bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transmission and Effect of Multiple Clusters of Seasonal Influenza in a Swiss Geriatric Hospital
Authors: Pagani Leonardo , Thomas Yves , Huttner Benedikt , Sauvan Valérie , Notaridis Grigorios , Kaiser Laurent , Iten Anne , Pittet Didier , Harbarth Stephan 
Published: April 2015

ObjectivesTo investigate a nosocomial outbreak of influenza.DesignProspective outbreak investigation with active case finding and molecular typing.SettingA large academic geriatric hospital in Switzerland.ParticipantsElderly hospitalized adults.MeasurementsBased on syndromic surveillance, a nosocomial influenza outbreak was suspected in February 2012. All suspected cases were screened for respiratory viruses using real‐time reverse transcription polymerase chain reaction of nasopharyngeal swabs. Infection control procedures (droplet precautions with single room isolation whenever possible) were implemented for all suspected or confirmed cases. Specimens positive for influenza viruses were processed and sequenced whenever possible to track transmission dynamics.ResultsRespiratory samples from 155 suspected cases were analyzed during the outbreak period, of which 69 (44%) were positive for influenza virus, 26 (17%) were positive for other respiratory viruses, and 60 (39%) were negative. Three other cases fulfilled clinical criteria for influenza infection but were not sampled, and one individual was admitted with an already positive test, resulting in a total of 73 influenza cases, of which 62 (85%) were classified as nosocomial. Five distinct clusters of nosocomial transmission were identified using viral sequencing, with epidemiologically unexpected in‐hospital transmission dynamics. Seven of 23 patients who experienced influenza complications died. Sixteen healthcare workers experienced an influenza‐like illness (overall vaccination rate, 36%).ConclusionNosocomial influenza transmission caused more secondary cases than repeated community importation during this polyclonal outbreak. Molecular tools revealed complex transmission dynamics. Low healthcare worker vaccination rates and gaps in recommended infection control procedures are likely to have contributed to nosocomial spread of influenza, which remains a potentially life‐threatening disease in elderly adults.
Creating a Network of High‐Quality Skilled Nursing Facilities: Preliminary Data on the Postacute Care Quality Improvement Experiences of an Accountable Care Organization
Authors: Lage Daniel E. , Rusinak Donna , Carr Darcy , Grabowski David C. , Ackerly D. Clay 
Published: April 2015

Postacute care (PAC) is an important source of cost growth and variation in the Medicare program and is critical to accountable care organization (ACO) and bundled payment efforts to improve quality and value in the Medicare program, but ACOs must often look outside their walls to identify high‐value external PAC partners, including skilled nursing facilities (SNFs). As a solution to this problem, the integrated health system, Partners HealthCare System (PHS) and its Pioneer ACO launched the PHS SNF Collaborative Network in October 2013 to identify and partner with high‐quality SNFs. This study details the method by which PHS selected SNFs using minimum criteria based on public scores and secondary criteria based on self‐reported measures, describes the characteristics of selected and nonselected SNFs, and reports SNF satisfaction with the collaborative. The selected SNFs (n = 47) had significantly higher CMS Five‐Star scores than the nonselected SNFs (n = 93) (4.6 vs 3.2, P < .001) and were more likely than nonselected SNFs that met the minimum criteria (n = 35) to have more than 5 days of clinical coverage (17.0% vs 2.9%, P = .02) and to have a physician see admitted individuals within 24 (38.3% vs 17.1%, P = .02) and 48 hours (93.6% vs 80.0%, P = .03). A survey sent to collaborative SNFs found high satisfaction with the process (average satisfaction, 4.6/5, with 1 = very dissatisfied and 5 = very satisfied, n = 19). Although the challenges of improving care in SNFs remain daunting, this approach can serve as a first step toward greater clinical collaboration between acute and postacute settings that will lead to better outcomes for frail older adults.
Dirty‐Appearing White Matter in the Brain is Associated with Altered Cerebrospinal Fluid Pulsatility and Hypertension in Individuals without Neurologic Disease
Authors: Beggs Clive B. , Magnano Christopher , Shepherd Simon J. , Belov Pavel , Ramasamy Deepa P. , Hagemeier Jesper , Zivadinov Robert 
Published: April 2015

