bluuebunny/crossref_metadata_2025 huggingface dataset:
Klossiella equi infection in a Cheval Canadien Mare
Authors: Baker Rose E. , Schlipf John W. , Brady Jacqueline V. , Gorman M. Elena
Published: October 2018

A 6‐year‐old Cheval Canadien mare was presented for clinical signs related to acute kidney injury after receiving a course of nonsteroidal anti‐inflammatory therapy. Cytologic examination of concentrated urine revealed small protozoal organisms that were later identified as Klossiella equi. Both sporocysts and free‐floating sporozoites were identified in the urine, which has not been previously documented. The mare responded well to intravenous fluid therapy, and as she regained tubular function, the presence of the protozoa in the urine also abated. The mare was discharged from the hospital after approximately 1 week of therapy. Repeat serum chemistries for up to 1 year following discharge demonstrated that all renal parameters had returned to normal, and the protozoa were not visualized on cytologic examination of the collected urine samples.
Circulating CD4(+)CD25(+)Foxp3(+) T regulatory cell levels in an experimental model of canine atopic dermatitis
Authors: Rostaher Ana , Fischer Nina M. , Urwyler Adrian , Favrot Claude
Published: October 2018

Background

The pathogenesis of canine atopic dermatitis (cAD) is characterized immunologically by an imbalanced T‐cell response. Mechanisms of immune regulation in cAD have not yet been completely elucidated.

Objectives

To investigate peripheral blood T regulatory (Treg) cells and their associated cytokines (TGF‐β and IL‐10) in an experimental model of cAD.

Animals

Eight beagle dogs that were initially naïve and subsequently sensitized to house dust mites (HDM).

Methods and materials

T regulatory cell phenotyping was performed by flow‐cytometric analysis on peripheral blood; serum cytokine levels were measured by ELISA, before sensitization and after challenge with HDM allergens. Additionally, clinical scores and allergen‐specific IgE were determined.

Results

After challenge of sensitized dogs to HDM allergen, a significant increase of Treg cells and simultaneous decrease in the serum TGF‐β were observed. However, in most dogs, serum IL‐10 values were below the detection limit. Treg cell proportions before sensitization were significantly negatively correlated with the HDM‐specific IgE levels and clinical scores after induction of AD signs.

Conclusion and clinical importance

The results confirm that Treg responses are involved in the pathogenesis of an experimental model cAD. Further investigations are required to clarify the precise immune modulating function of canine Treg cells and their interplay with other immune cell types.
Bartonella henselae in a dog with ear tip vasculitis
Authors: Southern Brittany L. , Neupane Pradeep , Ericson Marna E. , Dencklau Jamie C. , Linder Keith E. , Bradley Julie M. , McKeon Gabriel P. , Long Charles T. , Breitschwerdt Edward B.
Published: October 2018

Background

Bartonella henselae, a Gram‐negative, zoonotic, alpha‐proteobacteria has been previously implicated in association with cutaneous vasoproliferative lesions (bacillary angiomatosis), nodular panniculitis and multifocal erythema (erythema multiforme) in dogs.

Objective

Describe clinical, microbiological and histological lesions in a dog with ear margin vasculitis and B. henselae infection.

Animals

A 12‐month‐old, specific pathogen‐free intact female beagle dog maintained in a vector‐free laboratory animal resource facility.

Methods and materials

Bartonella and Rickettsia serological evaluation, Bartonella and Rickettsia PCR, Bartonella alpha‐proteobacteria growth medium (BAPGM) enrichment blood culture/PCR, histopathological investigation and confocal immunohistochemical evaluation.

Results

Serological investigation (seroreversion) and PCR testing of aural tissue biopsies failed to support Rickettsia rickettsii as a cause of the aural vasculitis; however, B. henselae, genotype San Antonio 2 DNA was amplified and sequenced from both ear tip margins and from normal‐appearing abdominal skin. Seroconversion to B. henselae was documented retrospectively by IFA testing. Bartonella henselae organisms were visualized by confocal immunostaining within all three biopsies. Histopathology revealed small vessel necrotizing vasculitis and dermal necrosis. Bartonella henselae seroreversion and complete resolution of skin lesions occurred in conjunction with administration of oral doxycycline and enrofloxacin for six weeks.

Conclusions and Clinical Importance

Bartonella henselae is an emerging zoonotic pathogen that has been associated with leucocytoclastic vasculitis in humans and may have had a contributing or causative role in the development of the cutaneous aural margin vasculitis in this beagle.
Retrospective characterization of canine coagulopathies using the turbidimetric ACL‐TOP 300 analyzer (2014–2015): Forty‐seven dogs
Authors: Richardson Rae , Todd Jeffrey M. , Sharkey Leslie C. , Washabau Robert J. , Williams Kevin D. , Little Kim J. , Rendahl Aaron
Published: October 2018

Objective

To characterize disseminated intravascular coagulation (DIC), liver failure (LF), post‐hepatic cholestasis (PHC), and anticoagulant rodenticide intoxication (ROD) in dogs using an immunoturbidimetric coagulation analyzer and to characterize the relationship between clinical bleeding and bleeding parameters.

Design

Retrospective study (August 2014–July 2015).

Setting

University teaching hospital.

Animals

Forty‐seven client‐owned dogs diagnosed with DIC (n = 24), LF (n = 9), PHC (n = 5), or ROD (n = 9) based on history, clinical pathology, cytology, histopathology. or exploratory surgery.

