bluuebunny/crossref_metadata_2025 huggingface dataset:
A Content Analysis of Online Suicide Notes: Attempted Suicide Versus Attempt Resulting in Suicide
Authors: Synnott John , Ioannou Maria , Coyne Angela , Hemingway Siobhan
Published: September 2017

Fifty suicide notes of those who died by suicide and 50 suicide notes of those who survived their suicide attempt were analyzed using Smallest Space Analysis. The core of all suicide notes was discovered to be constructed with the use of four variables:saying goodbye to their audience,feelings of loneliness,method used to attempt suicide, andnegative self‐image. Furthermore, three different suicide note themes of those who died and three suicide note themes from those who survived were also identified. The analysis revealed that suicide note writers who died by their attempt were more likely to combine a dislike of themselves and a concern for loved ones. The implications of the work in terms of suicide prevention are discussed.
Towards Neo‐Productivism? – Finnish Paths in the Use of Forest and Sea
Authors: Rannikko Pertti , Salmi Pekka
Published: September 2017

This article focuses on shifts in the use of natural resources by referencing a theoretical discussion of post‐productivism and neo‐productivism. Transitions from one form of nature use to another are not straightforward but entail various cycles and combinations. Neo‐productivism appears to be a versatile concept fit for describing the use of natural resources, which is becoming more complex and difficult to describe. Neo‐productivism describes a renewed form of productivism that emphasises environmental perspectives and sustainability in addition to the production of natural resources. It includes new characteristics in the material utilisation of nature, including pressures towards production increase. Our case studies present two Finnish natural resource peripheries: in the Forest Karelia, forests have been central to landscapes and incomes, whereas livelihoods in the archipelago have been dependent on sea and fish stocks.
Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus
Authors: Aona Brent D. , Rush John E. , Rozanski Elizabeth A. , Cunningham Suzanne M. , Sharp Claire R. , Freeman Lisa M.
Published: September 2017

Objective

To assess abnormalities in concentrations of cardiac troponin I(cTnI),lactate, and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV).

Design

Prospective observational study.

Setting

University hospital.

Animals

Twenty‐two dogs with naturally occurring GDV.

Samples

Concentrations of cTnI,plasma lactate, and NT‐proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization.

Interventions

None.

Measurements and Main Results

Cardiac rhythms were categorized on a 0–4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R‐on‐T phenomenon or ventricular tachycardia). Echocardiography was performed 6–18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n= 9], Grade 4 [n= 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P= 0.002) or Grade 1 (P= 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r= −0.52,P= 0.01) and systole (r= −0.57,P= 0.006), left ventricular free wall in diastole (LWDd,r= 0.59,P= 0.004), and interventricular septal thickness in diastole (IVDs,r= 0.65,P= 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P= 0.04) and IVSd (P= 0.05), and received significantly less fluids in the first 24 (P= 0.02) and 48 hours (P= 0.03) of hospitalization.

Conclusions

Concentrations of cTnI and NT‐proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.
Retrospective evaluation of 155 adult equids and 21 foals with tetanus from Western, Northern, and Central Europe (2000–2014). Part 2: Prognostic assessment
Authors: van Galen Gaby , Rijckaert Joke , Mair Tim , Amory Helene , Armengou Lara , Bezdekova Barbora , Durie Inge , Findshøj Delany Rikke , Fouché Nathalie , Haley Laura , Hewetson Michael , van den Hoven Rene , Kendall Anna , Malalana Fernando , Muller Cavalleri Jessika , Picavet Tresemiek , Roscher Katja , Verwilghen Denis , Westermann Cornélie , Saegerman Claude
Published: September 2017

Objective

To identify prognostic variables for adult equids and foals with tetanus.

Design

Multicenter retrospective study (2000–2014).

Setting

Twenty Western, Northern, and Central European university teaching hospitals and private referral centers.

Animals

One hundred fifty‐five adult equids and 21 foals with tetanus.

Interventions

None.

Measurements and Main Results

Variables from history and clinical examination were statistically compared between survivors and nonsurvivors (adults: 49 survivors, 85 nonsurvivors; foals: 7 survivors, 10 nonsurvivors). Cases euthanized for financial reasons were excluded. Mortality rates in adults and foals were 68.4% and 66.7%, respectively. Variables associated with survival in adults included: standing, normal intestinal sounds and defecation, voluntarily drinking, eating soft or normal food, lower heart and respiratory rates, high base excess on admission, longer diagnosis time, treatment and hospitalization delay, and mild severity grade. Variables associated with death included: anorexia, dysphagia, dyspnea, low blood potassium concentration on admission, moderate and severe disease grading, development of dysphagia, dyspnea, recumbency and seizures during hospitalization, treatment with glycerol guaiacolate, intravenous fluids, and intravenous glucose solutions. Variables associated with survival in foals included standing on admission, voluntarily eating soft food and drinking, older age, and longer hospitalization delay. Outcome was not different between different tetanus antitoxin (TAT) dosages, although there was a trend of increasing survival rate with increasing TAT dosages. Cases with appropriate vaccination prior to development of tetanus were rare, but had improved outcome and shorter hospitalization.