ABSTRACTBACKGROUND AND PURPOSEAging of the healthy brain is characterized by focal or nonfocal white matter (WM) signal abnormality (SA) changes, which are typically detected as leukoaraiosis (LA). Hypertension is a risk factor for WM lesion formation. This study investigated whether LA might be associated with increased cerebrospinal fluid (CSF) pulsatility linked to arterial hypertension.METHODSA total of 101 individuals without neurologic diseases (53 females and 48 males) aged between 18 and 75 years underwent 3T brain MRI with cine phase contrast imaging for CSF flow estimation, after providing their informed consent. LA was defined as the presence of focal T2 WM SA changes and/or nonfocal uniform areas of signal increase termed dirty appearing white matter (DAWM). Relevant information relating to cardiovascular risk factors was also collected.RESULTSWhen controlled for age and hypertension, significant partial correlations were observed between: DAWM volume and: net negative flow (r = –.294, P = .014); net positive flow (NPF) (r = .406, P = .001); and peak positive velocity (r = .342, P = .004). Multiple linear regression analysis revealed DAWM volume to be significantly correlated with CSF NPF (P = .019) and hypertension (P = .007), whereas T2 WM SA volume was only significantly correlated with age (P = .002). Combined DAWM and T2 WM SA volumes were significantly related with age (P = .001) and CSF peak negative velocity (P = .041).CONCLUSIONSRarefaction of WM leading to LA is a multifactorial process, in which formation of DAWM induced by hypertension and increased aqueductal CSF pulsatility, may play a contributory role. These two factors appear to act independently of each other in a process that is independent of age.
The amino acid and hydrocarbon contents of the Paris meteorite: Insights into the most primitive CM chondrite
Authors: Martins Zita , Modica Paola , Zanda Brigitte , d'Hendecourt Louis Le Sergeant 
Published: April 2015

AbstractThe Paris meteorite is one of the most primitive carbonaceous chondrites. It is reported to be the least aqueously altered CM chondrite, and to have experienced only weak thermal metamorphism. We have analyzed for the first time the amino acid and hydrocarbon contents of this pristine meteorite by gas chromatography–mass spectrometry (GC–MS). When plotting the relative amino acids abundances of several CM chondrites according to the increasing hydrothermal scale (petrologic subtypes), from the CM2.7/2.8 Paris to the CM2.0 MET 01070, Paris has the lowest relative abundance of β‐alanine/glycine (0.15), which fits with the relative abundances of β‐alanine/glycine increasing with increasing aqueous alteration for CM chondrites. These results confirm the influence of aqueous alteration on the amino acid abundances and distribution. The amino acid analysis shows that the isovaline detected in this meteorite is racemic (d/l = 0.99 ± 0.08; l‐enantiomer excess = 0.35 ± 0.5%; corrected d/l = 1.03; corrected l‐enantiomer excess = −1.4 ± 2.6%). The identified hydrocarbons show that Paris has n‐alkanes ranging from C16 to C25 and 3‐ to 5‐ring nonalkylated polycyclic aromatic hydrocarbons (PAHs). The lack of alkylated PAHs in Paris seems to be also related to this low degree of aqueous alteration on its parent body. The extraterrestrial hydrocarbon content, suggested by the absence of any biomarker, may well have a presolar origin. The chemistry of the Paris meteorite may thus be closely related to the early stages of the solar nebula with a contribution from interstellar (molecular cloud) precursors.
The Košice meteorite fall: Recovery and strewn field
Authors: Tóth Juraj , Svoreň Ján , Borovička Jiří , Spurný Pavel , Igaz Antal , Kornoš Leonard , Vereš Peter , Husárik Marek , Koza Július , Kučera Aleš , Zigo Pavel , Gajdoš Štefan , Világi Jozef , Čapek David , Krišandová Zuzana , Tomko Dušan , Šilha Jiří , Schunová Eva , Bodnárová Marcela , Búzová Diana , Krejčová Tereza 
Published: April 2015

AbstractWe provide the circumstances and details of the fireball observation, search expeditions, recovery, strewn field, and physical characteristics of the Košice meteorite that fell in Slovakia on February 28, 2010. The meteorite was only the 15th case of an observed bolide with a recovered mass and subsequent orbit determination. Despite multiple eyewitness reports of the bolide, only three videos from security cameras in Hungary were used for the strewn field determination and orbit computation. Multiple expeditions of professionals and individual searchers found 218 fragments with total weight of 11.3 kg. The strewn field with the size of 5 × 3 km is characterized with respect to the space distribution of the fragments, their mass and size‐frequency distribution. This work describes a catalog of 78 fragments, mass, size, volume, fusion crust, names of discoverers, geographic location, and time of discovery, which represents the most complex study of a fresh meteorite fall. From the analytical results, we classified the Košice meteorite as an ordinary H5 chondrite.
A genetic perspective on rapid evolution in cane toads (Rhinella marina)
Authors: Rollins Lee A. , Richardson Mark F. , Shine Richard 
Published: April 2015

