bluuebunny/crossref_metadata_2025 huggingface dataset:
Histologic evaluation of apical pulp of immature apex following extraction, surface treatment, and replantation in different storage media in dogs
Authors: Jabarifar Ebrahim , Khalighinejad Navid , Khademi Abbas Ali , Razavi Seyed Mohammad , Birjandi Neda , Badrian Hamid , Ansari Ghasem
Published: October 2014

Aim

This study was designed to evaluate the apical pulp of open apex teeth following extraction, surface treatment, and preservation in different storage media in dogs.

Materials and methods

Four healthy male dogs were included in this prospective animal study. In the first phase of extraction, 30 teeth were extracted atraumatically from dogs (incisors and premolars) and then randomly divided into three groups based on different types of storage media: (i) milk, (ii) HBSS, and (iii) dry storage. In milk and HBSS groups, teeth were contaminated by dog's saliva and then kept in milk and HBSS solution, respectively, for 2 h. In the third group, teeth were stored in a dry storage for 2 h. Before replantation, all teeth were soaked in 10% doxycycline. After 2 months, in the second phase of extraction, all experimental teeth were extracted (40 teeth including control group). Three longitudinal sections (3–4 mm thickness) were stained with H&E and investigated under optical microscope. Histologic evaluations were performed, and data were analyzed using Kruskal–Wallis and Fisher's exact test (α = 0.05).

Results

There was a significant difference between the milk and control groups regarding the presence of the odontoblastic layer and resorption (P = 0.04). Also, there was a significant difference between dry storage and control group in the presence of the odontoblastic layer (P = 0.02). There was no statistically significant difference in other histologic factors between different groups (P > 0.05). It was revealed that there is no significant difference between different groups regarding the intensity (P = 0.06) and the type of the inflammation (P = 0.24). Also, the hyperemia showed no significant difference between different groups (P = 0.51).

Conclusion

It was concluded that HBSS and milk are appropriate storage media. Also, it was shown that 2 h dry storage probably does not threaten the vitality of the pulp cells.
Successful treatment of Sarcoptes scabiei in a 33‐year‐old pony with underlying pituitary pars intermedia dysfunction
Authors: Sleutjens J.
Published: October 2014

A pony presented with a severe, chronic dermatitis around the ears, neck and trunk of the body, hind quarters and ventral abdomen. The pony was intensely pruritic as was an in‐contact pony and both owners. A superficial skin scraping demonstrated multiple living mites, identified as Sarcoptes scabiei. Equine pituitary pars intermedia dysfunction (PPID) was diagnosed as an underlying, potentially immunosuppressive disorder. The pony was treated for Sacroptes scabiei as well as PPID and is doing well 2 months after initial presentation.
Reduced myotube diameter, atrophic signalling and elevated oxidative stress in cultured satellite cells from COPD patients
Authors: Pomiès Pascal , Rodriguez Julie , Blaquière Marine , Sedraoui Sami , Gouzi Fares , Carnac Gilles , Laoudj‐Chenivesse Dalila , Mercier Jacques , Préfaut Christian , Hayot Maurice
Published: October 2014

The mechanisms leading to skeletal limb muscle dysfunction in chronic obstructive pulmonary disease (COPD) have not been fully elucidated. Exhausted muscle regenerative capacity of satellite cells has been evocated, but the capacity of satellite cells to proliferate and differentiate properly remains unknown. Our objectives were to compare the characteristics of satellite cells derived from COPD patients and healthy individuals, in terms of proliferative and differentiation capacities, morphological phenotype and atrophy/hypertrophy signalling, and oxidative stress status. Therefore, we purified and cultivated satellite cells from progressively frozen vastus lateralis biopsies of eight COPD patients and eight healthy individuals. We examined proliferation parameters, differentiation capacities, myotube diameter, expression of atrophy/hypertrophy markers, oxidative stress damages, antioxidant enzyme expression and cell susceptibility to H2O2 in cultured myoblasts and/or myotubes. Proliferation characteristics and commitment to terminal differentiation were similar in COPD patients and healthy individuals, despite impaired fusion capacities of COPD myotubes. Myotube diameter was smaller in COPD patients (P = 0.015), and was associated with a higher expression of myostatin (myoblasts: P = 0.083; myotubes: P = 0.050) and atrogin‐1 (myoblasts: P = 0.050), and a decreased phospho‐AKT/AKT ratio (myoblasts: P = 0.022). Protein carbonylation (myoblasts: P = 0.028; myotubes: P = 0.002) and lipid peroxidation (myotubes: P = 0.065) were higher in COPD cells, and COPD myoblasts were significantly more susceptible to oxidative stress. Thus, cultured satellite cells from COPD patients display characteristics of morphology, atrophic signalling and oxidative stress similar to those described in in vivo COPD skeletal limb muscles. We have therefore demonstrated that muscle alteration in COPD can be studied by classical in vitro cellular models.
Pemphigus. S2 Guideline for diagnosis and treatment – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)
Authors: Hertl M. , Jedlickova H. , Karpati S. , Marinovic B. , Uzun S. , Yayli S. , Mimouni D. , Borradori L. , Feliciani C. , Ioannides D. , Joly P. , Kowalewski C. , Zambruno G. , Zillikens D. , Jonkman M.F.
Published: October 2014

Background

Pemphigus encompasses a group of life‐threatening autoimmune bullous diseases characterized by blisters and erosions of the mucous membranes and skin. Before the era of immunosuppressive treatment, the prognosis of pemphigus was almost fatal. Due to its rarity, only few prospective controlled therapeutic trials are available.

