bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Wall Shear Stress in Cryptosporidium parvum Oocyst Attachment to Environmental Biofilms
Authors: Luo Xia , Jedlicka Sabrina S. , Jellison Kristen L.
Published: October 2017

This study investigated
Cryptosporidium parvum
oocyst deposition onto biofilms as a function of shear stress under laminar or turbulent flow. Annular rotating bioreactors were used to grow stabilized stream biofilms at shear stresses ranging from 0.038 to 0.46 Pa. These steady-state biofilms were then used to assess the impact of hydrodynamic conditions on
C. parvum
oocyst attachment.
C. parvum
deposition onto biofilms followed a pseudo-second-order model under both laminar (after a lag phase) and turbulent flows. The total number of oocysts attached to the biofilm at steady state decreased as the hydrodynamic wall shear stress increased. The oocyst deposition rate constant increased with shear stress but decreased at high shear, suggesting that increasing wall shear stress results in faster attachment of
Cryptosporidium
due to higher mass transport until the shear forces exceed a critical limit that prevents oocyst attachment. These data show that oocyst attachment in the short and long term are impacted differently by shear: higher shear (to a certain limit) may be associated with faster initial oocyst attachment, but lower shear is associated with greater numbers of oocysts attached at equilibrium.

IMPORTANCE
This research provides experimental evidence to demonstrate that shear stress plays a critical role in protozoan-pathogen transport and deposition in environmental waters. The data presented in this work expand scientific understanding of
Cryptosporidium
attachment and fate, which will further influence the development of timely and accurate sampling strategies, as well as advanced water treatment technologies, to target protozoan pathogens in surface waters that serve as municipal drinking water sources.
Formation of Staphylococcus aureus Biofilm in the Presence of Sublethal Concentrations of Disinfectants Studied via a Transcriptomic Analysis Using Transcriptome Sequencing (RNA-seq)
Authors: Slany M. , Oppelt J. , Cincarova L.
Published: October 2017

Staphylococcus aureus
is a common biofilm-forming pathogen. Low doses of disinfectants have previously been reported to promote biofilm formation and to increase virulence. The aim of this study was to use transcriptome sequencing (RNA-seq) analysis to investigate global transcriptional changes in
S. aureus
in response to sublethal concentrations of the commonly used food industry disinfectants ethanol (EtOH) and chloramine T (ChT) and their combination (EtOH_ChT) in order to better understand the effects of these agents on biofilm formation. Treatment with EtOH and EtOH_ChT resulted in more significantly altered expression profiles than treatment with ChT. Our results revealed that EtOH and EtOH_ChT treatments enhanced the expression of genes responsible for regulation of gene expression (
sigB
), cell surface factors (
clfAB
), adhesins (
sdrDE
), and capsular polysaccharides (
cap8EFGL
), resulting in more intact biofilm. In addition, in this study we were able to identify the pathways involved in the adaptation of
S. aureus
to the stress of ChT treatment. Further, EtOH suppressed the effect of ChT on gene expression when these agents were used together at sublethal concentrations. These data show that in the presence of sublethal concentrations of tested disinfectants,
S. aureus
cells trigger protective mechanisms and try to cope with them.

IMPORTANCE
So far, the effect of disinfectants is not satisfactorily explained. The presented data will allow a better understanding of the mode of disinfectant action with regard to biofilm formation and the ability of bacteria to survive the treatment. Such an understanding could contribute to the effort to eliminate possible sources of bacteria, making disinfectant application as efficient as possible. Biofilm formation plays significant role in the spread and pathogenesis of bacterial species.
Conjugation-Mediated Horizontal Gene Transfer of Clostridium perfringens Plasmids in the Chicken Gastrointestinal Tract Results in the Formation of New Virulent Strains
Authors: Lacey Jake A. , Keyburn Anthony L. , Ford Mark E. , Portela Ricardo W. , Johanesen Priscilla A. , Lyras Dena , Moore Robert J.
Published: October 2017

Clostridium perfringens
is a gastrointestinal pathogen capable of causing disease in a variety of hosts. Necrotic enteritis in chickens is caused by
C. perfringens
strains that produce the pore-forming toxin NetB, the major virulence factor for this disease. Like many other
C. perfringens
toxins and antibiotic resistance genes, NetB is encoded on a conjugative plasmid. Conjugative transfer of the
netB
-containing plasmid pJIR3535 has been demonstrated
in vitro
with a
netB
-null mutant. This study has investigated the effect of plasmid transfer on disease pathogenesis, with two genetically distinct transconjugants constructed under
in vitro
conditions, within the intestinal tract of chickens. This study also demonstrates that plasmid transfer can occur naturally in the host gut environment without the need for antibiotic selective pressure to be applied. The demonstration of plasmid transfer within the chicken host may have implications for the progression and pathogenesis of
C. perfringens
-mediated disease. Such horizontal gene transfer events are likely to be common in the clostridia and may be a key factor in strain evolution, both within animals and in the wider environment.

