bluuebunny/crossref_metadata_2025 huggingface dataset:
Responsible research for the construction of maximally humanlike automata: the paradox of unattainable informed consent
Authors: Miller Lantz Fleming
Published: July 2017

Since the Nuremberg Code and the first Declaration of Helsinki, globally there has been increasing adoption and adherence to procedures for ensuring that human subjects in research are as well informed as possible of the study’s reasons and risks and voluntarily consent to serving as subject. To do otherwise is essentially viewed as violation of the human research subject’s legal and moral rights. However, with the recent philosophical concerns about responsible robotics, the limits and ambiguities of research-subjects ethical codes become apparent on the matter of constructing automata that maximally resemble human beings (as defined hereunder). In this case, the automata themselves, as products of research and development, are in the very process of their construction subjects of research and development. However, such research faces a paradox: The subjects cannot give their informed consent to this research for their own development, although their consent would be needed for the research. According to ethical codes, this research would be unethical. The article then explores whether the background concepts giving rise to this paradox could be reframed in order to allow such research to proceed ethically.
Higher Lipophilic Index Indicates Higher Risk of Coronary Heart Disease in Postmenopausal Women
Authors: Liu Qing , Lichtenstein Alice H. , Matthan Nirupa R. , Howe Chanelle J. , Allison Matthew A. , Howard Barbara V. , Martin Lisa W. , Valdiviezo Carolina , Manson JoAnn E. , Liu Simin , Eaton Charles B.
Published: July 2017

Fatty acids (FAs) are essential components of cell membranes and play an integral role in membrane fluidity. The lipophilic index [LI, defined as the sum of the products between FA levels and melting points (°C), divided by the total amount of FA: ] is thought to reflect membrane and lipoprotein fluidity and may be associated with the risk of coronary heart disease (CHD). Therefore, we examined the associations of dietary and plasma phospholipid (PL) LI with CHD risk among postmenopausal women. We determined dietary LI for the cohort with completed baseline food frequency questionnaires and free of prevalent cardiovascular diseases in the Women's Health Initiative (WHI) observational study (N = 85,563). We additionally determined plasma PL LI in a matched case‐control study (N = 2428) nested within the WHI observational cohort study. Cox proportional hazard regression and multivariable conditional logistic regression were used to calculate HRs/ORs for CHD risk between quartiles of LI after adjusting for potential sources of confounding and selection bias. Higher dietary LI in the cohort study and plasma PL LI in the case‐control study were significantly associated with increased risk of CHD: HR = 1.18 (95% CI 1.07–1.31, P for trend <0.01) and OR = 1.76 (95% CI 1.33–2.33, P for trend <0.01) comparing extreme quartiles and adjusting for potential confounders. These associations still persisted after adjusting for the polyunsaturated to saturated fat ratio. Our study indicated that higher LI based on either dietary or plasma measurements, representing higher FA lipophilicity, was associated with elevated risk of CHD among postmenopausal women.
Dental care utilization in patients with different types of dementia: A longitudinal nationwide study of 58,037 individuals
Authors: Fereshtehnejad Seyed‐Mohammad , Garcia‐Ptacek Sara , Religa Dorota , Holmer Jacob , Buhlin Kåre , Eriksdotter Maria , Sandborgh‐Englund Gunilla
Published: July 2017

Introduction

Dementia may be associated with discontinuation of regular dental checkups, which in turn results in poorer oral health.

Methods

We investigated the trend of change in dental care utilization and the number of teeth before and after being diagnosed with dementia. Longitudinal cognitive‐ and dental health‐related information were merged using data on 58,037 newly diagnosed individuals from the Swedish Dementia Registry and Swedish Dental Health Register during 2007 to 2015.

Results

Following dementia diagnosis, rate of dental care visits significantly declined. Individuals with mixed dementia, dementia with parkinsonism, and those with more severe and faster cognitive impairment had significantly higher rate of decline in dental care utilization. Vascular dementia and lower baseline Mini–Mental State Examination score were significant predictors of faster loss of teeth.

Discussion

Dental care utilization markedly declines following dementia diagnosis. The reduction is more prominent in those with rapid progressive cognitive impairment and the ones with extra frailty burden.
Coloretal cancer in pregnant women
Authors: Gens Helena Margarida Cruz , Barbosa Laura Elisabete Ribeiro
Published: July 2017

Background Colorectal cancer in pregnancy is a rare pathology with limited high-grade evidence available for guidance. The diagnosis of CRC in pregnant women is usually delayed, and once diagnosis is made, challenges exist as treatment options may be limited.

Objective The study aims to highlight the importance of early investigation of symptomatic patients during pregnancy, as well as to update treatment and prognosis in CRC.

Methods A literature search in PubMed database, including articles from 2006 to 2016 and cross-research articles with the initial research.

Results Pregnancy can limit and contraindicate the utilization of standard diagnostic and therapeutic tools, which in particular can hamper the liberal use of colonoscopy and CT. Physical evaluation and abdominal US are first recommended; besides, MRI or CT may be used, only in indicated cases. Surgery is the main stay of treatment but radiotherapy and chemotherapy have significant role in posterior management of tumour.

