bluuebunny/crossref_metadata_2025 huggingface dataset:
R-Thanatin Inhibits Growth and Biofilm Formation of Methicillin-Resistant Staphylococcus epidermidis
In Vivo
and
In Vitro
Authors: Hou Zheng , Da Fei , Liu Baohui , Xue Xiaoyan , Xu Xiuli , Zhou Ying , Li Mingkai , Li Zhi , Ma Xue , Meng Jingru , Jia Min , Wang Yukun , Luo Xiaoxing
Published: August 2013

Staphylococcus epidermidis
is one of the most frequent causes of device-associated infections, because it is known to cause biofilms that grow on catheters or other surgical implants. The persistent increasing resistance of
S. epidermidis
and other coagulase-negative staphylococci (CoNS) has driven the need for newer antibacterial agents with innovative therapeutic strategies. Thanatin is reported to display potent antibiotic activities, especially against extended-spectrum-beta-lactamase-producing
Escherichia coli
. The present study aimed to investigate whether a shorter derivative peptide (R-thanatin) could be used as a novel antibacterial agent. We found that R-thanatin was highly potent
in vitro
against coagulase-negative staphylococci, such as
S. epidermidis
,
S. haemolyticus
, and
S. hominis
, and inhibited biofilm formation at subinhibitory concentrations. Properties of little toxicity to human red blood cells (hRBCs) and human umbilical vein endothelial cells, a low incidence of resistance, and relatively high stability in plasma were confirmed. Excellent
in vivo
protective effects were also observed using a methicillin-resistant
S. epidermidis
(MRSE)-induced urinary tract infection rat model. Electron microscopy and confocal laser-scanning microscopy analyses suggested that R-thanatin disturbed cell division of MRSE severely, which might be the reason for inhibition of MRSE growth. These findings indicate that R-thanatin is active against the growth and biofilm formation of MRSE
in vitro
and
in vivo
. R-thanatin might be considered as a specific drug candidate for treating CoNS infections.
N
-Cinnamoylated Aminoquinolines as Promising Antileishmanial Agents
Authors: Vale-Costa S. , Costa-Gouveia J. , Pérez B. , Silva T. , Teixeira C. , Gomes P. , Gomes M. S.
Published: August 2013

A series of cinnamic acid conjugates of primaquine and chloroquine were evaluated for their
in vitro
antileishmanial activities. Although primaquine derivatives had modest activity, chloroquine conjugates exhibited potent activity against both promastigotes (50% inhibitory concentration [IC
50
] = 2.6 to 21.8 μM) and intramacrophagic amastigotes (IC
50
= 1.2 to 9.3 μM) of
Leishmania infantum
. Both the high activity of these chloroquine analogues and their mild-to-low toxicity toward host cells make them promising leads for the discovery of new antileishmanial agents.
Unique Features of a Pseudomonas aeruginosa α2-Macroglobulin Homolog
Authors: Robert-Genthon Mylène , Casabona Maria Guillermina , Neves David , Couté Yohann , Cicéron Félix , Elsen Sylvie , Dessen Andréa , Attrée Ina
Published: August 2013

Human pathogens frequently use protein mimicry to manipulate host cells in order to promote their survival. Here we show that the opportunistic pathogen
Pseudomonas aeruginosa
synthesizes a structural homolog of the human α2-macroglobulin, a large-spectrum protease inhibitor and important player of innate immunity. Small-angle X-ray scattering analysis demonstrated that the fold of
P. aeruginosa
MagD (PA4489) is similar to that of the human macroglobulin and undergoes a conformational modification upon binding of human neutrophil elastase. MagD synthesis is under the control of a general virulence regulatory pathway including the inner membrane sensor RetS and the RNA-binding protein RsmA, and MagD undergoes cleavage from a 165-kDa to a 100-kDa form in all clinical isolates tested. Fractionation and immunoprecipitation experiments showed that MagD is translocated to the bacterial periplasm and resides within the inner membrane in a complex with three other molecular partners, MagA, MagB, and MagF, all of them encoded by the same six-gene genetic element. Inactivation of the whole 10-kb operon on the PAO1 genome resulted in mislocalization of uncleaved, in
trans
-provided MagD as well as its rapid degradation. Thus, pathogenic bacteria have acquired a homolog of human macroglobulin that plays roles in host-pathogen interactions potentially through recognition of host proteases and/or antimicrobial peptides; it is thus essential for bacterial defense.

IMPORTANCE
The pathogenesis of
Pseudomonas aeruginosa
is multifactorial and relies on surface-associated and secreted proteins with different toxic activities. Here we show that the bacterium synthesizes a 160-kDa structural homolog of the human large-spectrum protease inhibitor α2-macroglobulin. The bacterial protein is localized in the periplasm and is associated with the inner membrane through the formation of a multimolecular complex. Its synthesis is coregulated at the posttranscriptional level with other virulence determinants, suggesting that it has a role in bacterial pathogenicity and/or in defense against the host immune system. Thus, this new
P. aeruginosa
macromolecular complex may represent a future target for antibacterial developments.
Small-Molecule Inhibitors of
toxT
Expression in Vibrio cholerae
Authors: Anthouard Rebecca , DiRita Victor J.
Published: August 2013

