bluuebunny/crossref_metadata_2025 huggingface dataset:
Text Message Quality Improvement Project for Influenza Vaccine in a Low-Resource Largely Latino Pediatric Population
Authors: Sloand Elizabeth , VanGraafeiland Brigit , Holm Annie , MacQueen Augusta , Polk Sarah
Published: March 2019

Children with asthma are targeted for influenza vaccine because of their vulnerability to complications, particularly those with low income or family preference for Spanish language. We used text messaging to encourage caregivers to vaccinate. Participants were children (aged >6 months), predominantly low income and Latino, with an asthma diagnosis attending a pediatric clinic. Interactive text messages that described the vaccine and how to make an appointment were sent to parents in English or Spanish, January 2016 to April 2017. Year 1 messages were evaluated by the investigators considering vaccination results and evidence in the literature. Improvements for Year 2 included timing of message, clarity of message, and using the family language of preference. Messages went to 398 (Year 1) and 485 (Year 2) families. Sixty-four percent of families preferred English; 35% preferred Spanish. Children in Spanish-speaking families were significantly more likely than children in English-speaking families to be vaccinated, 66% versus 46%. Text messaging is a straightforward, low-cost health promotion strategy with potential to improve child health. Quality improvement efforts in outpatient settings with low-income and limited English proficiency families are needed. mHealth strategies may help address the needs of vulnerable populations. SQUIRE V.2.0 guidelines were used for manuscript writing and reporting.
Bridge to Transplant with Ventricular Assist Device Support in Pediatric Patients with Single Ventricle Heart Disease
Authors: Chen Sharon , Rosenthal David N. , Murray Jenna , Dykes John C. , Almond Christopher S. , Yarlagadda Vamsi V. , Wright Gail , Navaratnam Manchula , Reinhartz Olaf , Maeda Katsuhide
Published: March 2019

Ventricular assist device (VAD) support for children with single ventricle (SV) heart disease remains challenging. We performed a single-center retrospective review of SV patients on VAD support and examined survival to transplant using the Kaplan–Meier method. Patients transplanted were compared with those who died on support. Between 2009 and 2017, there were 14 SV patients with 1,112 patient-days of VAD support. Stages of palliation included pre-Glenn (n = 5), Glenn (n = 5), and Fontan (n = 4). Eight patients (57%) were successfully bridged to transplant at a median 107 days. Deaths occurred early (n = 6, median 16 days) and in smaller patients (10.1 vs. 28.3 kg, P = 0.04). All Fontan patients survived to transplant, whereas only 20% of Glenn patients survived to transplant. Adverse events occurred in 79% (n = 11). Five patients met hospital discharge criteria, with two patients (one pre-Glenn, one Glenn) discharged and transplanted after 219 and 174 days of VAD support. All transplanted patients were discharged at a median 21 days posttransplant. SV patients in various stages of palliation can be successfully bridged to transplant with VAD support. With use of intracorporeal continuous-flow devices, longer-term support and hospital discharge are possible.
Prognostic Factors for Survival After Extracorporeal Membrane Oxygenation for Cardiogenic Shock
Authors: Huang Mingjie , Ong Boon Hean , Hoo Anne Ean Ean , Gao Fei , Chao Victor Tar Toong , Lim Chong Hee , Tan Teing Ee , Sin Kenny Yoong Kong
Published: March 2019

The aim of this study is to examine factors that can predict mortality in patients that have veno-arterial extracorporeal membrane oxygenation (VA-ECMO) instituted for cardiogenic shock. A single-center, retrospective study of 127 patients who underwent VA-ECMO for cardiogenic shock between January 2003 and December 2017 was conducted. Eighty-three (65%) patients survived to weaning or bridging therapy. Complications on VA-ECMO include: hemorrhage (40%), stroke (14%), requirement for dialysis (42%), and limb ischemia (24%). Univariate analysis revealed shorter ECMO duration, higher body mass index, preimplantation creatinine > 100 mmol/l, lower preimplantation serum albumin, and the development of stroke or limb ischemia on ECMO to be significantly associated with mortality while on ECMO. Multivariate analysis by logistic regression found shorter ECMO duration and lower preimplantation serum albumin to be significantly associated with mortality. VA-ECMO is an effective strategy in treating patients with cardiogenic shock and provides a reasonable chance of survival to weaning or bridging to other therapy. Preimplantation hypoalbuminemia, preimplantation serum creatinine > 100 mmol/l, and the development of stroke and limb ischemia while on VA-ECMO are strongly associated with mortality.
A somatic missense mutation in GNAQ causes capillary malformation
Authors: Bichsel Colette , Bischoff Joyce
Published: March 2019

Purpose of review

Capillary malformations, the most common type of vascular malformation, are caused by a somatic mosaic mutation in GNAQ, which encodes the Gαq subunit of heterotrimeric G-proteins. How the single amino acid change – predicted to activate Gαq – causes capillary malformations is not known but recent advances are helping to unravel the mechanisms.

Recent findings

The GNAQ R183Q mutation is present not only in endothelial cells isolated from skin and brain capillary malformations but also in brain tissue underlying the capillary malformation, raising questions about the origin of capillary malformation-causing cells. Insights from computational analyses shed light on the mechanisms of constitutive activation and new basic science shows Gαq plays roles in sensing shear stress and in regulating cerebral blood flow.