Objectives

For this reason, a group of European dermatologists with a long‐standing interest and expertise in basic and clinical pemphigus research has sought to define diagnostic and therapeutic guidelines for the management of patients with pemphigus.

Results

This group identified the statements of major agreement or disagreement regarding the diagnostic and therapeutic management of pemphigus. The revised final version of the pemphigus guideline was finally passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV) and the European Union of Medical Specialists (UEMS).
Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the ear
Authors: Valesky E.M. , Kaufmann R. , Meissner M.
Published: October 2014

Background

The plastic reconstruction of the ear after microscopically controlled tumor surgery is a particular challenge. The chondrocutaneous helix rim advancement flap (CHRAF) is perfectly suited for the repair of different defects of the helix and even defects beyond.

Objective

Here, we describe two known and two new modifications of the CHRAF that enlarge the scope of application in tumor surgery of the ear.

Methods

We demonstrate the different techniques and practical application of the repair and evaluate the benefits and limitations.

Results

The CHRAF and its modifications is an excellent method for repair of various defects of the helical region of the ear.

Conclusion

The CHRAF and its modifications proves to be an good alternative to other methods of closure by preserving the anatomical contour and mechanical and acoustic functions in a single‐staged procedure with excellent aesthetic results. The two new modifications we introduced here, enlarge the known armentarium for very large defects of the upper pole and the mid‐helix of the ear.
Accuracy of in vivo confocal microscopy for diagnosis of basal cell carcinoma: a comparative study between handheld and wide‐probe confocal imaging
Authors: Castro R.P. , Stephens A. , Fraga‐Braghiroli N.A. , Oliviero M.C. , Rezze G.G. , Rabinovitz H. , Scope A.
Published: October 2014

Background

Reflectance confocal microscopy (RCM) increases specificity of identification of basal cell carcinoma (BCC). A smaller‐diameter handheld RCM (HH‐RCM) allows better access to limited anatomic locations.

Objective

To compare accuracy of HH‐RCM in identification of BCC to that of traditional wide‐probe RCM (TWP‐RCM).

Methods

Patients presenting at least one lesion clinically and dermoscopically suspicious for BCC, were recruited from two dermatology skin cancer clinics. Prior to excision, we attempted to image all lesions with HH‐RCM and TWP‐RCM using a standardized protocol. RCM images were retrospectively evaluated, jointly by two blinded readers. For purposes of comparative RCM, sensitivity and specificity analysis, we used a threshold of ≥3 RCM criteria to identify BCC, whereby at least one criterion had to be presence of ‘dark silhouettes’ or ‘bright tumor islands’.

Results

Among 54 lesions imaged with both RCM devices, 45 were biopsy‐proven BCCs. Comparison between TWP‐RCM vs. HH‐RCM was as follows: sensitivity (100% vs. 93%), specificity (78% for both probes), positive predictive value (96% vs. 95%), and negative predictive value (100% vs. 70%) respectively. Notably, both TWP‐RCM and HH‐RCM demonstrated the presence of ‘dark silhouettes’ or ‘bright tumor islands’ in all 45 BCCs.

Conclusion

Both RCM probes demonstrate high PPV. TWP‐RCM shows higher NPV, since its broader field‐of‐view probably allows more exhaustive search for BCC criteria. The RCM criteria threshold for BCC identification should be further tested.
Risk of peptic ulcer bleeding associated with Helicobacter pylori infection, nonsteroidal anti‐inflammatory drugs, low‐dose aspirin, and antihypertensive drugs: A case‐control study
Authors: Nagata Naoyoshi , Niikura Ryota , Sekine Katsunori , Sakurai Toshiyuki , Shimbo Takuro , Kishida Yoshihiro , Tanaka Shohei , Aoki Tomonori , Okubo Hidetaka , Watanabe Kazuhiro , Yokoi Chizu , Akiyama Junichi , Yanase Mikio , Mizokami Masashi , Uemura Naomi
Published: October 2014

Background and Aim

The associations between antithrombotic or antihypertensive drugs and peptic ulcer bleeding (PUB) remain unknown, particularly in Asia, where Helicobacter pylori infection is prevalent. This study aims to evaluate the risks of PUB from antithrombotic drugs, angiotensin II receptor blockers (ARBs), angiotensin‐converting enzyme (ACE) inhibitors, calcium channel blockers, α‐blockers, and β‐blockers.

Methods

This prospective hospital‐based case‐control study included 230 patients with endoscopically verified PUB and 920 age and sex‐matched controls (1:4) without bleeding on screening endoscopy. Adjusted odds ratios (AOR) for the risk of PUB were determined by conditional logistic regression analysis.

