bluuebunny/crossref_metadata_2025 huggingface dataset:
PARACENTRAL ACUTE MIDDLE MACULOPATHY AND DEEP RETINAL CAPILLARY PLEXUS INFARCTION SECONDARY TO REPERFUSED CENTRAL RETINAL ARTERY OCCLUSION
Authors: Iafe Nicholas A. , Onclinx Tania , Tsui Irena , Sarraf David
Published: September 2016

Purpose:

To report a case of reperfused central retinal artery occlusion causing a globular pattern of paracentral acute middle maculopathy with en face optical coherence tomography (OCT).

Methods:

Retrospective case report. Widefield fluorescein angiography, en face OCT, and OCT-angiography were performed. Retinal capillary plexus vessel density (mm−1) was measured using OCT-angiography analysis and was defined as total vessel length (mm) per area (mm2).

Results:

A 76-year-old female presented with decreased vision in the left eye for 1 day. Widefield fluorescein angiography revealed delayed venous filling in the early phase and selective arterial staining in the late phase. Spectral domain OCT demonstrated paracentral acute middle maculopathy. Optical coherence tomography–angiography showed an ischemic deep retinal capillary plexus that colocalized with a globular shaped hyper-reflective pattern identified with structural en face OCT. Quantitative vessel density analysis comparing the fellow eye to the affected eye at presentation demonstrated 43% reduction in the superficial capillary plexus vessel density and 33% reduction of the deep capillary plexus in the affected eye. At 2 months follow-up, the reduction of superficial capillary plexus vessel density improved to 33%, whereas the deep capillary plexus vessel density reduced further to 35% compared with the fellow eye.

Conclusion:

The authors report a case of reperfused central retinal artery occlusion leading to a globular shaped paracentral acute middle maculopathy lesion with en face OCT. Quantitative OCT-angiography vessel density analysis in the chronic phase revealed disproportionate reduction of deep capillary plexus vessel density. The globular pattern of paracentral acute middle maculopathy with en face OCT can be an important clue to the diagnosis of central retinal artery occlusion.
Pulmonary Blastomycosis in a Hematopoietic Cell Transplant Recipient
Authors: Linder Kathleen A. , Kauffman Carol A. , Miceli Marisa H.
Published: September 2016

Infections with the endemic fungus Blastomyces dermatitidis are uncommonly reported in hematopoietic cell transplant recipients. We present a case of pulmonary blastomycosis in a patient who had an allogeneic hematopoietic cell transplant 10 months previously and who responded rapidly to treatment with voriconazole.
Outpatient Parenteral Antimicrobial Therapy and Antimicrobial Stewardship
Authors: Bauer Karri A. , Mangino Julie E. , Paolo-Hohman Debra , Goff Debra A.
Published: September 2016

Objectives

Outpatient parenteral antimicrobial therapy (OPAT) is frequently used upon hospital discharge but often without infectious diseases (ID) or Antimicrobial Stewardship Programs (ASP) oversight. The purpose of this study was to evaluate the transition of care process for OPAT and identify the role of the ASP. Second, clinical and safety outcomes associated with the use of ertapenem for OPAT were evaluated.

Methods

This is a single-center, observational study of adult patients hospitalized from January 1, 2011, through December 31, 2011, who were discharged on ertapenem +/− additional antimicrobials. Population characteristics and clinical outcomes are outlined using descriptive statistics.

Results

There were 100 patients who met inclusion criteria. Clinical cure was achieved in 79% of patients. Median duration of ertapenem therapy was 21 (14–42) days. Among patients who had an ID consult, clinical cure was achieved in 59% compared with 41% of patients who did not have an ID consult (P = 1.000). The reasons for clinical failure included 15 (71%) lack of source control, 4 (19%) required an additional antibiotic, and 2 (10%) antibiotic-related adverse event. Sixteen patients could have potentially received an oral antibiotic instead of OPAT. Fourteen patients required readmission within 30 days.

Conclusions

The ASPs should assume a role in the management of OPAT patients and transition of care from inpatient to outpatient. We recommend a structured approach, including the implementation of a standard order set for patients discharged on OPAT.
Cytomegalovirus Polyradiculopathy in the Modern Age of Human Immunodeficiency Virus Therapies
Authors: Lee Timothy , Liu Sean , Kaplan-Lewis Emma , Lee Mikyung
Published: September 2016

Cytomegalovirus (CMV) polyradiculopathy in human immunodeficiency virus–infected patients is an increasingly rare disease given the widespread availability of effective antiretroviral therapy. Here, we describe a case of CMV polyradiculopathy in a man following the initiation of antiretrovirals. The patient presented with a 2-week history of rapidly progressing bilateral lower extremity weakness resulting in paraplegia; he was diagnosed with CMV polyradiculopathy based on cerebrospinal fluid and magnetic resonance imaging findings. Treatment with ganciclovir, foscarnet, and antiretroviral therapy resulted in rapid reduction of CMV viral load in cerebrospinal fluid and halting of disease progression. Six months after presentation, the patient continues to show improvement in lower extremity strength and has regained the ability to ambulate without assistance for short distances.
The Role of Metacognitive Self-Reflectivity in Emotional Awareness and Subjective Indices of Recovery in Schizophrenia
Authors: Bonfils Kelsey A. , Luther Lauren , George Sunita , Buck Kelly D. , Lysaker Paul H.
Published: September 2016

