bluuebunny/crossref_metadata_2025 huggingface dataset:
Geometrical characterization of fluorescently labelled surfaces from noisy 3D microscopy data
Authors: SHELTON ELIJAH , SERWANE FRIEDHELM , CAMPÀS OTGER
Published: September 2017

Modern fluorescence microscopy enables fast 3D imaging of biological and inert systems alike. In many studies, it is important to detect the surface of objects and quantitatively characterize its local geometry, including its mean curvature. We present a fully automated algorithm to determine the location and curvatures of an object from 3D fluorescence images, such as those obtained using confocal or light‐sheet microscopy. The algorithm aims at reconstructing surface labelled objects with spherical topology and mild deformations from the spherical geometry with high accuracy, rather than reconstructing arbitrarily deformed objects with lower fidelity. Using both synthetic data with known geometrical characteristics and experimental data of spherical objects, we characterize the algorithm's accuracy over the range of conditions and parameters typically encountered in 3D fluorescence imaging. We show that the algorithm can detect the location of the surface and obtain a map of local mean curvatures with relative errors typically below 2% and 20%, respectively, even in the presence of substantial levels of noise. Finally, we apply this algorithm to analyse the shape and curvature map of fluorescently labelled oil droplets embedded within multicellular aggregates and deformed by cellular forces.
Risking existence: The experience and handling of depression
Authors: Bygstad‐Landro Marte , Giske Tove
Published: September 2017

Aims and objectives

To gain insight into how people suffering from depression experience and manage life.

Background

Depression is the leading cause of incapacitation and constitutes the second largest healthcare burden worldwide, causing considerable discomfort for depression sufferers and their significant others. Depression must be understood against the backdrop of a person's context as well as biological, psychological and social factors. While various studies have been conducted on the process of depression, only a few studies have examined its existential aspects.

Design

A classical grounded theory methodology employing open and selective coding was used to identify the participants' main concern and the strategies they used to handle it.

Method

Data were collected in 2015–2016 during 18 in‐depth interviews with people with current or former moderate depression. The data were analysed through constant comparisons until the grounded theory emerged.

Results/findings

The main concern of the participants was Longing for belonging, and they handled their depression through a process named Risking existence. The process comprised four phases: (i) Ungraspable processing; (ii) Giving clues; (iii) Daring dependence; and (iv) Courage to be. The process of risking existence was accompanied from beginning to end by three essentials: to hope, to endure and shame.

Conclusion

Working in mental health care involves encountering the pain, suffering and despair that humans endure. This challenges nurses to go beyond the symptoms and to listen for their meaning to each individual person.

Relevance to clinical practice

The grounded theory of risking existence provides a model by which nurses can orient themselves when working with people who are depressed. Each phase describes different strategies that patients use that can help the nurse recognise what is going on, thus enabling him or her to understand and guide his or her patients.
Platelet‐rich fibrin/aspirin complex promotes alveolar bone regeneration in periodontal defect in rats
Authors: Du J. , Mei S. , Guo L. , Su Y. , Wang H. , Liu Y. , Zhao Z. , Wang S. , Liu Y.
Published: September 2017

Background and Objectives

The efficacy and outcomes of aspirin in local defects and the use of platelet‐rich fibrin (PRF) in periodontal defects were investigated. Whether the PRF/aspirin complex is a suitable scaffold and delivery system to carry sustained‐release aspirin/salicylic acid to promote periodontal bone regeneration was determined.

Material and Methods

PRF and PRF/aspirin complex were prepared. The concentrations of aspirin/salicylic acid released from the PRF/aspirin complex were calculated at 37°C. Periodontal ligament mesenchymal cells were cultured on six‐well plates with PRF or PRF/aspirin complex gel to analyze proliferation and migration. The alveolar bone between the inferior buccal mesial root and anterior buccal distal root of the first maxillary molar was removed in 15 rats randomly divided into three groups: no treatment, PRF or PRF/aspirin complex. Twelve weeks post‐transplantation, 2D/3D micro‐computed tomography and histomorphometric technique were used for quantitative analyses.

Results

The PRF/aspirin complex provided a sustained‐release aspirin/salicylic acid. Peak concentrations occurred 4 hours after transplantation and were sustained to 48 hours at 37°C; the total concentration of released aspirin/salicylic acid was 83.5 mg/mL, respectively. The sustained‐release promoted the proliferation and migration of periodontal ligament mesenchymal cells. Micro‐computed tomography and histological data showed that both the PRF and PRF/aspirin complex enhanced periodontal bone formation (P<.05). Moreover, the new bone formation was two times greater in the PRF/aspirin complex group than the PRF group.

Conclusion

Aspirin/salicylic acid could be sustained‐released from PRF/aspirin complex, which could inhibit inflammation and improve the function of mesenchymal cells. The data might provide a new safe and easy clinical therapeutic strategy to promote periodontal bone reparation.
Contrasting effects of two Acacia species on understorey growth in a drylands environment: interplay of canopy shading and litter interference
Authors: Helman David , Leu Stefan , Mussery Amir
Published: September 2017

Questions

Do tree species with similar canopy structures but distinct litter production volumes affect the understorey growth in dryland environments differently? How does rainfall impact the magnitude and sign of these effects?

