bluuebunny/crossref_metadata_2025 huggingface dataset:
How to perform posterior wall isolation in catheter ablation for atrial fibrillation
Authors: Sugumar Hariharan , Thomas Stuart P. , Prabhu Sandeep , Voskoboinik Aleksandr , Kistler Peter M.
Published: November 2017

Catheter ablation has become standard of care in patients with symptomatic atrial fibrillation (AF). Although there have been significant advances in our understanding and technology, a substantial proportion of patients have ongoing AF requiring repeat procedures. Pulmonary vein isolation (PVI) is the cornerstone of AF ablation; however, it is less effective in patients with persistent as opposed to paroxysmal atrial fibrillation. Left atrial posterior wall isolation (PWI) is commonly performed as an adjunct to PVI in patients with persistent AF with nonrandomized studies showing improved outcomes. Anatomical considerations and detailed outline of the various approaches and techniques to performing PWI are detailed, and advantages and pitfalls to assist the clinical electrophysiologist successfully and safely complete PWI are described.
Effects of circulating member B of the family with sequence similarity 3 on the risk of developing metabolic syndrome and its components: A 5‐year prospective study
Authors: Wang Haoyu , Yu Fadong , Zhang Zhuo , Hou Yuanyuan , Teng Weiping , Shan Zhongyan , Lai Yaxin
Published: November 2017

Aims/Introduction

Member B of the family with sequence similarity 3 (FAM3B), also known as pancreatic‐derived factor, is mainly synthesized and secreted by islet β‐cells, and plays a role in abnormal metabolism of glucose and lipids. However, the prospective association of FAM3B with metabolic disorders remains unclear. The present study aimed to reveal the predictive relationship between pancreas‐specific cytokine and metabolic syndrome (MetS).

Materials and Methods

A total of 210 adults (88 men and 122 women) without MetS, aged between 40 and 65 years, were recruited and received a comprehensive health examination. Baseline serum FAM3B levels were determined by sandwich enzyme‐linked immunosorbent assay. Subsequently, all participants underwent a follow‐up examination after 5 years. MetS was identified in accordance with the International Diabetes Federation criteria.

Results

During follow up, 35.7% participants developed MetS. In comparison with the non‐MetS group, participants with MetS had an increased serum FAM3B at baseline (21.85 ng/mL [19.38, 24.17 ng/mL] vs 28.56 ng/mL [25.32, 38.10 ng/mL], P < 0.001). Moreover, serum FAM3B was significantly associated with variations in fasting plasma insulin (r = −0.306, P < 0.001), homeostasis model assessment of β‐cell function (r = −0.328, P < 0.001) and homeostasis model assessment of insulin resistance (r = −0.191, P = 0.006). Furthermore, a positive correlation between baseline FAM3B and the incidence of MetS was observed, even after multivariable adjustment (relative risk 1.23 [1.15, 1.31], P < 0.001). Furthermore, the optimal cut‐off values of FAM3B was 23.98 ng/mL for predicting MetS based on the Youden Index.

Conclusions

Elevated circulating FAM3B might be considered as a predictor of newly‐onset MetS and its progression.
Incremental Material Flow Analysis with Bayesian Inference
Authors: Lupton Richard C. , Allwood Julian M.
Published: November 2017

Material flow analysis (MFA) is widely used to study the life cycles of materials from production, through use, to reuse, recycling, or disposal, in order to identify environmental impacts and opportunities to address them. However, development of this type of analysis is often constrained by limited data, which may be uncertain, contradictory, missing, or over‐aggregated.

This article proposes a Bayesian approach, in which uncertain knowledge about material flows is described by probability distributions. If little data is initially available, the model predictions will be rather vague. As new data is acquired, it is systematically incorporated to reduce the level of uncertainty.

After reviewing previous approaches to uncertainty in MFA, the Bayesian approach is introduced, and a general recipe for its application to material flow analysis is developed. This is applied to map the global production of steel using Markov Chain Monte Carlo simulations. As well as aiding the analyst, who can get started in the face of incomplete data, this incremental approach to MFA also supports efforts to improve communication of results by transparently accounting for uncertainty throughout.
Prioritizing Consumption‐Based Carbon Policy Based on the Evaluation of Mitigation Potential Using Input‐Output Methods
Authors: Wood Richard , Moran Daniel , Stadler Konstantin , Ivanova Diana , Steen‐Olsen Kjartan , Tisserant Alexandre , Hertwich Edgar G.
Published: November 2017

Carbon footprints aim to engage consumers in contributing to climate‐change mitigation. Consumption‐oriented policy measures attempt to cause voluntary or incentivized interventions that reduce environmental impact through the supply chain by utilizing demand drivers. A large body of life cycle assessment studies describe how specific actions can reduce the environmental footprint of an individual or household. However, these assessments are often conducted with a narrow focus on particular goods and processes. Here, we formalize a counterfactual method and operational tool for scoping the potential impact of such actions, focusing on economy‐wide impact. This “quickscan” tool can model shifts and reductions in demand, rebound effects (using marginal expenditure), changes in domestic and international production recipes, and reductions in the environmental intensity of production. This tool provides quick, macro‐level estimates of the efficacy of consumer‐oriented policy measures and can help to prioritize relevant policies. We demonstrate the method using two case studies on diet and clothing using the EXIOBASE3 multiregional input‐output database, giving spatially explicit information on where environmental impact reductions of the interventions occur, and where impacts may increase in the case of rebounds.
Examining polyquaternium polymers deposition on human excised hair fibers
Authors: Shokri Javad , Shamseddini Lori Maryam , Monajjemzadeh Farnaz
Published: November 2017

Background

Polyquaterniums (PQs) as important ingredients of hair products are synthetic cationic polymers and are used in commercial hair volumizers and conditioners.

