bluuebunny/crossref_metadata_2025 huggingface dataset:
Piloting an Objective Structured Clinical Examination to Evaluate the Clinical Competency of Pre‐Registration Pharmacists
Authors: Coombes Judith A , McGuire Treasure , Harrhy Karen L , Mc Robbie Duncan , Davies J Graham , Fleming Gail
Published: March 2016

Objectives:The primary aim of the study was to pilot the Objective Structured Clinical Examination (OSCE) as a method of evaluating the clinical competency of pre‐registration pharmacists trained in Brisbane and nearby hospitals. A secondary aim was to demonstrate that this model of assessment is transferable when used to evaluate preregistration pharmacists from the UK.

Method:A 15‐workstation OSCE was adapted from an examination used by the South Thames Clinical Pharmacy Network in the UK. The workstations were reviewed and updated to ensure their appropriateness to clinical pharmacy practice in Australia by a group of practising pharmacists and academics. The OSCE was first completed by pre‐registration pharmacists from Brisbane and nearby hospitals in October 1998 (QLD98) and then in November 1999 (QLD99). A sample of pre‐registration students from the UK who completed the same OSCE in 1998 (UK98) was used as the comparator group.

Results:The OSCEs were completed by 10 students in 1998 (QLD98) and 13 in 1999 (QLD99). These results were compared with 52 students who completed the OSCEs in the UK in 1998 (UK98). In general, the students performed well in the ‘medication focused’ activities such as counselling, calculations and chart review. However, they were less successful in more holistic tasks such as drug history taking, information retrieval from medical notes and interpretive calculations.

Conclusion:Having successfully piloted the OSCE model it was determined that the method is feasible to administer when students can be brought to an assessment centre. We recommend that the OSCE be considered a key component of assessing clinical competency as part of the registration requirements for pre‐registration pharmacists in Australia.
Patients' Willingness to Pay for Cognitive Pharmacy Services in Ambulatory Care Settings in the USA
Authors: Daftary Monika N , Lee Euni , Dutta Arjun P , Olagundoye Abiola , Xue Zhenyi (Eric)
Published: March 2016

Aim: To assess patients' willingness to pay (WTP) for cognitive pharmacy services and the current level at which patients receive these types of services.

Method: A self‐administered questionnaire was given to patients who visited two local ambulatory care pharmacies in metropolitan Washington DC, USA.

Results: Ninety patients responded to the questionnaire—the majority female (60%) and African American (58%). Analyses showed that WTP status was associated with annual income. However, the number of prescriptions, race, and insurance type did not show any associations with patients' WTP. Although the majority of respondents were not receiving cognitive pharmacy services many of them would be willing to pay for this type of service, and over 90% reported that insurance companies should cover cognitive pharmacy services.

Conclusion: The majority of patients surveyed were not receiving cognitive pharmacy services from the two local ambulatory care pharmacies. However, many were willing to pay for this type of service and would pay more for long‐term cognitive pharmacy services. Certain patient characteristics, such as high annual income, age, and perceived health status, were associated with WTP.
Developing a Form to Enhance the Continuum of Medication Care Following Hospital Discharge
Authors: Parke John , Howat Celia
Published: March 2016

Aim: To develop a form to enhance the continuum of medication care following hospital discharge, trial its introduction in a public hospital medical ward and estimate the human resources required for full implementation.

Method: A form was developed to facilitate the collection of information for compliance with the guidelines of the Australian Pharmaceutical Advisory Council to enhance the continuum of medication care. The form was trialed for one month by a project officer and for one month by the treatment team.

Results: During the first period there was a marked increase in the quantity and quality of medication histories, recording of medication pathways, medication risk assessments and counselling. None of these functions were performed by the treatment team during the second period. The time taken to gather the required information averaged 0.56 hours per patient.

Conclusion: The form enhanced the continuum of medication care from admission through to, and beyond, discharge. The treatment team did not have the time to complete the form and noted that pharmacists are ideally placed to perform this task. For the successful implementation of the form, sufficient staff may need to be employed.
Stability of Insulin Aspart in Normal Saline Infusion
Authors: Lim Stephen CB , Roberts Malcolm J , Paech Michael J , Peng Li , Jones Allan
Published: March 2016

Aim: To investigate the stability of insulin aspartin sodium chloride 0.9% (normal saline) during storage and continuous IV infusion.