Conclusions Many studies are needed in order to achieve development in CRC pathogenesis during pregnancy as well as in treatment outcomes. The potential curative treatment of the disease should be the main aim of treatment when considering CRC in pregnancy. However, it is crucial to adapt the treatment to each patient, taking into account conscious decision on pregnancy further management.
The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery
Authors: Lu I‐Cheng , Chang Pi‐Ying , Su Miao‐Pei , Chen Po‐Nien , Chen Hsiu‐Ya , Chiang Feng‐Yu , Wu Che‐Wei
Published: July 2017

The use of neuromuscular blocking agent (NMBA) during anesthesia may interfere with facial nerve monitoring (FNM) during parotid surgery. Sugammadex has been reported to be an effective and safe reversal of rocuronium‐induced neuromuscular block (NMB) during surgery. This study investigated the feasibility and clinical effectiveness of sugammadex for NMB reversal during FNM in Parotid surgery.

Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25) and sugammadex group (Group S, n = 25). Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%). In group S, rapid reverse of NMB was found and the twitch (%) recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery.
Nordic Walking for the Management of People With Parkinson Disease: A Systematic Review
Authors: Cugusi Lucia , Manca Andrea , Dragone Daniele , Deriu Franca , Solla Paolo , Secci Claudio , Monticone Marco , Mercuro Giuseppe
Published: July 2017

Background

It is well known that physical exercise is the main therapeutic element of rehabilitation programs for people with Parkinson disease (PD). As traditional forms of exercise can guarantee significant health benefits, the emergence of nonconventional physical activities, such as Nordic walking (NW), may add positive effects.

Objective

To appraise the available evidence on the main effects of NW in the rehabilitation programs for people with PD and to propose a design for upcoming research that might improve the uniformity of future trials.

Study Design

Systematic review.

Literature Survey

A literature search of 5 established databases (PubMed, MEDLINE, Scopus, Web of Science, and Cochrane) was conducted.

Methodology

Any relevant randomized controlled trials pertinent to NW in PD published in English from inception to February 2017 were included. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were followed, and the methodologic quality of each study was assessed by the Physiotherapy Evidence Database scale.

Data Synthesis

Sixty‐six studies were retrieved, and 6 randomized controlled trials (221 subjects) were entered into the qualitative synthesis. Overall, these studies portrayed NW as feasible and likely to be effective in improving the functional and clinical outcomes of people with PD. When we compared NW with other exercise‐based interventions, such as treadmill training, free walking, a program of standardized whole‐body movements with maximal amplitude (Lee Silverman Voice Treatment BIG training), or a home‐based exercise program, the findings proved controversial.

Conclusions

High heterogeneity and methodologic discrepancies among the studies prevent us from drawing firm conclusions on the effectiveness of NW in comparison with other exercise‐based interventions currently used by people with PD. Further investigations with a common design are necessary to verify whether NW may be included within conventional rehabilitation programs commonly recommended to people with PD.

Level of Evidence

II
Failed Removal of Indwelling Urinary Catheters in Patients With Acute Stroke: Incidence and Risk Factors
Authors: Frost Frederick S. , Fan Youran , Harrison Alexander , Modlin Trey , Samuel Susan , Thompson Nicholas , Katzan Irene
Published: July 2017

Background

Reducing the incidence of indwelling urinary catheter (IUC) use and early removal of the devices that are inserted are appropriate priorities for quality patient care. Just like symptomatic bacteriuria, failed catheter removal as a complication of IUC use is associated with considerable morbidity. In the ideal setting, patients who need IUCs have them, and patients who do not need them will have them removed safely, with the goal of reducing medical complications and facilitating the rehabilitation phase of care.

Objective

To determine the incidence of failed removal of IUCs and the factors associated with failed removal in persons hospitalized with acute stroke.

Design

Retrospective review of medical records and associated clinical data collection platforms.

Setting

Comprehensive stroke center at a tertiary care hospital.

Patients

The study cohort included 175 stroke patients admitted to the hospital and managed with IUCs. Mean age was 66.1 years (standard deviation = 15), 55% were female.

Methods

Univariable and multiple logistic regression analyses were performed. Variables assessed included age, gender, race, duration of hospital stay, stroke subtype, National Institutes of Health Stroke Scale, and 6‐Clicks Scale, which is a measure of functional status.

Main Outcome Measurements

The dependent variable was occurrence of a failed attempt at removal of an IUC, defined as removal followed by a catheter reinsertion.

Results

During the study period, 175 of 432 patients with acute hospital admission for new stroke had an IUC removal event. Of these patients, 46 (26%) experienced a failed catheter removal. On univariate analysis, factors significantly associated with failed removal included presence of a hemorrhagic stroke (P = .005), lower level of physical function (by 6‐Clicks and NIHSS scores), hospital length of stay (P < .001), and discharge location (P = .005). Bedside bladder ultrasound testing by nursing staff was used more frequently in the group of patients who had unsuccessful IUC removals (95% confidence interval 4.56‐21.67, P < .001). Length of stay (P < .001), white race (P = .001), and hemorrhagic stroke (P = .009) were associated independently with failed catheter removal after adjustment for other clinical variables.