Results

In multivariate analysis, alcohol consumption (AOR, 2.2; P < 0.001), history of peptic ulcer (AOR, 4.8; P < 0.001), H. pylori infection (AOR, 2.1; P < 0.001), comorbidity index (AOR, 1.1; P = 0.089), nonsteroidal anti‐inflammatory drugs (NSAIDs) (AOR, 2.0; P = 0.025), and low‐dose aspirin (AOR, 2.8; P = 0.003) increased the risk of PUB, whereas H. pylori eradication (AOR, 0.03; P < 0.001), proton pump inhibitors (PPIs) (AOR, 0.1; P < 0.001), and histamine 2‐receptor antagonists (H2RA) (AOR, 0.1; P < 0.001) reduced it. No significant interactions were observed between H. pylori infection and NSAIDs use for PUB (P = 0.913). ARBs (P = 0.564), ACE inhibitors (P = 0.213), calcium channel blockers (P = 0.215), α‐blockers (P = 0.810), and β‐blockers (P = 0.864) were not associated with PUB.

Conclusion

We found that alcohol consumption, history of peptic ulcer, H. pylori infection, NSAIDs use, and low‐dose aspirin use were independent risk factors for PUB, whereas H. pylori‐eradication, PPIs use, and H2RA use reduced its risk. Interactions between H. pylori and NSAIDs use in PUB were not observed. No antihypertensive drug was associated with PUB.
Does Familiarity Foster Innovation? The Impact of Alliance Partner Repeatedness on Breakthrough Innovations
Authors: Zheng Yanfeng , Yang Haibin
Published: October 2014

Does familiarity with alliance partners promote breakthrough innovations? This study draws on the literature of interorganizational routines to examine the impact of repeated R&D collaborations within a firm's alliance portfolio on its breakthrough innovations. Specifically, we contend that the benefits and liabilities of interorganizational routines, arising from alliance partner repeatedness at a firm's alliance portfolio level, lead to an inverted U‐shaped relationship between alliance partner repeatedness and breakthrough innovations. Further, we build on the recent theoretical development of interorganizational routines to propose that technological dynamism will make the inverted U‐shaped relationship steeper. Analyses of approximately 230 firms in the US biopharmaceutical industry from 1983 to 2002 support our hypotheses. Our findings provide important implications for research on alliance portfolio and management of firm innovation.
Social Acceleration Theory and the Self
Authors: Hsu Eric L. , Elliott Anthony
Published: October 2014

In recent years, there has been a rapidly growing body of work in the social sciences that underscores the prevalence of the phenomenon of ‘social acceleration'—the speeding up of social life— in many parts of theWestern world. Although research on social acceleration has tended to analyze the phenomenon on a social‐structural level, there is also a need to investigate how social acceleration has ‘ramifications for the socially dominant forms of self‐relation’. One way to gain a more in‐depth understanding of this facet of social acceleration is to investigate the speeding up of social life through the prism of the self. The central argument of this article is that there are at least five images of the self which can be associated with the social acceleration phenomenon: (1) the ‘detached’ self, (2) the ‘reflexive’ self, (3) the ‘reinventive’ self, (4) the ‘stationary’ self and (5) the ‘decelerating’ self. By explaining how these kinds of self relate to the speeding up process, we seek to advance a more nuanced and sophisticated theory of social acceleration, which captures some of the complexities and paradoxes that the phenomenon involves.
Toxic epidermal necrolysis treated with N‐acetylcysteine
Authors: Yavuz Haluk , Emiroglu Melike
Published: October 2014

Adverse drug reactions are the major cause of morbidity and mortality worldwide. Cutaneous drug reaction is the most common type of adverse reaction. Toxic epidermal necrolysis (TEN) is a rare, life‐threatening mucocutaneous disease, usually attributable to drugs. There is no proven therapy for TEN. The mainstay of therapy is immediate withdrawal of the culprit drug, using disease‐modifying agents, and meticulous supportive care. Several disease‐modifying agents have been used such as steroid, i.v. human immunoglobulin (IVIg), plasmapheresis. A 10‐year‐old epileptic girl was admitted with lamotrigine‐induced TEN. She was unresponsive to steroid. Her condition deteriorated despite IVIg treatment. She was treated with N‐acetylcysteine (NAC). To our knowledge this is the first report of a child with TEN, a potentially lethal disorder, treated with NAC. NAC may be effective for children with TEN.
Traumatic head injury mimicking acute encephalopathy with biphasic seizures and late reduced diffusion
Authors: Inoue Hirofumi , Hasegawa Shunji , Kajimoto Madoka , Matsushige Takeshi , Ichiyama Takashi
Published: October 2014

Many studies have reported acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) associated with viral infection at onset, but few studies have reported AESD without infection. We report the case of a 9‐month‐old boy who had a clinical course mimicking AESD after a traffic accident. The traffic accident caused a mild subdural hematoma without neurological abnormalities on admission. The boy became unconscious on the second day, and he was diagnosed with non‐convulsive status epilepticus on the third day. Diffusion‐weighted imaging showed reduced water diffusion in the subcortical white matter. On laboratory analysis interleukin (IL)‐6 was elevated in the cerebrospinal fluid (CSF), but not in the serum. He had severe neurological sequelae with mental retardation, spastic tetraplegia, and epilepsy. We suggest that brain damage mimicking AESD was caused by the traffic accident and the prolonged seizure during infancy.
Spontaneous pneumomediastinum as a complication in human bocavirus infection
Authors: Pekcan Sevgi , Gokturk Bahar , Uygun Kucukapan Hasibe , Arslan Ugur , Fındık Duygu
Published: October 2014