AbstractThe process of biological invasion exposes a species to novel pressures, in terms of both the environments it encounters and the evolutionary consequences of range expansion. Several invaders have been shown to exhibit rapid evolutionary changes in response to those pressures, thus providing robust opportunities to clarify the processes at work during rapid phenotypic transitions. The accelerating pace of invasion of cane toads (Rhinella marina) in tropical Australia during its 80‐year history has been well characterized at the phenotypic level, including common‐garden experiments that demonstrate heritability of several dispersal‐relevant traits. Individuals from the invasion front (and their progeny) show distinctive changes in morphology, physiology and behaviour that, in combination, result in far more rapid dispersal than is true of conspecifics from long‐colonized areas. The extensive body of work on cane toad ecology enables us to place into context studies of the genetic basis of these traits. Our analyses of differential gene expression from toads from both ends of this invasion‐history transect reveal substantial upregulation of many genes, notably those involved in metabolism and cellular repair. Clearly, then, the dramatically rapid phenotypic evolution of cane toads in Australia has been accompanied by substantial shifts in gene expression, suggesting that this system is well suited to investigating the genetic underpinnings of invasiveness.
Two amino acids near the N‐terminus of Cucumber mosaic virus 2b play critical roles in the suppression of RNA silencing and viral infectivity
Authors: Dong Kai , Wang Ying , Zhang Zhen , Chai Long‐Xiang , Tong Xin , Xu Jin , Li Dawei , Wang Xian‐Bing 
Published: April 2015

SummaryCucumber mosaic virus (CMV) 2b suppresses RNA silencing primarily through the binding of double‐stranded RNA (dsRNA) of varying sizes. However, the biologically active form of 2b remains elusive. Here, we demonstrate that the single and double alanine substitution mutants in the N‐terminal 15th leucine and 18th methionine of CMV 2b exhibit drastically attenuated virulence in wild‐type plants, but are efficiently rescued in mutant plants defective in RNA‐dependent RNA polymerase 6 (RDR6) and Dicer‐like 4 (DCL4). Moreover, the transgenic plants of 2b, but not 2blm (L15A/M18A), rescue the high infectivity of CMV‐Δ2b through the suppression of antiviral silencing. L15A, M18A or both weaken 2b suppressor activity on local and systemic transgene silencing. In contrast with the high affinity of 2b to short and long dsRNAs, 2blm is significantly compromised in 21‐bp duplex small interfering RNA (siRNA) binding ability, but maintains a strong affinity for long dsRNAs. In cross‐linking assays, 2b can form dimers, tetramers and oligomers after treatment with glutaraldehyde, whereas 2blm only forms dimers, rather than tetramers and oligomers, in vitro. Together, these findings suggest that L15 and M18 of CMV 2b are required for high affinity to ds‐siRNAs and oligomerization activity, which are essential for the suppression activity of 2b on antiviral silencing.
Utilizing functional lumen imaging probe topography to evaluate esophageal contractility during volumetric distention: a pilot study
Authors: Carlson D. A. , Lin Z. , Rogers M. C. , Lin C. Y. , Kahrilas P. J. , Pandolfino J. E. 
Published: April 2015

AbstractBackgroundThe functional lumen imaging probe (FLIP) measures luminal cross‐sectional area and pressure during volumetric distension. By applying novel customized software to produce FLIP topography plots, organized esophageal contractility can be visualized and analyzed. We aimed to describe the stimulus thresholds and contractile characteristics for distension‐induced esophageal body contractility using FLIP topography in normal controls.MethodsTen healthy controls were evaluated during endoscopy with FLIP. During stepwise bag distension, simultaneous intra‐bag pressure and luminal diameter measurements were obtained and exported to a MatLab program to generate FLIP topography plots. The distension volume, intra‐bag pressure, and maximum esophageal body diameters were measured for the onset and cessation of repetitive antegrade contractions (RACs). Contraction duration, interval, magnitude, and velocity were measured at 8 and 3‐cm proximal to the esophagogastric junction.Key ResultsEight of ten subjects demonstrated RACs at a median onset volume of 29 mL (IQR: 25–38.8), median intra‐bag pressure of 10.7 mmHg (IQR: 8.6–15.9), and median maximum esophageal body diameter of 18.5 mm (IQR: 17.5–19.6). Cessation of RACs occurred prior to completion of the distension protocol in three of the eight subjects exhibiting RACs. Values of the RAC‐associated contractile metrics were also generated to characterize these events.Conclusions & InferencesDistension‐induced esophageal contractions can be assessed utilizing FLIP topography. RACs are a common finding in asymptomatic controls in response to volume distention and have similar characteristics to secondary peristalsis and repetitive rapid swallows.
Indoor Tanning Practices of Colorado High School Students
Authors: Karimkhani Chante , Jadotte Yuri T. , Townley Cate , Collins Nicole , Dellavalle Robert P. 
Published: April 2015