Location

Woodland savanna, northern Negev drylands, Israel.

Methods

We determined understorey herbaceous productivity beneath the canopy of two N‐fixing tree species (Acacia victoriae and Acacia salicina) with comparable canopy structures (canopy height and area) but distinct litter production volumes. Biomass was measured beneath A. victoriae trees and in the open area between the trees for 7 yrs and beneath A. salicina and the nearby open area for 2 yrs. Light measurements, litter biomass, fine root density and nutrients and gravimetric water content in the top soil were assessed for both species. Annual rainfall and the coefficient of variation in daily rain were used to determine rainfall effects on tree–grass relations.

Results

Acacia victoriae and A. salicina had contrasting positive and negative effects on understorey growth, respectively. Both species had comparable fine root densities, soil moisture and nutrient content beneath their canopies, with a higher soil water content than the open area. The large amount of leaf litter produced by A. salicina appeared to suppress the understorey growth, likely via light interference at the soil surface, which outweighed the positive effect of moisture conditions. Acacia victoriae that produced significantly lesser amounts of litter facilitated the understorey growth via canopy shading (likely through reducing evaporative loss). Both the rainfall amount and its intra‐annual variability reduced the magnitude of the tree effect but did not change its sign.

Conclusions

Tree leaf litter production may have a contrasting effect on understorey growth, ranging from positive to negative even in the same environment. Changes in rainfall amount and intra‐annual rainfall variability affect the magnitude of the effect but not its sign.
Deinococcus radiodurans DR1088 is a novel RecF‐interacting protein that stimulates single‐stranded DNA annealing
Authors: Cheng Kaiying , Xu Guangzhi , Xu Hong , Zhao Ye , Hua Yuejin
Published: September 2017

RecF, together with the recombination mediators RecO and RecR, is required in the RecFOR homologous recombination repair pathway in bacteria. In this study, a recF‐dr1088 operon, which is highly conserved in the Deinococcus‐Thermus phylum, was identified in Deinococcus radiodurans. Interaction between DRRecF and DR1088 was confirmed by yeast two‐hybrid and pull‐down assays. DR1088 exhibited some RecO‐like biochemical properties including single/double‐stranded DNA binding activity, ssDNA binding protein (SSB) replacement ability and ssDNA (with or without SSB) annealing activity. However, unlike other recombination proteins, dr1088 is essential for cell viability. These results indicate that DR1088 might play a role in DNA replication and DNA repair processes.
Glucosamine oral administration as an adjunct to hyaluronic acid injection in treating temporomandibular joint osteoarthritis
Authors: Cen Xiao , Liu Yan , Wang Shasha , Yang Xianrui , Shi Zongdao , Liang Xinhua
Published: September 2017

Objective

To investigate the therapeutic effect of oral glucosamine (GS) as an adjunct to hyaluronic acid (HA) injection on patients with temporomandibular joint osteoarthritis (TMJ OA).

Methods

In this clinical trial, 136 participants, diagnosed as TMJ OA clinically and radiographically, were enrolled and randomized into two groups (group GS + HA: oral GS + HA injection; group placebo + HA: oral placebo + HA injection). Pain, maximum interincisal mouth opening (MMO), the levels of IL‐1β, IL‐6, and TGF‐β in TMJ synovial were defined as the outcome measurements and conducted before operation, and at 1‐month and 1‐year follow‐up.

Results

In both groups, pain scores were decreased and MMOs were increased at 1‐month and 1‐year follow‐up, the changes at 1‐year follow‐up showed statistically significant intergroup differences. At 1‐month follow‐up, only IL‐6 concentration was lower in group GS + HA than that in group placebo + HA. One year later, TGF‐β concentration was higher and IL‐6 and IL‐1β concentrations were lower in group GS + HA than those in group placebo + HA.

Conclusions

Both strategies alleviated symptoms in short term, but the patients treated with GS benefited more than those with placebo in long term, which may be due to the suppression of IL‐1β and IL‐6 and the stimulation of TGF‐β.
Is prolongation of corrected QT interval associated with seizures induced by electroconvulsive therapy reduced by atropine sulfate?
Authors: Suzuki Yoko , Miyajima Miho , Ohta Katsuya , Yoshida Noriko , Omoya Rie , Fujiwara Mayo , Watanabe Takafumi , Okumura Masaki , Yamazaki Hiroaki , Shintaku Masayuki , Murata Issei , Ozaki Shigeru , Sasaki Takeshi , Nakamura Mitsuru , Suwa Hiroshi , Sasano Tetsuo , Kawara Tokuhiro , Matsuura Masato , Matsushima Eisuke
Published: September 2017

Background

Electrocardiogram abnormalities have been reported during electroconvulsive therapy (ECT). A corrected QT interval (QTc) prolongation indicates delayed ventricular repolarization, which can trigger ventricular arrhythmias such as torsade de pointes (TdP). We examined the QTc changes during generalized tonic‐clonic seizures induced by ECT, and the effects of atropine sulfate on these QTc changes.