IMPORTANCE
Clostridium perfringens
is a major gastrointestinal pathogen of poultry.
C. perfringens
strains that express the NetB pore-forming toxin, which is encoded on a conjugative plasmid, cause necrotic enteritis. This study demonstrated that the conjugative transfer of the
netB
-containing plasmid to two different nonpathogenic strains converted them into disease-causing strains with disease-causing capability similar to that of the donor strain. Plasmid transfer of
netB
and antibiotic resistance was also demonstrated to occur within the gastrointestinal tract of chickens, with approximately 14% of the isolates recovered comprising three distinct,
in vivo
-derived, transconjugant types. The demonstration of
in vivo
plasmid transfer indicates the potential importance of strain plasticity and the contribution of plasmids to strain virulence.
Multiple Roles for Two Efflux Pumps in the Polycyclic Aromatic Hydrocarbon-Degrading Pseudomonas putida Strain B6-2 (DSM 28064)
Authors: Yao Xuemei , Tao Fei , Zhang Kunzhi , Tang Hongzhi , Xu Ping
Published: October 2017

Microbial bioremediation is a promising approach for the removal of polycyclic aromatic hydrocarbon (PAH) contaminants. Many degraders of PAHs possess efflux pump genes in their genomes; however, their specific roles in the degradation of PAHs have not been clearly elucidated. In this study, two efflux pumps, TtgABC and SrpABC, were systematically investigated to determine their functions in a PAH-degrading
Pseudomonas putida
strain B6-2 (DSM 28064). The disruption of genes
ttgABC
or
srpABC
resulted in a defect in organic solvent tolerance. TtgABC was found to contribute to antibiotic resistance; SrpABC only contributed to antibiotic resistance under an artificial overproduced condition. Moreover, a mutant strain without
srpABC
did not maintain its activity in long-term biphenyl (BP) degradation, which correlated with the loss of cell viability. The expression of SrpABC was significantly upregulated in the course of BP degradation. BP, 2-hydroxybiphenyl, 3-hydroxybiphenyl, and 2,3-dihydroxybiphenyl (2,3-DHBP) were revealed to be the inducers of
srpABC
. 2,3-DHBP was verified to be a substrate of pump SrpABC; SrpABC can enhance the tolerance to 2,3-DHBP by pumping it out. The mutant strain B6-2Δ
srpS
prolonged BP degradation with the increase of
srpABC
expression. These results suggest that the pump SrpABC of strain B6-2 plays a positive role in BP biodegradation by pumping out metabolized toxic substances such as 2,3-DHBP. This study provides insights into the versatile physiological functions of the widely distributed efflux pumps in the biodegradation of PAHs.

IMPORTANCE
Polycyclic aromatic hydrocarbons (PAHs) are notorious for their recalcitrance to degradation in the environment. A high frequency of the occurrence of the efflux pump genes was observed in the genomes of effective PAH degraders; however, their specific roles in the degradation of PAHs are still obscure. The significance of our study is in the identification of the function and mechanism of the efflux pump SrpABC of
Pseudomonas putida
strain B6-2 (DSM 28064) in the biphenyl degradation process. SrpABC is crucial for releasing the toxicity caused by intermediates that are unavoidably produced in PAH degradation, which enables an understanding of how cells maintain the intracellular balance of materials. The findings from this study provide a new perspective on PAH recalcitrance and shed light on enhancing PAH degradation by genetic engineering.
Prevalence and Antimicrobial Resistance of Enterococci Isolated from Retail Meats in the United States, 2002 to 2014
Authors: Tyson Gregory H. , Nyirabahizi Epiphanie , Crarey Emily , Kabera Claudine , Lam Claudia , Rice-Trujillo Crystal , McDermott Patrick F. , Tate Heather
Published: October 2017

Bacteria of the genus
Enterococcus
are important human pathogens that are frequently resistant to a number of clinically important antibiotics. They are also used as markers of animal fecal contamination of human foods and are employed as sentinel organisms for tracking trends in resistance to antimicrobials with Gram-positive activity. As part of the National Antimicrobial Resistance Monitoring System (NARMS), we evaluated several retail meat commodities for the presence of enterococci from 2002 to 2014, and we found 92.0% to be contaminated. The majority of isolates were either
Enterococcus faecalis
(64.0%) or
Enterococcus faecium
(28.6%), and the antimicrobial resistance of each isolate was assessed by broth microdilution. The resistance prevalences for several drugs, including erythromycin and gentamicin, were significantly higher among poultry isolates, compared to retail beef or pork isolates. None of the isolates was resistant to the clinically important human drug vancomycin, only 1 isolate was resistant to linezolid, and resistance to tigecycline was below 1%. In contrast, a majority of both
E. faecalis
(67.5%) and
E. faecium
(53.7%) isolates were resistant to tetracycline. Overall, the robust NARMS testing system employed consistent sampling practices and methods throughout the testing period, with the only significant trend in resistance prevalence being decreased
E. faecium
resistance to penicillin. These data provide excellent baseline levels of resistance that can be used to measure future changes in resistance prevalence that may result from alterations in the use of antimicrobials in food animal production.