Vibrio cholerae
, a Gram-negative bacterium, infects humans and causes cholera, a severe disease characterized by vomiting and diarrhea. These symptoms are primarily caused by cholera toxin (CT), whose production by
V. cholerae
is tightly regulated by the virulence cascade. In this study, we designed and carried out a high-throughput chemical genetic screen to identify inhibitors of the virulence cascade. We identified three compounds, which we named toxtazin A and toxtazin B and Bʹ, representing two novel classes of
toxT
transcription inhibitors. All three compounds reduce production of both CT and the toxin-coregulated pilus (TCP), an important colonization factor. We present evidence that toxtazin A works at the level of the
toxT
promoter and that toxtazins B and Bʹ work at the level of the
tcpP
promoter. Treatment with toxtazin B results in a 100-fold reduction in colonization in an infant mouse model of infection, though toxtazin A did not reduce colonization at the concentrations tested. These results add to the growing body of literature indicating that small-molecule inhibitors of virulence genes could be developed to treat infections, as alternatives to antibiotics become increasingly needed.

IMPORTANCE
V. cholerae
caused more than 580,000 infections worldwide in 2011 alone (WHO, Wkly. Epidemiol. Rec. 87:289-304, 2012). Cholera is treated with an oral rehydration therapy consisting of water, glucose, and electrolytes. However, as
V. cholerae
is transmitted via contaminated water, treatment can be difficult for communities whose water source is contaminated. In this study, we address the need for new therapeutic approaches by targeting the production of the main virulence factor, cholera toxin (CT). The high-throughput screen presented here led to the identification of two novel classes of inhibitors of the virulence cascade in
V. cholerae
, toxtazin A and toxtazins B and Bʹ. We demonstrate that (i) small-molecule inhibitors of virulence gene production can be identified in a high-throughput screen, (ii) targeting virulence gene production is an effective therapeutic strategy, and (iii) small-molecule inhibitors can uncover unknown layers of gene regulation, even in well-studied regulatory cascades.
Structure-Informed Design of an Enzymatically Inactive Vaccine Component for Group A
Streptococcus
Authors: Henningham Anna , Ericsson Daniel J. , Langer Karla , Casey Lachlan W. , Jovcevski Blagojce , Chhatwal G. Singh , Aquilina J. Andrew , Batzloff Michael R. , Kobe Bostjan , Walker Mark J.
Published: August 2013

Streptococcus pyogenes
(group A
Streptococcus
[GAS]) causes ~700 million human infections/year, resulting in >500,000 deaths. There is no commercial GAS vaccine available. The GAS surface protein arginine deiminase (ADI) protects mice against a lethal challenge. ADI is an enzyme that converts arginine to citrulline and ammonia. Administration of a GAS vaccine preparation containing wild-type ADI, a protein with inherent enzymatic activity, may present a safety risk. In an approach intended to maximize the vaccine safety of GAS ADI, X-ray crystallography and structural immunogenic epitope mapping were used to inform vaccine design. This study aimed to knock out ADI enzyme activity without disrupting the three-dimensional structure or the recognition of immunogenic epitopes. We determined the crystal structure of ADI at 2.5 Å resolution and used it to select a number of amino acid residues for mutagenesis to alanine (D166, E220, H275, D277, and C401). Each mutant protein displayed abrogated activity, and three of the mutant proteins (those with the D166A, H275A, and D277A mutations) possessed a secondary structure and oligomerization state equivalent to those of the wild type, produced high-titer antisera, and avoided disruption of B-cell epitopes of ADI. In addition, antisera raised against the D166A and D277A mutant proteins bound to the GAS cell surface. The inactivated D166A and D277A mutant ADIs are ideal for inclusion in a GAS vaccine preparation. There is no human ortholog of ADI, and we confirm that despite limited structural similarity in the active-site region to human peptidyl ADI 4 (PAD4), ADI does not functionally mimic PAD4 and antiserum raised against GAS ADI does not recognize human PAD4.

IMPORTANCE
We present an example of structural biology informing human vaccine design. We previously showed that the administration of the enzyme arginine deiminase (ADI) to mice protected the mice against infection with multiple GAS serotypes. In this study, we determined the structure of GAS ADI and used this information to improve the vaccine safety of GAS ADI. Catalytically inactive mutant forms of ADI retained structure, recognition by antisera, and immunogenic epitopes, rendering them ideal for inclusion in GAS vaccine preparations. This example of structural biology informing vaccine design may underpin the formulation of a safe and efficacious GAS vaccine.
Vertebral osteomyelitis caused byMycobacterium abscessus
Authors: Garcia Daniel C , Sandoval-Sus Jose , Razzaq Kanwal , Young Lary
Published: August 2013

Mycobacteriuminfection caused by non-tuberculous mycobacterial (NTBM) organisms is becoming more common. Although NTBM osteomyelitis is unusual, it can occur in otherwise healthy individuals, but it is also associated with immunocompromised states, such as steroidal therapy and AIDS, and may be observed following trauma.Mycobacterium aviumis reported to be the most common causative agent, andMycobacterium abscessushas only been described in two cases. We report the case of a 44-year-old man with history of hepatitis C diagnosed with osteomyelitis of the thoracic spine caused byM abscessus. We present a literature review of NTBM osteomyelitis and a discussion of its diagnosis and treatment.
A novel use for myocardial perfusion scans: diagnosis of bile duct injury
Authors: Donahoe Laura , Barnes David C , Alwayn Ian
Published: August 2013

