bluuebunny/crossref_metadata_2025_split huggingface dataset:
IncA/C Conjugative Plasmids Mobilize a New Family of Multidrug Resistance Islands in Clinical Vibrio cholerae Non-O1/Non-O139 Isolates from Haiti
Authors: Carraro Nicolas , Rivard Nicolas , Ceccarelli Daniela , Colwell Rita R. , Burrus Vincent 
Published: July 2016

ABSTRACT

Mobile genetic elements play a pivotal role in the adaptation of bacterial populations, allowing them to rapidly cope with hostile conditions, including the presence of antimicrobial compounds. IncA/C conjugative plasmids (ACPs) are efficient vehicles for dissemination of multidrug resistance genes in a broad range of pathogenic species of
Enterobacteriaceae
. ACPs have sporadically been reported in
Vibrio cholerae
, the infectious agent of the diarrheal disease cholera. The regulatory network that controls ACP mobility ultimately depends on the transcriptional activation of multiple ACP-borne operons by the master activator AcaCD. Beyond ACP conjugation, AcaCD has also recently been shown to activate the expression of genes located in the
Salmonella
genomic island 1 (SGI1). Here, we describe MGI
Vch
Hai6, a novel and unrelated mobilizable genomic island (MGI) integrated into the 3′ end of
trmE
in chromosome I of
V. cholerae
HC-36A1, a non-O1/non-O139 multidrug-resistant clinical isolate recovered from Haiti in 2010. MGI
Vch
Hai6 contains a mercury resistance transposon and an integron In104-like multidrug resistance element similar to the one of SGI1. We show that MGI
Vch
Hai6 excises from the chromosome in an AcaCD-dependent manner and is mobilized by ACPs. Acquisition of MGI
Vch
Hai6 confers resistance to β-lactams, sulfamethoxazole, tetracycline, chloramphenicol, trimethoprim, and streptomycin/spectinomycin.
In silico
analyses revealed that MGI
Vch
Hai6-like elements are carried by several environmental and clinical
V. cholerae
strains recovered from the Indian subcontinent, as well as from North and South America, including all non-O1/non-O139 clinical isolates from Haiti.

IMPORTANCE
Vibrio cholerae
, the causative agent of cholera, remains a global public health threat. Seventh-pandemic
V. cholerae
acquired multidrug resistance genes primarily through circulation of SXT/R391 integrative and conjugative elements. IncA/C conjugative plasmids have sporadically been reported to mediate antimicrobial resistance in environmental and clinical
V. cholerae
isolates. Our results showed that while IncA/C plasmids are rare in
V. cholerae
populations, they play an important yet insidious role by specifically propagating a new family of genomic islands conferring resistance to multiple antibiotics. These results suggest that nonepidemic
V. cholerae
non-O1/non-O139 strains bearing these genomic islands constitute a reservoir of transmissible resistance genes that can be propagated by IncA/C plasmids to
V. cholerae
populations in epidemic geographical areas as well to pathogenic species of
Enterobacteriaceae
. We recommend future epidemiological surveys take into account the circulation of these genomic islands.
A comparison of preprepared commercial infant feeding meals with home-cooked recipes
Authors: Carstairs Sharon A , Craig Leone CA , Marais Debbi , Bora Ourania E , Kiezebrink Kirsty 
Published: July 2016

ObjectivesTo compare the cost, nutritional and food variety contents of commercial meals and published infant and young child feeding (IYCF) home-cooked recipes, and to compare nutritional contents to age-specific recommendations.DesignCross-sectional study.SettingFull range of preprepared main meals available within the UK market. Main-meal recipes identified from a survey of Amazon's top 20 best-sellers and IYCF cookbooks available from local libraries.Samples278 commercial IYCF savoury meals from UK market and 408 home-cooked recipes from best-selling IYCF published cookbooks.Main outcome measuresCost and nutritional content per 100 g and food variety per meal for both commercial meals and home-cooked recipes.ResultsCommercial products provided more ‘vegetable’ variety per meal (median=3.0; r=−0.33) than home-cooked recipes (2.0). Home-cooked recipes provided 26% more energy and 44% more protein and total fat than commercial products (r=−0.40, −0.31, −0.40, respectively) while costing less (£0.33/100 g and £0.68/100 g, respectively). The majority of commercial products (65%) met energy density recommendations but 50% of home-cooked recipes exceeded the maximum range.ConclusionsThe majority of commercial meals provided an energy-dense meal with greater vegetable variety per meal to their home-cooked counterparts. Home-cooked recipes provided a cheaper meal option, however the majority exceeded recommendations for energy and fats.
Sugar-sweetened beverages coverage in the British media: an analysis of public health advocacy versus pro-industry messaging
Authors: Elliott-Green Alex , Hyseni Lirije , Lloyd-Williams Ffion , Bromley Helen , Capewell Simon 
Published: July 2016