Method: Five bags containing insulin 0.1 unit per mL were prepared for each of the four different experimental conditions‐room temperature, 37°C, 2 to 8°C, and within an IV administration set. Insulin was assayed by high pressure liquid chromatography.

Results: The insulin concentration fluctuated for 4 hours and then remained within the prescribed range over a 24‐hour period at both room temperature and 37°C. When stored at 2 to 8°C for eight days, the concentration remained stable after one day and was always within the prescribed range. Infusion through an administration set provided a stable concentration after the initial first hour of infusion.

Conclusion: Insulin aspart can be produced in batches in normal saline, stored at room temperature or 37°C for 24 hours or in the refrigerator for eight days, and administered without significant change in the prepared concentration.
Renal Function, Peak Anti‐Xa Levels and Enoxaparin Dosing
Authors: Peng Yan Ghee , Eikelboom John W , Tenni Peter , McQuillan Andrew , Thorn Jim
Published: March 2016

Background: Low molecular weight heparin is administered in a fixed, weight‐adjusted dose without laboratory monitoring in the majority of patients. However, there is still uncertainty regarding optimum dosing in patients with renal impairment.

Aim: To examine the association between peak anti‐Xa levels and creatinine clearance in patients treated with enoxaparin.

Method: Prospective study of hospitalised patients receiving enoxaparin 1 mg/kg twice daily. Peak anti‐Xa levels were measured after patients received at least 3 doses of SC enoxaparin and were compared in 3 patient groups according to baseline creatinine clearance (Group 1: Crcl ≤ 30 rnUmin; Group 2: Crcl < 30 and ≤ 60 mL/min; Group 3: Crcl < 60 mL/min).

Results: 50 patients were studied (54% male). Peak anti‐Xa levels after a mean of 5.2 doses of enoxaparin were within or above the recommended therapeutic range (0.6‐1.0 unit per mL) in 96% of patients ( 48/50). At this time, five of the seven patients (71.4%) in Group 1 had peak anti‐Xa levels < 1.0 unit per mL, compared with 15/19 (78.9%) in Group 2 and 7/24 (29.2%) in Group 3. Mean peak anti‐Xa levels were 1.58 ± 0.54 unit per mL, 1.25 ± 0.38 unit per mL and 0.93 ± 0.28 unit per mL in Groups 1, 2 and 3 respectively, p = 0.001.

Conclusion: Patients with reduced creatinine clearance who were receiving enoxaparin 1 mg/kg twice daily achieved significantly higher peak anti‐Xa levels compared with those with normal creatinine clearance. Dose reduction and/or routine laboratory monitoring of enoxaparin should be considered in patients with impaired renal function.
Attitudes of Physicians to Professional Roles of Community Pharmacists in Lebanon
Authors: Saab Yolande B , Hachem Alya H
Published: March 2016

Background: Pharmacists involved in patient‐centred clinical services can potentially reduce overall healthcare costs, morbidity and mortality. However, physicians might be ambivalent about pharmacists' capabilities.

Aim: To determine the opinions of medical and dental practitioners (physicians) to professional activities which could be provided by community pharmacists in Lebanon.

Method: 300 questionnaires were distributed by pharmacy students to registered physicians covering a range of specialties and experience. The questionnaire consisted of 20 closed questions and an open‐ended question to determine the physician's expectations of the pharmacist's role in patient care.

Results: 198 questionnaires were analysed and overall the results indicated that physicians have a need for information of the type that pharmacists can supply. However, the healthcare system is fragmented because of unclear and infrequent communication. Physicians believe that increased consensual cooperation and communication between the professions could improve therapeutic outcomes and the quality of advice given to patients.

Conclusion: There is a need for collaboration between physicians and pharmacists in Lebanon to improve the quality of pharmaceutical care for patients.
Comparison of Dextropropoxyphene and Paracetamol with Paracetamol After Third Molar Dental Extractions
Authors: Sorich Michael J , Osborne George A , Jarvis David A , Macintyre Pamela E , Sprigg Jillian , Doecke Christopher J
Published: March 2016

Background: Single‐dose studies comparing the analgesic efficacy of dextropropoxyphene and paracetamol with paracetamol have usually found equi‐analgesic effect. Whether this phenomenon is also so after multiple doses is uncertain.