Several studies confirm the GNAQ R183Q mutation in 90% of nonsyndromic and Sturge–Weber syndrome (SWS) capillary malformations. The mutation is enriched in endothelial cells and blood vessels isolated from skin, brain, and choroidal capillary malformations, but whether the mutation resides in other cell types must be determined. Further, the mechanisms by which the R183Q mutation alters microvascular architecture and blood flow must be uncovered to develop new treatment strategies for SWS in particular, a devastating disease for which there is no cure.
Systemic Epstein-Barr Virus-positive T-Cell Lymphoma of Childhood Presentation With Hemophagocytosis
Authors: Hung Giun-Yi , Yu Ting-Yen , Yen Hsiu-Ju , Yang Ching-Fen , Lin Li-Yih , Horng Jiun-Lin
Published: March 2019

A 2-year-old Asian girl presented to our facility for the evaluation of thrombocytopenia. She was treated with intravenous immunoglobulin under the impression of immune thrombocytopenia. However, her body temperature spiked and progressive pancytopenia, hepatosplenomegaly, abnormal liver function, coagulopathy, and pulmonary infiltration developed. The final diagnosis was systemic Epstein-Barr virus (EBV)-positive T-cell lymphoma of childhood with hemophagocytic syndrome. This type of cancer is extremely rare but occurs more commonly in Asians. Its prognosis is generally poor, and a treatment strategy is yet to be established. Double staining for EBV-encoded RNA and CD3 or CD8 is crucial for diagnosis. This type of lymphoma must be diagnosed differentially from acute EBV-associated hemophagocytic lymphohistiocytosis, which is considered nonmalignant. This case report highlights the importance of awareness of this type of rare cancer, a comprehensive diagnostic approach, and close communication between primary care physicians and pathologists.
Severe Factor X Deficiency Presenting as Febrile Seizure in an Infant
Authors: Garg Meenal , Ramzan Mohammed , Kumawat Anand , Mittal Jaikrishan , Katewa Satyendra , Gupta Piyush
Published: March 2019

Factor X deficiency is a severe inherited coagulation disorder, which is characterized by severe systemic bleeding manifestations in affected individuals. It is a rare disorder with a frequency of around 1:1,000,000 in the general population. We present the case of an infant with factor X deficiency who presented with complex febrile seizure. Although febrile seizures are very common in children, a closer scrutiny leads to neuroimaging and finding of intracranial bleed. Hematologic and genetic investigations confirmed the diagnosis. A high index of suspicion should be maintained to diagnose uncommon bleeding disorders in children.
Practice Structure and Locomotor Learning After Stroke
Authors: Helm Erin E. , Pohlig Ryan T. , Kumar Devina S. , Reisman Darcy S.
Published: March 2019

Background and Purpose:

The optimal characteristics of learning to promote recovery of walking have yet to be defined for the poststroke population. We examined characteristics of task practice that limit or promote learning of a novel locomotor pattern.

Methods:

Thirty-two persons with chronic hemiparesis were randomized to 2 conditions (constant and variable practice) and participated in two 15-minute sessions of split-belt treadmill walking. On day 1, subjects in the constant condition walked on the split-belt treadmill at a constant 2:1 speed ratio, while subjects in the variable condition walked on the split-belt treadmill at 3 different speed ratios. On day 2, both groups participated in 15 minutes of split-belt treadmill walking at the 2:1 speed ratio. Step length and limb phase symmetry metrics were measured to assess within-session learning (ie, adaptation) on day 1 and the ability to retain this new pattern of walking (ie, retention) on day 2.

Results:

The amount of adaptation on day 1 did not differ depending upon practice structure (constant and variable) for step length or limb phase (a)symmetry. The magnitude of reduction in asymmetry from day 1 to day 2 did not differ between groups for step and limb phase (a)symmetry.

Discussion and Conclusions:

The results suggest that variable practice utilizing alternating belt speed ratios does not influence the ability of those with chronic stroke to adapt and retain a novel locomotor pattern. The effects of other forms of variable practice within other locomotor learning paradigms should be explored in those with chronic hemiparesis after stroke.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A257).
Validity and Responsiveness of the Visual Vertigo Analogue Scale
Authors: Dannenbaum Elizabeth , Chilingarian Gevorg , Fung Joyce
Published: March 2019

Background and Purpose:

People with visual vertigo have dizziness provoked by visual stimulation. We have developed a Visual Vertigo Analogue Scale (VVAS) to evaluate their symptoms and response to rehabilitation. Our goal was to validate the VVAS against the Situation Characteristics Questionnaire (SITQ) score and determine its responsiveness to treatment.

Methods:

Participants (n = 115) completed 3 questionnaires: Dizziness Handicap Inventory (DHI), VVAS, and the SITQ at their initial and final sessions of vestibular rehabilitation. The SITQ was analyzed using the Space Motion Discomfort (SMD1) outcome measure and by calculating the average score of all the items (SMDavg). The results were stratified into those who had a significant clinical change in their DHI score posttreatment and those who did not. Associations of the VVAS with SMD scores and change scores were determined by Pearson and Spearman correlations. Nonparametric t tests were used to compare the 2 DHI groups on the clinical outcomes.

Results:

There were significant associations between VVAS scores (P < 0.0001) and both SMD1 (βVVAS = 0.02) and SMDavg scores (βVVAS = 0.03). Significant differences existed between the 2 DHI groups for all scores: VVAS (P = 0.0002), SMD1 (P = 0.02), and SMDavg (P = 0.0001).

