinoma (PDA). However, it is unknown whether CAFs uniformly carry out these tasks or if subtypes of CAFs with distinct phenotypes in PDA exist. We identified a CAF subpopulation with elevated expression of α-smooth muscle actin (αSMA) located immediately adjacent to neoplastic cells in mouse and human PDA tissue. We recapitulated this finding in co-cultures of murine PSCs and PDA organoids, and demonstrated that organoid-activated CAFs produced desmoplastic stroma. The co-cultures showed cooperative interactions and revealed another distinct subpopulation of CAFs, located more distantly from neoplastic cells, which lacked elevated αSMA expression and instead secreted IL6 and additional inflammatory mediators. These findings were corroborated in mouse and human PDA tissue, providing direct evidence for CAF heterogeneity in PDA tumor biology with implications for disease etiology and therapeutic development.
Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy
Authors: Schreiber Richard , Sittig Dean F , Ash Joan , Wright Adam
Published: February 2017

In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion. Although testing had shown that the laboratory system would cancel duplicate laboratory orders, it was thought that duplicate alerting in the new order entry system would prevent such events.
Analysis of Cost Variation in Craniotomy for Tumor Using 2 National Databases
Authors: Zygourakis Corinna C , Liu Caterina Y , Yoon Seungwon , Moriates Christopher , Boscardin Christy , Dudley R Adams , Lawton Michael T , Theodosopoulos Philip , Berger Mitchel S , Gonzales Ralph
Published: February 2017

BACKGROUND

There is a significant increase and large variation in craniotomy costs. However, the causes of cost differences in craniotomies remain poorly understood.

OBJECTIVE

To examine the patient and hospital factors that underlie the cost variation in tumor craniotomies using 2 national databases: the National Inpatient Sample (NIS) and Vizient, Inc. (Irving, Texas).

METHODS

For 41 483 patients who underwent primary surgery for supratentorial brain tumors from 2001 to 2013 in the NIS, we created univariate and multivariate models to evaluate the effect of several patient factors and hospital factors on total hospital cost. Similarly, we performed multivariate analysis with 15 087 cases in the Vizient 2012 to 2015 database.

RESULTS

In the NIS, the mean inflation-adjusted cost per tumor craniotomy increased 30%, from $23 021 in 2001 to $29 971 in 2013. In 2001, the highest cost region was the Northeast ($24 486 ± $1184), and by 2013 the western United States was the highest cost region ($36 058 ± $1684). Multivariate analyses with NIS data showed that male gender, white race, private insurance, higher mortality risk, higher severity of illness, longer length of stay, elective admissions, higher wage index, urban teaching hospitals, and hospitals in the western United States were associated with higher tumor craniotomy costs (all P < .05). Multivariate analyses with Vizient data confirmed that longer length of stay and the western United States were significantly associated with higher costs (P < .001).

CONCLUSION

After controlling for patient/clinical factors, hospital type, bed size, and wage index, hospitals in the western United States had higher costs than those in other parts of the country, based on analyses from 2 separate national databases.
Starspot activity and superflares on solar-type stars
Authors: Maehara Hiroyuki , Notsu Yuta , Notsu Shota , Namekata Kosuke , Honda Satoshi , Ishii Takako T. , Nogami Daisaku , Shibata Kazunari
Published: February 2017

We analyze the correlation between starspots and superflares on solar-type stars using observations from the Kepler mission. The analysis shows that the observed fraction of stars with superflares decreases as the rotation period increases and as the amplitude of photometric variability associated with rotation decreases. We found that the fraction of stars with superflares among the stars showing large-amplitude rotational variations, which are thought to be the signature of the large starspots, also decreases as the rotation period increases. The small fraction of superflare stars among the stars with large starspots in the longer-period regime suggests that some of the stars with large starspots show a much lower flare activity than the superflare stars with the same spot area. Assuming simple relations between spot area and lifetime and between spot temperature and photospheric temperature, we compared the size distribution of large starspot groups on slowly rotating solar-type stars with that of sunspot groups. The size distribution of starspots shows the power-law distribution and the size distribution of larger sunspots lies on this power-law line. We also found that frequency–energy distributions for flares originating from spots with different sizes are the same for solar-type stars with superflares and the Sun. These results suggest that the magnetic activity we observe on solar-type stars with superflares and on the Sun is caused by the same physical processes.
Hypoxia Induces Internalization of κ-Opioid Receptor
Authors: Xi Chunhua , Liang Xuan , Chen Chunhua , Babazada Hasan , Li Tianzuo , Liu Renyu
Published: February 2017