Aim: To determine whether the dextropropoxyphene and paracetamol combination has any advantages over paracetamol when used in multiple doses to relieve acute pain.

Method: A randomised, double‐blinded, parallel, controlled trial with two study arms: dextropropoxyphene hydrochloride 65 mg and paracetamol 650 mg combination with paracetamol 1000 mg. For the first 5 days following third molar dental extraction, patients in both study arms recorded scores for analgesia, satisfaction, wellbeing, and selected adverse effects.

Results: 119 patients provided data. There were no significant differences in analgesic efficacy, satisfaction or wellbeing between the two groups. Other than increased incidence of vomiting on the first day following surgery in the combination group, adverse effects were similar between the groups.

Conclusion: These results suggest that when patients with acute pain are blinded to the analgesic treatment, the combination of dextropropoxyphene and paracetamol has little or no advantage over paracetamol, even when multiple doses are used.
Treatment and Prevention of Age‐Related Macular Degeneration
Authors: Lim Lyndell , Guymer Robyn H
Published: March 2016

In Australia, age‐related macular degeneration is the leading cause of irreversible visual loss in individuals over 50 years of age. The complication of choroidal neovascularisation is responsible for the majority of severe visual loss in age‐related macular degeneration and current treatments concentrate on limiting the damage it causes. Until recently, argon laser photocoagulation was the only treatment for choroidal neovascularisation but collateral damage to the overlying retina has lead to newer treatments. Risk factor modification and prevention of age‐related macular degeneration is also a growing area of research, with increased age, family history and smoking identified as major risk factors. Some studies have suggested diet modification and supplements may have possible protective effects. Unfortunately, none of these treatments restore lost vision, or have a major impact on disease progression. Further research into the underlying aetiology and pathophysiology of age‐related macular degeneration is required to achieve more effective treatments and preventive measures.
Impact of Medication Review by General Practitioners andPatient Peer Education
Authors: Bolton Patrick GM , Parker Sharon M
Published: March 2016

Aim: To assess the combined and independent impact, of two Quality Use of Medicines initiatives‐medication review by general practitioners (GPs) and patient peer education.

Method: 27 GPs recruited 185 patients aged < 65 years and taking five or more medications. Patients were randomised to receive a medication review, peer education, both or neither. Peer educators were recruited and trained to educate and empower patients to obtain the information they need from their GPs. GPs attended an educational workshop on medication review for older patients.

Results: No significant difference was found for medication review by GPs or patient peer education, or for the interaction between the two, according to the two outcome measures: SF‐36 and medication count.

Conclusion: Despite the limitations of the study, particularly limited statistical power, the results raise questions about the value of medication review by GPs for the elderly. Greater engagement between peer educators and patients may be required if peer educators are to have a positive effect on health outcomes.
Diabetes Ward Management—Room for Improvement
Authors: Rando Leo , Keith Claire , Sardjono Donald A , Robertson Marion B , Colman Peter G
Published: March 2016

Background: Diabetes control frequently deteriorates during hospitalisation and changes to management are often required.

Aim: To evaluate the prevalence, diabetes type, admitting unit and glycaemic control of hospital inpatients with diabetes mellitus and the use of insulin‐to‐test orders (sliding scales).

Method: Information on demographics, glycaemic control and insulin‐to‐test orders were collected for inpatients with diabetes mellitus by surveying medical records, 48 hours of blood glucose levels (BGLs) and drug charts.

