bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nested Russian Doll-like Genetic Mobility Drives Rapid Dissemination of the Carbapenem Resistance GeneblaKPC
Authors: Sheppard Anna E. , Stoesser Nicole , Wilson Daniel J. , Sebra Robert , Kasarskis Andrew , Anson Luke W. , Giess Adam , Pankhurst Louise J. , Vaughan Alison , Grim Christopher J. , Cox Heather L. , Yeh Anthony J. ,   the Modernising Medical Microbiology (MMM) Informatics Group, Sifri Costi D. , Walker A. Sarah , Peto Tim E. , Crook Derrick W. , Mathers AmyJ. 
Published: December 2015

AbstractThe recent widespread emergence of carbapenem resistance inEnterobacteriaceaeis a major public health concern, as carbapenems are a therapy of last resort in this family of common bacterial pathogens. Resistance genes can mobilize via various mechanisms including conjugation and transposition, however the importance of this mobility in short-term evolution, such as within nosocomial outbreaks, is currently unknown. Using a combination of short- and long-read whole genome sequencing of 281blaKPC-positiveEnterobacteriaceaeisolated from a single hospital over five years, we demonstrate rapid dissemination of this carbapenem resistance gene to multiple species, strains, and plasmids. Mobility ofblaKPCoccurs at multiple nested genetic levels, with transmission ofblaKPCstrains between individuals, frequent transfer ofblaKPCplasmids between strains/species, and frequent transposition of theblaKPCtransposon Tn4401between plasmids. We also identify a common insertion site for Tn4401within various Tn2-like elements, suggesting that homologous recombination between Tn2-like elements has enhanced the spread of Tn4401between different plasmid vectors. Furthermore, while short-read sequencing has known limitations for plasmid assembly, various studies have attempted to overcome this with the use of reference-based methods. We also demonstrate that as a consequence of the genetic mobility observed herein, plasmid structures can be extremely dynamic, and therefore these reference-based methods, as well as traditional partial typing methods, can produce very misleading conclusions. Overall, our findings demonstrate that non-clonal resistance gene dissemination can be extremely rapid, presenting significant challenges for public health surveillance and achieving effective control of antibiotic resistance.ImportanceIncreasing antibiotic resistance is a major threat to human health, as highlighted by the recent emergence of multi-drug resistant “superbugs”. Here, we tracked how one important multi-drug resistance gene spread in a single hospital over five years. This revealed high levels of resistance gene mobility to multiple bacterial species, which was facilitated by various different genetic mechanisms. The mobility occurred at multiple nested genetic levels, analogous to a Russian doll set where smaller dolls may be carried along inside larger dolls. Our results challenge traditional views that drug-resistance outbreaks are due to transmission of a single pathogenic strain. Instead, outbreaks can be “gene-based”, and we must therefore focus on tracking specific resistance genes and their context rather than only specific bacteria.
From noise correlation to resonant ultrasound spectroscopy in rock acoustics
Authors: Barbouteau Sandra , Rasolofosaon Patrick , Dubos‐Sallée Noalwenn , Vassil Virginie , Poitrineau Valérie , Nauroy Jean‐François 
Published: December 2015

ABSTRACTThis article introduces an alternative experimental procedure for measuring the elastic properties of a solid material at laboratory scale, using both the principles of passive seismic interferometry and resonance ultrasound spectroscopy. We generate noise into the studied sample with a pneumatic air blow gun, and we cross‐correlate the signals recorded with two passive piezoelectric sensors put in soft contact with the sample surface. Resonance phenomena are induced in the sample, but in contrast with conventional resonance ultrasound spectroscopy experiments, we have no control over the injected frequencies that are sent all together within the noise spectrum. The spectrum of the correlogram is a good approximation of the resonance spectrum of the vibrating sample and can be inverted in terms of the elastic moduli of the constituent material of the sample.The experimental procedure is validated on samples made of standard materials (here, aluminium and Plexiglas) by consistently comparing the inverted elastic velocities with the velocities independently measured with the conventional technique of ultrasonic pulse transmission. Moreover, we got similar positive results on dry rock samples, such as Vilhonneur limestone. These encouraging preliminary results open up promising prospects for monitoring fluid substitution in rock samples using the technique described in this paper.
Gout on CT of the feet: A symmetric arthropathy
Authors: Doyle Anthony J , Dalbeth Nicola , McQueen Fiona , Boyer Lucinda , Dong Jing , Rome Keith , Frecklington Mike 
Published: December 2015