A 69-year-old woman was admitted to a tertiary care centre after suffering from an iatrogenic bile duct injury, diagnosed by the unexpected leakage of bile during laparotomy for a colectomy. On initial assessment the patient was clinically stable, although she remained intubated after her surgery. In order to diagnose whether or not she sustained a complete or partial bile duct injury, a finding that would determine if she underwent conservative management or surgical repair, a technetium-99m-hepatobiliary scan was requested. Owing to a shortage in technetium-99m-iminodiacetic acids, the radiopharmaceutical (tracer) for this imaging test, a decision was made to employ technetium-99m-tetrofosmin, the tracer for cardiac scans (traditionally used for diagnosis of myocardial perfusion) as it has been established that this tracer is excreted in the biliary tract. The imaging showed flow of bile into the bowel, thereby establishing bile duct continuity and permitting conservative management.
Quetiapine may reduce hospital admission rates in patients with mental health problems and alcohol addiction
Authors: Kong C , Chiu W , Davies A , Keating J
Published: August 2013

A 64-year-old man presented with 40 years history of chronic alcohol excess. On average, he had six hospital admissions a year with alcohol-related problems for at least a 10-year period. In 2009, he considered reducing his alcohol intake. He was noted to have mood disturbances, was seen by a psychogeriatrician who diagnosed bipolar disorder. He tried various bipolar medications including lithium and sodium valproate which was unsuccessful. He was then started on quetiapine 600 mg a day in divided doses. Subsequently this has not only controlled the bipolar disorder but also resulted in significant reduction in alcohol intake. He now shares a bottle of wine with his wife while in the past he was consuming a bottle of scotch daily. This case illustrates the benefits of quetiapine in assisting with this man's addiction to alcohol.
Cholesterol granuloma of the breast mimicking malignancy
Authors: Khan Roobina , Narula Varsha , Jain Anshu , Maheshwari Veena
Published: August 2013

Cholesterol granuloma of the breast is an unusual non-neoplastic condition which frequently resembles malignancy clinically as well as radiologically. We herein report a case of a 28-year-old woman who presented with a lump in the upper outer quadrant of right breast. Physical examination and ultrasonography strongly suggested a carcinomatous lesion, but histopathological examination confirmed the diagnosis to be cholestrol granulomas. This article highlights the perplexing clinical presentation of cholesterol granulomas and affirms the role of histopathological examination in diagnosing these lesions correctly.
A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence
Authors: Speed Cathy
Published: August 2013

Background

‘Shock wave’ therapies are now extensively used in the treatment of musculoskeletal injuries. This systematic review summarises the evidence base for the use of these modalities.

Methods

A thorough search of the literature was performed to identify studies of adequate quality to assess the evidence base for shockwave therapies on pain in specific soft tissue injuries. Both focused extracorporeal shockwave therapy (F-ESWT) and radial pulse therapy (RPT) were examined.

Results

23 appropriate studies were identified. There is evidence for the benefit of F-ESWT and of RPT in a number of soft tissue musculoskeletal conditions, and evidence that both treatment modalities are safe. There is evidence that F-ESWT is effective in the treatment of plantar fasciitis, calcific tendinitis, and that RPT is effective in plantar fasciitis. Where benefit is seen in F-ESWT, it appears to be dose dependent, with greater success seen with higher dose regimes. There is low level evidence for lack of benefit of low-dose F-ESWT and RPT in non-calcific rotator cuff disease and mixed evidence in lateral epicondylitis.
The predictive validity of a single leg bridge test for hamstring injuries in Australian Rules Football Players
Authors: Freckleton Grant , Cook Jill , Pizzari Tania
Published: August 2013

Background

Hamstring muscle strain injuries (HMSI) are the greatest injury problem in kicking sports such as Australian Rules Football. Reduced hamstring muscle strength is commonly perceived to be a risk factor for hamstring injury; however, evidence is inconclusive. Testing hamstring strength with the hip and knee at functional angles and assessing endurance parameters may be more relevant for examining the risk of hamstring injury.

Objective

The primary aim of this prospective study was to examine if reduced hamstring muscle strength assessed with the single leg hamstring bridge (SLHB) was a risk factor for hamstring injury.

Methods

Hamstring muscle strength of 482 amateur and semielite players from 16 football clubs, mean age 20.7 (range 16–34 years), was tested during the 2011 preseason. Players were then monitored throughout the 2011 playing season for HMSI.

Results

A total of 28 hamstring injuries, 16 right and 12 left, were recorded. Players who sustained a right HMSI during the season had a significantly lower mean right SLHB score (p=0.029), were older (p=0.002) and were more likely to have sustained a past right hamstring injury (p=0.02) or right knee injury (p=0.035). For left-sided hamstring injury, the injured group was more likely to be left leg dominant (p=0.001), older athletes (p=0.002) and there was a trend towards a history of left hamstring injury (p=0.07).