Results: Of the 698 inpatients, 108 (15%) had diabetes comprising 24 (22%) with type 2 controlled with diet, 39 (36%) with type 2 treated with oral hypoglycaemic agents, 40 (37%) with type 2 treated with insulin with or without oral hypoglycaemic agents and 5 (5%) with type 1. Diabetes was present in 82/351 (23%) medical, 7/61 (11%) psychiatric and 19/286 (7%) surgical patients. Control was ideal (BGL 3.5‐8.0 mmol/L) in 12% and modest (BGL 3.5‐8.0 mmol/L, plus at least one BGL 8.1‐12 mmol/L) in 29%, leaving 59% suboptimal (BGL not 3.5‐12 mmol/L). Severe hyperglycaemia (at least one BGL≥20 mmol/L) occurred in 12% and moderate hyperglycaemia (at least one BGL≥15 but none≥20 mmol/L) in 30%. Hypoglycaemia (at least one BGL < 3.5 mmol/L) was documented in 11%. Mean BGL was < 6 mmol/L in 5%, 6.1–8.0 mmol/L in 33%, 8.1‐10 mmol/L in 23%, and > 10 mmol/L in 39%. Suboptimal control was identified in 100% of type 1, 87% of type 2 treated with insulin with or without oral hypoglycaemic agents, 58% of type 2 treated with oral hypoglycaemic agents, and 9% of type 2 controlled with diet (p < 0.0001). There was no difference in glycaemic control between patients from medical, psychiatric or surgical units. Insulin‐to‐test orders, used in 34 (31%) patients, were judged as ‘safe’ in only 9 (26%) patients.

Conclusion: Management of inpatients with diabetes requires improvement, supporting the need for guideline development and continuing education.
Role of Therapeutic Drug Monitoring in HIV Therapy
Authors: Samios Peter A , Maxwell David J
Published: March 2016

Background: Therapeutic drug monitoring (TDM) is increasingly becoming part of the management of antiretroviral therapy for the treatment of HIV.

Aim: To review the role of TDM in HIV therapy focusing on the indications for its use and resultant changes to drug therapy.

Method: A 6‐month retrospective review of protease inhibitor TDM requests made by HIV clinicians was conducted. Patient medical records, STOCCA (dispensing program), pathology and the HIV outpatient unit database were reviewed to classify each TDM episode according to indication and outcome.

Results: 50 protease inhibitor TDM requests were identified for 38 patients. Indications for use ofTDM included 47 cases of suspected inadequate dosing, two suspected toxicities and one suspected drug interaction. Therapy was altered in approximately 16% of all protease inhibitor TDM requests. Drug dose alterations were recorded for 7 of 4 7 levels measured for adequate dosing and 1 of the 2 levels measured for suspected toxicities.

Conclusion: TDM is a valuable tool in managing antiretroviral therapy. It may play an important role in detecting both suboptimal or potentially toxic levels of protease inhibitors, which is an important factor in the success of antiretroviral therapy and the management of HIV.
Consumer Perceptions of Generic Drug Substitution Practices in the USA
Authors: Sansgiry Sujit S , Bhosle Monali J
Published: March 2016

Background: To improve the uptake of generic drugs, understanding consumer perceptions is important. Increased use of generic drugs may help contain escalating healthcare costs.

Aim: To evaluate consumer perceptions of generic drug substitution practices by pharmacists in the USA and predict the effect of health and social factors on the use of generic drugs.

Method: Surveys were administered to consumers filling prescriptions at 10 community pharmacies in metropolitan Houston, Texas. A 12‐item, 5‐point scale was used to evaluate consumer perceptions. Information on current drugs, purchase behaviour and sociodemographic factors was also requested.

Results: 505 surveys were completed (61% response rate). Participants had a slightly positive attitude toward generic drug substitution practices (mean 3.59, SD 1.13). Although participants perceived generic drugs to be safe (68%) and effective (62%), 50% did not consider them to be identical to brand equivalents. Attitude towards generic drugs was the most important predictor of consumer perceptions towards generic drug substitution practices by pharmacists.

Conclusion: To improve consumer perceptions of generic drug substitution practices, it is imperative to develop strategies to increase positive attitudes towards generic drugs. Pharmacists can improve consumer perceptions of generic drugs, enhance consumer awareness of potential savings, and help reduce the overall healthcare costs.

J Pharm Pract Res 2004; 34: 262–6.
Patients' Attitudes to Discharge Medications Supplied under the Pharmaceutical Benefits Scheme
Authors: Bortoletto Diana A , Swan Bryson J , Weeks Greg R
Published: March 2016

Aim: To assess patients' attitudes to discharge medications supplied under the Pharmaceutical Benefits Scheme (PBS).

Method: Patients who received discharge medications from The Geelong Hospital, Victoria between February and June 2003, and also in 2001 prior to the introduction of the PBS were surveyed. Demographic data and information on discharge medications and admitting specialities was collected from computer records of dispensing and patient information. Suitable patients were sent a reply‐paid questionnaire that assessed their attitudes towards the PBS and previous discharge systems.

