bluuebunny/crossref_metadata_2025 huggingface dataset:
Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery – A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage
Authors: Hansen Kristoffer , Hansen Peter , Ewertsen Caroline , Lönn Lars , Jensen Jørgen , Nielsen Michael
Published: March 2019

Stenosis of the superficial femoral artery (SFA) induces complex blood flow with increased velocities. Disease assessment is performed with Doppler ultrasound and digital subtraction angiography (DSA), but Doppler ultrasound is limited by angle dependency and DSA by ionizing radiation. An alternative is the vector flow imaging method based on transverse oscillation (TO), an angle-independent vector velocity technique using ultrasound. In this study, flow complexity and velocity measured with TO were compared with DSA for the assessment of stenosis in the SFA.

The vector concentration, a measure of flow complexity, and the velocity ratio obtained from the stenosis and a disease-free adjacent vessel segment, were estimated with TO in 11 patients with a total of 16 stenoses of the SFA. TO data were compared with the corresponding stenosis degree percentage obtained with DSA.

The correlation between the vector concentration and DSA was very strong (R=0.93; p<0.001; 95% confidence interval (CI): 0.81–0.98), while only moderate for velocity ratio and DSA (R=0.50; p<0.07; 95% CI: 0.00–0.80). The correlation coefficients that were found were significantly different (p<0.005) without overlapping CI.

The study indicated that flow changes in the SFA induced by stenosis can be quantified with TO, and that stenosis grading may be improved by estimation of flow complexity instead of velocity ratio. TO is a potential diagnostic tool for the assessment of atherosclerosis and peripheral arterial disease.
Plant Allergen-Induced Contact Dermatitis
Authors: Esser Philipp , Mueller Sabine , Martin Stefan
Published: March 2019

Although manifold beneficial effects of plant compounds for the treatment of skin disorders are known, cutaneous exposure to plants can also result in various types of incompatibility reactions such as contact dermatitis. In this mini-review, we briefly describe the different clinical forms of contact dermatitis (photoinduced, irritative, and allergic form) and highlight recent publications in the field of contact dermatitis. Major topics are recent recommendations regarding testing for plant contact dermatitis, advances in understanding the immunological mechanisms of plant contact dermatitis, and case reports for plant contact dermatitis. Unfortunately, most people still associate the terms “healthy and safe to use” with plant compounds due to their natural origin, leading to an increased utilization, be it for home-made remedies or as cosmetics. Therefore, it is on the one hand important to raise awareness in a broad audience that plants may cause contact dermatitis and on the other hand to indicate to clinicians that plants should be included in a patch test if a history of plant exposure exists.
Patellar Height Is Not Altered When the Knee Axis Correction Is Less than 15 Degrees and Has Good Short-Term Clinical Outcome
Authors: Jingbo Cheng , Mingli Feng , Guanglei Cao , Zheng Li , Shuai An , Jiang Huang
Published: March 2019

The objectives of our study were to evaluate (1) patellar height changes when the knee axis correction was < 15 degrees and (2) the clinical effect after open wedge high tibial osteotomy (OWHTO). Sixty-nine patients (69 knees) undergoing OWHTO between January 2016 and June 2017 were enrolled in this prospective study. All patients underwent OWHTO using a three-dimensional (3D)-printed patient-specific instrument. We used X-ray and lower-limb computed tomography scan to measure the osteotomy angle, patellar height, and other patellofemoral joint indices. We used the hospital for special surgery knee (HSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Kujala's scores to evaluate the clinical outcome. All knee axis corrections were less than 15 degrees. The change in posterior tibial slope (PTS) did not show a statistically significant difference. We observed that the patellar height was not altered when we used femur referenced measurement method. The change in modified Miura–Kawamura index (MKI) and Femoral patellar height index (FPHI) did not show a statistically significant difference. The differences in Blackburne–Peel index (BPI) and Caton–Deschamps index (CDI) were statistically significant, decreasing from 0.91 ± 0.12 and 1.06 ± 0.11 preoperatively to 0.79 ± 0.13 and 0.95 ± 0.11 postoperatively, respectively. In the axial plane, we did not observe a change in lateral patellar shift (LPS), but we found that lateral patellar tilt (LPT) showed a significant decrease from 8.67 ± 2.60 degrees preoperatively to 6.13 ± 2.30 postoperatively, respectively. The tuberositas tibae–trochlear groove (TT–TG) distance showed a significant decrease after OWHTO from 14.30 ± 4.10 mm preoperatively to 11.52 ± 3.63 mm postoperatively. The clinical score showed a significant increase after OWHTO, and all patients were satisfied with the outcome. After OWHTO, the patellar height was not altered when the knee axis correction was < 15 degrees. It was also found that there was still lateral displacement of the patella. Internal rotation of the distal tibia is an important cause of LPT reduction. After OWHTO, all patients achieved satisfactory clinical outcomes. At 1-year short-term follow-up, patients did not report discomfort in the patellofemoral joint. The Level of Evidence for this study was IV.
Incidence and Risk Factors for Hospital Readmission or Unexpected Visits in Women Undergoing Unscheduled Cesarean Delivery
Authors: La Rosa Mauricio , Jauk Victoria , Saade George R. , Boggess Kim , Longo Sherri , Clark Erin A. S. , Esplin Sean , Cleary Kirsten , Wapner Ronald , Letson Kellet , Owens Michelle Y. , Blackwell Sean , Szychowski Jeff M. , Andrews William , Tita Alan T. ,   for the Cesarean Section Optimal Antibiotic Prophylaxis Trial Consortium
Published: March 2019

Objective Hospital readmissions are increasingly tracked and assessed for value-based compensation. Our objective was to determine the incidence and risk factors associated with post-cesarean delivery (CD) readmissions or unexpected visits, defined as unexpected office or emergency room visits.