Emotional awareness deficits in people with schizophrenia have been linked to poorer objective outcomes, but no work has investigated the relationship between emotional awareness and subjective recovery indices or metacognitive self-reflectivity. The authors hypothesized that increased emotional awareness would be associated with greater self-esteem, hope, and self-reflectivity and that self-reflectivity would moderate links between emotional awareness and self-esteem and hope—such that significant relationships would only be observed at lower levels of self-reflectivity. Participants were 56 people with schizophrenia spectrum disorders. Correlations revealed that better emotional awareness was significantly associated with increased self-esteem and hope but not self-reflectivity. Self-reflectivity moderated the relationship between emotional awareness and self-esteem but not hope. Overall, findings suggest that emotional awareness may affect self-esteem for those low in self-reflectivity, but other factors may be important for those with greater self-reflectivity. Results emphasize the importance of interventions tailored to enhance self-reflective capacity in clients with schizophrenia.
Assessment of Lower Tear Meniscus
Authors: Wei Anji , Le Qihua , Hong Jiaxu , Wang Wentao , Wang Fei , Xu Jianjiang
Published: September 2016

Purpose

To evaluate the applicability of the fourth-generation OCULUS keratograph in measuring lower tear meniscus height.

Methods

Seventy cases (140 eyes) with dry eye disease and 37 controls (74 eyes) were enrolled. Tear breakup time (TBUT), Schirmer test I, and corneal fluorescein staining were examined. The images of lower tear meniscus were obtained by OCULUS keratograph. The tear meniscus height was measured and its correlation with traditional tear film diagnostic tests were analyzed.

Results

Using the hyper-reflective lines, the height of the tear meniscus was measured using the images of the OCULUS keratograph. For the inter-individual variation, the intraclass correlation coefficients and coefficient of variation values were 0.914 and 16.4%, respectively. For the intra-individual variation, the intraclass correlation coefficients and coefficient of variation values were 0.939 and 15.9%, respectively. The interobserver reproducibility and the intraobserver repeatability were for the control only. The average tear meniscus height value in dry eye disease group was 0.22 (0.19–0.24) mm, being significantly lower compared with 0.29 (0.26–0.34) mm in the control group (p<0.001). Tear meniscus height value had significantly correlation with TBUT and Schirmer test I (r=0.619 and 0.626, both p<0.001). The measurement of lower tear meniscus by OCULUS had lower individual variability and better repeatability.

Conclusions

OCULUS keratograph is a quick, noninvasive, and reliable method to measure lower tear meniscus, whose value has a significant correlation with traditional dry eye disease diagnostic tests.
Script Concordance Testing to Determine Infant Lumbar Puncture Practice Variation
Authors: Chime Nnenna Ogochukwu , Pusic Martin V. , Auerbach Marc , Mehta Renuka , Scherzer Daniel J. , Van Ittersum Wendy , McAninch Brett , Fein Daniel M. , Seelbach Elizabeth , Zaveri Pavan , Jackson Jennifer M. , Kessler David , Chang Todd P.
Published: September 2016

Objectives

Script concordance testing (SCT) is used to assess clinical decision-making. We explore the use of SCT to (1) quantify practice variations in infant lumbar puncture (LP) and (2) analyze physician's characteristics affecting LP decision making.

Methods

Using standard SCT processes, a panel of pediatric subspecialty physicians constructed 15 infant LP case vignettes, each with 2 to 4 SCT questions (a total of 47). The vignettes were distributed to pediatric attending physicians and fellows at 10 hospitals within the INSPIRE Network. We determined both raw scores (tendency to perform LP) and SCT scores (agreement with the reference panel) as well as the variation with participant factors.

Results

Two hundred twenty-six respondents completed all 47 SCT questions. Pediatric emergency medicine physicians tended to select LP more frequently than did general pediatricians, with pediatric emergency medicine physicians showing significantly higher raw scores (20.2 ± 10.2) than general pediatricians (13 ± 15; 95% confidence interval for difference, 1, 13). Concordance with the reference panel varied among subspecialties and by the frequency with which practitioners perform LPs in their practices.

Conclusion

Script concordance testing questions can be used as a tool to detect subspecialty practice variation. We are able to detect significant practice variation in the self-report of use of LP for infants among different pediatric subspecialties.
System Stresses in 2 Pediatric Emergency Departments and 2 Pediatric Urgent Care Centers During the 2014 Enterovirus-D68 Outbreak
Authors: Conners Gregory P. , Doyle Stacy J. , Fowler Milton A. , Schroeder Lisa L. , Tryon Thomas W.
Published: September 2016

Objective

To describe the association of an unprecedented large-scale Enterovirus-D68 outbreak in 2014 with changes in patient volume and acuity and system stress in 2 pediatric emergency departments and 2 pediatric urgent care centers of a single children's hospital.

Methods

We compared measures of patient volume, acuity, and system stress during the 2014 Enterovirus-D68 outbreak and the corresponding dates of the previous year.