ObjectivesTo assess the extent of media-based public health advocacy versus pro-industry messaging regarding sugar-sweetened beverages (SSBs).DesignWe conducted a systematic analysis to identify and examine all articles regarding SSBs published in all mainstream British print newspapers and their online news websites from 1 January 2014 to 31 December 2014. We initially conducted a brief literature search to develop appropriate search terms and categorisations for grouping and analysing the articles. Articles were then coded according to the publishing newspaper, article type, topic, prominence and slant (pro-SSB or anti-SSB). A contextual analysis was undertaken to examine key messages in the articles.ResultsWe identified 374 articles published during 2014. The majority of articles (81%) suggested that SSBs are unhealthy. Messaging from experts, campaign groups and health organisations was fairly consistent about the detrimental effects of SSB on health. However, relatively few articles assessed any approaches or solutions to potentially combat the problems associated with SSBs. Only one-quarter (24%) suggested any policy change. Meanwhile, articles concerning the food industry produced consistent messages emphasising consumer choice and individual responsibility for making choices regarding SSB consumption, and promoting and advertising their products. The food industry thus often managed to avoid association with the negative press that their products were receiving.ConclusionsSSBs were frequently published in mainstream British print newspapers and their online news websites during 2014. Public health media advocacy was prominent throughout, with a growing consensus that sugary drinks are bad for people's health. However, the challenge for public health will be to mobilise supportive public opinion to help implement effective regulatory policies. Only then will our population's excess consumption of SSBs come under control.
Simulation study to determine the impact of different design features on design efficiency in discrete choice experiments
Authors: Vanniyasingam Thuva , Cunningham Charles E , Foster Gary , Thabane Lehana 
Published: July 2016

ObjectivesDiscrete choice experiments (DCEs) are routinely used to elicit patient preferences to improve health outcomes and healthcare services. While many fractional factorial designs can be created, some are more statistically optimal than others. The objective of this simulation study was to investigate how varying the number of (1) attributes, (2) levels within attributes, (3) alternatives and (4) choice tasks per survey will improve or compromise the statistical efficiency of an experimental design.Design and methodsA total of 3204 DCE designs were created to assess how relative design efficiency (d-efficiency) is influenced by varying the number of choice tasks (2–20), alternatives (2–5), attributes (2–20) and attribute levels (2–5) of a design. Choice tasks were created by randomly allocating attribute and attribute level combinations into alternatives.OutcomeRelative d-efficiency was used to measure the optimality of each DCE design.ResultsDCE design complexity influenced statistical efficiency. Across all designs, relative d-efficiency decreased as the number of attributes and attribute levels increased. It increased for designs with more alternatives. Lastly, relative d-efficiency converges as the number of choice tasks increases, where convergence may not be at 100% statistical optimality.ConclusionsAchieving 100% d-efficiency is heavily dependent on the number of attributes, attribute levels, choice tasks and alternatives. Further exploration of overlaps and block sizes are needed. This study's results are widely applicable for researchers interested in creating optimal DCE designs to elicit individual preferences on health services, programmes, policies and products.
Association of age with health-related quality of life in a cohort of patients with systemic lupus erythematosus: the Georgians Organized Against Lupus study
Authors: Plantinga Laura , Lim S Sam , Bowling C Barrett , Drenkard Cristina 
Published: July 2016