Study Design This is a secondary analysis of a multicenter randomized controlled trial of adjunctive azithromycin prophylaxis for CD performed in laboring patients with viable pregnancies. Patients were followed up to 6 weeks postpartum. Our primary outcome was a composite of hospital readmission or unexpected visit, defined as unscheduled clinic or emergency department visits. Data of hospital readmissions, unexpected visits, and their reasons were collected. Demographics, antepartum, intrapartum, and postpartum risk factors were evaluated in bivariate analyses and multivariable logistic regression modeling.

Results A total of 1,019 women were randomized to azithromycin and 994 to placebo. The prevalence of readmission or unexpected visit was 10.2% (95% confidence interval [CI]: 8.9–11.6), with rates of 3.8% (95% CI: 3.0–4.7%) hospital readmissions, 6.9% (95% CI: 5.8–8.0%) emergency room visits, and 4.2% (95% CI: 3.4–5.2%) unexpected clinic visits. The most common causes were infectious disease and hypertensive disorder. Women with readmissions or unexpected visits were more likely to be obese and diabetic, as well as experience longer length of ruptured membranes, intrauterine pressure catheter placement, and postpartum fevers. On multivariable analysis, diabetes (adjusted odds ratio [aOR]: 1.6, 95% CI: 1.1–2.4), prolonged ruptured membranes (aOR: 1.9, 95% CI: 1.3–2.8), and postpartum fevers (aOR: 4.6, 95% CI: 3.0–7.0) were significantly positively associated with readmission or unscheduled visit, while azithromycin was a protective (aOR: 0.6, 95% CI: 0.5–0.9).

Conclusion Women who had postpartum fever were at especially high risk for readmission or unexpected visits. Diabetes, prolonged ruptured membranes, and postpartum fevers were significantly associated with the adverse outcome, and azithromycin was associated with lower rates of readmission and unexpected visits.
Generalized network dismantling
Authors: Ren Xiao-Long , Gleinig Niels , Helbing Dirk , Antulov-Fantulin Nino
Published: March 2019

Finding an optimal subset of nodes in a network that is able to efficiently disrupt the functioning of a corrupt or criminal organization or contain an epidemic or the spread of misinformation is a highly relevant problem of network science. In this paper, we address the generalized network-dismantling problem, which aims at finding a set of nodes whose removal from the network results in the fragmentation of the network into subcritical network components at minimal overall cost. Compared with previous formulations, we allow the costs of node removals to take arbitrary nonnegative real values, which may depend on topological properties such as node centrality or on nontopological features such as the price or protection level of a node. Interestingly, we show that nonunit costs imply a significantly different dismantling strategy. To solve this optimization problem, we propose a method which is based on the spectral properties of a node-weighted Laplacian operator and combine it with a fine-tuning mechanism related to the weighted vertex cover problem. The proposed method is applicable to large-scale networks with millions of nodes. It outperforms current state-of-the-art methods and opens more directions for understanding the vulnerability and robustness of complex systems.
Transposable elements drive rapid phenotypic variation inCapsella rubella
Authors: Niu Xiao-Min , Xu Yong-Chao , Li Zi-Wen , Bian Yu-Tao , Hou Xing-Hui , Chen Jia-Fu , Zou Yu-Pan , Jiang Juan , Wu Qiong , Ge Song , Balasubramanian Sureshkumar , Guo Ya-Long
Published: March 2019

Rapid phenotypic changes in traits of adaptive significance are crucial for organisms to thrive in changing environments. How such phenotypic variation is achieved rapidly, despite limited genetic variation in species that experience a genetic bottleneck is unknown.Capsella rubella, an annual and inbreeding forb (Brassicaceae), is a great system for studying this basic question. Its distribution is wider than those of its congeneric species, despite an extreme genetic bottleneck event that severely diminished its genetic variation. Here, we demonstrate that transposable elements (TEs) are an important source of genetic variation that could account for its high phenotypic diversity. TEs are (i) highly enriched inC. rubellacompared with its outcrossing sister speciesCapsella grandiflora, and (ii) 4.2% of polymorphic TEs inC. rubellaare associated with variation in the expression levels of their adjacent genes. Furthermore, we show that frequent TE insertions atFLOWERING LOCUS C (FLC)in natural populations ofC. rubellacould explain 12.5% of the natural variation in flowering time, a key life history trait correlated with fitness and adaptation. In particular, we show that a recent TE insertion at the 3′ UTR ofFLCaffects mRNA stability, which results in reducing its steady-state expression levels, to promote the onset of flowering. Our results highlight that TE insertions can drive rapid phenotypic variation, which could potentially help with adaptation to changing environments in a species with limited standing genetic variation.
Deprivation of glutamine in cell culture reveals its potential for treating cancer
Authors: Rubin Harry
Published: March 2019