Methods

Three different grades of polymers including PQ 87, 68, and 46 with various concentrations were used, and their hair deposition efficacy was measured at 5 different pH values using hair diameters measurements by digital micrometer. Deposition durability of polymer layer on the hair surface was tested by a defined washing test. Optical microscopic images and polarized light images were also taken from treated and untreated samples for further investigation. Attenuated total reflectance (ATR) spectral were recorded from hair samples to prove the polymer deposition and probable interaction with hair fibers.

Results

PQ‐68 with the highest molecular weight (300 kDa) at pH = 9 exhibited the best hair deposition efficacy. The results revealed that the deposition of polymers is directly proportional to the pH values. The best results were seen at pH = 9, and at the lowest pH (pH = 5), the efficiency of polymers was approximately equal to zero. The best resistance against washing was shown by PQ‐44 at pH = 6. ATR successfully tracked the presence of the polymers on the hair fibers and also proposed specific wave numbers for each polymeric agent, individually.

Conclusions

In general, two main parameter which can mainly influence the deposition efficacy of PQs are the type of polymer or its molecular weight and also the positive charge density on the polymer molecules.
Body size and risk of atrial fibrillation: a cohort study of 1.1 million young men
Authors: Andersen K. , Rasmussen F. , Neovius M. , Tynelius P. , Sundström J.
Published: November 2017

Background

Whilst tall stature has been related to lower risk of vascular disease, it has been proposed as a risk factor for atrial fibrillation. Little is known about other anthropometric measures and their joint effects on risk of atrial fibrillation.

Objectives

We aim to investigate associations and potential joint effects of height, weight, body surface area (BSA) and body mass index (BMI) with risk of atrial fibrillation.

Methods

In a cohort covering 1 153 151 18‐year‐old men participating in the Swedish military conscription (1972–1995), Cox regression was used to investigate associations of height, weight, BSA and BMI with risk of atrial fibrillation.

Results

During a median of 26.3 years of follow‐up, higher height was associated with higher risk of atrial fibrillation (hazard ratio [HR] 2.80; 95% CI 2.63–2.98; for 5th vs. 1st quintile) and so was larger BSA (HR 3.05; 95% CI 2.82–3.28; for 5th vs. 1st quintile). Higher weight and BMI were to a lesser extent associated with risk of atrial fibrillation (BMI: 1.42; 95% CI 1.33–1.52, for 5th vs. 1st quintile). We found a multiplicative joint effect of height and weight. Adjusting for muscle strength, exercise capacity and diseases related to atrial fibrillation attenuated these measures.

Conclusions

Higher height and weight are strongly associated with higher risk of atrial fibrillation. These associations are multiplicative and independent of each other and are summarized in a strong association of body surface area with risk of atrial fibrillation. The mechanisms remain unknown but may involve increased atrial volume load with larger body size.
Empowering public service workers to face bystander conflict: Enhancing resources through a training intervention
Authors: van Erp Kim J. P. M. , Gevers Josette M. P. , Rispens Sonja , Demerouti Evangelia
Published: November 2017

Public service employees work in occupations that are accompanied with high psychosocial risks. Police, firefighters, and paramedics are increasingly being confronted with argumentative, conflicting bystanders that frustrate them in executing their task. We developed a resource‐enhancement intervention and tested its usefulness for securing employees’ effective functioning and well‐being in bystander conflict. In a simulation‐based pre‐test post‐test control group design, paramedics in the intervention condition received training about how to increase their resources in terms of conflict management efficacy, perspective taking, task support, and emotional support. For those in the control condition, no such training was provided. Comparing pre‐ and post‐test measures (n = 81) of the participants in the intervention and control groups, we found evidence that the intervention successfully increased employees’ resources over time. Moreover, we found considerable support for a positive link between these resources and employees’ affective well‐being and job dedication. Thus, our study suggests that a resource‐enhancing intervention can serve as an important means to protect public service employees against the deleterious effects of bystander conflict.

Practitioner points

A resource‐enhancing intervention can protect public service employees against the deleterious effects of bystander conflict.