Interventions

None.

Measurements and Main Results

Median prothrombin time (PT), activated partial thromboplastin time (aPTT), and quantitative fribrinogen assay (QFA) were above the reference interval for DIC, LF, PHC and ROD with the exception of a normal QFA for LF. Clot curve analysis for DIC was characterized by elevated PT Delta, PT first derivative, and aPTT Delta, and normal for aPTT second derivative; all LF parameters were within the RI; all PHC parameters were above the RI; and ROD had elevated aPTT delta, but low aPTT second derivative. Coagulopathic bleeding recognized within the DIC group was characterized by median PT delta in mABS (milliabsorbance), first derivative and aPTT delta values in mABS within the RI at 35.0, 55.5 and 38, respectively. The nonbleeding DIC group median values of these same parameters were 189.5, 586.5 and 288, respectively.

Conclusions

The classically utilized indicators of secondary hemostasis, PT and aPTT, were prolonged within all 4 groups; DIC, LF, PHC and ROD as expected. Fibrinogen concentration was increased in both PHC and ROD, decreased in LF and increased but with a bimodal distribution in DIC that correlated with clinical bleeding. The degree of PT and aPTT prolongation did not correlate with clinical bleeding in the DIC group, however clot curve analysis, did reveal an association.
Comparison of Metzenbaum scissors and Y‐shaped fasciotome for deep metatarsal fasciotomy for the treatment of proximal suspensory ligament desmopathy in horses
Authors: Sidhu Anhad B. S. , Rosanowski Sarah M. , Davis Alexandra M. , Griffith James F. , Robinson Paul
Published: October 2018

Objective

To quantitate the iatrogenic injury associated with deep plantar metatarsal fasciotomy performed with Metzenbaum scissors compared with a Y‐shaped fasciotome.

Study design

Experimental ex vivo surgical study.

Study population

Cadaveric hind limbs (n = 20) from 10 sound thoroughbred racehorses.

Methods

A plantar metatarsal fasciotomy was performed, extending from the proximal extent of the deep metatarsal fascia, distally. Hind limbs were randomly assigned to 2 groups, undergoing fasciotomy with straight Metzenbaum scissors (n = 10) or a Y‐shaped fasciotome (n = 10). Magnetic resonance imaging was performed before and after surgery to identify the maximal depth of any iatrogenic trauma. Gross examination of the surgical site included measuring the length of the incision in the deep metatarsal fascia and localizing iatrogenic trauma sustained by the plantar aspect of the proximal suspensory ligament (PSL) during the procedure.

Results

Iatrogenic injury to the PSL was identified in 6 of 10 and 9 of 10 specimens prepared with the fasciotome and Metzenbaum scissors, respectively (P = .03), and was most commonly located in the distal third of the fascial incision. Differences between the length of incision (P = .02) and the maximal depth of signal (P = .03) for incisions created with Metzenbaum scissors or a fasciotome were identified.

Conclusion

The use of a fasciotome resulted in longer fascial incisions and less severe iatrogenic trauma to the PSL compared with using Metzenbaum scissors.

Clinical significance

A Y‐shaped fasciotome may be the preferred surgical instrument for successful desmopathy of the PSL fasciotomy because a greater release of compartmental pressure is possible through a longer incision with minimal iatrogenic trauma to the underlying PSL.
A Global Approach to Promoting Evidence‐Based Practice Knowledge: Validating the Translated Version of the Evidence‐Based Practice Knowledge Assessment in Nursing Into Spanish
Authors: Nick Jan M. , Wonder Amy H. , Suero Alfa R. , Spurlock Darrell
Published: October 2018

Background

Government and professional organizations have issued a call for evidence‐based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians.

Aims

This study sought to translate the Evidence‐based Practice Knowledge Assessment in Nursing (EKAN) instrument into Spanish, evaluate the psychometric performance of the newly translated instrument, and establish a baseline measure of EBP knowledge of baccalaureate nursing (BSN) students for future program improvement.

Methods

This study utilized a cross‐sectional, descriptive, correlational design. A total of 139 BSN students were recruited from a single study site in the Dominican Republic. Subjects completed the 20‐item EKAN‐Spanish, which was translated and back‐translated to promote semantic accuracy.

Results and Findings

Infit and outfit statistics for the sample centered around 1.0 (weighted mean square = 0.978; unweighted mean square = 0.988), indicating strong evidence of validity. The individual items on the EKAN‐Spanish showed item reliability of 0.94. The mean EBP knowledge score was 6.52 (SD = 2.03) with scores ranging from 2 to 12 points (20 points maximum). Differential item functioning (DIF) analysis supported translational accuracy.

Discussion

This study provides validation support for an objective assessment of EBP knowledge in the Spanish language and will be useful for future studies of EBP in over 21 Spanish‐speaking countries.