IMPORTANCE
Enterococci, including
E. faecalis
and
E. faecium
, are present in the guts of food-producing animals and are used as a measure of fecal contamination of meat. We used the large consistent sampling methods of NARMS to assess the prevalence of
Enterococcus
strains isolated from retail meats, and we found over 90% of meats to be contaminated with enterococci. We also assessed the resistance of the
Enterococcus
strains, commonly used as a measure of resistance to agents with Gram-positive activity, in foods. Resistance prevalence was over 25% for some antimicrobials and sample sources but was less than 1% for several of the most important therapeutic agents used in human medicine.
Aerobic Anoxygenic Photosynthesis Is Commonly Present within the Genus Limnohabitans
Authors: Kasalický Vojtěch , Zeng Yonghui , Piwosz Kasia , Šimek Karel , Kratochvilová Hana , Koblížek Michal
Published: October 2017

The genus
Limnohabitans
(
Comamonadaceae
,
Betaproteobacteria
) is a common and a highly active component of freshwater bacterioplanktonic communities. To date, the genus has been considered to contain only heterotrophic species. In this study, we detected the photosynthesis genes
pufLM
and
bchY
in 28 of 46 strains from three
Limnohabitans
lineages. The
pufM
sequences obtained are very closely related to environmental
pufM
sequences detected in various freshwater habitats, indicating the ubiquity and potential importance of photoheterotrophic
Limnohabitans
in nature. Additionally, we sequenced and analyzed the genomes of 5 potentially photoheterotrophic
Limnohabitans
strains, to gain further insights into their phototrophic capacity. The structure of the photosynthesis gene cluster turned out to be highly conserved within the genus
Limnohabitans
and also among all potentially photosynthetic
Betaproteobacteria
strains. The expression of photosynthetic complexes was detected in a culture of
Limnohabitans planktonicus
II-D5
T
using spectroscopic and pigment analyses. This was further verified by a novel combination of infrared microscopy and fluorescent
in situ
hybridization.

IMPORTANCE
The data presented document that the capacity to perform anoxygenic photosynthesis is common among the members of the genus
Limnohabitans
, indicating that they may have a novel role in freshwater habitats.
Microhomology-Mediated High-Throughput Gene Inactivation Strategy for the Hyperthermophilic Crenarchaeon Sulfolobus islandicus
Authors: Zhang Changyi , Whitaker Rachel J.
Published: October 2017

Sulfolobus islandicus
is rapidly emerging as a model system for studying the biology and evolution within the TACK lineage of the archaeal domain. As the tree of life grows, identifying the cellular functions of genes within this lineage will have significant impacts on our understanding of the evolution of the
l
ast
a
rchaeal
e
ukaryote
c
ommon
a
ncestor (LEACA) and the differentiation of archaea from eukaryotes during the evolution of the modern-day cell. To increase our understanding of this key archaeal organism, we report a novel high-throughput method for targeted gene inactivation in
S. islandicus
through one-step microhomology-directed homologous recombination (HR). We validated the efficacy of this approach by systematically deleting 21 individual toxin-antitoxin gene pairs and its application to delete chromosomal regions as large as 50 kb. Sequence analysis of 96 ArgD
+
transformants showed that
S. islandicus
can effectively incorporate donor markers as short segments through HR in a continuous or discontinuous manner. We determined that the minimal size of homology allowing native
argD
marker replacement was as few as 10 bp, whereas
argD
marker replacement was frequently observed when increasing the size of homology to 30 to 50 bp. The microhomology-mediated gene inactivation system developed here will greatly facilitate isolation of
S. islandicus
gene deletion strains, making generation of a collection of genome-wide targeted mutants feasible and providing a tool to investigate homologous recombination in this organism.

IMPORTANCE
Current procedures for the construction of deletion mutants of
S. islandicus
are still tedious and time-consuming. We developed a novel procedure based on microhomology-mediated HR, allowing for rapid and efficient removal for genetic regions as large as 50 kb. Our work will greatly facilitate functional genomic studies in this promising model organism. Additionally, we developed a quantitative genetic assay to measure HR properties in
S. islandicus
, providing evidence that the ability to incorporate short, mismatched donor DNA into the genome through HR was probably a common trait for members of the
Sulfolobus
genus that are recombinogenic.
Physiological stability in an indigenous sleep device: a randomised controlled trial
Authors: Baddock Sally A , Tipene-Leach David , Williams Sheila M , Tangiora Angeline , Jones Raymond , Mącznik Aleksandra K , Taylor Barry J
Published: October 2017

Objective

To compare overnight oxygen saturation, heart rate and the thermal environment of infants sleeping in an indigenous sleep device (wahakura) or bassinet to identify potential risks and benefits.

Design

Randomised controlled trial.

Setting

Family homes in low socio-economic areas in New Zealand.

Patients

200 mainly Māori mothers and their infants.

Interventions

Participants received a wahakura or bassinet from birth.

Main outcome measures

Overnight oximetry, heart rate and temperature at 1 month.