Resources related to dealing with a hindering bystander, as well as resources facilitating the continuation of the primary task, are positively associated with employees’ affective well‐being, job dedication, and job performance.
Inflammatory and metabolic responses to an intramammary lipopolysaccharide challenge in early lactating cows supplemented with conjugated linoleic acid
Authors: Gross J. J. , Grossen‐Rösti L. , Héritier R. , Tröscher A. , Bruckmaier R. M.
Published: November 2017

Supplementation of dairy cows with trans‐10, cis‐12 conjugated linoleic acid (CLA) allows nutrient repartitioning despite an energy deficiency in early lactation, which might be a benefit for the immune system, too. In this study, we investigated potential nutrient sparing effects of CLA in early lactating cows with low plasma glucose concentrations exposed to an intramammary lipopolysaccharide (LPS) challenge. Fifteen multiparous Holstein cows were exposed to an intramammary LPS challenge in week 4 p.p. Eight cows (CLA) were supplemented daily with 70 g of lipid‐encapsulated CLA (6.8 g trans‐10, cis‐12 and 6.6 g of the cis‐9, trans‐11 CLA isomer; CLA) and seven cows with 56 g of control fat (CON). Blood samples were obtained every 30 min along with rectal temperature, heart and respiratory rate, and milk samples were taken hourly until 10 hr after the LPS application. Plasma was analysed for concentrations of glucose, free fatty acids, beta‐hydroxybutyrate (BHB), cortisol, insulin and glucagon. In milk, somatic cell count and activity of lactate dehydrogenase were determined. Initial plasma glucose concentration was lower in CLA than in CON. During the immunostimulation, CLA had higher glucose concentrations than CON, and BHB decreased distinctly in CLA, whereas CON cows maintained BHB concentration at a lower level. Body temperature in CLA increased earlier, the difference between peak and basal temperature was higher, and the decline thereafter occurred earlier. In conclusion, CLA supplementation of early lactating cows exposed to an intramammary LPS challenge affected local and systemic immune responses. We assume that CLA supplementation triggered glycogen storage. Cows supplemented with CLA provided more glucose and preferentially used BHB as an energy source during the immune response. The more intense metabolic and more concentrated endocrine responses support an immunomodulatory effect of CLA supplementation.
A comparative meta‐analysis on the relationship of faecal calcium and phosphorus excretion in mammals
Authors: Böswald L. F. , Dobenecker B. , Clauss M. , Kienzle E.
Published: November 2017

To investigate the relationship between faecal calcium (Ca) and phosphorus (P) excretion in different mammalian species, a meta‐analysis on digestibility data derived from the literature was conducted. Seventy‐three studies on carnivores, omnivores, large and small hindgut fermenters, ruminants and hippos (a total of 21 mammalian species, precondition for inclusion dietary Ca/P ratio 1.5/1 – 3.0/1) were analysed for Ca and P digestibility. Dietary Ca/P ratios were lower than faecal Ca/P ratios in carnivores, omnivores, ruminants and hippos. In hindgut fermenters, dietary Ca/P ratios were higher than faecal Ca/P ratios, indicating higher intestinal Ca absorption in these species. In all species investigated, there was a significant positive relationship between Ca intake and faecal Ca excretion and between P intake and faecal P excretion. In the biologically relevant range, these equations predicted lower faecal Ca losses in hindgut fermenters than ruminants, for faecal P vice versa. In all species, faecal Ca and P excretion correlated significantly. In carnivores, this highly linear correlation was exceptionally strong (R² = .92). Yet, the linearity of the correlation was questionable in omnivores and ruminants. Possibly, the strong linear correlation of faecal Ca and P excretion in carnivores is due to the formation of insoluble Ca/P complexes in their relatively short and simple gastrointestinal tract. Another hypothesis is that in carnivores, Ca homeostasis relies on modifying bone turnover to a higher degree than on changes in intestinal Ca absorption. For the formation of bone matrix, a constant ratio of Ca and P absorption is of advantage.
The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya: A cohort study
Authors: Ngari Moses M. , Thitiri Johnstone , Mwalekwa Laura , Timbwa Molline , Iversen Per Ole , Fegan Greg W. , Berkley James A.
Published: November 2017

The effects of rickets on children recovery from severe acute malnutrition (SAM) are unknown. Rickets may affect both growth and susceptibility to infectious diseases. We investigated the associations of clinically diagnosed rickets with life‐threatening events and anthropometric recovery during 1 year following inpatient treatment for complicated SAM. This was a secondary analysis of clinical trial data among non‐human immunodeficiency virus‐infected Kenyan children with complicated SAM (2–59 months) followed for 1 year posthospital discharge (ClinicalTrials.gov ID NCT00934492). The outcomes were mortality, hospital readmissions, and growth during 12 months. The main exposure was clinically diagnosed rickets at baseline. Of 1,778 children recruited, 230 (12.9%, 95% CI [11.4, 14 .6]) had clinical signs of rickets at baseline. Enrolment at an urban site, height‐for‐age and head circumference‐for‐age z scores were associated with rickets. Rickets at study enrolment was associated with increased mortality (adjusted Hazard Ratio [aHR] 1.61, 95% CI [1.14, 2.27]), any readmission (aHR 1.37, 95% CI [1.09, 1.72]), readmission for severe pneumonia (aHR 1.37, 95% CI [1.05, 1.79]), but not readmission with diarrhoea (aHR 1.05, 95% CI [0.73, 1.51]). Rickets was associated with increased height gain (centimetres), adjusted regression coefficient 0.19 (95% CI [0.10, 0.28]), but not changes in head circumference, mid‐upper arm circumference, or weight. Rickets was common among children with SAM at urban sites and associated with increased risks of severe pneumonia and death. Increased height gain may have resulted from vitamin D and calcium treatment. Future work should explore possibility of other concurrent micronutrient deficiencies and optimal treatment of rickets in this high‐risk population.
Workplace bullying and burnout among healthcare employees: The moderating effect of control‐related resources
Authors: Livne Yael , Goussinsky Ruhama
Published: November 2017