Conclusions

Prognosis for equine tetanus is poor with similar outcome and prognostic factors in foals and adults. The prognostic assessment of cases with tetanus provides clinicians with new evidence‐based information related to patient management. Several prognostic indicators relate to the ability to eat or drink, and more severe clinical signs relate to poor outcome. Increasing intravenous dosages of TAT has no significant effect on outcome, but the positive trend identified may support a recommendation for high intravenous TAT dosages. Further evaluation is warranted.
Bacterial testing of platelets – has it prevented transfusion‐transmitted bacterial infections in Australia?
Authors: Thyer J. , Perkowska‐Guse Z. , Ismay S. L. , Keller A. J. , Chan H. T. , Dennington P. M. , Bell B. , Kotsiou G. , Pink J. M.
Published: September 2017

Background and Objectives

Australia introduced bacterial contamination screening (BCS) for platelet components in April 2008. This study presents analysis performed to assess the efficacy of testing.

Materials and Methods

Seven‐day aerobic and anaerobic culture is performed using the BacT/ALERT 3D system. Following an initial machine positive (IMP) flag, all associated components are recalled, and/or clinicians treating already transfused patients are notified. IMPs are categorized as ‘machine false positive’, ‘confirmed positive’ or ‘indeterminate’ depending on culture results of initial and repeat samples.

Results

Between 2010 and 2012, 1·1% of platelet donations tested IMP; since 2013, this rate has fallen to 0·6% through improved instrument management, reducing false‐positive IMPs but maintaining sensitivity for cultures yielding bacterial growth. On average, 66% of confirmed positive and indeterminate platelet units had been transfused at the time of detection. The majority (95%) of these grew Propionibacterium sp., a slow‐growing organism that rarely causes sepsis in the transfusion setting. The incidence of reported transfuion‐transmitted bacterial infection (TTBI) has fallen since the introduction of BCS, with a 4·2‐fold [0·5, 28·2] lower rate from platelets.

Conclusion

BCS has been successful in detecting platelet units containing pathogenic bacteria. The incidence of TTBI from platelets has fallen since the introduction of BCS, but the risk has not been eliminated due to rare false‐negative results. In the absence of a pathogen inactivation system for red blood cells, BCS provides ‘surrogate’ testing of red blood cells from which platelets have been manufactured.
Electronic recording of transfusion‐related patient observations: a comparison of two bedside systems
Authors: Staples S. , Noel S. , Watkinson P. , Murphy M. F.
Published: September 2017

Background and Objectives

Vital sign observations should be monitored before, during and after transfusion to enable adverse events to be identified, but surveys in the UK show poor compliance with good practice. At the Oxford University Hospitals, there are two electronic bedside processes for recording observations; BloodTrack Tx (Haemonetics Corp.), the routine electronic transfusion process and a locally developed process, the System for Electronic Nursing Documentation (SEND) with integrated ‘track and trigger’ calculation for monitoring vital signs. The purpose of this study was to evaluate the conduct of patient observation monitoring for blood transfusion using two electronic bedside processes.

Materials and Methods

This study examined the observations recorded during 200 single red cell unit transfusions.

Results

186/200 (93%) transfusions had pretransfusion observations recorded using BloodTrack Tx. Mid‐transfusion checks were performed during 133/200 (67%) of transfusions, of these checks most (87/200 (44%)) were documented as ‘no apparent change’ in observations. End transfusion observations were performed using BloodTrack Tx in 178/200 (89%). Both systems were frequently used, and staff had a preference for using SEND first for documenting the pretransfusion observations (102/116 (88%)) and at the end of a transfusion (75/115 (65%)).

Conclusion

Electronic bedside systems result in improved monitoring of transfusion‐related observations compared to manual processes based on data from UK surveys. There is increasing use of electronic systems in clinical practice; linkage between these two systems would prevent wasteful duplication of observations and could provide improved early warning of adverse events to transfusion compared to manual processes.
A new approach for fat removal in a discontinuous autotransfusion device–concept and evaluation
Authors: Seyfried T. F. , Gruber M. , Pawlik M. T. , Kasper S. , Mandle R. J. , Hansen E.
Published: September 2017

Background

Fat present during blood salvage in orthopaedic or cardiac surgery can pose a risk of fat embolism and should be eliminated before transfusion. Based on observations of central fat accumulation at the bottom of Latham bowls, a fat reduction program was developed using two volume displacements, where blood temporarily is removed and respun in the bowl to force the fat through the RBC sediment.

Materials and methods

Pooled ABO‐matched RBC and FFP were adjusted to a haematocrit of 10%, and human fat tissue added to a concentration of 1·25 vol%. In six experiments, blood was processed with the new‐generation cell salvage device CS Elite in a newly developed fat reduction program in bowls of three sizes. Volumetric quantification of fat was performed after centrifugation of blood samples in Pasteur pipettes. From volumes, haematocrits and the concentrations of fat, RBC recovery and fat elimination rates were calculated.

Results

Fat removal rates of 93·2 ± 2·8, 97·0 ± 2·1 and 99·6 ± 0·3% were observed with a 70‐ml, 125‐ml and 225‐ml bowl, respectively, and even higher rates when removal rates were calculated one cycle. At the same time, high RBC recovery and plasma elimination rates were maintained, not significantly different to the default program mode.