ObjectiveTo examine whether older age was associated with lower health-related quality of life (HRQOL) among patients with systemic lupus erythematosus (SLE) and whether differential disease-related damage and activity explained these associations.MethodsWe used cross-sectional data on 684 patients with SLE aged ≥20 years from the Georgians Organized Against Lupus cohort to estimate the associations between age (categorised as 20–39, 40–59 and ≥60 years) and HRQOL (Short Form-12 norm-based domain and physical component summary (PCS) and mental component summary (MCS) scores), using multivariable linear regression. We then examined the effect of disease-related damage and activity on these associations.ResultsThe mean age of the cohort was 48.2±13.1 years (range, 20–88 years), with 28.0%, 52.9% and 19.1% of participants being aged 20–39, 40–59 and ≥60 years, respectively; 79.0% were African-American and 93.7% were female. The mean PCS score was 39.3 (41.8, 38.7 and 37.4 among those aged 20–39, 40–59 and ≥60 years, respectively), while the mean MCS score was 44.3 (44.2, 43.8 and 46.1, respectively). In general, lower physical but not mental HRQOL scores were associated with older age. With adjustment, older ages (40–59 and ≥60, respectively, vs 20–39) remained associated (β (95% CI)) with lower PCS (−2.53 (−4.58 to −0.67) and −3.57 (−6.19 to −0.96)) but not MCS (0.47 (−1.46 to 2.41) and 1.20 (−1.52 to 3.92)) scores. Associations of age with HRQOL domain and summary scores were not substantially changed by further adjustment for disease-related damage and/or activity.ConclusionsNearly one in five participants in this large, predominantly African-American cohort of patients with SLE was at least 60 years old. The associations of older age with lower physical, but not mental, HRQOL were independent of accumulated SLE damage and current SLE activity. The results suggest that studies of important geriatric outcomes in the setting of SLE are needed to inform patient-centred clinical care of the ageing SLE population.
PI3K/Akt/mTOR Signaling and Plasma Membrane Proteins Are Implicated in Responsiveness to Adjuvant Dendritic Cell Vaccination for Metastatic Colorectal Cancer
Authors: Qian David C. , Xiao Xiangjun , Byun Jinyoung , Suriawinata Arief A. , Her Stephanie C. , Amos Christopher I. , Barth Richard J. 
Published: July 2016

AbstractPurpose: We have previously demonstrated that patients with metastatic colorectal cancer who exhibit immune responses to a dendritic cell (DC) vaccine have superior recurrence-free survival following surgery, compared with patients in whom responses do not occur. We sought to characterize the patterns of T-lymphocyte infiltration and somatic mutations in metastases that are associated with and predictive of response to the DC vaccine.Experimental Design: Cytotoxic, memory, and regulatory T cells in resected metastases and surrounding normal liver tissue from 22 patients (11 responders and 11 nonresponders) were enumerated by immunohistochemistry prior to vaccine administration. In conjunction with tumor sequencing, the combined multivariate and collapsing method was used to identify gene mutations that are associated with vaccine response. We also derived a response prediction score for each patient using his/her tumor genotype data and variant association effect sizes computed from the other 21 patients; greater weighting was placed on gene products with cell membrane–related functions.Results: There was no correlation between vaccine response and intratumor, peritumor, or hepatic densities of T-cell subpopulations. Associated genes were found to be enriched in the PI3K/Akt/mTOR signaling axis (P &lt; 0.001). Applying a consistent prediction score cutoff over 22 rounds of leave-one-out cross-validation correctly inferred vaccine response in 21 of 22 patients (95%).Conclusions: Adjuvant DC vaccination has shown promise as a form of immunotherapy for patients with metastatic colorectal cancer. Its efficacy may be influenced by somatic mutations that affect pathways involving PI3K, Akt, and mTOR, as well as tumor surface proteins. Clin Cancer Res; 23(2); 399–406. ©2016 AACR.
Kidney Function Does Not Modify the Favorable Quality of Life Changes Associated With Revascularization for Coronary Artery Disease: Cohort Study
Authors: James Matthew T. , Wilton Stephen B. , Clement Fiona M. , Ghali William A. , Knudtson Merril L. , Tan Zhi , Tonelli Marcello , Hemmelgarn Brenda R. , Norris Colleen M. ,   the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) and Alberta Kidney Disease Network (AKDN) Investigators
Published: July 2016

Background
Although patients with kidney disease have potential to benefit from revascularization, they are also at higher risk of complications, which may affect quality of life.