Discussion and Conclusions:

VVAS scores correlated well with SMD1 and SMDavg scores. Changes in VVAS pre- and posttreatment scores corresponded to the changes seen in SMD1 and SMDavg scores. The VVAS shows validity and responsiveness to change. The VVAS can be used to detect clients with visual vertigo and to verify the progression of the client's symptoms.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A258).
Eye Movements, Dizziness, and Mild Traumatic Brain Injury (mTBI): A Topical Review of Emerging Evidence and Screening Measures
Authors: Whitney Susan L. , Sparto Patrick J.
Published: March 2019

Background and Purpose:

Eye movements may be adversely affected after mild traumatic brain injury (mTBI) and should be examined. The purpose of this topical review is to provide the clinician with the most up-to-date knowledge related to eye movement abnormalities, screening measures, and evidence related to exercise interventions that are designed to enhance outcomes in persons after mTBI.

Summary of Key Points:

Presence of eye misalignment such as tropias or phoria or symptoms with head/eye movements such as vestibulo-ocular reflex (VOR) × 1, saccades, or smooth pursuits may slow the person's recovery. Tools such as the Convergence Insufficiency Symptom Survey, the Vestibular/Ocular Motor Screening, the Pediatric Vestibular Symptom Questionnaire, and the Pediatric Visually Induced Dizziness questionnaire may aid in identifying visual concerns to target in the physical therapy intervention program. There is emerging evidence that vestibular rehabilitation enhances recovery in persons after mTBI.

Recommendations for Clinical Practice:

A thorough eye examination is highly recommended after mTBI to identify targeted areas for intervention.
Impaired Calcium Metabolism in Benign Paroxysmal Positional Vertigo: A Topical Review
Authors: Jeong Seong-Hae , Kim Ji-Soo
Published: March 2019

Background and Purpose:

Although acute attacks of benign paroxysmal positional vertigo (BPPV) may be treated with canalith repositioning maneuvers, there have been no well-designed prospective trials to prevent this highly prevalent and recurrent disorder. This topical review explores the evidence related to the association between deficient calcium metabolism and BPPV. We also describe the development of therapeutic options to prevent recurrences of BPPV and introduce results from a recent randomized controlled trial on the effect of vitamin D and calcium supplementation in preventing BPPV recurrences.

Summary of Key Points:

The literature describes 3 lines of evidence on association of impaired calcium metabolism and development of BPPV: (1) decreased bone mineral density was more frequently observed in persons with BPPV than in healthy controls; (2) estrogen plays a vital role in maintenance of otoconia, and estrogen deficiency appears to precipitate degeneration of otoconia and development of BPPV; and (3) lower serum vitamin D level is associated with development of BPPV, and supplementation of vitamin D and calcium carbonate may reduce further attacks of BPPV in persons with BPPV and subnormal serum vitamin D level.

Recommendations for Clinical Practice:

Restoration of impaired calcium metabolism with supplementation of vitamin D or estrogen should be considered in the treatment of individuals with frequent recurrences of BPPV. Future randomized controlled trials are mandatory to validate these supplementation therapies in individuals with recurrent BPPV.
Body Coloration Artifacts Encountered at Medicolegal Autopsy in India
Authors: Behera Chittaranjan , Chauhan Mohit , Sikary Asit Kumar
Published: March 2019

Application of color on the external body surface before, during, and after death, such as during a festivity, cultural occasion, or after death ritual, can present as an artifact at forensic autopsy. The present study is a retrospective review of body color artifacts collected from postmortem reports, inquest papers and photographs of each individual case autopsied at our institutes during a 12 year period from 2004 to 2015. The reason for body colorations were various festivities, after death rituals and beautification products, among others. The body coloration mimicked antemortem changes, such as cyanosis, injury, jaundice, and congestion, as well as postmortem changes, such as postmortem lividity and early decomposition changes. These artifacts were differentiated by seeing the body before the washing of the color, history of the application of the color, and by various additional features, such as unusual appearance, distribution, and sites. They were not supported by any other findings on the body to consider them as genuine antemortem or postmortem findings.
Penetration Depths of Conducted Electrical Weapon Probes Into Human Skull Phantoms
Authors: Bolliger Stephan Andreas , Gort Silvan , Kaelin Beat , Barrera Vera , Thali Michael Josef , Martinez Rosa Maria
Published: March 2019

Occasional case reports have described isolated cases of conducted electrical weapon (CEW) probes piercing the human skull. In an experimental setting, we examined whether these cases were just unfortunate incidents, how deeply such probes can pierce the skull, and whether firing distance and CEW probe type play a role in the skull-piercing capability.

We fired 5 different CEW cartridges (XP 10.6 m, XP 7.6 m, smart 10.6 m, smart 7.6 m, and smart probe 7.6 m) from 4 different distances (0.5, 1, 2, and 4 m) at head phantoms made of either 5- or 7-mm-thick polyurethane spheres covered with a thin layer of gelatine and buckskin. The piercing depths were recorded by computed tomographic scanning.

All tested cartridges managed to pierce the head phantoms. Piercing depths of up to 6.6 mm in the 5-mm heads and depths of almost 5 mm in the 7-mm heads were recorded. Deepest piercing depths were attained with firing distances of 2 m or less.