Background

It has been demonstrated that κ-opioid receptor agonists can reduce hypoxia–ischemia brain injury in animal models. However, it is unclear how the κ-opioid receptor responds to hypoxia–ischemia. In the current study, the authors used an in vitro model of oxygen–glucose deprivation and reoxygenation to explore how κ-opioid receptors respond to hypoxia and reoxygenation.

Methods

Mouse neuroblastoma Neuro2A cells were stably transfected with mouse κ-opioid receptor–tdTomato fusion protein or Flag-tagged mouse κ-opioid receptor, divided into several groups (n = 6 to 12), and used to investigate the κ-opioid receptor movement. Observations were performed under normal oxygen, at 30 min to 1 h after oxygen–glucose deprivation and at 1 h after reoxygenation using high-resolution imaging techniques including immunoelectronmicroscopy in the presence and absence of κ-opioid receptor antagonist, dynamin inhibitors, potassium channel blockers, and dopamine receptor inhibitor.

Results

Hypoxic conditions caused the κ-opioid receptor to be internalized into the cells. Inhibition of dynamin by Dyngo-4a prevented the receptor internalization. Interestingly, a specific κ-opioid receptor antagonist norbinaltorphimine blocked internalization, suggesting the involvement of activation of a specific κ-opioid receptor. κ-Opioid receptor internalization appears to be reversed by reoxygenation. Quantities of intracellular κ-opioid receptor-associated gold particles as demonstrated by immunoelectron microscopy were increased from 37 to 85% (P < 0.01) after oxygen–glucose deprivation. Potassium channel blockers and dopamine receptor inhibitor failed to block hypoxia-induced κ-opioid receptor internalization.

Conclusions

Hypoxia induces reversible κ-opioid receptor internalization, which was inhibited by selective κ-opioid receptor antagonists or dynamin inhibitor, and can be reversed by reoxygenation in neuroblastoma cells, indicating the modulating effects between κ-opioid receptor and hypoxia via κ-opioid receptor activation and the dynamin-dependent mechanism.
Less-Restrictive Food Intake During Labor in Low-Risk Singleton Pregnancies
Authors: Ciardulli Andrea , Saccone Gabriele , Anastasio Hannah , Berghella Vincenzo
Published: February 2017

OBJECTIVE:

To evaluate benefits and harms of food intake during labor.

DATA SOURCES:

Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016.

METHODS OF STUDY SELECTION:

We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI).

TABULATION, INTEGRATION, AND RESULTS:

Ten trials, including 3,982 laboring women, were included. All the studies involved laboring singletons considered at low risk because they had no obstetric or medical complications that would increase the likelihood of cesarean delivery. In three studies, women were allowed to select from a low-residue diet throughout the course of labor. One study had honey date syrup as the allowed food intake. Five studies had carbohydrate drinks as food intake in labor. The last one was the only trial that allowed unrestrictive food intake. In the included studies, all women in the intervention group were allowed the assigned food intake until delivery, whereas women in a control group were allowed only ice chips, water, or sips of water until delivery. A policy of less-restrictive food intake was associated with a significantly shorter duration of labor (mean difference –16 minutes, 95% CI −25 to −7). No other benefits or harms in obstetric or neonatal outcome were noticed. Regurgitation during general anesthesia and Mendelson syndrome did not occur in either group.

CONCLUSION:

Women with low-risk singleton pregnancies who were allowed to eat more freely during labor had a shorter duration of labor. A policy of less-restrictive food intake during labor did not influence other obstetric or neonatal outcomes nor did it increase the incidence of vomiting. Operative delivery rates were similar.
Fecal Microbiota Transplant for Clostridium difficile Infection in a Pregnant Patient
Authors: Saeedi Bejan J. , Morison Doree Gardner , Kraft Colleen S. , Dhere Tanvi
Published: February 2017

BACKGROUND:

Clostridium difficile infection has been associated with negative outcomes in the general population and in pregnant patients. Fecal microbiota transplant has become the standard for treatment of recurrent as well as refractory C difficile infection.