Methods

We analyzed heart rate, QT interval, and QTc in 32 patients with depression who underwent ECT (25 women, 67.4 ± 8.7 years of age). The QTc from −30 to 0 seconds prestimulation was used as baseline, which was compared with QTc at 20–30 seconds and 140–150 seconds poststimulus onset.

Results

QTc was significantly prolonged at 20–30 seconds poststimulus, then significantly decreased at 140–150 seconds poststimulus, compared with baseline. QTc prolongation induced by ECT was significantly decreased by atropine sulfate.

Conclusions

These data suggest that the risk of TdP may be enhanced by ECT. Further, the risk of cardiac ventricular arrhythmias, including TdP, may be reduced by administration of atropine sulfate.
Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note
Authors: van Velsen Valery , van Helmond Noud , Chapman Kenneth B.
Published: September 2017

Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio‐economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45‐year‐old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented.
Trends in outcomes of very preterm infants in Romania: A tale of three cities
Authors: Suciu Laura Mihaela , Puscasiu Lucian , Cucerea Manuela , Szabo Bela , Ognean Maria Livia , Petrescu Olimpia , Sîmpălean Dan Ștefan , Bell Edward F
Published: September 2017

Background

Although survival of preterm infants has improved, prematurity remains the second most frequent cause of death before 5 years of age in Romania. Data on the changing mortality of Romanian preterm infants born before 29 weeks of gestation have not been available.

Methods

Outcomes of infants of gestational age 25–28 weeks born in 2007–2010 (n = 247) were compared with those born in 2011–2014 (n = 235). Data were analyzed from three tertiary neonatal intensive care centers. Mortality rates and major morbidities were compared between these two epochs.

Results

Infants in the later epoch were more likely to have been born by cesarean section and had higher 1 and 5 min Apgar scores. Mortality rate decreased significantly with increasing gestational age at birth. Between the two epochs, the in‐hospital mortality rate decreased from 65.6% to 29.4% (P < 0.001); death in the first 48 h decreased from 30.0% to 8.5% (P < 0.001); and prevalence of severe intraventricular hemorrhage decreased from 52.2% to 11.9% (P < 0.001). There were significant increases in the rates of necrotizing enterocolitis and bronchopulmonary dysplasia among survivors but no change in the rate of retinopathy of prematurity. The rate of antenatal corticosteroid use did not change and was only 47% in the more recent epoch (2011–2014).

Conclusions

Overall mortality is decreasing, and infants admitted in the later epoch had substantially different rates of mortality and several serious morbidities. The low rate of antenatal corticosteroid use provides an opportunity for further reductions in mortality and morbidity among very preterm infants born in Romania.
Modification of growth anisotropy and cortical microtubule dynamics in Arabidopsis hypocotyls grown under microgravity conditions in space
Authors: Soga Kouichi , Yamazaki Chiaki , Kamada Motoshi , Tanigawa Naoki , Kasahara Haruo , Yano Sachiko , Kojo Kei H. , Kutsuna Natsumaro , Kato Takehide , Hashimoto Takashi , Kotake Toshihisa , Wakabayashi Kazuyuki , Hoson Takayuki
Published: September 2017

We carried out a space experiment, denoted as Aniso Tubule, to examine the effects of microgravity on the growth anisotropy and cortical microtubule dynamics in Arabidopsis hypocotyls, using lines in which microtubules are visualized by labeling tubulin or microtubule‐associated proteins (MAPs) with green fluorescent protein (GFP). In all lines, GFP‐tubulin6 (TUB6)‐, basic proline‐rich protein1 (BPP1)‐GFP‐ and spira1‐like3 (SP1L3)‐GFP‐expressing using a constitutive promoter, and spiral2 (SPR2)‐GFP‐ and GFP‐65 kDa MAP‐1 (MAP65‐1)‐expressing using a native promoter, the length of hypocotyls grown under microgravity conditions in space was longer than that grown at 1 g conditions on the ground. In contrast, the diameter of hypocotyls grown under microgravity conditions was smaller than that of the hypocotyls grown at 1 g. The percentage of cells with transverse microtubules was increased under microgravity conditions, irrespective of the lines. Also, the average angle of the microtubules with respect to the transverse cell axis was decreased in hypocotyls grown under microgravity conditions. When GFP fluorescence was quantified in hypocotyls of GFP‐MAP65‐1 and SPR2‐GFP lines, microgravity increased the levels of MAP65‐1, which appears to be involved in the maintenance of transverse microtubule orientation. However, the levels of SPR2 under microgravity conditions were comparable to those at 1 g. These results suggest that the microgravity‐induced increase in the levels of MAP65‐1 is involved in increase in the transverse microtubules, which may lead to modification of growth anisotropy, thereby developing longer and thinner hypocotyls under microgravity conditions in space.
Thermomechanical Analysis of an Electrically Assisted Wire Drawing Process
Authors: Sánchez Egea Antonio J. , González Rojas Hernán A. , Celentano Diego J. , Jorba Perió Jordi , Cao Jian
Published: September 2017