Our results showed that all tested CEW probes are capable of piercing the skull and that shorter firing distances tend to lead to deeper piercing depths.
A Comparison of 3 Established Skeletal Age Estimation Methods in an African Group From Benin and an Italian Group From Southern Italy
Authors: Santoro Valeria , Marini Chiara , Fuzio Grazia , Introna Francesco , De Donno Antonio
Published: March 2019

Age estimation is a crucial matter in several forensic and legal instances. The literature recommends carrying out hand and wrist radiograph to assess skeletal age. Much research has been conducted to examine the application of various methods in different categories. Our study aims to evaluate the reliability of Greulich and Pyle, Tanner-Whitehouse 2, and FELS methods in Beninese and Italian samples, with a total of 204 subjects, 102 (51 were male and 51 were female) from Benin and 102 (51 were male and 51 were female) from Italy, aged between 4 and 19 years. Hand-wrist radiographs were carried out at Saint Luc Hospital in Cotonou for the African sample and in 2 hospitals in Southern Italy for Italian sample. Skeletal maturity was obtained, applying the 3 methodologies. The arithmetic mean of the 3 ages obtained was calculated, as well as the possible difference between the known chronological age and the estimated mean skeletal age. Data were analyzed statistically using the χ2 test, Student t test, and Bland-Altman plots. There are no significant statistical differences between real age and skeletal age calculated using the Greulich and Pyle and FELS methods. Comparison between Tanner-Whitehouse 2 and the average of the methods used results in statistically significant, but clinically insignificant, differences.
CSF-oma Identification With Nuclear Medicine Shunt-o-Gram
Authors: Schmieder Stephanie , Schraml Frank
Published: March 2019

A nuclear medicine shunt-o-gram is used to evaluate ventriculoperitoneal shunt patency and dispersion of radiotracer into the peritoneal cavity. A 73-year-old man presented with worsening memory, gait disturbance, and urinary incontinence. Shunt-o-gram revealed antegrade flow through the tubing and spillage into the peritoneal cavity without dispersion. CT confirmed a CSF-oma. Symptoms resolved after CSF-oma resection. Normal passage of radiotracer through the shunt without normal dispersion into the peritoneal cavity along with CT imaging correctly identified a CSF-oma. This is an unexpected complication of a shunt. Correct diagnosis on imaging likely saved this patient from unnecessary complete shunt revision.
Malignant Perivascular Epithelioid Cell Tumor of Lung on FDG PET/CT
Authors: Wu Jiyong , Jiang Lei , Zhang Fengxian , Huang Yan , Wang Huoqiang
Published: March 2019

Chest CT images were acquired in a 67-year-old man to evaluate a left lung mass revealed by chest radiography. The image findings suggested possible pulmonary malignancy. FDG PET/CT was performed for staging, which showed the abnormally increased activity in the lung mass with hypermetabolic lymph node. Pathology from the biopsy confirmed malignant perivascular epithelioid cell tumor.
68Ga-DOTATOC PET/CT Differentiates Meningioma From Dural Metastases
Authors: Unterrainer Marcus , Ruf Viktoria , Ilhan Harun , Vettermann Franziska Jill , Cyran Clemens C. , Niyazi Maximilian , Bartenstein Peter , Tonn Joerg-Christian , Albert Nathalie Lisa
Published: March 2019

A 77-year-old woman with history of breast cancer presented with 2 unclear dural contrast-enhancing lesions on MRI; differential diagnoses were breast cancer metastases and meningiomas. On 68Ga-DOTATOC PET/CT, the temporal lesion showed high uptake and was classified as meningioma, whereas the lesion at the falx showed barely any 68Ga-DOTATOC uptake uncharacteristic for meningioma and suggestive for a brain metastasis. After resection, histological specimens from the temporal lesion showed meningioma tissue with distinct SSTR2A expression, whereas the falx lesion revealed a breast cancer metastasis without significant SSTR2A expression. Therefore, 68Ga-DOTATOC PET represents a powerful imaging modality for the evaluation of unclear dural lesions.
Whole-Body Blood Pool Metastatic Superscan (Bone Hunger Pattern)
Authors: Shakeri Sara , Khosravi Somayeh , Divband Ghasemali , Sadeghi Ramin , Shafiei Susan
Published: March 2019

We presented a 61-year-old man's surprising 99mTc-MDP whole-body blood pool superscan pattern with early unexpected generalized bone uptake. He complained of weakness and undesired weight loss with anemia and elevated erythrocyte sedimentation rate. As a malignancy workup in a patient without obvious suspicious origin, a whole-body 99mTc-MDP bone scan was requested. This unusual tracer distribution on blood pool imaging was very similar to the whole-body delayed scan except for visible kidneys.
Dual Imaging With 68Ga-DOTATOC and 18F-FDG PET for Planning and Follow-up of PRRT in Combination With Temozolomide Treatment in a Patient With a Metastatic Neuroendocrine Tumor
Authors: Wei Xiao , Hain Susanne , Hartmann Lynn , Hirzebruch Stefan , Ahmadzadehfar Hojjat
Published: March 2019

A 68-year-old man with a metastatic neuroendocrine tumor with unknown primary was found to have partially dedifferentiated metastases according to 18F-FDG uptake. He received 3 cycles of radiopeptide therapy using [177Lu]Lutetium-DOTATATE combined with temozolomide. Before this treatment, the patient had already undergone a series of therapies, including biotherapy, everolimus, 5 cycles of radiopeptide therapies, radiotherapy, and bone-protecting therapy with bisphosphonate and receptor activator of NF-κB ligand, each of which temporarily stalled the progress of the disease. After combined treatment with radiopeptide therapy and temozolomide, the patient showed a very good response in all tumor lesions, including the FDG-positive ones.
Posterior Vaginal Compartment Anatomy: Implications for Surgical Repair
Authors: Maldonado Pedro A. , Carrick Kelley S. , Montoya T. Ignacio , Corton Marlene M.
Published: March 2019

Objectives

To examine the gross and histologic anatomy of the proximal, mid, and distal posterior vaginal compartment and discuss implications for surgical repair.