AbstractIntroductionThe aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy.MethodsCT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi‐quantitative method based on the rheumatoid arthritis MRI scoring system (RAMRIS). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions.ResultsObserver agreement was excellent (intra‐class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant (Student's t‐test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter‐observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease.ConclusionsErosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.
Utility of CT‐cisternogram for radiosurgery in trigeminal neuralgia: A not‐to‐be forgotten technique
Authors: Vellayappan Balamurugan , Chakraborty Santanu , Althagafi Saif , MacLean Jillian , Szanto Janos , Sinclair John , Malone Shawn 
Published: December 2015

SummaryRadiosurgery (RS) is a well‐established ablative therapy for trigeminal neuralgia (TGN). Successful RS requires the delivery of an extremely high dose of radiation to a small cisternal portion of the nerve, which lies amidst critical structures. This study describes the utility of CT‐cisternogram in RS targeting for TGN. We report on patients with TGN who required CT‐cisternogram for target identification for CyberKnife (CK) RS at our institution between September 2010 and April 2015. CT‐cisternogram is a well‐tolerated procedure that adds useful information to RS planning. Illustrative cases with complex anatomy and MRI artifacts related to postoperative changes and Teflon implant are described. CT‐cisternogram is a complementary imaging modality that is useful in some patients, for RS target delineation.
Lounging with robots – social spaces of residents in care: A comparison trial
Authors: Peri Kathryn , Kerse Ngaire , Broadbent Elizabeth , Jayawardena Chandimal , Kuo Tony , Datta Chandan , Stafford Rebecca , MacDonald Bruce 
Published: December 2015

AimsTo investigate whether robots could reduce resident sleeping and stimulate activity in the lounges of an older persons' care facility.MethodsNon‐randomised controlled trial over a 12‐week period. The intervention involved situating robots in low‐level and high‐dependency ward lounges and a comparison with similar lounges without robots. A time sampling observation method was utilised to observe resident behaviour, including sleep and activities over periods of time, to compare interactions in robot and no robot lounges.ResultsThe use of robots was modest; overall 13% of residents in robot lounges used the robot. Utilisation was higher in the low‐level care lounges; on average, 23% used the robot, whereas in high‐level care lounges, the television being on was the strongest predictor of sleep.ConclusionThis study found that having robots in lounges was mostly a positive experience. The amount of time residents slept during the day was significantly less in low‐level care lounges that had a robot.
Electoral Rule Disproportionality and Platform Polarization
Authors: Matakos Konstantinos , Troumpounis Orestis , Xefteris Dimitrios 
Published: December 2015

AbstractDespite common perception, existing theoretical literature lacks a complete formal argument regarding the relationship between the electoral rule disproportionality and platform polarization. In this article, we build a model that incorporates the disproportionality of the electoral system in a standard Downsian electoral competition setup with mainly, but not necessarily purely, policy‐motivated parties. We first show that in equilibrium, platform polarization is decreasing in the level of the electoral rule disproportionality. We then argue that the number of parties has a positive effect on platform polarization when polarization is measured by the distance between the two most distant platforms. This effect does not hold when polarization is measured by the widely used Dalton index. Constructing a data set covering more than 300 elections, our main theoretical findings are empirically supported, pointing toward the electoral rule disproportionality as a major determinant of polarization.
Integration of trauma and rehabilitation services is the answer to more cost‐effective care
Authors: Wu Jane , Faux Steven G. , Harris Ian , Poulos Christopher J. 
Published: December 2015