Workplace bullying is a widespread and challenging problem in healthcare organizations, bearing negative consequences for individuals and organizations. Drawing on the job demands–resources theory, in this study, we examined the relationship between workplace bullying and burnout among healthcare employees, as well as the moderating role of job autonomy and occupational self‐efficacy in this relationship. Using a cross‐sectional design with anonymous questionnaires, data were collected from two samples of 309 healthcare employees in a mental health facility, and 105 nurses studying for their bachelor degree in health systems administration. The findings indicated that workplace bullying was positively related to burnout dimensions, and that this relationship was moderated by job autonomy and occupational self‐efficacy resources. Job autonomy interacted with workplace bullying in predicting emotional exhaustion and depersonalization; the interaction of bullying with occupational self‐efficacy significantly predicted depersonalization. These results underscore the importance of control‐related resources in mitigating the harmful effects of workplace bullying on employees. Implications for research and managerial practices are discussed.
Optimization analysis of the factors affecting the soil arching effect between landslide stabilizing piles
Authors: He Guo‐Feng , Li Zhi‐Guang , Yuan Ying , Li Xue‐Hua , Hu Long‐Hu , Zhang Yun
Published: November 2017

To enhance the effective control of landslides, it is important for practitioners to consider the effectiveness of soil arching. The aim of this paper is to analyze the order of importance of the factors that affect the soil arching effect and determine their optimal combination for the design of landslide stabilizing piles. First a plane‐strain finite element model was established to investigate the soil arching effect. Then, the orthogonal test method was used to perform a multilevel analysis. The results show that for one row of piles, the top three factors are uniform load, pile spacing, and interfacial strength parameters, while for two rows of piles, the top three are pile spacing, Poisson's ratio, and row spacing. At last, the optimal combination is determined. The proposed method represents a new and effective approach to determine the major and minor factors and their optimal combination, which can reduce costs and contribute to the control of landslides.

Summary for Managers

It is efficiency to use orthogonal method. The orthogonal test is used to reduce the number of trials in the case of a variety of factors and a variety of levels of tests. This method requires fewer experiments to achieve the same results as comprehensive experiments.

The PLAXIS finite element software is used to simulate the arching effect in soil mass. PLAXIS is a finite element calculation program for the analysis of deformation and stability of geotechnical engineering.

The importance order is determined by computing the range value, and the optimal combination is determined by comparing the sum of all combinations’ index value.
New trace fossil evidence for eurypterid swimming behaviour
Authors: Vrazo Matthew B. , Ciurca Samuel J.
Published: November 2017

We describe a recently discovered trace fossil from a eurypterid Konservat‐Lagerstätte in the upper Silurian Tonoloway Formation of Pennsylvania, and formally describe contemporaneous traces from the Williamsville Formation Lagerstätte of Ontario. The traces from both localities are assigned here to Arcuites bertiensis igen. et isp. nov. Based on comparisons with previously described eurypterid trackways, neoichnological experiments, and the co‐occurrence with eurypterid remains, Arcuites is interpreted as having been made by the swimming leg (sixth prosomal appendage) of swimming juvenile to adult eurypteroid eurypterids, and represents the first unambiguous trace fossil evidence for eurypterid swimming behaviour. The morphology of Arcuites indicates that eurypteroid eurypterids swam using drag‐based rowing, whereby the animal propelled itself forward by moving its oar blade‐like swimming paddles in an in‐phase backstroke. Arcuites morphology also indicates that the eurypteroid swimming appendage had a greater degree of movement than was previously suggested, and a revised rowing model is proposed. Differences in the abundance of A. bertiensis in the Tonoloway and Williamsville formations suggest a bathymetric control on eurypterid swimming behaviour and trace production. The association of Arcuites with eurypterid body fossils in both units indicates that these Lagerstätten were autochthonous assemblages and provides additional evidence for eurypterid inhabitation of shallow subtidal marine environments in the late Silurian.
Plant organ senescence – regulation by manifold pathways
Authors: Wojciechowska N. , Sobieszczuk‐Nowicka E. , Bagniewska‐Zadworna A.
Published: November 2017

Senescence is the final stage of plant ontogeny before death. Senescence may occur naturally because of age or may be induced by various endogenous and exogenous factors. Despite its destructive character, senescence is a precisely controlled process that follows a well‐defined order. It is often inseparable from programmed cell death (PCD), and a correlation between these processes has been confirmed during the senescence of leaves and petals. Despite suggestions that senescence and PCD are two separate processes, with PCD occurring after senescence, cell death responsible for senescence is accompanied by numerous changes at the cytological, physiological and molecular levels, similar to other types of PCD. Independent of the plant organ analysed, these changes are focused on initiating the processes of cellular structural degradation via fluctuations in phytohormone levels and the activation of specific genes. Cellular structural degradation is genetically programmed and dependent on autophagy. Phytohormones/plant regulators are heavily involved in regulating the senescence of plant organs and can either promote [ethylene, abscisic acid (ABA), jasmonic acid (JA), and polyamines (PAs)] or inhibit [cytokinins (CKs)] this process. Auxins and carbohydrates have been assigned a dual role in the regulation of senescence, and can both inhibit and stimulate the senescence process. In this review, we introduce the basic pathways that regulate senescence in plants and identify mechanisms involved in controlling senescence in ephemeral plant organs. Moreover, we demonstrate a universal nature of this process in different plant organs; despite this process occurring in organs that have completely different functions, it is very similar. Progress in this area is providing opportunities to revisit how, when and which way senescence is coordinated or decoupled by plant regulators in different organs and will provide a powerful tool for plant physiology research.
When Does Government Listen to the Public? Voluntary Associations and Dynamic Agenda Representation in the United States
Authors: Bevan Shaun , Rasmussen Anne
Published: November 2017