Results

Both settings experienced large census increases during the Enterovirus-D68 outbreak; patient census increased significantly more in the pediatric urgent care setting (20.3%) than in the pediatric emergency departments (14.3%). Both settings had significant increases in patient acuity. The proportion of pediatric emergency department patients requiring hospital admission increased; the proportion of patients who left the pediatric urgent care setting without being seen also increased. Although there was no emergency department inpatient boarding during the 2013 comparison period, 4.4% of admitted patients required emergency department boarding during the 2014 outbreak. There was no significant change in the mean length of stay or the probability that patient admission was to the pediatric intensive care unit.

Conclusions

Both the pediatric emergency departments and the pediatric urgent care centers experienced increased patient volumes and acuity and significant system stress in association with the 2014 Enterovirus-D68 outbreak. These data will inform those planning resource allocation for future large-scale viral outbreaks.
Concomitant Anticonvulsants With Bitemporal Electroconvulsive Therapy
Authors: Rakesh Gopalkumar , Thirthalli Jagadisha , Kumar Channaveerachari Naveen , Muralidharan Kesavan , Phutane Vivek H , Gangadhar Bangalore N
Published: September 2016

Background

Electroconvulsive therapy (ECT) is an effective treatment for major affective disorders. The combined use of ECT and anticonvulsant mood stabilizers is a common clinical scenario. There is dearth of systematic studies on the use of this combination with regard to clinical or cognitive outcomes.

Objective/Hypothesis

We aimed to compare clinical improvement and cognitive adverse effects between patients who received only ECT versus those who received ECT and anticonvulsants. We hypothesized that improvement would be fastest in patients who received only ECT.

Methods

We conducted a randomized controlled trial in which patients prescribed ECT while being treated with anticonvulsants were randomized into 3 groups: full-dose (FD), half-dose (HD), and stop anticonvulsant. A blind rater assessed clinical improvement in patients using rating scales [Young’s Mania Rating Scale (YMRS) and Clinical Global Impression] for clinical improvement and cognitive adverse effects (Postgraduate Institute memory scale). Analysis was done using mixed-effects modeling to delineate differences in clinical and cognitive outcomes across the 3 arms of the study over the course of ECT.

Results

Of the 54 patients recruited, 36 patients went into treatment allocation arms per the initial randomization plan. The main anticonvulsants prescribed were sodium valproate and carbamazepine. Patients in the 3 groups were comparable on clinical features. The most common diagnosis was bipolar affective disorder—with current episode of mania. Overall, there was no difference across the 3 groups in final clinical outcome scores (YMRS and Clinical Global Impression) when analyzed as intention to treat (ITT) or “as treated.” In both analyses, group × time interaction was significant when comparing trend of YMRS scores between the FD anticonvulsant group and the HD group from baseline to last ECT (P = 0.0435 in ITT and P = 0.0055 in as treated). Patients in the FD group improved faster than those in the HD group. There were no differences across the 3 groups with regard to their cognitive adverse effects in the ITT analysis; “as-treated analysis” showed the HD patients to have performed poorly on some domains. Seizure parameters showed no significant difference across the 3 groups.

Conclusion

This is a preliminary prospective study examining whether coprescription of anticonvulsants with ECT affected clinical or cognitive outcomes. The most important takeaway point from this study is the significant reduction in YMRS scores when ECT was given with FD anticonvulsant compared with halving the dose (HD) of anticonvulsant. This difference was shown in both ITT and as-treated analysis. There is a need for more prospective studies to examine this clinical question.
Comparative analysis of 2D and 3D distance measurements to study spatial genome organization
Authors: Finn Elizabeth H. , Pegoraro Gianluca , Shachar Sigal , Misteli Tom
Published: September 2016

The spatial organization of eukaryotic genomes is non-random, cell-type specific, and has been linked to cellular function. The investigation of spatial organization has traditionally relied extensively on fluorescence microscopy. The validity of the imaging methods used to probe spatial genome organization often depends on the accuracy and precision of distance measurements. Imaging-based measurements may either use 2 dimensional datasets or 3D datasets including the z-axis information in image stacks. Here we compare the suitability of 2D versus 3D distance measurements in the analysis of various features of spatial genome organization. We find in general good agreement between 2D and 3D analysis with higher convergence of measurements as the interrogated distance increases, especially in flat cells. Overall, 3D distance measurements are more accurate than 2D distances, but are also more prone to noise. In particular, z-stacks are prone to error due to imaging properties such as limited resolution along the z-axis and optical aberrations, and we also find significant deviations from unimodal distance distributions caused by low sampling frequency in z. These deviations can be ameliorated by sampling at much higher frequency in the z-direction. We conclude that 2D distances are preferred for comparative analyses between cells, but 3D distances are preferred when comparing to theoretical models in large samples of cells. In general, 2D distance measurements remain preferable for many applications of analysis of spatial genome organization.
Mapping protein function with CRISPR/Cas9-mediated mutagenesis
Authors: Donovan Katherine F , Hegde Mudra , Sullender Meagan , Vaimberg Emma W , Johannessen Cory M , Root David E , Doench John G
Published: September 2016

CRISPR/Cas9 screening has proven to be a versatile tool for genomics research. We describe a CRISPR/Cas9-mediated approach to mutagenesis, exploiting the allelic diversity generated by error-prone non-homologous end-joining (NHEJ) to identify gain-of-function alleles of the MAPK signaling pathway genes MEK1 and BRAF. These results illustrate a scalable technique to easily generate cell populations containing thousands of endogenous allelic variants of any gene or genes to map variant functions.
Zipper plot: visualizing transcriptional activity of genomic regions
Authors: Avila Cobos Francisco , Anckaert Jasper , Volders Pieter-Jan , Rombaut Dries , Vandesompele Jo , De Preter Katleen , Mestdagh Pieter
Published: September 2016