Results: 180 patients returned the questionnaire. 79% either strongly agreed or agreed that the quantity of medications supplied under the PBS system was convenient compared to 63% for the ‘5‐day supply’ system. In a direct comparison between the two systems, 68% preferred the PBS. Only 24% had been informed of the possible cost of discharge medications prior to admission. Nonetheless, 69% either strongly agreed or agreed that paying for discharge medications was appropriate.

Conclusion: Discharge medications supplied under the PBS system was positively accepted by patients.

J Pharm Pract Res 2004; 34: 288–9.
Pharmacist Prescribing: Review of the Literature
Authors: Kay Olivia C , Brien Jo‐anne E
Published: March 2016

Aim: To evaluate the literature describing pharmacist prescribing activities and identify areas in need of further research.

Method: Relevant literature was identified by searching Medline (1974 to February 2004), Embase (1980 to February 2004) and Pharmline (1980 to February 2004). Relevant studies were selected based on titles and abstracts.

Results: 18 studies (17 USA, 1 UK) measured outcomes of drug therapy management by a dependent pharmacist prescriber compared to standard care. 19 studies described pharmacist interventions or recommendations on drug therapy that could be implemented with the approval of an independent prescriber. 52 papers described pharmacist‐prescribing activities in practice but lacked an experimental design. Prescribing protocols used were presented in 14 papers. Evidence from these studies supports the role of dependent prescribing pharmacists through positive patient outcomes.

Conclusion: Few studies employed adequate research designs to control threats to internal and external validity. Additional research is needed to assess clinical, humanistic and economic outcomes to establish the viability of pharmacist prescribers.

J Pharm Pract Res 2004; 34: 300–4.
Ginger for Nausea and Vomiting in Pregnancy
Authors: Dib Jean G , El‐Saddik Rita A
Published: March 2016

Background: Ginger has a long tradition of use for the treatment of nausea and vomiting in pregnancy but there are doubts about its efficacy and safety.

Aim: To evaluate the efficacy and safety of ginger in the treatment of nausea and vomiting in pregnancy.

Method: Relevant clinical studies were identified by searching Medline, Embase and ScienceDirect in December 2003.

Clinical studies: Six clinical trials were considered and summarised. Although the studies were limited in scale and duration the results suggested that ginger is well tolerated and available evidence does not indicate an increased risk of congenital malformations. Ginger appears to have a modest potential for efficacy.

Conclusion: The limited studies suggest that low‐dose, short‐term use of ginger may be considered as an alternative for nausea and vomiting in pregnancy.

J Pharm Pract Res 2004; 34: 305–7.
Chronic Trauma Effects on Personality Traits in Police Officers
Authors: Leigh Wills Jennifer , Schuldberg David
Published: March 2016

The impact of cumulative occupational exposure to traumatic events (TEs), posttraumatic stress (PTS) symptoms, and work environment stress on personality traits over time was examined in 38 police officers from an urban agency. California Psychological Inventory (CPI) personality trait scores from prehire evaluations were compared with follow‐up CPI scores to test whether exposure to traumatic events was correlated with changes in traits from baseline to 5–10 years later. Measures of occupational TEs, PTS symptoms, and police work environment stress were administered. Mean trait scores declined on all CPI traits analyzed in the study. Trait change was evaluated using the Reliable Change Index; change in participants’ scores unlikely to occur by chance ranged from 11% to 63% in the traits examined. All participants reported substantial TE exposure. PTS symptoms were correlated with steeper decline in 4 of 5 traits, with effect sizes ranging from r =  −.47 to r = −.67. Scores on measures of job‐related TEs were negatively correlated with only one CPI trait (empathy) at T2 (r = −.31), and were unrelated to slope of trait change. Work environment stress was significantly related to gender, with female officers reporting higher levels of operational (r = .45) and organizational (r = .54) stress.
Spatial plasticity of the auditory cortex in single‐sided deafness
Authors: Chang Jolie L. , Pross Seth E. , Findlay Anne M. , Mizuiri Danielle , Henderson‐Sabes Jennifer , Garrett Coleman , Nagarajan Srikantan S. , Cheung Steven W.
Published: March 2016

Objectives/Hypothesis

To evaluate spatial plasticity of the auditory cortex in single‐sided deafness (SSD).

