bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of biological variation in blood‐based therapy – a summary of a meta‐analysis to inform manufacturing in the clinic
Authors: Thurman‐Newell J. A. , Petzing J. N. , Williams D. J.
Published: July 2015

Background and Objectives

Biological raw materials, the basis for cellular therapies such as stem cells, have a significantly greater degree of complexity than their traditional pharmaceutical counterparts. This can be attributed to the inherent variation of its source – human beings. Currently, cell therapies are made in small, ad hoc batches, but larger scale production is a prerequisite to meeting future demand and will require a quality‐by‐design approach to manufacturing that will be designed around, or be robust to this variation. Quantification of variation will require understanding of the current baseline and stratification of its sources.

Materials and Methods

Haematopoietic stem cell therapy was chosen as a case study to explore this variation, and a PRISMA‐guided (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) systematic meta‐analysis was carried out for a number of predetermined cell measurements.

Results

From this data set, it appears that the extent of variation in therapeutic dose (in terms of transplanted total nucleated cells and CD34+ cells per kilogram) for HSCT is between one and four orders of magnitude of the median.

Conclusions

This is tolerated under the practice of medicine but would be unmanageable from a biomanufacturing perspective and raises concerns about comparable levels of efficacy and treatment. A number of sources that will contribute towards this variation are also reported, as is the direction of travel for 4 greater clarity of the scale of this challenge.
Microfluidic PMMA‐based microarray sensor chip with imaging analysis for ABO and RhD blood group typing
Authors: Pipatpanukul C. , Amarit R. , Somboonkaew A. , Sutapun B. , Vongsakulyanon A. , Kitpoka P. , Srikhirin T. , Kunakorn M.
Published: July 2015

Background and Objectives

Solid phase microarrays have been described for use in blood typing; red blood cells (RBCs) captured on immobilized antibodies were detected using surface plasmon resonance or fluorescence. We present antibody microarray on Poly (methylmethacrylate) (PMMA) surface coupled with microfluidic system for ABO and RhD blood typing. After immobilized by antigen–antibody interaction, the RBCs were detected by image recognition.

Materials and Methods

The sensor surface was produced from grafted aminopropyltriethoxysilane (APTES) on photochemical modified PMMA surface by UV irradiation and subsequently reacted with glutaraldehyde cross‐linking. The amine group of monoclonal antibody of anti‐A, anti‐B and anti‐D was reacted with an aldehyde group on the glutaraldehyde modified surface, forming an imine linkage. RBCs were captured by the coated antibody via antigen–antibody interaction, and blood grouping was determined by microarray image cell counting.

Results

Suitable condition for RBC detection was 10% RBC concentration at 10 μl/min flow rate. This setting eliminated non‐specific RBC binding resulting in correct blood groups identification of all 136 samples tested. The platform showed good reproducibility with coefficient of variation of 2·17%, 3·62% and 2·51% for anti‐A, anti‐B and anti‐D respectively. The antibody‐coated surface can be stabilized by stabilizer coating and stored for long‐term use.

Conclusion

The PMMA array chip demonstrated its good accuracy and precision in rapid blood group testing. For its high throughput, the method has potential for use in large blood donation centre.
Noninvasive device readouts validated by immunohistochemical analysis enable objective quantitative assessment of acute wound healing in human skin
Authors: Ud‐Din Sara , Greaves Nicholas S. , Sebastian Anil , Baguneid Mohamed , Bayat Ardeshir
Published: July 2015

Objective evaluation of cutaneous wounds through use of noninvasive devices has important implications for diagnosis, monitoring treatment efficacy, progression and may lead to development of improved theranostic treatment strategies. However, there is a lack of validation in the use of certain devices in wound repair, where objective measurements taken by noninvasive devices have been corroborated by immunohistochemical analysis. Thus, data from three acute wound‐healing studies in healthy volunteers using three noninvasive objective devices were further evaluated by immunohistochemistry. One hundred ten participants had 5‐mm diameter skin biopsies to their arms. Spectrophotometric intracutaneous analysis (SIAscopy), full‐field laser perfusion imaging, and three‐dimensional imaging provided quantitative measurements of melanin, hemoglobin, collagen, blood flow, and wound size; all of which were validated by immunohistochemistry. Full‐field laser perfusion imaging showed blood flow increased to D7 and decreased by 40% to D14. SIAscopy showed that hemoglobin increased to D7 and reduced to D14. CD31 analysis corroborated this by showing a 76% increase in blood vessel density to D7 and a reduction by 14% to D14. Three‐dimensional imaging showed that wound surface area reduced by 50% from day 7 to day 14. Alpha‐smooth muscle Actin (Alpha‐SMA) staining supported these trends by showing increased levels by 72% from D0 to D14 (corresponding to wound contraction). Collagen, measured by SIAscopy, decreased to D7 and increased to D14, which was validated by collagen III analysis. Additionally, collagen I increased by 14% from D0 to D14. SIAscopy measurements for melanin showed an increase at D7 and a slight reduction to D14, while melanogenesis increased by 46.7% from D0 to D14. These findings show the utility of noninvasive objective devices in the quantitative evaluation of wound‐healing parameters in human skin as corroborated by immunohistochemistry. This may contribute to the development of prognostic parameters for assessment of response to wound therapy.
Effect of Tool Wear on Hole Quality in Drilling of Carbon Fiber Reinforced Plastic–Titanium Alloy Stacks Using Tungsten Carbide and Polycrystalline Diamond Tools
Authors: Kim D. , Beal A. , Kwon P.
Published: July 2015

