bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal activation of Fc-mediated effector functions by influenza virus hemagglutinin antibodies requires two points of contact
Authors: Leon Paul E. , He Wenqian , Mullarkey Caitlin E. , Bailey Mark J. , Miller Matthew S. , Krammer Florian , Palese Peter , Tan Gene S.
Published: September 2016

Significance

The mechanism of how antiviral antibodies induce Fc–FcγR effector functions remains to be fully elucidated. Although the ability to activate effector functions is attributed to antibody isotype, this does not fully address why identical isotypes have different capabilities to stimulate effector function. We show that antibodies that target the influenza virus hemagglutinin (HA) require a second intermolecular interaction to optimally activate effector cells. We demonstrate that the receptor-binding domain of the HA is required to bind to sialic acid expressed on the surface of effector cells to optimize effector cell activation. This finding provides a basic understanding of how an optimal antibody-dependent cell-mediated response against influenza virus is achieved and may allow for better vaccine design.
Striosome–dendron bouquets highlight a unique striatonigral circuit targeting dopamine-containing neurons
Authors: Crittenden Jill R. , Tillberg Paul W. , Riad Michael H. , Shima Yasuyuki , Gerfen Charles R. , Curry Jeffrey , Housman David E. , Nelson Sacha B. , Boyden Edward S. , Graybiel Ann M.
Published: September 2016

Significance

The dopamine-containing nigrostriatal system and its return striatonigral pathway form a loop–circuit crucial for the functions of dopamine in modulating movement and mood. Here we identify a specialized subsystem within this loop. With new mouse models and tissue expansion to allow nanoscale imaging, we demonstrate that striatonigral fibers originating in striosomes form bouquet-like arborizations innervating clusters of dopamine-containing neurons and their ventrally extending, tightly bundled dendrites. Within these formations (termed “striosome–dendron bouquets”), striosomal axons and dopamine-containing dendrites are intimately intertwined, as are other afferent and glial elements. The stunning selectivity of striosomal output to the bouquets suggests that the bouquets could exert powerful and focused control over elements of the dopamine system in normal and abnormal states.
Discourse marking in spoken intercultural communication between British and Taiwanese adolescent learners
Authors: Lin Yen-Liang
Published: September 2016

This study investigates and compares the use of discourse markers (DMs) by native speakers and learners of English based on a corpus of adolescent intercultural exchange students. Thestudy employs a discourse analytical approach, in whichFung and Carter’s (2007)multi-category framework is appliedwith a view to examiningDMs used bya group of Taiwanese and British adolescentsin an intercultural setting.The analytical frameworkcontains four main functional categories: Interpersonal, referential, structural and cognitive DMs. Each DM was analysed qualitatively and quantitatively in order to identifythe functions it serves in its original contextandtofurther reveal the different uses of DMs between Taiwanese and British participants. The findings demonstrate that the DMs used by both groups of participants serve the fourcentral functions,andin particularTaiwanese participants display a significant use of interpersonal (e.g., yeah, oh) and structural DMs (e.g., so, okay), while British participants have a significantly higher usage of referential (e.g., coz/because, and) and cognitive DMs (e.g., like, well). The results of this study have direct pedagogical implications that can enhance the teaching of English as a Foreign Language (EFL)to better prepare learners for real life communication scenarios.
Blurring the boundaries between domestic and digital spheres
Authors: Rosenbaun Laura , Rafaeli Sheizaf , Kurzon Dennis
Published: September 2016

This study explores the phenomenon of multiactivity during recreational video-mediated communication (VMC) through the analysis of competing engagements. From a data corpus of naturally occurring interactions in public Google Hangouts, we focus on instances of competing engagements triggered by the co-presence of unratified participants in broadcasters’ physical environments. As users are immersed in their everyday spaces, interferences from their domestic sphere are common occurrences that break the participatory framework established in the digital sphere. Following a conversation analytic approach, we intend to show that these interferences lead to competing engagements that can be exploited rather than simply dealt with. Drawing on literature on multiactivity, we argue that participants at times organize and coordinate these multiple engagements to add playfulness and advance their interactions. In sum, this study aims to highlight how situated competing streams of action are coordinated and the purpose they may serve in recreational VMC.
A pragmatic analysis of german impersonally used first person singular ‘ICH’
Authors: Zobel Sarah
Published: September 2016

The German first and second person singular pronouns ich and du allow for a referential use and an impersonal use. In their impersonal use, both pronouns behave like the impersonal pronoun man (Engl. one) in generic sentences. I argue that the aspect of impersonally used singular personal pronouns that distinguishes them (i) from each other, (ii) from impersonal pronouns, and (iii) from “ordinary” generic sentences is their pragmatic effects. The semantic contribution of the three pronouns and their containing utterances is discussed before a comparative analysis of the pragmatic effects of impersonally used ich and du and impersonal man is given. The analyses are illustrated with naturally occurring data from a self-compiled data collection. Turning to a more practical topic in the second part of the paper, I discuss a methodological issue regarding corpus-based analyses of low-frequency phenomena, such as impersonally used ich in the second part of this paper by reporting a small-scale corpus study.
Purification and characterization of a novel alginate lyase from the marine bacterium Cobetia sp. NAP1 isolated from brown algae
Authors: Yagi Hisashi , Fujise Asako , Itabashi Narumi , Ohshiro Takashi
Published: September 2016