CASE:

We present a case of a 28-year-old pregnant woman who presented with recurrent C difficile infection despite treatment with vancomycin and fidaxomicin and underwent a successful fecal microbiota transplant through colonoscopy at 18 weeks of gestation. She no longer required antibiotics for the remainder of her pregnancy to treat C difficile and had a term vaginal delivery at 39 weeks of gestation.

CONCLUSION:

Our pregnant patient tolerated and responded to a fecal microbiota transplant for treatment of recurrent C difficile infection. Future large-scale studies are needed to determine the efficacy, safety, and long-term effects of manipulating the microbiome in pregnant patients and the neonates.
Closed reduction with or without adductor tenotomy for developmental dysplasia of the hip presenting at walking age
Authors: Barakat Ahmed Samir , Zein Abou Bakr , Arafa Amr Said , Azab Mostafa Abdelmaboud , Reda Walid , Hegazy Mohamed Mahmoud , Al Barbary Hassan Magdy , Kaddah Mohamed Abdelhalim
Published: February 2017

Background:

Many children with developmental dislocation of the hip especially in underdeveloped countries reach walking age and still remain undiagnosed, which can be detrimental to their growth and development. Because of the lack medical services often encountered in these regions, it would be attractive to find a cheap and effective treatment. Our work evaluated the results of treatment of these children by closed reduction with or without adductor tenotomy in a prospective study.

Methods:

We included 20 patients in this study with 29 affected hips (15 right and 14 left). Nine patients (45%) had bilateral DDH and 11 (55%) had unilateral DDH. There were 18 girls (90%) and two boys (10%) who were followed up for a mean of 21 mo (18-24 mo). Ages ranged from 9 to 36 mo (mean age 18.3 mo). Patients were divided according to age into two groups: between 9-18 mo and from 19-36 mo. The first group included nine patients (14 hips) while the second had 11 patients (15 hips).

Results:

In the first group, closed reduction failed in two patients (two hips) during the follow-up period (14.3%) and this necessitated shift to open reduction, while in the second group only one patient (bilateral DDH) had a similar failure (13.3%). We identified four hips with avascular necrosis. Three of them required no further treatment, the remaining hip was openly reduced.

Conclusions:

Closed reduction in older children offers a valid and reproducible treatment modality in the hands of an experienced pediatric orthopaedic surgeon as long as there is close follow-up and thorough knowledge of possible complications and their management including the ability to shift timely to open reduction.
Current trends in orthobiologics and shoulder surgery
Authors: Wiseman Stephen P. , Nelson Stephen J. , Tyagi Vineet , Kovacevic David , Blaine Theodore A.
Published: February 2017

Shoulder pathology is of growing concern for the aging population, people who pursue an active lifestyle, and manual laborers. Rotator cuff disease and osteoarthritis represent the two most common disorders leading to shoulder pain, disability, and degeneration. The use of biologic adjuvants in the treatment of these conditions has shown promise. Platelet concentrates, scaffolds, and hyaluronic acid continue to be studied extensively to better understand the mechanism of action, clinical indications, and favored mode of application to be of greatest benefit to the pathologic shoulder. This review presents the most current literature update on the use of biologics to treat patients with shoulder disease.
Distal biceps tendon ruptures and repairs: current trends
Authors: Sethi Paul M. , Rubin Evan , Radler Keith
Published: February 2017

Injuries to the distal biceps tendon occur rather infrequently and the usual mechanism of injury is forced extension of the elbow. Rupture of the distal biceps tendon is usually accompanied by a popping sensation and results in loss of supination and flexion strength along with retraction of the biceps muscle. Surgical treatment of this injury is strongly recommended for patients who want to avoid losing significant supination, flexion, and grip strength. The traditional method of repair is reattachment of the tendon to the anatomical footprint on the radial tuberosity. This article examines the different treatment strategies and their clinical outcomes for distal biceps tendon ruptures.
Management of Toxic Epidermal Necrolysis with Plasmapheresis and Cyclosporine A: Our 10 Years’ Experience
Authors: Giudice Giuseppe , Maggio Giulio , Bufano Loredana , Memeo Giuseppe , Vestita Michelangelo
Published: February 2017

Background:

The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy.