Conclusions

This single‐site study identified a high incidence of failed urinary catheter removal in patients with stroke, along with factors associated with failed removal. This is the first step in developing a predictive model that could reduce the incidence of this adverse event. Policies, penalties, and protocols designed to reduce catheter days must be sensitive to the special situations in which IUCs are medically necessary and equal consideration given to identifying the patients for which catheter removal poses a greater risk than continued catheter use.

Level of Evidence

III
Neotectonics of eastern Gorny Altai: Evidence from magnetotelluric data
Authors: Novikov I.S. , Pospeeva E.V.
Published: July 2017

According to 2D magnetotelluric (MT) data from northeastern and southeastern Altai, numerous neotectonic faults cut the Gorny Altai territory as a whole, as well as large basins within its limits, into blocks. Large neotectonic faults are traceable depthward in MT-based cross sections as zones of very low resistivities (below 0.5 Ohm·m). The MT data generally confirm the fault geometry inferred previously from morphotectonic and geological evidence. Fault plane dips are vertical in normal and strike-slip faults and inclined in reverse faults. The nearly vertical and dipping zones of neotectonic faults crosscut a horizontal conductivity anomaly at depths of 10–15 km. The anomaly makes a natural divide between the zones of brittle crustal failure above and ductile downward pressing of material below. It may be responsible for the high tectonic and seismic activity potential of the upper lithosphere in Gorny Altai associated with growth of mountains and crust thickening. Beneath the Chuya and Kurai large basins, the conductivity anomaly occurs at a shallow depth of 10 km and has a resistivity below 10 Ohm·m. © 2017, V.S. Sobolev IGM, Siberian Branch of the RAS. Published by Elsevier B.V. All rights reserved.
Conditions of formation of gold-bearing magnetite–chlorite–carbonate rocks of the Karabash ultrabasic massif (South Urals)
Authors: Murzin V.V. , Varlamov D.A. , Palyanova G.A.
Published: July 2017

Ilmenite, apatite, monazite, aeshynite-(Y), zircon, baddeleyite, thorianite, uraninite, and copper-containing native gold have been revealed in specific magnetite–chlorite–carbonate rocks and chloritolites in the Karabash ultrabasic massif in the South Urals. Dolomite from the magnetite–chlorite–carbonate rocks are characterized by a rather uniform isotope composition (δ13C = –0.9 to –1.9‰, δ18O = 11.5–13.6‰, 87Sr/86Sr = 0.70422–0.70469) corresponding to a mixture of sources: marine limestones and mantle fluids. We determined the isotope compositions of antigorite from serpentinites (δD = –79.1 and –89.6‰, 518O = 7.4 and 7.6‰), of chlorite from chloritolites (δD = –57.8‰, δ18O = 7.8‰), and of magnetite–chlorite–carbonate rocks (δD = –59.2 and –69.6‰, δ18O = 6.4 and 5.9‰). The latter probably formed by the mechanism of filling of the free space at 480-280 °C, and chloritolites were developed after serpentinites. Oceanic serpentinites, gabbros, limestones, and mantle fluids can be considered the source of material during the formation of magnetite–chlorite–carbonate rocks. A comparative analysis of the latter and the massif rodingites (chlograpites) bearing copper-containing gold was carried out. The established common features of these types of rocks are the localization in zones of tectonic melange, the presence of chloritolite rims, geochemical specialization, thermal conditions of formation, and isotope parameters of minerals and fluids.
Advancement of mineragenic regionalization of eastern Transbaikalia based on geophysical studies
Authors: Khomich V.G. , Boriskina N.G.
Published: July 2017

Several metallogenic belts were earlier recognized by S.S. Smirnov in Transbaikalia rich in polymetallic endogenous mineralization. Despite the continuing geological and geophysical studies in the region, the borders of these belts are still hotly debatable. The results of geophysical and seismic tomographic studies in East Asia (where a stagnant oceanic slab was discovered in the mantle transition zone) and the location of highly productive ore-magmatic systems in the regional Earth’s crust testify to the spatial coincidence of the projection of the frontal part of the slab with the Dalainor–Gazimur-Olekma mineragenic zone. Most of large and superlarge ore nodes and fields with Au, Mo, U, Pb–Zn, Cu, and fluorite mineralization are localized in this zone. The difficult problem of mineragenic regionalization here can be solved by proving the probable influence of mantle fluid flows formed near the frontal part of the slab on the formation of highly productive ore-magmatic systems of the above zone oriented orthogonally to the earlier recognized belts. The experience gained during the comprehensive studies of minerageny both in eastern Transbaikalia and in other ore-bearing provinces can be used to choose ore-promising areas for prediction, prospecting, and assessment works.
Transient electric field response to a uniform, magnetically viscous earth excited by a grounded line source
Authors: Antonov E.Yu. , Kozhevnikov N.O.
Published: July 2017