The application of marine resources, instead of fossil fuels, for biomass production is important for building a sustainable society. Seaweed is valuable as a source of marine biomass for producing biofuels such as ethanol, and can be used in various fields. Alginate is an anionic polysaccharide that forms the main component of brown algae. Various alginate lyases (e.g. exo- and endo-types and oligoalginate lyase) are generally used to degrade alginate. We herein describe a novel alginate lyase, AlgC-PL7, which belongs to the polysaccharide lyase 7 family. AlgC-PL7 was isolated from the halophilic Gram-negative bacterium Cobetia sp. NAP1 collected from the brown algae Padina arborescens Holmes. The optimal temperature and pH for AlgC-PL7 activity were 45 °C and 8, respectively. Additionally, AlgC-PL7 was thermostable and salt-tolerant, exhibited broad substrate specificity, and degraded alginate into monosaccharides. Therefore, AlgC-PL7 is a promising enzyme for the production of biofuels.
Effect of epigallocatechin-3-o-gallate and quercetin on the cryopreservation of cartilage tissue
Authors: Kasai Nobuhiro , Mera Hisashi , Wakitani Shigeyuki , Morita Yusuke , Tomita Naohide , Takagi Mutsumi
Published: September 2016

The effects of epigallocatechin-3-o-gallate (EGCG) and quercetin on the contents of extracellular matrix (ECM) in porcine cartilage at 4 °C were investigated. The addition of quercetin at 0.01 mM for the incubation of porcine cartilage disks at 4 °C for 2 week could suppress the decrease in ECM and the compliance of the disks, markedly greater than those of EGCG (1.0 mM).
Same sides of different coins: contrasting militant activisms between Georgian fighters in Syria and Ukraine
Authors: Cecire Michael
Published: September 2016

While the conflicts in Syria and Ukraine share few similarities as operational cases, both wars can be characterized by the heavy participation and prominence of “foreign fighters” – combatants drawn from nominally non-participating countries. Georgia, approximately geographically equidistant from both Ukraine and Syria, has emerged as a small but consistent reservoir of foreign fighters in a variety of groups in both conflicts. In surveying and examining trends of Georgian foreign fighter flow to both Syria and Ukraine, it is possible to organize Georgian participation into roughly two groups. One group, broadly representing “first wave” flows to Syria and pro-Kyiv forces in Ukraine, largely adheres to more conventional allegiances based on ethnicity, religion, or ideology. A second group, found in “second wave” flows to Syria and pro-Russia fighters in Ukraine, is motivated by “fictive kinship” networks created from transnational philosophical enterprises. From these cases, it may be possible to draw lessons to further analyse foreign fighter tendencies and trajectories more globally.
Final report on COOMET key comparison of AC/DC voltage transfer references (COOMET.EM-K6.a)
Authors: Velychko O , Darmenko Yu
Published: September 2016

An intercomparison of AC/DC voltage transfer references has taken place within the framework of COOMET. The intercomparison, piloted by State Enterprise 'Ukrmetrteststandard'-UMTS (Ukraine), has involved five laboratories, including one who is a member of another regional metrological organization-EURAMET (INM, Romania). The results presented in this report appear to show that there are significant differences between some laboratories' representations of the volt. However, the agreement demonstrated by the intercomparison provides confidence in maintaining traceability for the AC/DC voltage transfer references. Proposed to link the results from this key comparison to the CCEM-K6.a comparison. VNIIM (Russia) is linking NMI as far as they participated in CCEM-K6.a.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Shrinking sea ice, increasing snowfall and thinning lake ice: a complex Arctic linkage explained
Authors: Brock Ben W
Published: September 2016

The dramatic shrinkage of Arctic sea ice is one of the starkest symptoms of global warming, with potentially severe and far-reaching impacts on arctic marine and terrestrial ecology (Post et al 2013 Science

341 519–24) and northern hemisphere climate (Screen et al 2015 Environ. Res. Lett.
10 084006). In their recent article, Alexeev et al (2016 Environ. Res. Lett.
11 074022) highlight another, and unexpected, consequence of Arctic sea ice retreat: the thinning of lake ice in northern Alaska. This is attributed to early winter ‘ocean effect’ snowfall which insulates lake surfaces and inhibits the formation of deep lake ice. Lake ice thinning has important consequences for Arctic lake hydrology, biology and permafrost degradation.
Côte d’Ivoire
Authors: Hunt Charles T.
Published: September 2016