Significance

Transformed Balb 3T3 cells consume glutamine at a much faster rate than nontransformed cells. The stepwise decrease in glutamine concentration is paralleled by the decreased growth rate of the transformed cells. At the lowest concentration of glutamine used here, the transformed cells stop increasing, while the nontransformed cells continue to increase at a relatively rapid rate without visible damage to the cells. Related results were obtained in NIH 3T3 cells during the process of transformed focus formation. Widely varying the background of amino acids and serum concentrations did not alter the basic results. The findings call for similar experiments with a wider range of cell culture types, extension to experimental animals, and clinical trials in human cancers.
Changes in belowground biodiversity during ecosystem development
Authors: Delgado-Baquerizo Manuel , Bardgett Richard D. , Vitousek Peter M. , Maestre Fernando T. , Williams Mark A. , Eldridge David J. , Lambers Hans , Neuhauser Sigrid , Gallardo Antonio , García-Velázquez Laura , Sala Osvaldo E. , Abades Sebastián R. , Alfaro Fernando D. , Berhe Asmeret A. , Bowker Matthew A. , Currier Courtney M. , Cutler Nick A. , Hart Stephen C. , Hayes Patrick E. , Hseu Zeng-Yei , Kirchmair Martin , Peña-Ramírez Victor M. , Pérez Cecilia A. , Reed Sasha C. , Santos Fernanda , Siebe Christina , Sullivan Benjamin W. , Weber-Grullon Luis , Fierer Noah
Published: March 2019

Belowground organisms play critical roles in maintaining multiple ecosystem processes, including plant productivity, decomposition, and nutrient cycling. Despite their importance, however, we have a limited understanding of how and why belowground biodiversity (bacteria, fungi, protists, and invertebrates) may change as soils develop over centuries to millennia (pedogenesis). Moreover, it is unclear whether belowground biodiversity changes during pedogenesis are similar to the patterns observed for aboveground plant diversity. Here we evaluated the roles of resource availability, nutrient stoichiometry, and soil abiotic factors in driving belowground biodiversity across 16 soil chronosequences (from centuries to millennia) spanning a wide range of globally distributed ecosystem types. Changes in belowground biodiversity during pedogenesis followed two main patterns. In lower-productivity ecosystems (i.e., drier and colder), increases in belowground biodiversity tracked increases in plant cover. In more productive ecosystems (i.e., wetter and warmer), increased acidification during pedogenesis was associated with declines in belowground biodiversity. Changes in the diversity of bacteria, fungi, protists, and invertebrates with pedogenesis were strongly and positively correlated worldwide, highlighting that belowground biodiversity shares similar ecological drivers as soils and ecosystems develop. In general, temporal changes in aboveground plant diversity and belowground biodiversity were not correlated, challenging the common perception that belowground biodiversity should follow similar patterns to those of plant diversity during ecosystem development. Taken together, our findings provide evidence that ecological patterns in belowground biodiversity are predictable across major globally distributed ecosystem types and suggest that shifts in plant cover and soil acidification during ecosystem development are associated with changes in belowground biodiversity over centuries to millennia.
Optogenetic reactivation of memory ensembles in the retrosplenial cortex induces systems consolidation
Authors: de Sousa André F. , Cowansage Kiriana K. , Zutshi Ipshita , Cardozo Leonardo M. , Yoo Eun J. , Leutgeb Stefan , Mayford Mark
Published: March 2019

Significance

This study examines a question in memory research that has been extant since the observation of temporally graded retrograde amnesia in patient HM after temporal lobe resection; namely, how does the circuit structure underlying memory change over prolonged periods after initial learning, such that recent memories require the hippocampus whereas older remote memories do not? We use optogenetic reactivation of the neurons active naturally during initial learning (engram neurons) to show that postlearning neural replay can produce this shift in memory. Interestingly, this was only observed in sleeping, not awake, mice. This is consistent with a model in which natural activity in memory ensemble during offline periods results in the circuit change to remote memory.
Networks of electrostatic and hydrophobic interactions modulate the complex folding free energy surface of a designed βα protein
Authors: Basak Sujit , Nobrega R. Paul , Tavella Davide , Deveau Laura M. , Koga Nobuyasu , Tatsumi-Koga Rie , Baker David , Massi Francesca , Matthews C. Robert
Published: March 2019

Significance

Natural protein sequences have evolved to fold efficiently to their functional forms, traversing a relatively smooth energy surface with minimal frustration. The optimization of stability in de novo-designed proteins, without regard to dynamical processes required for function, can have unintended consequences on energy surfaces. Electrostatic and hydrophobic networks of side chains for Di-III_14, a small βα protein with a natural topology, create a rough energy surface whose high-energy states reflect the progressive unlocking of a tightly packed interior. Unbiased explorations of sequence space can reveal complex properties not seen in natural proteins, expanding our understanding of the relationships among sequence, structure, folding, and function of these ubiquitous biopolymers.
Unifying structural signature of eukaryotic α-helical host defense peptides
Authors: Yount Nannette Y. , Weaver David C. , Lee Ernest Y. , Lee Michelle W. , Wang Huiyuan , Chan Liana C. , Wong Gerard C. L. , Yeaman Michael R.
Published: March 2019