Study Design

In this cadaver study, pelvic organs were resected en bloc, immersed in formalin solution, and transected in the mid sagittal plane. Measured distances included: posterior vaginal wall length, cervicovaginal junction or vaginal cuff to posterior peritoneal reflection, peritoneal reflection to proximal edge (apex) of perineal body, and perineal body apex to hymenal remnant (height). The posterior vaginal wall was divided into 3 segments along the midsagittal plane and submitted in whole tissue blocks for staining. Histologic analysis included that of 2 young nulliparous women whose tissue was harvested within 12 hours of death.

Results

Eleven cadavers were examined. Median (interquartile range [IQR]) posterior vaginal length was 7.6 (2.2) cm. The peritoneum attached to the posterior vaginal wall a median (IQR) of 1.3 cm (0.5 cm) distal to the cervicovaginal junction (n = 8). The rectovaginal space, spanning from the peritoneal reflection to perineal body apex, had a median (IQR) length of 4.7 cm (2.1 cm). Microscopic examination of the mid segment revealed a layer of loose fibroadipose tissue between the vaginal/rectal walls, with no distinct dense fibroconnective tissue layer. The median (IQR) perineal body height was 2.3 cm (1.2 cm). No discrete fibrous capsule was seen surrounding the external anal sphincter muscle.

Conclusions

These findings support evidence showing absence of a rectovaginal fascia. The anal sphincter lacks a fibrous capsule, which is important during closure of third-/fourth-degree obstetric lacerations.
Management of neurosarcoidosis: a clinical challenge
Authors: Voortman Mareye , Drent Marjolein , Baughman Robert P.
Published: March 2019

Purpose of review

Sarcoidosis is a complex disease with many faces, and the clinical manifestation and course of neurosarcoidosis are particularly variable. Although neurosarcoidosis occurs in up to 10% of sarcoidosis patients, it can lead to significant morbidity and some mortality.

Recent findings

Three criteria are usually required for a diagnosis of (neuro)sarcoidosis: clinical and radiologic manifestations, noncaseating granulomas, and no evidence of alternative disease. Recent guidelines have helped to clarify criteria for diagnosing neurosarcoidosis. No firm guidelines exist on whether, when, and how treatment should be started. Treatment depends on the presentation and distribution, extensiveness, and severity of neurosarcoidosis. As regards evidence-based treatment, only a few randomized controlled trials have been done. Hence, several aspects of (neuro)sarcoidosis management are not fully addressed by the current literature.

Significant advances have been made in the potential and accuracy of diagnostics for neurosarcoidosis. Treatment should be approached within the context of the patient's anticipated clinical course, avoidance of adverse drug effects, and, if necessary, from the perspective of the comprehensive management of a chronic disease. A multidisciplinary approach to the management of sarcoidosis is strongly recommended.
Instabilities of soft dielectrics
Authors: Dorfmann Luis , Ogden Ray W.
Published: March 2019

The basic modern theory of nonlinear electroelasticity and its use in the formulation of constitutive laws governing the behaviour of dielectric elastomer materials was summarized in a recent review article by Dorfmann & Ogden (Dorfmann & Ogden 2017
Proc. R. Soc. A
473
, 20170311 (
doi:10.1098/rspa.2017.0311
)). The theory is used, in particular, to analyse the behaviour of transducer devices such as actuators and sensors. Important considerations for the design and effective functioning of such devices are the issues of material and geometric instabilities. Following on from the above-cited work, the present paper provides a detailed account of the types of instabilities that arise for some of the geometries used in transducer devices and the theory that is adopted for the analysis of such instabilities. The theory is then used in two illustrative examples: (i) determination of instabilities of a thin electroelastic plate with flexible electrodes attached to its major surfaces, in particular comparison of the results for the so-called Hessian approach and a general incremental bifurcation analysis in respect of an equibiaxially stretched plate, with numerical results presented for a Gent electroelastic model; (ii) a general analysis of axi-symmetric bifurcation from a circular cylindrical configuration of a thin-walled tube of an electroelastic material with flexible electrodes on its curved surfaces, illustrated by numerical results for neo-Hookean and Gent electroelastic models.

This article is part of the theme issue ‘Rivlin's legacy in continuum mechanics and applied mathematics’.
Bosea psychrotolerans sp. nov., a psychrotrophic alphaproteobacterium isolated from Lake Michigan water
Authors: Albert Richard A. , McGuine Molly , Pavlons Shawn C. , Roecker Jon , Bruess Jennifer , Mossman Shane , Sun Sona , King Mike , Hong Sunhee , Farrance Christine E. , Danner Joseph , Joung Yochan , Shapiro Nicole , Whitman William B. , Busse Hans-Jürgen
Published: March 2019

Three strains of a Gram-stain negative bacterium were isolated from Lake Michigan water. 16S rRNA gene sequence analysis revealed that strain 1131 had sequence similarities to