This paper reviews the nature of hole defects and postulates the cause of hole defects resulting from the drilling process of carbon fiber reinforced plastic–titanium alloy stacked panels (CFRP–Ti stacks) using tungsten carbide (WC) and polycrystalline diamond (PCD) twist drills. The parameters that describe the hole quality of the CFRP–Ti stacks include CFRP entry hole delamination, hole diameter and roundness, inner hole surface roughness, CFRP hole profile, CFRP–Ti interplate damage, and Ti exit burr. They are caused by heat generation during drilling as well as hot Ti chips and adhesion, Ti burr formation, tool instability, and tool geometry change due to tool wear. For the WC drills, large flank wear and margin wear occurred at the high spindle speed condition, resulting in a reduction of the hole size and an increase of the hole roundness and CFRP–Ti interface damage. At the low spindle speed condition, tool geometry was changed due to the large edge rounding. This resulted in large fiber pull-out at the CFRP hole surface. Ti entry burrs caused damage associated with fiber removal and matrix discoloring at the bottom of the CFRP panel and this interplate damage was observed to increase with tool wear. When compared with the WC tool at the same speed condition, the PCD drill maintained relatively small hole defects under all parameters.
Enhancement of Low-Cycle Fatigue Performance From Tailored Microstructures Enabled by Electron Beam Melting Additive Manufacturing Technology
Authors: Morton Philip A. , Mireles Jorge , Mendoza Heimdall , Cordero Paola M. , Benedict Mark , Wicker Ryan B.
Published: July 2015

Electron beam melting (EBM) additive manufacturing (AM) technology has allowed the layerwise fabrication of parts from metal powder precursor materials that are selectively melted using an electron beam. An advantage of EBM technology over conventional manufacturing processes has been the capability to change processing variables (e.g., beam current, beam speed, and beam focus) throughout part fabrication, enabling the processing of a wide variety of materials. In this research, additional scans were implemented in an attempt to promote grain coarsening through the added thermal energy. It is hypothesized that the additional energy caused coarsening of Ti-6Al-4V microstructure that has been shown to increase mechanical properties of as-fabricated parts as well as improve surface characteristics (e.g., reduced porosity). Fatigue testing was performed on an L-bracket using a loading configuration designed to cause failure at the corner (i.e., intersection of the two members) of the bracket. Results showed 22% fatigue life improvement from L-brackets with as-fabricated conditions to L-brackets with a graded microstructure resulting from the selective addition of thermal energy in the expected failure region. Three L-brackets were fabricated and exposed to a triple melt cycle (compared to the standard single melt cycle) during fabrication, machined to specific dimensions, and tested. Results for fatigue performance were within ∼1% of wrought L-brackets. The work from this research shows that new design procedures can be implemented for AM technologies that involve evaluation of stress concentration sites using finite element analysis and implementation of scanning strategies during fabrication that help improve performance by spatially adjusting thermal energy at potential failure sites or high stress regions.
Gain-Scheduled H∞ Control for Linear Parameter Varying Stochastic Systems
Authors: Ku Cheung-Chieh , Wu Cheng-I
Published: July 2015

In this paper, a gain-scheduled controller design method is proposed for linear parameter varying (LPV) stochastic systems subject to H∞ performance constraint. Applying the stochastic differential equation, the stochastic behaviors of system are described via multiplicative noise terms. Employing the gain-scheduled design technique, the stabilization problem of LPV stochastic systems is discussed. Besides, the H∞ attenuation performance is employed to constrain the effect of external disturbance. Based on the Lyapunov function and Itô's formula, the sufficient conditions are derived to propose the stability criteria for LPV stochastic systems. The derived sufficient conditions are converted into linear matrix inequality (LMI) problems that can be solved by using convex optimization algorithm. Through solving these conditions, the gain-scheduled controller can be obtained to guarantee asymptotical stability and H∞ performance of LPV stochastic systems. Finally, numerical examples are provided to demonstrate the applications and effectiveness of the proposed controller design method.
Regular Folding Pattern for Deployable Nonaxisymmetric Tubes1
Authors: Ishida Sachiko , Nojima Taketoshi , Hagiwara Ichiro
Published: July 2015

This paper presents two techniques for modeling the folding patterns of deployable nonaxisymmetric tubes using regular arrangement of the fold lines and three different fundamental folding designs, namely, Miura folding, bellows folding, and torsional buckling-based folding. The first modeling technique involves the cutting and removal of unnecessary parts from the original folding pattern of the corresponding straight cylinder, and the second technique involves the design of additional fold lines for folding the unnecessary parts into the tube without being cut. The applicability and constraints of each folding design and modeling technique are discussed and summarized.
Self-etching zinc-doped adhesives improve the potential of caries-affected dentin to be functionally remineralized
Authors: Toledano Manuel , Aguilera Fátima S. , Osorio Estrella , Cabello Inmaculada , Toledano-Osorio Manuel , Osorio Raquel
Published: July 2015

