bluuebunny/crossref_metadata_2025 huggingface dataset:
High Frequency of OXA-253-Producing Acinetobacter baumannii in Different Hospitals in Recife, Brazil
Authors: de Sá Cavalcanti Felipe Lira , Mendes-Marques Carina Lucena , Vasconcelos Crhisllane Rafaele dos Santos , de Lima Campos Túlio , Rezende Antonio Mauro , Xavier Danilo Elias , Leal Nilma Cintra , de-Melo-Neto Osvaldo Pompilio , de Morais Marcia Maria Camargo , Leal-Balbino Tereza Cristina
Published: November 2016

Here, we report the isolation of 31
Acinetobacter baumannii
strains producing OXA-253 in a single large Brazilian city. These strains belonged to five different sequence types (STs), including 4 STs not previously associated with
bla
OXA-253
. In all strains, the
bla
OXA-253
gene was located in a plasmid within a genetic environment similar to what was found previously in Brazil and Italy. The reported data emphasize the successful transmission of the
bla
OXA-253
gene through a large area and the tendency for this resistance determinant to remain in the
A. baumannii
population.
Low Caspofungin Exposure in Patients in Intensive Care Units
Authors: van der Elst Kim C. M. , Veringa Anette , Zijlstra Jan G. , Beishuizen Albertus , Klont Rob , Brummelhuis-Visser Petra , Uges Donald R. A. , Touw Daan J. , Kosterink Jos G. W. , van der Werf Tjip S. , Alffenaar Jan-Willem C.
Published: November 2016

In critically ill patients, drug exposure may be influenced by altered drug distribution and clearance. Earlier studies showed that the variability in caspofungin exposure was high in intensive care unit (ICU) patients. The primary objective of this study was to determine if the standard dose of caspofungin resulted in adequate exposure in critically ill patients. A multicenter prospective study in ICU patients with (suspected) invasive candidiasis was conducted in the Netherlands from November 2013 to October 2015. Patients received standard caspofungin treatment, and the exposure was determined on day 3 of treatment. An area under the concentration-time curve from 0 to 24 h (AUC
0–24
) of 98 mg · h/liter was considered adequate exposure. In case of low exposure (i.e., <79 mg · h/liter, a ≥20% lower AUC
0–24
), the caspofungin dose was increased and the exposure reevaluated. Twenty patients were included in the study, of whom 5 had a positive blood culture. The median caspofungin AUC
0–24
at day 3 was 78 mg · h/liter (interquartile range [IQR], 69 to 97 mg · h/liter). A low AUC
0–24
(<79 mg · h/liter) was seen in 10 patients. The AUC
0–24
was significantly and positively correlated with the caspofungin dose in mg/kg/day (
P
= 0.011). The median AUC
0–24
with a caspofungin dose of 1 mg/kg was estimated using a pharmacokinetic model and was 114.9 mg · h/liter (IQR, 103.2 to 143.5 mg · h/liter). In conclusion, the caspofungin exposure in ICU patients in this study was low compared with that in healthy volunteers and other (non)critically ill patients, most likely due to a larger volume of distribution. A weight-based dose regimen is probably more suitable for patients with substantially altered drug distribution. (This study has been registered at ClinicalTrials.gov under registration no. NCT01994096.)
Tigecycline Nonsusceptibility Occurs Exclusively in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates, Including the Major Multidrug-Resistant Lineages O25b:H4-ST131-H
30
R and O1-ST648
Authors: Sato Toyotaka , Suzuki Yuuki , Shiraishi Tsukasa , Honda Hiroyuki , Shinagawa Masaaki , Yamamoto Soh , Ogasawara Noriko , Takahashi Hiroki , Takahashi Satoshi , Tamura Yutaka , Yokota Shin-ichi
Published: November 2016

Tigecycline (TGC) is a last-line drug for multidrug-resistant
Enterobacteriaceae
. We investigated the mechanism(s) underlying TGC nonsusceptibility (TGC resistant/intermediate) in
Escherichia coli
clinical isolates. The MIC of TGC was determined for 277 fluoroquinolone-susceptible isolates (ciprofloxacin [CIP] MIC, <0.125 mg/liter) and 194 fluoroquinolone-resistant isolates (CIP MIC, >2 mg/liter). The MIC
50
and MIC
90
for TGC in fluoroquinolone-resistant isolates were 2-fold higher than those in fluoroquinolone-susceptible isolates (MIC
50
, 0.5 mg/liter versus 0.25 mg/liter; MIC
90
, 1 mg/liter versus 0.5 mg/liter, respectively). Two fluoroquinolone-resistant isolates (O25b:H4-ST131-
H
30R and O125:H37-ST48) were TGC resistant (MICs of 4 and 16 mg/liter, respectively), and four other isolates of O25b:H4-ST131-
H
30R and an isolate of O1-ST648 showed an intermediate interpretation (MIC, 2 mg/liter). No TGC-resistant/intermediate strains were found among the fluoroquinolone-susceptible isolates. The TGC-resistant/intermediate isolates expressed higher levels of
acrA
and
acrB
and had lower intracellular TGC concentrations than susceptible isolates, and they possessed mutations in
acrR
and/or
marR
. The MICs of
acrAB
-deficient mutants were markedly lower (0.25 mg/liter) than those of the parental strain. After continuous stepwise exposure to CIP
in vitro
, six of eight TGC-susceptible isolates had reduced TGC susceptibility. Two of them acquired TGC resistance (TGC MIC, 4 mg/liter) and exhibited expression of
acrA
and
acrB
and mutations in
acrR
and/or
marR
. In conclusion, a population of fluoroquinolone-resistant
E. coli
isolates, including major extraintestinal pathogenic lineages O25b:H4-ST131-
H
30R and O1-ST648, showed reduced susceptibility to TGC due to overexpression of the efflux pump AcrAB-TolC, leading to decreased intracellular concentrations of the antibiotics that may be associated with the development of fluoroquinolone resistance.
Prevalence of Colistin Resistance Gene
mcr-1
and Absence of
mcr-2
in Escherichia coli Isolated from Healthy Food-Producing Animals in Japan
Authors: Kawanishi Michiko , Abo Hitoshi , Ozawa Manao , Uchiyama Mariko , Shirakawa Takahiro , Suzuki Satowa , Shima Ayaka , Yamashita Akifumi , Sekizuka Tsuyoshi , Kato Kengo , Kuroda Makoto , Koike Ryoji , Kijima Mayumi
Published: November 2016