Reconstructing transcript models from RNA-sequencing (RNA-seq) data and establishing these as independent transcriptional units can be a challenging task. The Zipper plot is an application that enables users to interrogate putative transcription start sites (TSSs) in relation to various features that are indicative for transcriptional activity. These features are obtained from publicly available datasets including CAGE-sequencing (CAGE-seq), ChIP-sequencing (ChIP-seq) for histone marks and DNasesequencing (DNase-seq). The Zipper plot application requires three input fields (chromosome, genomic coordinate (hg19) of the TSS and strand) and generates a report that includes a detailed summary table, a Zipper plot and several statistics derived from this plot.

Availability and Implementation

The Zipper plot is implemented using the statistical programming language R and is freely available athttp://zipperplot.cmgg.be

Contact

Pieter.Mestdagh@UGent.be;Katleen.DePreter@UGent.be;Francisco.AvilaCobos@UGent.be

Supplementary information

Supplementary Methods available online.
Multiple major disease-associated clones ofLegionella pneumophilahave emerged recently and independently
Authors: David Sophia , Rusniok Christophe , Mentasti Massimo , Gomez-Valero Laura , Harris Simon R. , Lechat Pierre , Lees John , Ginevra Christophe , Glaser Philippe , Ma Laurence , Bouchier Christiane , Underwood Anthony , Jarraud Sophie , Harrison Timothy G. , Parkhill Julian , Buchrieser Carmen
Published: September 2016

Legionella pneumophilais an environmental bacterium and the leading cause of Legionnaires’ disease. Just five sequence types (ST), from more than 2000 currently described, cause nearly half of disease cases in northwest Europe. Here, we report the sequence and analyses of 364L. pneumophilagenomes, including 337 from the five disease-associated STs and 27 representative of the species diversity. Phylogenetic analyses revealed that the five STs have independent origins within a highly diverse species. The number of de novo mutations is extremely low with maximum pairwise single-nucleotide polymorphisms (SNPs) ranging from 19 (ST47) to 127 (ST1), which suggests emergences within the last century. Isolates sampled geographically far apart differ by only a few SNPs, demonstrating rapid dissemination. These five STs have been recombining recently, leading to a shared pool of allelic variants potentially contributing to their increased disease propensity. The oldest clone, ST1, has spread globally; between 1940 and 2000, four new clones have emerged in Europe, which show long-distance, rapid dispersal. That a large proportion of clinical cases is caused by recently emerged and internationally dispersed clones, linked by convergent evolution, is surprising for an environmental bacterium traditionally considered to be an opportunistic pathogen. To simultaneously explain recent emergence, rapid spread and increased disease association, we hypothesize that these STs have adapted to new man-made environmental niches, which may be linked by human infection and transmission.
A NAC Transcription Factor Represses Putrescine Biosynthesis and Affects Drought Tolerance
Authors: Wu Hao , Fu Bing , Sun Peipei , Xiao Chang , Liu Ji-Hong
Published: September 2016

Arginine decarboxylase (ADC)-mediated putrescine biosynthesis plays an important role in plant stress responses, but the transcriptional regulation of ADC in response to abiotic stress is not well understood. We isolated a NAM, ATAF1/2, and CUC (NAC) domain-containing transcription factor, PtrNAC72, from trifoliate orange (Poncirus trifoliata) by yeast one-hybrid screening. PtrNAC72, localized to the nucleus, binds specifically to the promoter of PtADC and acts as a transcriptional repressor. PtrNAC72 expression was induced by cold, drought, and abscisic acid. ADC messenger RNA abundance and putrescine levels were decreased in transgenic tobacco (Nicotiana nudicaulis) plants overexpressing PtrNAC72 but increased, compared with the wild type, in an Arabidopsis (Arabidopsis thaliana) transfer DNA insertion mutant, nac72. While transgenic tobacco lines overexpressing PtrNAC72 were more sensitive to drought, plants of the Arabidopsis nac72 mutant exhibited enhanced drought tolerance, consistent with the accumulation of reactive oxygen species in the tested genotypes. In addition, exogenous application of putrescine to the overexpression lines restored drought tolerance, while treatment with d-arginine, an ADC inhibitor, compromised the drought tolerance of nac72. Taken together, these results demonstrate that PtrNAC72 is a repressor of putrescine biosynthesis and may negatively regulate the drought stress response, at least in part, via the modulation of putrescine-associated reactive oxygen species homeostasis.
Informatics and data science: an overview for the information
professional
Authors: Cervone H Frank
Published: September 2016

Purpose

– This paper aims to describe the emerging field of data science, its significance in the larger information landscape and some issues that distinguish the problems of data science and informatics from traditional approaches in the information sciences.

Design/methodology/approach

– Through a general overview of the topic, the author discusses some of the major aspects of how work in the data sciences and informatics differ from traditional library and information science.

Findings

– Data science and informatics, as emerging fields, are expanding our understanding of how the massive amount of information currently being generated can be collected, managed and used. While these may not be traditional “library” problems, the contributions of the library and information science communities are critical to help address aspects of these issues.