Linking Evidence to Action

While EBP is a global nursing concept, there has been no instrument to objectively measure EBP knowledge across levels of education in academe and practice in Spanish‐speaking countries until just recently. The availability of a validated instrument will promote global consistency in assessing EBP knowledge. Further, this will promote a collaborative approach in teaching EBP to nursing students and practicing nurses.
Axial stress determination using highly nonlinear solitary waves
Authors: Nasrollahi Amir , Rizzo Piervincenzo
Published: October 2018

This article presents a nondestructive evaluation (NDE) method to infer the neutral temperature and the axial stress in thick beams. The method relies on the propagation of highly nonlinear solitary waves generated at one end of a chain of spherical particles in a dry point contact with the beam to be evaluated. The waves are reflected back to the chain and the research hypothesis is that the axial stress, which influences the beam's stiffness, affects the amplitude and speed of the reflected waves. To verify this hypothesis a general finite element model of thermally stressed beams was developed and coupled to a discrete particle model able to predict the propagation of the waves along an L-shaped granular medium. The models were validated experimentally to quantify the repeatability of the setup, the sensitivity of the wave features on the thermal stress, and the independence of the wave features on the neutral temperature of the beam. The hypothesis was proven valid by both the numerical and the experimental results. In the future, these findings may be used to refine a NDE method to assess stress in columns, to infer the neutral temperature of continuous welded rails, and to prevent thermal buckling of critical structures.
Voice Onset Time in English voiceless stops is affected by following postvocalic liquids and voiceless onsets
Authors: Mielke Jeff , Nielsen Kuniko
Published: October 2018

Voice Onset Time is an important characteristic of stop consonants that plays a large role in perceptual discrimination in many languages, and is widely used in phonetic research. The current paper aims to account for Voice Onset Time variation in English that has defied previously understood phonetic and lexical factors, particularly involving stops that are followed in the word by liquids and voiceless obstruents. 122 Canadian English speakers produced 120 /p/- and /k/-initial words (n = 17 533), and word-initial Voice Onset Time was analyzed. It was found that Voice Onset Time is shorter when the following syllable starts with a voiceless obstruent, and that this effect is mediated by speech rate. Voice Onset Time is also longer before postvocalic liquids, even when they are intervocalic. Voice Onset Time generally decreases through the course of the task, and speakers tend to drift during the course of a word reading task, and this is best accounted for by the residual Voice Onset Time of recently spoken words.
Cooperative Function of TraJ and ArcA in Regulating the F Plasmid
tra
Operon
Authors: Lu Jun , Peng Yun , Wan Sereana , Frost Laura S. , Raivio Tracy , Glover J. N. Mark
Published: October 2018

Conjugation is a major mechanism for dissemination of antibiotic resistance and virulence among bacterial populations. The
tra
operon in the F family of conjugative plasmids encodes most of the proteins involved in bacterial conjugation. This work reveals that activation of
tra
operon transcription requires two proteins, TraJ and ArcA, to bind cooperatively to adjacent sites immediately upstream of the major
tra
promoter P
Y
. The interaction of TraJ and ArcA with the
tra
operon not only relieves P
Y
from silencers but also directly activates it. These findings provide insights into the regulatory circuit of the F-family plasmid-mediated bacterial conjugation.
Mobile-Genetic-Element-Encoded Hypertolerance to Copper Protects Staphylococcus aureus from Killing by Host Phagocytes
Authors: Zapotoczna Marta , Riboldi Gustavo P. , Moustafa Ahmed M. , Dickson Elizabeth , Narechania Apurva , Morrissey Julie A. , Planet Paul J. , Holden Matthew T. G. , Waldron Kevin J. , Geoghegan Joan A.
Published: October 2018

Methicillin-resistant
Staphylococcus aureus
(MRSA) poses a substantial threat to human health worldwide and evolves rapidly by acquiring mobile genetic elements, such as plasmids. Here we investigate how the
copB
-
mco
copper hypertolerance operon carried on a mobile genetic element contributes to the virulence potential of clinical isolates of MRSA. Copper is a key component of innate immune bactericidal defenses. Here we show that copper hypertolerance genes enhance the survival of
S. aureus
inside primed macrophages and in whole human blood. The
copB
and
mco
genes are carried by clinical isolates responsible for invasive infections across Europe, and more broadly among three successful clonal lineages of
S. aureus
. Our findings show that a gain of copper hypertolerance genes increases the resistance of MRSA to phagocytic killing by host immune cells and imply that acquisition of this mobile genetic element can contribute to the success of MRSA.
Natural Selection of Glycoprotein B Mutations That Rescue the Small-Plaque Phenotype of a Fusion-Impaired Herpes Simplex Virus Mutant
Authors: Fan Qing , Kopp Sarah J. , Byskosh Nina C. , Connolly Sarah A. , Longnecker Richard
Published: October 2018

Glycoprotein B (gB) is an essential viral protein that is conserved in all herpesviruses and is required for virus entry. gB is thought to undergo a conformational change that provides the energy to fuse the viral and cellular membranes; however, the details of this conformational change and the structure of the prefusion and intermediate conformations of gB are not known. Previously, we demonstrated that mutations in the gB “arm” region inhibit fusion and impart a small-plaque phenotype. Using serial passage of a virus carrying these mutations, we identified revertants with restored plaque size. The revertant viruses acquired novel mutations in gB that restored fusion function and mapped to two sites in the gB ectodomain. This work supports our hypothesis that an interaction between the gB arm and the core of gB is critical for gB refolding and provides details about the function of gB in herpesvirus-mediated fusion and subsequent virus entry.
Ribosome Profiling of
Synechocystis
Reveals Altered Ribosome Allocation at Carbon Starvation
Authors: Karlsen Jan , Asplund-Samuelsson Johannes , Thomas Quentin , Jahn Michael , Hudson Elton P.
Published: October 2018