Results

Intention-to-treat analysis for 83 bassinet and 84 wahakura infants showed no significant differences between groups for the mean time oxygen saturation (SpO2) was less than 94% (0.54 min, 95% CI -1.36 to 2.45) or less than 90% (0.22 min, 95% CI -0.56 to 1.00), the mean number of SpO2dips per hour >5% (-0.19, 95% CI -3.07 to 2.69) or >10% (-0.41, 95% CI -1.63 to 0.81), mean heart rate (1.99 beats/min, 95% CI -1.02 to 4.99), or time shin temperature >36°C (risk ratio (RR): 0.63, 95% CI 0.13 to 2.99) or <34°C (RR: 0.89, 95% CI 0.61 to 1.30). A per-protocol analysis of 45 bassinet and 26 wahakura infants and an as-used analysis of 104 infants in a bassinet and 48 in a wahakura found no significant differences between groups for all outcome measures.

Conclusions

This indigenous sleep device is at least as safe as the currently recommended bassinet, which supports its use as a sleep environment that offers an alternative way of bed-sharing.

Trial registration number

Australian New Zealand Clinical Trials Registry: ACTRN12610000993099.
High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days
Authors: Derman Wayne , Runciman Phoebe , Schwellnus Martin , Jordaan Esme , Blauwet Cheri , Webborn Nick , Lexell Jan , van de Vliet Peter , Tuakli-Wosornu Yetsa , Kissick James , Stomphorst Jaap
Published: October 2017

Objectives

To describe the incidence of injury in the precompetition and competition periods of the Rio 2016 Summer Paralympic Games.

Methods

A total of 3657 athletes from 78 countries, representing 83.4% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system over 51 198 athlete days during the Rio 2016 Summer Paralympic Games. Injury data were obtained daily from teams with their own medical support.

Results

A total of 510 injuries were reported during the 14-day Games period, with an injury incidence rate (IR) of 10.0 injuries per 1000 athlete days (12.1% of all athletes surveyed). The highest IRs were reported for football 5-a-side (22.5), judo (15.5) and football 7-a-side (15.3) compared with other sports (p<0.05). Precompetition injuries were significantly higher than in the competition period (risk ratio: 1.40, p<0.05), and acute traumatic injuries were the most common injuries at the Games (IR of 5.5). The shoulder was the most common anatomical area affected by injury (IR of 1.8).

Conclusion

The data from this study indicate that (1) IRs were lower than those reported for the London 2012 Summer Paralympic Games, (2) the sports of football 5-a-side, judo and football 7-a-side were independent risk factors for injury, (3) precompetition injuries had a higher IR than competition period injuries, (4) injuries to the shoulder were the most common. These results would allow for comparative data to be collected at future editions of the Games and can be used to inform injury prevention programmes.
Preventing cerebral palsy in preterm labour: a multiorganisational quality improvement approach to the adoption and spread of magnesium sulphate for neuroprotection
Authors: Burhouse Anna , Lea Charlotte , Ray Stephen , Bailey Hannah , Davies Ruth , Harding Hannah , Howard Rachel , Jordan Sharon , Menzies Noshin , White Sarah , Phillips Kathryn , Luyt Karen
Published: October 2017

Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered prematurely (under 37 weeks’ gestational age). Antenatal administration reduces infant mortality and cerebral palsy (CP); however, uptake in the UK has been significantly lower than other countries. A quality improvement (QI) project (PReventing Cerebral palsy in Pre Term labour (PReCePT)) was carried out in the West of England, UK, to raise awareness of evidence and to improve the uptake of magnesium sulphate as neuroprotectant in preterm deliveries. Five National Health Service (NHS) Trusts and the West of England Academic Health Science Network participated in the QI project. The project was underpinned by a multifaceted QI approach that included: patient and clinical coproduction of resources; recruitment of clinical champions to support the local microsystems and create a stimulating/supporting environment for change; Plan, Do, Study, Act cycles; training for over 600 NHS staff and awareness raising and strategic influencing of key leaders. A baseline audit and regular measurement of the number of eligible women receiving magnesium sulphate was undertaken at each hospital site, and the overall programme was evaluated using data from an international benchmarking organisation for neonatal care outcomes—the Vermont Oxford Network. During the project 664 staff received magnesium sulphate training. The use of magnesium sulphate increased across the West of England from an average baseline of 21% over the 2 years preceding the project to 88% by the conclusion of the project. The project was also able to influence the development of a national data collection process for benchmarking the use of magnesium sulphate for neuroprotection in preterm deliveries in the U.K. PReCePT appears to have had a favourable effect on the uptake of magnesium sulphate across the West of England. The project has also provided learning about how to stimulate adoption and spread of evidence using a QI approach across a network.
Higher BMI is associated with higher expiratory airflow normalised for lung volume (FEF25–75/FVC) in COPD
Authors: Abston Eric , Comellas Alejandro , Reed Robert Michael , Kim Victor , Wise Robert A , Brower Roy , Fortis Spyridon , Beichel Reinhard , Bhatt Surya , Zabner Joseph , Newell John , Hoffman Eric A , Eberlein Michael
Published: October 2017

Introduction

The obesity paradox in chronic obstructive pulmonary disease (COPD), whereby patients with higher body mass index (BMI) fare better, is poorly understood. Higher BMIs are associated with lower lung volumes and greater lung elastic recoil, a key determinant of expiratory airflow. The forced expiratory flow (25–75) (FEF25–75)/forced vital capacity (FVC) ratio reflects effort-independent expiratory airflow in the context of lung volume and could be modulated by BMI.