The aim of this study was to evaluate if mechanical cycling influences bioactivity at the resin–carious dentin interface after bonding with Zn-doped self-etching adhesives. Caries-affected dentin surfaces were bonded with: Clearfil SE bond (SEB), and 10 wt. % ZnO nanoparticles or 2 wt. % ZnCl2 were added into the SEB primer or bonding components. Bonded interfaces were stored during 24 h and then tested or submitted to mechanical loading. Microtensile bond strength was assessed. Debonded dentin surfaces were studied by field emission scanning electron microscopy. Remineralization of the bonded interfaces was evaluated through nanohardness (Hi) and Young's modulus (Ei), Raman spectroscopy/cluster analysis, and Masson's trichrome staining technique. New precipitation of minerals composed of zinc-base salts and multiple Zn-rich phosphate deposits was observed in samples infiltrated with the Zn-doped adhesives. At the hybrid layer, specimens treated with ZnO incorporated in the primer (SEB·P-ZnO), after load cycling, attained the highest Ei and Hi. Load cycling increased Ei at the bottom of the hybrid layer when both, SEB undoped and SEB with ZnCl2 included in the bonding (SEB·Bd-ZnCl2), were used. ZnO incorporated in the primer promoted an increase in height of the phosphate and carbonate peaks, crystallinity, relative mineral concentration, and lower collagen crosslinking. ZnCl2 included in the bonding attained similar results, but relative mineral concentration decreased, associated to higher crosslinking and restricted collagen maturation. In general, a substantial restoration of the mechanical properties of caries-affected dentin substrata occurred when SEB-Zn doped adhesives were used and load cycled was applied, leading to functional and biochemical remineralization.
Superior electro-optical properties of electrically controlled birefringence mode using solution-derived La2O3 films
Authors: Jeong Hae-Chang , Park Hong-Gyu , Lee Ju Hwan , Seo Dae-Shik , Oh Byeong-Yun
Published: July 2015

The authors demonstrate a high performance electrically controlled birefringence (ECB) mode with solution-derived La2O3 films at various molar concentrations. Uniform and homogeneous liquid crystal (LC) alignment was spontaneously achieved on the La2O3 films for lanthanum concentrations at ratios greater than and equal to 0.2. A preferred orientation of LC molecules appeared along the filling direction, and the LC alignment was maintained via van der Waals force by nanocrystals of the La2O3 films. The LC alignment mechanism was confirmed by x-ray photoelectron spectroscopy and high-resolution transmission electron microscopy analysis. Superior electro-optical characteristics of the ECB cells constructed with solution-derived La2O3 films were observed, which suggests that the proposed solution-derived La2O3 films have strong potential for use in the production of advanced LC displays.
Experimental analysis and prediction of antisymmetric wave motion in a tapered anisotropic waveguide
Authors: Moll Jochen , Wandowski Tomasz , Malinowski Pawel , Radzienski Maciej , Opoka Szymon , Ostachowicz Wieslaw
Published: July 2015

This paper presents experimental results for wave propagation in an anisotropic multilayered structure with linearly varying cross section. Knowing the dispersion and wave propagation properties in such a structure is of great importance for non-destructive material testing and structural health monitoring applications for accurate damage detection and localization. In the proposed study, the wavefield is generated by a circular piezoelectric wafer active sensor and measured by a scanning laser-Doppler-vibrometer. The measurements are compared with a theoretical group delay estimation and a signal prediction for the antisymmetric wave motion along the non-uniform propagation path. The required dispersion curves are derived from the well-known global matrix method for segments of constant thickness. A multidimensional frequency-wavenumber analysis of linescan data and the full wavefield provides further insight of the adiabatic wave motion because the wavenumber changes along the tapered geometry of the waveguide. In addition, it is demonstrated that a terahertz time-domain system can be used in glass-fiber reinforced plastic structures as a tool to estimate the thickness profile of thin structures by means of time-of-flight measurements. This information is particularly important for guided wave-based diagnostics of structures with unknown thickness.
Atlanta Streets Alive: A Movement Building a Culture of Health in an Urban Environment
Authors: Torres Andrea , Steward John , Strasser Sheryl , Lyn Rodney , Serna Rebecca , Stauber Christine
Published: July 2015

Background:

Open Streets are community-based programs that promote the use of public space for physical activity (PA), recreation and socialization by closing streets temporarily to motorized vehicles, allowing access to pedestrians. The city of Atlanta hosted its first Open Streets event, Atlanta Streets Alive (ASA), in May 2010. An evaluation of the first 5 ASA events from May 2010 to May 2012 was conducted. The purpose was to learn about the characteristics of ASA participants, the influence of the event on their PA, and perceptions of safety and neighborhood social capital.

Methods:

ASA’s evaluation had 2 components: participant counts and a participant survey. Characteristics of participation were compared among the 3 different events in which surveys were conducted using the Pearson χ2 test and F test as appropriate.

Results:

The estimated participation at ASA increased from nearly 3,500 (ASA 1 to 4) to 12,520 (ASA 5). The number of events increased to 3 per year for a total of 10 events until 2014. Overall, 19.4% of participants met the weekly PA recommendation during 1 event.

Conclusions:

The expanding diversity of routes, participants, and sponsorships highlights the potential promise such programming offers in terms of establishing an urban culture of health.
As Iron Sharpens Iron? Athletes’ Perspectives of Positional Competition
Authors: Harenberg Sebastian , Riemer Harold A. , Karreman Erwin , Dorsch Kim
Published: July 2015

The study explored the competition between teammates for playing time (i.e., positional competition) within university team sports from the athletes’ perspective. Sixteen Canadian interuniversity team sport athletes (11 women, 5 men) participated in semistructured interviews. Results revealed that positional competition (a) occurs between players in the same position, (b) is necessary to determine playing time, (c) is an ongoing, omni-present process, and (d) happens under the awareness of the coach. Furthermore, various inputs (by the individual athlete, team, coach), processes (performance-related, information-related), and outcomes (individual, collective) became apparent. Positional competition is a group process that occurs across multiple competitive situations (e.g., practices, games). Future research is needed to clearly define and operationalize it as its own construct.
Immunity pipelines
Authors: VanHook Annalisa M.
Published: July 2015