A new method is suggested for calculation of transient electric field response to conducting magnetically viscous earth excited by a grounded line source. Calculation algorithms are implemented in the computer program FwLL_MV. Using a uniform, conducting magnetically viscous half-space as an earth model, we have shown that magnetic relaxation affects the TEM response of equatorial and in-line arrays. As in the case of loop arrays, apparent resistivity steadily decreases with time. The higher the half-space resistivity and the shorter the offset, the earlier the voltage and the apparent resistivity begin to decrease as 1/t. Magnetic relaxation and decay of eddy currents are independent processes within the range of resistivities typical of rocks.
MCM-41 support for ultrasmall γ-Fe2O3 nanoparticles for H2S removal
Authors: Cara C. , Rombi E. , Musinu A. , Mameli V. , Ardu A. , Sanna Angotzi M. , Atzori L. , Niznansky D. , Xin H. L. , Cannas C.
Published: July 2017

MCM-41 is proposed to build mesostructured γ-Fe2O3-based sorbents as an alternative to other silica or alumina supports for mid-temperature H2S removal.
Electronic and protonic conduction in LaFeO3
Authors: Zhu Zhen , Peelaers Hartwin , Van de Walle Chris G.
Published: July 2017

Charge transport mechanisms of perovskite-type LaFeO3 are elucidated for battery-electrode applications.
Interface engineering of a noble-metal-free 2D–2D MoS2/Cu-ZnIn2S4 photocatalyst for enhanced photocatalytic H2 production
Authors: Yuan Yong-Jun , Chen Daqin , Zhong Jiasong , Yang Ling-Xia , Wang Jingjing , Liu Mei-Jiao , Tu Wen-Guang , Yu Zhen-Tao , Zou Zhi-Gang
Published: July 2017

A 2D–2D MoS2/Cu-ZnIn2S4 nanocomposite is designed as a highly efficient noble-metal-free photocatalyst for solar H2 generation.
Regulation of the trafficking and the function of the metalloprotease ADAM10 by tetraspanins
Authors: Saint-Pol Julien , Eschenbrenner Etienne , Dornier Emmanuel , Boucheix Claude , Charrin Stéphanie , Rubinstein Eric
Published: July 2017

By interacting directly with partner proteins and with one another, tetraspanins organize a network of interactions referred to as the tetraspanin web. ADAM10 (A Disintegrin And Metalloprotease 10), an essential membrane-anchored metalloprotease that cleaves off the ectodomain of a large variety of cell surface proteins including cytokines, adhesion molecules, the precursor of the β-amyloid peptide APP or Notch, has emerged as a major component of the tetraspanin web. Recent studies have shown that ADAM10 associates directly with all members (Tspan5, Tspan10, Tspan14, Tspan15, Tspan17 and Tspan33) of a subgroup of tetraspanins having eight cysteines in the large extracellular domain and referred to as TspanC8. All TspanC8 regulate ADAM10 exit from the endoplasmic reticulum, but differentially regulate its subsequent trafficking and its function, and have notably a different impact on Notch signaling. TspanC8 orthologs in invertebrates also regulate ADAM10 trafficking and Notch signaling. It may be possible to target TspanC8 tetraspanins to modulate in a tissue- or substrate-restricted manner ADAM10 function in pathologies such as cardiovascular diseases, cancer or Alzheimer's disease.
Lnc-ing inflammation to disease
Authors: Magagula Loretta , Gagliardi Maria , Naidoo Jerolen , Mhlanga Musa
Published: July 2017

Termed ‘master gene regulators’ long ncRNAs (lncRNAs) have emerged as the true vanguard of the ‘noncoding revolution’. Functioning at a molecular level, in most if not all cellular processes, lncRNAs exert their effects systemically. Thus, it is not surprising that lncRNAs have emerged as important players in human pathophysiology. As our body's first line of defense upon infection or injury, inflammation has been implicated in the etiology of several human diseases. At the center of the acute inflammatory response, as well as several pathologies, is the pleiotropic transcription factor NF-κβ. In this review, we attempt to capture a summary of lncRNAs directly involved in regulating innate immunity at various arms of the NF-κβ pathway that have also been validated in human disease. We also highlight the fundamental concepts required as lncRNAs enter a new era of diagnostic and therapeutic significance.
Resource allocation in living organisms
Authors: Goelzer Anne , Fromion Vincent
Published: July 2017

Quantitative prediction of resource allocation for living systems has been an intensive area of research in the field of biology. Resource allocation was initially investigated in higher organisms by using empirical mathematical models based on mass distribution. A challenge is now to go a step further by reconciling the cellular scale to the individual scale. In the present paper, we review the foundations of modelling of resource allocation, particularly at the cellular scale: from small macro-molecular models to genome-scale cellular models. We enlighten how the combination of omic measurements and computational advances together with systems biology has contributed to dramatic progresses in the current understanding and prediction of cellular resource allocation. Accurate genome-wide predictive methods of resource allocation based on the resource balance analysis (RBA) framework have been developed and ensure a good trade-off between the complexity/tractability and the prediction capability of the model. The RBA framework shows promise for a wide range of applications in metabolic engineering and synthetic biology, and for pursuing investigations of the design principles of cellular and multi-cellular organisms.
Anti-inflammatory ω-3 endocannabinoid epoxides
Authors: McDougle Daniel R. , Watson Josephine E. , Abdeen Amr A. , Adili Reheman , Caputo Megan P. , Krapf John E. , Johnson Rodney W. , Kilian Kristopher A. , Holinstat Michael , Das Aditi
Published: July 2017