This chapter examines the international response to Côte d’Ivoire’s post-election crisis in 2010/11. In particular, it analyses the elements that relate to the responsibility to protect (R2P), including how R2P informed the political and practical responses to the crisis. It identifies the major contentions/issues that the case highlights about the nature and future of R2P. It argues that despite the relative inattention paid to this case in the academic literature to date, the experience of Côte d’Ivoire offers important insights into the opportunities and challenges associated with all three pillars of R2P and recalls debates around the responsibility to rebuild as well as the emergent relationship between the R2P framework and protection of civilians in United Nations peace operations.
Definitive LC-MS/MS Drug Monitoring Impacts Substance-use Treatment Planning and Patient Outcomes: A Brief Report
Authors: Rzetelny Adam , Zeller Barbara , Miller Nicholas , Kirsh Kenneth L. , Passik Steven D.
Published: September 2016

Clinical drug monitoring has an increasingly important role in the treatment of substance use disorders. Through semistructured interviews, we asked substance-use counselors about the clinical impact of drug tests on patients’ treatment planning and outcomes. This study was conducted around the time of a facility-wide switch to a laboratory utilizing definitive liquid chromatography with tandem mass spectrometry from a laboratory that had utilized the less-sensitive, presumptive immunoassay-based drug-testing methodology. Twelve counselors volunteered to be interviewed, and each counselor chose 2 patients to discuss. Counselors reported that the facility-wide switch to definitive drug testing revealed some patients with newly identified relapses and substance use. They also reported that, as a result of the new information provided by definitive liquid chromatography with tandem mass spectrometry monitoring, 75% of the patients they discussed had a change made to their treatment plan, 79% were provided enhanced education, and 63% had an increase in their treatment intensity. Counselors also reported that 58% of these patients reduced their illicit drug and nonmedical prescription medication use as a result of treatment changes associated with the newly implemented definitive testing. Improvements in therapeutic relationships and honesty were also reported. These preliminary data are consistent with previous data and guidelines, suggesting that the results of definitive drug monitoring inform clinical decision-making and can help clinicians enhance treatment outcomes.
Absence of Neuropathology With Prolonged Isoflurane Sedation in Healthy Adult Rats
Authors: DeYoung Timothy P. , Li John C. , Tang Xiaorui , Ward Christopher G. , Dworkin Barry R. , Eckenhoff Maryellen F. , Kofke William A.
Published: September 2016

Background:

The use of isoflurane sedation for prolonged periods in the critical care environment is increasing. However, isoflurane-mediated neurotoxicity has been widely reported. The goal of the present study was to determine whether long-term exposure to low-dose isoflurane in mechanically ventilated rodents is associated with evidence of neurodegeneration or neuroinflammation.

Methods:

Adult female Sprague-Dawley rats were used in this study. Experimental animals (n=11) were induced with 1.5% isoflurane, intubated, and given a neuromuscular blockade with α-cobratoxin. EEG electrodes were surgically implanted, subcutaneous precordial EKG Ag wire electrodes, and bladder, femoral artery, and femoral vein cannulas permanently placed. After these procedures, the isoflurane concentration was reduced to 0.5% and, in conjunction with the neuromuscular blockade, continued for 7 days. Arterial blood gases and chemistry were measured at 3 time points and core body temperature servoregulated and maintenance IV fluids were given during the 7 days. Experimental animals and untreated controls (n=9) were euthanized on day 7.

Results:

Immunohistochemical and cytochemical assays did not detect evidence of microgliosis, astrocytosis, neuronal apoptosis or necrosis, amyloidosis, or phosphorylated-tau accumulation. Blood glucose levels were significantly reduced on days 3/4 and 6/7 and partial pressure of oxygen was significantly reduced, but still within the normal range, on day 6/7. All other blood measurements were unchanged.

Conclusions:

No neuropathologic changes consistent with neurotoxicity were detected in the brain after 1 week of continuous exposure to 0.5% isoflurane in healthy rats. These data suggest that even long exposures to low concentrations of isoflurane have no overt consequences on neuropathology.
Safe Sleep Infant Care Practices Reported by Mothers of Twins
Authors: Damato Elizabeth G. , Haas Madeline C. , Czeck Pamela , Dowling Donna A. , Barsman Sarah Gutin
Published: September 2016

Background:

The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants.

Purpose:

The study describes infant care practices reported by mothers of twins in the first 6 months postpartum.

Methods:

Mothers caring for twin infants (N = 35) were surveyed online both longitudinally (at 2, 8, 16, and 24 weeks after infant hospital discharge) and cross-sectionally. AAP recommendations (2011) guided survey content.

Results:

The degree of adherence to AAP recommendations varied over time. For example, mothers of twins reported 100% adherence to placing twins supine for sleep initially, but many reported putting babies on their stomachs for naps as twins became older. Sharing a parent's bedroom decreased over time as did frequency of crib sharing. Fewer than half of mothers offered a pacifier most or all of the time for sleep.

Implications for Practice:

Opportunities exist for development of an educational program geared specifically for postpartum parents of twins.

Implications for Research:

Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.
Application of Laparoscopic Lumbar Discectomy and Artificial Disc Replacement
Authors: Wang Wenjun , Liu Shangli , He Gengsheng , Yan Yiguo , Li Xuelin , Ouyang Zhihua , Zuo Jianhong
Published: September 2016

Study Design.

This prospective observational study included 22 patients who were diagnosed with symptomatic degenerative disc disease treated via artificial disc replacement (ADR) with a laparoscopic technique.

Objective.