Factors important for the plant immune response are transferred from chloroplasts to nuclei through stromules.
Microglia get a gut feeling
Authors: Prabakaran Sudhakaran
Published: July 2015

Gut microbes promote the maturation and activation of microglia in the brain through the production of short-chain fatty acids.
Increasing ATP release to increase metastasis
Authors: Wong Wei
Published: July 2015

A truncated form of the ATP-releasing channel PANX1 enhances the survival of metastasizing breast cancer cells in the microvasculature.
Inhibition of AAC(6′)-Ib-Mediated Resistance to Amikacin in Acinetobacter baumannii by an Antisense Peptide-Conjugated 2′,4′-Bridged Nucleic Acid-NC-DNA Hybrid Oligomer
Authors: Lopez Christina , Arivett Brock A. , Actis Luis A. , Tolmasky Marcelo E.
Published: July 2015

Multiresistant
Acinetobacter baumannii
, a common etiologic agent of severe nosocomial infections in compromised hosts, usually harbors
aac(6
′
)-Ib.
This gene specifies resistance to amikacin and other aminoglycosides, seriously limiting the effectiveness of these antibiotics. An antisense oligodeoxynucleotide (ODN4) that binds to a duplicated sequence on the
aac(6
′
)-Ib
mRNA, one of the copies overlapping the initiation codon, efficiently inhibited translation
in vitro
. An isosequential nuclease-resistant hybrid oligomer composed of 2′,4′-bridged nucleic acid-NC (BNA
NC
) residues and deoxynucleotides (BNA
NC
-DNA) conjugated to the permeabilizing peptide (RXR)
4
XB (“X” and “B” stand for 6-aminohexanoic acid and β-alanine, respectively) (CPPBD4) inhibited translation
in vitro
at the same levels observed in testing ODN4. Furthermore, CPPBD4 in combination with amikacin inhibited growth of a clinical
A. baumannii
strain harboring
aac(6
′
)-Ib
in liquid cultures, and when both compounds were used as combination therapy to treat infected
Galleria mellonella
organisms, survival was comparable to that seen with uninfected controls.
Lamellipodin Is Important for Cell-to-Cell Spread and Actin-Based Motility in Listeria monocytogenes
Authors: Wang Jiahui , King Jane E. , Goldrick Marie , Lowe Martin , Gertler Frank B. , Roberts Ian S.
Published: July 2015

Listeria monocytogenes
is a foodborne pathogen capable of invading a broad range of cell types and replicating within the host cell cytoplasm. This paper describes the colocalization of host cell lamellipodin (Lpd) with intracellular
L. monocytogenes
detectable 6 h postinfection of epithelial cells. The association was mediated via interactions between both the peckstrin homology (PH) domain in Lpd and phosphatidylinositol (3,4)-bisphosphate [PI(3,4)P
2
] on the bacterial surface and by interactions between the C-terminal EVH1 (Ena/VASP [vasodilator-stimulated phosphoprotein] homology domain 1) binding domains of Lpd and the host VASP (vasodilator-stimulated phosphoprotein) recruited to the bacterial cell surface by the listerial ActA protein. Depletion of Lpd by short interfering RNA (siRNA) resulted in reduced plaque size and number, indicating a role for Lpd in cell-to-cell spread. In contrast, overexpression of Lpd resulted in an increase in the number of
L. monocytogenes
-containing protrusions (listeriopods). Manipulation of the levels of Lpd within the cell also affected the intracellular velocity of
L. monocytogenes
, with a reduction in Lpd corresponding to an increase in intracellular velocity. These data, together with the observation that Lpd accumulated at the interface between the bacteria and the developing actin tail at the initiation of actin-based movement, indicate a possible role for Lpd in the actin-based movement and the cell-to-cell spread of
L. monocytogenes
.
Plasmodium falciparum Infection of Human Volunteers Activates Monocytes and CD16
+
Dendritic Cells and Induces Upregulation of CD16 and CD1c Expression
Authors: Teirlinck Anne C. , Roestenberg Meta , Bijker Else M. , Hoffman Stephen L. , Sauerwein Robert W. , Scholzen Anja
Published: July 2015

Antigen-presenting cells (APCs) are key players in the induction and regulation of immune responses. In
Plasmodium falciparum
malaria, determination of which cells and pathways are activated in the network of APCs remains elusive. We therefore investigated the effects of a controlled human malaria infection in healthy, malaria-naive volunteers on the subset composition and activation status of dendritic cells (DCs) and monocytes. While subsets of monocytes increased in frequency during blood-stage infection, DC frequencies remained largely stable. Activation markers classically associated with peptide presentation to and priming of αβT cells, HLA-DR and CD86, were upregulated in monocytes and inflammatory CD16 myeloid DCs (mDCs) but not in the classical CD1c, BDCA2, or BDCA3 DC subsets. In addition, these activated APC subsets showed increased expression of CD1c, which is involved in glycolipid antigen presentation, and of the immune complex binding Fcγ receptor III (CD16). Our data show that
P. falciparum
asexual parasites do not activate classical DC subsets but instead activate mainly monocytes and inflammatory CD16 mDCs and appear to prime alternative activation pathways via induction of CD16 and/or CD1c. Changes in expression of these surface molecules might increase antigen capture and enhance glycolipid antigen presentation in addition to the classical major histocompatibility complex class II (MHC-II) peptide presentation and thereby contribute to the initiation of T-cell responses in malaria. (This study has been registered at Clinicaltrials.gov under registration no. NCT01086917.)
A Single Host-Derived Glycan Impacts Key Regulatory Nodes of Symbiont Metabolism in a Coevolved Mutualism
Authors: Pan Min , Schwartzman Julia A. , Dunn Anne K. , Lu Zuhong , Ruby Edward G.
Published: July 2015