Significance

The health benefits of ω-3 fatty acids are mediated, in part, through metabolic conversion to bioactive epoxides. Here we detail the discovery and initial characterization of naturally occurring ω-3–derived endocannabinoid epoxides that are formed via enzymatic oxidation of ω-3 endocannabinoids by cytochrome P450s. These dual functional ω-3 endocannabinoid epoxides are anti-inflammatory and vasodilatory and reciprocally modulate platelet aggregation. By virtue of their physiological properties, they are expected to play important roles in neuroinflammation and in cerebrovascular diseases such as stroke.
Two dynamin-like proteins stabilize FtsZ rings during
Streptomyces
sporulation
Authors: Schlimpert Susan , Wasserstrom Sebastian , Chandra Govind , Bibb Maureen J. , Findlay Kim C. , Flärdh Klas , Buttner Mark J.
Published: July 2017

Significance

Bacterial dynamins were discovered ∼10 y ago and the explosion in genome sequencing has shown that they radiate throughout the bacteria, being present in >1,000 species. In eukaryotes, dynamins play critical roles in the detachment of endocytic vesicles from the plasma membrane, the division of chloroplasts and peroxisomes, and both the fusion and fission of mitochondria. However, in evolutionary terms, dynamins are of bacterial origin, and yet the biological functions of bacterial dynamins remain poorly understood. Here we demonstrate a critical role for dynamins in bacterial cytokinesis, reminiscent of the essential role of eukaryotic dynamins in the division of chloroplasts and mitochondria.
In situ synthesis of TiC-TiN-reinforced Fe-base plasma cladding coatings
Authors: Feng Zaiqiang , Tang Mingqi , Liu Yuqiang , Yan Zhenwei , Li Gang , Zhang Ruizhu
Published: July 2017

Using titanium, boron carbide and iron-based alloy powders as reactive sources, an Fe-based cladding coating reinforced by in situ synthesised TiC-TiN particles was fabricated using the plasma cladding method. The effects of Ti and B4C content on the phase composition, microstructure, microhardness, wear resistance and corrosion resistance of the coating were studied. The cladding coatings were composed of α-Fe, Cr, Fe3C, TiC, TiN, Fe23B6 and Fe23(C,B)6. The relative content of TiC, TiN, Fe23B6, and Fe23(C,B)6 in the cladding layer increased with an increase in Ti and B4C contents. The hardness, wear resistance and corrosion resistance of the cladding coating increased with an increase in Ti and B4C content. The results indicated that the composite coatings exhibited excellent wear resistance and corrosion resistance.
The BioCyc collection of microbial genomes and metabolic pathways
Authors: Karp Peter D , Billington Richard , Caspi Ron , Fulcher Carol A , Latendresse Mario , Kothari Anamika , Keseler Ingrid M , Krummenacker Markus , Midford Peter E , Ong Quang , Ong Wai Kit , Paley Suzanne M , Subhraveti Pallavi
Published: July 2017

BioCyc.org is a microbial genome Web portal that combines thousands of genomes with additional information inferred by computer programs, imported from other databases and curated from the biomedical literature by biologist curators. BioCyc also provides an extensive range of query tools, visualization services and analysis software. Recent advances in BioCyc include an expansion in the content of BioCyc in terms of both the number of genomes and the types of information available for each genome; an expansion in the amount of curated content within BioCyc; and new developments in the BioCyc software tools including redesigned gene/protein pages and metabolite pages; new search tools; a new sequence-alignment tool; a new tool for visualizing groups of related metabolic pathways; and a facility called SmartTables, which enables biologists to perform analyses that previously would have required a programmer’s assistance.
Comparison of Standardized Cytomegalovirus (CMV) Viral Load Thresholds in Whole Blood and Plasma of Solid Organ and Hematopoietic Stem Cell Transplant Recipients with CMV Infection and Disease
Authors: Dioverti M Veronica , Lahr Brian D , Germer Jeffrey J , Yao Joseph D , Gartner Michelle L , Razonable Raymund R
Published: July 2017

Background

Quantification of cytomegalovirus (CMV) deoxyribonucleic acid (DNA) has important diagnostic, prognostic, and therapeutic implications in the management of transplant recipients. We aimed to assess a viral load in plasma and whole blood that distinguishes CMV disease from asymptomatic infection in a cohort of solid organ and hematopoietic stem cell transplantation.

Methods

We prospectively measured and compared CMV viral load in paired plasma and whole blood samples collected from transplant recipients with CMV infection and disease. Cytomegalovirus viral loads were determined by a commercially available US Food and Drug Administration-approved quantitative assay (COBAS AmpliPrep/COBAS TaqMan CMV Test [CAP/CTM CMV]) calibrated to the first World Health Organization International Standard for CMV DNA quantification.