Electrically assisted (EA) wire drawing process is a hybrid manufacturing process characterized by enhancement of the formability, ductility, and elongation of the wire drawn specimen. A thermomechanical model to describe the change of the mechanical response due to the thermal contribution is proposed in this work. Additionally, a numerical simulation was conducted to study the potential and limitations of this hybrid process by using two different hardening laws: a phenomenological and a dislocation-based hardening laws. The results show how the flow stress, the effective plastic strain, and residual stresses behave under the electroplusing effect. In addition, electron backscattered diffraction was used to study the electropulsing treatments on the microstructure during cold drawing. It is observed a decrease of the high- and low-angle grain boundaries (LAGB) for samples deformed with electropulsing. This detwinning process has a strong influence on the strain hardening by improving the material formability. It was shown that the two proposed hardening laws adequately describe the EA wire drawing process showing a similar mechanical behavior. Nevertheless, the dislocation-based hardening law has the potential to be generalized to many other material and process configurations without extensive number of material tests as the phenomenological hardening law would require.
Power Cycle Assessment of Nuclear Systems, Providing Energy Storage for Low Carbon Grids
Authors: Fathi Nima , McDaniel Patrick , Forsberg Charles , de Oliveira Cassiano
Published: September 2017

The intermittency of renewable power generation systems on the low carbon electric grid can be alleviated by using nuclear systems as quasi-storage systems. Nuclear air-Brayton systems can produce and store hydrogen when electric generation is abundant and then burn the hydrogen by co-firing when generation is limited. The rated output of a nuclear plant can be significantly augmented by co-firing. The incremental efficiency of hydrogen to electricity can far exceed that of hydrogen in a standalone gas turbine. Herein, we simulate and evaluate this idea on a 50 MW small modular liquid metal/molten salt reactor. Considerable power increases are predicted for nuclear air-Brayton systems by co-firing with hydrogen before the power turbine.
Fatigue-Ratcheting Behavior of 6 in Pressurized Carbon Steel Piping Systems Under Seismic Load: Experiments and Analysis
Authors: Ravi Kiran A. , Reddy G. R. , Dubey P. N. , Agrawal M. K.
Published: September 2017

This article presents the experimental and numerical studies of fatigue-ratcheting in carbon steel piping systems under internal pressure and earthquake load. Shake table tests are carried out on two identical 6 in pressurized piping systems made of carbon steel of grade SA333 Gr 6. Tests are carried out using similar incremental seismic load till failure. Wavelet analysis is carried to evaluate frequency change during testing. The tested piping systems are analyzed using iterative response spectrum (IRS) method, which is based on fatigue-ratcheting and compared with test results. Effect of thickness variation in elbow on strain accumulation is studied. Excitation level for fatigue-ratcheting failure is also evaluated and the details are given in this paper.
Characterization of Various Channel Fields Using an Initial Ensemble Selection Schemeand Covariance Localization
Authors: Jung Hyungsik , Jo Honggeun , Lee Kyungbook , Choe Jonggeun
Published: September 2017

Ensemble Kalman filter (EnKF) uses recursive updates for data assimilation and provides dependable uncertainty quantification. However, it requires high computing cost. On the contrary, ensemble smoother (ES) assimilates all available data simultaneously. It is simple and fast, but prone to showing two key limitations: overshooting and filter divergence. Since channel fields have non-Gaussian distributions, it is challenging to characterize them with conventional ensemble based history matching methods. In many cases, a large number of models should be employed to characterize channel fields, even if it is quite inefficient. This paper presents two novel schemes for characterizing various channel reservoirs. One is a new ensemble ranking method named initial ensemble selection scheme (IESS), which selects ensemble members based on relative errors of well oil production rates (WOPR). The other is covariance localization in ES, which uses drainage area as a localization function. The proposed method integrates these two schemes. IESS sorts initial models for ES and these selected are also utilized to calculate a localization function of ES for fast and reliable channel characterization. For comparison, four different channel fields are analyzed. A standard EnKF even using 400 models shows too large uncertainties and updated permeability fields lose channel continuity. However, the proposed method, ES with covariance localization assisted by IESS, characterizes channel fields reliably by utilizing good 50 models selected. It provides suitable uncertainty ranges with correct channel trends. In addition, the simulation time of the proposed method is only about 19% of the time required for the standard EnKF.
Centrifugal Compressor Performance Improvements Through Impeller Splitter Location
Authors: Xu C. , Amano R. S.
Published: September 2017