We screened
mcr-1
and
mcr-2
genes in 9,306
Escherichia coli
strains isolated from healthy animals in the Japanese Veterinary Antimicrobial Resistance Monitoring (JVARM) system.
mcr-1
was detected in 39 strains (5, 20, and 14 strains isolated from cattle, swine, and broilers, respectively), whereas
mcr-2
was not detected.
mcr-2
was also not detected with the investigation sequence homology search against our curated GenEpid-J database.
Both
adhE
and a Separate NADPH-Dependent Alcohol Dehydrogenase Gene,
adhA
, Are Necessary for High Ethanol Production in Thermoanaerobacterium saccharolyticum
Authors: Zheng Tianyong , Olson Daniel G. , Murphy Sean J. , Shao Xiongjun , Tian Liang , Lynd Lee R.
Published: November 2016

Thermoanaerobacterium saccharolyticum
has been engineered to produce ethanol at about 90% of the theoretical maximum yield (2 ethanol molecules per glucose equivalent) and a titer of 70 g/liter. Its ethanol-producing ability has drawn attention to its metabolic pathways, which could potentially be transferred to other organisms of interest. Here, we report that the iron-containing AdhA is important for ethanol production in the high-ethanol strain of
T. saccharolyticum
(LL1049). A single-gene deletion of
adhA
in LL1049 reduced ethanol production by ∼50%, whereas multiple gene deletions of all annotated alcohol dehydrogenase genes except
adhA
and
adhE
did not affect ethanol production. Deletion of
adhA
in wild-type
T.
saccharolyticum
reduced NADPH-linked alcohol dehydrogenase (ADH) activity (acetaldehyde-reducing direction) by 93%.

IMPORTANCE
In this study, we set out to identify the alcohol dehydrogenases necessary for high ethanol production in
T. saccharolyticum
. Based on previous work, we had assumed that
adhE
was the primary alcohol dehydrogenase gene. Here, we show that both
adhA
and
adhE
are needed for high ethanol yield in the engineered strain LL1049. This is the first report showing
adhA
is important for ethanol production in a native
adhA
host, which has important implications for achieving higher ethanol yields in other microorganisms.
Imaging the Motility and Chemotaxis Machineries in Helicobacter pylori by Cryo-Electron Tomography
Authors: Qin Zhuan , Lin Wei-ting , Zhu Shiwei , Franco Aime T. , Liu Jun
Published: November 2016

Helicobacter pylori
is a bacterial pathogen that can cause many gastrointestinal diseases, including ulcers and gastric cancer. A unique chemotaxis-mediated motility is critical for
H. pylori
to colonize in the human stomach and to establish chronic infection, but the underlying molecular mechanisms are not well understood. Here, we employ cryo-electron tomography (cryo-ET) to reveal detailed structures of the
H. pylori
cell envelope, including the sheathed flagella and chemotaxis arrays. Notably,
H. pylori
possesses a distinctive periplasmic cage-like structure with 18-fold symmetry. We propose that this structure forms a robust platform for recruiting 18 torque generators, which likely provide the higher torque needed for swimming in high-viscosity environments. We also reveal a series of key flagellar assembly intermediates, providing structural evidence that flagellar assembly is tightly coupled with the biogenesis of the membrane sheath. Finally, we determine the structure of putative chemotaxis arrays at the flagellar pole, which have implications for how the direction of flagellar rotation is regulated. Together, our pilot cryo-ET studies provide novel structural insights into the unipolar flagella of
H. pylori
and lay a foundation for a better understanding of the unique motility of this organism.

IMPORTANCE
Helicobacter pylori
is a highly motile bacterial pathogen that colonizes approximately 50% of the world's population.
H. pylori
can move readily within the viscous mucosal layer of the stomach. It has become increasingly clear that its unique flagella-driven motility is essential for successful gastric colonization and pathogenesis. Here, we use advanced imaging techniques to visualize novel
in situ
structures with unprecedented detail in intact
H. pylori
cells. Remarkably,
H. pylori
possesses multiple unipolar flagella, which are driven by one of the largest flagellar motors found in bacteria. These large motors presumably provide the higher torque needed by the bacterial pathogens to navigate in the viscous environment of the human stomach.
Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis
Authors: Pearson R G , Clement R G E , Edwards K L , Scammell B E
Published: November 2016

Objectives

Systematic review and meta-analysis of published observational cohort studies. To quantify the increased risk smokers have of experiencing a delayed and/or non-union in fractures, spinal fusion, osteotomy, arthrodesis or established non-unions.