Methods

We analysed data from the COPDGene study, an observational study of 10 192 subjects, with at least a 10 pack-year smoking history. Data were limited to subjects with BMI 20–40 kg/m2(n=9222). Subjects were stratified according to forced expiratory volume in 1 s (FEV1) (%predicted)-quintiles. In regression analyses and Cox proportional hazard models, we analysed the association between BMI, the FEF25–75/FVC ratio, the imaging phenotype, COPD exacerbations, hospitalisations and death.

Results

There was no correlation between BMI and FEV1(%predicted). However, a higher BMI is correlated with a higher FEF25–75/FVC ratio. In CT scans, a higher BMI was associated with less emphysema and less air trapping. In risk-adjusted models, the quintile with the highest FEF25–75/FVC ratio was associated with a 46% lower risk of COPD exacerbations (OR 0.54, p<0.001) and a 40% lower risk of death (HR 0.60, p=0.02), compared with the lowest quintile. BMI was not independently associated with these outcomes.

Conclusions

A higher BMI is associated with lower lung volumes and higher expiratory airflows when normalised for lung volume, as quantified by the FEF25–75/FVC ratio. A higher FEF25–75/FVC ratio is associated with a lower risk of COPD exacerbations and death and might quantify functional aspects of the paradoxical effect of higher BMIs on COPD.
Simulation-based education to improve communication skills: a systematic review and identification of current best practice
Authors: Blackmore Andrew , Kasfiki Eirini Vasileiou , Purva Makani
Published: October 2017

Background

Good communication in healthcare between professionals and between professionals and patients is important in delivering high-quality care. Evidence of translation of technical skills taught through simulation into the clinical environment has been demonstrated, but the evidence for the impact of communication skills is less well known.

Objectives

To identify and critically appraise the evidence for the impact of communication taught through simulation-based education (SBE) and use this evidence to suggest a model for future SBE interventions for communication skills.

Study selection

MEDLINE, CINAHL, EMBASE and PsycINFO were searched for articles pertaining to communication skills taught through simulation. A content expert was consulted to suggest additional studies. 1754 studies were initially screened for eligibility, with 274 abstracts screened further. 147 full-text articles were further assessed for eligibility, with 79 of these excluded. The remaining 68 studies were reviewed and 18 studies were included in the qualitative synthesis as studies designed to show benefits beyond the simulation centre.

Findings

The 18 identified studies with an impact at a Kirkpatrick level of ≥3, are analysed; 4 looking specifically at communication between healthcare professionals and 14 looking at communication between health professionals and patients or relatives.

Conclusions

There is some evidence that the improvements in communication taught through simulation can be translated into benefits measurable beyond the simulation centre, but this evidence is limited due to the way that most of the studies are designed. We suggest a model for SBE aimed at teaching communication skills that is informed by the current evidence and takes into account the need to collect higher-level outcome data.
Outcome of intracerebral haemorrhage related to non-vitamin K antagonists oral anticoagulants versus vitamin K antagonists: a comprehensive systematic review and meta-analysis
Authors: Boulouis Gregoire , Morotti Andrea , Pasi Marco , Goldstein Joshua N , Gurol M Edip , Charidimou Andreas
Published: October 2017

Introduction

The characteristics and natural history of acute non-vitamin K antagonists oral anticoagulants (NOAC)-associated intracerebral haemorrhage (ICH) are largely unknown. We performed a comprehensive systematic review and meta-analysis to compare baseline ICH volume, haematoma expansion and clinical outcomes between NOAC-ICH versus vitamin K antagonists-ICH (VKA-ICH).

Methods

We searched PubMed and conference abstracts for observational studies comparing baseline characteristics and outcomes in patients with NOAC-ICH versus VKA-ICH using an appropriate keyword/MeSH term search strategy. Data were extracted following PRISMA and MOOSE guidelines. The main outcome measures were mortality and unfavourable functional outcome (modified Rankin Score: 4–6) at discharge and at 3 months, as well as ICH volumes and haematoma expansion rates in the two groups. Random-effects models with DerSimonian-Laird weights were used for pooled estimates calculation.

Results

Twelve studies including 393 NOAC-ICH and 3482 VKA-ICH were pooled in meta-analysis. There was no difference in mean ICH-volume between the two groups (standard mean difference: −0.24; 95% CI −0.52 to 0.04, p=0.093). The rates of haematoma expansion were comparable in NOAC-ICH versus VKA-ICH (OR: 0.76; 95% CI 0.49 to 1.19, p=0.236). We did not find any difference between patients with NOAC-ICH versus VKA-ICH in all-cause mortality at discharge (OR: 0.66; 95% CI 0.42 to 1.05, p=0.077) and unfavourable functional outcome at discharge (OR: 0.77; 95% CI 0.41 to 1.44, p=0.413). The 3-month outcome was also comparable between the two ICH groups. Moderate-to-substantial statistical heterogeneity was noted.