Originality/value

– The emerging fields of data science and informatics have not been extensively explored from the perspective of the information professional. This paper is designed to help information professionals better understand some of the implications of data science in a changing information environment.
Earnings Announcement Disclosures and Changes in Analysts' Information
Authors: Barron Orie E. , Byard Donal , Yu Yong
Published: September 2016

This study examines how financial disclosures with earnings announcements affect sell‐side analysts' information about future earnings, focusing on disclosures of financial statements and management earnings forecasts. We find that disclosures of balance sheets and segment data are associated with an increase in the degree to which analysts' forecasts of upcoming quarterly earnings are based on private information. Further analyses show that balance sheet disclosures are associated with an increase in the precision of both analysts' common and private information, segment disclosures are associated with an increase in analysts' private information, and management earnings forecast disclosures are associated with an increase in analysts' common information. These results are consistent with analysts processing balance sheet and segment disclosures into new private information regarding near‐term earnings. Additional analysis of conference calls shows that balance sheet, segment, and management earnings forecast disclosures are all associated with more discussion related to these items in the questions‐and‐answers section of conference calls, consistent with analysts playing an information interpretation role with respect to these disclosures.
Prioritizing Systemic Corticosteroid Treatments to Mitigate Relapse in Adults With Acute Asthma: A Systematic Review and Network Meta‐analysis
Authors: Rowe Brian H. , Kirkland Scott W. , Vandermeer Ben , Campbell Sandy , Newton Amanda , Ducharme Francine M. , Villa‐Roel Cristina
Published: September 2016

Objectives

While systemic corticosteroids (SCS) are widely used to prevent relapse in adults with acute asthma discharged from the emergency department, the most effective route of administration is unclear. The objective of this review was to examine the effectiveness of SCS in adults and to identify the most effective route of SCS to preventing relapse.

Methods

A search was conducted to identify randomized controlled trials comparing the effectiveness of intramuscular (IM) or oral (PO) short‐course or long‐course corticosteroids to prevent relapse in adults with acute asthma. Two independent reviewers judged study relevance, inclusion, and risk of bias. Pooled statistics were calculated as risk ratios (RR) and odds ratios (OR) with 95% confidence intervals (CI) and credibility intervals (CrI) using a random‐effects model. A Bayesian network meta‐analysis was performed for indirect comparisons of SCS to placebo. Probability of best (PB) analysis was reported for comparisons between the routes of administration.

Results

Thirteen studies of moderate quality were included. Four studies compared SCS to placebo, in which SCS significantly reduced relapse (RR = 0.43; 95% CI = 0.25 to 0.74). In the network meta‐analysis, a significant reduction in relapse within 10 days of discharge was found in adults receiving IM (OR = 0.21; 95% CrI = 0.05 to 0.73) and PO long‐course (OR = 0.31; 95% CrI = 0.09 to 0.95) corticosteroids. Relapse rates between PO short‐course corticosteroids and placebo were not statistically significantly different (OR = 0.37; 95% CrI = 0.04 to 3.38). PB analysis favored IM corticosteroids (62%) followed by PO short‐course (20.3%) and PO long‐course (14.1%) corticosteroids.

Conclusions

The network analysis identified IM corticosteroids and PO long‐course corticosteroids as the most effective strategies to prevent relapse among adults with acute asthma, compared to PO short‐course corticosteroids. The lack of significant findings with PO short‐course corticosteroids is likely due to the paucity of research. Further comparative studies are required to determine the safety and effectiveness of briefer PO SCS treatment options in adults.
Scoping review of medical assessment units and older people with complex health needs
Authors: Rushton Carole , Crilly Julia , Adeleye Adeniyi , Grealish Laurie , Beylacq Mandy , Forbes Mark
Published: September 2016

Objectives

To explore current knowledge of medical assessment units (MAUs) with specific reference to older people with complex needs and to stimulate new topics and questions for future policy, research and practice.

Methods

A scoping review was conducted using an integrated‐latent thematic approach.

Results

This review provides a unique perspective on MAUs and older people which is framed using four themes: efficiency, effectiveness, equity and time. Eighteen articles were reviewed. Most (14) articles reported on efficiency and effectiveness while none reported explicitly on equity. Time was identified as a fourth, latent theme within the literature.

Conclusion

Findings from this review indicate that future policy, research and practice relating to MAUs should focus on older people with complex needs, patient‐centred metrics and those MAU characteristics most likely to deliver positive health outcomes to this particular cohort of patients.
Zirconia abutments for single‐tooth implant restorations: a 10‐ to 11‐year follow‐up study
Authors: Ekfeldt Anders , Fürst Björn , Carlsson Gunnar E.
Published: September 2016

Objectives

To evaluate the clinical outcome of custom‐made zirconia abutments for implant‐supported single‐tooth restorations 10–11 years after insertion.

Material and methods

The study comprises a clinical examination of 23 patients with 30 restorations placed 10–11 years ago. Oral surgeons placed the implants. The prosthodontic treatment was provided at a prosthodontic specialist clinic. The restoration was either an all‐ceramic crown for cementation or a screw‐retained one‐piece restoration with the veneering porcelain baked directly to the zirconia abutment. Besides the clinical and radiographic examination at the 10‐ to 11‐year follow‐up, the patients’ records were scrutinized regarding clinical and radiographic data from insertion of the restoration up to the last visit at the clinic.