Study Design

Cross‐sectional study comparing a cohort with adult‐onset, idiopathic SSD to a cohort with normal hearing.

Methods

Demographic, audiometric, magnetoencephalographic imaging, and magnetic resonance imaging data were collected for 13 SSD adult subjects and 13 normal‐hearing controls. Locations of peak activation corresponding to the M100 response in auditory cortices ipsilateral and contralateral to tonal stimuli (0.5 kHz and 4 kHz) were extracted from advanced biomagnetic source imaging analyses. Spatial extent of frequency representation across the 0.5 kHz to 4 kHz zone was computed for the two hemispheres.

Results

Spatial separation distance between peak locations for 0.5 kHz and 4 kHz stimuli in SSD showed increased activation spread distance in the hemisphere contralateral to the only hearing ear and decreased distance in the ipsilateral hemisphere. In contrast, normal hearing controls had nearly the same activation spread distance in the two hemispheres for ipsilateral and contralateral inputs. The difference between interhemispheric activation spread distance in SSD is significantly increased to 6.5 mm, when compared to 1.7 mm in normal controls (P < .05).

Conclusions

Loss of unilateral peripheral input in SSD is associated with spatial reorganization of the auditory cortex in both hemispheres. This change in central auditory functional organization may in turn lead to higher order hearing deficits that rely on interhemispheric processing. Hearing optimization in the only hearing ear may require remediation of both spatial and temporal central auditory changes in SSD.

Level of Evidence

NA Laryngoscope, 126:2785–2791, 2016
High‐stability organic red‐light photodetector for narrowband applications
Authors: Li Wenhai , Li Dong , Dong Guifang , Duan Lian , Sun Jialin , Zhang Deqiang , Wang Liduo
Published: March 2016

Red‐light photodetectors without filters are in urgent need for narrowband applications such as full‐color imaging and multi‐output visible light communication (VLC). However, their development is hindered by the lack of small‐band‐gap and narrowband response materials. Without wavelength filters, a new type of photodetector with a simple single‐layer architecture is developed, based on a stable small‐band‐gap squarylium dye and characterized by a detectivity peak at 680 nm and full width at half maximum of 80 nm. The device, which exhibits high stability in air and humid conditions, shows a significantly low dark current of ∼2 nA·cm−2 at −2 V and high specific detectivity of 3.2 × 1012 Jones. The response current ratio of the device to red, green, and blue lights with a luminous flux amplitude ratio of 3:6:1 (standard ratio for white light) is 100:12:1.1. These properties indicate that the squarylium dye red‐light photodetectors are promising for VLC and other narrowband optoelectronic applications.

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Enzymatic Modification of Soluble Cyanophycin Using the Type II Peptidyl Arginine Deiminase from Oryctolagus cuniculus
Authors: Wiefel Lars , Steinbüchel Alexander
Published: March 2016

An increased structural variety expands the number of putative applications for cyanophycin (multi‐l‐arginyl‐poly‐[l‐aspartic acid], CGP). Therefore, structural modifications of CGP are of major interest; these are commonly obtained by modification and optimization of the bacterial producing strain or by chemical modification. In this study, an enzymatic modification of arginine side chains from lysine‐rich CGP is demonstrated using the peptidyl arginine deiminase from Oryctolagus cuniculus, purified from Escherichia coli after heterologous expression. About 10% of the arginine side chains are converted to citrulline which corresponds to 4% of the polymer's total side chains. An inhibition of the reaction in the presence of small amounts of l‐citrulline is observed, thereby explaining the low conversion rate. CGP dipeptides can be modified with about 7.5 mol% of the Asp‐Arg dipeptides being converted to Asp‐Cit. These results show that the enzymatic modification of CGP is feasible, opening up a whole new area of possible CGP modifications for further research.

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A flexible fast spin echo triple‐echo Dixon technique
Authors: Son Jong Bum , Hwang Ken‐Pin , Madewell John E. , Bayram Ersin , Hazle John D. , Low Russell N. , Ma Jingfei
Published: March 2016

Purpose

To develop a flexible fast spin echo (FSE) triple‐echo Dixon (FTED) technique.