Ribosome profiling accesses the translational step of gene expression via deep sequencing of ribosome-protected mRNA footprints. Pairing of ribosome profiling and transcriptomics data provides a translational efficiency for each gene. Here, the translatome and transcriptome of the model cyanobacterium
Synechocystis
were compared under carbon-replete and carbon starvation conditions. The latter may be experienced when cyanobacteria are cultivated in poorly mixed bioreactors or engineered to be product-secreting cell factories. A small fraction of genes (<200), including stress response genes, showed changes in translational efficiency during carbon starvation, indicating condition-dependent translation-level regulation. We observed ribosome occupancy in untranslated regions, possibly due to an alternative translation initiation mechanism in
Synechocystis.
The higher proportion of ribosomes residing in untranslated regions during carbon starvation may be a mechanism to quickly inactivate superfluous ribosomes. This work provides the first ribosome profiling data for cyanobacteria and reveals new regulation strategies for coping with nutrient limitation.
Announcement of the 2019 BLAST Conference: “BLAST XV: 15th International Conference on Bacterial Locomotion and Signal Transduction”
Authors: Josenhans Christine , Bourret Robert B. , Ottemann Karen , Harshey Rasika , Briegel Ariane , Wolfe Alan , Scharf Birgit E.
Published: October 2018

An exciting conference showcasing cutting edge research in bacterial signal transduction, chemotaxis, and motility will be held in January 2019. This conference, called Bacterial Locomotion and Signal Transduction (BLAST), will be held in New Orleans, LA, USA, under the auspices of chair Birgit Scharf.
How to use the videofluoroscopy swallow study in paediatric practice
Authors: Batchelor Gemma , McNaughten Ben , Bourke Thomas , Dick Julie , Leonard Claire , Thompson Andrew
Published: October 2018

In paediatric practice feeding, eating, drinking and swallowing difficulties are present in up to 1% of children. Dysphagia is any disruption to the swallow sequence that results in compromise to the safety, efficiency or adequacy of nutritional intake. Swallowing difficulties may lead to pharyngeal aspiration, respiratory compromise or poor nutritional intake. It causes sensory and motor dysfunction impacting on a child’s ability to experience normal feeding. Incoordination can result in oral pharyngeal aspiration where fluid or food is misdirected and enters the airway, or choking where food physically blocks the airway The incidence is much higher in some clinical populations, including children with neuromuscular disease, traumatic brain injury and airway malformations. The prevalence of dysphagia and aspiration-related disease is increasing secondary to the better survival of children with highly complex medical and surgical needs. This article aims to outline the indications for performing videofluoroscopy swallow (VFS). This includes the technical aspects of the study, how to interrupt a VFS report and some of the limitations to the study.
Proton magnetic resonance spectroscopy lactate/N-acetylaspartate within 2 weeks of birth accurately predicts 2-year motor, cognitive and language outcomes in neonatal encephalopathy after therapeutic hypothermia
Authors: Mitra Subhabrata , Kendall Giles S , Bainbridge Alan , Sokolska Magdalena , Dinan Mary , Uria-Avellanal Cristina , Price David , Mckinnon Katie , Gunny Roxana , Huertas-Ceballos Angela , Golay Xavier , Robertson Nicola J
Published: October 2018

Objective

Brain proton (1H) magnetic resonance spectroscopy (MRS) lactate/N-acetylaspartate (Lac/NAA) peak area ratio is used for prognostication in neonatal encephalopathy (NE). At 3 Tesla in NE babies, the objectives were to assess: (1) sensitivity and specificity of basal ganglia and thalamus (BGT) 1H MRS Lac/NAA for the prediction of Bayley III outcomes at 2 years using optimised metabolite fitting (Tarquin) with threonine and total NAA; (2) prediction of motor outcome with diffusion-weighted MRI; (3) BGT Lac/NAA correlation with the National Institute of Child Health and Human Development (NICHD) MRI score.

Subjects and methods

55 (16 inborn, 39 outborn) infants at 39w+5 d (35w+5d–42w+0d) with NE admitted between February 2012 and August 2014 to University College London Hospitals for therapeutic hypothermia underwent MRI and 1H MRS at 3T on day 2–14 (median day 5). MRIs were scored. Bayley III was assessed at 24 (22–26) months.

Results

16 babies died (1 inborn, 15 outborn); 20, 19 and 21 babies had poor motor, cognitive and language outcomes. Using a threshold of 0.39, sensitivity and specificity of BGT Lac/NAA for 2-year motor outcome was 100% and 97%, cognition 90% and 97% and language 81% and 97%, respectively. Sensitivity and specificity for motor outcome of mean diffusivity (threshold 0.001 mm2/s) up to day 9 was 72% and 100% and fractional anisotropy (threshold 0.198) was 39% and 94%, respectively. Lac/NAA correlated with BGT injury on NICHD scores (2A, 2B, 3).