The aim of the article is to examine how the population size of voluntary associations affects the process through which the public's issue priorities are translated into policy priorities. We conduct a time series analysis of political attention in executive and legislative agendas at the U.S. federal level in the period 1971–2001, covering all issues addressed by the U.S. government. We show that the number of voluntary associations in a policy area has a positive conditioning effect on the link between public priorities and attention for the president's State of the Union Address. However, our results do not find a positive effect for voluntary associations at later stages of the policy cycle, which experience a higher degree of institutional friction. The findings underline the importance of distinguishing between different stages of policymaking when considering the impact of voluntary associations on dynamic agenda responsiveness.
Unions, Parties, and the Politics of State Government Legacy Cost
Authors: DiSalvo Daniel , Kucik Jeffrey
Published: November 2017

Many American state governments have made extensive promises to pay for employees’ health care and other benefits in retirement. Currently estimated at over $1 trillion in unfunded liabilities, these other postemployment benefits (OPEB) are creating a major fiscal problem for state governments. In this article, we examine the politics of OPEB. We seek to explain the variation in the generosity of OPEB across U.S. states. We argue that party competition theories do not adequately explain the outcomes we observe. Instead, we draw on the emerging Schattschneiderian approach to the politics of public policy to show that public union strength conditions a party's incentives to represent unions’ interests. In states where public sector unions are strong, unions can find their way into either party's coalition. We find that Republicans are more responsive to public union interests than either their ideological brand or prior research would suggest. It is only in states where public employees are weak that Republicans can act unilaterally and enact their preference for less government spending. To test our theories, we carry out an empirical analysis using a newly assembled data set of per capita OPEB liabilities across 49 states.
State Agencies’ Use of Administrative Data for Improved Practice: Needs, Challenges, and Opportunities
Authors: Allard Scott W. , Wiegand Emily R. , Schlecht Colleen , Datta A. Rupa , Goerge Robert M. , Weigensberg Elizabeth
Published: November 2017

Growing interest in the use of administrative data to answer questions around program implementation and effectiveness has led to greater discussion of how government agencies can develop the necessary internal data infrastructure, analytic capacity, and office culture. However, there is a need for more systematic research into how states find different pathways and strategies to build administrative data capacity. Drawing on interviews with almost 100 human service agency staff and their data partners, the authors examine the realities of administrative data use. They summarize the experiences of data users in order to address two main challenges: limited analytic capacity and challenges to linking or sharing data resources. The article concludes by examining a range of approaches that government agencies take to improve data quality and capacity to analyze that data.
Bridging the gap for future clinician‐educators
Authors: Dilly Christen K , Carlos W Graham , Hoffmann‐Longtin Krista , Buckley John , Burgner Anna
Published: November 2017

Background

In contrast to the training required in the UK, opportunities for medical education training in the USA are limited. Resident‐as‐teacher programmes are typically insufficient to prepare trainees to be successful clinician‐educators, but few pursue formal education degrees. We sought to assess the need for, and feasibility of, a training pathway for subspecialty fellows in a large Department of Medicine that would prepare our trainees to become effective educators.

Methods

Quantitative and qualitative methods were used. Previous fellowship applicants and current programme directors were surveyed to determine the potential benefits of the programme. A pilot programme was conducted with fellows interested in education to determine the feasibility of the programme. Pilot participants were interviewed regarding the benefits that they gained from the pilot and the logistical challenges that they experienced.

In contrast to the training required in the UK, opportunities for medical education training in the USA are limited

Results

Five highly ranked fellows would have scored our programmes higher if we offered this training pathway. Pilot participants and fellowship programme directors agreed that there is a compelling need for such a training pathway. A number of themes arose from the interviews that enabled us to build the framework for a strong programme.

Discussion

Our findings suggest that a clinician‐educator training pathway that draws from multiple subspecialties has the potential to improve recruitment, provide needed career counselling and skills development to trainees, and to build a community of educators that will benefit the institution. Important insights from pilot participant interviews will inform the programme design, in order to keep trainees engaged and overcome logistical challenges.
Deceased organ donor screening for human immunodeficiency virus, hepatitis B virus and hepatitis C virus: Discordant serology and nucleic acid testing results
Authors: Theodoropoulos Nicole , Nowicki Marek J. , Chinchilla‐Reyes Claudia , Dionne Sara , Jaramillo Andrés , Mone Tom , Hasz Richard , Jendrisak Martin D. , Ladner Daniela P. , Ison Michael G.
Published: November 2017

Background

Before the 2014 policy change pertaining to infectious disease screening, many organ procurement organizations (OPOs) were supplementing serologic screening of deceased organ donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV‐1), hepatitis B virus (HBV), and hepatitis C virus (HCV). The number of seronegative, NAT‐positive donors has not been directly measured.

