bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profound autoimmune hemolysis and Evans syndrome in two asplenic patients with babesiosis
Authors: Shatzel Joseph J. , Donohoe Kelsey , Chu Ngoc‐Quynh , Garratty George , Mody Kabir , Bengtson Elizabeth M. , Dunbar Nancy M. 
Published: October 2014

BackgroundEvans syndrome (ES) is characterized by the simultaneous or sequential presence of multiple autoimmune cytopenias. It is often secondary to rheumatologic disorders or lymphoid malignancies, but has not previously been associated with babesiosis. Here we present two cases of severe cytopenias in asplenic patients precipitated by active babesiosis.Case ReportThe first patient had a history of Hodgkin's lymphoma in remission and autoimmune hemolytic anemia (AIHA) treated by splenectomy 12 years prior who presented with severe AIHA and thrombocytopenia after Babesia infection. The second patient had a history of ES requiring splenectomy, which relapsed after Babesia infection.ResultsThe complex presentation and medical histories of both patients made the diagnosis challenging. Both patients’ cytopenias responded to therapy, although the use of immunosuppressive agents in patients with active hematologic infections was challenging and required a multidisciplinary approach.ConclusionThese two cases illustrate the possibility of babesiosis to not only reactivate ES in asplenic patients, but also precipitate increased levels of immune deregulation, potentially provoking ES, a phenomenon not previously reported.
Epidermolysis bullosa in animals: a review
Authors: Medeiros Gildenor X. , Riet‐Correa Franklin 
Published: October 2014

Epidermolysis bullosa (EB) is a hereditary mechanobullous disease of animals and humans, characterized by an extreme fragility of the skin and mucous membranes. The main feature of EB in humans and animals is the formation of blisters and erosions in response to minor mechanical trauma.Epidermolysis bullosa is caused by mutations in the genes that code for structural proteins of the cytoskeleton of the basal keratinocytes or of the basement membrane zone. Based on the ultrastructural levels of tissue separation, EB is divided into the following three broad categories: epidermolysis bullosa simplex, junctional epidermolysis bullosa and dystrophic epidermolysis bullosa. Human types of EB are divided into several subtypes based on their ultrastructural changes and the mode of inheritance; subtypes are not fully established in animals. In humans, it is estimated that EB affects one in 17,000 live births; the frequency of EB in different animals species is not known.In all animal species, except in buffalo with epidermolysis bullosa simplex, multifocal ulcers are observed on the gums, hard and soft palates, mucosa of the lips, cheek mucosa and dorsum of the tongue. Dystrophic or absent nails, a frequent sign seen in human patients with EB, corresponds to the deformities and sloughing of the hooves in ungulates and to dystrophy or atrophy of the claws in dogs and cats.This review covers aspects of the molecular biology, diagnosis, classification, clinical signs and pathology of EB reported in animals.
Longitudinal assessment of T‐lymphocyte subpopulations during generalized demodicosis in dogs and their relationship with remission
Authors: Oliveira Camila D. , Larsson Carlos E. , de Camargo Maristela M. 
Published: October 2014

BackgroundThe pathogenesis of canine generalized demodicosis is poorly understood but is thought to involve dysfunction of the immune system. Previous studies showed diminished CD4+ T lymphocyte counts in affected dogs, but none has evaluated this subpopulation through resolution of the disease.Hypothesis/ObjectivesIn this longitudinal study, we tested whether quantification of CD4+ cells, CD8+ cells and the ratio of CD4+ to CD8+ cells are good indicators of immunological status and could be used as biomarkers of treatment efficacy and prognosis.AnimalsSixteen dogs of several breeds with diagnoses of generalized demodicosis, plus 30 age/breedmatched healthy dogs.MethodsTotal lymphocytes, CD4+, CD8+ and CD4+:CD8+ ratio were quantified at four time points: at diagnosis, 30 days after diagnosis (during treatment), at first negative parasitological examination and at clinical cure.ResultsAbsolute numbers of CD4+ cells were significantly lower in affected dogs at the time of diagnosis. Absolute numbers of CD4+ and CD8+ cells were significantly augmented in affected animals compared with control dogs after treatment was established, and this persisted until the first negative parasitological examination, at which time the CD4+ counts equalled those of the control group.Conclusions and clinical importanceOur findings suggest that longitudinal quantification of CD4+ and CD8+ T lymphocytes is a useful indicator of the efficacy of demodicosis treatment.
Explicit solutions of the radiative transport equation in the P3 approximation
Authors: Liemert André , Kienle Alwin 
Published: October 2014