Setting

Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Allied and Complementary Medicine Database (AMED) and Web of Science Core Collection from 1966 to 2015.

Study eligibility criteria, participants and interventions

Observational cohort studies that reported adult smokers and non-smokers with delayed and/or non-union or time to union of the fracture, spinal fusion, osteotomy, arthrodesis or established non-union were eligible.

Data extraction and outcome measures

2 authors screen titles, abstracts and full papers. Data were extracted by 1 author and checked independently by a second. The relative risk ratios of smoking versus non-smoking and the mean difference in time to union patients developing a delayed and/or non-union were calculated.

Results

The search identified 3013 articles; of which, 40 studies were included. The meta-analysis of 7516 procedures revealed that smoking is linked to an increased risk of delayed and/or non-union. When considered collectively, smokers have 2.2 (1.9 to 2.6) times the risk of experiencing delayed and/or non-union. In all the subgroups, the increased risk was always ≥1.6 times that of non-smokers. In the patients where union did occur, it was a longer process in the smokers. The data from 923 procedures were included and revealed an increase in time to union of 27.7 days (14.2 to 41.3).

Conclusions

Smokers have twice the risk of experiencing a non-union after fracture, spinal fusion, osteotomy, arthrodesis or treatment of non-union. Time to union following fracture, osteotomy, arthrodesis or treatment of an established non-union is longer in smokers. Smokers should be encouraged to abstain from smoking to improve the outcome of these orthopaedic treatments.
Online Two Stage k-Search Problem and Its Competitive Analysis
Authors: Zhang Wenming , Zhang E. , Zheng Feifeng
Published: November 2016

This work investigates an online two stage k-search problem where an online player makes selections in two stages. In the first stage a number of more than k quoted prices are selected as candidates, and then exactly k highest quoted prices are chosen from the candidates in the second stage. The objective is to maximize the total profit of the k final accepted prices. We mainly propose a deterministic online algorithm and prove that it is optimal in competitiveness. A further discussion is given considering various relationships between the value of k and the number of candidates.
Weak-Rupture Degree of Graphs
Authors: Aslan Ersin
Published: November 2016

The rupture degree of a graph is a measure of the vulnerability of a graph. In this paper we investigate a refinement that involves the weak version of the parameter. The weak-rupture degree of a connected graph G is defined to be [Formula: see text] where [Formula: see text] is the number of the components of [Formula: see text] and [Formula: see text] is the number of edges of the largest component of [Formula: see text]. Like the rupture degree itself, this is a measure of the vulnerability of a graph, but it is more sensitive. This paper, the weak-rupture degree of some special graphs are obtained and some bounds of the weak-rupture degree are given. Moreover some results about the weak-rupture degree of graphs obtained by graph operations are given.
Neighbor Rupture Degree of Harary Graphs
Authors: Altundag Ferhan Nihan , Bacak-Turan Goksen
Published: November 2016

The vulnerability shows the endurance of the network until the communication collapse after the breakdown of certain stations or communication links. If a spy or a station is invaded in a spy network, then the adjacent stations are treacherous. A vulnerability parameter the neighbor rupture degree can be used to obtain the vulnerability of a spy network. The neighbor rupture degree of a noncomplete connected graph G is defined to be [Formula: see text] where S is any vertex subversion strategy of G, w(G/S) is the number of connected components in G/S, and c(G/S) is the maximum order of the components of G/S. In this paper, the neighbor rupture degree of Harary graphs are obtained.
A Note on Edge Isoperimetric Numbers and Regular Graphs
Authors: Bonnet Édouard , Sikora Florian
Published: November 2016

This note resolves an open problem asked by Bezrukov in the open problem session of IWOCA 2014. It shows an equivalence between regular graphs and graphs for which a sequence of invariants presents some symmetric property. We extend this result to a few other sequences.
Tunable power splitter based on MIM waveguide-rectangle cavity system with Kerr material
Authors: Chen Fang , Xu Yiping
Published: November 2016

A tunable power splitter based on metal-dielectric metal (MDM) waveguide coupled with rectangle cavity with Kerr nonlinear material is proposed. The power splitter properties are simulated by the finite-difference time-domain (FDTD) method [Y. H. Guo et al., Opt. Express 19 (2011) 13831–13838]. Simple theoretically analysis and numerically calculation demonstrate that the waveguide-rectangle cavity coupled system performs a tunable plasmonic power splitter. Additionally, the output power ratio can be efficiency tuned by varying the control light intensity. Results obtained by the coupled mode theory are consistent with those from the FDTD simulation. The plasmonic splitter may become a choice for the highly integrated optical circuits.
New model of the pinning potential barrier in layered HTc superconductors
Authors: Sosnowski J.
Published: November 2016