Conclusion

Modifications in process parameters and sequence led to a fat reduction program that significantly improves fat removal with the Cell Saver Elite from 77·4 ± 5·1% in the default mode to an average of 98·6 ± 1·1%, yielding results equivalent to the continuous cell salvage system (C.A.T.S).
High platelet content can increase storage lesion rates following Intercept pathogen inactivation primarily in platelet concentrates prepared by apheresis
Authors: Feys H. B. , Devloo R. , Sabot B. , De Pourcq K. , Coene J. , Compernolle V.
Published: September 2017

Background

Pathogen inactivation methods for platelet concentrates are increasingly being used in blood banks worldwide. In vitro studies have demonstrated its effects on storage lesion, but little routine quality control data on blood banking outcomes have been reported.

Materials and Methods

Swirling of distributed products was monitored before and after implementation of Intercept pathogen inactivation. Metabolic parameters pH, glucose and lactic acid were determined in a random cohort of expired pathogen‐inactivated products. Storage lesion indicators in apheresis concentrates with premature low swirling were compared to concentrates with normal swirling.

Results

During validation for implementing Intercept pathogen inactivation, pH and glucose levels decreased faster in apheresis platelet concentrates with high platelet content than with low platelet content or than in pathogen‐inactivated pooled buffy coat‐derived products. In routine products, glucose exhaustion was more often found in apheresis compared to buffy coat‐derived platelet concentrates despite 3–7% more plasma carryover in the former. Annual incidence of premature low swirling increased significantly by 50% following implementation of pathogen inactivation implementation for apheresis but not for pooled buffy coat platelet concentrates. In addition, apheresis concentrates with premature low swirling had a significantly higher median platelet count (5·0 × 1011) than unaffected products (3·5 × 1011).

Conclusion

The risk of increased storage lesion rates following Intercept pathogen inactivation is higher for apheresis than for buffy coat‐derived platelet concentrates, especially when platelet contents are higher than 5·0 × 1011.
Value of retaining HBsAg donor screening where HBV NAT and anti‐HBc donor screening apply
Authors: Seed C. R.
Published: September 2017

Hepatitis B virus (HBV) is a transfusion‐transmissible human DNA virus with a global distribution. Since the early 1970s, hepatitis B surface antigen (HBsAg) detection has been the mainstay to identify donors infected with HBV. The implementation of donor HBsAg screening substantially reduced but did not eliminate the risk of transfusion‐transmitted HBV (TT‐HBV). In the late 1970s, it was recognized that TT‐HBV occurred more commonly from HBsAg‐negative donations containing detectable antibodies to the viral core (anti‐HBc) leading to some countries subsequently implementing universal anti‐HBc screening in addition to HBsAg.

Since the late 1990s, HBV nucleic acid tests (NATs) have been applied to donation screening to ‘close’ the acute window period, thereby reducing the residual risk of TT‐HBV. Their implementation also identified HBsAg‐negative/anti‐HBc‐positive individuals with detectable HBV DNA, a novel pattern of infection termed occult hepatitis B infection. A number of countries now combine HBsAg, anti‐HBc and HBV NAT donation testing, which provides the opportunity to determine the proportional HBV risk reduction contribution of each test. The cumulative published data indicate HBV‐infected donors with HBsAg as the only marker are exceedingly rare, occurring at a rate of about 1 in 4 million in the largest published study. There are no recorded cases of TT‐HBV involving ‘HBsAg‐only’ positive donors.

Ultimately, HBsAg testing retains value for characterizing the HBV infection stage, but the accumulating data strongly suggest that HBsAg testing now adds little, if any, TT‐HBV risk reduction value where sensitive HBV NAT and anti‐HBc screening also apply.
How do blood donors interpret the Swedish donor history questionnaire?
Authors: Öhrner C. , Kvist M.
Published: September 2017

Background and Objectives

The blood donor history questionnaire, together with blood samples, aims to ensure that blood donation is safe for both donor and recipient. Donors’ interpretation of the questions is of the utmost importance. The objective of this study was to examine how blood donors in Sweden interpret the donor history questionnaire and to assess the need for rewording any questions.

Materials and Methods

Twelve cognitive interviews were conducted with blood donors. A survey was distributed at blood centres in two regions in Sweden. Altogether, 671 donors returned the survey.

Results

Although a majority claimed to understand the donor history questions, not all donors reported on their medications or healthcare episodes. There was a significant correlation between donors who did not report on medications and the third of donors who did not read the donor information. The concept of being in full health varied for different donors and many were uncertain about the definition of new sexual partner.

Conclusion

Overall, the blood donors were satisfied with the readability of the questions. However, some questions turned out to be more difficult to interpret, and may need to be reworded. The study demonstrates the need for easy access to blood safety information.
Hospital transfusion medicine committees – problems and pitfalls
Authors: Nahirniak S.
Published: September 2017

Hospital Transfusion Medicine Committees (TMCs) are multidisciplinary committees that provide oversight of a variety of clinical activities as they pertain to transfusion medicine and patient care in hospital environments. Across the globe, there are many different standards that provide guidance on the goals, structure and function of hospital transfusion medicine committees but these are not always implemented in the same manner. This review will highlight some of these standards and undertake a high‐level review of the similarities and differences. Awareness of common barriers to success for TMCs will allow strategies to be developed locally to ensure that the TMC functions in the most effective manner to provide high‐quality transfusion medicine care to patients.
Correlation of target properties and plasma parameters in DC magnetron sputtering with Langmuir probe measurements
Authors: Raggl Stefan , Postler Johannes , Winkler Jörg , Strauss Georg , Feist Christian , Plankensteiner Arno , Eidenberger-Schober Michael , Scheier Paul
Published: September 2017