Most animal-microbe mutualistic associations are characterized by nutrient exchange between the partners. When the host provides the nutrients, it can gain the capacity to shape its microbial community, control the stability of the interaction, and promote its health and fitness. Using the bioluminescent squid-vibrio model, we demonstrate how a single host-derived glycan, chitin, regulates the metabolism of
Vibrio fischeri
at key points in the development and maintenance of the symbiosis. We first characterized the pathways for catabolism of chitin sugars by
V. fischeri
, demonstrating that the Ccr-dependent phosphoenolpyruvate-pyruvate phosphotransferase system (PTS) prioritizes transport of these sugars in
V. fischeri
by blocking the uptake of non-PTS carbohydrates, such as glycerol. Next, we found that PTS transport of chitin sugars into the bacterium shifted acetate homeostasis toward a net excretion of acetate and was sufficient to override an activation of the acetate switch by AinS-dependent quorum sensing. Finally, we showed that catabolism of chitin sugars decreases the rate of cell-specific oxygen consumption. Collectively, these three metabolic functions define a physiological shift that favors fermentative growth on chitin sugars and may support optimal symbiont luminescence, the functional basis of the squid-vibrio mutualism.

IMPORTANCE
Host-derived glycans have recently emerged as a link between symbiont nutrition and innate immune function. Unfortunately, the locations at which microbes typically access host-derived glycans are inaccessible to experimentation and imaging, and they take place in the context of diverse microbe-microbe interactions, creating a complex symbiotic ecology. Here we describe the metabolic state of a single microbial symbiont in a natural association with its coevolved host and, by doing so, infer key points at which a host-controlled tissue environment might regulate the physiological state of its symbionts. We show that the presence of a regulatory glycan is sufficient to shift symbiont carbohydrate catabolism, acetate homeostasis, and oxygen consumption.
PHACE syndrome misdiagnosed as a port-wine stain
Authors: Thomson Jason , Greig Aina , Lloyd Claire , Morrison Danny , Flohr Carsten
Published: July 2015

We present the case of a boy born with a large macular, segmental vascular anomaly over the left face, initially diagnosed as a capillary malformation (port-wine stain) by the postnatal paediatric team. The vascular anomaly in the face then grew rapidly during the first few weeks of life and started to occlude the left eye, causing parental concerns about the infant's vision. A dermatological opinion established that the lesion was a segmental infantile haemangioma (IH). This, in combination with the posterior fossa malformation previously detected on antenatal scanning and confirmed by an MRI postnatally, satisfied the criteria forPosterior fossa abnormalities,Haemangiomas,Arterial abnormalities,Cardiac abnormalities andEye abnormalities (PHACE) syndrome: a rare cutaneous neurovascular syndrome. This case highlights the diagnostic challenge posed by early phenotypes of haemangiomas as well as the importance of correctly diagnosing PHACE syndrome.
Jejunal diverticulum enterolith causing perforation and upper abdominal peritonitis
Authors: Hubbard Thomas James Eliot , Balasubramanian Rajesh , Smith Jason J
Published: July 2015

A patient presented with a 4 h history of acute onset, progressive upper abdominal pain. There was localised peritonitis, with raised inflammatory markers and lactate. CT scan showed a large calcified mass, with evidence of mesenteric twist/volvulus causing some degree of small bowel obstruction. At laparotomy, there were multiple jejunal diverticula, one of which had perforated due to a large enterolith. Resection of the affected jejunum and washout was performed and the patient recovered well. Complications of jejunal diverticula and enteroliths are reported and should be considered in patients with an acute abdomen.
Dislocation and dissociation of bipolar hip hemiarthroplasty
Authors: Moriarity Andrew , Ellanti Prasad , Talha Samir , McKenna John
Published: July 2015

Hemiarthroplasty of the hip is a commonly performed procedure for subcapital neck of femur fractures. Dislocation of the hemiarthroplasty is a recognised but uncommon complication. Dislocations can be complicated by the uncoupling or dissociation of the femoral head component from the femoral stem. Dissociations are rare and require open reduction. We present a case of a patient with a hip hemiarthroplasty dislocation and dissociation subsequent to a fall.
Neonatal acute lymphocytic leukaemia: an unusual presentation of a rare disease
Authors: Palman Jason , Karam Maria , Chee Ying , Kandala Vijay
Published: July 2015

Infantile acute lymphocytic leukaemia (ALL) seldom presents within the first month of life. Most are diagnosed before birth. Postnatal diagnoses are easily recognisable when characteristic features are present, namely hepatosplenomegaly, leukaemia cutis or infiltrative disease of the extramedullar and central nervous system. However, some children present with vague and non-specific symptoms masquerading as other diseases. We report an unusual presentation of infantile ALL in a 19-day-old infant, who struggled with feeding after a diagnosis of gastro-oesophageal reflux disease since birth. To the best of our knowledge, this is the youngest case report of neonatal ALL, presenting with vomiting, lethargy and dehydration. The neonate presented to our paediatric assessment unit acutely due to progression of her symptoms. General physical examination was unremarkable apart from signs of lethargy and dehydration. Blood investigation revealed an incidental finding of high white cells, including 90% blast cells. Early diagnosis in this case meant early treatment and a good prognosis.
Bilateral patellar tendon-bearing Symes-type prostheses in a severe case of Freeman-Sheldon syndrome in a 21-year-old woman presenting with uncorrectable equinovarus
Authors: McCormick Rodger J , Poling Mikaela I , Chamberlain Robert L
Published: July 2015