New model of the pinning potential barrier in multilayered HTc superconductors is presented, based on geometrical approach to the capturing interaction of pancake-type vortices with nano-sized defects. Using the above model the transport current flow phenomena in these materials, especially the current–voltage characteristics and critical current density, have been considered. Details of theoretical analysis are given, including the derivation of basic mathematical equations describing the potential barrier as a function of transport current intensity and the initial position of captured pancake vortex. Computer simulation has been performed of the influence of transport current amplitude on the potential barrier height for various sizes of pinning centers and initial pancake vortex position as well as the influence of fast neutrons irradiation creating nano-sized defects on critical current of HTc layered superconductor.
Parrondo Games with Two-Dimensional Spatial Dependence
Authors: Ethier S. N. , Lee Jiyeon
Published: November 2016

Parrondo games with one-dimensional (1D) spatial dependence were introduced by Toral and extended to the two-dimensional (2D) setting by Mihailović and Rajković. [Formula: see text] players are arranged in an [Formula: see text] array. There are three games, the fair, spatially independent game [Formula: see text], the spatially dependent game [Formula: see text], and game [Formula: see text], which is a random mixture or non-random pattern of games [Formula: see text] and [Formula: see text]. Of interest is [Formula: see text] (or [Formula: see text]), the mean profit per turn at equilibrium to the set of [Formula: see text] players playing game [Formula: see text] (or game [Formula: see text]). Game [Formula: see text] is fair, so if [Formula: see text] and [Formula: see text], then we say the Parrondo effect is present.

We obtain a strong law of large numbers (SLLN) and a central limit theorem (CLT) for the sequence of profits of the set of [Formula: see text] players playing game [Formula: see text] (or game [Formula: see text]). The mean and variance parameters are computable for small arrays and can be simulated otherwise. The SLLN justifies the use of simulation to estimate the mean. The CLT permits evaluation of the standard error of a simulated estimate. We investigate the presence of the Parrondo effect for both small arrays and large ones. One of the findings of Mihailović and Rajković was that “capital evolution depends to a large degree on the lattice size.” We provide evidence that this conclusion is partly incorrect. A paradoxical feature of the 2D game [Formula: see text] that does not appear in the 1D setting is that, for fixed [Formula: see text] and [Formula: see text], the mean function [Formula: see text] is not necessarily a monotone function of its parameters.
Knowledge Management in Criminal Investigations: The Case of Fraud Examiners
Authors: Gottschalk Petter
Published: November 2016

The activity of private investigations by fraud examiners is a business of lawyers, auditors and other professionals who investigate suspicions of financial crime by white-collar criminals. Private investigations represent an interesting and unique field of knowledge management. In this paper, a number of private internal investigation reports or cases are evaluated in terms of their knowledge management approaches. The core message from all cases evaluated is that a contingent knowledge management approach is needed in internal investigations. The situation should determine what kind of knowledge to apply in a specific investigative challenge. Legal knowledge seems to dominate many investigations, where forensic accounting knowledge and management consulting knowledge might have been more appropriate.
High-capacity quantum secure direct communication using hyper-entanglement of photonic qubits
Authors: Cai Jiarui , Pan Ziwen , Wang Tie-Jun , Wang Sihai , Wang Chuan
Published: November 2016

Hyper-entanglement is a system constituted by photons entangled in multiple degrees of freedom (DOF), being considered as a promising way of increasing channel capacity and guaranteeing powerful eavesdropping safeguard. In this work, we propose a coding scheme based on a 3-particle hyper-entanglement of polarization and orbital angular momentum (OAM) system and its application as a quantum secure direct communication (QSDC) protocol. The OAM values are specially encoded by Fibonacci sequence and the polarization carries information by defined unitary operations. The internal relations of the secret message enhances security due to principle of quantum mechanics and Fibonacci sequence. We also discuss the coding capacity and security property along with some simulation results to show its superiority and extensibility.
Control of price acceptability under the univariate Vasicek model
Authors: Dang-Nguyen S. , Rakotondratsimba Y.
Published: November 2016

The valuation of the probability of a financial contract to be lower or higher than a given price under the univariate Vasicek model is discussed in this paper. This price restriction can be justified by consistency reasons, since some prices may not be coherent on a financial point of view, e.g. they imply negative yields, or thought as unreachable by the asset manager. At first, assuming that the pricing functions is monotone, the price constraints are formulated in terms of a threshold on the value of the spot rate process. Since this process is Gaussian, these limits are reformulated in terms of a barrier of the Gaussian increments. Next, once the thresholds are identified, the probability to satisfy the price restriction after the generation of the spot rate at one future date can be computed. Then, assuming that the bounds on the spot rate are constant during a Monte-Carlo simulation, the probability of generating a path of this process that does not satisfy the constraint is valued using some results related to the hitting times. Lastly, the proposed approach is applied to various interest rates sensitive contracts and is illustrated by some numerical examples.
Integrated stratigraphy of a continental Pliensbachian–Toarcian Boundary (Lower Jurassic) section at Taskomirsay, Leontiev Graben, southwest Kazakhstan
Authors: Schnyder Johann , Pons Denise , Yans Johan , Tramoy Romain , Abdulanova Saya
Published: November 2016

During the Early Jurassic, major palaeoclimatic changes, associated with large carbon-cycle perturbations, occurred at the Pliensbachian–Toarcian boundary. Although the detailed marine palaeoclimatic record of this time interval and its impact on the marine biota is well recorded, much less is known about the continental realm. The current study documents new palynological and high-resolution carbon isotope data measured on bulk organic matter from the continental Lower Jurassic section of Taskomirsay in Kazakhstan, Central Asia. Both datasets allow a transition zone between the Pliensbachian and Toarcian to be identified. In addition, the spore and pollen distribution suggests a warming trend from the Pliensbachian to the Toarcian, most probably associated with a shift in floristic associations from the Siberian to the Sino-European palaeofloristic provinces, as recorded elsewhere in Central Asia during the Early Jurassic. The Taskomirsay section is thus of primary interest for palaeoclimatic studies as it is one of the very few well-dated continental section worldwide that records the Pliensbachian–Toarcian palaeoclimatic changes.