Results

Moderate agreement of CMV viral load was observed between plasma and whole blood, with 31% of samples having discordant findings, particularly among samples with low DNA levels. Among the subset of samples where both paired samples had quantifiable levels, we observed a systematic bias that reflected higher viral load in whole blood compared with plasma. Based on receiver operating curve analysis, an initial plasma CMV viral load threshold of 1700 IU/mL in solid organ transplant recipients (sensitivity 80%, specificity 74%) and 1350 IU/mL in allogeneic hematopoietic stem cell transplant recipients (sensitivity 87%, specificity 87%) distinguished CMV disease and asymptomatic infection.

Conclusions

This study identifies standardized viral load thresholds that distinguish CMV disease from asymptomatic infection using CAP/CTM CMV assay. We propose these thresholds as potential triggers to be evaluated in prospective studies of preemptive therapy. Plasma was better than whole blood for measuring viral load using the CAP/CTM CMV assay.
The Intestinal Microbiome in Infectious Diseases: The Clinical Relevance of a Rapidly Emerging Field
Authors: Harris Vanessa C , Haak Bastiaan W , Boele van Hensbroek Michaël , Wiersinga Willem J
Published: July 2017

The field of infectious disease is undergoing a paradigm shift as the intestinal microbiome is becoming understood. The aim of this review is to inform infectious disease physicians of the potential relevance of the intestinal microbiome to their practice. We searched Medline using both index and text words relating to infectious diseases, microbiome, and probiotics. Relevant articles published up through 2017 were reviewed within Rayyan. The review illustrates pathophysiologic concepts linking the microbiome and infectious diseases; specifically, the intestinal microbiome’s relevance to early immune development, the microbiome and enteric infections, the microbiome’s relevance in compromised hosts, and antimicrobial resistance. Within each subject, there are specific examples of diseases and at-risk patient populations where a role for the microbiome has been strongly established. This provides an overview of the significance of the intestinal microbiome to microbiology, pediatric and adult infectious diseases with an underpinning of concepts useful for the practicing clinician.
Intravenous Tranexamic Acid Bolus plus Infusion Is Not More Effective than a Single Bolus in Primary Hip Arthroplasty
Authors: Zufferey Paul J. , Lanoiselée Julien , Chapelle Céline , Borisov Dmitry B. , Bien Jean-Yves , Lambert Pierre , Philippot Rémi , Molliex Serge , Delavenne Xavier ,   for the investigators of the PeriOpeRative Tranexamic acid in hip arthrOplasty (PORTO) Study
Published: July 2017

Background

Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss.

Methods

This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty. Patients received a preoperative intravenous bolus of 1 g of tranexamic acid followed by a continuous infusion of either tranexamic acid 1 g (bolus-plus-infusion group) or placebo (bolus group) for 8 h. The primary outcome was calculated perioperative blood loss up to day 5. Erythrocyte transfusion was implemented according to a restrictive transfusion trigger strategy.

Results

The mean perioperative blood loss was 919 ± 338 ml in the bolus-plus-infusion group (84 patients analyzed) and 888 ± 366 ml in the bolus group (83 patients analyzed); mean difference, 30 ml (95% CI, −77 to 137; P = 0.58). Within 6 weeks postsurgery, three patients in each group (3.6%) underwent erythrocyte transfusion and two patients in the bolus group experienced distal deep-vein thrombosis. A meta-analysis combining data from this study with those of five other trials showed no incremental efficacy of additional perioperative administration of tranexamic acid.

Conclusions

A preoperative bolus of tranexamic acid, associated with a restrictive transfusion trigger strategy, resulted in low erythrocyte transfusion rates in patients undergoing hip arthroplasty. Supplementary perioperative administration of tranexamic acid did not achieve any further reduction in blood loss.
Auditory Cognitive Training for Pediatric Cochlear Implant Recipients
Authors: Mishra Srikanta K. , Boddupally Shiva P.
Published: July 2017

Objectives:

Understanding speech in noise is the biggest challenge faced by individuals with cochlear implants (CIs). Improving speech-in-noise perception for pediatric CI recipients continues to remain a high priority for all stakeholders. This study was designed to investigate the efficacy of working memory training for improving speech-in-noise recognition for children with CIs.

Design:

Fourteen children with CIs (aged 6 to 15 years) received adaptive, home-based training on forward digit span task for 5 weeks, while 13 children with CIs participated in backward digit span training. Seventeen age-matched children with CIs in the control group received a placebo. Outcome measures included forward and backward digit span and speech recognition threshold for digit triplets in noise at pretraining, post-training, and 5-week follow-up. Performance measures from 26 age-matched children with normal hearing were also obtained only at the baseline session to generate normative standards for comparison.

Results:

Digit span scores were significantly higher at post-training and follow-up compared with pretraining for both forward- and backward-trained groups. Both trained groups showed similar training-induced shifts. The control group showed no such improvement. There was no effect of training on the speech recognition threshold. Children with CIs showed significantly lower digit span scores and a higher speech recognition threshold relative to children with normal hearing.