Described is the use of bilateral patellar tendon-bearing Symes-type prostheses in a severe case of Freeman-Sheldon syndrome (FSS) in a 21-year-old woman presenting with uncorrectable equinovarus and multiple surgical sequela of the lower extremities. FSS is considered a type of myopathic distal arthrogryposis; diagnosis requires the following: microstomia, whistling-face appearance, H-shaped chin dimpling, nasolabial folds, and multiple contractures of the hands and feet. Spinal deformities, metabolic and gastroenterological problems, other dysmorphic craniofacial characteristics, and visual and auditory impairments, are frequent findings. We highlight what we believe to be a unique approach to enhancing the patient’s ability to ambulate and engage in physical activity, particularly critical determinates of wellness and long-term functional outcome in FSS, when the feet are non-correctable but not amputated. Important implications exist for physiatrists, other rehabilitation providers and surgeons regarding this likely under-diagnosed syndrome.
Group Medical Visits (GMVs) in primary care: an RCT of group-based versus individual appointments to reduce HbA1c in older people
Authors: Khan Karim M , Windt Adriaan , Davis Jennifer C , Dawes Martin , Liu-Ambrose Teresa , Madden Ken , Marra Carlo A , Housden Laura , Hoppmann Christiane , Adams David J
Published: July 2015

Introduction

Type 2 diabetes mellitus (T2DM) affects more than 1.1 million Canadians aged ≥65 years. Group Medical Visits are an emerging health service delivery method. Recent systematic reviews show that they can significantly reduce glycated haemoglobin (HbA1c) levels, but Group Visits have not been evaluated within primary care. We intend to determine the clinical effectiveness, quality of life and economic implications of Group Medical Visits within a primary care setting for older people with T2DM.

Methods and analysis

A 2-year proof-of-concept, single-blinded (measurement team) randomised control trial to test the efficacy of Group Medical Visits in an urban Canadian primary care setting. Participants ≥65 years old with T2DM (N=128) will be equally randomised to either eight groups of eight patients each (Group Medical Visits; Intervention) or to Individual visits (Standard Care; Controls). Those administering cointerventions are not blinded to group assignment. Our sample size is based on estimates of variance (±1.4% for HbA1c) and effect size (0.9/1.4=0.6) from the literature and from our own preliminary data. Forty participants per group will provide a β likelihood of 0.80, assuming an α of 0.05. A conservative estimation of an effect size of 0.7/1.4 changes the N in the power calculation to 59 per group. Hence, we aim to enrol 64 participants in each study arm. We will use intention-to-treat analysis and compare mean HbA1c (% glycosylated HbA1c) (primary outcome) of Intervention/Control participants at 12 months, 24 months and 1 year postintervention on selected clinical, patient-rated and economic measures.

Trial registration number

NCT02002143.
Non-medical use of prescription pain relievers among high school students in China: a multilevel analysis
Authors: Guo Lan , Xu Yan , Deng Jianxiong , He Yuan , Gao Xue , Li Pengsheng , Wu Hong , Zhou Jinhua , Lu Ciyong
Published: July 2015

Objectives

Given the differences between general high school (GHS) and vocational high school (VHS) students, this study aimed to investigate the lifetime prevalence of non-medical use of prescription pain relievers (NMUPPR) among high school students as well as the associations between NMUPPR and individual-level factors and school category.

Methods

A cross-sectional study was conducted in GHS and VHS students in 2012 in Chongqing, and 11 906 students’ questionnaires were completed and qualified for the survey. Self-reported NMUPPR and information regarding individual-level determinants and school category were collected. A multilevel multivariate logistic regression model was fitted to explore independent predictors of NMUPPR.

Results

The total lifetime prevalence of NMUPPR was 11.3%, and NMUPPR was more prevalent among VHS students (15.8%) compared with GHS students (9.8%). Overall, the results indicated that VHS students were more likely to be involved in NMUPPR (adjusted OR (AOR)=1.64, 95% CI 1.42 to 1.89). Regarding the individual-level predictors of NMUPPR, below-average family economic status was negatively correlated with NMUPPR (AOR=0.77, 95% CI 0.60 to 0.98), and students with more pocket money were more likely to be engaged in NMUPPR. Students who had difficult family relationships, had poor relationships with teachers, had parents or friends who engaged in non-medical prescription drug use, and considered or attempted suicide were more likely to be engaged in NMUPPR.

Conclusions

NMUPPR among high school students is a multidetermined phenomenon. The current findings indicate that VHS students are an important subgroup of adolescents and highlight the need for additional research as well as targeted prevention and intervention programmes for NMUPPR.
Failure mode and effects analysis: a comparison of two common risk prioritisation methods
Authors: McElroy Lisa M , Khorzad Rebeca , Nannicelli Anna P , Brown Alexandra R , Ladner Daniela P , Holl Jane L
Published: July 2015

Background

Failure mode and effects analysis (FMEA) is a method of risk assessment increasingly used in healthcare over the past decade. The traditional method, however, can require substantial time and training resources. The goal of this study is to compare a simplified scoring method with the traditional scoring method to determine the degree of congruence in identifying high-risk failures.