Significance

The emergence of multidrug-resistant pathogens is outpacing development of new antibiotics, which remains a slow and empirical process. Although machine-learning–based metrics exist, no principle-based formulae have been applied to define α-helical host defense peptides (αHDPs). Here, knowledge-based annotation of bioinformatic databases was validated with artificial intelligence methods to converge on a common structural framework for eukaryotic αHDPs. This multidimensional structural formula successfully predicted antimicrobial activity in α-helical peptides and domains embedded in larger proteins that had no previously known antimicrobial activity. The α-core signature provides a foundational definition for evolutionary diversity among αHDPs, sheds light on host defense immunology, and may accelerate the process of antiinfective discovery and development.
Structural and mechanistic insights into mechanoactivation of focal adhesion kinase
Authors: Bauer Magnus Sebastian , Baumann Fabian , Daday Csaba , Redondo Pilar , Durner Ellis , Jobst Markus Andreas , Milles Lukas Frederik , Mercadante Davide , Pippig Diana Angela , Gaub Hermann Eduard , Gräter Frauke , Lietha Daniel
Published: March 2019

Focal adhesion kinase (FAK) is a key signaling molecule regulating cell adhesion, migration, and survival. FAK localizes into focal adhesion complexes formed at the cytoplasmic side of cell attachment to the ECM and is activated after force generation via actomyosin fibers attached to this complex. The mechanism of translating mechanical force into a biochemical signal is not understood, and it is not clear whether FAK is activated directly by force or downstream to the force signal. We use experimental and computational single-molecule force spectroscopy to probe the mechanical properties of FAK and examine whether force can trigger activation by inducing conformational changes in FAK. By comparison with an open and active mutant of FAK, we are able to assign mechanoactivation to an initial rupture event in the low-force range. This activation event occurs before FAK unfolding at forces within the native range in focal adhesions. We are also able to assign all subsequent peaks in the force landscape to partial unfolding of FAK modules. We show that binding of ATP stabilizes the kinase domain, thereby altering the unfolding hierarchy. Using all-atom molecular dynamics simulations, we identify intermediates along the unfolding pathway, which provide buffering to allow extension of FAK in focal adhesions without compromising functionality. Our findings strongly support that forces in focal adhesions applied to FAK via known interactions can induce conformational changes, which in turn, trigger focal adhesion signaling.
Exploring the unification of quantum theory and general relativity with a Bose–Einstein condensate
Authors: Howl Richard , Penrose Roger , Fuentes Ivette
Published: March 2019

Despite almost a century’s worth of study, it is still unclear how general relativity (GR) and quantum theory (QT) should be unified into a consistent theory. The conventional approach is to retain the foundational principles of QT, such as the superposition principle, and modify GR. This is referred to as ‘quantizing gravity’, resulting in a theory of ‘quantum gravity’. The opposite approach is ‘gravitizing QT’ where we attempt to keep the principles of GR, such as the equivalence principle, and consider how this leads to modifications of QT. What we are most lacking in understanding which route to take, if either, is experimental guidance. Here we consider using a Bose–Einstein condensate (BEC) to search for clues. In particular, we study how a single BEC in a superposition of two locations could test a gravitizing QT proposal where wavefunction collapse emerges from a unified theory as an objective process, resolving the measurement problem of QT. Such a modification to QT due to general relativistic principles is testable near the Planck mass scale, which is much closer to experiments than the Planck length scale where quantum, general relativistic effects are traditionally anticipated in quantum gravity theories. Furthermore, experimental tests of this proposal should be simpler to perform than recently suggested experiments that would test the quantizing gravity approach in the Newtonian gravity limit by searching for entanglement between two massive systems that are both in a superposition of two locations.
The Future of Autonomous Vehicles: Lessons from the Literature on Technology Adoption
Authors: Kaplan Scott , Gordon Ben , El Zarwi Feras , Walker Joan L. , Zilberman David
Published: March 2019

The introduction and adoption of autonomous vehicles (AVs) will likely reshape the transportation system and many economic activities. The economic literature on technology adoption, based on studies in agriculture and other sectors, provides lessons on the diffusion of AVs and its social and economic impacts. We rely on the threshold model of diffusion, where heterogeneous agents make decisions pursuing their self‐interests. Applications of the threshold model point to case studies of other technologies where one can gain information and make predictions about the future of AVs. We find that private ownership of AVs may prevail after a transition period, as was the case in other technologies like computers, tractors, and conventional vehicles. With technological progress, the cost of privately owning AVs may decline. Further, there will be an increase in vehicle miles traveled (VMT) per capita, there may be more vehicles on the road, and perhaps the transportation user‐base will expand to include those currently facing limited mobility. Congestion is likely to depend on the tradeoff between the expansion of VMT and increased efficiency of AVs to communicate and help regulate traffic. Furthermore, differentiation of vehicles will increase as driving time becomes freed for other activities. These trends may lead to increased greenhouse gas emissions and expansion of the transportation sector. Finally, the technology will evolve and may result in complementary innovations needing to be addressed, including the “last 10 feet” problem. It is evident that the future of the transportation system governed by AVs is most likely not going to be sustainable. This necessitates the importance of developing and enforcing rigorous policies at the metropolitan level and TNC levels to ensure a sustainable evolution of the future of transportation mobility.
Changes in US Outpatient Antibiotic Prescriptions From 2011–2016
Authors: King Laura M , Bartoces Monina , Fleming-Dutra Katherine E , Roberts Rebecca M , Hicks Lauri A
Published: March 2019

Background

While antibiotics are life-saving drugs, their use is not without risk, including adverse events and antibiotic resistance. The majority of US antibiotic prescriptions are prescribed in outpatient settings, making outpatient antibiotic prescribing an important antibiotic stewardship target. The primary objective of this study was to describe trends in US outpatient oral antibiotic prescriptions from 2011–2016.