The current study aimed to assess the safety and efficacy of ADR using a laparoscopic technique for lumbar disc herniation.

Summary of Background Data.

Symptomatic degenerative disc disease is the major cause of low back pain with lumbar segmental instability. ADR has increased in popularity as an alternative treatment for lumbar disc herniation. However, the traditional approach to spinal surgery carries the risk of catastrophic bleeding from injury to major vessels, as well as iatrogenic injury to the viscera and associated structures. Therefore, laparoscopic lumbar discectomy and ADR may represent a useful alternative.

Methods.

Twenty-two patients (8 males and 14 females) who were diagnosed with symptomatic degenerative disc disease were included in this study. Seven cases involved the L4/5 level, and 15 cases involved the L5/S1 level. All patients were ineffective after at least 6 months of conservative treatments; all patients were informed of the surgery before the operation and provided consent. Three-dimensional computed tomographic angiography (3D-CTA) of the iliac great blood vessels was completed before the surgery. All surgical procedures were performed under a laparoscope. All patients were followed up.

Results.

All surgeries were successfully completed. The average operation time was 120 minutes (range 110–150 min), and the average hemorrhage was 145 mL (range 80–360 mL). All cases underwent X-rays at 3 days, 3 months, 6 months, 1 year, and the final postoperative follow-up. The outcome indicated that there was no mobilization, displacement, or subsidence in all patients with the exception of one case with prosthesis migration. The follow-up time was 43.8 months (range 24–64 months). The mean visual analog scale (VAS) and Oswestry scores were decreased postoperatively. The mean improvement rate of the VAS score was 73.5%.

Conclusion.

Lumbar ADR using a laparoscope represents a novel, minimally invasive treatment for symptomatic degenerative disc disease and severe lumbar discogenic pain.

Level of Evidence: 3
Novel Cutaneous Manifestations of Pleuroparenchymal Fibroelastosis
Authors: Lowther Christopher M. , Morrison Annie O. , Candelario Nicole M. , Khalafbeigi Sheva , Cockerell Clay J.
Published: September 2016

Pleuroparenchymal fibroelastosis (PPFE) is a rare progressive disease that manifests as parenchymal fibrosis of the upper lobe and pleura. Approximately 100 cases have been reported. Cutaneous manifestations of PPFE have not previously been described. Diagnosis is dependent on histologic identification of fibrosis with atypical elastic fibers, necessitating an invasive peripheral lung wedge biopsy.

A 68-year-old male with a history of pleuroparenchymal fibroelastosis presented with an asymptomatic, telangiectatic erythematous eruption on bilateral lower extremities. Biopsies demonstrated a subtle perivascular infiltrate with marked increase in atypical elastic fibers, similar to the elastosis in the patient's lungs.

This is the first documented case of cutaneous manifestations in PPFE. Clinicians need to be aware that cutaneous eruptions clinically simulating telangiectasia macularis eruptiva perstans but lacking a mast cell infiltrate histologically, may have increased abnormal elastic fibers. Thus, early recognition of these lesions in patients with an undefined restrictive lung disorder, may facilitate the diagnosis of PPFE in some patients.
Osteogenic Melanoma With Desmin Expression
Authors: Trevisan Flávia , Tregnago Aline C. , Lopes Pinto Clóvis A. , Urvanegia Ana C. M. , Morbeck Diogo L. , Bertolli Eduardo , Riva Neto Floriano R. , Duprat Neto João P. , de Macedo Mariana P.
Published: September 2016

Background:

Osteogenic differentiation is rarely seen in melanomas, when it occurs it is mainly in acral lesions.

Methods:

We report a case of an osteogenic melanoma in a 49-year-old woman who presented with a pigmented lesion in the subungueal region of her left hallux. The lesion was ulcerated and infiltrated until the deep dermis without bone involvement.

Results:

The tumor was composed of pleomorphic atypical epithelioid and fusiform cells disposed in nests or cords, with vesicular nuclei and prominent central nucleoli. Focal lentiginous proliferation of large atypical melanocytes was present along the dermoepidermal junction. Areas of osteoid matrix focally mineralized were disposed in trabeculae, and there were islands of neoplastic cells. Immunohistochemistry revealed strong expression of S-100 protein and, unexpectedly, of desmin. Focal expression of Melan-A, microphthalmia transcription factor, and HMB-45 is also revealed. Mutations in BRAF and NRAS genes were not present. The patient was submitted to an amputation of the left hallux with negative sentinel lymph node.

Conclusion:

The importance of recognizing osteogenic melanoma is based on difficulties for histologic recognition and its differentials diagnosis.
Chronic Headaches After a Concussion in an Obese 16-Year-Old Girl
Authors: Kumar Maya , Gahagan Sheila , Pickering Bretten , Gold Jeffrey , Stein Martin T.
Published: September 2016

CASE:

Jennifer is a 16-year-old Latina girl who is new to your practice. During her first well visit, she mentions that she has had daily headaches for 2 years. They began after sustaining a concussion in a car accident. Typically, her headaches are bilateral and “squeezing”; they occur in the afternoons and last for a few hours. Her concussion also resulted in depressed mood, which has improved over time.