The splitter blades are very common to use for centrifugal compressor impellers to improve the compressor performance and manufacturing capability. In this study, a low-flow single-stage centrifugal compressor with a vaneless diffuser was used to investigate the location effects of the impeller splitter between two main blades. It is demonstrated that the splitter position provides an opportunity to improve the compressor performance and reduce the operational cost. The splitter location optimizations were performed numerically, and the optimal splitter location was identified. A prototype was built for the impeller with optimal splitter position. The performance tests were performed, and test results are compared with numerical analyses. The studies indicated that splitter positions have impacts on the compressor stage performances. The studies showed that the traditional splitter located in the middle of the two main blades is not the optimal location for aerodynamic performance. The splitter location optimization provided the opportunity to improve the centrifugal compressor performance further.
Chemical copatterning strategies using azlactone-based block copolymers
Authors: Masigol Mohammadali , Barua Niloy , Retterer Scott T. , Lokitz Bradley S. , Hansen Ryan R.
Published: September 2017

Interfaces can be modified with azlactone-functional polymers in order to manipulate the chemical surface reactivity. Azlactone groups are highly reactive toward amine, thiol, and alcohol nucleophiles, providing a versatile coupling chemistry for secondary surface modification. Azlactone-based surface polymers have been explored in numerous applications, including chemical and biological capture, sensing, and cell culture. These applications often require that the polymer is copatterned within a chemically or biologically inert background; however, common fabrication methods degrade azlactone groups during processing steps or result in polymer films with poorly controlled thicknesses. Here, the authors develop fabrication strategies using parylene lift-off and interface-directed assembly methods to generate microscale patterns of azlactone-based block copolymer in chemically or biologically inert backgrounds. The functionality of azlactone groups was preserved during fabrication, and patterned films appeared as uniform, 80–120 nm brushlike films. The authors also develop a patterning approach that uses a novel microcontact stamping method to generate cross-linked, three-dimensional structures of azlactone-based polymers with controllable, microscale thicknesses. The authors identify the benefits of each approach and expect these polymers and patterning strategies to provide a versatile toolbox for developing synthetic interfaces with tuned chemical and physical features for sensing, cell culture, or material capture applications.
Genome Sequence of
Roseovarius
sp. Strain MCTG156(2b) Isolated from a Phytoplankton Net Trawl on the Scottish West Coast
Authors: Gutierrez Tony , Whitman William B. , Huntemann Marcel , Copeland Alex , Chen Amy , Vargese Neha , Kyrpides Nikos C. , Pillay Manoj , Ivanova Natalia , Mikhailova Natalia , Mukherjee Supratim , Stamatis Dimitrios , Reddy T. B. K. , Ngan Chew Yee , Chovatia Mansi , Daum Chris , Shapiro Nicole , Woyke Tanja
Published: September 2017

Roseovarius
sp. strain MCTG156(2b) was isolated from a phytoplankton net sample collected on the west coast of Scotland and was selected based on its ability to degrade polycyclic aromatic hydrocarbons. Here, we present the genome sequence of this strain, which is 5,113,782 bp, with 5,142 genes and an average G+C content of 60.7%.
Complete Genome Sequence of Systemically Disseminated Sequence Type 8 Staphylococcal Cassette Chromosome
mec
Type IVl Community-Acquired Methicillin-Resistant Staphylococcus aureus
Authors: Hisatsune Junzo , Hagiya Hideharu , Shiota Sumiko , Sugai Motoyuki
Published: September 2017

Staphylococcus aureus
JH4899, a community-acquired methicillin-resistant
Staphylococcus aureus
(CA-MRSA) isolate collected from a patient with systematically disseminated infection, is classified as sequence type 8 and carries the staphylococcal cassette chromosome
mec
type IVl (SCC
mec
IVl). It produces TSST-1, SEC, a newly discovered enterotoxin (SE1), and epidermal cell differentiation inhibitor A (EDIN-A). Here, we present the complete genome sequence of the chromosome and a plasmid harboring the
se1
and
ednA
genes.
Complete Genome Sequence of
Frog virus 3
, Isolated from a Strawberry Poison Frog (
Oophaga pumilio
) Imported from Nicaragua into the Netherlands
Authors: Saucedo Bernardo , Hughes Joseph , van Beurden Steven J. , Suárez Nicolás M. , Haenen Olga L. M. , Voorbergen-Laarman Michal , Gröne Andrea , Kik Marja J. L.
Published: September 2017

Frog virus 3
was isolated from a strawberry poison frog (
Oophaga pumilio
) imported from Nicaragua via Germany to the Netherlands, and its complete genome sequence was determined.
Frog virus 3
isolate
Op
/2015/Netherlands/UU3150324001 is 107,183 bp long and has a nucleotide similarity of 98.26% to the reference
Frog virus 3
isolate.
Complete Genome Sequences of Two Swiss Hepatitis E Virus Isolates from Human Stool and Raw Pork Sausage
Authors: Kubacki Jakub , Fraefel Cornel , Jermini Marco , Giannini Petra , Martinetti Gladys , Ripellino Paolo , Bernasconi Enos , Sidler Xaver , Stephan Roger , Bachofen Claudia
Published: September 2017