The most common causes of spontaneous pneumomediastinum (SPM) in children are asthma attack and respiratory tract infection. Here, we describe a case of SPM in a human bocavirus‐infected 2‐year‐old boy with bronchiolitis.
Modulation of eyeblink and postauricular reflexes during the anticipation and viewing of food images
Authors: Hebert Karen R. , Valle‐Inclán Fernando , Hackley Steven A.
Published: October 2014

One of the goals of neuroscience research on the reward system is to fractionate its functions into meaningful subcomponents. To this end, the present study examined emotional modulation of the eyeblink and postauricular components of startle in 60 young adults during anticipation and viewing of food images. Appetitive and disgusting photos served as rewards and punishments in a guessing game. Reflexes evoked during anticipation were not influenced by valence, consistent with the prevailing view that startle modulation indexes hedonic impact (liking) rather than incentive salience (wanting). During the slide‐viewing period, postauricular reflexes were larger for correct than incorrect feedback, whereas the reverse was true for blink reflexes. Probes were delivered in brief trains, but only the first response exhibited this pattern. The specificity of affective startle modification makes it a valuable tool for studying the reward system.
Factors affecting the variability of IRT equating coefficients
Authors: Battauz Michela
Published: October 2014

Knowing the effect of the factors that can influence the variability of the equating coefficients is an important tool for the development of the linkage plans. This paper explores the effect of various factors on the variability of item response theory equating coefficients. The factors studied are the sample size, the number of common items, the length of the chain, and the possibility of averaging the equating transformations related to different paths that connect the same two forms. Both asymptotic and simulations results are provided.
Inverse Identification at Very High Strain Rate of the Johnson–Cook Constitutive Model on the Ti‐6Al‐4 V Alloy With a Specially Designed Direct‐impact Kolsky Bar Device
Authors: Guo X. , Heuzé T. , Othman R. , Racineux G.
Published: October 2014

In the present work, an inverse identification of the Johnson–Cook constitutive model is performed on the titanium alloy Ti‐6Al‐4 V at three strain rates until about 2·104 s−1 (till about 1.1·104 s−1 of plastic strain rate) on a specially designed direct impact Kolsky bar device. First, the design of such a device must meet several criteria, and is shown to be the solution of an optimization problem. A systematic design procedure for such a device is then introduced. Second, an inverse analysis using the finite element code ABAQUS is carried out to identify the Johnson–Cook parameters on experimental data obtained with the designed system.
Corneal grafting for the treatment of feline corneal sequestrum: a retrospective study of 18 eyes (13 cats)
Authors: Laguna Fernando , Leiva Marta , Costa Daniel , Lacerda Rodrigo , Peña Gimenez Teresa
Published: October 2014

Objective

To determine the clinical outcome of corneal grafting for the treatment of feline corneal sequestrum (FCS).

Animal studied

Domestic cats.

Procedures

A review of the medical records of cats that underwent keratoplasty as a treatment ofFCSat theVTH‐UAB, from 2002 to 2012, was carried out.

Results

Thirteen cats (18 eyes) of different breed, age, and gender were included. Persian cats were overrepresented (12/13;92%). There were nine males and four females, of a mean age of 3.4 years (0.7–7.1). Ipsilateral chronic corneal ulceration was reported as the most common concurrent ocular disease (6/18;33%). Keratoplasty was performed bilaterally in 5 cats (5/13;38%) and unilaterally in 8 (8/13;62%). Lamellar keratoplasty was performed in 17 eyes (17/18;95%) and full‐thickness keratoplasty in 1 (1/18;5%). Mean graft size was 8.3 mm (4–11.5). Fresh homologous graft was performed in 2 eyes (2/18;11%) and frozen graft in 16 (16/18;89%). Of the latter group, homologous graft was performed in 6 eyes (6/16;37.5%) and heterologous in 10 (10/16;62.5%). In all the cats, postoperative treatment included topical antibiotics, corticosteroids, cycloplegics, and 0.2% cyclosporine A. Median follow‐up time was 18.2 months, and main postoperative complications were diffuse mild epithelial pigment formation (2/18;11%), graft malacia (1/18;5%), and sequestrum recurrence (1/18;5%). Mean epithelial healing time was 19.2 days. Good visual outcome was achieved in all the eyes (100%), the majority of them having faint or mild corneal opacity (15/18;83%).

Conclusions

Keratoplasty is an effective surgical treatment forFCS. The donor tissue provides excellent tectonic support to the affected corneas, with good visual and cosmetic outcome.
Image‐based thresholds for weeds in maize fields
Authors: Ali A , Streibig J C , Christensen S , Andreasen C
Published: October 2014