When you ask if her headaches have changed recently, she says that they have been worse for the last few days. The quality and severity are unchanged; however, they now occur first thing in the morning, are worse when supine, and no longer remit. In the last 2 days, she has developed new-onset blurry vision, nausea, dizziness, photophobia, and sonophobia. Although she previously experienced sadness with her concussion, she now feels irritable. She has never used tobacco, alcohol, or drugs, and she takes no medications.

On examination, her body mass index is above the 99th percentile. You note mild papilledema bilaterally. She has no focal neurological deficits. The remainder of her examination is normal.

You send her to an emergency department. Her head computed tomography is normal. A lumbar puncture demonstrates an opening pressure of 32 cm H2O; she feels relief after the procedure. She is admitted with a diagnosis of benign intracranial hypertension and is started on acetazolamide. What is the differential diagnosis of chronic headaches in an obese adolescent? How should a busy community pediatrician manage Jennifer acutely? What follow-up care should Jennifer receive?
Recent developments in epigenetics of pediatric asthma
Authors: Harb Hani , Alashkar Alhamwe Bilal , Garn Holger , Renz Harald , Potaczek Daniel P.
Published: September 2016

Purpose of review

The goal of this review was to systematically analyze recent studies updating our knowledge on the role of epigenetic mechanisms in childhood asthma.

Recent findings

A systematic literature search was conducted that identified 23 fresh articles published within the last 5 years reporting the results of human studies on the relationships between epigenetic modifications and childhood asthma or its/related phenotypes. In almost all these studies, meaningful associations between levels of epigenetic marks (DNA methylation and/or histone modifications) and pediatric asthma or its/related phenotypes have been observed. In addition, many studies identified by our screening analyzed those associations in the context of environmental factors, such as pollution, tobacco smoke, farming, or diet, showing in a huge majority a modifying effect of those exposures.

The results of our systematic literature search provide a strong support for the role of epigenetic mechanisms in (mediating the effects of environmental exposure on) pediatric asthma. This knowledge may possibly be translated into diagnostic and/or therapeutic approaches.
An Interdisciplinary Approach to Reducing Length of Stay in Joint Replacement Patients
Authors: McCann-Spry Lisa , Pelton JoAnne , Grandy Glenda , Newell Dawn
Published: September 2016

Demand for hip and knee arthroplasty in the United States is rising rapidly. This is creating considerable strain on healthcare systems' institutional resources and finances. To reduce this strain, Spectrum Health in Grand Rapids, MI, developed a strategy to decrease length of stay for most primary hip and knee joint replacement patients. Four specific interventions were undertaken concurrently: (1) communication with providers, (2) modification of patient communications, (3) standardized risk assessment and prediction, and (4) physical therapy on POD (postoperative day) 0 (i.e., the day of surgery). Length of stay was reduced an average of 0.5 days per patient for primary hip and knee joint replacement surgeries, creating a positive financial outcome without negatively affecting quality and patient satisfaction. This demonstrated the ability of a large, high-volume joint replacement center to transform organizational culture and generate rapid, measureable change.
Implementation of a Clinical Pathway for Chest Pain in a Pediatric Emergency Department
Authors: Mohan Shaun , Nandi Deipanjan , Stephens Paul , M'Farrej Mirna , Vogel R. Lee , Bonafide Christopher P.
Published: September 2016

Objective

To evaluate the impact of a pediatric emergency department (ED) chest pain clinical pathway on resource utilization.

Methods

Motivated by perceived overuse of cardiology consultation for non-cardiac chest pain in the ED, clinicians from the Divisions of Cardiology and Emergency Medicine collaboratively developed a chest pain clinical pathway, educated staff, and implemented the pathway on March 1, 2014. We reviewed records of children aged 3 to 18 years without prior diagnoses of heart disease who presented to the ED with chest pain between March 1, 2013, and April 22, 2015. We compared diagnostic testing rates, ED length of stay, and cardiology consults before and after implementation of the pathway.

Results

A total of 1687 patients were pathway eligible (675 patients preimplementation and 1012 postimplementation). Resource utilization was lower than expected before pathway implementation and remained low after implementation. There was a statistically significant reduction in rates of chest x-ray ordering after pathway implementation and ED length of stay but no change in other diagnostic testing or cardiology consultation. Follow-up in our health care system for pediatric chest pain increased from 15% to 29% with implementation, but none of these visits resulted in the diagnosis of a new cardiac condition. There were no instances identified where use of the pathway resulted in missed cardiac disease.

Conclusions

Implementation of a clinical pathway for pediatric chest pain did lead to a reduction in chest x-ray ordering in the ED and was associated with a higher rate of outpatient follow up for non-pathologic chest pain. Preimplementation utilization was lower than the prepathway perceptions of overuse suggested.
Brief Report: Interpersonal and Intrapersonal Factors as Parallel Independent Mediators in the Association Between Internalized HIV Stigma and ART Adherence
Authors: Seghatol-Eslami Victoria C. , Dark Heather E. , Raper James L. , Mugavero Michael J. , Turan Janet M. , Turan Bulent
Published: September 2016

Introduction:

People living with HIV (PLWH) need to adhere to antiretroviral therapy (ART) to achieve optimal health. One reason for ART nonadherence is HIV-related stigma.