Conclusion

BGT Lac/NAA on 1H MRS at 3T within 14 days accurately predicts 2-year motor, cognitive and language outcome and may be a marker directing decisions for therapies after cooling.
Interstitial lung disease and inflammatory myopathy in antisynthetase syndrome with PL-12 antibody
Authors: Jubber Ameen , Tripathi Mudita , Taylor James
Published: October 2018

We report the case of an 80-year-old Caucasian man with PL-12 antibody positive antisynthetase syndrome. He presented with progressive dyspnoea and weight loss, later developing dysphagia, mild proximal muscle weakness and mild sicca symptoms. Investigations revealed interstitial lung disease, inflammatory myopathy and an immunology profile consistent with PL-12 antisynthetase syndrome. Prednisolone and cyclophosphamide resulted in a significant improvement of all his symptoms.
Cannabis hyperemesis syndrome
Authors: Sharma Umesh
Published: October 2018

A young woman with chronic cannabis use presents with 2-day history of cyclical nausea, vomiting and abdominal pain. Clinical and laboratory examination excluded other causes. Patient’s symptoms improved with topical capsaicin, hot showers, antiemetics and she was subsequently discharged home 4 days later. The patient was educated on side effects of cannabis use and chose to stop cannabis use completely.
Autologous internal limiting membrane flap for retinal detachment due to posterior retinal tears over choroidal atrophy in highly myopic eyes
Authors: Rossi Tommaso , Caporossi Tomaso , Rizzo Stanislao , Trillo Carlandrea , Telani Serena , Barca Francesco , Ripandelli Guido
Published: October 2018

Purpose

To review a series of highly myopic eyes with retinal detachment undergoing pars plana vitrectomy with autologous internal limiting membrane (ILM) flap placed over posterior retinal breaks located in areas of choroidal atrophy.

Methods

Retrospective review of 13 consecutive patients receiving pars plana vitrectomy with ILM flap over causative breaks, compared with 19 controls receiving the same surgery with ILM peeling but no ILM flap. Main outcome measures included anatomical success rate, visual acuity, number of surgeries and the rate of silicone oil removal.

Results

Patients in the ILM group required 2.08±0.37 interventions versus 2.58±0.75 in the control group (p=0.037). One (1/13; 7.6%) patient in the ILM group required additional unplanned surgery versus 8/19 (42.10%) in the control group (p=0.038). Final anatomical success rate defined as attached retina after silicone oil (SiO) removal was 13/13 in the I-ILM group and 14/19 (73.6%) in the control group (p=0.052). No patients (0/13) in the I-ILM group retained SiO at the end of follow-up versus 4/19 (21.1%) patients in the control group (p=0.061). Best-corrected visual acuity at the end of follow-up was logMAR 0.65±0.36 (20/91 Snellen) in the ILM group and logMAR 0.89±0.44 (20/158 Snellen) in the control group (p=0.20).

Conclusion

Autologous ILM may help seal posterior retinal breaks and improve the surgical prognosis of retinal detachment due to breaks located over areas of choroidal atrophy within the myopic staphyloma.
Cam morphology in young male football players mostly develops before proximal femoral growth plate closure: a prospective study with 5-yearfollow-up
Authors: van Klij Pim , Heijboer Marinus P , Ginai Abida Z , Verhaar Jan A N , Waarsing Jan H , Agricola Rintje
Published: October 2018

Objectives

Cam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-up.

Methods

Academy male football players (n=49) participated in this prospective 5-year follow-up study (baseline 12–19 years old). Anteroposterior and frog-leg lateral views were obtained at baseline (142 hips), 2.5-year (126 hips) and 5-year follow-up (98 hips). Cam morphology on these time points was defined as: (A) visual scores of the anterior head-neck junction, classified as: (1) normal, (2) flattening, and (3) prominence; and (B) alpha angle ≥60°. Proximal femoral growth plates were classified as open or closed. Cam morphology development was defined as every increase in visual score and/or increase in alpha angle from <60° to ≥60°, between two time points. This resulted in 224 measurements for cam morphology development analysis.

Results

Cam morphology development was significantly associated with open growth plates based on visual score (OR: 10.03, 95% CI 3.49 to 28.84, p<0.001) and alpha angle (OR: 2.85, 95% CI 1.18 to 6.88, p=0.020). With both definitions combined, cam developed in 104 of 142 hips during follow-up. Of these 104 hips, cam developed in 86 hips (82.7%) with open growth plate and in 18 hips (17.3%) with a closed growth plate. Cam morphology developed from 12 to 13 years of age until growth plate closure around 18 years.

Conclusion

Cam morphology of the hip is more likely to develop with an open growth plate.
Specialist emergency care and COPD outcomes
Authors: Lane Nicholas David , Brewin Karen , Hartley Tom Murray , Gray William Keith , Burgess Mark , Steer John , Bourke Stephen C
Published: October 2018

Introduction

In exacerbation of chronic obstructive pulmonary disease (ECOPD) requiring hospitalisation greater access to respiratory specialists improves outcome, but is not consistently delivered. The UK National Confidential Enquiry into Patient Outcome and Death 2015 enquiry showed over 25% of patients receiving acute non-invasive ventilation (NIV) for ECOPD died in hospital. On 16 June 2015 the Northumbria Specialist Emergency Care Hospital (NSECH) opened, introducing 24/7 specialty consultant on-call, direct admission from the emergency department to specialty wards and 7-day consultant review. A Respiratory Support Unit opened for patients requiring NIV. Before NSECH the NIV service included mandated training and competency assessment, 24/7 single point of access, initiation of ventilation in the emergency department, a door-to-mask time target, early titration of ventilation pressures and structured weaning. Pneumonia or hypercapnic coma complicating ECOPD have never been considered contraindications to NIV. After NSECH staff-patient ratios increased, the NIV pathway was streamlined and structured daily multidisciplinary review introduced. We compared our outcomes with historical and national data.

Methods

Patients hospitalised with ECOPD between 1 January 2013 and 31 December 2016 were identified from coding, with ventilation status and radiological consolidation confirmed from records. Age, gender, admission from nursing home, consolidation, revised Charlson Index, key comorbidities, length of stay, and inpatient and 30-day mortality were captured. Outcomes pre-NSECH and post-NSECH opening were compared and independent predictors of survival identified via logistic regression.