Recent development of site‐specific weed management strategies suggests patch application of herbicides to avoid their excessive use in crops. The estimation of infestation of weeds and control thresholds are important components for taking spray decisions. If weed pressure is below a certain level in some parts of the field and if late germinating weeds do not affect yield, it may not be necessary the spray such places from an economic point of view. Consequently, it makes sense to develop weed control thresholds for patch spraying, based on weed cover early in the growing season. In Danish maize field experiments conducted from 2010 to 2012, we estimated competitive ability parameters and control thresholds of naturally established weed populations in the context of decision‐making for patch spraying. The most frequent weed was Chenopodium album, accompanied by Capsella bursa‐pastoris, Cirsium arvense, Lamium amplexicaule, Tripleurospermum inodorum, Poa annua, Polygonum aviculare, Polygonum persicaria, Stellaria media and Veronica persica. Relative leaf cover of weeds was estimated using an image analysis method. The relation between relative weed leaf cover and yield loss was analysed by nonlinear regression models. The competitive ability parameters and economic thresholds were estimated from the regression models. The competitive ability of weed mixtures was influenced by the increasing proportion of large size weeds in the mixtures. There was no significant effect of weeds which survived or established after the first herbicide application, indicating that early image analysis was robust for use under these conditions.
Genetic diversity of East and West African Striga hermonthica populations and virulence effects on a contrasting set of sorghum cultivars
Authors: Bozkurt M L , Muth P , Parzies H K , Haussmann B I G
Published: October 2014

The root hemiparasite Striga hermonthica causes very significant yield loss in its dryland staple cereal host, Sorghum bicolor. Striga‐resistant sorghum cultivars could be an important part of integrated S. hermonthica control. For effective resistance breeding, knowledge about the diversity of the parasite is essential. This study aimed (i) to determine the genetic diversity within and between seven S. hermonthica populations from East and West Africa using 15 microsatellite markers and (ii) to assess the virulence and host–parasite interactions of these Striga populations grown on 16 diverse sorghum genotypes in a glasshouse trial. Most of the genetic variance (91%) assessed with microsatellite markers occurred within S. hermonthica populations. Only a small portion (8%) occurred between regions of origin of the populations. A positive correlation (R2 = 0.14) between pairwise geographic and genetic distances reflected the slightly increasing differentiation of S. hermonthica populations with increasing geographic distance. East African S. hermonthica populations, especially those from Sudan, had significantly greater average infestation success across all sorghum genotypes than West African populations. Some specific host–parasite interaction effects were observed. The high genetic variation among individuals of each S. hermonthica population underlines the high potential adaptability to different hosts and changing environments. This points to the need to manage sorghum resistance alleles in space and time and to employ resistant varieties as part of integrated S. hermonthica control, so as to hinder the parasite overcoming resistance.
Multiple resistance across glufosinate, glyphosate, paraquat and ACCase‐inhibiting herbicides in an Eleusine indica population
Authors: Jalaludin A , Yu Q , Powles S B
Published: October 2014

An Eleusine indica population was previously reported as the first global case of field‐evolved glufosinate resistance. This study re‐examines glufosinate resistance and investigates multiple resistance to other herbicides in the population. Dose–response experiments with glufosinate showed that the resistant population is 5‐fold and 14‐fold resistant relative to the susceptible population, based on GR50 and LD50 R/S ratio respectively. The selected glufosinate‐resistant subpopulation also displayed a high‐level resistance to glyphosate, with the respective GR50 and LD50 R/S ratios being 12‐ and 144‐fold. In addition, the subpopulation also displayed a level of resistance to paraquat and ACCase‐inhibiting herbicides fluazifop‐P‐butyl, haloxyfop‐P‐methyl and butroxydim. ACCase gene sequencing revealed that the Trp‐2027‐Cys mutation is likely responsible for resistance to the ACCase inhibitors examined. Here, we confirm glufosinate resistance and importantly, we find very high‐level glyphosate resistance, as well as resistance to paraquat and ACCase‐inhibiting herbicides. This is the first confirmed report of a weed species that evolved multiple resistance across all the three non‐selective global herbicides, glufosinate, glyphosate and paraquat.
A hardware investigation of robotic SPECT for functional and molecular imaging onboard radiation therapy systems
Authors: Yan Susu , Bowsher James , Tough MengHeng , Cheng Lin , Yin Fang‐Fang
Published: October 2014

Purpose:

To construct a robotic SPECT system and to demonstrate its capability to image a thorax phantom on a radiation therapy flat‐top couch, as a step toward onboard functional and molecular imaging in radiation therapy.

Methods:

A robotic SPECT imaging system was constructed utilizing a gamma camera detector (Digirad 2020tc) and a robot (KUKA KR150 L110 robot). An imaging study was performed with a phantom (PET CT PhantomTM), which includes five spheres of 10, 13, 17, 22, and 28 mm diameters. The phantom was placed on a flat‐top couch. SPECT projections were acquired either with a parallel‐hole collimator or a single‐pinhole collimator, both without background in the phantom and with background at 1/10th the sphere activity concentration. The imaging trajectories of parallel‐hole and pinhole collimated detectors spanned 180° and 228°, respectively. The pinhole detector viewed an off‐centered spherical common volume which encompassed the 28 and 22 mm spheres. The common volume for parallel‐hole system was centered at the phantom which encompassed all five spheres in the phantom. The maneuverability of the robotic system was tested by navigating the detector to trace the phantom and flat‐top table while avoiding collision and maintaining the closest possible proximity to the common volume. The robot base and tool coordinates were used for image reconstruction.