Utilizing different manufacturing methods for producing sputtering targets leads to significant variations in target microstructure with the latter showing a pronounced impact on the performance of the target in direct current magnetron sputtering (DCMS) in terms of varying sputtering yields. This study aims at correlating measured plasma parameters on the one hand with varying microstructure of molybdenum targets on the other hand. To this end, the sputtering performance of targets manufactured by means of selected powder metallurgy as well as melting metallurgy processes in DCMS is experimentally investigated. Ranging over two orders of magnitude, the mean grain size is identified as the major varying microstructural parameter of the investigated targets. Measurements of spatially varying plasma parameters under steady state sputtering conditions are carried out by means of a Langmuir probe moved over the target at several distances perpendicular to the target top surface. The largest differences in the measured parameters are found in the vicinity of the target surface. In particular, the electron density is found to decrease with increasing mean grain size.
Label-free detection of interleukin-6 using electrolyte gated organic field effect transistors
Authors: Diacci Chiara , Berto Marcello , Di Lauro Michele , Bianchini Elena , Pinti Marcello , Simon Daniel T. , Biscarini Fabio , Bortolotti Carlo A.
Published: September 2017

Cytokines are small proteins that play fundamental roles in inflammatory processes in the human body. In particular, interleukin (IL)-6 is a multifunctional cytokine, whose increased levels are associated with infection, cancer, and inflammation. The quantification of IL-6 is therefore of primary importance in early stages of inflammation and in chronic diseases, but standard techniques are expensive, time-consuming, and usually rely on fluorescent or radioactive labels. Organic electronic devices and, in particular, organic field-effect transistors (OFETs) have been proposed in the recent years as novel platforms for label-free protein detection, exploiting as sensing unit surface-immobilized antibodies or aptamers. Here, the authors report two electrolyte-gated OFETs biosensors for IL-6 detection, featuring monoclonal antibodies and peptide aptamers adsorbed at the gate. Both strategies yield biosensors that can work on a wide range of IL-6 concentrations and exhibit a remarkable limit of detection of 1 pM. Eventually, electrolyte gated OFETs responses have been used to extract and compare the binding thermodynamics between the sensing moiety, immobilized at the gate electrode, and IL-6.
Optimal Resistive Forces for Maximizing the Reliability of Leg Muscles’ Capacities Tested on a Cycle Ergometer
Authors: García-Ramos Amador , Torrejón Alejandro , Morales-Artacho Antonio J. , Pérez-Castilla Alejandro , Jaric Slobodan
Published: September 2017

This study determined the optimal resistive forces for testing muscle capacities through the standard cycle ergometer test (1 resistive force applied) and a recently developed 2-point method (2 resistive forces used for force-velocity modelling). Twenty-six men were tested twice on maximal sprints performed on a leg cycle ergometer against 5 flywheel resistive forces (R1–R5). The reliability of the cadence and maximum power measured against the 5 individual resistive forces, as well as the reliability of the force-velocity relationship parameters obtained from the selected 2-point methods (R1–R2, R1–R3, R1–R4, and R1–R5), were compared. The reliability of outcomes obtained from individual resistive forces was high except for R5. As a consequence, the combination of R1 (≈175 rpm) and R4 (≈110 rpm) provided the most reliable 2-point method (CV: 1.46%–4.04%; ICC: 0.89–0.96). Although the reliability of power capacity was similar for the R1–R4 2-point method (CV: 3.18%; ICC: 0.96) and the standard test (CV: 3.31%; ICC: 0.95), the 2-point method should be recommended because it also reveals maximum force and velocity capacities. Finally, we conclude that the 2-point method in cycling should be based on 2 distant resistive forces, but avoiding cadences below 110 rpm.
Evaluation of Agreement Between Participant and Expert on Jump-Landing Characteristics During a 4-Week Intervention
Authors: Ericksen Hayley M. , Pietrosimone Brian , Gribble Phillip A. , Thomas Abbey C.
Published: September 2017

Context: Feedback is an important factor in interventions designed to reduce anterior cruciate ligament injury risk. Self-analysis feedback requires participants to self-critique their jump-landing mechanics; however, it is unknown if individuals can effectively self-analyze their own biomechanics and if this self-analysis agrees with observed biomechanical changes by an expert. Objective: To determine agreement between an expert and participants on biomechanical errors committed during 3 of 12 sessions, which were part of an intervention to change jump-landing biomechanics in healthy females. Design: Descriptive analysis. Setting: Research laboratory. Patients or Other Participants: Healthy recreationally active females with no history of lower-extremity fracture or surgery. Interventions: Participants completed a 4-week, 12-session feedback intervention. Each intervention session lasted approximately 15 minutes and included asking participants to perform 6 sets of 6 jumps off a 30-cm-high box placed 50% of their height away from the target landing area. Participants performed self-analysis feedback and received expert feedback on 7 different jump-landing criteria following each set of jumps. Main Outcome Measures: Data were coded, and agreement between the expert and the participant was assessed using Cohen’s unweighted kappa for sessions 1, 6, and 12. Results: There was agreement between the expert and participants for 0/7 criteria for session 1, 3/7 criteria for session 6, and 4/7 criteria for session 12. Conclusions: Participants demonstrated some agreement with the expert when evaluating their jump-landing biomechanics. Self-analysis feedback may not replace what an expert can provide; both types of feedback may be better used in conjunction to produce significant biomechanical changes. Changes made by the participant may not translate into biomechanical changes during a real-life game or practice situation. Future research should continue to investigate effective interventions to reduce injury risk.
Asymmetry hidden in birds’ tracks reveals wind, heading, and orientation ability over the ocean
Authors: Goto Yusuke , Yoda Ken , Sato Katsufumi
Published: September 2017