Results

There were 6291 cases. 24/7 specialist emergency care was a strong independent predictor of lower mortality. Length of stay reduced by 1  day, but 90-day readmission rose in both ventilated and non-ventilated patients.

Conclusion

Provision of 24/7 respiratory specialist emergency care improved ECOPD survival and shortened length of stay for both non-ventilated and ventilated patients. The potential implications in respect to service design and provision nationally are substantial and challenging.
Epidemiology of injuries among Italian footballers: the role of the playing field
Authors: Bianchi Francesco Paolo , Veneziani Valter , Cantalice Michele Alberto , Notarnicola Angela , Tafuri Silvio
Published: October 2018

Background

Football has a higher injury rate compared with other team sports such as rugby, in terms of two main categories: intrinsic (individual) and extrinsic (environmental) factors. The playing field is an extrinsic risk factor which has been poorly investigated in the literature.

Purpose

The aim of our study was to define the incidence and risk factors of injuries in a cohort of footballers comparing the role of three different types of playing field (hard court, natural grass or synthetic grass).

Study design

This was a cross sectional prevalence study.

Methods

The population comprised footballers recruited by a convenience sample; the instrument used for the survey was an anonymous self-administered questionnaire.

Results

267 football players were enrolled (average age 23.4±4.8 years), of whom 33.7% (n=90/267) played on hard court, 33.0% (n=88/267) on natural grass and 33.3% (n=89/267) on synthetic grass. The overall incidence of injury was 40.1 (95% CI 34.1 to 46.8) ×1000 person-years of training, with higher values for ankle and knee injuries. Ankle injuries (aOR 0.4; P=0.021) were associated with playing on natural grass as a protective factor, while playing on natural grass seemed to be a risk factor for muscular injuries (aOR 2.3; P=0.026).

Conclusion

Our study showed a high lifetime prevalence of injury among footballers (57%), in particular among athletes who play and train on a hard court. We have studied a topic poorly investigated previously and provide the opportunity to understand interventions to increase the capacity of stakeholders in preventing injuries.
De novo pathogenic variants in neuronal differentiation factor 2 (NEUROD2) cause a form of early infantile epileptic encephalopathy
Authors: Sega Annalisa G , Mis Emily K , Lindstrom Kristin , Mercimek-Andrews Saadet , Ji Weizhen , Cho Megan T , Juusola Jane , Konstantino Monica , Jeffries Lauren , Khokha Mustafa K , Lakhani Saquib Ali
Published: October 2018

Background

Early infantile epileptic encephalopathies are severe disorders consisting of early-onset refractory seizures accompanied often by significant developmental delay. The increasing availability of next-generation sequencing has facilitated the recognition of single gene mutations as an underlying aetiology of some forms of early infantile epileptic encephalopathies.

Objectives

This study was designed to identify candidate genes as a potential cause of early infantile epileptic encephalopathy, and then to provide genetic and functional evidence supporting patient variants as causative.

Methods

We used whole exome sequencing to identify candidate genes. To model the disease and assess the functional effects of patient variants on candidate protein function, we used in vivo CRISPR/Cas9-mediated genome editing and protein overexpression in frog tadpoles.

Results

We identified novel de novo variants inneuronal differentiation factor 2(NEUROD2) in two unrelated children with early infantile epileptic encephalopathy. Depletingneurod2with CRISPR/Cas9-mediated genome editing induced spontaneous seizures in tadpoles, mimicking the patients’ condition. Overexpression of wild-type NEUROD2 induced ectopic neurons in tadpoles; however, patient variants were markedly less effective, suggesting that both variants are dysfunctional and likely pathogenic.

Conclusion

This study provides clinical and functional support forNEUROD2variants as a cause of early infantile epileptic encephalopathy, the first evidence of human disease caused byNEUROD2variants.
Specific combinations of biallelic POLR3A variants cause Wiedemann-Rautenstrauch syndrome
Authors: Paolacci Stefano , Li Yun , Agolini Emanuele , Bellacchio Emanuele , Arboleda-Bustos Carlos E , Carrero Dido , Bertola Debora , Al-Gazali Lihadh , Alders Mariel , Altmüller Janine , Arboleda Gonzalo , Beleggia Filippo , Bruselles Alessandro , Ciolfi Andrea , Gillessen-Kaesbach Gabriele , Krieg Thomas , Mohammed Shehla , Müller Christian , Novelli Antonio , Ortega Jenny , Sandoval Adrian , Velasco Gloria , Yigit Gökhan , Arboleda Humberto , Lopez-Otin Carlos , Wollnik Bernd , Tartaglia Marco , Hennekam Raoul C
Published: October 2018

Background

Wiedemann-Rautenstrauch syndrome (WRS) is a form of segmental progeria presenting neonatally, characterised by growth retardation, sparse scalp hair, generalised lipodystrophy with characteristic local fatty tissue accumulations and unusual face. We aimed to understand its molecular cause.

Methods

We performed exome sequencing in two families, targeted sequencing in 10 other families and performed in silico modelling studies and transcript processing analyses to explore the structural and functional consequences of the identified variants.