Results:

The robotic SPECT system was able to maneuver parallel‐hole and pinhole collimated SPECT detectors in close proximity to the phantom, minimizing impact of the flat‐top couch on detector radius of rotation. Without background, all five spheres were visible in the reconstructed parallel‐hole image, while four spheres, all except the smallest one, were visible in the reconstructed pinhole image. With background, three spheres of 17, 22, and 28 mm diameters were readily observed with the parallel‐hole imaging, and the targeted spheres (22 and 28 mm diameters) were readily observed in the pinhole region‐of‐interest imaging.

Conclusions:

Onboard SPECT could be achieved by a robot maneuvering a SPECT detector about patients in position for radiation therapy on a flat‐top couch. The robot inherent coordinate frames could be an effective means to estimate detector pose for use in SPECT image reconstruction.
The Invisibility of Steam
Authors: Greenslade Thomas B.
Published: October 2014

Almost everyone “knows” that steam is visible. After all, one can see the cloud of white issuing from the spout of a boiling tea kettle. In reality, steam is the gaseous phase of water and is invisible. What you see is light scattered from the tiny droplets of water that are the result of the condensation of the steam as its temperature falls below 100 °C (under standard conditions).
Introducing the Moon's Orbital Eccentricity
Authors: Oostra Benjamin
Published: October 2014

I present a novel way to introduce the lunar orbital eccentricity in introductory astronomy courses. The Moon is perhaps the clearest illustration of the general orbital elements such as inclination, ascending node, eccentricity, perigee, and so on. Furthermore, I like the students to discover astronomical phenomena for themselves, by means of a guided exercise, rather than just telling them the facts.1 The inclination and nodes may be found by direct observation, monitoring carefully the position of the Moon among the stars. Even the regression of the nodes may be discovered in this way2 To find the eccentricity from students' observations is also possible,3 but that requires considerable time and effort. if a whole class should discover it in a short time, here is a method more suitable for a one-day class or home assignment. The level I aim at is, more or less, advanced high school or first-year college students. I assume them to be acquainted with celestial coordinates and the lunar phases, and to be able to use algebra and trigonometry.
A cosmic perspective timeline
Authors: Concannon Kristi
Published: October 2014

The study of astronomy is vast both in space and time. A typical astronomy course leads students through the entire 14 billion-year evolution of our universe while covering everything from atoms to planets and stars to galaxies. To students, the 15-week tour of the universe is often little more than a series of facts and figures related to objects beyond reach or comprehension; there is little connection to their human story. Even worse, the desire to cover so many topics in the course results in students memorizing properties and processes of ever-larger and ever-more-distant objects without comprehending the empirical nature of astronomy. To them, our understanding of the universe seems fixed, not fluid. while students may learn the story of the physical universe, they fail to appreciate how our understanding of our human place in the cosmos has changed over time.
Functional Analysis of Rhomboid Proteases during
Toxoplasma
Invasion
Authors: Shen Bang , Buguliskis Jeffrey S. , Lee Tobie D. , Sibley L. David
Published: October 2014

Host cell invasion by
Toxoplasma gondii
and other apicomplexan parasites requires transmembrane adhesins that mediate binding to receptors on the substrate and host cell to facilitate motility and invasion. Rhomboid proteases (ROMs) are thought to cleave adhesins within their transmembrane segments, thus allowing the parasite to disengage from receptors and completely enter the host cell. To examine the specific roles of individual ROMs during invasion, we generated single, double, and triple knockouts for the three ROMs expressed in
T. gondii
tachyzoites. Analysis of these mutants demonstrated that ROM4 is the primary protease involved in adhesin processing and host cell invasion, whereas ROM1 or ROM5 plays negligible roles in these processes. Deletion of ROM4 blocked the shedding of adhesins such as MIC2 (microneme protein 2), causing them to accumulate on the surface of extracellular parasites. Increased surface adhesins led to nonproductive attachment, altered gliding motility, impaired moving junction formation, and reduced invasion efficiency. Despite the importance of ROM4 for efficient invasion, mutants lacking all three ROMs were viable and MIC2 was still efficiently removed from the surface of invaded mutant parasites, implying the existence of ROM-independent mechanisms for adhesin removal during invasion. Collectively, these results suggest that although ROM processing of adhesins is not absolutely essential, it is important for efficient host cell invasion by
T. gondii
.

IMPORTANCE
Apicomplexan parasites such as
Toxoplasma gondii
express surface proteins that bind host cell receptors to aid invasion. Many of these adhesins are subject to cleavage by rhomboid proteases (ROMs) within their transmembrane segments during invasion. Previous studies have demonstrated the importance of adhesin cleavage for parasite invasion and proposed that the ROMs responsible for processing would be essential for parasite survival. In
T. gondii
, ROM5 was thought to be the critical ROM for adhesin shedding due to its robust protease activity
in vitro
and posterior localization on the parasite surface. Here, we knocked out all three ROMs in
T. gondii
tachyzoites and found that ROM4, but not ROM5, was key for adhesin cleavage. However, none of the ROMs individually or in combination was essential for cell entry, further emphasizing that essential pathways such as invasion typically rely on redundant pathways to ensure survival.
Capturing patient information at nursing shift changes: methodological evaluation of speech recognition and information extraction
Authors: Suominen Hanna , Johnson Maree , Zhou Liyuan , Sanchez Paula , Sirel Raul , Basilakis Jim , Hanlen Leif , Estival Dominique , Dawson Linda , Kelly Barbara
Published: October 2014

Objective We study the use of speech recognition and information extraction to generate drafts of Australian nursing-handover documents.