Conclusions

This study demonstrated a significant deficit in preseason SLHB scores on the right leg of players that subsequently sustained a right-sided hamstring injury. Age, previous knee injury and a history of hamstring injury were other risk factors supported in this study. Low hamstring strength appears to be a risk factor for hamstring injury; however, due to the confounding variables and low injury rate in this study, further studies are required.
Can intensity of long-term follow-up for survivors of childhood and teenage cancer be determined by therapy-based risk stratification?
Authors: Edgar A B , Duffin K , Borthwick S , Marciniak-Stepak P , Wallace W H
Published: August 2013

Objective

To determine the feasibility of therapy-based, risk-stratified follow-up guidelines for childhood and teenage cancer survivors by evaluating adverse health outcomes in a survivor cohort retrospectively assigned a risk category.

Design

Retrospective cohort study.

Setting

Tertiary level, single centre, paediatric cancer unit in South East Scotland.

Participants

All children and teenagers diagnosed with cancer (<19 years) between 1 January 1971 and 31 July 2004, who were alive more than 5 years from diagnosis formed the study cohort. Each survivor was retrospectively assigned a level of follow-up, based on their predicted risk of developing treatment-related late effects (LEs; levels 1, 2 and 3 for low, medium and high risk, respectively). Adverse health outcomes were determined from review of medical records and postal questionnaires. LEs were graded using the Common Terminology Criteria for Adverse Event, V.3.

Results

607 5-year survivors were identified. Risk stratification identified 86 (14.2%), 271 (44.6%) and 250 (41.2%) as levels 1, 2 and 3 survivors, respectively. The prevalence of LEs for level 1 survivors was 11.6% with only one patient with grade 3 or above toxicity. 35.8% of level 2 survivors had an LE, of whom 9.3%, 58.8%, 18.5%, 10.3% and 3% had grades 1, 2, 3, 4 and 5 toxicity, respectively. 65.2% of level 3 survivors had LE, of whom 5.5% (n=9), 34.4% (n=56), 36.2% (n=59), 22.1% (n=36) and 1.8% (n=3) had grades 1, 2, 3, 4 and 5 toxicity, respectively.

Conclusions

Therapy-based risk stratification of survivors can predict which patients are at significant risk of developing moderate-to-severe LEs and require high-intensity long-term follow-up. Our findings will need confirmation in a prospective cohort study that has the power to adjust for all potentially confounding variables.
Sepsis-associated mortality in England: an analysis of multiple cause of death data from 2001 to 2010
Authors: McPherson Duncan , Griffiths Clare , Williams Matthew , Baker Allan , Klodawski Ed , Jacobson Bobbie , Donaldson Liam
Published: August 2013

Objectives

To quantify mortality associated with sepsis in the whole population of England.

Design

Descriptive statistics of multiple cause of death data.

Setting

England between 2001 and 2010.

Participants

All people whose death was registered in England between 2001 and 2010 and whose certificate contained a sepsis-associated International Classification of Diseases, 10th Revision (ICD-10) code.

Data sources

Multiple cause of death data extracted from Office for National Statistics mortality database.

Statistical methods

Age-specific and sex-specific death rates and direct age-standardised death rates.

Results

In 2010, 5.1% of deaths in England were definitely associated with sepsis. Adding those that may be associated with sepsis increases this figure to 7.7% of all deaths. Only 8.6% of deaths definitely associated with sepsis in 2010 had a sepsis-related condition as the underlying cause of death. 99% of deaths definitely associated with sepsis have one of the three ICD-10 codes—A40, A41 and P36—in at least one position on the death certificate. 7% of deaths definitely associated with sepsis in 2001–2010 did not occur in hospital.

Conclusions

Sepsis is a major public health problem in England. In attempting to tackle the problem of sepsis, it is not sufficient to rely on hospital-based statistics, or methods of intervention, alone. A robust estimate of the burden of sepsis-associated mortality in England can be made by identifying deaths with one of the three ICD-10 codes in multiple cause of death data. These three codes could be used for future monitoring of the burden of sepsis-associated mortality.
An evaluation of the efficacy of the exercise on referral scheme in Northumberland, UK: association with physical activity and predictors of engagement. A naturalistic observation study
Authors: Hanson Coral L , Allin Linda J , Ellis Jason G , Dodd-Reynolds Caroline J
Published: August 2013

Objectives

Exercise on referral schemes (ERS) are widely commissioned in the UK but there is little evidence of their association with physical activity levels. We sought to assess the Northumberland exercise on referral scheme in terms of increased levels of physical activity and identify predictors of engagement.

Design

A naturalistic observational study.

Setting

9 local authority leisure sites in Northumberland.

Participants

2233 patients referred from primary and secondary care between July 2009 and September 2010.

Intervention

A 24-week programme including motivational consultations and supervised exercise sessions for participants.

Outcome measures

Uptake, 12-week adherence, 24-week completion, changes in Godin Leisure-Time Exercise Questionnaire scores after 24-weeks and attendance levels at supervised exercise sessions during the scheme. Three binary logistic regressions were used to examine demographic and referral factors associated with initial uptake, 12-week adherence and 24-week completion.