Methods

We estimated annual oral antibiotic prescription rates using national prescription dispensing count data from IQVIA Xponent, divided by census estimates for 2011–2016. We calculated the ratio of broad- to narrow-spectrum prescriptions by dividing broad-spectrum prescription rates by narrow-spectrum prescription rates. We used Poisson models to estimate prevalence rate ratios, comparing 2011 and 2016 antibiotic prescription rates, and linear models to evaluate temporal trends throughout the study period.

Results

Oral antibiotic prescription rates decreased 5%, from 877 prescriptions per 1000 persons in 2011 to 836 per 1000 persons in 2016. During this period, rates of prescriptions dispensed to children decreased 13%, while adult rates increased 2%. The ratio of broad- to narrow-spectrum antibiotics decreased from 1.62 in 2011 to 1.49 in 2016, driven by decreases in macrolides and fluoroquinolones. The proportion of prescriptions written by nurse practitioners and physician assistants increased during the study period; in 2016, these providers prescribed over one-quarter of all antibiotic prescriptions.

Conclusions

Outpatient antibiotic prescription rates, especially of broad-spectrum agents, have decreased in recent years. Clinicians who prescribe to adults, including nurse practitioners and physician assistants, are important targets for antibiotic stewardship.
Modality and Interrelations Among Language, Reading, Spoken Phonological Awareness, and Fingerspelling
Authors: Lederberg Amy R , Branum-Martin Lee , Webb Mi-young , Schick Brenda , Antia Shirin , Easterbrooks Susan R , Connor Carol McDonald
Published: March 2019

Better understanding of the mechanisms underlying early reading skills can lead to improved interventions. Hence, the purpose of this study was to examine multivariate associations among reading, language, spoken phonological awareness, and fingerspelling abilities for three groups of deaf and hard-of-hearing (DHH) beginning readers: those who were acquiring only spoken English (n = 101), those who were visual learners and acquiring sign (n = 131), and those who were acquiring both (n = 104). Children were enrolled in kindergarten, first, or second grade. Within-group and between-group confirmatory factor analysis showed that there were both similarities and differences in the abilities that underlie reading in these three groups. For all groups, reading abilities related to both language and the ability to manipulate the sublexical features of words. However, the groups differed on whether these constructs were based on visual or spoken language. Our results suggest that there are alternative means to learning to read. Whereas all DHH children learning to read rely on the same fundamental abilities of language and phonological processing, the modality, levels, and relations among these abilities differ.
The Importance of Being Revolutionary: Oath-taking and the ‘Feeling Rules’ of Violence (1789–1794)
Authors: Buscemi Francesco
Published: March 2019

Historians of the French Revolution have identified many cultural and ideological sources of its violence: ideological commitments to virtue, the inevitable clashes involved in founding a new order, the emotions of fear and anger unleashed by political upheaval, and religious commitments to Catholicism. Rarely, however, have they explored how civic religious practices gave rise to violence. This article shows how the practice of oath-taking generated emotional “sacred” commitments and a propensity for violence in maintaining them. Given the legal and institutional weaknesses of the new regime, oath-taking helped establish political allegiances, but oaths often came into conflict with other sacred commitments, old and new. The widespread practice of oath-taking during the Revolution offers a revealing vantage point to understand the sacred, civic-religious dimensions of these various political commitments. The imperative to maintain vows, I argue, prompted contemporaries to see violence as extreme but necessary.
Confocal Laser Endomicroscopy in the Evaluation of Inflammatory Bowel Disease
Authors: Buchner Anna M
Published: March 2019

Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, can be effectively monitored with the use of endoscopy. The additional application of small field imaging technology such as confocal laser endomicroscopy CLE during ongoing endoscopic evaluation has led to real-time visualization of mucosal abnormalities and thus in vivo histology. The endomicroscopy (CLE) can improve IBD endoscopic evaluation by identifying seemingly normal-appearing mucosa, assessing the function of the intestinal barrier of the epithelium and vascular permeability, and by characterizing any mucosal lesions, including dysplastic lesions. CLE used during conventional endoscopy could especially facilitate the evaluation of mucosal healing in IBD. In addition, future developments in molecular imaging in IBD may optimize therapeutic approaches by identifying mucosal targets for therapy and determining the reasons for lack of response to specific therapy or subsequent loss of the response.
Contraception, Venous Thromboembolism, and Inflammatory Bowel Disease: What Clinicians (and Patients) Should Know
Authors: Limdi Jimmy K , Farraye Jennifer , Cannon Rachel , Woodhams Elisabeth , Farraye Francis A
Published: March 2019

The peak incidence of the inflammatory bowel diseases (IBDs) is between the second and fourth decades of life, which coincides with prime reproductive years. Unplanned or mistimed pregnancies may account for nearly half of all pregnancies and are associated with adverse consequences such as a higher risk of delayed preconceptual care, increased risk of preterm birth, low birth weight, and adverse maternal and neonatal outcomes. Increased IBD activity during pregnancy is also associated with adverse pregnancy-related outcomes, such as miscarriage, intrauterine growth retardation, and preterm birth. Furthermore, the increased risk of venous thromboembolism (VTE) conferred by active IBD may be potentially augmented by hormonal contraceptives. Recent literature suggests that women with IBD seek counseling on contraception from gastroenterologists in preference to their primary care physicians. Meanwhile, attitudes and awareness regarding contraception counseling remain suboptimal, underpinning the importance and need for physician and patient education in this area. We discuss the association between contraception and IBD, benefits and risks associated with various contraceptive methods in women with IBD, and practical recommendations for clinicians caring for women with IBD.

