bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human capital consequences of violence in schools: Estimating the impact of violence in schools on education outcomes in Brazil
Authors: Deole Sumit S. 
Published: September 2017

AbstractImplementation of policies to reduce the incidence of violence in schools needs a comprehensive understanding of the phenomenon and its consequences for the victims, perpetrators, and witnesses alike. However, much of the existing literature either focuses on the impact of violence on victim students or studies the specific cases of violent conflicts. Using Brazilian education data, this paper examines the impact of violence in schools on educational outcomes of the schooling system and emphasizes the human capital consequences of recorded violent incidents in schools. First, the paper establishes the psychological stress–threat mechanism by which violent incidents in schools directly impact students' mathematics test scores as well as school level average of these test scores. Thereafter, the paper demonstrates the reduced learning mechanism by which violence further detriments the quality of education, albeit indirectly, by disengaging the teachers and students from their professional responsibilities. The main results are tested for robustness and policy implications are discussed.
Swedish primary healthcare nurses’ perceptions of using digital eHealth services in support of patient self‐management
Authors: Öberg Ulrika , Orre Carl Johan , Isaksson Ulf , Schimmer Robyn , Larsson Håkan , Hörnsten Åsa 
Published: September 2017

BackgroundNurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self‐management for people with chronic conditions, it is important to highlight nurses’ experiences. This study is part of a larger project aimed at implementing person‐centred interactive self‐management support (iSMS) in primary health care.AimThe aim of this study was to describe Swedish primary healthcare nurses’ perceptions of using digital eHealth systems and services to support patient self‐management.MethodsFocus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis.ResultsThree themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes.Conclusion and relevance to clinical practiceThe results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self‐management support as well as giving the primary healthcare nurses adequate resources to support patients’ self‐management while still maintaining the values associated with person‐centred care.
Pro‐arrhythmic atrial phenotypes in incrementally paced murine Pgc1β−/− hearts: effects of age
Authors: Valli Haseeb , Ahmad Shiraz , Fraser James A. , Jeevaratnam Kamalan , Huang Christopher L.‐H. 
Published: September 2017

New Findings
What is the central question of this study?
Can we experimentally replicate atrial pro‐arrhythmic phenotypes associated with important chronic clinical conditions, including physical inactivity, obesity, diabetes mellitus and metabolic syndrome, compromising mitochondrial function, and clarify their electrophysiological basis?

What is the main finding and its importance?
Electrocardiographic and intracellular cardiomyocyte recording at progressively incremented pacing rates demonstrated age‐dependent atrial arrhythmic phenotypes in Langendorff‐perfused murine Pgc1β−/− hearts for the first time. We attributed these to compromised action potential conduction and excitation wavefronts, whilst excluding alterations in recovery properties or temporal electrophysiological instabilities, clarifying these pro‐arrhythmic changes in chronic metabolic disease.

Atrial arrhythmias, most commonly manifesting as atrial fibrillation, represent a major clinical problem. The incidence of atrial fibrillation increases with both age and conditions associated with energetic dysfunction. Atrial arrhythmic phenotypes were compared in young (12–16 week) and aged (>52 week) wild‐type (WT) and peroxisome proliferative activated receptor, gamma, coactivator 1 beta (Ppargc1b)‐deficient (Pgc1β−/−) Langendorff‐perfused hearts, previously used to model mitochondrial energetic disorder. Electrophysiological explorations were performed using simultaneous whole‐heart ECG and intracellular atrial action potential (AP) recordings. Two stimulation protocols were used: an S1S2 protocol, which imposed extrasystolic stimuli at successively decremented intervals following regular pulse trains; and a regular pacing protocol at successively incremented frequencies. Aged Pgc1β−/− hearts showed greater atrial arrhythmogenicity, presenting as atrial tachycardia and ectopic activity. Maximal rates of AP depolarization (dV/dtmax) were reduced in Pgc1β−/− hearts. Action potential latencies were increased by the Pgc1β−/− genotype, with an added interactive effect of age. In contrast, AP durations to 90% recovery (APD90) were shorter in Pgc1β−/− hearts despite similar atrial effective recovery periods amongst the different groups. These findings accompanied paradoxical decreases in the incidence and duration of alternans in the aged and Pgc1β−/− hearts. Limiting slopes of restitution curves of APD90 against diastolic interval were correspondingly reduced interactively by Pgc1β−/− genotype and age. In contrast, reduced AP wavelengths were associated with Pgc1β−/− genotype, both independently and interacting with age, through the basic cycle lengths explored, with the aged Pgc1β−/− hearts showing the shortest wavelengths. These findings thus implicate AP wavelength in possible mechanisms for the atrial arrhythmic changes reported here.
Evaluation of the cobas Cdiff Test for Detection of Toxigenic Clostridium difficile in Stool Samples
Authors: Peterson Lance R. , Young Stephen A. , Davis Thomas E. , Wang Zi-Xuam , Duncan John , Noutsios Christopher , Liesenfeld Oliver , Osiecki John C. , Lewinski Michael A. 
Published: September 2017