Results

The zirconia abutments performed well. Both technical and biological complications were rare; most patients were in general extremely satisfied with the restorations. No all‐ceramic crowns fractured during the observation period. One implant was lost after 5½ years in service. There were no significant differences for changes in any of the soft tissue registrations or the peri‐implant marginal bone level between the conventional two‐piece abutment‐crown restoration and the one‐piece restoration. The peri‐implant bone level changes from placement to the clinical examination 10–11 years later were small (mean 0.26 mm, SD 0.6 mm).

Conclusions

Zirconia abutments for single‐implant crowns demonstrated excellent technical and biological results over 10–11 years of function, and most patients were extremely satisfied with the aesthetics and the function of their single‐implant restorations.
Levodopa Effect on Basal Ganglia Motor Circuit in Parkinson's Disease
Authors: Gao Lin‐Lin , Zhang Jia‐Rong , Chan Piu , Wu Tao
Published: September 2016

Aims

To investigate the effects of levodopa on the basal ganglia motor circuit (BGMC) in Parkinson's disease (PD).

Methods

Thirty PD patients with asymmetrical bradykinesia and 30 control subjects were scanned using resting‐state functional MRI. Functional connectivity of the BGMC was measured and compared before and after levodopa administration in patients with PD. The correlation between improvements in bradykinesia and changes in BGMC connectivity was examined.

Results

In the PD‐off state (before medication), the posterior putamen and internal globus pallidus (GPi) had decreased connectivity while the subthalamic nucleus (STN) had enhanced connectivity within the BGMC relative to control subjects. Levodopa administration increased the connectivity of posterior putamen‐ and GPi‐related networks but decreased the connectivity of STN‐related networks. Improvements in bradykinesia were correlated with enhanced connectivity of the posterior putamen‐cortical motor pathway and with decreased connectivity of the STN‐thalamo‐cortical motor pathway.

Conclusion

In PD patients with asymmetrical bradykinesia, levodopa can partially normalize the connectivity of the BGMC with a larger effect on the more severely affected side. Moreover, the beneficial effect of levodopa on bradykinesia is associated with normalization of the striato‐thalamo‐cortical motor and STN‐cortical motor pathways. Our findings inform the neural mechanism of levodopa treatment in PD.
Perceived employability and reemployment: Do job search strategies and psychological distress matter?
Authors: De Battisti Francesca , Gilardi Silvia , Guglielmetti Chiara , Siletti Elena
Published: September 2016

Employability perceptions have been suggested to protect well‐being in times of job insecurity. Perceived employability (PE) refers to an individual's perception of his/her possibilities of obtaining employment. Some scholars showed that PE is also associated with the length of unemployment. However, it is not clear how employability perceptions can facilitate the reemployment process. Our research aim was to investigate the relationships among PE, job search strategies, psychological distress (PD), and reemployment. The two‐wave study (a questionnaire administered during the initial contact with employment agencies and objective data on reemployment after 12 months) involved 136 unemployed people. Results of the structural equation model analysis (partial least‐squares path analysis [SEM‐PLS]) showed that PE led to focused job search strategy (FJSS) and the focused strategy increased the likelihood of reemployment. The hypothesized negative correlation between PE and PD was not confirmed. Higher levels of distress attributed to job loss were positively associated with a haphazard job search strategy and negatively with a FJSS. The study makes an original contribution to both the research and the practice, highlighting the role of PE as a protective resource for the unemployed.

Practitioner points

Perceived employability (PE) can be considered as a personal protective resource during unemployment because can spur the unemployed to adopt a focused job search strategy (FJSS), even if it cannot reduce the job‐loss triggered psychological distress (PD).

Evidence that a FJSS facilitates reemployment suggests that behavioural training programmes need to be extended beyond the confines of job search intensity.

Both PE and PD should be considered to understand how unemployed individuals choose job search strategies.

Labour policies should support reemployment programmes that help the unemployed reframe their employability beliefs.
Compassion interventions: The programmes, the evidence, and implications for research and practice
Authors: Kirby James N.
Published: September 2016

Purpose

Over the last 10–15 years, there has been a substantive increase in compassion‐based interventions aiming to improve psychological functioning and well‐being.

Methods

This study provides an overview and synthesis of the currently available compassion‐based interventions. What do these programmes looks like, what are their aims, and what is the state of evidence underpinning each of them?

Results

This overview has found at least eight different compassion‐based interventions (e.g., Compassion‐Focused Therapy, Mindful Self‐Compassion, Cultivating Compassion Training, Cognitively Based Compassion Training), with six having been evaluated in randomized controlled trials, and with a recent meta‐analysis finding that compassion‐based interventions produce moderate effect sizes for suffering and improved life satisfaction.

Conclusions

Although further research is warranted, the current state of evidence highlights the potential benefits of compassion‐based interventions on a range of outcomes that clinicians can use in clinical practice with clients.

Practitioner points

There are eight established compassion intervention programmes with six having RCT evidence.

The most evaluated intervention to date is compassion‐focused therapy.

Further RCTs are needed in clinical populations for all compassion interventions.