Conclusion

Our results confirm that ICH volume, haematoma expansion, mortality and functional outcome appear to be similar for NOAC-ICH versus VKA-ICH. Large prospective cohorts and updated meta-analyses are needed to provide more precise estimates.
Accuracy of clinical diagnosis of dementia with Lewy bodies: a systematic review and meta-analysis
Authors: Rizzo Giovanni , Arcuti Simona , Copetti Massimiliano , Alessandria Maria , Savica Rodolfo , Fontana Andrea , Liguori Rocco , Logroscino Giancarlo
Published: October 2017

Background

The diagnosis of dementia with Lewy bodies (DLB) is based on diagnostic clinical criteria, which were updated over the years.

Objective

To evaluate, through a systematic review, accuracy of the diagnostic criteria, testing a possible improvement over time.

Methods

We searched on MEDLINE and SCOPUS databases for studies reporting diagnostic parameters regarding the clinical diagnosis of DLB until October 2016. We performed meta-analysis, using a Bayesian approach, on those using pathological examination as gold standard, subclassified based on the different diagnostic criteria used.

Results

We selected 22 studies on 1585 patients. Pooled sensitivity, specificity and accuracy were 60.2%, 93.8%, 79.7%, respectively, for criteria antecedents to McKeith 1996. For McKeith 1996-possible, pooled sensitivity, specificity and accuracy were 65.6%, 80.6%, 77.9% in early stages and 72.3%, 64.3%, 66% in late stages, respectively. For McKeith 1996-probable, pooled sensitivity, specificity and accuracy were 19.4%, 95.1%, 77.7% in early stages and 48.6%, 88%, 79.2% in late stages, respectively. McKeith criteria 2005 were evaluated only in late stages: pooled sensitivity, specificity and accuracy were 91.3%, 66.7% and 81.6%, respectively, for possible diagnosis (only one study) and 88.3%, 80.8%, 90.7% for probable diagnosis, decreasing to 85.6%, 77.1% and 81.7% if only considering clinical settings focused on dementia diagnosis and care.

Conclusions and relevance

Diagnostic criteria have become more sensitive and less specific over time, without substantial change in the accuracy. Based on current data, about 20% of DLB diagnosis are incorrect. Future studies are needed to evaluate if the recently released revised consensus criteria will improve the diagnostic accuracy of DLB.
Dignitarian medical ethics
Authors: Barclay Linda
Published: October 2017

Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from the concrete patient experiences described in healthcare literature. Dignity is conferred on people when they are treated as having equal status, something the sick and frail are often denied in healthcare settings. The importance of equal status as a unique value has been forcefully argued and widely recognised in political philosophy in the last 15 years. This paper brings medical ethics up to date with philosophical discussion about the value of equal status by developing an equal status conception of dignity.
Poor health as a potential risk factor for job loss due to automation: the case of Norway
Authors: Hessel Philipp , Christiansen Solveig , Skirbekk Vegard
Published: October 2017

Objective

This study aimed to quantify the extent to which health characteristics of workers are related to the potential risk of experiencing job displacement due to automation.

Methods

Linking the 2015 Norwegian Statistics on Income and Living Conditions survey (n=6393) with predicted probabilities of automation by occupation, we used Kruskal-Wallis tests and multivariate generalised linear models to assess the association between long-standing illnesses and risk of job automation.

Results

Individuals with long-standing illnesses face substantially greater risks of losing their job due to automation. Whereas the average risk of job automation is 57% for men and 49% for women with long-standing illnesses, the risk is only 50% for men and 44% for women with limitations (p<0.001). Controlling for age, having a long-standing illness significantly increases the relative risk of facing job automation among men (risk ratio (RR) 1.13, 95% CI 1.09 to 1.19), as well as women (RR 1.11, 95% CI 1.05 to 1.17). While, among men, the association between long-standing illness and risk of job automation remains significant when controlling for education and income, it becomes insignificant among women.

Conclusions

Individuals with poor health are likely to carry the highest burden of technological change in terms of worsening employment prospects because of working in occupations disproportionally more likely to be automated. Although the extent of technology-related job displacement will depend on several factors, given the far-reaching negative consequences of job loss on health and well-being, this process represents a significant challenge for public health and social equity.
Faster on-scene times associated with decreased mortality in Helicopter Emergency Medical Services (HEMS) transported trauma patients
Authors: Pham Hannah , Puckett Yana , Dissanaike Sharmila
Published: October 2017

Background

The ‘Golden Hour’ emphasizes the importance of rapidly providing definitive care to trauma patients. Dispatch time, defined as the time it takes the Helicopter Emergency Medical Service (HEMS) to dispatch from their base and reach the patient, and on-scene time, defined as the time spent with the patient prior to departure to a trauma center, can impact how quickly the patient will reach definitive care. We evaluated HEMS dispatch and on-scene times by investigating the survival rates among patients transported by air to a level 1 trauma center. We hypothesize that longer HEMS dispatch and on-scene times are associated with worse patient outcomes.

Methods

A retrospective, single institution analysis was performed on patients transported by HEMS. Inclusion criteria were air transported patients aged 18 years and above admitted to a level 1 trauma center from January 1, 2005 to January 1, 2015. Total dispatch time and on-scene times were divided into five incremental groups and mortality data were analyzed. Mortality was defined as death during initial hospital admission. A Pearson’s correlation was used to analyze relationship between dispatch times, on-scene times, and mortality. Simple binary logistic regression was used to run a multivariate analysis on confounding variables of Injury Severity Score (ISS), gender, age, and Glasgow Coma Scale.