AbstractBackgroundThe pathway from acute trauma care to inpatient rehabilitation has not been previously studied in New South Wales (NSW), Australia. This study aimed to examine the outcomes of patients transferred from a trauma service to its ‘in‐house’ rehabilitation service (Group A) compared with outcomes of patients transferred from a designated trauma centre to an external rehabilitation service (Group B). This is carried out to identify any inefficiencies, delays and opportunities for improvement.MethodsThis is a retrospective cohort study using linked registry data. This study included all patients admitted after a motor vehicle collision to trauma services in NSW over the period of 2009–2012, who required inpatient rehabilitation. Those requiring specialized brain or spinal injury rehabilitation or those who went to private rehabilitation units were excluded.ResultsThere were 249 patients in this cohort with majority (59%) in Group A and the remainder in Group B. There was no significant difference between the age of the patients, injury severity or acute length of stay (LOS) between the two groups. Admission and discharge functional independence measure scores were also similar between the two groups. There was a significant difference in the LOS in rehabilitation (30 days for Group A compared with 40 days in Group B, P = 0.02).ConclusionsTransferring patients to an external rehabilitation service from a designated trauma service is less efficient than providing the same care by the ‘in‐house’ rehabilitation service. There may be opportunities to improve the efficiency of trauma management and reduce costs.
Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression?
Authors: McCoy Melanie J. , Hemmings Chris , Hillery Simon , Penter Cheryl , Bulsara Max K. , Zeps Nik , Platell Cameron F. 
Published: December 2015

AbstractBackgroundPathological complete response following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with reduced local recurrence and improved long‐term outcome. However, the prognostic value of a partial response, or of tumour regression in patients with metastatic disease, is less clear.MethodsWe present a single‐centre cohort study of 205 patients with stage II–IV rectal cancer treated with surgery and neoadjuvant CRT between 2006 and 2013. Tumour regression was assessed using the Dworak system.ResultsThe probability of 3‐year recurrence‐free survival (RFS) was 95% for Dworak grade 4, 82% for grade 3, 64% for grade 2 and 53% for grade 1 (P = 0.0005). In univariate regression analysis, Dworak grade was associated with RFS (hazard ratio (HR) 0.51, P < 0.0001; trend analysis) and cancer‐specific survival (HR 0.52, P = 0.002). In multivariate analysis, Dworak grade remained an independent predictor of RFS (HR 0.62, P = 0.012), along with clinical metastases stage, resection margin status, the presence or absence of extramural venous invasion and type of surgical procedure.ConclusionsTumour regression grade after neoadjuvant CRT was an independent prognostic factor for RFS, highlighting the importance of the degree of local response to CRT.
Milk protein profiles in response to Streptococcus agalactiae subclinical mastitis in dairy cows
Authors: Pongthaisong Pongphol , Katawatin Suporn , Thamrongyoswittayakul Chaiyapas , Roytrakul Sittiruk 
Published: December 2015

AbstractThe objective of this study was to investigate the milk protein profiles of normal milk and those of milk during the course of subclinical mastitis, caused by natural Streptococcus agalactiae infection. Two‐dimensional gel electrophoresis and liquid chromatography mass spectrometry were used to assess protein profiles and to identify the proteins. The results showed that S. agalactiae subclinical mastitis altered the protein profiles of milk. Following Mascot database matching, 11 and 12 protein types were identified in the milk collected from healthy and S. agalactiae subclinical mastitic udders, respectively. The distinct presence of the antibacterial protein cathelicidin‐1 was detected in infected milk samples, which in turn was highly correlated to the severity of subclinical mastitis as represented by the milk somatic cell count (r = 0.616), but not the bacterial count. The protein profile of milk reveals changes in the host response to S. agalactiae intramammary infection; cathelicidin‐1 could therefore serve as a biomarker for the detection of subclinical mastitis in dairy cows.
Self‐expanding metallic stent improves histopathological edema compared with transanal drainage tube for malignant colorectal obstruction
Authors: Takeyama Hiroshi , Kitani Kotaro , Wakasa Tomoko , Tsujie Masanori , Fujiwara Yoshinori , Mizuno Shigeto , Yukawa Masao , Ohta Yoshio , Inoue Masatoshi 
Published: December 2015