10.1093/ibd/izz025_video1 izz025.video1 6014727518001 10.1093/ibd/izz025_video2 izz025.video2 6014726992001
How Does Crossing Roads with Friends Impact Risk Taking in Young Adolescents and Adults?
Authors: O’Neal Elizabeth E , Jiang Yuanyuan , Brown Kathryne , Kearney Joseph K , Plumert Jodie M
Published: March 2019

Objective

The goal of this investigation was to examine how crossing roads with a friend versus alone affects gap decisions and movement timing in young adolescents and adults.

Methods

Ninety-six 12-year-olds and adults physically crossed a single lane of continuous traffic in an immersive pedestrian simulator. Participants completed 30 crossings either with a friend or alone. Participants were instructed to cross the road without being hit by a car, but friend pairs were not instructed to cross together.

Results

Pairs of adolescent friends exhibited riskier road-crossing behavior than pairs of adult friends. For gaps crossed together, adult pairs were more discriminating in their gap choices than adult solo crossers, crossing fewer of the smaller gaps and more of the larger gaps. This pattern did not hold for 12-year-old pairs compared to 12-year-old solo crossers. To compensate for their less discriminating gap choices, pairs of 12-year-olds adjusted their movement timing by entering and crossing the road more quickly. For gaps crossed separately, both adult and 12-year-old first crossers chose smaller gaps than second crossers. Unlike adults, 12-year-old first crossers were significantly less discriminating in their gap choices than 12-year-old second crossers.

Conclusions

Compared to adults, young adolescents took riskier gaps in traffic when crossing virtual roads with a friend than when crossing alone. Given that young adolescents often cross roads together in everyday life, peer influences may pose a significant risk to road safety in early adolescence.
The role of the augmin complex in establishing microtubule arrays
Authors: Tian Juan , Kong Zhaosheng
Published: March 2019

Microtubule-dependent microtubule nucleation occurs on the lateral surface of pre-existing microtubules and provides a highly efficient means of amplifying their populations and reorganizing their architectures. The γ‑tubulin ring complex serves as the template to initiate nascent microtubule polymerization. Augmin, a hetero-octameric protein complex, acts as a recruiting factor to target the γ‑tubulin ring complex to pre-existing microtubules and trigger new microtubule growth. Although microtubule-dependent microtubule nucleation has been extensively studied in both animal and plant cells, it remains unclear how the augmin complex assembles in plant cells, especially in cell-cycle-specific and cell-type-specific manners, and how its spatial structure orchestrates the nucleation geometry. In this review, we summarize the advances in knowledge of augmin-dependent microtubule nucleation and the regulation of its geometry, and highlight recent findings and emerging questions concerning the role of the augmin complex in establishing microtubule arrays and the cell-cycle-specific composition of augmin in plant cells.
Successful Surgical Treatment of Severe Perforating Diametric Craniocerebral Gunshot Wound Sustained during Combat: A Case Report
Authors: Sirko Andrii , Kyrpa Igor , Yovenko Ihor , Miziakina Kateryna , Romanukha Dmytro
Published: March 2019

Many researchers classify perforating diametric craniocerebral gunshot wounds as fatal because mortality exceeds 96% and the majority of patients with such injuries die before hospitalization. A 23-year-old Ukrainian male soldier was admitted to a regional hospital with a severe perforating craniocerebral wound in a comatose state (Glasgow Coma Scale score, 5). Following brain helical computed tomography, the patient underwent primary treatment of the cerebral wound with primary duraplasty and inflow/outflow drainage. After 18 days of treatment in the intensive care unit, he was transferred to a military hospital for further rehabilitation. This report details our unusual case of successful treatment of a perforating diametric craniocerebral gunshot wound.
Comparison of National and Local Approaches to Detecting Suicides in Healthcare Settings
Authors: Riblet Natalie B , Shiner Brian , Watts Bradley V , Britton Peter
Published: March 2019

Introduction

In order to address the problem of suicide, healthcare providers and researchers must be able to accurately identify suicide deaths. Common approaches to detecting suicide in the healthcare setting include the National Death Index (NDI) and Root-Cause Analysis (RCA) methodology. No study has directly compared these two methods.

Materials and Methods

Suicide reporting was evaluated within the Veterans Affairs (VA) healthcare system. All suicides were included that occurred within 7 days of discharge from an inpatient mental health unit and were reported to the VA through the NDI record linkage and/or RCA database between 2002 and 2014. The proportion of suicide deaths that were identified by NDI and found in the RCA database were calculated. Potential misclassification by the NDI was evaluated, whereby the RCA database identified a suicide case, but the NDI classified the death as a non-suicide.