Results

There was a strong positive linear correlation between HEMS on-scene time and mortality, R=0.962, p=0.038. Additionally, there was a positive trend between HEMS dispatch time and mortality. ISS was found to be a significant confounder of mortality in our cohort with on-scene times >20 min, with mortality increasing by 7.5% for every 0.1 increase in ISS score (p=0.01).

Conclusion

Longer HEMS on-scene and dispatch times appeared to be associated with increased mortality in trauma patients. However, those with higher ISS require longer on-scene times, increasing mortality. Regardless, efforts should focus on reducing on-scene and dispatch times.

Level of evidence and study type

Level III; Therapeutic/Care Management.
A case of mortality in suckling piglets due to pneumonia caused by Actinobacillus pleuropneumoniae
Authors: Ustulin Martina , Giorgiutti Mirco , Conedera Gabriella , Vio Denis
Published: October 2017

Two 7‐day‐old suckling piglets were submitted to the Diagnostic Laboratory of Pordenone of the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe) for pathomorphological examination. The piglets had died suddenly, showing blood‐stained discharge from nostrils and mouth, without any sign of crushing. Macroscopic examination revealed dark and solid pneumonic lesions in the diaphragmatic lobes associated with fibrinous pleurisy. Actinobacillus pleuropneumoniae was isolated from lesions; porcine reproductive and respiratory syndrome virus (PRRSV) was detected by RT‐PCR from the lungs. A pleuropneumoniae is a known cause of pneumonia and pleurisy in fattening and weaned pigs but, although colonisation of tonsils is well documented in suckling piglets, the clinical form of the disease in infant pigs has been infrequently described in endemically infected farms. Such events may be a consequence of the introduction of a new A pleuropneumoniae serovar, an incorrect gilt immunisation for this pathogen or inadequate colostrum intake by piglets.
Unusual presentation of bilateral stifle osteochondritis dissecans in two labrador retrievers
Authors: Earley Naomi Frances , Piola Valentina , Radke Heidi , Salgüero Raquel
Published: October 2017

There are few published reports of CT findings for the diagnosis of stifle osteochondritis dissecans (OCD) in the dog. This report describes the radiographic and multidetector CT (MDCT) findings of two cases with bilateral stifle osteochondrosis and OCD lesions. In both cases, radiographs did not provide a complete picture of the pathology and CT was needed for a definitive diagnosis. In case 1, CT showed bilateral defects on the caudomedial part of the lateral femoral condyles with joint mice within the cranial right stifle joint. In case 2, CT showed large bilateral joint mice within the intercondylar fossa originating from the medial aspect of the lateral femoral condyles as well as a defect on the right medial femoral condyle. MDCT provided an accurate diagnosis in both these cases and facilitated surgical planning.
Understanding the Determinants of Penal Policy: Crime, Culture, and Comparative Political Economy
Authors: Lacey Nicola , Soskice David , Hope David
Published: October 2017

This review sets out four main explanatory paradigms of penal policy—focusing on, in turn, crime, cultural dynamics, economic structures and interests, and institutional differences in the organization of different political economies as the key determinants of penal policy. We argue that these paradigms are best seen as complementary rather than competitive and present a case for integrating them analytically in a comparative political economy framework situated within the longue durée of technology regime change. To illustrate this, we present case studies of one exceptional case—the United States—and of one substantive variable—race. Race has long been thought to be of importance in most of these paradigms and provides a pertinent example of how the different dynamics intersect in practice. We conclude by summarizing the explanatory challenges and research questions that we regard as most urgent for the further development of the field and point to the approaches that will be needed if scholars are to meet these challenges and answer these questions.
Desistance from Offending in the Twenty-First Century
Authors: Bersani Bianca E. , Doherty Elaine Eggleston
Published: October 2017

After decades of relative obscurity, research on desistance from offending has experienced an exponential, and much warranted, escalation in attention. This precipitous growth is motivated by the timely alignment of theory, data, and method that characterized the opening of the twenty-first century. Despite the growth of the field, fundamental questions remain. This chapter provides a focused review of key twenty-first-century theoretical and methodological developments on desistance as well as a pointed discussion of critical issues. After outlining the current definitions and longitudinal trends of desistance, we discuss contemporary theories and the studies that inform these theories. We use an organizational schema situating theories in terms of the primacy with which they place structural opportunities or subjective motivations in their explanations of the transition away from offending. We conclude by presenting avenues for advancing research in the areas of definitions, theoretical testing, and bridging the research-policy divide.
The Long Reach of Violence: A Broader Perspective on Data, Theory, and Evidence on the Prevalence and Consequences of Exposure to Violence
Authors: Sharkey Patrick
Published: October 2017

In this review, I argue for a broader perspective on exposure to violence, one that extends beyond victimization and direct witnessing of violence to consider exposure to violent situations and violent residential environments. The first part of the review focuses on the measurement of exposure to violence. I review national estimates of prevalence and trends in victimization and direct exposure to violence and describe novel forms of data measuring violent situations and violent environments. The second part of the article reviews theory and evidence on the consequences of exposure to violence. I discuss the theoretical and methodological problem of selection into violent situations and environments and describe several studies that directly address each problem through theory, data collection, and research design. I conclude with a call for a broader conceptualization of exposure to violence, and an expanded, more creative set of methods to measure and identify the long reach of violence.
Situational Opportunity Theories of Crime
Authors: Wilcox Pamela , Cullen Francis T.
Published: October 2017