Purpose:Explicit solutions of the monoenergetic radiative transport equation in the P3 approximation have been derived which can be evaluated with nearly the same computational effort as needed for solving the standard diffusion equation (DE). In detail, the authors considered the important case of a semi‐infinite medium which is illuminated by a collimated beam of light.Methods:A combination of the classic spherical harmonics method and the recently developed method of rotated reference frames is used for solving the P3 equations in closed form.Results:The derived solutions are illustrated and compared to exact solutions of the radiative transport equation obtained via the Monte Carlo (MC) method as well as with other approximated analytical solutions. It is shown that for the considered cases which are relevant for biomedical optics applications, the P3 approximation is close to the exact solution of the radiative transport equation.Conclusions:The authors derived exact analytical solutions of the P3 equations under consideration of boundary conditions for defining a semi‐infinite medium. The good agreement to Monte Carlo simulations in the investigated domains, for example, in the steady‐state and time domains, as well as the short evaluation time needed suggests that the derived equations can replace the often applied solutions of the diffusion equation for the homogeneous semi‐infinite medium.
Effects of Patterns of Walking Training on Metabolic Health of Untrained Postmenopausal Women
Authors: Di Blasio Andrea , Izzicupo Pascal , D’Angelo Emanuele , Melanzi Sandra , Bucci Ines , Gallina Sabina , Di Baldassarre Angela , Napolitano Giorgio 
Published: October 2014

Purpose:High-intensity aerobic interval training (AIT) has been reported to be more effective than continuous aerobic training (CoAT) to improve metabolic health. The aim of our study was to investigate whether moderate-intensity AIT is more effective than CoAT on metabolic health when applied to a walking training program.Design/Methods:Thirty-two postmenopausal women (55.37 ± 3.46 years) were investigated for body composition, plasma glucose, insulin, lipids, adiponectin, HOMA-IR, HOMA-AD, aerobic fitness, dietary habits, and spontaneous physical activity, and randomly assigned to one of two different walking training programs: CoAT or AIT.Results:CoAT and AIT elicited the same physiological benefits, including: reduction of plasma glucose, insulin, HOMA-IR and HOMA-AD, and increase of plasma HDL-C, adiponectin, and aerobic fitness.Conclusions:An AIT scheme as part of an outdoor walking training program elicits the same physiological adaptations as a CoAT scheme, probably because walking does not promote exercise intensities that elicit greater effects.
Effects of 1 Week of Unilateral Ankle Immobilization on Plantar-Flexor Strength, Balance, and Walking Speed: A Pilot Study in Asymptomatic Volunteers
Authors: Caplan Nick , Forbes Andrew , Radha Sarkhell , Stewart Su , Ewen Alistair , Gibson Alan St Clair , Kader Deiary 
Published: October 2014

Context:Ankle immobilization is often used after ankle injury.Objective:To determine the influence of 1 week’s unilateral ankle immobilization on plantar-flexor strength, balance, and walking gait in asymptomatic volunteers.Design:Repeated-measures laboratory study.Setting:University laboratory.Participants:6 physically active male participants with no recent history of lower-limb injury.Interventions:Participants completed a 1-wk period of ankle immobilization achieved through wearing a below-knee ankle cast. Before the cast was applied, as well as immediately, 24 h, and 48 h after cast removal, their plantar-flexor strength was assessed isokinetically, and they completed a single-leg balance task as a measure of proprioceptive function. An analysis of their walking gait was also completedMain Outcome Measures:Peak plantar-flexor torque and balance were used to determine any effect on muscle strength and proprioception after cast removal. Ranges of motion (3D) of the ankle, knee, and hip, as well as walking speed, were used to assess any influence on walking gait.Results:After cast removal, plantar-flexor strength was reduced for the majority of participants (P = .063, CI = −33.98 to 1.31) and balance performance was reduced in the immobilized limb (P < .05, CI = 0.84−5.16). Both strength and balance were not significantly different from baseline levels by 48 h. Walking speed was not significantly different immediately after cast removal but increased progressively above baseline walking speed over the following 48 h. Joint ranges of motion were not significantly different at any time point.Conclusions:The reduction in strength and balance after such a short period of immobilization suggested compromised central and peripheral neural mechanisms. This suggestion appeared consistent with the delayed increase in walking speed that could occur as a result of the excitability of the neural pathways increasing toward baseline levels.
Comparing Computer-Derived and Human-Observed Scores for the Balance Error Scoring System
Authors: Caccese Jaclyn B. , Kaminski Thomas W. 
Published: October 2014