Supplementary material:
Table of δ
13
C
org
data, Taskomirsay section, Karatau Graben, Kazakhstan is available at
https://doi.org/10.6084/m9.figshare.c.3495645
Congestion-Aware MAC Layer Adaptation to Improve Video Telephony over Wi-Fi
Authors: Chen Wei , Ma Liangping , Shen Chien-Chung
Published: November 2016

In wireless networks such as those based on IEEE 802.11, packet losses due to fading and interference are often misinterpreted as indications of congestion by the congestion control protocol at higher layers, causing an unnecessary decrease in the data sending rate. For delay-constrained applications such as video telephony, packet losses may result in excessive artifacts or freeze in the decoded video. We propose a simple and yet effective mechanism to detect and reduce channel-caused packet losses by adjusting the retry limit parameter of the IEEE 802.11 protocol while taking into account the delay requirement of the traffic. Since the retry limit is left configurable in the IEEE 802.11 standard and does not require cross-layer coordination, our scheme can be easily implemented and incrementally deployed. Experimental results of applying the proposed scheme to a WebRTC-based real-time video communication prototype show significant performance gain compared to the case where the retry limit is configured statically.
A Nine Year Story of the India Software Engineering Conference from 2008 to 2016
Authors: Sharma Richa , Sureka Ashish
Published: November 2016

The India Software Engineering Conference (ISEC) is an annual conference in the field of Software Engineering (SE) in India. ISEC started in the year 2008 and completed 9 years in 2016. The ISEC conference has evolved into a high-quality academic event for SE researchers from universities and industry in India with considerable international participation. Assessment and evaluation of ISEC conference quality, status and evolution is important for the national SE scientific community, ISEC steering committee, sponsors and science and technology-related government bodies. In this paper, we conduct scientific paper publication mining and scientometric and bibliometric analysis of 9 years of ISEC publications and programs. We conduct an in-depth multi-dimensional analysis of the conference across various aspects such as a summary of 9 years of ISEC programs (paper submission data, tutorials, workshops, keynotes, invited talks, geographical location, program and general chairs), author-affiliation-based geographical contribution (analysis at the international and national levels), topic analysis, university and industry collaborations, contributions across university types in India, prolific and new authors, gender equality and imbalance, program committee characteristics, open-source or closed-source datasets and citation-based impact. We also present our recommendations for future editions of the ISEC based on our comprehensive analysis study presented in this paper.
Polymorphism of 41 kD Flagellin Gene and Its Human B-Cell Epitope inBorrelia burgdorferiStrains of China
Authors: Liu Huixin , Liu Wei , Hou Xuexia , Zhang Lin , Hao Qin , Wan Kanglin
Published: November 2016

The 41 kD flagellin ofBorrelia burgdorferi (B. burgdorferi)is a major component of periplasmic flagellar filament core and a good candidate for serodiagnosis in early stage of Lyme disease. Here, we chose 89B. burgdorferistrains in China, amplified the gene encoding the 41 kD flagellin, and compared the sequences. The results showed that genetic diversity presented in the 41 kD flagellin genes of all 89 strains among the four genotypes ofB. burgdorferi, especially in the genotype ofB. garinii. Some specific mutation sites for each genotype of the 41 kD flagellin genes were found, which could be used for genotypingB. burgdorferistrains in China. Human B-cell epitope analysis showed that thirteen of 15 nonsynonymous mutations occurred in the epitope region of 41 kD flagellin and thirty of 42 B-cell epitopes were altered due to all 13 nonsynonymous mutations in the epitope region, which may affect the function of the antigen. Nonsynonymous mutations and changed human B-cell epitopes exist in 41 kD flagellin ofB. burgdorferi sensu latostrains; these changes should be considered in serodiagnosis of Lyme disease.
An Integrated Method of Supply Chains Vulnerability Assessment
Authors: Liu Jiaguo , Liu Fan , Zhou Huan , Kong Yudan
Published: November 2016

Supply chain vulnerability identification and evaluation are extremely important to mitigate the supply chain risk. We present an integrated method to assess the supply chain vulnerability. The potential failure mode of the supply chain vulnerability is analyzed through the SCOR model. Combining the fuzzy theory and the gray theory, the correlation degree of each vulnerability indicator can be calculated and the target improvements can be carried out. In order to verify the effectiveness of the proposed method, we use Kendall’s tau coefficient to measure the effect of different methods. The result shows that the presented method has the highest consistency in the assessment compared with the other two methods.
Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy
Authors: Santos Lopes Sofia , Furtado Andrea , Oliveira Rita , Cebola Ana , Graça Bruno , Ferreira Coelho Manuel , Ferrito Fernando , Gomes Carrasquinho
Published: November 2016

Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.
CD4+T Cell Fate in Glomerulonephritis: A Tale of Th1, Th17, and Novel Treg Subtypes
Authors: Krebs Christan F. , Steinmetz Oliver M.
Published: November 2016

Multiple studies have identified CD4+T cells as central players of glomerulonephritis (GN). Cells of the Th1 and Th17 responses cause renal tissue damage, while Tregs mediate protection. Recently, a high degree of plasticity among these T cell lineages was proposed. During inflammation, Th17 cells were shown to have the potential of transdifferentiation into Th1, Th2, or alternatively anti-inflammatory Tr1 cells. Currently available data from studies in GN, however, do not indicate relevant Th17 to Th1 or Th2 conversion, leaving the Th17 cell fate enigmatic. Tregs, on the other hand, were speculated to transdifferentiate into Th17 cells. Again, data from GN do not support this concept. Rather, it seems that previously unrecognized subspecialized effector Treg lineages exist. These include Th1 specific Treg1 as well as Th17 directed Treg17 cells. Furthermore, a bifunctional Treg subpopulation was recently identified in GN, which secrets IL-17 and coexpresses Foxp3 together with the Th17 characteristic transcription factor RORγt. Similarities between these different and highly specialized effector Treg subpopulations with the corresponding T helper effector cell lineages might have resulted in previous misinterpretation as Treg transdifferentiation. In summary, Th17 cells have a relatively stable phenotype during GN, while, in the case of Tregs, currently available data suggest lineage heterogeneity rather than plasticity.
Clinical Effects of the Probing Method with Depth Gauge for Determining the Screw Depth of Locking Proximal Humeral Plate
Authors: Jin Lin , Guo Jialiang , Guo Junfei , Yin Yingchao , Hou Zhiyong , Zhang Yingze
Published: November 2016

Background. The use of locking plates has gained popularity to treat proximal humeral fractures. However, the complication rates remain high. Biomechanical study suggested that subchondral screw-tip abutment significantly increased the stability of plant. We present a simple method to obtain the proper screw length through the depth gauge in elderly patients and compared the clinical effects with traditional measuring method.Methods. 40 patients were separated into two groups according to the two surgical methods: the probing method with depth gauge and the traditional measuring method. The intraoperative indexes and postoperative complications were recorded. The Constant and Murley score was used for the functional assessment in the 12th month.Results. Operative time and intraoperative blood loss indicated no statistical differences. X-ray exposure time and the patients with screw path penetrating the articular cartilage significantly differed. Postoperative complications and Constant and Murley score showed no statistical differences.Conclusions. Probing method with depth gauge is an appropriate alternative to determine the screw length, which can make the screw-tip adjoin the subchondral bone and keep the articular surface of humeral head intact and at the same time effectively avoid frequent X-ray fluoroscopy and adjusting the screws.
Increased Blood Pressure Variability Is Associated with Worse Neurologic Outcome in Acute Anterior Circulation Ischemic Stroke
Authors: de Havenon Adam , Bennett Alicia , Stoddard Gregory J. , Smith Gordon , Wang Haimei , Wold Jana , Chung Lee , Tirschwell David L. , Majersik Jennifer J.
Published: November 2016

Background. Although research suggests that blood pressure variability (BPV) is detrimental in the weeks to months after acute ischemic stroke, it has not been adequately studied in the acute setting. Methods. We reviewed acute ischemic stroke patients from 2007 to 2014 with anterior circulation stroke. Mean blood pressure and three BPV indices (standard deviation, coefficient of variation, and successive variation) for the intervals 0–24, 0–72, and 0–120 hours after admission were correlated with follow-up modified Rankin Scale (mRS) in ordinal logistic regression models. The correlation between BPV and mRS was further analyzed by terciles of clinically informative stratifications. Results. Two hundred and fifteen patients met inclusion criteria. At all time intervals, increased systolic BPV was associated with higher mRS, but the relationship was not significant for diastolic BPV or mean blood pressure. This association was strongest in patients with proximal stroke parent artery vessel occlusion and lower mean blood pressure. Conclusion. Increased early systolic BPV is associated with worse neurologic outcome after ischemic stroke. This association is strongest in patients with lower mean blood pressure and proximal vessel occlusion, often despite endovascular or thrombolytic therapy. This hypothesis-generating dataset suggests potential benefit for interventions aimed at reducing BPV in this patient population.
Quercetin Isolated from Toona sinensis Leaves Attenuates Hyperglycemia and Protects Hepatocytes in High-Carbohydrate/High-Fat Diet and Alloxan Induced Experimental Diabetic Mice
Authors: Zhang Yali , Dong Huanhuan , Wang Mimi , Zhang Jingfang
Published: November 2016