Bosea vaviloviae

LMG 28367T,

Bosea lathyri

LMG 26379T,

Bosea lupini

LMG 26383T,

Bosea eneae

CCUG 43111T,

Bosea vestrisii

CCUG 43114T and

Bosea

massiliensis

CCUG 43117T of 99.8, 99.1, 98.4, 98.4, 98.4 and 98.2 %, respectively. The average nucleotide identity value between strain 1131T and

Bosea vaviloviae

Vaf-18T was 93.4 % and the DNA relatedness was 38 %. The primary cellular fatty acids of strain 1131T were C16 : 1ω7c and C18 : 1ω7c. The primary polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and phosphatidylcholine. The major compound in the quinone system was ubiquinone Q-10 and in the polyamine pattern sym-homospermidine was predominant. Additional phenotypic characteristics included growth at 5–35 °C, pH values of pH 5.5–8.0, a salt tolerance range of 0.0–1.2 % (w/v), and production of an unknown water soluble brown pigment. After phenotypic, chemotaxonomic and genomic analyses, this isolate was identified as a novel species for which the name

Bosea
psychrotolerans is proposed. The type strain is 1131T (NRRL B-65405=LMG 30034).
HIV reservoir size is determined prior to ART initiation and linked to CD8 T cell activation and memory expansion
Authors: Martin Genevieve E , Pace Matthew , Shearer Freya , Zilber Eva , Hurst Jacob , Meyerowitz Jodi , Thornhill John P , Lwanga Julianne , Brown Helen , Robinson Nicola , Hopkins Emily , Olejniczak Natalia , Nwokolo Nneka , Fox Julie , Fidler Sarah , Willberg Christian B , Frater John ,   on behalf of the CHERUB investigators
Published: March 2019

Initiation of antiretroviral therapy (ART) in early compared with chronic HIV infection is associated with a smaller HIV reservoir. This longitudinal analysis of 63 individuals who commenced ART during primary HIV infection (PHI) investigates which pre-and post-therapy factors associate most closely with reservoir size (HIV DNA) following treatment initiation during PHI. The best predictor of reservoir size at one-year was pre-ART HIV DNA which was in turn significantly associated with CD8 memory differentiation (effector memory, naïve and T-betnegEomesnegsubsets), CD8 T cell activation (CD38 expression) and PD-1 and Tim-3 expression on memory CD4 T cells. No associations were found for any immunological variables following one-year of ART. HIV reservoir size is determined around the time of ART initiation in individuals treated during PHI. CD8 T cell activation and memory expansion are linked to HIV reservoir size, suggesting the importance of the initial host-viral interplay in eventual reservoir size.
Forty high-intensity interval training sessions blunt exercise-induced changes in the nuclear protein content of PGC-1α and p53 in human skeletal muscle
Authors: Granata Cesare , Oliveira Rodrigo S.F. , Little Jonathan P. , Bishop David J.
Published: March 2019

Exercise-induced increases in peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and p53 protein content in the nucleus mediate the initial phase of exercise-induced mitochondrial biogenesis. Here we investigated if exercise-induced increases in these and other markers of mitochondrial biogenesis were altered after 40 sessions of twice-daily high-volume high-intensity interval training (HVT) in human skeletal muscle. Vastus lateralis muscle biopsies were collected from 10 healthy recreationally active participants before, immediately post, and 3h after a session of HIIE performed at the same absolute exercise intensity before and after HVT (Pre-HVT and Post-HVT, respectively). The protein content of common markers of exercise-induced mitochondrial biogenesis were assessed in nuclear- and cytosolic-enriched fractions by immunoblotting; mRNA contents of key transcription factors and mitochondrial genes were assessed by qPCR. Despite exercise-induced increases in PGC-1α, p53, and plant homeodomain finger-containing protein 20 (PHF20) protein content, the phosphorylation of p53 and acetyl-CoA carboxylase (p-p53Ser15 and p-ACCSer79, respectively), and PGC-1α mRNA Pre-HVT, no significant changes were observed Post-HVT. Forty sessions of twice-daily high-intensity interval training blunted all of the measured exercise-induced molecular events associated with mitochondrial biogenesis that were observed Pre-HVT. Future studies should determine if this loss relates to the decrease in relative exercise intensity, habituation to the same exercise stimulus, or a combination of both.
Structural basis for the delivery of activated sialic acid into Golgi for sialyation
Authors: Nji Emmanuel , Gulati Ashutosh , Qureshi Abdul Aziz , Coincon Mathieu , Drew David
Published: March 2019

The decoration of secretory glycoproteins and glycolipids with sialic acid is critical to many physiological and pathological processes. Sialyation is dependent on a continuous supply of sialic acid into Golgi organelles in the form of CMP-sialic acid. Translocation of CMP-sialic acid into Golgi is carried out by the CMP-sialic acid transporter (CST). Mutations in human CST are linked to glycosylation disorders, and CST is important for glycopathway engineering, as it is critical for sialyation efficiency of therapeutic glycoproteins. The mechanism of how CMP-sialic acid is recognized and translocated across Golgi membranes in exchange for CMP is poorly understood. Here we have determined the crystal structure of a eukaryotic CMP-sialic acid transporter in complex with CMP. We conclude that the specificity of CST for CMP-sialic acid is established by the nucleotide CMP to such an extent, they are uniquely able to work both as passive and as (secondary) active antiporters.
Coloring Single Nanoparticle Trajectory in Live Cell with its Own History: a Presuppositionless Preprocessing Approach
Authors: Zhao Hansen , Huang Zhenrong , Ge Feng , Shi Xiangjun , Xiong Bin , Liao Xuebin , Wang Zonghua , Zhang Sichun , Zhang Xinrong , He Yan
Published: March 2019