Ten recommendations are provided to improve the evidence‐base of compassion interventions.
Identification and characterization of a fusarium head blight resistance gene TaACT in wheat QTL‐2DL
Authors: Kage Udaykumar , Karre Shailesh , Kushalappa Ajjamada C. , McCartney Curt
Published: September 2016

Fusarium head blight (FHB) resistance in wheat is considered to be polygenic in nature. Cell wall fortification is one of the best resistance mechanisms in wheat against Fusarium graminearum which causes FHB. Metabolomics approach in our study led to the identification of a wide array of resistance‐related (RR) metabolites, among which hydroxycinnamic acid amides (HCAAs), such as coumaroylagmatine and coumaroylputrescine, were the highest fold change RR metabolites in the rachis of a resistant near‐isogenic line (NIL‐R) upon F. graminearum infection. Placement of these metabolites in the secondary metabolic pathway led to the identification of a gene encoding agmatine coumaroyl transferase, herein referred to as TaACT, as a candidate gene. Based on wheat survey sequence, TaACT was located within a FHB quantitative trait loci on chromosome 2DL (FHB QTL‐2DL) between the flanking markers WMC245 and GWM608. Phylogenetic analysis suggested that TaACT shared closest phylogenetic relationship with an ACT ortholog in barley. Sequence analysis of TaACT in resistant and susceptible NILs, with contrasting levels of resistance to FHB, led to the identification of several single nucleotide polymorphisms (SNPs) and two inversions that may be important for gene function. Further, a role for TaACT in FHB resistance was functionally validated by virus‐induced gene silencing (VIGS) in wheat NIL‐R and based on complementation studies in Arabidopsis with act mutant background. The disease severity, fungal biomass and RR metabolite analysis confirmed TaACT as an important gene in wheat FHB QTL‐2DL, conferring resistance to F. graminearum.
Autologous intrauterine transfusion in a case of anti‐U
Authors: Adam Sumaiya , Lombaard Hennie
Published: September 2016

BACKGROUND

Minor red blood cell antibodies are becoming a more common cause of hemolytic disease of the newborn. Anti‐U are a rare alloantibody found almost exclusively in people of black descent. There is limited experience to guide the management of pregnancies complicated by anti‐U. Furthermore, there is often no suitable cross‐matched blood available for transfusion of a patient with anti‐U.

CASE REPORT

A 21‐year‐old P0G1 presented at 25 weeks' gestation with D– disease in pregnancy. She had a significant indirect antiglobulin test titer of 512. Anti‐U were identified and no suitable cross‐matched blood was available. Maternal blood was prepared for autologous intrauterine fetal transfusion. Two such transfusions were performed.

RESULTS

A healthy fetus delivered at 32 weeks that did not require phototherapy or an exchange transfusion.

CONCLUSION

Autologous transfusion of prepared maternal blood provides a safe option for intrauterine fetal therapy in pregnancies complicated by rare alloantibodies.
The contribution of unsafe blood transfusion to human immunodeficiency virus incidence in sub‐Saharan Africa: reexamination of the 5% to 10% convention
Authors: Morar Malika M. , Pitman John P. , McFarland Willi , Bloch Evan M.
Published: September 2016

BACKGROUND

Historical estimates have attributed 5% to 10% of new human immunodeficiency virus (HIV) infections in sub‐Saharan Africa (SSA) to unsafe blood transfusions. Although frequently cited, the validity of this statistic is uncertain or outdated. Recent estimates suggest blood transfusion's contribution to new HIV infections in the region may be much lower.

STUDY DESIGN AND METHODS

We searched the peer‐reviewed and gray literature for quantitative estimates of the specific contribution of unsafe blood transfusion to the proportion of new HIV infections occurring in SSA. The sources and methods used to generate attribution estimates were evaluated against published country‐specific HIV prevalence data.

RESULTS

Despite multiple secondary citations, a primary published source attributing 5% to 10% of new HIV infections to blood transfusions in SSA could not be established for the current era. The United Nations Programme on HIV and AIDS (UNAIDS) modes of transmission (MOT) reports representing 15 countries suggest that between 0 and 1.1% of new HIV infections per year (median, 0.2% or approx. two out of 1000 new infections each year) may be attributable to blood transfusions.

CONCLUSION

Recent modeled estimates suggest that blood transfusions account for a very low proportion of new HIV infections in SSA, likely an order of magnitude lower than 5% to 10%. Direct quantification of risk is challenging given the paucity of data on the variables that impact transfusion‐associated HIV. Specifically, data on HIV incidence in blood donors, blood bank laboratory test performance, and posttransfusion surveillance are lacking. Findings suggest an urgent need for improved surveillance and modeling of transfusion‐associated HIV transmission in the region.
Residual effects of cultivation methods on weed seed banks and weeds in Cambodia
Authors: Kamoshita Akihiko , Ikeda Hiroyuki , Yamagishi Junko , Lor Bunna , Ouk Makara
Published: September 2016