Results

Biallelic POLR3A variants were identified in eight affected individuals and monoallelic variants of the same gene in four other individuals. In the latter, lack of genetic material precluded further analyses. Multiple variants were found to affect POLR3A transcript processing and were mostly located in deep intronic regions, making clinical suspicion fundamental to detection. While biallelic POLR3A variants have been previously reported in 4H syndrome and adolescent-onset progressive spastic ataxia, recurrent haplotypes specifically occurring in individuals with WRS were detected. All WRS-associated POLR3A amino acid changes were predicted to perturb substantially POLR3A structure/function.

Conclusion

Biallelic mutations in POLR3A, which encodes for the largest subunit of the DNA-dependent RNA polymerase III, underlie WRS. No isolated functional sites in POLR3A explain the phenotype variability in POLR3A-related disorders. We suggest that specific combinations of compound heterozygous variants must be present to cause the WRS phenotype. Our findings expand the molecular mechanisms contributing to progeroid disorders.
Job strain and cognitive change: the Baltimore Epidemiologic Catchment Area follow-up study
Authors: Dong Liming , Eaton William W , Spira Adam P , Agnew Jacqueline , Surkan Pamela J , Mojtabai Ramin
Published: October 2018

Objectives

To investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study.

Methods

The sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993–1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004–2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition.

Results

Participants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: −0.24, 95% CI −0.36 to –0.11; verbal memory scores: −0.26, 95% CI −0.44 to –0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors.

Conclusions

Findings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.
Multisite musculoskeletal pain trajectories from midlife to old age: a 28-year follow-up of municipal employees
Authors: Neupane Subas , Nygård Clas-Håkan , Prakash K C , von Bonsdorff Mikaela B , von Bonsdorff Monika E , Seitsamo Jorma , Rantanen Taina , Ilmarinen Juhani , Leino-Arjas Päivi
Published: October 2018

Objectives

We studied the developmental trajectories of multisite musculoskeletal pain (MSP) to learn whether pain in midlife persists to old age, and whether pain trajectories associate with midlife work or lifestyle exposures or retirement from work.

Methods

Municipal employees aged 44–58 years were studied in 1981 (n=6257) with follow-ups in 1985, 1992, 1997 and 2009. Pain in the neck, low back, and upper and lower limbs was assessed in each survey. Trajectories of the number (0–4) of pain sites were defined using growth mixture modelling (n=3093). Workload, lifestyle and morbidity were elicited by questionnaire and retirement from registries. Associations of baseline factors with pain trajectories were assessed by multinomial logistic regression. Cumulative hazard curves for retirement by trajectory group were calculated.

Results

Three trajectories of pain over 28 years emerged: low (25%), moderate (52%) and high-decreasing (23%). In the latter, the number of pain sites first decreased sharply, stabilising to a moderate level after most subjects had retired. The disability pension rate was highest in this trajectory, which associated with high baseline morbidity, particularly musculoskeletal disorder (OR 8.06; 95% CI 5.97 to 10.87). Also high biomechanical exposure (2.86;95% CI 2.16 to 3.78), high job demands (1.79; 95% CI 1.39 to 2.30), high job control (OR 0.70; 95% CI 0.54 to 0.90), body mass index (BMI) ≥25.0 kg/m2 (1.40; 95% CI 1.09 to 1.80) and low leisure-time physical activity (LTPA) (1.39; 95% CI 1.09 to 1.78) at baseline were associated with this trajectory. However, high LTPA and BMI in repeated surveys also associated with the high-decreasing trajectory.

Conclusion

MSP in midlife often persists to old age. However, high widespreadness of pain may decrease with retirement from work.
Will an innovative connected AideSmart! app-based multiplex, point-of-care screening strategy for HIV and related coinfections affect timely quality antenatal screening of rural Indian women? Results from a cross-sectional study in India
Authors: Pant Pai Nitika , Daher Jana , Prashanth HR , Shetty Achal , Sahni Rani Diana , Kannangai Rajesh , Abraham Priya , Isaac Rita
Published: October 2018

Objectives

In rural pregnant Indian women, multiple missed antenatal screening opportunities due to inadequate public health facility-based screening result in undiagnosed HIV and sexually transmitted bloodborne infections (STBBIs) and conditions (anaemia). Untreated infections complicate pregnancy management, precipitate adverse outcomes and risk mother-to-child transmission. Additionally, a shortage of trained doctors, rural women’s preference for home delivery and health illiteracy affect health service delivery. To address these issues, we developed AideSmart!, an innovative, app-based, cloud-connected, rapid screening strategy that offers multiplex screening for STBBIs and anaemia at the point of care. It offers connectivity, integration, expedited communications and linkages to clinical care throughout pregnancy.

Methods

In a cross-sectional study, we evaluated the AideSmart! strategy for feasibility, acceptability, preference and impact. We trained 15 healthcare professionals (HCPs) to offer the AideSmart! strategy to 510 pregnant women presenting for care to outreach rural service units of Christian Medical College, Vellore, India.

Results

With the AideSmart! screening strategy, we recorded an acceptability of 100% (510/510), feasibility (completion rate) of 91.6% (466/510) and preference of 73%. We detected 239 infections/conditions (239/510, 46.8%) at the point-of-care, of which 168 (168/239; 70%) were lab confirmed, staged and treated rapidly. Of the 168 confirmed infections/conditions, 127 were anaemia, 11 Trichomonas and 30 hepatitis B virus (HBV) (25 resolved naturally, 5 active infections). Four infants (4/5; 80%) were prophylaxed for HBV and were declared disease-free at 9 months. Recruited participants were young; mean age was 24 years (range: 17–40) and 74% (376/510) were in their second trimester. Furthermore, 95% of the participants were retained throughout their pregnancy.