Objectives:

We aimed to examine whether HIV treatment self-efficacy (an intrapersonal mechanism) mediates the stigma–adherence association. We also examined whether self-efficacy and the concern about being seen while taking HIV medication (an interpersonal mechanism) are parallel mediators independent of each other.

Methods:

A total of 180 people living with HIV self-reported internalized HIV stigma, ART adherence, HIV treatment self-efficacy, and concerns about being seen while taking HIV medication. We calculated bias-corrected 95% confidence intervals for indirect effects using bootstrapping to conduct mediation analyses.

Results:

Adherence self-efficacy mediated the relationship between internalized stigma and ART adherence. Additionally, self-efficacy and concern about being seen while taking HIV medication uniquely mediated and explained almost all the stigma–adherence association in independent paths (parallel mediation).

Conclusion:

These results can inform intervention strategies to promote ART adherence.
Knowledge and Comfort With Pessary Use: A Survey of US Obstetrics and Gynecology Residents
Authors: Kandadai Padma , Mcvay Samantha , Larrieux Jean-Robert , O'Dell Katharine
Published: September 2016

Objective

This study aimed to determine factors associated with perceived comfort with pessary management among obstetrics and gynecology (OB/GYN) residents in the United States.

Methods

A 31-item anonymous electronic survey regarding experience with, attitudes toward, and comfort with pessary management was distributed to US OB/GYN residents in all postgraduate years (PGYs). Demographic and program-specific data on pessary education were collected. Descriptive statistical analyses were performed. Single-predictor logistic regression analysis, followed by analysis of a multivariable model that included significant single predictors, was performed to determine factors associated with residents' perception of comfort. Results were stratified for junior (PGYs 1, 2), senior (PGYs 3, 4), and chief (PGY4) residents.

Results

Four hundred seventy-eight completed surveys were returned and analyzed. Mean age of respondents was 29.5 (±2.56) years. Training levels were distributed evenly (PGY1, 25%; PGY2, 28%; PGY3, 25%; PGY4, 22%). Twenty-eight percent had a urogynecology fellowship in the department. Factors associated with comfort were similar for all training levels and included working with advanced practitioners, a formal urogynecology rotation, experience with pessary fitting, and receiving formal pessary-specific didactics (P < 0.001). PGY4s also benefitted from a formal urogynecology rotation. Factors that did not improve comfort were having a urogynecology fellowship and receiving general didactics on prolapse and incontinence.

Conclusions

Gaining outpatient experience, especially with pessary fitting, along with formal didactics specific to pessary fitting and management may improve resident' confidence with pessary use.
Noninvasive brain stimulation after stroke: it is time for large randomized controlled trials!
Authors: Grefkes Christian , Fink Gereon R.
Published: September 2016

Purpose of review

We here provide an update about studies published recently in the field of noninvasive neuromodulation of the motor system, aiming at facilitating recovery of function after stroke.

Recent findings

A number of longitudinal studies have confirmed that repeated stimulation of the motor cortex in combination with motor training improves performance compared with control or sham stimulation. In the early postacute stroke phase, enhancement of ipsilesional motor cortex excitability by means of repetitive transcranial magnetic stimulation (rTMS) seems to be a well tolerated and effective strategy to promote motor recovery. In contrast, recent studies suggest that transcranial direct current stimulation (tDCS) in the early poststroke phase does not facilitate motor recovery. In the chronic phase, however, both rTMS and tDCS have been shown to be beneficial when applied over several days combined with training. Interestingly, bihemispheric stimulation strategies (ipsilesional activation and contralesional suppression) seem to constitute effective protocols, especially when using rTMS.

Noninvasive brain stimulation seems to support motor recovery. However, to date randomised controlled trials (RCTs) that are sufficiently powered are lacking. Data suggest that the most promising protocols should now be tested in RCTs with sufficiently large samples taking into account the clinical heterogeneity of stroke.
Correlations of genotype with climate parameters suggestCaenorhabditis elegansniche preferences
Authors: Evans Kathryn S. , Zhao Yuehui , Brady Shannon C. , Long Lijiang , McGrath Patrick T. , Andersen Erik C.
Published: September 2016

Species inhabit a variety of environmental niches, and the adaptation to a particular niche is often controlled by genetic factors, including gene-by-environment interactions. The genes that vary in order to regulate the ability to colonize a niche are often difficult to identify, especially in the context of complex ecological systems and in experimentally uncontrolled natural environments. Quantitative genetic approaches provide an opportunity to investigate correlations between genetic factors and environmental parameters that might define a niche. Previously, we have shown how a collection of 208 whole-genome sequenced wildCaenorhabditis eleganscan facilitate association mapping approaches. To correlate climate parameters with the variation found in this collection of wild strains, we used geographic data to exhaustively curate daily weather measurements in short-term (three month), middle-term (one year), and long-term (three year) durations surrounding the data of strain isolation. These climate parameters were then used as quantitative traits in the mapping approaches. We identified 10 QTL underlying variation in three traits: elevation, relative humidity, and average temperature. We then performed statistical analyses to further narrow the genomic interval of interest to identify gene candidates with variants potentially underlying phenotypic differences. Additionally, we performed two-strain competition assays at high and low temperatures to validate a QTL for temperature preference and found suggestive evidence that genotypes might be adapted to particular temperatures.