We present here the full-length genome sequences of two hepatitis E virus genotype 3 (HEV-3) isolates from a human stool sample from a patient with acute hepatitis and a raw sausage containing pig liver. Sequence analysis implies that Swiss HEV isolates may form a novel subgroup of HEV-3 viruses.
Whole-Genome Sequence of Chlamydia abortus Strain GN6 Isolated from Aborted Yak Fetus
Authors: Li Zhaocai , Cai Jinshan , Cao Xiaoan , Lou Zhongzi , Chao Yilin , Kan Wei , Zhou Jizhang
Published: September 2017

The obligate intracellular Gram-negative bacterium
Chlamydia abortus
is one of the causative agents of abortion and fetal loss in sheep, goats, and cattle in many countries. It also affects the reproductivity of yaks (
Bos grunniens
). This study reports the whole-genome sequence of
Chlamydia abortus
strain GN6, which was isolated from aborted yak fetus in Qinghai-Tibetan Plateau, China.
Complete Genome Sequences of Two Pseudomonas aeruginosa Strains Isolated from Children with Bacteremia
Authors: Espinosa-Camacho Luis F. , Delgado Gabriela , Miranda-Novales Guadalupe , Soberón-Chávez Gloria , Alcaraz Luis D. , Morales-Espinosa Rosario
Published: September 2017

Two
Pseudomonas aeruginosa
strains isolated from children with bacteremia in Mexico City were sequenced using PacBio RS-II single-molecule real-time (SMRT) technology. The strains consist of a 7.0- to 7.4-Mb chromosome, with a high content of mobile elements, and variation in the genetic content of class 1 integron In1409.
Excess all-cause mortality before age 30 in childhood onset type 1 diabetes: data from the Brecon Group Cohort in Wales
Authors: Wasag Diana R , Gregory John W , Dayan Colin , Harvey John N
Published: September 2017

Background

Long-term outcomes in young people with type 1 diabetes continue to be of interest, and may help evaluate the effects of changes to the clinical care of children that have occurred in recent decades.

Aims

To identify mortality and its causes before age 30 years in patients developing type 1 diabetes before age 15 years.

Methods

Since 1995, paediatricians in Wales have compiled a prospective register of incident cases of type 1 diabetes occurring before age 15 years in Wales (the Brecon Cohort). Their subsequent mortality rates were compared with mortality in the general populations of Wales and England using the patient-years exposure method. Causes of death were ascertained from death certificates and from clinicians.

Results

The standardised mortality ratio for young people with type 1 diabetes in Wales was 2.91 with no clear evidence of improvement or worsening of mortality risk over time. Most deaths occurred between ages 15 and 30 years although at a slightly younger age than in the general population. There were more deaths with increasing age at diagnosis of diabetes. Ketoacidosis remains the most common cause of death before age 30 years. Hypoglycaemia was difficult to ascertain with certainty but also caused some deaths. In this age group, chronic complications of diabetes were not a cause of mortality.

Conclusions

Despite the developments in clinical care in recent years, the mortality risk for people developing type 1 diabetes in childhood remains high in young adult life before the onset of chronic complications.
Over-the-scope-clip system secured nasojejunal tube feeding in refractory hyperemesis gravidarum
Authors: Kubovy Jan , Them Agnieszka , Cameron Rees , Langdana Fali
Published: September 2017

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It complicates up to 2% of all pregnancies and can be associated with adverse outcomes. Its management commonly involves a combination pharmacotherapy, however, the efficacy of such treatment is limited. Supplemental nutrition is often required in refractory cases. Enteral route is preferred over parenteral, given the high rate of intravenous catheter-related complications. Enteral feeding tube placement can be challenging and is commonly thwarted by dislodgement. We present a pharmacotherapy refractory HG case where the over-the-scope-clip (OTSC) system was successfully used for durable mucosal fixation of the nasojejunal feeding tube.
Lens power in Iranian schoolchildren: a population-based study
Authors: Hashemi Hassan , Pakzad Reza , Iribarren Rafael , Khabazkhoob Mehdi , Emamian Mohammad Hassan , Fotouhi Akbar
Published: September 2017

Aims

To evaluate lens power (LP) in schoolchildren aged 6–12 years.

Methods

This cross-sectional study was conducted in Shahroud, northeast Iran. The students were selected through random cluster sampling and underwent the measurements of biometry, uncorrected and corrected visual acuity, non-cycloplegic and cycloplegic refraction. The LP was calculated using the Bennett formula.

Results

Of 6624 invited children, 5620 (84.8%) participated in the study and data of 4870 children were finally analysed. The mean age of the participants was 9.7 years and 2277 participants (46.02%) were girls. The mean LPs were 22.86 dioptres (D) in total study population, 23.91 D in 6 and 22.10 D in 12-year-old children. The mean LP was higher in girls than boys (23.48 D vs 22.34 D), in rural children than urban children (23.17 D vs 22.83 D) and in children with hyperopia (23.25 D) than children with myopia or emmetropia (22.64 D and 22.86 D, respectively). In the multiple linear regression model, lens thickness (β=1.59, p<0.001), anterior chamber depth (β=2.21, p<0.001) and female sex (β=0.016, p=0.015) were associated with an increase in the LP, while axial length (AL) (β=−4.41, p<0.001), corneal power (CP) (β=−1.47, p<0.001), spherical equivalent (SE) (β=−1.50, p<0.001) and age (β=−0.005, p=0.001) were associated with a decrease in the LP. AL and sex had the highest and lowest impact on LP, respectively.