ABSTRACT

Nucleic acid amplification tests (NAATs) are reliable tools for the detection of toxigenic
Clostridium difficile
from unformed (liquid or soft) stool samples. The objective of this study was to evaluate performance of the cobas Cdiff test on the cobas 4800 system using prospectively collected stool specimens from patients suspected of having
C. difficile
infection (CDI). The performance of the cobas Cdiff test was compared to the results of combined direct and broth-enriched toxigenic culture methods in a large, multicenter clinical trial. Additional discrepancy analysis was performed by using the Xpert
C. difficile
Epi test. Sample storage was evaluated by using contrived and fresh samples before and after storage at −20°C. Testing was performed on samples from 683 subjects (306 males and 377 females); 113 (16.5%) of 683 subjects were positive for toxigenic
C. difficile
by direct toxigenic culture, and 141 of 682 subjects were positive by using the combined direct and enriched toxigenic culture method (reference method), for a prevalence rate of 20.7%. The sensitivity and specificity of the cobas Cdiff test compared to the combined direct and enriched culture method were 92.9% (131/141; 95% confidence interval [CI], 87.4% to 96.1%) and 98.7% (534/541; 95% CI, 97.4% to 99.4%), respectively. Discrepancy analysis using results for retested samples from a second NAAT (Xpert C. difficile/Epi test; Cepheid, Sunnyvale, CA) found no false-negative and 4 false-positive cobas Cdiff test results. There was no difference in positive and negative results in comparisons of fresh and stored samples. These results support the use of the cobas Cdiff test as a robust aid in the diagnosis of CDI.
Optimizing Test Utilization in the Clinical Microbiology Laboratory: Tools and Opportunities
Authors: Pritt Bobbi S. 
Published: September 2017

ABSTRACT

Optimal laboratory test utilization is important for providing high-quality clinical care and efficiently using limited health care resources. While microbiologists have long been advocates for appropriate laboratory test utilization, the widespread availability of electronic medical records capable of supporting clinician order entry and of clinical decision support tools (CDSTs) has provided expanded opportunities for implementing effective, automated test stewardship protocols. D. Nikolic et al. (J. Clin. Microbiol. 55:3350–3354, 2017,
https://doi.org/10.1128/JCM.01052-17
) describe the results of implementing a CDST at their institution to curtail stool microbiology testing for patients hospitalized for more than 3 days. Their intervention significantly decreased unnecessary test orders and saved their laboratory over $8,000 in reagent and labor costs during an 11-month postintervention period. That report provides an excellent example of how clinical microbiologists can use electronic tools to optimize laboratory test utilization in their health care system.
Differentiated Human SH-SY5Y Cells Provide a Reductionist Model of Herpes Simplex Virus 1 Neurotropism
Authors: Shipley Mackenzie M. , Mangold Colleen A. , Kuny Chad V. , Szpara Moriah L. 
Published: September 2017