Context:The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring.Objective:To compare computerderived BESS scores with those taken from 3 trained human scorers.Design:Interrater reliability study.Setting:Athletic training room.Patients:NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg).Interventions:Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria.Main Outcome Measures:The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values.Results:The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement.Conclusions:Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS.
Performance Evaluation of the Elecsys Syphilis Assay for the Detection of Total Antibodies to Treponema pallidum
Authors: Enders Martin , Hunjet Andrea , Gleich Michael , Imdahl Roland , Mühlbacher Annelies , Schennach Harald , Chaiwong Kriangsak , Sakuldamrongpanich Tasanee , Turhan Ajda , Sertöz Rüchan , Wolf Eva , Mayer Wolfgang , Tao Chuanmin , Wang Lan Lan , Semprini Simona , Sambri Vittorio 
Published: October 2014

ABSTRACT
Syphilis is a health problem of increasing incidence in recent years that may have severe complications if not diagnosed and treated at an early stage. There are many diagnostic tests available for syphilis, but there is no gold standard, and diagnosis therefore usually relies upon a combination of tests. In this multicenter study, we evaluated the treponemal Elecsys syphilis assay for use in the diagnosis of syphilis in routine samples, i.e., when syphilis is suspected or during antenatal or blood donation screening. The sensitivity and specificity of the Elecsys syphilis assay were compared head to head with those of other treponemal assays used in routine clinical practice and were assessed in potentially cross-reactive samples from patients with Epstein-Barr virus, HIV, and Lyme disease. In a total of 8,063 syphilis-negative samples collected from routine diagnostic requests and blood donations, the Elecsys syphilis assay had a specificity of 99.88%. In 928 samples previously identified as syphilis positive, the sensitivity was 99.57 to 100% (the result is presented as a range depending on whether four initially indeterminate samples are included in the assessment). The specificity of the Elecsys syphilis assay in patients with other infections was 100%; no false-positive samples were identified.
Pseudo-Outbreak of Actinomyces graevenitzii Associated with Bronchoscopy
Authors: Peaper David R. , Havill Nancy L. , Aniskiewicz Michael , Callan Deborah , Pop Olivia , Towle Dana , Boyce John M. 
Published: October 2014

ABSTRACT

Outbreaks and pseudo-outbreaks of infection related to bronchoscopy typically involve Gram-negative bacteria,
Mycobacterium
species or
Legionella
species. We report an unusual bronchoscopy-related pseudo-outbreak due to
Actinomyces graevenitzii
. Extensive epidemiological and microbiological investigation failed to identify a common source. Strain typing revealed that the cluster was comprised of heterogeneous strains of
A. graevenitzii
. A change in laboratory procedures for
Actinomyces
cultures was coincident with the emergence of the pseudo-outbreak, and we determined that
A. graevenitzii
isolates more readily adopted a white, dry, molar tooth appearance on anaerobic colistin nalidixic acid (CNA) agar which likely facilitated its detection and identification in bronchoscopic specimens. This unusual pseudo-outbreak was related to frequent requests of bronchoscopists for
Actinomyces
cultures combined with a change in microbiology laboratory practices.
Investigations of Mycoplasma pneumoniae Infections in the United States: Trends in Molecular Typing and Macrolide Resistance from 2006 to 2013
Authors: Diaz Maureen H. , Benitez Alvaro J. , Winchell Jonas M. 
Published: October 2014

ABSTRACT

Mycoplasma pneumoniae
is a leading cause of respiratory infections, including community-acquired pneumonia (CAP). Currently, pathogen-specific testing is not routinely performed in the primary care setting, and the United States lacks a systematic surveillance program for
M. pneumoniae
. Documentation of individual cases and clusters typically occurs only when severe illness and/or failure to improve with empirical antibiotic therapy is observed. Outbreaks, some lasting for extended periods and involving a large number of cases, occur regularly. However, many more likely go unrecognized due to the lack of diagnostic testing and structured reporting. We reviewed data from 17 investigations of cases, small clusters, and outbreaks of
M. pneumoniae
infections that were supported by the Centers for Disease Control and Prevention (CDC) between 2006 and 2013. We examined 199
M. pneumoniae
-positive specimens collected during this time period in order to identify trends in antimicrobial resistance and circulating types. Overall, macrolide resistance was identified in approximately 10% of
M. pneumoniae
infections occurring during this time period. Typing of strains revealed cocirculation of multiple multilocus variable-number tandem-repeat analysis (MLVA) and P1 types throughout this period, including diversity in types detected within individual outbreaks. Three MLVA types (4572, 3562, and 3662) accounted for 97% of the infections during the study period. A systematic surveillance program is necessary to understand the burden of
M. pneumoniae
disease in the United States, facilitate case and outbreak identification, and inform appropriate therapeutic and infection control strategies.
Varicella-Zoster Virus-Derived Major Histocompatibility Complex Class I-Restricted Peptide Affinity Is a Determining Factor in the HLA Risk Profile for the Development of Postherpetic Neuralgia
Authors: Meysman Pieter , Ogunjimi Benson , Naulaerts Stefan , Beutels Philippe , Van Tendeloo Viggo , Laukens Kris 
Published: October 2014