Methods Speech recognition correctness and clinicians’ preferences were evaluated using 15 recorder–microphone combinations, six documents, three speakers, Dragon Medical 11, and five survey/interview participants. Information extraction correctness evaluation used 260 documents, six-class classification for each word, two annotators, and the CRF++ conditional random field toolkit.

Results A noise-cancelling lapel-microphone with a digital voice recorder gave the best correctness (79%). This microphone was also the most preferred option by all but one participant. Although the participants liked the small size of this recorder, their preference was for tablets that can also be used for document proofing and sign-off, among other tasks. Accented speech was harder to recognize than native language and a male speaker was detected better than a female speaker. Information extraction was excellent in filtering out irrelevant text (85% F1) and identifying text relevant to two classes (87% and 70% F1). Similarly to the annotators’ disagreements, there was confusion between the remaining three classes, which explains the modest 62% macro-averaged F1.

Discussion We present evidence for the feasibility of speech recognition and information extraction to support clinicians’ in entering text and unlock its content for computerized decision-making and surveillance in healthcare.

Conclusions The benefits of this automation include storing all information; making the drafts available and accessible almost instantly to everyone with authorized access; and avoiding information loss, delays, and misinterpretations inherent to using a ward clerk or transcription services.
‘Connecting the dots’: leveraging visual analytics to make sense of patient safety event reports
Authors: Ratwani Raj M , Fong Allan
Published: October 2014

An increasing number of healthcare providers are adopting patient safety event reporting systems, yet leveraging these data to improve safety remains a challenge, particularly with large datasets composed of thousands of event reports. A MedStar Health research team, with expertise in data analytics and human factors, developed intuitive visualization dashboards to facilitate data exploration and trend analysis. Dashboards were developed using an iterative design and development process that was end-user focused. A system level dashboard, representing data from multiple hospitals, and a hospital level dashboard were developed. The dashboards allowed users to directly manipulate the data, provided coordinated displays in different formats, and allowed users to quickly zoom in on specific variables of interest. Overall feedback was incredibly positive with nearly all users wanting to adopt the system immediately. Several improvements were suggested and are discussed. The success of this approach highlights the need for more intuitive data analysis tools.
Benchmarks for detecting ‘breakthroughs’ in clinical trials: empirical assessment of the probability of large treatment effects using kernel density estimation
Authors: Miladinovic Branko , Kumar Ambuj , Mhaskar Rahul , Djulbegovic Benjamin
Published: October 2014

Objective

To understand how often ‘breakthroughs,’ that is, treatments that significantly improve health outcomes, can be developed.

Design

We applied weighted adaptive kernel density estimation to construct the probability density function for observed treatment effects from five publicly funded cohorts and one privately funded group.

Data Sources

820 trials involving 1064 comparisons and enrolling 331 004 patients were conducted by five publicly funded cooperative groups. 40 cancer trials involving 50 comparisons and enrolling a total of 19 889 patients were conducted by GlaxoSmithKline.

Results

We calculated that the probability of detecting treatment with large effects is 10% (5–25%), and that the probability of detecting treatment with very large treatment effects is 2% (0.3–10%). Researchers themselves judged that they discovered a new, breakthrough intervention in 16% of trials.

Conclusions

We propose these figures as the benchmarks against which future development of ‘breakthrough’ treatments should be measured.
Quality indicators for hip fracture patients: a scoping review protocol
Authors: Pitzul Kristen B , Munce Sarah E P , Perrier Laure , Beaupre Lauren , Morin Suzanne N , McGlasson Rhona , Jaglal Susan B
Published: October 2014

Introduction

Hip fractures are a significant cause of morbidity and mortality and care of hip fracture patients places a heavy burden on healthcare systems due to prolonged recovery time. Measuring quality of care delivered to hip fracture patients is important to help target efforts to improve care for patients and efficiency of the health system. The purpose of this study is to synthesise the evidence surrounding quality of care indicators for patients who have sustained a hip fracture. Using a scoping review methodology, the research question that will be addressed is: “What patient, institutional, and system-level indicators are currently in use or proposed for measuring quality of care across the continuum for individuals following a hip fracture?”.

Methods and analysis

We will employ the methodological frameworks used by Arksey and O'Malley and Levacet al. The synthesis will be limited to quality of care indicators for individuals who suffered low trauma hip fracture. All English peer-reviewed studies published from the year 2000-most recent will be included. Literature search strategies will be developed using medical subject headings and text words related to hip fracture quality indicators and the search will be peer-reviewed. Numerous electronic databases will be searched. Two reviewers will independently screen titles and abstracts for inclusion, followed by screening of the full text of potentially relevant articles to determine final inclusion. Abstracted data will include study characteristics and indicator definitions.