Results

Uptake was 81% (n=1811), 12-week adherence was 53.5% (n=968) and 24-week completion was 42.9% (n=777). Participants who completed significantly increased their self-reported physical activity levels at 24-weeks t (638)=−11.55, p<0.001. Completers attended a mean of 22.87 (12.47 SD) of a target 48 supervised sessions. Increasing age, being female and leisure site were associated with uptake, increasing age, Index of Multiple Deprivation and leisure site were associated with 12-week adherence and Body Mass Index and leisure site were associated with 24-week completion. Each regression significantly increased the prediction accuracy of stage of exit (non-starters vs starters 81.5%, dropouts before 12 weeks vs 12-week adherers 66.9%, and dropouts between 13 and 24 weeks 82.2%).

Conclusions

Completers of the Northumberland ERS increased physical activity at 24 weeks, although the levels achieved were below the current UK guidelines of 150 min of moderate exercise per week. Leisure site was associated with uptake, adherence and completion.
Mental health status and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based cohort study
Authors: Nielsen Tine Jepsen , Vestergaard Mogens , Christensen Bo , Christensen Kaj Sparle , Larsen Karen Kjær
Published: August 2013

Objective

To examine the association between mental health status after first-time myocardial infarction (MI) and new cardiovascular events or death, taking into account depression and anxiety as well as clinical, sociodemographic and behavioural risk factors.

Design

Population-based cohort study based on questionnaires and nationwide registries. Mental health status was assessed 3 months after MI using the Mental Component Summary score from the Short-Form 12 V.2.

Setting

Central Denmark Region.

Participants

All patients hospitalised with first-time MI from 1 January 2009 through 31 December 2009 (n=880). The participants were categorised in quartiles according to the level of mental health status (first quartile=lowest mental health status).

Main outcome measures

Composite endpoint of new cardiovascular events (MI, heart failure, stroke/transient ischaemic attack) and all-cause mortality.

Results

During 1940 person-years of follow-up, 277 persons experienced a new cardiovascular event or died. The cumulative incidence following 3 years after MI increased consistently with decreasing mental health status and was 15% (95% CI 10.8% to 20.5%) for persons in the fourth quartile, 29.1% (23.5% to 35.6%) in the third quartile, 37.0% (30.9% to 43.9%) in the second quartile, and 47.5% (40.9% to 54.5%) in the first quartile. The HRs were high, even after adjustments for age, sociodemographic characteristics, cardiac disease severity, comorbidity, secondary prophylactic medication, smoking status, physical activity, depression and anxiety (HR3rd quartile1.90 (95% CI 1.23 to 2.93), HR2nd quartile2.14 (1.37 to 3.33), HR1st quartile2.23 (1.35 to 3.68) when using the fourth quartile as reference).

Conclusions

Low mental health status following first-time MI was independently associated with an increased risk of new cardiovascular events or death. Further research is needed to disentangle the pathways that link mental health status following MI to prognosis and to identify interventions that can improve mental health status and prognosis.
Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework
Authors: Kontopantelis Evangelos , Buchan Iain , Reeves David , Checkland Kath , Doran Tim
Published: August 2013

Objectives

To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system.

Design

Retrospective longitudinal study.

Setting

Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England.

Participants

All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice.

Main outcome measures

Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement.

Results

Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels).

Conclusions

Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.
Prescribing errors on admission to hospital and their potential impact: a mixed-methods study
Authors: Basey Avril Janette , Krska Janet , Kennedy Thomas Duncan , Mackridge Adam John
Published: August 2013

Background

Medication errors are an important cause of morbidity and mortality and adversely affect clinical outcomes. Prescribing errors constitute one type of medication error and occur particularly on admission to hospital; little is known about how they arise.

Aim

This study investigated how doctors obtain the information necessary to prescribe on admission to hospital, and the number and potential impact of any errors.

Setting

English teaching hospital—acute medical unit.

Methods

Ethics approval was granted. Data were collected over four 1-week periods; November 2009, January 2010, April 2010 and April 2011. The patient admission process was directly observed, field notes were recorded using a standard form. Doctors participated in a structured interview; case notes of all patients admitted during study periods were reviewed.

Results

There were differences between perceived practice stated in interviews and actual practice observed. All 19 doctors interviewed indicated that they would sometimes or always use more than one source of information for a medication history; a single source was used in 31/68 observed cases. 7/12 doctors both observed and interviewed indicated that they would confirm medication with patients; observations showed they did so for only 2/12 patients. In 66/68 cases, the patient/carer was able to discuss medication, 14 were asked no medication-related questions. Of 688 medication charts reviewed, 318 (46.2%) had errors. A total of 851 errors were identified; 737/851 (86.6%) involved omission of a medicine; 94/737 (12.8%) of these were potentially significant.

Conclusions

Although doctors know the importance of obtaining an accurate medication history and checking prescriptions with patients, they often fail to put this into practice, resulting in prescribing errors.
UK colorectal cancer patients are inadequately assessed for Lynch syndrome
Authors: Adelson Maria , Pannick Samuel , East James E , Risby Peter , Dawson Peter , Monahan Kevin J
Published: August 2013

Objective

To establish whether colorectal cancer patients in two centres in the UK are screened appropriately for Lynch syndrome, in accordance with current international guidance.

Design

Patients newly diagnosed with colorectal cancer over an 18-month period were identified from the UK National Bowel Cancer Audit Programme. Their records and management were reviewed retrospectively.