ABSTRACT
Postherpetic neuralgia (PHN) is the most common complication of herpes zoster and is typified by a lingering pain that can last months or years after the characteristic herpes zoster rash disappears. It is well known that there are risk factors for the development of PHN, such as its association with certain HLA alleles. In this study, previous HLA genotyping results were collected and subjected to a meta-analysis with increased statistical power. This work shows that the alleles HLA-A*33 and HLA-B*44 are significantly enriched in PHN patients, while HLA-A*02 and HLA-B*40 are significantly depleted. Prediction of the varicella-zoster virus (VZV) peptide affinity for these four HLA variants by using one in-house-developed and two existing state-of-the-art major histocompatibility complex (MHC) class I ligand prediction methods reveals that there is a great difference in their absolute and relative peptide binding repertoires. It was observed that HLA-A*02 displays a high affinity for an ∼7-fold-higher number of VZV peptides than HLA-B*44. Furthermore, after correction for HLA allele-specific limitations, the relative affinity of HLA-A*33 and HLA-B*44 for VZV peptides was found to be significantly lower than those of HLA-A*02 and HLA-B*40. In addition, HLA peptide affinity calculations indicate strong trends for VZV to avoid high-affinity peptides in some of its proteins, independent of the studied HLA allele.

IMPORTANCE
Varicella-zoster virus can cause two distinct diseases: chickenpox (varicella) and shingles (herpes zoster). Varicella is a common disease in young children, while herpes zoster is more frequent in older individuals. A common complication of herpes zoster is postherpetic neuralgia, a persistent and debilitating pain that can remain months up to years after the resolution of the rash. In this study, we show that the relative affinity of HLA variants associated with higher postherpetic neuralgia risk for varicella-zoster virus peptides is lower than that of variants with a lower risk. These results provide new insight into the development of postherpetic neuralgia and strongly support the hypothesis that one of its possible underlying causes is a suboptimal anti-VZV immune response due to weak HLA binding peptide affinity.
T Cell Epitope Clustering in the Highly Immunogenic BZLF1 Antigen of Epstein-Barr Virus
Authors: Rist Melissa J. , Neller Michelle A. , Burrows Jacqueline M. , Burrows Scott R. 
Published: October 2014

ABSTRACTPolymorphism in the human leukocyte antigen (HLA) loci ensures that the CD8+T cell response to viruses is directed against a diverse range of antigenic epitopes, thereby minimizing the impact of virus escape mutation across the population. The BZLF1 antigen of Epstein-Barr virus is an immunodominant target for CD8+T cells, but the response has been characterized only in the context of a limited number of HLA molecules due to incomplete epitope mapping. We have now greatly expanded the number of defined CD8+T cell epitopes from BZLF1, allowing the response to be evaluated in a much larger proportion of the population. Some regions of the antigen fail to be recognized by CD8+T cells, while others include clusters of overlapping epitopes presented by different HLA molecules. These highly immunogenic regions of BZLF1 include polymorphic sequences, such that up to four overlapping epitopes are impacted by a single amino acid variation common in different regions of the world. This focusing of the immune response to limited regions of the viral protein could be due to sequence similarity to human proteins creating “immune blind spots” through self-tolerance. This study significantly enhances the understanding of the immune response to BZLF1, and the precisely mapped T cell epitopes may be directly exploited in vaccine development and adoptive immunotherapy.IMPORTANCEEpstein-Barr virus (EBV) is an important human pathogen, associated with several malignancies, including nasopharyngeal carcinoma and Hodgkin lymphoma. T lymphocytes are critical for virus control, and clinical trials aimed at manipulating this arm of the immune system have demonstrated efficacy in treating these EBV-associated diseases. These trials have utilized information on the precise location of viral epitopes for T cell recognition, for either measuring or enhancing responses. In this study, we have characterized the T cell response to the highly immunogenic BZLF1 antigen of EBV by greatly expanding the number of defined T cell epitopes. An unusual clustering of epitopes was identified, highlighting a small region of BZLF1 that is targeted by the immune response of a high proportion of the world's population. This focusing of the immune response could be utilized in developing vaccines/therapies with wide coverage, or it could potentially be exploited by the virus to escape the immune response.