Methods

An FMEA of the operating room (OR) to intensive care unit (ICU) handoff was conducted. Failures were scored and ranked using both the traditional risk priority number (RPN) and criticality-based method, and a simplified method, which designates failures as ‘high’, ‘medium’ or ‘low’ risk. The degree of congruence was determined by first identifying those failures determined to be critical by the traditional method (RPN≥300), and then calculating the per cent congruence with those failures designated critical by the simplified methods (high risk).

Results

In total, 79 process failures among 37 individual steps in the OR to ICU handoff process were identified. The traditional method yielded Criticality Indices (CIs) ranging from 18 to 72 and RPNs ranging from 80 to 504. The simplified method ranked 11 failures as ‘low risk’, 30 as medium risk and 22 as high risk. The traditional method yielded 24 failures with an RPN ≥300, of which 22 were identified as high risk by the simplified method (92% agreement). The top 20% of CI (≥60) included 12 failures, of which six were designated as high risk by the simplified method (50% agreement).

Conclusions

These results suggest that the simplified method of scoring and ranking failures identified by an FMEA can be a useful tool for healthcare organisations with limited access to FMEA expertise. However, the simplified method does not result in the same degree of discrimination in the ranking of failures offered by the traditional method.
Best in show but not best shape: a photographic assessment of show dog body condition
Authors: Such Z. R. , German A. J.
Published: July 2015

Previous studies suggest that owners often wrongly perceive overweight dogs to be in normal condition. The body shape of dogs attending shows might influence owners’ perceptions, with online images of overweight show winners having a negative effect. This was an observational in silico study of canine body condition. 14 obese‐prone breeds and 14 matched non‐obese‐probe breeds were first selected, and one operator then used an online search engine to identify 40 images, per breed, of dogs that had appeared at a major national UK show (Crufts). After images were anonymised and coded, a second observer subjectively assessed body condition, in a single sitting, using a previously validated method. Of 1120 photographs initially identified, 960 were suitable for assessing body condition, with all unsuitable images being from longhaired breeds. None of the dogs (0 per cent) were underweight, 708 (74 per cent) were in ideal condition and 252 (26 per cent) were overweight. Pugs, basset hounds and Labrador retrievers were most likely to be overweight, while standard poodles, Rhodesian ridgebacks, Hungarian vizslas and Dobermanns were least likely to be overweight. Given the proportion of show dogs from some breeds that are overweight, breed standards should be redefined to be consistent with a dog in optimal body condition.
Ecological release leads to novel ontogenetic diet shift in kokanee (Oncorhynchus nerka)
Authors: Shedd Kyle R. , von Hippel Frank A. , Willacker James J. , Hamon Troy R. , Schlei Ora L. , Wenburg John K. , Miller Joe L. , Pavey Scott A.
Published: July 2015

We investigate adaptive resource polymorphism in kokanee (Oncorhynchus nerka) from Jo-Jo Lake, Alaska, by determining whether previously observed niche expansion occurs at the population or individual level. Utilizing morphological, genetic, and stable isotope techniques, we found no evidence of discrete trophic morphotypes as previously described, but instead found evidence for an ontogenetic diet shift. Carbon and nitrogen isotope data indicate a 40% decrease in the proportion of benthic feeding and an increase of one trophic position over the size and age ranges of adult kokanee, corresponding to a diet shift from consumption of macroinvertebrates in smaller individuals to piscivory in larger individuals. This novel piscivory in kokanee may result from predatory and competitive freedom resulting from the lack of limnetic predators in Jo-Jo Lake. Piscivorous feeding despite a phenotype–environment mismatch has resulted in large, piscivorous kokanee having up to 70% of their gill rakers damaged. Observed reductions in gill raker number relative to the putative ancestral population are convergent with expectations for piscivorous fishes, despite a presumed lack of standing genetic variation for piscivory in the sockeye salmon – kokanee species complex. Jo-Jo Lake kokanee are a distinctive example of adaptation in salmonids in response to ecological release. This unusual population highlights the importance of phenotypic plasticity in response to competition in shaping the adaptive landscape and altering evolutionary trajectories.
Covariant Lie derivatives and Frölicher–Nijenhuis bracket on Lie algebroids
Authors: De Nicola Antonio , Yudin Ivan
Published: July 2015

We define covariant Lie derivatives acting on vector-valued forms on Lie algebroids and study their properties. This allows us to obtain a concise formula for the Frölicher–Nijenhuis bracket on Lie algebroids.
On interface transmission conditions for conservation laws with discontinuous flux of general shape
Authors: Andreianov Boris , Cancès Clément
Published: July 2015

Conservation laws of the form ∂tu + ∂xf(x;u) = 0 with space-discontinuous flux f(x;⋅) = fl(⋅)1x<0 + fr(⋅)1x>0 were deeply investigated in the past ten years, with a particular emphasis in the case where the fluxes are "bell-shaped". In this paper, we introduce and exploit the idea of transmission maps for the interface condition at the discontinuity, leading to the well-posedness for the Cauchy problem with general shape of fl,r. The design and the convergence of monotone Finite Volume schemes based on one-sided approximate Riemann solvers are then assessed. We conclude the paper by illustrating our approach by several examples coming from real-life applications.
A Note on the Commutativity of Prime Near-rings
Authors: Shang Yilun
Published: July 2015

Let N be a prime near-ring. We show two main results on the commutativity of N: (1) If there exist k, l ∈ ℕ such that N admits a generalized derivation D satisfying either D([x,y])=xk[x,y]xlfor all x, y ∈ N or D([x,y])=-xk[x,y]xlfor all x, y ∈ N, then N is a commutative ring. (2) If there exist k, l ∈ ℕ such that N admits a generalized derivation D satisfying either D(x ◦ y)= xk(x ◦ y) xlfor all x, y ∈ N or D(x ◦ y)= -xk(x ◦ y) xlfor all x, y ∈ N, then N is a commutative ring. Moreover, some interesting relations between the prime graph and zero-divisor graph of N are studied.
The Lie Conformal Algebra of a Block Type Lie Algebra
Authors: Gao Ming , Xu Ying , Yue Xiaoqing
Published: July 2015