Conclusion

LP decreased with age between 6 and 12 years and was associated with a shorter AL, deeper ACD, higher SE, thicker lens and lower CP.
The relationship between school type and academic performance at medical school: a national, multi-cohort study
Authors: Kumwenda Ben , Cleland Jennifer A , Walker Kim , Lee Amanda J , Greatrix Rachel
Published: September 2017

Objectives

Differential attainment in school examinations is one of the barriers to increasing student diversity in medicine. However, studies on the predictive validity of prior academic achievement and educational performance at medical school are contradictory, possibly due to single-site studies or studies which focus only on early years’ performance. To address these gaps, we examined the relationship between sociodemographic factors, including school type and average educational performance throughout medical school across a large number of diverse medical programmes.

Methods

This retrospective study analysed data from students who graduated from 33 UK medical schools between 2012 and 2013. We included candidates’ demographics, pre-entry grades (adjusted Universities and Colleges Admissions Service tariff scores) preadmission test scores (UK Clinical Aptitude Test (UKCAT) and Graduate Medical School Admissions Test (GAMSAT)) and used the UK Foundation Programme’s educational performance measure (EPM) decile as an outcome measure. Logistic regression was used to assess the independent relationship between students’ background characteristics and EPM ranking.

Results

Students from independent schools had significantly higher mean UKCAT scores (2535.1, SD=209.6) than students from state-funded schools (2506.1, SD=224.0, p<0.001). Similarly, students from independent schools came into medical school with significantly higher mean GAMSAT scores (63.9, SD=6.9) than students from state-funded schools (60.8, SD=7.1, p<0.001). However, students from state-funded schools were almost twice as likely (OR=2.01, 95% CI 1.49 to 2.73) to finish in the highest rank of the EPM ranking than those who attended independent schools.

Conclusions

This is the first large-scale study to examine directly the relationship between school type and overall performance at medical school. Our findings provide modest supportive evidence that, when students from independent and state schools enter with similar pre-entry grades, once in medical school, students from state-funded schools are likely to outperform students from independent schools. This evidence contributes to discussions around contextualising medical admission.
Predictors of discharge destination from acute care in patients with traumatic brain injury
Authors: Zarshenas Sareh , Tam Laetitia , Colantonio Angela , Alavinia Seyed Mohammad , Cullen Nora
Published: September 2017

Introduction

Many studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.

Methods and analysis

This systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.

Ethics and dissemination

The results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.

Trial registration number

Trial registration number (PROSPERO) is CRD42016033046.
Improving health maintenance supervision in a paediatric IBD clinic
Authors: Dykes Dana M H , Jean Marie Raphaelle , Morgan Pamela , Hill Denise , Williams Elizabeth , Opipari-Arigan Lisa , Huggins Jennifer , Saeed Shehzad A
Published: September 2017

Background

Previsit planning (PVP) has been an integral part of clinical care for paediatric patients with inflammatory bowel disease (IBD) at Cincinnati Children’s Hospital Medical Center since 2007. Over the past years, we have adopted several programmes to improve health maintenance supervision for our paediatric patients with IBD but did not have a sustainable way to provide health maintenance updates for every patient at every encounter that was concise and complete in the setting of an increasing patient population and fewer support staff to complete the work.

Methods

Using quality improvement methods, we completed several Plan-Do-Study-Act (PDSA) cycles aimed at improving our centre’s ability to provide complete health maintenance ‘bundle’ recommendations from 0% to 90% of patients over a period of 11 months.

Results

First steps included consensus gathering and summarising evidence into guidelines suitable for the group. PDSAs centred on consensus building from standardised guidelines, using empty checklists for simulated and real patients, and use of autofilled checklists. After several PDSA cycles, we have improved our ability to provide complete health maintenance PVP from 0% to nearly 100% with very little variation.

Conclusion

Using the health maintenance PVP process, we can now sustainably provide health maintenance guidance for all outpatient clinic visits. We have begun to scale up this work and anticipate over the coming months that we will be able to expand the health maintenance PVP to provide complete PVP for over 90% of patients for any scheduled encounter including biologic infusion visits. We anticipate that using this reliable process we can improve remission rates and reduce preventable infections for these at-risk patients.
Electronic display board in operating theatres for easy patient identification
Authors: Lim Si Ching , Koh Adrian Jit Hin , Poon Edward Wing Hong
Published: September 2017

ObjectiveTo correct patient identification for surgery nd reduce risk of wrong site surgery.

Surgical care is high risk and complex and errors are associated with huge negative implications. The need to identify patients correctly before surgeries is important to reduce risk of wrong-site surgeries. Operating theatres (OT) are a highly stressful work environment where time and resources are precious and errors are more likely to occur. Having a clear display of the two patients’ identifiers improves ease and safety during time out and noting critical results in the OT.