Methods

HIV, HBV, and HCV screening results of 11 229 donor referrals evaluated from 2010 to 2013 were obtained from 3 OPO‐affiliated laboratories, capturing 35% of all donors in the United States. Laboratories used either polymerase chain reaction assay or transcription‐mediated amplification assay to test 9643 deceased donors by NAT.

Results

The NAT results were positive in 21 (0.2%), 1 (0.02%), and 11 (0.1%) donors who were seronegative for HIV, HBV, and HCV, respectively. All discordant HIV‐1 results were from one laboratory using a polymrease chain reaction assay. Thirteen of the reactive HIV NAT results in seronegative referrals were repeated and were non‐reproducibly positive (NRP). Ten (0.1%), 452 (7.8%), and 197 (2.2%) of HIV‐, HBV‐, and HCV‐seropositive donors, respectively, were negative by NAT.

Conclusions

This study highlights the importance of robust quality assurance to minimize NRP NAT results. NAT may allow for increased utilization of organs from HBV‐ and HCV‐seropositive, NAT‐negative donors.
Structural breaks, dynamic correlations, and hedge and safe havens for stock and foreign exchange markets in Greater China
Authors: Dong Xiyong , Yoon Seong‐Min
Published: November 2017

This study investigates the dynamic relationship and hedging strategy between stock and foreign exchange markets in Greater China for the period 22 July 2005 to 30 November 2015. Using the DCC‐GARCH model with and without structural breaks, the results provide strong evidence of negative time‐varying correlations between these two markets in Greater China, consistent with the “stock‐oriented” models of exchange rates. Moreover, adding structural breaks reduces the degree of volatility persistence for all considered markets and can provide more accurate hedge and safe haven properties of the US dollar against Greater China stock markets. The findings have several important implications for portfolio risk managers, international investors and policymakers.
Hypoxia‐induced intestinal barrier changes in balloon‐assisted enteroscopy
Authors: Lee Tsung‐Chun , Huang Yi‐Chen , Lu Yen‐Zhen , Yeh Yu‐Chang , Yu Linda Chia‐Hui
Published: November 2017

Key points

Balloon‐assisted enteroscopy (BAE) is an emerging standard procedure by utilizing distensible balloons to facilitate deep endoscopy in the small and large intestine. Sporadic cases of bacteraemia were found after BAE.

Balloon distension by BAE caused gut tissue hypoxia. The impact of balloon distension‐induced hypoxia on intestinal barriers remains unclear.

Murine models of BAE by colonic balloon distension showed that short‐ and long‐term hypoxia evoked opposite effects on epithelial tight junctions (TJs). Short‐term hypoxia fortified TJ integrity, whereas long‐term hypoxia caused damage to barrier function.

Our data showed for the first time the molecular mechanisms and signalling pathways of epithelial barrier fortification and TJ reorganization by short‐term hypoxia for the maintenance of gut homeostasis.

The findings suggest avoiding prolonged balloon distension during BAE to reduce the risk of hypoxia‐induced gut barrier dysfunction.

Balloon‐assisted enteroscopy (BAE) is an emerging standard procedure that uses distensible balloons to facilitate deep endoscopy. Intestines are known to harbour an abundant microflora. Whether balloon distension causes perturbation of blood flow and gut barrier dysfunction, and elicits risk of bacterial translocation remains unknown. Our aims were to (1) conduct a prospective study to gather microbiological and molecular evidence of bacterial translocation by BAE in patients, (2) establish a murine model of colonic balloon distension to investigate tissue hypoxia and intestinal barrier, and (3) assess the effect of short‐ and long‐term hypoxia on epithelial permeability using cell lines. Thirteen patients were enrolled for BAE procedures, and blood samples were obtained before and after BAE for paired comparison. Four of the 13 patients (30.8%) had positive bacterial DNA in blood after BAE. Post‐BAE endotoxaemia was higher than the pre‐BAE level. Nevertheless, no clinical symptom of sepsis or fever was reported. To mimic clinical BAE, mice were subjected to colonic balloon distension. Local tissue hypoxia was observed during balloon inflation, and reoxygenation after deflation. A trend of increased gut permeability was seen after long‐term distension, whereas a significant reduction of permeability was observed by short‐term distension in the proximal colon. Human colonic epithelial Caco‐2 cells exposed to hypoxia for 5–20 min exhibited increased tight junctional assembly, while those exposed to longer hypoxia displayed barrier disruption. In conclusion, sporadic cases of bacteraemia were found after BAE, without septic symptoms. Short‐term hypoxia by balloon distension yielded a protective effect whereas long‐term hypoxia caused damage to the gut barrier.
Free Vibration of Doubly Curved Thin Shells
Authors: Bryan April
Published: November 2017