Setting

Two university teaching hospitals, Imperial College Healthcare and Oxford Radcliffe Hospitals NHS Trusts.

Outcomes measured

Whether patients were screened for Lynch syndrome—and the outcome of that evaluation, if it took place—were assessed from patients' clinical records. The age, tumour location and family history of screened patients were compared to those of unscreened patients.

Results

Five hundred and fifty three patients with newly diagnosed colorectal cancer were identified. Of these, 97 (17.5%) satisfied the revised Bethesda criteria, and should have undergone further assessment. There was no evidence that those guidelines had been contemporaneously applied to any patient. In practice, only 22 of the 97 (22.7%) eligible patients underwent evaluation. The results for 14 of those 22 (63.6%) supported a diagnosis of Lynch syndrome, but only nine of the 14 (64.3%) were referred for formal mismatch repair gene testing. No factors reliably predicted whether or not a patient would undergo Lynch syndrome screening.

Conclusions

Colorectal teams in the UK do not follow international guidance identifying the patients who should be screened for Lynch syndrome. Patients and their families are consequently excluded from programmes reducing colorectal cancer incidence and mortality. Multidisciplinary teams should work with their local genetics services to develop reliable algorithms for patient screening and referral.
One cancer destroys another: short report of a myeloid sarcoma causing ischaemic necrosis of an adenocarcinoma
Authors: Tucker D , Sarsfield P , Chandler I , Kerr P
Published: August 2013

We present a highly unusual case and histological images of a patient who underwent complete resection of a perforated caecal adenocarcinoma caused by angiodestruction of the proximal vasculature by a distinct acute myeloid infiltrate. Both tumours were removed in their entirety at one visit to theatre and the patient remains well and in remission 18 months later.
Management strategies for intraprocedural coil migration during endovascular treatment of intracranial aneurysms
Authors: Ding Dale , Liu Kenneth C
Published: August 2013

Migration of a coil during endovascular treatment of intracranial aneurysm occurs in 2–6% of cases. The consequences of coil migration vary significantly from minor flow alterations of the parent artery which are asymptomatic to thromboembolic occlusion of major intracranial vessels resulting in large territory infarcts. We performed a comprehensive literature review and identified 37 reported cases of migrated coil retrieval consisting of 10 case reports and six case series. Most of the aneurysms presented with rupture (65%) and were located in the anterior circulation (70%). The endovascular treatment approaches were coil embolization alone (57%), stent-assisted coiling (26%) and balloon remodeling (17%). Endovascular retrieval was performed with microwires, the Alligator Retrieval device, Merci devices, snares and stentrievers. There was a single report of microsurgical extraction following failed endovascular removal and three cases of coil fracture in which the coil fragments were secured to the vessel walls with stents.
Prevalence of pharyngeal and rectalChlamydia trachomatisandNeisseria gonorrhoeaeinfections among men who have sex with men in Germany
Authors: Dudareva-Vizule Sandra , Haar Karin , Sailer Andrea , Wisplinghoff Hilmar , Wisplinghoff Fabian , Marcus Ulrich ,   the PARIS study group
Published: August 2013

Objectives

To determine the prevalence of pharyngeal and rectalChlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) infections among men who have sex with men (MSM) in Germany and describe associations between these infections, sexual practices and other factors to provide an evidence base for screening recommendations.

Methods

We conducted a cross-sectional study in 22 sentinel sites of sexually transmitted infections across Germany. Pharyngeal and rectal swabs were collected and tested for CT and NG with a nucleic acid amplification test (NAAT). Information on HIV status, number of sex partners and sexual practices was collected and linked to NAAT results.

Results

Overall, 2247 MSM were screened for pharyngeal or rectal CT and NG infections; median age was 34 years (range 16–83). Prevalence of CT was 1.5% in pharyngeal and 8.0% in rectal specimens. Prevalence of NG was 5.5% in pharyngeal and 4.6% in rectal specimens. Local symptoms were reported in 5.1% of pharyngeal and 11.9% of rectal infections. Altogether 90.8% of rectal or pharyngeal infections would remain undetected if only symptomatic cases were tested. Rectal infection was significantly more likely in men reporting multiple partners (2–5 partners, OR=1.85; 6–10 partners, OR=2.10; >11 partners, OR=2.95), men diagnosed with HIV (OR=1.60) and men practising receptive anal intercourse without a condom (OR=1.54). Pharyngeal infection was more likely in men reporting multiple partners (6–10 partners, OR=2.88; >11 partners, OR=4.96), and men diagnosed with HIV (OR=1.78).