100-word summary forG3

Quantitative genetic approaches provide an opportunity to investigate correlations between genetic factors and environmental parameters that might define a niche, but these genes are difficult to identify, especially in the context of complex ecological systems. Here, we used a collection of 152 sequenced wildCaenorhabditis elegansto correlate climate parameters with the variation found in this collection of wild strains. We identified 10 QTL in five traits, including elevation, relative humidity, and temperature. Additionally, we performed competition assays to validate a QTL for temperature preference and found suggestive evidence that genotypes might be adapted to particular temperatures.
GenomeScope: Fast reference-free genome profiling from short reads
Authors: Vurture Gregory W. , Sedlazeck Fritz J. , Nattestad Maria , Underwood Charles J. , Fang Han , Gurtowski James , Schatz Michael C.
Published: September 2016

GenomeScope is an open-source web tool to rapidly estimate the overall characteristics of a genome, including genome size, heterozygosity rate, and repeat content from unprocessed short reads. These features are essential for studying genome evolution, and help to choose parameters for downstream analysis. We demonstrate its accuracy on 324 simulated and 16 real datasets with a wide range in genome sizes, heterozygosity levels, and error rates.

Availability and Implementation

http://genomescope.org,https://github.com/schatzlab/genomescope.git

Contact

mschatz@jhu.edu.

Supplementary information

Supplementary data are available atBioinformaticsonline.
PTRNAmark: an all-atomic distance-dependent knowledge-based potential for 3D RNA structure evaluation
Authors: Yang Yi , Gu Qi , Shi Ya-Zhou
Published: September 2016

RNA molecules play vital biological roles, and understanding their structures gives us crucial insights into their biological functions. Model evaluation is a necessary step for better prediction and design of 3D RNA structures. Knowledge-based statistical potential has been proved to be a powerful approach for evaluating models of protein tertiary structures. In present, several knowledge-based potentials have also been proposed to assess models of RNA 3D structures. However, further amelioration is required to rank near-native structures and pick out the native structure from near-native structures, which is crucial in the prediction of RNA tertiary structures. In this work, we built a novel RNA knowledge-based potential— PTRNAmark, which not only combines nucleotides’ mutual and self energies but also fully considers the specificity of every RNA. The benchmarks on different testing data sets all show that PTRNAmark are more efficient than existing evaluation methods in recognizing native state from a pool of near-native states of RNAs as well as in ranking near-native states of RNA models.
Tracking single-cell gene regulation in dynamically controlled environments using an integrated microfluidic and computational setup
Authors: Kaiser Matthias , Jug Florian , Silander Olin , Deshpande Siddharth , Pfohl Thomas , Julou Thomas , Myers Gene , Nimwegen Erik van
Published: September 2016

Bacteria adapt to changes in their environment by regulating gene expression, often at the level of transcription. However, since the molecular processes underlying gene regulation are subject to thermodynamic and other stochastic fluctuations, gene expression is inherently noisy, and identical cells in a homogeneous environment can display highly heterogeneous expression levels. To study how stochasticity affects gene regulation at the single-cell level, it is crucial to be able to directly follow gene expression dynamics in single cells under changing environmental conditions. Recently developed microfluidic devices, used in combination with quantitative fluorescence time-lapse microscopy, represent a highly promising experimental approach, allowing tracking of lineages of single cells over long time-scales while simultaneously measuring their growth and gene expression. However, current devices do not allow controlled dynamical changes to the environmental conditions which are needed to study gene regulation. In addition, automated analysis of the imaging data from such devices is still highly challenging and no standard software is currently available. To address these challenges, we here present an integrated experimental and computational setup featuring, on the one hand, a new dual-input microfluidic chip which allows mixing and switching between two growth media and, on the other hand, a novel image analysis software which jointly optimizes segmentation and tracking of the cells and allows interactive user-guided fine-tuning of its results. To demonstrate the power of our approach, we study the lac operon regulation inE. colicells grown in an environment that switches between glucose and lactose, and quantify stochastic lag times and memory at the single cell level.
NGS-based reverse genetic screen for common embryonic lethal mutations compromising fertility in livestock
Authors: Charlier Carole , Li Wanbo , Harland Chad , Littlejohn Mathew , Coppieters Wouter , Creagh Frances , Davis Steve , Druet Tom , Faux Pierre , Guillaume François , Karim Latifa , Keehan Mike , Kadri Naveen Kumar , Tamma Nico , Spelman Richard , Georges Michel
Published: September 2016