While several numerical approaches exist for the vibration analysis of thin shells, there is a lack of analytical approaches to address this problem. This is due to complications that arise from coupling between the midsurface and normal coordinates in the transverse differential equation of motion (TDEM) of the shell. In this research, an Uncoupling Theorem for solving the TDEM of doubly curved, thin shells with equivalent radii is introduced. The use of the uncoupling theorem leads to the development of an uncoupled transverse differential of motion for the shells under consideration. Solution of the uncoupled spatial equation results in a general expression for the eigenfrequencies of these shells. The theorem is applied to four shell geometries, and numerical examples are used to demonstrate the influence of material and geometric parameters on the eigenfrequencies of these shells.
Statistical Uncertainty Analysis in Time-Domain Fatigue Assessment of Steel Risers
Authors: da Costa Rodrigo C. , Sagrilo Luis. V. S.
Published: November 2017

This paper addresses the statistical uncertainty in long-term fatigue damage in offshore structures due to the short-term simulation length used in time domain analysis of stresses. The paper focuses on steel risers applications. A new simulation-based estimator for the variance of the short-term fatigue damage is presented. The proposed estimator is based on a variation of the original nonparametric bootstrap. It works with blocks of data instead of discrete values, in order to better account for the autocorrelation of the stress cycles in the stress time series. This versatile estimator can be applied in time-domain fatigue analyses to assess the variance of the fatigue damage using a single stress time series and does not require any previous assumptions on the stochastic stress process.
Temporal effects in interaural and sequential level difference perception
Authors: Laback Bernhard , Dietz Mathias , Joris Philip
Published: November 2017

Temporal effects in interaural level difference (ILD) perception are not well understood. While it is often assumed that ILD sensitivity is independent of the temporal stimulus properties, a reduction of ILD sensitivity for stimuli with a high modulation rate has been reported (known under the term binaural adaptation). Experiment 1 compared ILD thresholds and sequential-level-difference (SLD) thresholds using 300-ms bandpass-filtered pulse trains (centered at 4 kHz) with rates of 100, 400, and 800 pulses per second (pps). In contrast to the SLD thresholds, ILD thresholds were elevated at 800 pps, consistent with literature data that had previously been attributed to binaural adaptation. Experiment 2 showed better ILD sensitivity for pulse trains than for pure tones, suggesting that amplitude modulation enhances ILD sensitivity. The present ILD data and binaural adaptation data from the literature were predicted by a model combining well-established auditory periphery front-ends with an interaural comparison stage. The model also accounted for other published ILD data, including target ILD thresholds in diotic forward and backward fringes and ILD thresholds with different amounts of interaural correlation. Overall, a variety of temporal effects in ILD perception, including binaural adaptation, appear to be largely attributable to monaural peripheral auditory processing.
Improving Health Behaviors and Outcomes: An Intervention to Support Engagement in Physical Activity
Authors: Houghton Laura J. , Knowles Zoe R.
Published: November 2017

The purpose of this case study is to offer reflections on the personal experiences, processes of behavioral change; and subsequent outcomes of designing and implementing a collaborative exercise psychology intervention. The intervention, based on Bandura’s (1977) Self Efficacy Theory and using self-efficacy related behavior change techniques (Michie et al., 2015), aimed to provide families affected by health inequalities with opportunities to enhance their understanding of health and make positive behavioral changes. This case is based around one female client aged 48 years of age who took part in the project with her ten-year-old daughter. Pre-intervention the client was engaging in minimal levels of weekly physical activity and reported poor self-rated mental well-being. Through improvements in self-efficacy, achieved through opportunities on the project, the client was able to make notable improvements to her physical activity levels leading to significant weight loss and improvements in mental well-being. From the practitioners’ perspective, reflection on areas for future work within the field of exercise psychology, particularly guidance on developing effective client-practitioner relationships with ‘hard-to-reach’ individuals and groups is warranted. More consideration for the suitability of the PA guidelines for individuals with poor physical and mental health is also required.
Azithromycin Pharmacodynamics against Persistent Haemophilus influenzae in Chronic Obstructive Pulmonary Disease
Authors: Tsuji Brian T. , Fisher James , Boadi-Yeboah Raheal , Holden Patricia N. , Sethi Sanjay , Pettigrew Melinda M. , Murphy Timothy F.
Published: November 2017

The pharmacodynamic profile of azithromycin against persistent strains of nontypeable
Haemophilus influenzae
(NTHi) from chronic obstructive pulmonary disease (COPD) patients was characterized. Azithromycin displayed differential concentration-dependent activities (
R
2
≥ 0.988); the pharmacodynamic response was attenuated when we compared the “first” and “last” strains of NTHi that persisted in the airways of the same patient for 819 days (the 50% effective concentration [EC
50
] increased more than 50 times [0.0821 mg/liter versus 4.23 mg/liter]). In the hollow-fiber infection model, NTHi viability was maintained throughout simulated azithromycin (Zithromax) Z-Pak regimens over 10 days.
Increasing Antimicrobial Resistance in Nontyphoidal Salmonella Isolates in Australia from 1979 to 2015
Authors: Williamson Deborah A. , Lane Courtney R. , Easton Marion , Valcanis Mary , Strachan Janet , Veitch Mark G. , Kirk Martyn D. , Howden Benjamin P.
Published: November 2017