The development of diabetes mellitus is related to oxidant stress induced by a high carbohydrate/high-fat diet (HFD). Quercetin, as a major bioactive component in Toona sinensis leaves (QTL), is a natural antioxidant. However, the exact mechanism by which QTL ameliorate diabetes mellitus is still unknown. In this study, we investigated the hypoglycemic effects and hepatocytes protection of QTL on HFD and alloxan induced diabetic mice. Intragastric administration of QTL significantly reduced body weight gain, serum glucose, insulin, total cholesterol, triglyceride, low density lipoprotein-cholesterol, alanine aminotransferase, and aspartate aminotransferase serum levels compared to those of diabetic mice. Furthermore, it significantly attenuated oxidative stress, as determined by lipid peroxidation, nitric oxide content, and inducible nitric oxide synthase activity and as a result attenuated liver injury. QTL also significantly suppressed the diabetes-induced activation of the p65/NF-κB and ERK1/2/MAPK pathways, as well as caspase-9 and caspase-3 levels in liver tissues of diabetic mice. Finally, micrograph analysis of liver samples showed decreased cellular organelle injury in hepatocytes of QTL treated mice. Taken together, QTL can be viewed as a promising dietary agent that can be used to reduce the risk of diabetes mellitus and its secondary complications by ameliorating oxidative stress in the liver.
Overexpression of MMP-3 and uPA with Diminished PAI-1 Related to Metastasis in Ductal Breast Cancer Patients Attending a Public Hospital in Mexico City
Authors: Barajas-Castañeda Luis Miguel , Cortés-Gutiérrez Evelin , García-Rodríguez Francisco Mario , Campos-Rodríguez Rafael , Lara-Padilla Eleazar , Enríquez-Rincón Fernando , Castro-Mussot María Eugenia , Figueroa-Arredondo Paula
Published: November 2016

Extracellular matrix metalloproteases and the fibrinolytic system are important protease systems interacting with each other in charge of remodeling and recycling of tissues. Their role in tumor invasion and metastasis is often discussed. In this study several metalloproteases such as MMP-1, MMP-3, MMP-9, and TIMP-1 together with molecules from the fibrinolytic system like uPA, its receptor uPAR, and its inhibitor, PAI-1, were studied by immune-histochemistry to establish a comparison with and without metastasis. From the (118) primary tumors of Mexican patients with ductal breast cancer studied, 56% were grade II and 69% were size T2; the group with metastatic ganglia included 64 samples (54.3%). In patients with metastasis the estimated expression of MMP-3 and uPA (resp., 28% and 45%) was higher than that from no metastatic tumors; it means there is higher expression of both markers in metastatic tumors (p<0.05). At the same time, metastatic tumors showed statistically significant lower signal of PAI-1 (24%) than tumors without metastasis (p<0.05). We concluded that overexpression of MMP-3 and uPA, altogether with diminished expression of PAI-1 from metastatic tumors, might be a crucial step towards metastasis in ductal breast cancer. Nevertheless, additional studies in different populations are necessary to establish a pattern.
Influence of Surface Properties on Adhesion Forces and Attachment ofStreptococcus mutansto ZirconiaIn Vitro
Authors: Yu Pei , Wang Chuanyong , Zhou Jinglin , Jiang Li , Xue Jing , Li Wei
Published: November 2016

Zirconia is becoming a prevalent material in dentistry. However, any foreign bodies inserted may provide new niches for the bacteria in oral cavity. The object of this study was to explore the effect of surface properties including surface roughness and hydrophobicity on the adhesion and biofilm formation ofStreptococcus mutans(S. mutans) to zirconia. Atomic force microscopy was employed to determine the zirconia surface morphology and the adhesion forces between theS. mutansand zirconia. The results showed that the surface roughness was nanoscale and significantly different among tested groups (P<0.05): Coarse (23.94±2.52 nm) > Medium (17.00±3.81 nm) > Fine (11.89±1.68 nm). The contact angles of the Coarse group were the highest, followed by the Medium and the Fine groups. Increasing the surface roughness and hydrophobicity resulted in an increase of adhesion forces and early attachment (2 h and 4 h) ofS. mutanson the zirconia but no influence on the further development of biofilm (6 h~24 h). Our findings suggest that the surface roughness in nanoscale and hydrophobicity of zirconia had influence on theS. mutansinitial adhesion force and early attachment instead of whole stages of biofilm formation.
Identification of Five NovelSalmonellaTyphi-Specific Genes as Markers for Diagnosis of Typhoid Fever Using Single-Gene Target PCR Assays
Authors: Goay Yuan Xin , Chin Kai Ling , Tan Clarissa Ling Ling , Yeoh Chiann Ying , Ja’afar Ja’afar Nuhu , Zaidah Abdul Rahman , Chinni Suresh Venkata , Phua Kia Kien
Published: November 2016

SalmonellaTyphi (S. Typhi) causes typhoid fever which is a disease characterised by high mortality and morbidity worldwide. In order to curtail the transmission of this highly infectious disease, identification of new markers that can detect the pathogen is needed for development of sensitive and specific diagnostic tests. In this study, genomic comparison ofS. Typhi with other enteric pathogens was performed, and 6S. Typhi genes, that is, STY0201, STY0307, STY0322, STY0326, STY2020, and STY2021, were found to be specificin silico. Six PCR assays each targeting a unique gene were developed to test the specificity of these genesin vitro. The diagnostic sensitivities and specificities of each assay were determined using 39S. Typhi, 62 non-TyphiSalmonella, and 10 non-Salmonellaclinical isolates. The results showed that 5 of these genes, that is, STY0307, STY0322, STY0326, STY2020, and STY2021, demonstrated 100% sensitivity (39/39) and 100% specificity (0/72). The detection limit of the 5 PCR assays was 32 pg for STY0322, 6.4 pg for STY0326, STY2020, and STY2021, and 1.28 pg for STY0307. In conclusion, 5 PCR assays using STY0307, STY0322, STY0326, STY2020, and STY2021 were developed and found to be highly specific at single-gene target resolution for diagnosis of typhoid fever.
Integration of Novel Agents into the Care of Patients with Multiple Myeloma
Authors: Orlowski Robert Z. , Lonial Sagar
Published: November 2016