Estimation of wind and heading vectors from GPS tracking data reveals seabirds’ ability to orient themselves over the ocean.
Laser streaming: Turning a laser beam into a flow of liquid
Authors: Wang Yanan , Zhang Qiuhui , Zhu Zhuan , Lin Feng , Deng Jiangdong , Ku Geng , Dong Suchuan , Song Shuo , Alam Md Kamrul , Liu Dong , Wang Zhiming , Bao Jiming
Published: September 2017

New optofluidic coupling of photoacoustics to acoustic streaming enables laser-driven jet flow via plasmonic-acoustic cavity.
Quantized gravitational responses, the sign problem, and quantum complexity
Authors: Ringel Zohar , Kovrizhin Dmitry L.
Published: September 2017

Energy transport in metals helps uncover a link between Einstein’s gravity and quantum computational complexity.
Robotic metamorphosis by origami exoskeletons
Authors: Miyashita Shuhei , Guitron Steven , Li Shuguang , Rus Daniela
Published: September 2017

The shape and the functionality of a robot can be changed by using interchangeable self-folding origami exoskeletons.
Rapid antigen tests for dengue virus serotypes and Zika virus in patient serum
Authors: Bosch Irene , de Puig Helena , Hiley Megan , Carré-Camps Marc , Perdomo-Celis Federico , Narváez Carlos F. , Salgado Doris M. , Senthoor Dewahar , O’Grady Madeline , Phillips Elizabeth , Durbin Ann , Fandos Diana , Miyazaki Hikaru , Yen Chun-Wan , Gélvez-Ramírez Margarita , Warke Rajas V. , Ribeiro Lucas S. , Teixeira Mauro M. , Almeida Roque P. , Muñóz-Medina José E. , Ludert Juan E. , Nogueira Mauricio L. , Colombo Tatiana E. , Terzian Ana C. B. , Bozza Patricia T. , Calheiros Andrea S. , Vieira Yasmine R. , Barbosa-Lima Giselle , Vizzoni Alexandre , Cerbino-Neto José , Bozza Fernando A. , Souza Thiago M. L. , Trugilho Monique R. O. , de Filippis Ana M. B. , de Sequeira Patricia C. , Marques Ernesto T. A. , Magalhaes Tereza , Díaz Francisco J. , Restrepo Berta N. , Marín Katerine , Mattar Salim , Olson Daniel , Asturias Edwin J. , Lucera Mark , Singla Mohit , Medigeshi Guruprasad R. , de Bosch Norma , Tam Justina , Gómez-Márquez Jose , Clavet Charles , Villar Luis , Hamad-Schifferli Kimberly , Gehrke Lee
Published: September 2017

A low-cost, equipment-free rapid antigen test distinguishes dengue virus serotypes and Zika virus in patient sera without detectable cross-reactivity.
Multilaboratory Evaluation of a Novel Lateral Flow Immunochromatographic Assay for Confirming Isolation of Mycobacterium bovis from Veterinary Diagnostic Specimens
Authors: Stewart Linda D. , McCallan Lyanne , McNair James , McGoldrick Adrian , Morris Rowan , Moyen Jean-Louis , De Juan Ferré Lucía , Romero Beatriz , Alonso Elena , Parsons Sven D. C. , Van Helden Paul , Araújo Flábio R. , Grant Irene R.
Published: September 2017

A novel lateral flow immunochromatographic device (LFD) was evaluated in several veterinary diagnostic laboratories. It was confirmed to be specific for
Mycobacterium bovis
and
M.
caprae
cells. The performance of the novel LFD was assessed relative to the confirmatory tests routinely applied after culture (spoligotyping or quantitative PCR [qPCR]) in each laboratory; liquid (MGIT or BacT/Alert) and/or solid (Stonebrink, Coletsos, or Lowenstein-Jensen) cultures were tested. In comparison to spoligotyping of acid-fast-positive MGIT cultures, percent agreement between positive LFD and spoligotyping results was excellent in two United Kingdom laboratories (97.7 to 100%) but lower in the Spanish context (76%), where spoligotyping was applied to MGIT cultures previously confirmed to be positive for
M. tuberculosis
complex (MTBC) by qPCR. Certain spoligotypes of
M. bovis
and
M. caprae
were not detected by the LFD in Spanish MGIT cultures. Compared to qPCR confirmation, the agreement between positive LFD and qPCR results was 42.3% and 50% for BacT/Alert and MGIT liquid cultures, respectively, and for solid cultures, it ranged from 11.1 to 89.2%, depending on the solid medium employed (Coletsos, 11.1%; Lowenstein-Jensen, 55.6%; Stonebrinks, 89.2%). Correlation between the novel LFD and BD MGIT TBc Identification test results was excellent when 190 MGIT cultures were tested (
r
= 0.9791;
P
< 0.0001), with the added benefit that
M. bovis
was differentiated from another MTBC species in one MGIT culture by the novel LFD. This multilaboratory evaluation demonstrated the novel LFD's potential utility as a rapid test to confirm isolation of
M. bovis
and
M. caprae
from veterinary specimens following culture.
An Envelope-Modified Tetravalent Dengue Virus-Like-Particle Vaccine Has Implications for Flavivirus Vaccine Design
Authors: Urakami Akane , Ngwe Tun Mya Myat , Moi Meng Ling , Sakurai Atsuko , Ishikawa Momoko , Kuno Sachiko , Ueno Ryuji , Morita Kouichi , Akahata Wataru
Published: September 2017