Methods and Results

We studied a cohort of 8198 adults who underwent coronary angiography in Alberta, between 2004 and 2008, and completed health‐related quality‐of‐life (
HR
‐
QOL
) surveys. Changes in
HR
‐
QOL
measures were most favorable among patients who received coronary artery bypass graft (
CABG
), but did not significantly differ by kidney function within groups of patients who received
CABG
, percutaneous coronary intervention (
PCI
), or medical therapy (
P
value for interaction between estimated glomerular filtration rate [
eGFR
] and revascularization status >0.10 for all outcomes). Among those who received
CABG
, the adjusted mean EuroQol 5 dimensions (
EQ
‐5D) utility score for those with
eGFR
>90 mL/min per 1.73 m
2
increased by 0.11 (95%
CI
, 0.09–0.14) and for those with
eGFR
<30 mL/min per 1.73m
2
by 0.13 (95%
CI
, 0.05–0.21). The adjusted mean
EQ
‐5D utility score also increased similarly at all levels of
eGFR
for those who received
PCI
and for those who received medical management. Mean changes in Seattle Angina Questionnaire (
SAQ
) scores were also similar across all levels of
eGFR
within each treatment group for the quality of life, angina frequency, angina stability, physical limitations, and treatment satisfaction domains of the
SAQ
. Among those who received
CABG
, the adjusted mean
SAQ
quality of life score for those with
eGFR
>90 mL/min per 1.73m
2
increased by 22.1 (95%
CI
, 18.5–25.7) and for those with
eGFR
<30 mL/min per 1.73m
2
by 14.0 (95% CI, 2.31–25.63).

Conclusions

Changes in
HR
‐
QOL
do not vary by kidney function among patients selected for
CABG
,
PCI
, or medical management of coronary disease.
Relative Roles of Background Moisture and Vertical Shear in Regulating Interannual Variability of Boreal Summer Intraseasonal Oscillations
Authors: Deng Li , Li Tim 
Published: July 2016

Abstract
The interannual variability of the boreal summer intraseasonal oscillation (BSISO) is investigated using observed outgoing longwave radiation (OLR) and ERA-Interim data for the period of 1980–2012. It is found that the interannual variability of BSISO intensity is much stronger in the tropical western Pacific (TWP) than the tropical Indian Ocean (TIO). A BSISO intensity index is defined based on a multivariate EOF analysis in TWP. It is found that strong BSISO years are associated with El Niño–like sea surface temperature anomalies in the tropical Pacific, anomalous easterly shear, and enhanced background moisture condition in the region. Using a 2.5-layer atmospheric model with a specified idealized background mean state, the authors further examine the relative roles of background moisture and vertical shear fields in modulating the BSISO intensity. Sensitivity numerical experiments indicate that the background moisture change is most important in regulating the BSISO intensity, whereas the background vertical shear change also plays a role.
Regionalizing Rainfall at Very High Resolution over La Réunion Island: A Case Study for Tropical Cyclone Ando
Authors: Pohl Benjamin , Morel Béatrice , Barthe Christelle , Bousquet Olivier 
Published: July 2016

AbstractEnsemble simulations of Tropical Cyclone (TC) Ando (31 December 2000–9 January 2001) are performed over the southwest Indian Ocean using the nonhydrostatic WRF Model. Nested domains centered over the island of La Réunion allow for the simulation of local rainfall amounts associated with TC Ando at very high resolution (680-m grid spacing). The model is forced by and nudged toward ERA-Interim during the first (1–6) day(s) of the TC’s life cycle. The nudging ends at various dates to constrain either the whole life cycle or only parts of it.As expected, results show weakened member dispersion, as the relaxation lasts longer, with more members producing similar cyclone tracks and intensities. The model shows reasonable skill to simulate local rainfall amounts and distribution, as soon as the simulated TC approaches La Réunion with a realistic distance and azimuth. Strong lower-level wind associated with the TC is forced to ascend over the slopes of the island. The model is able to successfully simulate the extreme daily precipitation amounts (>1200 mm) and their distribution over the highest parts of La Réunion. Nevertheless, smaller-scale features of the rainfall field are less realistic in the simulations. The wind speed and direction upstream of the island are the main drivers of such local uncertainties and errors, and they appear as an important issue to assess the local impacts of the TC over such a complex terrain.
Presentation to Emergency Departments for Acute Rhinosinusitis
Authors: Bergmark Regan W. , Sedaghat Ahmad R. 
Published: July 2016