Background and AimTo compare the usefulness of the self‐expanding metallic stent (SEMS) with that of the transanal drainage tube (TDT) and emergency surgery after failure of decompression (ESFD) in patients with malignant colonic obstruction (MCO), and to evaluate post‐decompression histopathological changes.MethodsFrom January 2010 to June 2015, 39 patients with MCO received SEMS, TDT, and ESFD. We evaluated the outcomes including success rates of placement, clinical outcomes after decompression, and histopathological findings of the resected specimens.ResultsTechnical success rates were 100% for SEMS and 78.9% for TDT. Clinical success rates were 100% for SEMS and 80.0% for TDT. Postoperative ileus was significantly less frequent after SEMS than after TDT (P = 0.014). Histopathological edema grade was significantly lower for SEMS than for TDT and ESFD (P < 0.0001). There was no significant difference between edema grade and duration of decompression in the TDT group (P = 0.629), whereas all patients with SEMS were classified in a low edema grade (grade 0–2). Rate of stoma creation was significantly higher in patients with a high edema grade (grade 3) than in those with a low edema grade (grade 0–2) (P = 0.003). There was no microscopic perforation in any group.ConclusionSignificantly greater resolution of histopathological edema was achieved after placement of SEMS than after placement of TDT. These findings provide an indication of favorable clinical outcomes of SEMS in comparison with TDT and ESFD.
Response of degraded vegetation to introduction of prescribed burning or mowing management in a Mongolian steppe
Authors: Koyama Asuka , Kubo Daisuke , Yoshihara Yu , Jamsran Undarmaa , Okuro Toshiya 
Published: December 2015

AbstractThe understanding of the effectiveness of prescribed burning and mowing as restoration tools of degraded grasslands is important for dryland rangeland management. We examined the effects of spring prescribed burning or seasonal mowing treatments on the degraded vegetation dominated by an unpalatable subshrub, Artemisia adamsii, in grazed Mongolian steppe. Spring burning was conducted in 2013, and three types of mowing treatments (spring, previous summer, and previous summer and autumn) were conducted with varying seasons and frequency, respectively. Soil samples were collected immediately after the spring treatments. Four months after the spring treatments, total plant biomass, the numbers of flowering shoots and florets per shoot of A. adamsii were compared among the treatments. Plant biomass was divided into A. adamsii and herbaceous plants (forbs and graminoids) with different Raunkiaer life forms (chamaephytes, hemicryptophytes and geophytes). Soil properties and total plant biomass were not different among the treatments. For A. adamsii, the biomass and number of flowering shoots were decreased by spring burning and growing‐season mowing, owing to the disappearance of woody‐shoots of A. adamsii. On the other hand, spring mowing had less negative impact on the biomass of A. adamsii due to an increase of the newly‐formed shoots. The biomass of perennial herbaceous‐plants was not affected by spring burning, regardless of the life form, whereas that of the geophytic sedge Carex duriuscula increased in the summer‐and‐autumn mowing. Thus, spring burning and growing‐season mowing have the potential to control undesirable subshrubs due to loss of the woody shoots, while spring mowing may not be recommended as a useful management tool in the Mongolian steppe. Our results emphasize that the introduction of these management tools for degraded‐grassland restoration in dryland rangelands needs more long‐term evaluation considering the relation with external factors such as climate variation and grazing impact.
There is more to risk and safety planning than dramatic risks: Mental health nurses’ risk assessment and safety‐management practice
Authors: Higgins Agnes , Doyle Louise , Downes Carmel , Morrissey Jean , Costello Paul , Brennan Michael , Nash Michael 
Published: December 2015