Dengue viruses (DENV) infect 50 to 100 million people each year. The spread of DENV-associated infections is one of the most serious public health problems worldwide, as there is no widely available vaccine or specific therapeutic for DENV infections. To address this, we developed a novel tetravalent dengue vaccine by utilizing virus-like particles (VLPs). We created recombinant DENV1 to -4 (DENV1-4) VLPs by coexpressing precursor membrane (prM) and envelope (E) proteins, with an F108A mutation in the fusion loop structure of E to increase the production of VLPs in mammalian cells. Immunization with DENV1-4 VLPs as individual, monovalent vaccines elicited strong neutralization activity against each DENV serotype in mice. For use as a tetravalent vaccine, DENV1-4 VLPs elicited high levels of neutralization activity against all four serotypes simultaneously. The neutralization antibody responses induced by the VLPs were significantly higher than those with DNA or recombinant E protein immunization. Moreover, antibody-dependent enhancement (ADE) was not observed against any serotype at a 1:10 serum dilution. We also demonstrated that the Zika virus (ZIKV) VLP production level was enhanced by introducing the same F108A mutation into the ZIKV envelope protein. Taken together, these results suggest that our strategy for DENV VLP production is applicable to other flavivirus VLP vaccine development, due to the similarity in viral structures, and they describe the promising development of an effective tetravalent vaccine against the prevalent flavivirus.

IMPORTANCE
Dengue virus poses one of the most serious public health problems worldwide, and the incidence of diseases caused by the virus has increased dramatically. Despite decades of effort, there is no effective treatment against dengue. A safe and potent vaccine against dengue is still needed. We developed a novel tetravalent dengue vaccine by using virus-like particles (VLPs), which are noninfectious because they lack the viral genome. Previous attempts of other groups to use dengue VLPs resulted in generally poor yields. We found that a critical amino acid mutation in the envelope protein enhances the production of VLPs. Our tetravalent vaccine elicited potent neutralizing antibody responses against all four DENV serotypes. Our findings can also be applied to vaccine development against other flaviviruses, such as Zika virus or West Nile virus.
Genesis and Spread of Newly Emerged Highly Pathogenic H7N9 Avian Viruses in Mainland China
Authors: Yang Lei , Zhu Wenfei , Li Xiyan , Chen Minmei , Wu Jie , Yu Pengbo , Qi Shunxiang , Huang Yiwei , Shi Weixian , Dong Jie , Zhao Xiang , Huang Weijuan , Li Zi , Zeng Xiaoxu , Bo Hong , Chen Tao , Chen Wenbing , Liu Jia , Zhang Ye , Liang Zhenli , Shi Wei , Shu Yuelong , Wang Dayan
Published: September 2017

The novel low-pathogenic avian influenza A H7N9 viruses (LPAI H7N9 viruses) have been a threat to public health since their emergence in 2013 because of the high rates of mortality and morbidity that they cause. Recently, highly pathogenic variants of these avian influenza A H7N9 viruses (HPAI H7N9 viruses) have emerged and caused human infections and outbreaks among poultry in mainland China. However, it is still unclear how the HPAI H7N9 virus was generated and how it evolved and spread in China. Here, we show that the ancestor virus of the HPAI H7N9 viruses originated in the Yangtze River Delta region and spread southward to the Pearl River Delta region, possibly through live poultry trade. After introduction into the Pearl River Delta region, the origin LPAI H7N9 virus acquired four amino acid insertions in the hemagglutinin (HA) protein cleavage site and mutated into the HPAI H7N9 virus in late May 2016. Afterward, the HPAI H7N9 viruses further reassorted with LPAI H7N9 or H9N2 viruses locally and generated multiple different genotypes. As of 14 July 2017, the HPAI H7N9 viruses had spread from Guangdong Province to at least 12 other provinces. The rapid geographical expansion and genetic evolution of the HPAI H7N9 viruses pose a great challenge not only to public health but also to poultry production. Effective control measures, including enhanced surveillance, are therefore urgently needed.