ABSTRACTNeuron-virus interactions that occur during herpes simplex virus (HSV) infection are not fully understood. Neurons are the site of lifelong latency and are a crucial target for long-term suppressive therapy or viral clearance. A reproducible neuronal model of human origin would facilitate studies of HSV and other neurotropic viruses. Current neuronal models in the herpesvirus field vary widely and have caveats, including incomplete differentiation, nonhuman origins, or the use of dividing cells that have neuropotential but lack neuronal morphology. In this study, we used a robust approach to differentiate human SH-SY5Y neuroblastoma cells over 2.5 weeks, producing a uniform population of mature human neuronal cells. We demonstrate that terminally differentiated SH-SY5Y cells have neuronal morphology and express proteins with subcellular localization indicative of mature neurons. These neuronal cells are able to support a productive HSV-1 infection, with kinetics and overall titers similar to those seen in undifferentiated SH-SY5Y cells and the related SK-N-SH cell line. However, terminally differentiated, neuronal SH-SY5Y cells release significantly less extracellular HSV-1 by 24 h postinfection (hpi), suggesting a unique neuronal response to viral infection. With this model, we are able to distinguish differences in neuronal spread between two strains of HSV-1. We also show expression of the antiviral protein cyclic GMP-AMP synthase (cGAS) in neuronal SH-SY5Y cells, which is the first demonstration of the presence of this protein in nonepithelial cells. These data provide a model for studying neuron-virus interactions at the single-cell level as well as via bulk biochemistry and will be advantageous for the study of neurotropic virusesin vitro.IMPORTANCEHerpes simplex virus (HSV) affects millions of people worldwide, causing painful oral and genital lesions, in addition to a multitude of more severe symptoms such as eye disease, neonatal infection, and, in rare cases, encephalitis. Presently, there is no cure available to treat those infected or prevent future transmission. Due to the ability of HSV to cause a persistent, lifelong infection in the peripheral nervous system, the virus remains within the host for life. To better understand the basis of virus-neuron interactions that allow HSV to persist within the host peripheral nervous system, improved neuronal models are required. Here we describe a cost-effective and scalable human neuronal model system that can be used to study many neurotropic viruses, such as HSV, Zika virus, dengue virus, and rabies virus.
Epstein-Barr Virus Fusion with Epithelial Cells Triggered by gB Is Restricted by a gL Glycosylation Site
Authors: Möhl Britta S. , Chen Jia , Park Seo Jin , Jardetzky Theodore S. , Longnecker Richard 
Published: September 2017

ABSTRACT
Epstein-Barr virus (EBV) entry into epithelial cells is mediated by the conserved core fusion machinery, composed of the fusogen gB and the receptor-binding complex gH/gL. The heterodimeric gH/gL complex binds to the EBV epithelial cell receptor or gp42, which binds to the B-cell receptor, triggering gB-mediated fusion of the virion envelope with cellular membranes. Our previous study found that the gL glycosylation mutant N69L/S71V had an epithelial cell-specific hyperfusogenic phenotype. To study the influence of this gL mutant on the initiation and kinetics of gB-driven epithelial cell fusion, we established a virus-free split-green fluorescent protein cell-cell fusion assay that enables real-time measurements of membrane fusion using live cells. The gL_N69L/S71V mutant had a large increase in epithelial cell fusion activity of up to 300% greater than that of wild-type gL starting at early time points. The hyperfusogenicity of the gL mutant was not a result of alterations in complex formation with gH or alterations in cellular localization. Moreover, the hyperfusogenic phenotype of the gL mutant correlated with the formation of enlarged syncytia. In summary, our present findings highlight an important role of gL in the kinetics of gB-mediated epithelial cell fusion, adding to previous findings indicating a direct interaction between gL and gB in EBV membrane fusion.