AbstractRisk assessment and safety planning are considered a cornerstone of mental health practice, yet limited research exists into how mental health nurses conceptualize ‘risk’ and how they engage with risk assessment and safety planning. The aim of the present study was to explore mental health nurses’ practices and confidence in risk assessment and safety planning. A self‐completed survey was administered to 381 mental health nurses in Ireland. The findings indicate that nurses focus on risk to self and risk to others, with the risk of suicide, self‐harm, substance abuse, and violence being most frequently assessed. Risk from others and ‘iatrogenic’ risk were less frequently considered. Overall, there was limited evidence of recovery‐oriented practice in relation to risk. The results demonstrate a lack of meaningful engagement with respect to collaborative safety planning, the identification and inclusion of protective factors, and the inclusion of positive risk‐taking opportunities. In addition, respondents report a lack of confidence working with positive risk taking and involving family/carers in the risk‐assessment and safety‐planning process. Gaps in knowledge about risk‐assessment and safety‐planning practice, which could be addressed through education, are identified, as are the implications of the findings for practice and research.
Novel functions of platelets in the liver
Authors: Kurokawa Tomohiro , Zheng Yun‐Wen , Ohkohchi Nobuhiro 
Published: December 2015

AbstractPlatelets contain not only proteins needed for hemostasis but also many growth factors that are required for organ development, tissue regeneration, and repair. Thrombocytopenia, which is frequently observed in patients with chronic liver disease (CLD) and cirrhosis, is due to various causes, such as decreased thrombopoietin production and accelerated platelet destruction caused by hypersplenism; however, the relationship between thrombocytopenia and hepatic pathogenesis and the role of platelets in CLD are poorly understood. Thus, in this paper, the experimental evidence for platelets improving liver fibrosis and accelerating liver regeneration is summarized and addressed based on studies conducted in our laboratory and current progress reports from other investigators. Platelets improve liver fibrosis by inactivating hepatic stellate cells to decrease collagen production. The level of intracellular cAMP is increased by adenosine through its receptors on hepatic stellate cells, thereby resulting in inactivation of these cells. Adenosine is produced by degradation of adenine nucleotides, which are stored in abundance within the dense granules of platelets. The regenerative effect of platelets in the liver consists of three mechanisms: a direct effect on hepatocytes, a cooperative effect with liver sinusoidal endothelial cells, and a collaborative effect with Kupffer cells. Based on these experiments, a clinical trial suggested that the increase in platelets induced by platelet transfusion improved liver function in patients with CLD in a clinical setting.We highlight the current knowledge concerning the role of platelets in CLD and expect to open a novel avenue for application of these clinical therapies to treat liver disease.
Active gas aspiration versus simple gas evacuation to reduce shoulder pain after diagnostic laparoscopy: A randomized controlled trial
Authors: Leelasuwattanakul Nujaree , Bunyavehchevin Suvit , Sriprachittichai Pin 
Published: December 2015

AbstractAimTo evaluate the effectiveness of active gas aspiration to reduce postoperative shoulder pain in infertile women undergoing day‐case diagnostic laparoscopy.Material and MethodsSeventy four infertile women undergoing diagnostic laparoscopy during July 2013 to February 2014 were randomized to an active gas aspiration or simple gas evacuation (control) group at the end of the surgery. Postoperative shoulder and wound pain were assessed using a visual analog scale at 6, 12 and 24 h after surgery. Consumption of rescue analgesics and adverse events were recorded.ResultsThere were 37 patients in each group. The shoulder pain scores of the active gas aspiration group showed lower pain intensity than the simple gas evacuation group, with statistically significant results at at all time points. There was no significant difference in surgical wound pain. The proportion of patients who required postoperative rescue analgesics was lower in the study than in control group (43.2% vs 67.6%, P = 0.035). There was no significant difference in adverse events until 24 h after surgery.ConclusionsActive gas aspiration provided a significantly superior effect on postoperative shoulder pain relief after diagnostic laparoscopy when compared to simple gas evacuation, without any adverse events.