ObjectiveMedicaid and self‐pay insurance statuses and race are associated with emergency department (ED) presentation for uncomplicated acute rhinosinusitis (ARS). We investigated whether ARS symptomatology could explain this disproportionate ED use.Study Design2006‐2010 National Hospital Ambulatory Medical Care Surveys.SettingEDs in the United States.Subjects and MethodsThe data comprise 1,632,826 adult visits for uncomplicated ARS at hospital EDs. Patient‐reported reasons for presentation included constitutional symptoms, facial pain or headache, sinonasal symptoms, head cold or flu‐like symptoms, cough or sputum production, and sore throat. Patient‐reported pain level was also included. Symptoms were assessed for associations with insurance status and race after controlling for clinical, demographic, and socioeconomic characteristics.ResultsMedicaid patients had similar symptomatology and levels of pain when compared with privately insured patients. Self‐pay patients reported higher pain levels (P =. 033) and were less likely to report head cold or flu‐like symptoms (P =. 018) but were equally likely to report other symptomatology. Relative to white patients, Hispanic patients were more likely to complain of facial pain and headaches (P =. 033) and less likely to complain of other classical ARS symptoms, such as cough or sputum production (P =. 013), sinonasal symptoms (P =. 019), or head cold or flu‐like symptoms (P =. 019). Black patients were also less likely to complain of sinonasal symptoms (P =. 038).ConclusionSymptomatology does not explain disproportionate ED use for ARS by Medicaid patients, while higher self‐reported pain levels may explain self‐pay patients’ disproportionate ED utilization. Likewise, ED presentation for ARS among Hispanic patients may be related to symptomatology that is less specific for ARS, such as headache and facial pain.
The NMDA receptor partial agonist d-cycloserine does not enhance motor learning
Authors: Günthner Jan , Scholl Jacqueline , Favaron Elisa , Harmer Catherine J , Johansen-Berg Heidi , Reinecke Andrea 
Published: July 2016

Rationale: There has recently been increasing interest in pharmacological manipulations that could potentially enhance exposure-based cognitive behaviour therapy for anxiety disorders. One such medication is the partial NMDA agonist d-cycloserine. It has been suggested that d-cycloserine enhances cognitive behaviour therapy by making learning faster. While animal studies have supported this view of the drug accelerating learning, evidence in human studies has been mixed. We therefore designed an experiment to measure the effects of d-cycloserine on human motor learning. Methods: Fifty-four healthy human volunteers were randomly assigned to a single dose of 250mg d-cycloserine versus placebo in a double-blind design. They then performed a motor sequence learning task. Results: D-cycloserine did not increase the speed of motor learning or the overall amount learnt. However, we noted that participants on d-cycloserine tended to respond more carefully (shifting towards slower, but more correct responses). Conclusion: The results suggest that d-cycloserine does not exert beneficial effects on psychological treatments via mechanisms involved in motor learning. Further studies are needed to clarify the influence on other cognitive mechanisms.
Ramipril + amlodipine and ramipril + hydrochlorothiazide fixed-dose combinations in relation to patient adherence
Authors: Simonyi Gábor , Ferenci Tamás , Alföldi Sándor , Farsang Csaba 
Published: July 2016

Objective To compare 1-year treatment adherence of ramipril + amlodipine and ramipril +hydroclorothiazide fixed-dose combination therapies in patients with hypertension. Methods Data were extracted from the database of the National Health Insurance Fund of Hungary. Treatment adherence was modelled using survival analysis. Results At 2 months after initiation of treatment, 42% of patients using ramipril +hydrochlorothiazide ( n = 28,800) had discontinued treatment, compared with 0% of patients using ramipril + amlodipine ( n = 10,295). At 1 year, treatment adherence was 29% in the ramipril + hydrochlorothiazide group and 54% in the ramipril + amlodipine group. The hazard ratio for discontinuing ramipril + hydrochlorothiazide vs ramipril + amlodipine was 2.318 (95% confidence intervals 2.246, 2.392). Conclusion Ramipril + amlodipine had significantly higher 1-year treatment adherence than ramipril + hydrochlorothiazide in patients with hypertension.
Anaphylaxis Knowledge Among Pediatric Intensivists in Brazil: A Multicenter Survey
Authors: Colleti Junior José , de Carvalho Werther Brunow 
Published: July 2016

Objective: To assess the knowledge and practice preferences of anaphylaxis treatment among pediatric intensivists in 5 Brazilian pediatric intensive care unit (PICU) settings. Study Design: The cohort was a cross-sectional sample from 5 PICUs; a 7-question survey was personally applied to participants regarding their professional clinical experience and the first-line drug choices when treating an anaphylaxis episode. Results: Of 43 participant physicians, the majority (83.8%) correctly identified epinephrine as the treatment of choice for anaphylaxis, yet only 41.9% chooses the intramuscular route of administration. Conclusion: This study shows that the knowledge of anaphylaxis treatment is deficient among pediatric intensivists in Brazil. The dissemination of recent World Allergy Organization guidelines on anaphylaxis should be encouraged.