IMPORTANCE
The LPAI H7N9 virus has caused five outbreak waves in humans and was recently reported to have mutated into highly pathogenic variants. It is unknown how the HPAI H7N9 virus originated, evolved, and disseminated in China. In this study, we comprehensively analyzed the sequences of HPAI H7N9 viruses from 28 human and 21 environmental samples covering eight provinces in China that were taken from November 2016 to June 2017. The results show that the ancestor virus of the HPAI H7N9 viruses originated in the Yangtze River Delta region. However, the insertion of four amino acids into the HA protein cleavage site of an LPAI H7N9 virus occurred in late May 2016 in the Pearl River Delta region. The mutated HPAI H7N9 virus further reassorted with LPAI H7N9 or H9N2 viruses that were cocirculating in poultry. Considering the rapid geographical expansion of the HPAI H7N9 viruses, effective control measures are urgently needed.
Individual Patterns of Complexity in Cystic Fibrosis Lung Microbiota, Including Predator Bacteria, over a 1-Year Period
Authors: de Dios Caballero Juan , Vida Rafael , Cobo Marta , Máiz Luis , Suárez Lucrecia , Galeano Javier , Baquero Fernando , Cantón Rafael , del Campo Rosa
Published: September 2017

Cystic fibrosis (CF) lung microbiota composition has recently been redefined by the application of next-generation sequencing (NGS) tools, identifying, among others, previously undescribed anaerobic and uncultivable bacteria. In the present study, we monitored the fluctuations of this ecosystem in 15 CF patients during a 1-year follow-up period, describing for the first time, as far as we know, the presence of predator bacteria in the CF lung microbiome. In addition, a new computational model was developed to ascertain the hypothetical ecological repercussions of a prey-predator interaction in CF lung microbial communities. Fifteen adult CF patients, stratified according to their pulmonary function into mild (
n
= 5), moderate (
n
= 9), and severe (
n
= 1) disease, were recruited at the CF unit of the Ramón y Cajal University Hospital (Madrid, Spain). Each patient contributed three or four induced sputum samples during a 1-year follow-up period. Lung microbiota composition was determined by both cultivation and NGS techniques and was compared with the patients’ clinical variables. Results revealed a particular microbiota composition for each patient that was maintained during the study period, although some fluctuations were detected without any clinical correlation. For the first time,
Bdellovibrio
and
Vampirovibrio
predator bacteria were shown in CF lung microbiota and reduced-genome bacterial parasites of the phylum
Parcubacteria
were also consistently detected. The newly designed computational model allows us to hypothesize that inoculation of predators into the pulmonary microbiome might contribute to the control of chronic colonization by CF pathogens in early colonization stages.

IMPORTANCE
The application of NGS to sequential samples of CF patients demonstrated the complexity of the organisms present in the lung (156 species) and the constancy of basic individual colonization patterns, although some differences between samples from the same patient were observed, probably related to sampling bias.
Bdellovibrio
and
Vampirovibrio
predator bacteria were found for the first time by NGS as part of the CF lung microbiota, although their ecological significance needs to be clarified. The newly designed computational model allows us to hypothesize that inoculation of predators into the lung microbiome can eradicate CF pathogens in early stages of the process. Our data strongly suggest that lower respiratory microbiome fluctuations are not necessarily related to the patient’s clinical status.
The Gut Microbiota of Healthy Aged Chinese Is Similar to That of the Healthy Young
Authors: Bian Gaorui , Gloor Gregory B. , Gong Aihua , Jia Changsheng , Zhang Wei , Hu Jun , Zhang Hong , Zhang Yumei , Zhou Zhenqing , Zhang Jiangao , Burton Jeremy P. , Reid Gregor , Xiao Yongliang , Zeng Qiang , Yang Kaiping , Li Jiangang
Published: September 2017

We report the large-scale use of compositional data analysis to establish a baseline microbiota composition in an extremely healthy cohort of the Chinese population. This baseline will serve for comparison for future cohorts with chronic or acute disease. In addition to the expected difference in the microbiota of children and adults, we found that the microbiota of the elderly in this population was similar in almost all respects to that of healthy people in the same population who are scores of years younger. We speculate that this similarity is a consequence of an active healthy lifestyle and diet, although cause and effect cannot be ascribed in this (or any other) cross-sectional design. One surprising result was that the gut microbiota of persons in their 20s was distinct from those of other age cohorts, and this result was replicated, suggesting that it is a reproducible finding and distinct from those of other populations.
The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction
Authors: Korakakis Vasileios , Whiteley Rodney , Tzavara Alexander , Malliaropoulos Nikolaos
Published: September 2017

Objective

To evaluate extracorporeal shockwave therapy (ESWT) in treating Achilles tendinopathy (AT), greater trochanteric pain syndrome (GTPS), medial tibial stress syndrome (MTSS), patellar tendinopathy (PT) and proximal hamstring tendinopathy (PHT).

Design

Systematic review.

Eligibility criteria

Randomised and non-randomised studies assessing ESWT in patients with AT, GTPS, MTSS, PT and PHT were included. Risk of bias and quality of studies were evaluated.

Results

Moderate-level evidence suggests (1) no difference between focused ESWT and placebo ESWT at short and mid-term in PT and (2) radial ESWT is superior to conservative treatment at short, mid and long term in PHT. Low-level evidence suggests that ESWT (1) is comparable to eccentric training, but superior to wait-and-see policy at 4 months in mid-portion AT; (2) is superior to eccentric training at 4 months in insertional AT; (3) less effective than corticosteroid injection at short term, but ESWT produced superior results at mid and long term in GTPS; (4) produced comparable results to control treatment at long term in GTPS; and (5) is superior to control conservative treatment at long term in PT. Regarding the rest of the results, there was only very low or no level of evidence. 13 studies showed high risk of bias largely due to methodology, blinding and reporting.