Conclusions:

Training improves working memory capacity as measured by digit spans for children with CIs. Training-induced improvements are stable for at least 5 weeks. Learning effects demonstrate near-transfer, from forward to backward digit span and vice versa, but failed to show far-transfer to speech-in-noise recognition. Current evidence is not supportive of cognitive training for improving speech-in-noise performance for children with CIs.
Telenursing Intervention for Clean Intermittent Urinary Catheterization Patients
Authors: de Souza-Junior Valtuir Duarte , Mendes Isabel Amélia Costa , Mazzo Alessandra , de Godoy Simone , dos Santos Cristiano Alves
Published: July 2017

Telenursing is a promising strategy to make nursing care feasible in different health situations, mainly to help patients with chronic illnesses. The aim in this study was to test the feasibility (acceptability and usability) of a telenursing intervention in care delivery to patients using clean intermittent urinary catheterization. This descriptive study focused on an intervention involving urology outpatients. The telenursing intervention was implemented synchronously by audio calls and chat and asynchronously by e-mail as part of a pilot study. The contact between nurse and patient was undertaken through an active search or on spontaneous demand, in which the patient contacted the nurse when necessary. During the 5 weeks of study, 21 telenursing care sessions took place, including 13 (61.9%) on spontaneous demand and eight (38.1%) on active demand. With regard to the technological resource used, 13 telenursing sessions (61.9%) took place by telephone call and eight (30.1%) by e-mail. The pilot study demonstrated the potential of the telenursing intervention to achieve important results, and as a complement to the patients' traditional health treatment. In addition, it revealed various barriers that need to be overcome for this type of care to take place effectively.
A Nursing Pain Assessment and Record Information System
Authors: Wang Pan-Feng , Shen Li-Qiong , Zhang Hong-Jun , Li Bao-Hua , Ji Hong
Published: July 2017

Pain is an unpleasant sensory and emotional feeling accompanying existing, impending, or potential tissue damage. Valid pain assessment and standardized pain documentation are important in oncology pain management; however, they are still deficient. Thus, we developed a pain assessment and record information system for nurses in the oncology department and implemented a questionnaire survey to evaluate users' acceptance of the system. The pain assessment system focused on usability and efficiency to provide a modified workflow that was safe, less time-consuming, patient centered, enjoyable, and efficient. The pain assessment and record chart types in the system enabled greater standardization of pain assessments and records. The application of the system greatly improved the efficiency of nursing in the oncology department, guiding nurses in an accurate and comprehensive patient pain assessment and contributing significantly to further improvement in pain care standards and care decisions. Nurses and doctors surveyed reported a high degree of satisfaction with factors such as saving time and improving the capacity of pain control, suggesting that the system enhanced the quality of pain management. Through this system, we can promote pain management, improving care quality for patients.
Assessing Intensity of Nursing Care Needs Using Electronically Available Data
Authors: Larson Elaine L. , Cohen Bevin , Liu Jianfang , Zachariah Philip , Yao David , Shang Jingjing
Published: July 2017

Although previous research has confirmed that nurse staffing affects patient outcomes, some potentially important factors have not been accounted for in tools to assess relationships between staffing and outcomes. The aim of this project was to develop and test a Nursing Intensity of Care Index using electronically available data from 152 072 patient discharges from three hospitals. Initially, 1765 procedure codes were reviewed; 69 were confirmed as directly increasing nursing workload by at least 15 minutes per shift. Two research staff independently reviewed a random sample of 5 patient days to assess interrater reliability with complete scoring agreement. To assess face validity, eight nurse clinician experts reviewed factors included in the Nursing Intensity of Care Index to assess the accuracy of the nursing time estimates in the tool. To examine concurrent validity, Nursing Intensity of Care Index scores for a random sample of 28 patients from four clinical units were compared with assessments made by a unit-based clinical nurse (low/medium/high intensity) for the same patients on the same day with a Spearman correlation of 0.94. In preliminary testing, data for the Nursing Intensity of Care Index, which accurately reflect nursing care intensity, can be obtained electronically in real time. The next steps will be a discrete-event simulation model and large-scale field trials.
Syringotropic Mycosis Fungoides: A Rare Form of Cutaneous T-cell Lymphoma Enabling a Histopathologic “Sigh of Relief”
Authors: Lehmer Larisa M. , Amber Kyle T. , de Feraudy Sébastien M.
Published: July 2017

Syringotropic mycosis fungoides (STMF) is a very rare variant of cutaneous T-cell lymphoma. It follows a much milder disease course than its clinically indistinguishable adnexal counterpart, folliculotropic mycosis fungoides (FMF). We report a case of a 36-year-old man who presented with erythematous, studded papules and plaques on the left upper extremity and right anterior thigh diagnosed as mycosis fungoides (MF) Stage 1A on initial superficial shave biopsy. Lesions recurred after initial improvement with narrow-band ultraviolet light therapy demonstrating a concentration of abnormal lymphocytes around eccrine sweat glands on repeat biopsy consistent with STMF. Although the deeper, periadnexal infiltrate found in both STMF and FMF confers increased resistance to skin-directed therapies effective in classic MF, these entities diverge with respect to their clinical behavior. Syringotropism is a marker for increased disease-specific survival, whereas even FMF carries a prognosis worse than conventional MF. Increased awareness among the dermatopathology community of the histopathologic distinction between STMF and FMF is essential to guide treatment type, duration, and intensity in adnexal disease.
Melanocytes Pattern in the Normal Nail, With Special Reference to Nail Bed Melanocytes
Authors: Perrin Christophe , Michiels Jean-F. , Boyer Julien , Ambrosetti Damien
Published: July 2017