The effects of the planting method (transplanting vs. direct seeding), rice cultivar (Sen Pidao vs. Phka Rumduol), and herbicide application (admixture of bentazone and cyhalofop‐butyl) on weeds and weed seed banks were quantified in unflooded, shallowly flooded, and deeply flooded paddy fields in Cambodia in 2005 and 2006. Broad‐leaved weeds infested more toward maturity in 2006 than in 2005, particularly in directly seeded plots. Weed dry weights at pre‐heading and/or maturity were consistently reduced by herbicide application and Phka Rumduol cultivar, while weed numbers increased under unflooded condition. The proportion of sedges was consistently larger in directly seeded and non‐herbicide plots at pre‐heading. Larger numbers and dry weights of sedges and total weeds in 2005 caused larger seed bank sizes of sedges and total weeds in 2006, which further caused their infestation in 2006. A greater weed dry weight at 62 days after sowing in 2005 resulted in larger seed banks of Cyperus iria and Fimbristylis miliacea, which were most severe under non‐herbicide, direct‐seeded treatment, while that at rice maturity resulted in larger seed banks of Cyperus difformis, Scirpus juncoides, and Lindernia antipoda. Overall, sedges shared the majority of the total weed seed bank, followed by broad‐leaved weeds and then grasses. A lower yield in 2005 led to significantly larger seed bank sizes of sedges, but not of grasses or broad‐leaved weeds. Rice yield reduction was consistently related to larger numbers of sedges by heading and those of grasses at maturity.
Mice engrafted with human hematopoietic stem cells support a human myeloid cell inflammatory response in vivo
Authors: Baird Andrew , Deng Chenliang , Eliceiri Matthew H. , Haghi Fatima , Dang Xitong , Coimbra Raul , Costantini Todd W. , Torbett Bruce E. , Eliceiri Brian P.
Published: September 2016

Mice engrafted with human CD34+ hematopoietic stem and progenitor cells (CD34+‐HSPCs) have been used to study human infection, diabetes, sepsis, and burn, suggesting that they could be highly amenable to characterizing the human inflammatory response to injury. To this end, human leukocytes infiltrating subcutaneous implants of polyvinyl alcohol (PVA) sponges were analyzed in immunodeficient NSG mice reconstituted with CD34+‐HSPCs. It was reported that human CD45+ (hCD45+) leukocytes were present in PVA sponges 3 and 7 days postimplantation and could be localized within the sponges by immunohistochemistry. The different CD45+ subtypes were characterized by flow cytometry and the profile of human cytokines they secreted into PVA wound fluid was assessed using a human‐specific multiplex bead analyses of human IL‐12p70, TNFα, IL‐10, IL‐6, IL1β, and IL‐8. This enabled tracking the functional contributions of HLA‐DR+, CD33+, CD19+, CD62L+, CD11b+, or CX3CR1+ hCD45+ infiltrating inflammatory leukocytes. PCR of cDNA prepared from these cells enabled the assessment and differentiation of human, mouse, and uniquely human genes. These findings support the hypothesis that mice engrafted with CD34+‐HSPCs can be deployed as precision avatars to study the human inflammatory response to injury.
Production and Characterization of Neutralizing Antibodies against Bungarus multicinctus Snake Venom
Authors: Lee Chi-Hsin , Lee Yu-Ching , Leu Sy-Jye , Lin Liang-Tzung , Chiang Jen-Ron , Hsu Wei-Jane , Yang Yi-Yuan
Published: September 2016

The venom of the banded krait (
Bungarus multicinctus
), one of the major venomous species in Taiwan, contains neurotoxic venom proteins (
B. multicinctus
proteins) that pose a serious medical problem in tropical and subtropical countries. Even though horse-derived serum is an efficient therapy against snake venom, it is associated with a high cost and side effects. Therefore, developing a more cost-effective alternative treatment option is highly envisaged. In this study, chickens were immunized with
B. multicinctus
proteins, and polyclonal immunoglobulin Y (IgY) antibodies were purified from eggs. IgY showed a binding activity to
B. multicinctus
proteins that was similar to horse antivenin, and its titer in chickens lasted for at least 6 months. We constructed two antibody libraries by phage display antibody technology, which contain 1.0 × 10
7
and 2.9 × 10
8
transformants, respectively. After biopanning, a phage-based enzyme-linked immunosorbent assay (ELISA) indicated that specific clones were enriched. Thirty randomly selected clones expressing monoclonal single-chain variable-fragment (scFv) antibodies were classified into four groups with a short linker and two with a long linker. These selected scFv antibodies showed specific binding activities to
B. multicinctus
proteins but not to the venomous proteins of other snakes. Most importantly, polyclonal IgY demonstrated a similar neutralization efficiency as did horse-derived antivenin in mice that were injected with a minimum lethal dosage (MLD) of venom proteins. A mixture of several monoclonal anti-
B. multicinctus
scFv antibodies was also able to partially inhibit the lethal effect on mice. We profoundly believe that IgY and scFv antibodies can be applied in developing diagnostic agents for wound exudates and as an alternative treatment for snakebite envenomation in the future.

IMPORTANCE
Snake envenomation is one of the global medical issues of concern. Horse-derived antivenin is an effective way to treat snakebites, but it is costly and occasionally causes severe side effects. In this study, we first generated and characterized IgY antibodies with neutralization activity in chickens. Subsequently, we generated a panel of monoclonal scFv antibodies using phage display antibody technology. A mixture of scFv antibodies was able to partially inhibit the lethal effect in mice that were injected with lethal dosages of venom proteins and prolong their survival time. We believe that chicken-derived IgY and scFv antibodies have great potential for the development of diagnostic agents for wound exudates and therapeutic agents against snake envenomation in the future.