We herein report the result of a large-scale, next generation sequencing (NGS)-based screen for embryonic lethal (EL) mutations in Belgian beef and New Zealand dairy cattle. We estimated by simulation that cattle might carry, on average, ∼0.5 recessive EL mutations. We mined exome sequence data from >600 animals, and identified 1377 stop-gain, 3139 frame-shift, 1341 splice-site, 22,939 disruptive missense, 62,399 benign missense, and 92,163 synonymous variants. We show that cattle have a comparable load of loss-of-function (LoF) variants (defined as stop-gain, frame-shift, or splice-site variants) as humans despite having a more variable exome. We genotyped >40,000 animals for up to 296 LoF and 3483 disruptive missense, breed-specific variants. We identified candidate EL mutations based on the observation of a significant depletion in homozygotes. We estimated the proportion of EL mutations at 15% of tested LoF and 6% of tested disruptive missense variants. We confirmed the EL nature of nine candidate variants by genotyping 200 carrier × carrier trios, and demonstrating the absence of homozygous offspring. The nine identified EL mutations segregate at frequencies ranging from 1.2% to 6.6% in the studied populations and collectively account for the mortality of ∼0.6% of conceptuses. We show that EL mutations preferentially affect gene products fulfilling basic cellular functions. The resulting information will be useful to avoid at-risk matings, thereby improving fertility.
An exploratory insight into the workplace demographic challenges in the public sector
Authors: Madichie Nnamdi O. , Nyakang’o Margaret
Published: September 2016

Purpose

The purpose of this paper is to investigate the need for a Strategic Workforce Plan (SWP) in a public sector organization (PSO) confronting an ageing workforce situation.

Design/methodology/approach

The study is based upon an action research protocol with a view to initiating change through SWP developed in-house at a PSO that is arguably the custodian of workplace diversity.

Findings

The findings reveal a general consensus on the ageing workforce challenges at the PSO requiring the need to revisit the status quo on the recruitment and retention strategies as well as succession planning and talent management practices within the organization.

Research limitations/implications

The study highlights the case of a PSO that has set about addressing the workplace demographic challenge by involving employees to become more reflexive in their engagement within the organization, which serves the dual purpose of “custodian” and “role model” for the country.

Originality/value

The challenge of an ageing workforce is not common occurrence in developing countries such as Kenya. However the manifestations of this unusual occurrence, and attempts to “nip things in the bud”, using an internally generated SWP with a view to changing the status quo is a demonstration of organizational learning and employee buy-in.
A new method to improve the objectivity of early Six Sigma analysis
Authors: Cox Steven , Elton Virginia , Garside John A. , Kotsialos Apostolos , Marmo João Victor , Cunha Lorena , Lennon Grant , Gill Chris
Published: September 2016

Purpose

A process improvement sampling methodology, known as process variation diagnostic tool (PROVADT), was proposed by Cox et al. (2013). The method was designed to support the objectivity of Six Sigma projects performing the measure-analyse phases of the define-measure-analyse-improve-control cycle. An issue in PROVADT is that it is unable to distinguish between measurement and product variation in the presence of a poor Gage repeatability and reproducibility (R&R) result. The purpose of this paper is to improve and address PROVADT’s sampling structure by enabling a true Gage R&R as part of its design.

Design/methodology/approach

This paper derives an enhanced PROVADT method by examining the theoretical sampling constraints required to perform a Gage R&R study. The original PROVADT method is then extended to fulfil these requirements. To test this enhanced approach, it was applied first to a simulated manufacturing process and then in two industry case studies.

Findings

The results in this paper demonstrates that enhanced PROVADT was able to achieve a full Gage R&R result. This required 20 additional measurements when compared to the original method, but saved up to ten additional products and 20 additional measurements being taken in future experiments if the original method failed to obtain a valid Gage R&R. These benefits were highlighted in simulation and industry case studies.

Originality/value

The work into the PROVADT method aims to improve the objectivity of early Six Sigma analyses of quality issues, which has documented issues.
Greenhouse gas management model – a triple cause-effect logic
Authors: Chen Chi-Kuang , Kamba Madi , Shie An-Jin , Dahlgaard Jens
Published: September 2016

Purpose

The purpose of this paper is to develop a greenhouse gas (GHG) management model for mitigating GHG emission. GHG emission by way of human activities is causing catastrophic effects on the natural environment in the form of climate change and global warming. GHG management of different products, bodies and processes is going on worldwide, expressed through carbon footprints by using product life cycle assessment (LCA). LCA is a useful approach, but it only looks at the micro level of cause-effect scenarios rather than the macro level cause-effect scenarios of GHG emission. Therefore, a system to scrutinize underlined assumptions and values of such policies/strategies is an urgent necessity.

Design/methodology/approach

This paper uses the double-loop learning concept, which was proposed by Argyris in 1976, to develop a triple cause-effect model for the management of GHG emission. The proposed model has a knowledge system that introduces the learning loop of GHG emission and environmental impact management.

Findings

A case study is conducted to demonstrate how the proposed triple cause-effect model is operationalized. The ideas and benefits of the proposed model are further discussed.

Originality/value

A triple cause-effect model for the measurement and analysis of GHG emission is proposed in this paper to complement GHG management by using only product LCA. This paper seeks to show that GHG management should look at not only a single tree (product LCA approach) but also the whole forest (the proposed model).