Objective:

To share our 10 years’ experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis.

Methods:

In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital.

Results:

Average body surface area was 77; average SCORETEN was 4.3. The 12 patients had been treated with culprit drug withdrawal, systemic corticosteroids, and/or cyclosporine A with no response. The protocol was successfully administered in all 12 cases. Average time to response from protocol start was 4.9 days. Average time to remission from protocol start was 22 days; average hospital stay at our unit was 24.8 days. Four patients developed severe complications; 1 patient died. No complications linked to the protocol therapeutic measures were observed. The relatively small number of cases given the rarity of the condition is a limitation of this report.

Conclusion:

Our protocol based on the association of cyclosporine A and plasmapheresis is safe and efficacious in treating severe TEN.
Antimicrobial Susceptibility Evaluation and Multiple-Locus Variable Number Tandem Repeat Analysis of Neisseria gonorrhoeae Isolates in China in 2012
Authors: Yu Rui-xing , Yin Yueping , Dai Xiu-qin , Chen Shao-chun , Han Yan , Zheng Bing-jie , Zhang Guo-yi , Chen Xiang-sheng
Published: February 2017

Objective

This study aimed to gain information on the antimicrobial susceptibility and molecular epidemiological typing of Neisseria gonorrhoeae (NG) isolates in China in 2012.

Methods

A total of 244 NG isolates were consecutively recovered from patients with uncomplicated gonorrhea attending sexually transmitted disease clinics in 3 Chinese cities—Guangzhou, Nanjing, and Tianjin—in 2012. Neisseria gonorrhoeae susceptibilities to penicillin and tetracycline were examined by detecting penicillinase-producing NG (PPNG) and high-level tetracycline-resistant NG, and NG susceptibilities to ciprofloxacin, spectinomycin, ceftriaxone, and cefixime were determined using an agar dilution method. Neisseria gonorrhoeae isolates were typed by multiple-locus variable number tandem repeat analysis. We conducted a χ2 analysis to compare clusters with Bonferroni correction and Kruskal-Wallis test.

Results

Neisseria gonorrhoeae isolates gathered from the 3 cities differed significantly in the prevalence of tetracycline-resistant NG (P < 0.001) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.001). The analysis of the combination of the 7 variable number of tandem repeats loci for all of the 244 isolates yielded 110 multiple-locus variable number tandem repeat analysis types falling into 5 clusters. Cluster III was associated with PPNG, whereas cluster II was associated with non-PPNG (P < 0.05) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.05).

Conclusions

Antimicrobials that can be used with confidence to treat NG infection currently in China include ceftriaxone and spectinomycin, but not penicillin, tetracycline, ciprofloxacin, and cefixime. Moreover, some of the resulting clusters were associated with PPNG and NG with decreased ceftriaxone susceptibility.
The Impact of Ethnic and Cultural Differences on Parental Satisfaction in the PICU*
Authors: Sng Qian Wen , Kirk Angela H. P. , Buang Siti Nur Hanim , Lee Jan Hau
Published: February 2017

Objectives:

This study examined satisfaction of parents whose children were admitted to the PICU to identify priority areas for improvement. We hypothesized that differences exist in satisfaction of parents of different ethnicities.

Design:

Prospective observational study.

Setting:

PICU in a tertiary care pediatric hospital.

Patients:

All English-literate parents whose child was admitted to our PICU between February 2014 and February 2015 were eligible after informed consent was obtained. Parents included in this study in previous admission(s) were excluded.

Intervention:

Nil.