Historically speaking, criminological theory tends to pay great attention to identifying the various sources of criminal motivation while downplaying the opportunity to carry out crime in particular situations. However, perspectives that address situational opportunity have gained tremendous traction in the field over the past several decades to the point that there is now a substantial body of theory and research on the issue. This article reviews such theory and research within the context of four overlapping yet distinct lines of inquiry. First, we review scholarship that uses situational opportunity to understand individual victimization. Second, we discuss theory and research that link situational opportunity and high-crime places. Third, we explore scholarship that embraces a multicontextual opportunity perspective to understand crime and victimization events within neighborhood contexts. Fourth, we examine work that integrates situational opportunity into explanations of offending.
Inmate Society in the Era of Mass Incarceration
Authors: Kreager Derek A. , Kruttschnitt Candace
Published: October 2017

The origins and contours of inmate social organization were once central research areas that stalled just as incarceration rates dramatically climbed. In this review, we return to seminal works in this area and connect these with six interrelated changes to correctional contexts that accompanied mass incarceration. We argue that changes in prison racial, age, crowding, gender, offense type, and managerial characteristics potentially altered inmate informal organization and have yet to receive adequate criminological attention. We review the few recent studies that document contemporary inmate social life and call for increased researcher-practitioner partnerships that achieve mutual goals and embed criminologists within carceral settings. We suggest that network approaches are particularly useful for building on past qualitative and ethnographic insights to provide replicable results that are also easily conveyed to correctional authorities. As the era of mass incarceration peaks, we assert that the time is ripe for renewed interest in inmate society and its connections to prison stability, rehabilitation, and community reintegration.
Environmental Adaptations, Ecological Filtering, and Dispersal Central to Insect Invasions
Authors: Renault David , Laparie Mathieu , McCauley Shannon J. , Bonte Dries
Published: October 2017

Insect invasions, the establishment and spread of nonnative insects in new regions, can have extensive economic and environmental consequences. Increased global connectivity accelerates rates of introductions, while climate change may decrease the barriers to invader species’ spread. We follow an individual-level insect- and arachnid-centered perspective to assess how the process of invasion is influenced by phenotypic heterogeneity associated with dispersal and stress resistance, and their coupling, across the multiple steps of the invasion process. We also provide an overview and synthesis on the importance of environmental filters during the entire invasion process for the facilitation or inhibition of invasive insect population spread. Finally, we highlight important research gaps and the relevance and applicability of ongoing natural range expansions in the context of climate change to gain essential mechanistic insights into insect invasions.
Nutritional Physiology and Ecology of Honey Bees
Authors: Wright Geraldine A. , Nicolson Susan W. , Shafir Sharoni
Published: October 2017

Honey bees feed on floral nectar and pollen that they store in their colonies as honey and bee bread. Social division of labor enables the collection of stores of food that are consumed by within-hive bees that convert stored pollen and honey into royal jelly. Royal jelly and other glandular secretions are the primary food of growing larvae and of the queen but are also fed to other colony members. Research clearly shows that bees regulate their intake, like other animals, around specific proportions of macronutrients. This form of regulation is done as individuals and at the colony level by foragers.
Intracellular Fluid Mechanics: Coupling Cytoplasmic Flow with Active Cytoskeletal Gel
Authors: Mogilner Alex , Manhart Angelika
Published: October 2017

The cell is a mechanical machine, and continuum mechanics of the fluid cytoplasm and the viscoelastic deforming cytoskeleton play key roles in cell physiology. We review mathematical models of intracellular fluid mechanics, from cytoplasmic fluid flows, to the flow of a viscous active cytoskeletal gel, to models of two-phase poroviscous flows, to poroelastic models. We discuss application of these models to cell biological phenomena, such as organelle positioning, blebbing, and cell motility. We also discuss challenges of understanding fluid mechanics on the cellular scale.
The Interpretation of Legal Language
Authors: Solan Lawrence M.
Published: October 2017

In everyday interactions, we do our best to resolve linguistic vagueness, ambiguity, and other indeterminacies contextually. When these problems arise in the interpretation of authoritative legal texts, by contrast, it is not abundantly clear what context is relevant, or even legitimate. This article discusses approaches that legal analysts take in resolving linguistic indeterminacy. The most basic principle is reliance on the “ordinary meaning” of a term in dispute, on the assumption that this default interpretation is most likely to be within the intention of the drafters. However, there is no clear understanding of what “ordinary meaning” means or how to find it. Most recently, judges and legal scholars have turned to using linguistic corpora to assist in determining ordinary meaning in such cases. Other cases, focusing on the resolution of syntactic or semantic ambiguity, are less common. Courts in these cases sometimes resort to legally based “tiebreakers,” such as the rule of lenity, which requires courts to resolve ambiguity in favor of the accused in criminal cases.