The pace of therapeutic drug development in multiple myeloma has reached unprecedented levels, with five regulatory approvals for relapsed and/or refractory disease of either new drugs or new drug regimens in 2015, one already in 2016, and still others anticipated. This has provided a wide array of options to be considered by patients and their health care providers in the event of relapse after or progression on front-line therapy. Most of these agents are currently being evaluated in earlier patient populations, including as parts of induction, consolidation, and maintenance therapy approaches, where their benefits may be even greater. Moreover, additional randomized studies have been completed with our previous stable of novel agents that inform their use in these settings as well. In the current contribution to this CCR Focus on multiple myeloma, we will present an overview of some of the key recent data that have supported the addition of these new therapeutics to our armamentarium against multiple myeloma. Also, we will provide some guidelines about possible best practices in applying these regimens and attempt to extrapolate how they will be used as parts of our future standards of care. Clin Cancer Res; 22(22); 5443–52. ©2016 AACR.

See all articles in this CCR Focus section, “Multiple Myeloma: Multiplying Therapies.”
Gene Expression Profiles in Myeloma: Ready for the Real World?
Authors: Szalat Raphael , Avet-Loiseau Herve , Munshi Nikhil C.
Published: November 2016

Multiple myeloma is a plasma cell malignancy characterized by molecular and clinical heterogeneity. The outcome of the disease has been dramatically improved with the advent of new drugs in the past few years. However, even in this context of increasing therapeutic options, important challenges remain, such as accurately evaluating patients' prognosis and predicting sensitivity to specific treatments and drug combinations. Transcriptomic studies have largely contributed to help decipher multiple myeloma complexity, characterizing multiple myeloma subgroups distinguished by different outcomes. Microarrays and, more recently, RNA sequencing allow evaluation of expression of coding and noncoding genes, alternate splicing events, mutations, and novel transcriptome modifiers, providing new information regarding myeloma biology, prognostication, and therapy. In this review, we discuss the role and impact of gene expression profiling studies in myeloma. Clin Cancer Res; 22(22); 5434–42. ©2016 AACR.

See all articles in this CCR Focus section, “Multiple Myeloma: Multiplying Therapies.”
Multilayered Closure of Cerebrospinal Fluid Rhinorrhea with Inlay Fascia Lata, Autologous Fat, and Outlay Fascia Lata: Our Experience
Authors: Eryılmaz Mehmet Akif , Arıcıgil Mitat , Alan Mehmet Akif
Published: November 2016

Background/Aims: Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition. Methods: In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (CSF) rhinorrhea. Results and Conclusion: Twenty-one CSF rhinorrhea patients were operated with this technique in our hospital. Two patients had large skull base defects and 15 patients had high-flow CSF leaks. We reached a 100% success rate in the first attempt without any long-term recurrence. Multilayered endoscopic closure with this technique offers satisfactory results with minimal morbidity even in large defects and high-flow CSF leaks.
Association Between Long-Term Blood Pressure Variability and 10-Year Progression in Arterial Stiffness
Authors: Tedla Yacob G. , Yano Yuichiro , Carnethon Mercedes , Greenland Philip
Published: November 2016

Experimental studies conducted on animal and human endothelium suggested that higher systolic blood pressure (SBP) variability reduces bioavailability of nitric oxide and increases vascular smooth muscle cell proliferation. These vascular wall changes could stiffen the arterial wall. Using data from the Multiethnic Study of Atherosclerosis, we investigated the association between long-term SBP variability and 10-year percent change in arterial stiffness among 1122 individuals (mean age 57 years, 46% males at baseline) who were not taking antihypertensive medications. Within-individual standard deviation, variability independent of the mean, and coefficient of variation of SBP across 5 visits were used to capture long-term SBP variability. Carotid arterial stiffness was measured using distensibility coefficient and Young’s elastic modulus at baseline and after a mean of 9.5 years of follow-up (visit 5). In a multivariate linear regression model, individuals in the fifth quintile as compared with those in the first quintile of standard deviation, variability independent of the mean, and coefficient of variation of SBP had a 9.8% (95% confidence interval [CI] −17.0%, −2.7%), 6.4% (95% CI −13.2%, 0.4%), and 8.7% (95% CI −15.4%, −1.9%) higher decline in distensibility coefficient and a 27.5% (95% CI 15.8%, 39.3%), 25.8% (95% CI 14.7%, 36.9%), and 27.9% (95% CI 16.8%, 39.1%) higher progression in Young’s elastic modulus, respectively, after 10 years of follow-up. Linear trends in the decline of distensibility coefficient and progression of Young’s elastic modulus were observed across the quintiles of SBP variability indices. These findings suggest that higher long-term SBP variability may be a risk factor for arterial stiffness progression independent of mean BP.