Analyzing single particle trajectories is a prominent issue in understanding complex dynamics such as nanoparticle-cell interactions. Existing methods treat data points as isolated “atoms” and use predefined mechanical models to “frame” their complicated relationship. Herein, we propose a “historical evolution” based model-free strategy. It allows spatiotemporal heterogeneity embedded in a trajectory to self-emerge as consecutive colored segments before any model assumption, provide both an overall picture and local state transitions on the particle movement with minimum information loss, and inspire further model-based investigation. We demonstrate with simulations and experiments that the underlying mechanisms of various time-series and motion states of single nanoparticles on live cell membranes could all be revealed successfully. Since complexity studies at different levels of molecules, particles, cells, human beings, vehicles, and even stars could all be reduced to analyzing spatiotemporal trajectories of “single particles”, this presuppositionless approach will help fundamental researches on many important systems.

Impact Statement

A preprocessing strategy for single particle trajectory analysis is established by providing an intuitive global pattern from “historical experiences” of the particle without predefining any mechanical models.
The structure of Macrophage Expressed Gene-1, a phagolysosome immune effector that is activated upon acidification
Authors: Pang Siew Siew , Bayly-Jones Charles , Radjainia Mazdak , Spicer Bradley A. , Law Ruby H.P. , Hodel Adrian W. , Ekkel Sue M. , Conroy Paul J. , Ramm Georg , Venugopal Hariprasad , Bird Phillip I. , Hoogenboom Bart W. , Voskoboinik Ilia , Gambin Yann , Sierecki Emma , Dunstone Michelle A. , Whisstock James C.
Published: March 2019

Macrophage Expressed Gene-1 (MPEG-1; also termed Perforin-2) is an endosomal / phagolysosomal perforin-like protein that is conserved across the metazoan kingdom and that functions within the phagolysosome to damage engulfed microbes. Like the Membrane Attack Complex and perforin, MPEG-1 has been postulated to form pores in target membranes, however, its mode of action remains to be established. We used single particle cryo-Electron Microscopy to determine the 2.4 Å structure of a hexadecameric assembly of MPEG-1 that displays the expected features of a soluble pre-pore complex. We further discovered that the MPEG-1 pre-pore-like assemblies can be induced to perforate membranes through mild acidification, such as would occur within maturing phagolysosomes. We next solved the 3.6 Å cryo-EM structure of MPEG-1 in complex with liposomes. Remarkably these data revealed that a C-terminal Multi-vesicular body of 12 kDa (MVB12)-associatedβ-prism (MABP) domain interacts with target membranes in a mode that positions the pore forming machinery of MPEG-1 to point away from the bound membrane. This unexpected mechanism of membrane interaction raises the intriguing possibility that MPEG-1 may be able to remain bound to the phagolysosome membrane while simultaneously forming pores in engulfed bacterial targets.
Selection and gene flow shape niche-associated copy-number variation of pheromone receptor genes
Authors: Lee Daehan , Zdraljevic Stefan , Cook Daniel E. , Frézal Lise , Hsu Jung-Chen , Sterken Mark G. , Riksen Joost A.G. , Wang John , Kammenga Jan E. , Braendle Christian , Félix Marie-Anne , Schroeder Frank C. , Andersen Erik C.
Published: March 2019

From quorum sensing in bacteria to pheromone signaling in social insects, chemical communication mediates interactions among individuals in a local population. InCaenorhabditis elegans, ascaroside pheromones can dictate local population density, in which high levels of pheromones inhibit the reproductive maturation of individuals. Little is known about how natural genetic diversity affects the pheromone responses of individuals from diverse habitats. Here, we show that a niche-associated copy-number variation (CNV) of pheromone receptor genes contributes to natural differences in pheromone responses. We found putative loss-of-function deletions that reduce copy number of duplicated pheromone receptor genes (srg-36 and srg-37), which were shown previously to be selected in population-dense laboratory cultures. A common natural deletion in the less functional copy (srg-37) arose from a single ancestral population that spread throughout the world and underlies reduced pheromone sensitivity across the globalC. eleganspopulation. This deletion is enriched in wild strains that were isolated from a rotting fruit niche, where proliferating populations are often found. Taken together, these results demonstrate that selection and gene flow together shape the copy number of pheromone receptor genes in naturalC. eleganspopulations to facilitate local adaptation to diverse niches.
How sequence alignment scores correspond to probability models
Authors: Frith Martin C.
Published: March 2019

Sequence alignment remains fundamental in bioinformatics. Pairwise alignment is traditionally based on ad hoc scores for substitutions, insertions, and deletions, but can also be based on probability models (pair hidden Markov models: PHMMs). PHMMs enable us to: fit the parameters to each kind of data, calculate the reliability of alignment parts, and measure sequence similarity integrated over possible alignments.