Conclusions

Pharyngeal and rectal infections in sexually active MSM can remain undetected and thus transmissible if swabbing is not offered routinely. Screening should be offered particularly to MSM diagnosed with HIV and MSM reporting multiple partners.
Risk behaviours exhibited by free‐roaming cats in a suburban US town
Authors: Loyd K. A. T. , Hernandez S. M. , Abernathy K. J. , Shock B. C. , Marshall G. J.
Published: August 2013

Free‐roaming cats may experience numerous hazardous encounters in the outdoor environment, including: vehicular accidents, aggression from other animals and exposure to infectious disease. This research quantitatively examined the outdoor activities of 55 owned cats by monitoring pets outfitted with ‘KittyCam’ video cameras. KittyCams are a type of Crittercam, designed by National Geographic to allow recording of a cat‐eye view without disrupting behaviour. We investigated the activities of free‐roaming cats in suburban Athens‐Clarke County, Georgia, during all four seasons. Research objectives included documenting the type and regularity of risk behaviours exhibited by free‐roaming cats and identifying characteristics of pet cats (eg, age, sex, roaming habitat) which predict risky behaviour in the outdoors. The most common risk behaviours exhibited by suburban free‐roaming cats included crossing roads (45 per cent of our sample), encountering strange cats (25 per cent), eating and drinking substances away from home (25 per cent), exploring storm drain systems (20 per cent), and entering crawlspaces of houses (20 per cent). Male cats were more likely to engage in risk behaviours than female cats, and older cats engaged in fewer risk behaviours than younger individuals. We hope this information can be used to encourage the public to keep cats indoors more often (with consideration for their indoor quality of life) or supervise them while outdoors.
The effect of disease on the urinary purine metabolite concentrations in dogs
Authors: Rivara C. M. , Johnson C. R. , Lulich J. P. , Osborne C. A. , Murtaugh M.
Published: August 2013

This prospective study was designed to determine the urinary concentrations of purine metabolites in healthy and diseased dogs. The goals were to test the hypothesis that urine concentrations of terminal purine metabolites will identify dogs with diseases that disturb purine degradation. Five hundred and sixty‐three client‐owned dogs admitted sequentially to the veterinary medical centre were included. Dogs were divided into groups on the basis of their disease. Urine concentrations of xanthine, uric acid, allantoin and creatinine were measured by high‐pressure liquid chromatography. Xanthine and uric acid to creatinine ratios were significantly increased in dogs with chronic kidney disease (p = 0.01). The uric acid to creatinine ratio was significantly increased in dogs with cancer compared with clinically healthy dogs (p = 0.04), and significantly increased in dogs receiving chemotherapy for their disease (p < 0.01). Compared to clinically healthy dogs, xanthine and uric acid to creatinine ratios were significantly increased in dogs with hyperadrenocorticism (p < 0.01, and 0.04, respectively). Therefore, the results of this study found that the urinary concentrations of purine metabolites in dogs are significantly impacted by systemic disease. Cancer, chronic kidney disease, and hyperadrenocorticism are associated with altered concentrations of urinary purine metabolites in dogs.
Association between somatic cell count after first parturition and cumulative milk yield in dairy cows
Authors: Archer S. C. , Mc Coy F. , Wapenaar W. , Green M. J.
Published: August 2013

The aim was to assess the association between the somatic cell count of parity 1 cows between 5 and 30 days in milk (SCC1), and subsequent cumulative milk yield over approximately two years for cows in English and Welsh dairy herds. The dataset included records from 43,461 cows in 2111 herds, from 2004 to 2006. Cumulative milk yield was the model outcome, and a random effect was included to account for variation between herds. The model fitted the data well and was used to make predictions of cumulative milk yield, based on SCC1. A unit increase in the natural logarithm of SCC1/1000 was associated with a median decrease in cumulative milk yield of 482 kg, over a median study period of 868 days.
LATTICE-BOLTZMANN SIMULATIONS OF FLOWS OVER BACKWARD-FACING INCLINED STEPS
Authors: KOTAPATI RUPESH B. , SHOCK RICHARD , CHEN HUDONG
Published: August 2013

The lattice-Boltzmann method (LBM) is used in conjunction with a very large-eddy simulation (VLES) turbulence modeling approach to compute separated flows over backward-facing steps at different wall inclination angles. The Reynolds number Re H based on the step height H and center-line velocity at the channel inlet ucl is 64 000. The expansion ratio of the outlet section to the inlet section of the channel is 1.48. Wall inclination angles α considered include 10°, 15°, 20°, 25°, 30° and 90°. The computed flow fields for different inclination angles of the step are assessed against the laser Doppler anemometry (LDA) measurements of Makiola [B. Makiola, Ph.D. Thesis, University of Karlsruhe (1992); B. Ruck and B. Makiola, Flow separation over the step with inclined walls, in Near-Wall Turbulent Flows, eds. R. M. C. So, C. G. Speziale and B. E. Launder (Elsevier, 1993), p. 999.]. In addition to validating the lattice-Boltzmann solution with the experiments, this study also investigates the effects of three dimensionality, the proximity of the inlet to the step, and the grid resolution on the quality of the predictions.
CREDIT CARD OWNERSHIP AND DEBT STATUS IN MALAYSIA
Authors: LOKE YIING JIA , YEN STEVEN T. , TAN ANDREW K. G.
Published: August 2013

This paper examines the role of socio-demographic and credit consumption tendencies in affecting credit card ownership and debt status. Based on a sample of 938 individuals from three major cities in Malaysia, card holders' debt status is measured in relation to credit card expenditure, which in turn is categorized into convenience users, low-risk credit revolvers and high-risk credit revolvers. While socio-demographic factors play significant roles in determining card ownership, card holders' credit consumption tendencies, such as past debt history and type of loan possessed, have varying adverse effects on the card holder's debt status.
DETERMINATION OF THE STRONG COUPLING FROM HADRONIC TAU DECAYS USING RENORMALIZATION GROUP SUMMED PERTURBATION THEORY
Authors: ABBAS GAUHAR , ANANTHANARAYAN B. , CAPRINI IRINEL
Published: August 2013