Australia has high and increasing rates of salmonellosis. To date, the serovar distribution and associated antimicrobial resistance (AMR) patterns of nontyphoidal
Salmonella enterica
(NTS) in Australia have not been assessed. Such information provides critical knowledge about AMR in the food chain and informs decisions about public health. We reviewed longitudinal data on NTS in two Australian states over a 37-year period, between 1979 and 2015, and antimicrobial resistance since 1984. Overall, 17% of isolates were nonsusceptible to at least one antimicrobial, 4.9% were nonsusceptible to ciprofloxacin, and 0.6% were nonsusceptible to cefotaxime. In total, 2.5% of isolates were from invasive infections, with no significant difference in AMR profiles between invasive and noninvasive isolates. Most isolates with clinically relevant AMR profiles were associated with travel, particularly to Southeast Asia, with multiple “incursions” of virulent and resistant clones into Australia. Our findings represent the largest longitudinal surveillance system for NTS in Australia and provide valuable public health knowledge on the trends and distribution of AMR in NTS. Ongoing surveillance is critical to identify local emergence of resistant isolates.
Antibacterial and Sterilizing Effect of Benzylpenicillin in Tuberculosis
Authors: Deshpande Devyani , Srivastava Shashikant , Bendet Paula , Martin Katherine R. , Cirrincione Kayle N. , Lee Pooi S. , Pasipanodya Jotam G. , Dheda Keertan , Gumbo Tawanda
Published: November 2017

The modern chemotherapy era started with Fleming's discovery of benzylpenicillin. He demonstrated that benzylpenicillin did not kill
Mycobacterium tuberculosis
. In this study, we found that >64 mg/liter of static benzylpenicillin concentrations killed 1.16 to 1.43 log
10
CFU/ml below starting inoculum of extracellular and intracellular
M. tuberculosis
over 7 days. When we added the β-lactamase inhibitor avibactam, benzylpenicillin maximal kill (
E
max
) of extracellular log-phase-growth
M. tuberculosis
was 6.80 ± 0.45 log
10
CFU/ml at a 50% effective concentration (EC
50
) of 15.11 ± 2.31 mg/liter, while for intracellular
M. tuberculosis
it was 2.42 ± 0.14 log
10
CFU/ml at an EC
50
of 6.70 ± 0.56 mg/liter. The median penicillin (plus avibactam) MIC against South African clinical
M. tuberculosis
strains (80% either multidrug or extensively drug resistant) was 2 mg/liter. We mimicked human-like benzylpenicillin and avibactam concentration-time profiles in the hollow-fiber model of tuberculosis (HFS-TB). The percent time above the MIC was linked to effect, with an optimal exposure of ≥65%. At optimal exposure in the HFS-TB, the bactericidal activity in log-phase-growth
M. tuberculosis
was 1.44 log
10
CFU/ml/day, while 3.28 log
10
CFU/ml of intracellular
M. tuberculosis
was killed over 3 weeks. In an 8-week HFS-TB study of nonreplicating persistent
M. tuberculosis
, penicillin-avibactam alone and the drug combination of isoniazid, rifampin, and pyrazinamide both killed >7.0 log
10
CFU/ml. Monte Carlo simulations of 10,000 preterm infants with disseminated disease identified an optimal dose of 10,000 U/kg (of body weight)/h, while for pregnant women or nonpregnant adults with pulmonary tuberculosis the optimal dose was 25,000 U/kg/h, by continuous intravenous infusion. Penicillin-avibactam should be examined for effect in pregnant women and infants with drug-resistant tuberculosis, to replace injectable ototoxic and teratogenic second-line drugs.
Generation of Bacteriophage-Insensitive Mutants of Streptococcus thermophilus via an Antisense RNA CRISPR-Cas Silencing Approach
Authors: McDonnell Brian , Mahony Jennifer , Hanemaaijer Laurens , Kouwen Thijs R. H. M. , van Sinderen Douwe
Published: November 2017

Predation of starter lactic acid bacteria such as
Streptococcus thermophilus
by bacteriophages is a persistent and costly problem in the dairy industry. CRISPR-mediated
b
acteriophage
i
nsensitive
m
utants (BIMs), while straightforward to generate and verify, can quickly be overcome by mutant phages. The aim of this study was to develop a tool allowing the generation of derivatives of commercial
S. thermophilus
strains which are resistant to phage attack through a non-CRISPR-mediated mechanism, with the objective of generating BIMs exhibiting stable resistance against a range of isolated lytic
S. thermophilus
phages. To achieve this, standard BIM generation was complemented by the use of the wild-type (WT) strain which had been transformed with an antisense mRNA-generating plasmid (targeting a crucial CRISPR-associated [
cas
] gene) in order to facilitate the generation of non-CRISPR-mediated BIMs. Phage sensitivity assays suggest that non-CRISPR-mediated BIMs exhibit some advantages compared to CRISPR-mediated BIMs derived from the same strain.

IMPORTANCE
The outlined approach reveals the presence of a powerful host-imposed barrier for phage infection in
S. thermophilus
. Considering the detrimental economic consequences of phage infection in the dairy processing environment, the developed methodology has widespread applications, particularly where other methods may not be practical or effective in obtaining robust, phage-tolerant
S. thermophilus
starter strains.