Measurements and Main Results:

We adapted Empowerment of Parent in the Intensive Care Questionnaire, a validated questionnaire survey specific for measuring parental satisfaction in PICUs. This adapted survey consisted of 31 questions (based on a scale of 1–6) examining five domains as follows: information giving, care and cure, parental participation, organization, and professional attitude. Reliability of Empowerment of Parent in the Intensive Care Questionnaire in our population was analyzed using Cronbach’s alpha. We used ordinal logistic regression, controlling for socioeconomic status and educational level, to examine differences in parental perceptions of various ethnicities. We obtained a total of 206 responses (36.5%) from 543 admissions. There were 116 (56%) emergency and 90 (44%) elective admissions. The proportion of respondents were Chinese (126 [61%]), Malay (32 [16%]), Indian (23 [11%]), and “Others” (25 [12%]). Cronbach’s alpha for domains of information giving (α = 0.80), care and cure (α = 0.93), parental participation (α = 0.84), organization (α = 0.79), and professional attitude (α = 0.88) were good. In all five domains, our median PICU scores were 6 (interquartile range, 5–6). Compared to other ethnic groups, Malay parents did perceive that domains of “care and cure,” “parental participation,” and “professional attitude” were less satisfactory.

Conclusions:

Significant differences were found in satisfaction ratings between parents of different ethnicities. Further studies are needed to explore and determine reasons for these differences.
Patient Safety Culture in Mutual Insurance Companies in Spain
Authors: Manzanera Rafael , Mira José Joaquín , Plana Manel , Moya Diego , Guilabert Mercedes , Ortner Jordi
Published: February 2017

Objectives

The aim of the study was to assess the safety culture in a mutual insurance sector, searching for improvement opportunities. This sector offers health insurance for work-related injuries and occupational illnesses and represents an annual volume of patients corresponding to approximately 10% of the working population in Europe.

Methods

A cross-sectional study was conducted to assess the safety culture in the mutual insurance sector in Spain. All physicians, nurses, and physiotherapists (N = 816) working in the organization in hospitals, outpatient clinics, and managerial settings were invited to reply to an online survey.

Results

A total of 499 professionals completed the questionnaire (response rate, 61%). Two dimensions were assessed: attitudinal (5 items) and instrumental (5 items). There were no differences between professional profiles or centers in the attitudinal (7.8; standard deviation, 1.3; 95% confidence interval, 7.6–7.9) or instrumental (8.5; standard deviation, 1.0; 95% confidence interval, 8.5–8.6) factors. The lowest level of implementation (<9 points) was related to the following: open disclosure after an adverse event (73%), having a quality and safety plan (75%), prioritizing the improvement of patient care (75%), and involving patients when making decisions on potential treatments (63%). Managers showed lower scores than the rest of professionals’ groups (P < 0.05).

Conclusions

This intent is to introduce a patient safety culture assessment in the mutual insurance companies. These results may encourage the implementation of quality and safety plans in this sector by paying more attention to attitudinal aspects.
Pneumothorax After Laparoscopic Robotic-Assisted Supracervical Hysterectomy and Sacrocolpopexy
Authors: Kim Ashley , Geynisman-Tan Julia , Lewicky-Gaupp Christina
Published: February 2017

We present a case of a patient in whom subcutaneous emphysema, pneumoperitoneum, and pneumothorax occurred on postoperative day 1 after robotic-assisted supracervical hysterectomy, bilateral salpingectomy, sacrocolpopexy, and retropubic midurethral sling placement for pelvic organ prolapse and stress urinary incontinence. This case demonstrates a rare complication of gynecologic laparoscopic procedures.
Diagnostic Accuracy and Clinical Implications of Translabial Ultrasound for the Assessment of Levator Ani Defects and Levator Ani Biometry in Women With Pelvic Organ Prolapse: A Systematic Review
Authors: Notten Kim J.B. , Vergeldt Tineke F.M. , van Kuijk Sander M.J. , Weemhoff Mirjam , Roovers Jan-Paul W.R.
Published: February 2017

Objective

The aim of this study was to assess the diagnostic accuracy and clinical implications of translabial 3-dimensional (3D) ultrasound for the assessment of levator ani defects and biometry in women with pelvic organ prolapse (POP).

Methods

We performed a systematic literature search through computerized databases including MEDLINE (via PubMed), EMBASE (via OvidSP), and the Cochrane Library using both medical subject headings and text terms from January 1, 2003, to December 25, 2015.