Results

In the study period, the NDI identified 222 patients who died by suicide within 7 days of discharge, while the RCA database only detected 95 reports of suicide. A comparison of cases across the two methods indicated that the RCA database identified only 35% (N = 78) of NDI detected suicides (N = 222). Conversely, the RCA database detected 13 suicide cases that the NDI had coded as deaths due to accidental poisoning or other causes. Importantly, RCA accounted for 13% (N = 7) of overdose suicides identified in all databases (N = 52).

Conclusions

Combining national and local approaches to detect suicide may help to improve the classification of suicide deaths in the healthcare setting.
Extended Ketogenic Diet and Physical Training Intervention in Military Personnel
Authors: LaFountain Richard A , Miller Vincent J , Barnhart Emily C , Hyde Parker N , Crabtree Christopher D , McSwiney Fionn T , Beeler Mathew K , Buga Alex , Sapper Teryn N , Short Jay A , Bowling Madison L , Kraemer William J , Simonetti Orlando P , Maresh Carl M , Volek Jeff S
Published: March 2019

Introduction

Ketogenic diets (KDs) that elevate ketones into a range referred to as nutritional ketosis represent a possible nutrition approach to address the emerging physical readiness and obesity challenge in the military. An emerging body of evidence demonstrates broad-spectrum health benefits attributed to being in nutritional ketosis, but no studies have specifically explored the use of a KD in a military population using daily ketone monitoring to personalize the diet prescription.

Materials and Methods

To evaluate the feasibility, metabolic, and performance responses of an extended duration KD, healthy adults (n = 29) from various military branches participated in a supervised 12-wk exercise training program. Fifteen participants self-selected to an ad libitum KD guided by daily measures of capillary blood ketones and 14 continued their normal mixed diet (MD). A battery of tests were performed before and after the intervention to assess changes in body mass, body composition, visceral fat, liver fat, insulin sensitivity, resting energy metabolism, and physical performance.

Results

All KD subjects were in nutritional ketosis during the intervention as assessed by daily capillary beta-hydroxybutyrate (βHB) (mean βHB 1.2 mM reported 97% of all days) and showed higher rates of fat oxidation indicative of keto-adaptation. Despite no instruction regarding caloric intake, the KD group lost 7.7 kg body mass (range −3.5 to −13.6 kg), 5.1% whole-body percent fat (range −0.5 to −9.6%), 43.7% visceral fat (range 3.0 to −66.3%) (all p < 0.001), and had a 48% improvement in insulin sensitivity; there were no changes in the MD group. Adaptations in aerobic capacity, maximal strength, power, and military-specific obstacle course were similar between groups (p > 0.05).

Conclusions

US military personnel demonstrated high adherence to a KD and showed remarkable weight loss and improvements in body composition, including loss of visceral fat, without compromising physical performance adaptations to exercise training. Implementation of a KD represents a credible strategy to enhance overall health and readiness of military service members who could benefit from weight loss and improved body composition.
Agriculture: science and technology safeguard sustainability
Authors: Jia Hepeng
Published: March 2019

China has traditionally placed tremendous importance on agricultural research. Meanwhile, in recent years, sustainable agriculture has been increasingly highlighted in both policy agenda and the capital market. However, while terms like environmental friendliness, low carbon, organic and green agriculture have become buzzwords in the media, few meaningful discussions have been raised to examine the relationship between science and technology (S&T) development and sustainable agriculture. What's more, some environmentalists stress that sustainable agriculture should abandon modern agriculture's heavy reliance on science and industrialization, making the link between agricultural S&T and sustainable agriculture seem problematic. What is the truth? If S&T are to play an important role in advancing sustainable agriculture, what is the current status of the field? What factors have caused the sustainable development of agriculture in China? At an online forum organized by the National Science Review (NSR), Hepeng Jia, commissioned by NSR executive editor-in-chief Mu-ming Poo, asked four scientists in the field to examine the dynamic relationship between sustainable agriculture and agricultural S&T in the Chinese context.

Jikun Huang

Agricultural economist at Peking University, Beijing, China

Xiaofeng Luo

Agricultural economist at Huazhong Agricultural University, Wuhan, China

Jianzhong Yan

Agricultural and environmental scientist at Southwest University, Chongqing, China

Yulong Yin

Veterinary scientist at Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, China

Hepeng Jia (Chair)

Science communication scholar at Cornell University, Ithaca, NY, USA
Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program
Authors: Diekema Daniel J , Pfaller Michael A , Shortridge Dee , Zervos Marcus , Jones Ronald N
Published: March 2019

Background

Staphylococcus aureus is among the most common human pathogens, with therapy complicated by the epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA).

Methods

The SENTRY Antimicrobial Surveillance Program evaluated the in vitro activity of >20 antimicrobials against 191 460 clinical S. aureus isolates collected from 427 centers in 45 countries from 1997 to 2016. Each center contributed isolates and clinical data for consecutive episodes of bacteremia, pneumonia in hospitalized patients, urinary tract infection, and skin and skin structure infection.