Let L be a Lie algebra of Block type over ℂ with basis {Lα,i | α,i ∈ ℤ} and brackets [Lα,i,Lβ,j]=(β(i+1)-α(j+1)) Lα+β,i+j. In this paper, we first construct a formal distribution Lie algebra of L. Then we decide its conformal algebra B with ℂ[∂]-basis {Lα(w) | α ∈ ℤ} and λ-brackets [Lα(w)λ Lβ(w)]= (α∂+(α+β)λ) Lα+β(w). Finally, we give a classification of free intermediate series B-modules.
Finite Groups with Four Relative Commutativity Degrees
Authors: Erfanian A. , Farrokhi D.G. M.
Published: July 2015

It is shown that a finite group G has four relative commutativity degrees if and only if G/Z(G) is a p-group of order p3 and G has no abelian maximal subgroups, or G/Z(G) is a Frobenius group with Frobenius kernel and complement isomorphic to ℤp × ℤp and ℤq, respectively, and the Sylow p-subgroup of G is abelian, where p and q are distinct primes.
Coronary smooth muscle reactivity to muscarinic stimulation after ischemia-reperfusion in porcine myocardial infarction
Authors: Rodríguez-Sinovas Antonio , Bis Josep , Anivarro Inocencio , de la Torre Javier , Bayés-Genís Antoni , Cinca Juan
Published: July 2015

This study tested whether ischemia-reperfusion alters coronary smooth muscle reactivity to vasoconstrictor stimuli such as those elicited by an adventitial stimulation with methacholine. In vitro studies were performed to assess the reactivity of endothelium-denuded infarct-related coronary arteries to methacholine ( n = 18). In addition, the vasoconstrictor effects of adventitial application of methacholine to left anterior descending (LAD) coronary artery was assessed in vivo in pigs submitted to 2 h of LAD occlusion followed by reperfusion ( n = 12), LAD deendothelization ( n = 11), or a sham operation ( n = 6). Endothelial-dependent vasodilator capacity of infarct-related LAD was assessed by intracoronary injection of bradykinin ( n = 13). In vitro, smooth muscle reactivity to methacholine was unaffected by ischemia-reperfusion. In vivo, baseline methacholine administration induced a transient and reversible drop in coronary blood flow (9.6 ± 4.6 to 1.9 ± 2.6 ml/min, P < 0.01), accompanied by severe left ventricular dysfunction. After ischemia-reperfusion, methacholine induced a prolonged and severe coronary blood flow drop (9.7 ± 7.0 to 3.4 ± 3.9 ml/min), with a significant delay in recovery ( P < 0.001). Endothelial denudation mimics in part the effects of methacholine after ischemia-reperfusion, and intracoronary bradykinin confirmed the existence of endothelial dysfunction. Infarct-related epicardial coronary artery shows a delayed recovery after vasoconstrictor stimuli, because of appropriate smooth muscle reactivity and impairment of endothelial-dependent vasodilator capacity.
Regulation of matrix turnover in meniscal explants: role of mechanical stress, interleukin-1, and nitric oxide
Authors: Shin Sang-jin , Fermor Beverley , Weinberg J. Brice , Pisetsky David S. , Guilak Farshid
Published: July 2015

The meniscus is an intra-articular fibrocartilaginous structure that serves essential biomechanical roles in the knee. With injury or arthritis, the meniscus may be exposed to significant changes in its biochemical and biomechanical environments that likely contribute to the progression of joint disease. The goal of this study was to examine the influence of mechanical stress on matrix turnover in the meniscus in the presence of interleukin-1 (IL-1) and to determine the role of nitric oxide (NO) in these processes. Explants of porcine menisci were subjected to dynamic compressive stresses at 0.1 MPa for 24 h at 0.5 Hz with 1 ng/ml IL-1, and the synthesis of total protein, proteoglycan, and NO was measured. The effects of a nitric oxide synthase 2 (NOS2) inhibitor were determined. Dynamic compression significantly increased protein and proteoglycan synthesis by 68 and 58%, respectively, compared with uncompressed explants. This stimulatory effect of mechanical stress was prevented by the presence of IL-1 but was restored by specifically inhibiting NOS2. Release of proteoglycans into the medium was increased by IL-1 or mechanical compression and further enhanced by IL-1 and compression together. Stimulation of proteoglycan release in response to compression was dependent on NOS2 regardless of the presence of IL-1. These finding suggest that IL-1 may modulate the effects of mechanical stress on extracellular matrix turnover through a pathway that is dependent on NO.
Airway wall remodeling: friend or foe?
Authors: McParland Brent E. , Macklem Peter T. , Paré Peter D.
Published: July 2015

Airway wall remodeling is well documented for asthmatic airways and is believed to result from chronic and/or short-term exposure to inflammatory stimuli. Airway wall remodeling can contribute to airway narrowing as well as to the airway hyperresponsiveness, which is a characteristic abnormality in asthma. However, the potential for airway narrowing could be much worse if it were not for some of the protective effects of remodeling that may help to limit airway narrowing in asthmatic patients. This minireview discusses the evidence for airway wall remodeling and its effects, friend and/or foe, on airway narrowing in asthmatic patients.