Previous studies of the density of melanocytes in the normal nail bed have had conflicting results. This is unfortunate because knowing the normal values might help the difficult distinction between a benign subungual melanotic macule and an early melanoma in situ. Five specimens of normal nail unit were analyzed. On hematoxylin and eosin–stained sections the melanocytes were undetectable. We defined the melanocyte count (MC) as the number of melanocytes per 1-mm stretch of nail epithelium. The mean MC for nail matrix was 6.86 with a range of 4–14. The melanocytes were irregularly scattered in the basal and suprabasilar layer of the matrix epithelium. Abundant and uneven cytoplasmic dendrites were focally observed in the matrix. The MC for the nail bed ranged from 0 to 5 with a mean of 0.43. The melanocytes were restricted to the basal layer with thin cytoplasmic dendrites. Two cases showed a complete absence of melanocytes in the nail bed. In the ventral portion of the proximal nail fold, called the eponychium, the MC ranged between 0 and 5/mm with a mean of 2.27/mm. In conclusion, we discovered foci in normal nail beds, in which the melanocytic density can be relatively high and reach the level seen in the matrix. HMB45 is more sensitive than Microphtalmia-associated transcription factor (MITF) for the evaluation of intraepithelial melanocytic density of the nail unit. If MITF is used alone in the nail bed, its weak sensitivity may result in a false-negative interpretation and may be wrongly reassuring in the evaluation of early melanomas. On hematoxylin and eosin sections, basal and suprabasal nail keratinocytes are sometimes crowded, showing oval or elongated dark-staining nucleus and a clear cytoplasm and mimics a melanocytic proliferation. On HMB45 or Melan A staining, the morphology and the distribution of the dendrites of matrical melanocytes can mimic the dendritic pattern usually described in acral melanoma. Therefore, the interpretation of nail melanocytic atypia must be prudent.
Associations Between Feeding Problems and Maternal Sensitivity Across Infancy: Differences in Very Preterm and Full-Term Infants
Authors: Bilgin Ayten , Wolke Dieter
Published: July 2017

Objective:

To determine the influence of maternal sensitivity on infant feeding problems in very preterm/very low birth weight (VP/VLBW) and full-term (FT) infants.

Methods:

Longitudinal study of 178 infants (73 VP/VLBW and 105 FT). Feeding problems and maternal sensitivity were assessed at term, 3 and 18 months. A cross-lagged path model was tested to assess the longitudinal associations.

Results:

The direction of the association between maternal sensitivity and feeding problems differed among VP/VLBW and FT infants. In VP/VLBW infants, higher feeding problems at term and 3 months were associated with less maternal sensitivity at 3 months (β = −.27, p < .05) and at 18 months (β = −.36, p < .05), respectively. In FT infants, a reciprocal relationship of feeding problems and maternal sensitivity over time was found. Feeding problems at 3 months were associated with decreased maternal sensitivity at 18 months (β = −.32, p < .05), whereas decreased maternal sensitivity at 3 months was related to increased feeding problems at 18 months (β = −.25, p < .05).

Conclusion:

Feeding problems are frequent in VP/VLBW infants and subsequently are associated with poorer maternal sensitivity. In FT infants, poorer levels of maternal sensitivity were both predicted by feeding problems but also were associated with more feeding problems over time.
PREVALENCE OF FOVEOLAR LUCENCY WITH DIFFERENT GAS TAMPONADES IN SURGICALLY CLOSED MACULAR HOLES ASSESSED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Zarranz-Ventura Javier , Ellabban Abdallah A. , Sim Dawn A. , Keane Pearse A. , Kirkpatrick James N. , Sallam Ahmed A. B.
Published: July 2017

Purpose:

To evaluate the prevalence of foveolar lucency (FL) in surgically closed macular holes by spectral domain optical coherence tomography.

Methods:

One hundred forty-two eyes of 132 patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade in a 60-month time frame. Anatomical success and FL rates assessed by spectral domain optical coherence tomography, mean preoperative, and postoperative best-measured visual acuity and surgical details were retrospectively analyzed.

Results:

Spectral domain optical coherence tomography confirmed closed holes with FL in 33.7% (34/101) of eyes at 1 month, 7.3% (9/123) at 3 months, 4.6% (6/129) at 6 months, and 3% (4/133) at 12 months. Prevalence of FL in closed holes at Month 1 was lower in C3F8-treated eyes (9.5%, 2/21) compared with C2F6 (40.9%, 18/44, P = 0.03) and SF6-treated eyes (38.9%, 14/36, P = 0.05). No differences were observed at Month 3. No differences in best-measured visual acuity change were observed between closed holes with or without FL at Month 1 (−0.14 ± 0.19 vs. −0.11 ± 0.23, P = 0.48) or any of the other time points.

Conclusion:

Temporary FL is a highly prevalent feature in successfully closed macular holes. Eyes treated with C3F8 gas had lower rates of FL at Month 1 than C2F6 and SF6-treated eyes. The presence of FL in closed holes does not seem to have any effect on the visual outcomes.