Results

Overall, 191 460 S. aureus isolates were collected, of which 77 146 (40.3%) were MRSA, varying geographically from 26.8% MRSA in Europe to 47.0% in North America. The highest percentage of MRSA was in nosocomial isolates from patients aged >80 years. Overall, MRSA occurrences increased from 33.1% in 1997–2000 to a high of 44.2% in 2005–2008, then declined to 42.3% and 39.0% in 2009–2012 and 2013–2016, respectively. S. aureus bacteremia had a similar trend, with nosocomial and community-onset MRSA rates peaking in 2005–2008 and then declining. Vancomycin activity against S. aureus remained stable (minimum inhibitory concentration [MIC]90 of 1 mg/L and 100% susceptibility in 2016; no increase over time in isolates with a vancomycin MIC >1 mg/L). Several agents introduced during the surveillance period exhibited in vitro potency against MRSA.

Conclusions

In a large global surveillance program, the rise of MRSA as a proportion of all S. aureus peaked a decade ago and has declined since, consistent with some regional surveillance program reports. Vancomycin maintained high activity against S. aureus, and several newer agents exhibited excellent in vitro potencies.
Antimicrobial Resistance Surveillance and New Drug Development
Authors: Sader Helio S , Rhomberg Paul R , Fuhrmeister Andrew S , Mendes Rodrigo E , Flamm Robert K , Jones Ronald N
Published: March 2019

Surveillance represents an important informational tool for planning actions to monitor emerging antimicrobial resistance. Antimicrobial resistance surveillance (ARS) programs may have many different designs and can be grouped in 2 major categories based on their main objectives: (1) public health ARS programs and (2) industry-sponsored/product-oriented ARS programs. In general, public health ARS programs predominantly focus on health care and infection control, whereas industry ARS programs focus on an investigational or recently approved molecule(s). We reviewed the main characteristics of industry ARS programs and how these programs contribute to new drug development. Industry ARS programs are generally performed to comply with requirements from regulatory agencies responsible for commercial approval of antimicrobial agents, such as the US Food and Drug Administration, European Medicines Agency, and others. In contrast to public health ARS programs, which typically collect health care and diverse clinical data, industry ARS programs frequently collect the pathogens and perform the testing in a central laboratory setting. Global ARS programs with centralized testing play an important role in new antibacterial and antifungal drug development by providing information on the emergence and dissemination of resistant organisms, clones, and resistance determinants. Organisms collected by large ARS programs are extremely valuable to evaluate the potential of new agents and to calibrate susceptibility tests once a drug is approved for clinical use. These programs also can provide early evaluations of spectrum of activity and postmarketing trends required by regulatory agencies, and the programs may help drug companies to select appropriate dosing regimens and the appropriate geographic regions in which to perform clinical trials. Furthermore, these surveillance programs provide useful information on the potency and spectrum of new antimicrobial agents against indications and organisms in which clinicians have little or no experience. In summary, large ARS programs, such as the SENTRY Antimicrobial Surveillance Program, contribute key data for new drug development.
Variations in the Occurrence of Resistance Phenotypes and Carbapenemase Genes Among Enterobacteriaceae Isolates in 20 Years of the SENTRY Antimicrobial Surveillance Program
Authors: Castanheira Mariana , Deshpande Lalitagauri M , Mendes Rodrigo E , Canton Rafael , Sader Helio S , Jones Ronald N
Published: March 2019

Background

A total of 178 825 Enterobacteriaceae isolates collected in 199 hospitals from 42 countries worldwide over 20 years (1997 to 2016) of the SENTRY Program were susceptibility tested by reference broth microdilution methods.

Methods

Trends in percentages over time were analyzed by the χ2 test. Results were reported as the percentage difference between the first (1997–2000) and the last (2013–2016) time period.

Results

Enterobacteriaceae exhibiting resistance to cephalosporins (extended-spectrum β-lactamase [ESBL] phenotype) and carbapenem resistance (CRE) significantly increased (P < 0.05; χ2 test) from 10.3% to 24.0% and 0.6% to 2.9%, respectively. Similar trends were noted for all regions and infection sources. Klebsiella pneumoniae mainly drove the CRE increase. Multidrug-resistance (MDR) rates significantly increased from 7.3% to 15.3% overall, with important trends in all regions and infection sources. Significant increases were noted for MDR K. pneumoniae and Escherichia coli, polymyxin-resistant K. pneumoniae (2.0% to 5.5% overall), and aminoglycoside-resistant E. coli (7.0% to 18.0%) and K. pneumoniae (18.1% to 26.9%) over time in North America and Latin America. Carbapenemase-encoding genes were screened after 2007, and the occurrence of these genes was compared for 2007–2009 and 2014–2016. Among 1298 CRE isolates from the 2 study periods, blaKPC was detected among 186 (49.7%) and 501 (54.2%) isolates in 2007–2009 and 2014–2016, respectively. Metallo-β-lactamase genes were detected among 4.3% of the isolates from 2007 to 2009 and 12.7% of the isolates from 2014 to 2016, mainly due to the dissemination of isolates carrying blaNDM. Genes encoding IMP and VIM enzymes were observed in 1.9% and 2.4% (7 and 9 isolates) of the isolates from 2007 to 2009 and 0.4% and 1.9% of the isolates from 2014 to 2016. OXA-48 and variants increased from 4.3% in 2007–2009 to 12.6% in 2014–2016 (mainly in Europe).

Conclusions

A change in the epidemiology of carbapenemases and important increases in ESBL, CRE, MDR, and other resistant phenotypes among virtually all geographic regions and infection sources were noted in the 20 years of surveillance, highlighting the impact of antimicrobial resistance and the importance of its continuous monitoring.