MethodologyDeming's Plan-Do-Study-act cycle where the work group meet regularly to review results of various strategies put up and implement further changes.

ResultsBoth the surgeons and nurses found it safer to have patients' two identifiers and nature of operation on display while noting critical results and confirming patients' details during time out.
Climate change, weather and road deaths
Authors: Robertson Leon
Published: September 2017

In 2015, a 7% increase in road deaths per population in the USA reversed the 35-year downward trend. Here I test the hypothesis that weather influenced the change in trend. I used linear regression to estimate the effect of temperature and precipitation on miles driven per capita in urbanizedurbanised areas of the USA during 2010. I matched date and county of death with temperature on that date and number of people exposed to that temperature to calculate the risk per persons exposed to specific temperatures. I employed logistic regression analysis of temperature, precipitation and other risk factors prevalent in 2014 to project expected deaths in 2015 among the 100 most populous counties in the USA. Comparison of actual and projected deaths provided an estimate of deaths expected without the temperature increase.
Recent advances in neuropathology, biomarkers and therapeutic approach of multiple system atrophy
Authors: Koga Shunsuke , Dickson Dennis W
Published: September 2017

Multiple system atrophy (MSA) is a progressive neurodegenerative disorder characterised by a variable combination of autonomic failure, levodopa-unresponsive parkinsonism, cerebellar ataxia and pyramidal symptoms. The pathological hallmark is the oligodendrocytic glial cytoplasmic inclusion (GCI) consisting of α-synuclein; therefore, MSA is included in the category of α-synucleinopathies. MSA has been divided into two clinicopathological subtypes: MSA with predominant parkinsonism and MSA with predominant cerebellar ataxia, which generally correlate with striatonigral degeneration and olivopontocerebellar atrophy, respectively. It is increasingly recognised, however, that clinical and pathological features of MSA are broader than previously considered.

In this review, we aim to describe recent advances in neuropathology of MSA from a review of the literature and from information derived from review of nearly 200 definite MSA cases in the Mayo Clinic Brain Bank. In light of these new neuropathological findings, GCIs and neuronal cytoplasmic inclusions play an important role in clinicopathological correlates of MSA. We also focus on clinical diagnostic accuracy and differential diagnosis of MSA as well as candidate biomarkers. We also review some controversial topics in MSA. Cognitive impairment, which has been a non-supporting feature of MSA, is considered from both clinical and pathological perspectives. The cellular origin of α-synuclein in GCI and a ‘prion hypothesis’ are discussed. Finally, completed and ongoing clinical trials targeting disease modification, including immunotherapy, are summarised.
Correlation of hypogammaglobulinaemia with proteinuria, and the relationship between hypogammaglobulinaemia and infection in active lupus nephritis
Authors: Smilek Dawn Elaine , Lim Noha , Ding Linna , Murray Sara G. , Diamond Betty , Wofsy David
Published: September 2017

Objective

To evaluate hypogammaglobulinaemia and risk of serious infectious adverse events in active lupus nephritis.

Methods

The Abatacept and Cyclophosphamide Combination Efficacy and Safety Study (ACCESS) compared abatacept with placebo in participants with lupus nephritis undergoing treatment with Euro-Lupus Nephritis low-dose cyclophosphamide. Serum IgG levels were assessed prior to initiation of treatment and throughout the trial. Hypogammaglobulinaemia was defined as IgG <450 mg/dL.

Results

Hypogammaglobulinaemia was observed in 16/102 (15.7%) participants prior to initiation of induction therapy for active lupus nephritis. Participants with nephrotic range proteinuria were more likely to have hypogammaglobulinaemia, and serum IgG levels were inversely correlated with urine protein to creatinine ratio (r=−0.42, p<0.0001). Following initiation of treatment for active lupus nephritis, additional participants developed hypogammaglobulinaemia by weeks 2–4. Serum IgG levels then increased, and all but one participant had serum IgG ≥450 mg/dL at 24 weeks. Hypogammaglobulinaemia was not associated with an increased risk of serious infectious adverse events.

Conclusions

In active lupus nephritis in ACCESS, hypogammaglobulinaemia was common and inversely correlated with proteinuria. Serum IgG levels were lowest in the weeks immediately following initiation of induction therapy, and subsequently improved by 24 weeks. Hypogammaglobulinaemia was not associated with serious infectious adverse events.

Trial registration
Acute hepatitis A infection after hepatitis A immunity in a HIV-positive individual
Authors: Lee Ming Jie , Douthwaite Sam , Kulasegaram Ranjababu
Published: September 2017

Hepatitis A is a self-limiting infection caused by the hepatitis A virus (HAV), transmitted predominantly by the faecal–oral route including some sexual practices. Outbreaks are commonly reported in the men who have sex with men (population. Previous exposure is thought to provide life-long immunity against subsequent infections with the development of an HAV IgG response. This paper reports a case of acute Hepatitis A infection, despite evidence of a previously positive Hepatitis A IgG results in an HIV-positive individual.