We determine the strong coupling constant αs from the τ hadronic width using a renormalization group summed (RGS) expansion of the QCD Adler function. The main theoretical uncertainty in the extraction of αs is due to the manner in which renormalization group invariance is implemented, and the as yet uncalculated higher order terms in the QCD perturbative series. We show that new expansion exhibits good renormalization group improvement and the behavior of the series is similar to that of the standard CIPT expansion. The value of the strong coupling in [Formula: see text] scheme obtained with the RGS expansion is [Formula: see text]. The convergence properties of the new expansion can be improved by Borel transformation and analytic continuation in the Borel plane. This is discussed elsewhere in these issues.
TAU LEPTON HADRONIC DECAYS AT BABAR AND BELLE
Authors: LAFFERTY G. D.
Published: August 2013

The BaBar and Belle experiments together recorded a total sample of some 3 ×109 tau lepton decays between the years 2000 and 2010. This enabled many new and improved measurements of tau hadronic decays to be made, and resulted in lower limits for branching fractions to rare and forbidden hadronic modes, such as those mediated by second-class weak currents which are sensitive to the u–d quark mass difference. Better measurements of strange decays have contributed to more precise data on the CKM matrix element, |Vus|. However, only limited progress has been made in measurements that feed into knowledge of the value of the strong coupling constant, αs, and the strange quark mass. This is largely due to the dominance of systematic uncertainties on branching fractions and shapes of mass spectra (spectral functions) for some of the important hadronic tau decay modes.
INFRARED FIXED POINT IN THE STRONG RUNNING COUPLING: UNRAVELING THE ΔI = 1/2 PUZZLE IN K-DECAYS
Authors: CREWTHER R. J. , TUNSTALL LEWIS C.
Published: August 2013

In this paper, we present an explanation for the ΔI = 1/2 rule in K-decays based on the premise of an infrared fixed point α IR in the running coupling αs of quantum chromodynamics (QCD) for three light quarks u, d, s. At the fixed point, the quark condensate [Formula: see text] spontaneously breaks scale and chiral SU (3)L× SU (3)R symmetry. Consequently, the low-lying spectrum contains nine Nambu–Goldstone bosons: π, K, η and a QCD dilaton σ. We identify σ as the f0(500) resonance and construct a chiral-scale perturbation theory χPTσ for low-energy amplitudes expanded in αs about α IR . The ΔI = 1/2 rule emerges in the leading order of χPTσ through a σ-pole term KS→σ→ππ, with a gKSσ coupling fixed by data on γγ→π0π0 and KS→γγ. We also determine R IR ≈5 for the nonperturbative Drell–Yan ratio at α IR .
JET CROSS-SECTION MEASUREMENTS IN CMS
Authors: GANGULY SANMAY , GUCHAIT MONORANJAN
Published: August 2013

The Large Hadron Collider experiment has successfully completed data taking at center-of-mass energy 7 TeV in 2011 and very recently for 8 TeV. Measurements of cross-sections predicted by the standard model were the main tasks in the beginning. The inclusive jet cross-section and dijet mass measurement are already done at 7 TeV energy by Compact Muon Solenoid (CMS) detector with integrated luminosity 5 fb-1. In these measurement, one needs to understand and measure precisely the kinematic properties of jets which involve many theoretical and experimental issues. The goal of this paper is to discuss all these issues including jet measurements in CMS and subsequently review the inclusive jet cross-section and dijet mass measurement in CMS at 7 TeV with integrated luminosity 5 fb-1. The measurements, after unfolding the data, are also compared with the next-to-leading-order theory predictions, corrected for the nonperturbative effects, for five different sets of parton distribution functions. It is observed that the measurements, for both cases, agree with the theory prediction within ~8–10% depending on transverse momentum (pT) and dijet invariant mass (Mjj) of jets.
GLUON-FUSION-INDUCED Zg AND Zgg PRODUCTIONS IN THE STANDARD MODEL AT THE LHC
Authors: GAO XIANGDONG , LI QIANG , LÜ CAI-DIAN
Published: August 2013

We report calculations of the gluon-induced Zg and Zgg productions in the Standard Model at the Large Hadron Collider (LHC) operating at both 7 TeV and 14 TeV collision energies. We present total cross-sections and differential distributions of the processes and compare them with the leading and next-to-leading order QCD pp → Z+1 jet, Z+2 jets results. Our results show that the gluon-induced Zg and Zgg productions contribute to pp → Z+1 jet, Z+2 jets at 1% level.
MOTIVIC DYSON–SCHWINGER EQUATIONS
Authors: SHOJAEI-FARD ALI
Published: August 2013

We consider Dyson–Schwinger Equations (DSEs) in the context of Connes–Kreimer renormalization Hopf algebra of Feynman diagrams and Connes–Marcolli universal Tannakian formalism. This study leads us to formulate a family of Picard–Fuchs equations and a category of Feynman motivic sheaves with respect to each combina torial DSE.