We included articles that reported on POP status and diagnostic accuracy measurements with translabial 3D ultrasound or transperineal ultrasound for the detection of levator ani defects or for measuring pelvic floor biometry, that is, levator ani hiatus, or reported on the clinical relevance of using translabial 3D ultrasound for levator ani defects or measuring pelvic floor biometry in women with POP.

Results

Thirty-one articles were selected in accordance with parts of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines that can be applied to studies of diagnostic accuracy. Twenty-two articles (71%) are coauthored by 1 expert in this field. Detecting levator ani defects with translabial 3D ultrasound compared with magnetic resonance imaging showed a moderate to good agreement, whereas measuring hiatal biometry on translabial 3D ultrasound compared with magnetic resonance imaging showed a moderate to very good agreement.

The interobserver agreement for diagnosing levator ani defects and measuring the levator hiatal area showed a moderate to very good agreement. Furthermore, levator ani defects increase the risk of cystocele and uterine prolapse, and levator ani defects are associated with recurrent POP.

Finally, a larger hiatus was associated with POP and recurrent POP.

Conclusions

Translabial 3D ultrasound is reproducible for diagnosing levator ani defects and ballooning hiatus. Both levator ani defects and a larger hiatal area are, in a selected population of patients with pelvic floor dysfunction, associated with POP and recurrent POP. More research is needed concerning external validation because most data in this article are coauthored by 1 expert in this field.
Magnetic fields in non-convective regions of stars
Authors: Braithwaite Jonathan , Spruit Henk C.
Published: February 2017

We review the current state of knowledge of magnetic fields inside stars, concentrating on recent developments concerning magnetic fields in stably stratified (zones of) stars, leaving out convective dynamo theories and observations of convective envelopes. We include the observational properties of A, B and O-type main-sequence stars, which have radiative envelopes, and the fossil field model which is normally invoked to explain the strong fields sometimes seen in these stars. Observations seem to show that Ap-type stable fields are excluded in stars with convective envelopes. Most stars contain both radiative and convective zones, and there are potentially important effects arising from the interaction of magnetic fields at the boundaries between them; the solar cycle being one of the better known examples. Related to this, we discuss whether the Sun could harbour a magnetic field in its core. Recent developments regarding the various convective and radiative layers near the surfaces of early-type stars and their observational effects are examined. We look at possible dynamo mechanisms that run on differential rotation rather than convection. Finally, we turn to neutron stars with a discussion of the possible origins for their magnetic fields.
Genetic rescue, the greater prairie chicken and the problem of conservation reliance in the Anthropocene
Authors: Mussmann S. M. , Douglas M. R. , Anthonysamy W. J. B. , Davis M. A. , Simpson S. A. , Louis W. , Douglas M. E.
Published: February 2017

A central question in conservation is how best to manage biodiversity, despite human domination of global processes (= Anthropocene). Common responses (i.e. translocations, genetic rescue) forestall potential extirpations, yet have an uncertain duration. A textbook example is the greater prairie chicken (GRPC:Tympanuchus cupido pinnatus), where translocations (1992–1998) seemingly rescued genetically depauperate Illinois populations. We re-evaluated this situation after two decades by genotyping 21 microsatellite loci from 1831 shed feathers across six leks in two counties over 4 years (2010–2013). Low migration rates (less than 1%) established each county as demographically independent, but with declining-population estimates (4 year averageN = 79). Leks were genetically similar and significantly bottlenecked, with low effective population sizes (averageNe = 13.1; 4 yearNe/N = 0.166). Genetic structure was defined by 12 significantly different family groups, with relatednessr = 0.31 > half-sibr = 0.25. Average heterozygosity, indicating short-term survival, did not differ among contemporary, pre- and post-translocated populations, whereas allelic diversity did. Our results, the natural history of GRPC (i.e. few leks, male dominance hierarchies) and its controlled immigration suggest demographic expansion rather than genetic rescue. Legal protection under the endangered species act (ESA) may enhance recovery, but could exacerbate political–economic concerns on how best to manage ‘conservation-reliant’ species, for which GRPC is now an exemplar.