Dissemination

To improve quality of care for patients and create a more efficient healthcare system, mechanisms for the measurement of quality of care are required. The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery. Knowledge translation activities will occur throughout the review with dissemination of the project goals and findings to local, national, and international stakeholders.
Improving the accuracy of operation coding in surgical discharge summaries
Authors: Martinou Eirini , Shouls Genevieve , Betambeau Nadine
Published: October 2014

Procedural coding in surgical discharge summaries is extremely important; as well as communicating to healthcare staff which procedures have been performed, it also provides information that is used by the hospital’s coding department. The OPCS code (Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures) is used to generate the tariff that allows the hospital to be reimbursed for the procedure. We felt that the OPCS coding on discharge summaries was often incorrect within our breast and endocrine surgery department. A baseline measurement over two months demonstrated that 32% of operations had been incorrectly coded, resulting in an incorrect tariff being applied and an estimated loss to the Trust of £17,000.

We developed a simple but specific OPCS coding table in collaboration with the clinical coding team and breast surgeons that summarised all operations performed within our department. This table was disseminated across the team, specifically to the junior doctors who most frequently complete the discharge summaries. Re-audit showed 100% of operations were accurately coded, demonstrating the effectiveness of the coding table. We suggest that specifically designed coding tables be introduced across each surgical department to ensure accurate OPCS codes are used to produce better quality surgical discharge summaries and to ensure correct reimbursement to the Trust.
Self-management of vaginal pessaries for pelvic organ prolapse
Authors: Kearney Rohna , Brown Claire
Published: October 2014

Two thirds of women opt to use a vaginal pessary initially to manage the symptoms of pelvic organ prolapse. In the UK most women attend a health care professional at least every six months to change the pessary. This represents a significant burden both economically to the health care system and personally for the woman. Annually there are more than 300 appointments for pessary changes at our hospital. We developed a programme to teach women to self-manage their pessaries with the aim of improving patient experience and reducing outpatient attendances to free up outpatient capacity for new referrals. A physiotherapist was recuited to deliver this programme involving a one to one training session supplemented with written materials and an online video. Women using pessaries were offered the option of self-management.

Eighty-eight women aged between 29 to 84 years enrolled in the programme. Sixty-three women (73% of those enrolled) successfully continued with self-management at six months, creating 126 extra outpatient appointment capacity in one year alone. Women self-managing reported higher levels of convenience (94% vs 81%), accessibility (97% vs 73%), support (100% vs. 83%), and comfort (86% vs. 53%) than those attending the hospital for GP practice for pessary change.

Self-management appears to be an acceptable option for many women using vaginal pessaries, with personal benefits to the women and economic benefits to the hospital and commissioners.
Brain drain: the cost of neglected responsibilities in evaluating cumulative effects of environmental chemicals
Authors: Maffini Maricel V , Neltner Thomas G
Published: October 2014

Developmental disabilities affect millions of people and have a great impact on their lives, their families and the societies where they live. The prevalence of disorders such as autism, attention deficit hyperactivity disorder as well as subclinical decrements in brain function cannot be explained solely as genetic diseases. Exposures to environmental chemicals, especially during prenatal and early postnatal life, are one likely explanation for some of the decrements. The current chemical risk assessment approach is typically based on the toxicity caused by a single chemical on a variety of organs without acknowledging additional exposures to other chemicals also affecting the same organ or system. We identified more than 300 chemicals allowed in food that may have potential harmful effects on the developing brain. Each individual chemical may or may not have a harmful effect if it were the only one present, but we know next to nothing about their cumulative biological effects on the brain. An expanded cumulative risk assessment approach is needed, and it should focus on health outcomes, like developmental disabilities, arising from the accumulation of effects of multiple chemicals on the brain. The laws regulating the safety of additives already require that regulators in Europe and the USA consider cumulative effects; so far, they seem to have neglected the mandate. We must move beyond treating chemical exposures as isolated incidents and look at their cumulative biological effects on organs and their role in the onset of chronic diseases. The time has come to overhaul chemical risk assessment.
The influence of supine posture on chest wall volume changes is higher in obese than in normal weight children
Authors: Silva Letícia , Barcelar Jacqueline de Melo , Rattes Catarina Souza , Sayão Larissa Bouwman , Reinaux Cyda Albuquerque , Campos Shirley L. , Brandão Daniella Cunha , Fregonezi Guilherme , Aliverti Andrea , Dornelas de Andrade Armèle
Published: October 2014

The objective of this study was to analyze thoraco-abdominal kinematics in obese children in seated and supine positions during spontaneous quiet breathing. An observational study of pulmonary function and chest wall volume assessed by optoelectronic plethysmography was conducted on 35 children aged 8–12 years that were divided into 2 groups according to weight/height ratio percentiles: there were 18 obese children with percentiles greater than 95 and 17 normal weight children with percentiles of 5–85. Pulmonary function (forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); and FEV1/FVC ratio), ventilatory pattern, total and compartment chest wall volume variations, and thoraco-abdominal asynchronies were evaluated. Tidal volume was greater in seated position. Pulmonary and abdominal rib cage tidal volume and their percentage contribution to tidal volume were smaller in supine position in both obese and control children, while abdominal tidal volume and its percentage contribution was greater in the supine position only in obese children and not in controls. No statistically significant differences were found between obese and control children and between supine and seated positions regarding thoraco-abdominal asynchronies. We conclude that in obese children thoraco-abdominal kinematics is influenced by supine posture, with an increase of the abdominal and a decreased rib cage contribution to ventilation, suggesting that in this posture areas of hypoventilation can occur in the lung.