AbstractFor the first time, the 2013 Colorado Youth Risk Behavior Survey assessed indoor tanning practices of Colorado high school students. The survey revealed that girls are more likely to use indoor tanning devices than boys and that the majority of students who tan do so once or twice annually. Health care professionals and policymakers should focus on these groups in efforts to curtail indoor tanning and the associated risk of skin cancer in youth.
Congenital Plantar Angiofibroma‐Like Hamartoma
Authors: Burgess Elizabeth M. , Greyling Laura A. , Davis Loretta S. 
Published: April 2015

AbstractA 2‐year‐old girl presented with a congenital, slow‐growing, exophytic nodule on the plantar surface of the foot. Histopathology revealed a hamartoma consisting of dermal angiofibroma features with overlying epidermal verruciform hyperplasia.
Multiple Pyogenic Granulomas After Burns: Response to Conservative Treatment in Five Children
Authors: Zhao Hongliang , Zhao Huanjun , Zhang Cuiping , Fu Xiaobing 
Published: April 2015

AbstractWe describe five children with multiple pyogenic granulomas after burns that were healed effectively using conservative treatment consisting of 1% povidone‐iodine, silver nanoparticle dressing, and antibiotics. No relapse of the lesions was observed from 6 months to 2 years later.
Efficiency of pollination and satiation of predators determine reproductive output in Iberian Juniperus thurifera woodlands
Authors: Mezquida E. T. , Rodríguez‐García E. , Olano J. M. 
Published: April 2015

AbstractFruit production in animal‐dispersed plants has a strong influence on fitness because large crops increase the number of seeds dispersed by frugivores. Large crops are costly, and environmental control of plant resources is likely play a role in shaping temporal and spatial variations in seed production, particularly in fluctuating environments such as the Mediterranean. The number of fruits that start to develop and the proportion of viable seeds produced are also linked to the number of flowers formed and the efficiency of pollination in wind‐pollinated plants. Finally, large fruit displays also attract seed predators, having a negative effect on seed output. We assessed the relative impact of environmental conditions on fruit production, and their combined effect on seed production, abortion and seed loss through three predispersal predators in Juniperus thurifera L., sampling 14 populations across the Iberian Peninsula. Wetter than average conditions during flowering and early fruit development led to larger crop sizes; this effect was amplified at tree level, with the most productive trees during more favourable years yielding fruits with more viable seeds and less empty and aborted seeds. In addition, large crops satiated the less mobile seed predator. The other two predispersal predators responded to plant traits, the presence of other seed predators and environmental conditions, but did not show a satiation response to the current‐year crop. Our large‐scale study on a dioecious, wind‐pollinated Mediterranean juniper indicates that pollination efficiency and satiation of seed predators, mediated by environmental conditions, are important determinants of reproductive output in this juniper species.
Assessing the toxic effects of DMSO on cord blood to determine exposure time limits and the optimum concentration for cryopreservation
Authors: Fry L. J. , Querol S. , Gomez S. G. , McArdle S. , Rees R. , Madrigal J. A. 
Published: April 2015