IMPORTANCE
EBV predominantly infects epithelial cells and B lymphocytes, which are the cells of origin for the EBV-associated malignancies Hodgkin and Burkitt lymphoma as well as nasopharyngeal carcinoma. Contrary to the other key players of the core fusion machinery, gL has the most elusive role during EBV-induced membrane fusion. We found that the glycosylation site N69/S71 of gL is involved in restricting epithelial cell fusion activity, strongly correlating with syncytium size. Interestingly, our data showed that the gL glycosylation mutant increases the fusion activity of the hyperfusogenic gB mutants, indicating that this gL mutant and the gB mutants target different steps during fusion. Our studies on how gL and gB work together to modulate epithelial cell fusion kinetics are essential to understand the highly tuned tropism of EBV for epithelial cells and B lymphocytes and may result in novel strategies for therapies preventing viral entry into target host cells. Finally, making our results of particular interest is the absence of gL syncytial mutants in other herpesviruses.
APOBEC3A Is Upregulated by Human Cytomegalovirus (HCMV) in the Maternal-Fetal Interface, Acting as an Innate Anti-HCMV Effector
Authors: Weisblum Yiska , Oiknine-Djian Esther , Zakay-Rones Zichria , Vorontsov Olesya , Haimov-Kochman Ronit , Nevo Yuval , Stockheim David , Yagel Simcha , Panet Amos , Wolf Dana G. 
Published: September 2017

ABSTRACT

Human cytomegalovirus (HCMV) is the leading cause of congenital infection and is associated with a wide range of neurodevelopmental disabilities and intrauterine growth restriction. Yet our current understanding of the mechanisms modulating transplacental HCMV transmission is poor. The placenta, given its critical function in protecting the fetus, has evolved effective yet largely uncharacterized innate immune barriers against invading pathogens. Here we show that the intrinsic cellular restriction factor
apo
lipoprotein B
e
diting
c
atalytic subunit-like 3A (APOBEC3A [A3A]) is profoundly upregulated following
ex vivo
HCMV infection in human decidual tissues—constituting the maternal aspect of the placenta. We directly demonstrated that A3A severely restricted HCMV replication upon controlled overexpression in epithelial cells, acting by a cytidine deamination mechanism to introduce hypermutations into the viral genome. Importantly, we further found that A3 editing of HCMV DNA occurs both
ex vivo
in HCMV-infected decidual organ cultures and
in vivo
in amniotic fluid samples obtained during natural congenital infection. Our results reveal a previously unexplored role for A3A as an innate anti-HCMV effector, activated by HCMV infection in the maternal-fetal interface. These findings pave the way to new insights into the potential impact of APOBEC proteins on HCMV pathogenesis.

IMPORTANCE
In view of the grave outcomes associated with congenital HCMV infection, there is an urgent need to better understand the innate mechanisms acting to limit transplacental viral transmission. Toward this goal, our findings reveal the role of the intrinsic cellular restriction factor A3A (which has never before been studied in the context of HCMV infection and vertical viral transmission) as a potent anti-HCMV innate barrier, activated by HCMV infection in the authentic tissues of the maternal-fetal interface. The detection of naturally occurring hypermutations in clinical amniotic fluid samples of congenitally infected fetuses further supports the idea of the occurrence of A3 editing of the viral genome in the setting of congenital HCMV infection. Given the widely differential tissue distribution characteristics and biological functions of the members of the A3 protein family, our findings should pave the way to future studies examining the potential impact of A3A as well as of other A3s on HCMV pathogenesis.
Functional performance 6 months after ACL reconstruction can predict return to participation in the same preinjury activity level 12 and 24 months after surgery
Authors: Nawasreh Zakariya , Logerstedt David , Cummer Kathleen , Axe Michael , Risberg May Arna , Snyder-Mackler Lynn 
Published: September 2017