Conclusion

Low level of evidence suggests that ESWT may be effective for some lower limb conditions in all phases of the rehabilitation.
Comparison of amateur boxing before and after the 2013 rules change and the impact on boxers’ safety
Authors: Davis Philip , Waldock Robert , Connorton Andrew , Driver Sonny , Anderson Sean
Published: September 2017

Objectives

The effect of the rules change in 2013 on amateur boxing strategy, technique and safety in comparison with pre-2013 is unknown.

Methods

Pre-2013 and post-2013 3×3 min elite level amateur boxing was compared from video footage of 29 Olympic (pre-2013) and 50 World Championship bouts (post-2013) totalling 99 male boxers (mean±SD) age: 24.3±3.2 years, height: 177.3±11.3 cm and body mass: 70.7±16.4 kg.

Result

Many techniques that were dominant pre-2013 were used less post-2013, including: total punches thrown, rear hand punches, hook rear hand, punches landed, uppercut punches, total punches to the body (all <0.05), while movement around the ring and defensive movements were higher post-2013 (both p<0.004). Post-2013 boxers have increased their foot movement by 20% to move in and then away from their opponent, combined with long-range punches and deliberate defensive movements. The percentage of rounds where standing counts were issued changed from 9% to 3% pre-2013 to post-2013. However, pre-2013, 1.7% of bouts did not last the full duration due to referee stoppage, while post-2013, this increased to 4.2% as a result of two knockouts and eight technical knockouts.

Discussion and conclusion

Boxers should be aware of the large changes in technical demands of boxing. An increased risk of concussive or traumatic brain injury post-2013 is equivocal. However, an increase in skin splits and technical knockouts is apparent. It is likely that boxers believe head guard removal has made them more prone to knockouts.
Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials
Authors: Sweegers Maike G , Altenburg Teatske M , Chinapaw Mai J , Kalter Joeri , Verdonck-de Leeuw Irma M , Courneya Kerry S , Newton Robert U , Aaronson Neil K , Jacobsen Paul B , Brug Johannes , Buffart Laurien M
Published: September 2017

Objective

Certain exercise prescriptions for patients with cancer may improve self-reported quality of life (QoL) and self-reported physical function (PF). We investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics.

Design

We searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Pooled effects (Hedges’ g) were calculated using Comprehensive Meta-Analysis software. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors).

Results

We included 74 exercise arms. Patients who were randomised to exercise interventions had significantly improved QoL (g=0.15, 95% CI (0.10 to 0.20), n=67 exercise arms) and PF (g=0.21, 95% CI (0.15 to 0.27), n=59 exercise arms) compared with patients in control groups. We found a significant between-group difference for exercise delivery mode, with significant beneficial effects for supervised exercise interventions (g=0.20, 95% CI (0.14 to 0.26) for QoL and g=0.27, 95% CI (0.20 to 0.33) for PF), but not for unsupervised interventions (g=0.04, 95% CI (−0.06 to 0.13) for QoL and g=0.09, 95% CI (−0.01 to 0.19) for PF). No statistically significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure (z=2.34, p=0.02).

Conclusions

Exercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.
Did the accuracy of oral amoxicillin dosing of children improve after British National Formulary dose revisions in 2014? National cross-sectional survey in England
Authors: Rann Olivia , Sharland Mike , Long Paul , Wong Ian C K , Laverty Anthony A , Bottle Alex , Barker Charlotte I , Bielicki Julia , Saxena Sonia
Published: September 2017

Objectives

Inaccurate antibiotic dosing can lead to treatment failure, fuel antimicrobial resistance and increase side effects. The British National Formulary for Children (BNFC) guidance recommends oral antibiotic dosing according to age bands as a proxy for weight. Recommended doses of amoxicillin for children were increased in 2014 ‘after widespread concerns of under dosing’. However, the impact of dose changes on British children of different weights is unknown, particularly given the rising prevalence of childhood obesity in the UK. We aimed to estimate the accuracy of oral amoxicillin dosing in British children before and after the revised BNFC guidance in 2014.

Setting and participants

We used data on age and weights for 1556 British children (aged 2–18 years) from a nationally representative cross-sectional survey, the Health Survey for England 2013.

Interventions

We calculated the doses each child would receive using the BNFC age band guidance, before and after the 2014 changes, against the ‘gold standard’ weight-based dose of amoxicillin, as per its summary of product characteristics.

Primary outcome measure

Assuming children of different weights were equally likely to receive antibiotics, we calculated the percentage of the children who would be at risk of misdosing by the BNFC age bands.

Results

Before 2014, 54.6% of children receiving oral amoxicillin would have been underdosed and no child would have received more than the recommended dose. After the BNFC guidance changed in 2014, the number of children estimated as underdosed dropped to 5.8%, but 0.5% of the children would have received too high a dose.

Conclusions

Changes to the BNFC age-banded amoxicillin doses in 2014 have significantly reduced the proportion of children who are likely to be underdosed, with only a minimal rise in the number of those above the recommended range.