Background and ObjectivesAdvantages of using cord blood (CB) over other sources of haematopoietic progenitor cells, such as bone marrow, include the ability to cryopreserve and bank the samples until requested for a transplant. Cryopreservation requires the addition of a cryoprotectant to prevent the formation of intracellular ice during freezing. Dimethyl sulphoxide (DMSO) is commonly used at a concentration of 10% (v/v); however, there is evidence to suggest this chemical is toxic to cells as well as to patients after infusion.Materials and MethodsThe toxic effects of DMSO were assessed through cell viability and in vitro functional assays in fresh and post‐thaw CB samples before determining the maximum exposure time and optimal concentration for cryopreservation.ResultsA dose‐dependent toxicity of DMSO was observed in fresh samples with 40% removing all viable and functional haematopoietic progenitor cells (HPC). In fresh and post‐thaw analysis, minimal toxic effect was observed when cryopreservation was delayed for up to 1 h after 10% DMSO addition. After thawing, DMSO washout was superior to dilution or unmanipulated when maintained for long periods (advantage observed 1 h after thawing). Finally, the optimum concentration for cryopreserving CB was found to be 7·5 to 10% with detrimental effects observed outside of this range.ConclusionThese results support the use of 7·5–10% as the optimal DMSO concentration and the maximum exposure time should be limited to <1 h prior to freezing and 30 min post‐thaw.
Platelet transfusion in thrombotic thrombocytopenic purpura
Authors: Otrock Z. K. , Liu C. , Grossman B. J. 
Published: April 2015

BackgroundPlatelet (PLT) transfusion has been considered contraindicated in patients with thrombotic thrombocytopenic purpura (TTP). However, adverse clinical outcomes and death in patients with TTP after receiving PLT transfusion were based on case reports prior to routine use of plasma exchange (PEX) therapy. PLT transfusions are often required by the interventional radiologist before the insertion of a central venous catheter. In this study, we evaluate whether PLT transfusions are harmful in patients with TTP undergoing PEX.MethodsWe retrospectively reviewed the records of consecutive patients with the clinical diagnosis of TTP who received PEX at our institution between January 2004 and September 2014. An adverse event was defined as any complication including seizures, cerebrovascular accident, bleeding, thrombosis, myocardial infarction or death for any reason within 30 days from the PLT transfusion. Analyses were performed on only patients with ADAMTS13 activity <10%.ResultsOur cohort included 110 patients with the clinical diagnosis of TTP. Fifty‐five patients had ADAMTS13‐deficient TTP, 23 of whom received PLT at some point during disease course. The patients who received PLT transfusion were not different from those who did not in terms of age, gender, race, haematocrit, PLT count, creatinine, LDH and complications. The three patients who received PLT and died had malignancy and complicated disease course. None of them died from a thrombotic event.ConclusionAll deaths in the transfused group happened in very ill patients that had alternative causes of death. PLT transfusions in patients with TTP do not appear harmful in regard to thrombotic complications.
Quantifying morphological heterogeneity: a study of more than 1 000 000 individual stored red blood cells
Authors: Piety N. Z. , Gifford S. C. , Yang X. , Shevkoplyas S. S. 
Published: April 2015

Background and ObjectivesThe morphology of red blood cells (RBCs) deteriorates progressively during hypothermic storage. The degree of deterioration varies between individual cells, resulting in a highly heterogeneous population of cells contained within each RBC unit. Current techniques capable of categorizing the morphology of individual stored RBCs are manual, laborious and error‐prone procedures that limit the number of cells that can be studied. Our objective was to create a simple, automated system for high‐throughput RBC morphology classification.Materials and MethodsA simple microfluidic device, designed to enable rapid, consistent acquisition of images of optimally oriented RBCs, was fabricated using soft lithography. A custom image analysis algorithm was developed to categorize the morphology of each individual RBC in the acquired images. The system was used to determine morphology of individual RBCs in several RBC units stored hypothermically for 6–8 weeks.ResultsThe system was used to automatically determine the distribution of cell diameter within each morphological class for >1 000 000 individual stored RBCs (speed: >10 000 cells/h; accuracy: 91·9% low resolution, 75·3% high resolution). Diameter mean and standard deviation by morphology class were as follows: discocyte 7·80 ± 0·49 μm, echinocyte 1 7·61 ± 0·63 μm, echinocyte 2 7·02 ± 0·61 μm, echinocyte 3 6·47 ± 0·42 μm, sphero‐echinocyte 6·01 ± 0·26 μm, spherocyte 6·02 ± 0·27 μm, stomatocyte 1 6·95 ± 0·61 μm and stomatocyte 2 7·32 ± 0·47 μm.ConclusionsThe automated morphology classification procedure described in this study is significantly simpler, faster and less subjective than conventional manual procedures. The ability to evaluate the morphology of individual RBCs automatically, rapidly and in statistically significant numbers enabled us to perform the most extensive study of stored RBC morphology to date.