BackgroundAssessing athletes’ readiness is a key component for successful outcomes after ACL reconstruction (ACLR).ObjectivesTo investigate whether return-to-activity criteria, individually or in combination, at 6 months after ACLR can predict return to participation in the same preinjury activity level at 12 and 24 months after ACLR.MethodsNinety-five level I/II participants completed return-to-activity criteria testing (isometric quadriceps index, single-legged hop tests, Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and Global Rating Score (GRS)) at 6 months after ACLR. The PASS group was defined as scoring>90% on all criteria and the FAIL group as scoring <90% on any criteria. At 12 and 24 months after ACLR, participants were asked if they had returned to participate in the same preinjury activity level or not. All return-to-activity criteria, except quadriceps index, were entered into the logistic regression model.Results81% and 84.4% of the PASS group returned to participation in the same preinjury activity level, while only 44.2% and 46.4% of the FAIL group returned at 12 and 24 months, respectively, after ACLR. The 6-meter timed hop, single hop and triple hop limb symmetry indexes; GRS; and KOS-ADLS individually predicted the outcome of interest at 12 months after ACLR (range: R2: 0.12–0.22, p<0.024). In combination, they explained 27% of the variance (p=0.035). All hop tests, individually, predicted the outcome of interest at 24 months after ACLR (range: R2: 0.26–0.37; p<0.007); in combination they explained 45% of the variance (p<0.001).ConclusionReturn to participation in the same preinjury activity level at 12 and 24 months after ACLR was higher in those who passed the criteria compared with those who failed. Individual and combined return-to-activity criteria predicted the outcomes of interest, with the hop tests as consistent predictors at 12 and 24 months after ACLR.
A systematic review of prospective epidemiological research into injury and illness in Olympic combat sport
Authors: Bromley Sally J , Drew Michael K , Talpey Scott , McIntosh Andrew S , Finch Caroline F 
Published: September 2017

BackgroundCombat sports involve body contact through striking, kicking and/or throwing. They are anecdotally referred to as ‘dangerous’, yet long-term investigation into specific injury rates is yet to be explored.ObjectiveTo describe incidence and prevalence of injury and illness within Olympic combat sports and to investigate risk of bias of prospective injury and illness research within these sports.MethodsWe systematically searched literature published up until May 2016. We included prospective studies of injury/illness in elite combat athletes lasting more than 12 weeks. Risk of bias was assessed using a modified version of the Downs and Black checklist for methodological quality. Included studies were mapped to the Oxford Centre for Evidence-Based Medicine levels of evidence.ResultsNine studies were included, and most (n=6) had moderate risk of bias. Studies provided level 1/2b evidence that the most frequently injured areas were the head/face (45.8%), wrist (12.0%) and lower back (7.8%) in boxing; the lower back (10.9%), shoulder (10.2%) and knee (9.7%) in judo; the fingers (22.8%) and thigh (9.1%) in taekwondo; and the knee (24.8%), shoulder (17.8%) and head/face (16.6%) in wrestling. Heterogeneity of injury severity classifications and inconsistencies inexposure measures prevented any direct comparisons of injury severity/incidence across combat sports.ConclusionsThere is currently a lack of consensus in the collection of injury/illness data, limiting the development of prevention programmes for combat sport as a whole. However, sport-specific data that identify body areas with high injury frequency can provide direction to clinicians, enabling them to focus their attention on developing pathologies in these areas. In doing so, clinicians can enhance the practical elements of their role within the integrated combat sport performance team and assist in the regular update of surveillance records.
A frog in the throat?
Authors: Waseem Hunniya , Welch Matthew 
Published: September 2017

Clinical introductionA 44-year-old woman, with an unremarkable medical history, presented in the middle of the night with discomfort in her throat. She described being assaulted by an assailant who put his ‘fist in her mouth’, trying to suffocate her. On examination, she had normal observations and no signs of injury, other than scratch marks around her mouth; she reported no odynophagia and was able to swallow fluids readily. During examination, she complained that lying flat made her increasingly uncomfortable and was causing burgeoning dyspnoea. She had lateral soft tissue radiography of her neck as shown in figure 1.Figure 1Lateral neck soft tissue radiograph of the 44-year-old woman.QuestionWhat is the diagnosis?Caustic stricture of the oesophagusPharyngeal perforationPharyngeal pouchBoerhaave’s syndrome