Conclusion

The AideSmart! strategy was deemed feasible to operationalise by HCPs. It was accepted and preferred by participants, resulting in timely screening and treatment of HIV/STIs and anaemia, preventing mother-to-child transmission. The strategy could be reverse-innovated to any context to maximise its health impact.
Low‐dose intravenous lipid emulsion as a safe treatment for lipophilic intoxications in five cats
Authors: Pelizzola Marco , Mattavelli Clara , Troìa Roberta , Murgia Elsa , Giunti Massimo
Published: October 2018

The use of a low‐dose infusion of intravenous lipid emulsion (ILE) in five young cats presented with acute neurotoxicity is reported. Suspected toxic compounds were permethrin (three, dermal), fipronil/eprinomectin/praziquantel (one, oral) and milbemycin (one, oral). Cats presented with acute onset of generalised tremors of variable severity. Initial treatment included toxin decontamination whenever possible, and control of neurological signs by administration of benzodiazepine and eventually a continuous rate infusion of propofol. Due to persisting clinical signs, a low‐dose ILE therapy was additionally given. Discontinuation of treatment, once a resolution of neurological signs was achieved, ranged between two and nine  hours from hospital admission. All the cats fully recovered and were discharged within 18–92  hours. No side effects were noticed and follow‐up was normal. The authors report the use of a low‐dose infusion of ILE as an adjunctive and safe treatment for the management of lipophilic intoxications in cats.
Solitary spinal nephroblastoma progressing to multifocal disease in a dog
Authors: Yu Sonya , Hoffmann Karon , Taylor David , Lurie David
Published: October 2018

A two‐ year‐old neutered Labrador dog was evaluated for acute onset hindlimb paresis and proprioceptive deficits. Spinal MRI revealed a lesion at the level of T9–T10, from which a presumptive diagnosis of spinal nephroblastoma was made. The dog showed clinical improvement after receiving neoadjuvant stereotactic radiotherapy but re‐presented six  weeks later with neurological deterioration. In addition to the primary lesion, a repeat MRI study revealed lesions at T6–T7 and T12. The dog was euthanased and multiple intradural, extramedullary spinal cord lesions were found at postmortem examination. Histopathological analysis of the lesions confirmed spinal nephroblastoma. This report substantiates the likelihood of intraspinal metastases of nephroblastoma occurring in the dog.
Association of cardiorespiratory fitness levels with dietary habits and lifestyle factors in schoolchildren
Authors: Tambalis Konstantinos D. , Panagiotakos Demosthenes B. , Psarra Glyceria , Sidossis Labros S.
Published: October 2018

This study examined the association between cardiorespiratory fitness (CRF) levels and lifestyle factors in a representative sample of Greek schoolchildren. In 2015, a health survey was carried out in 177 091 participants 8–17 years of age. Dietary habits, sleeping hours, physical activity (PA), and sedentary activities were assessed through self-completed questionnaires. CRF was evaluated with a 20-m shuttle run test. Insufficient dietary habits were greater in boys and girls classified as having low CRF than in their peers with healthy CRF. Skipping breakfast (odds ratio (OR), 0.82; 95% confidence interval (CI) 0.79–0.85), fast food consumption (OR, 0.70; 95% CI 0.68–0.72), and regular sweet intake (OR, 0.79; 95% CI 0.76–0.82) decreased the odds of having a healthy CRF level. An increase in age by 1 year (OR, 0.71; 95% CI, 0.70–0.72), overweight/obesity (OR, 0.30; 95% CI 0.29–0.31), and insufficient sleep duration (OR, 0.74; 95% CI 0.72–0.76) decreased the odds of a healthy CRF level, whereas sufficient dietary habits and adequate PA levels increased a participant’s odds of having a healthy CRF level, by 48% and 40%, respectively. Although the mechanisms via which CRF may be influenced by dietary habits remain unclear, health policy-makers should consider opportunities for improving both CRF and dietary habits.
Some products of commutators in an associative ring
Authors: Deryabina Galina , Krasilnikov Alexei
Published: October 2018

Let [Formula: see text] be a unital associative ring and let [Formula: see text] be the two-sided ideal of [Formula: see text] generated by all commutators [Formula: see text] [Formula: see text] where [Formula: see text], [Formula: see text] [Formula: see text]. It has been known that, if either [Formula: see text] or [Formula: see text] is odd, then [Formula: see text] for all [Formula: see text]. This was proved by Sharma and Srivastava in 1990 and independently rediscovered later (with different proofs) by various authors. The aim of our paper is to give a simple proof of the following result: if at least one of the integers [Formula: see text] is odd, then for all [Formula: see text], [Formula: see text] Since it has been known that, in general, [Formula: see text] our result cannot be improved further for all [Formula: see text] such that at least one of them is odd.
Quandle coloring conditions and zeros of the Alexander polynomials of Montesinos links
Authors: Ishikawa Katsumi
Published: October 2018

We give a simple condition for the existence of a nontrivial quandle coloring on a Montesinos link, which describes the distribution of the zeros of the Alexander polynomial. By this condition, we prove that the real parts of the zeros of the Alexander polynomial of any link that admits an alternating pretzel diagram are greater than [Formula: see text]: Hoste’s conjecture holds for such a link. Furthermore, we show the existence of infinitely many counterexamples for Hoste’s conjecture.