This study shows how multiple models correspond to one set of scores. Scores can be converted to probabilities by partition functions with a “temperature” parameter: for any temperature, this corresponds to some PHMM. There is a special class of models with balanced length probability, i.e. no bias towards either longer or shorter alignments. The best way to score alignments and assess their significance depends on the aim: judging whether whole sequences are related versus finding related parts. This clarifies the statistical basis of sequence alignment.
Homeostasis of the intervertebral disc requires regulation of STAT3 signaling by the adhesion G-protein coupled receptor ADGRG6
Authors: Liu Zhaoyang , Easson Garrett W.D. , Zhao Jingjing , Makki Nadja , Ahituv Nadav , Hilton Matthew J. , Tang Simon Y. , Gray Ryan S.
Published: March 2019

Degenerative changes of the intervertebral disc (IVD) are a leading cause of disability affecting humans worldwide. While this is primarily attributed to trauma and aging, genetic variation is associated with disc degeneration in humans. However, the precise mechanisms driving the initiation and progression of disease remain elusive due to a paucity of genetic animal models. Here, we discuss a novel genetic mouse model of endplate-oriented disc degeneration. We show that the adhesion G-protein coupled receptor G6 (ADGRG6) mediates several anabolic and catabolic factors, fibrotic collagen genes, pro-inflammatory pathways, and mechanical properties of the IVD, prior to the onset of overt histopathology of these tissues. Furthermore, we found increased IL-6/STAT3 activation in the IVD and demonstrate that treatment with a chemical inhibitor of STAT3 activation ameliorates disc degeneration in these mutant mice. These findings establish ADGRG6 as a critical regulator of homeostasis of adult disc homeostasis and implicate ADGRG6 and STAT3 as promising therapeutic targets for degenerative joint diseases.

Author summary

Degenerative changes of the intervertebral disc (IVD) are a leading cause of disability affecting humans worldwide. While this is primarily attributed to trauma and aging, genetic variation is associated with disc degeneration in humans. However, the precise mechanisms driving the initiation and progression of disease remain elusive due to a paucity of genetic animal models. Here, we discuss a novel genetic mouse model of endplate-oriented disc degeneration. We show that the adhesion G-protein coupled receptor G6 (ADGRG6) mediates fibrotic collagen expression, causing increased mechanical stiffness of the IVD prior to the onset of histopathology in adult mice. Furthermore, we found increased IL-6/STAT3 activation in the IVD and demonstrate that treatment with a chemical inhibitor of STAT3 activation ameliorates disc degeneration in these mutant mice. Our results demonstrate that ADGRG6 regulation of STAT3 signaling is important for IVD homeostasis, indicating potential therapeutic targets for degenerative joint disorders.
Genomic analysis unveils important aspects of population structure, virulence, and antimicrobial resistance inKlebsiella aerogenes
Authors: Passarelli-Araujo Hemanoel , Palmeiro Jussara K. , Moharana Kanhu C. , Pedrosa-Silva Francisnei , Dalla-Costa Libera M. , Venancio Thiago M.
Published: March 2019

Klebsiella aerogenesis an important pathogen in healthcare-associated infections. Nevertheless, in comparison to other clinically important pathogens,K. aerogenespopulation structure, genetic diversity, and pathogenicity remain poorly understood. Here, we elucidateK. aerogenesclonal complexes (CCs) and genomic features associated with resistance and virulence. We present a detailed description of the population structure ofK. aerogenesbased on 97 publicly available genomes by using both, multilocus sequence typing and single nucleotide polymorphisms extracted from core genome. We also assessed virulence and resistance profiles using VFDB and CARD, respectively. We show thatK. aerogeneshas an open pangenome and a large effective population size, which account for its high genomic diversity and support that negative selection prevents fixation of most deleterious alleles. The population is structured in at least ten CCs, including two novel ones identified here, CC9 and CC10. The repertoires of resistance genes comprise a high number of antibiotic efflux proteins as well as narrow and extended spectrum β-lactamases. Regarding the population structure, we identified two clusters based on virulence profile due to the presence of the toxin-encodingclboperon and the siderophore production genes,irpandybt.Notably, CC3 comprises the majority ofK. aerogenesisolates associated with hospital outbreaks, emphasizing the importance of its constant monitoring. Collectively, our results can be useful in the development of new therapeutic and surveillance strategies worldwide.
Silulo Ulutho Technologies: African social enterprise driving inclusive business practice
Authors: Smuts Eckard , Campello Beckwith Sophia , Nkonyeni Ncedisa , Scheepers Ella , Bonnici François
Published: March 2019

Learning outcomes

This paper aims to present an opportunity to explore the opportunities and challenges involved in running a business with a strongly ingrained social vision in the complex, multi-dimensional environment of an emerging economy. Key learning areas are as follows: How the concept of inclusive innovation applies to the real-world difficulties faced by businesses operating in informal economies. By exploring the tensions between growth and inclusivity in Silulo’s development, students will grasp the challenges entrepreneurs face as a business starts to gain momentum and change, and gain appreciation for the trade-offs that occur when choosing between franchising and organic growth. The challenges of a rapidly evolving technological environment, the need to adapt service offerings at pace, and the importance of balancing financial considerations with deeper social values will find application far beyond the informal economy context of the Silulo story.

Case overview/synopsis

This teaching case looks at Silulo Ulutho Technologies via CEO Luvuyo Rani and the challenges he faces in balancing expansion and profitability with its mission of empowering disenfranchised communities – challenges exacerbated by a changing telecommunications environment, with more widespread internet availability, mobile phones and online training courses encroaching on Silulo’s traditional service offering.

Complexity academic level

This case focusses primarily on the processes of inclusive innovation and is suitable for graduate courses in social entrepreneurship, business model innovation, sustainability, business and society, strategic management, emerging markets, business in Africa and organisational studies in general. The case is suitable for Masters of Business Administration (MBA) and Executive MBA academic programmes and delegates on Executive Education programmes.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 3: Entrepreneurship