Methods

An FSE pulse sequence was modified by replacing each readout gradient with three fast‐switching bipolar readout gradients with minimal interecho dead time. The corresponding three echoes were used to generate three raw images with relative phase shifts of −θ, 0, and θ between water and fat signals. A region growing–based two‐point Dixon phase correction algorithm was used to joint process two separate pairs of the three raw images, yielding a final set of water‐only and fat‐only images. The flexible FTED technique was implemented on 1.5T and 3.0T scanners and evaluated in five subjects for fat‐suppressed T2‐weighted imaging and in one subject for post‐contrast fat‐suppressed T1‐weighted imaging.

Results

The flexible FTED technique achieved a high data acquisition efficiency, comparable to that of FSE, and was flexible in scan protocols. The joint two‐point Dixon phase correction algorithm helped to ensure consistency in the processing of the two separate pairs of raw images. Reliable and uniform separation of water and fat was achieved in all of the test cases.

Conclusion

The flexible FTED technique incorporates the benefits of both FSE and Dixon imaging and provided more flexibility than the original FTED in applications such as fat‐suppressed T2‐weighted and T1‐weighted imaging. Magn Reson Med 77:1049–1057, 2017. © 2016 International Society for Magnetic Resonance in Medicine
Quantification of microcirculatory parameters by joint analysis of flow‐compensated and non‐flow‐compensated intravoxel incoherent motion (IVIM) data
Authors: Ahlgren André , Knutsson Linda , Wirestam Ronnie , Nilsson Markus , Ståhlberg Freddy , Topgaard Daniel , Lasič Samo
Published: March 2016

The aim of this study was to improve the accuracy and precision of perfusion fraction and blood velocity dispersion estimates in intravoxel incoherent motion (IVIM) imaging, using joint analysis of flow‐compensated and non‐flow‐compensated motion‐encoded MRI data. A double diffusion encoding sequence capable of switching between flow‐compensated and non‐flow‐compensated encoding modes was implemented.In vivobrain data were collected in eight healthy volunteers and processed using the joint analysis. Simulations were used to compare the performance of the proposed analysis method with conventional IVIM analysis. With flow compensation, strong rephasing was observed for thein vivodata, approximately cancelling the IVIM effect. The joint analysis yielded physiologically reasonable perfusion fraction maps. Estimated perfusion fractions were 2.43 ± 0.81% in gray matter, 1.81 ± 0.90% in deep gray matter, and 1.64 ± 0.72% in white matter (mean ± SD,n = 8). Simulations showed improved accuracy and precision when using joint analysis of flow‐compensated and non‐flow‐compensated data, compared with conventional IVIM analysis. Double diffusion encoding with flow compensation was feasible forin vivoimaging of the perfusion fraction in the brain. The strong rephasing implied that blood flowing through the cerebral microvascular system was closer to the ballistic limit than the diffusive limit. © 2016 The Authors NMR in Biomedicine published by John Wiley & Sons Ltd.
An efficient method for estimating global sensitivity indices
Authors: Yun Wanying , Lu Zhenzhou , Jiang Xian , Liu Shiyu
Published: March 2016

An efficient method is proposed to estimate the first‐order global sensitivity indices based on failure probability and variance by using maximum entropy theory and Nataf transformation. The computational cost of this proposed method is quite small, and the proposed method can efficiently overcome the ‘dimensional curse’ due to dimensional reduction technique. Ideas for the estimation of higher‐order sensitivity indices are discussed. Copyright © 2016 John Wiley & Sons, Ltd.
Heavy childhood television use persists into young adulthood and is associated with increased BMI
Authors: York Chance
Published: March 2016

Objective

To test whether TV use has both concurrent effects on body mass index (BMI) at the time of survey interviews and long‐term, enduring effects via the promotion of future levels of TV use.

Methods

Two waves of survey data from the Panel Study of Income Dynamics were used to test relationships between TV use and BMI among a nationally representative sample of children and their parents (n = 1,421). Path analysis was used to model effects of childhood (1997) levels of TV use and BMI on the same variables 14 years later (2011).

Results

Path analysis showed childhood TV use was associated positively with childhood BMI (β = 0.08, P < 0.05), and young adult TV use was related positively to young adult BMI (β = 0.10, P < 0.01). Heavy childhood TV use also persisted into young adulthood (β = 0.15, P < 0.001), indirectly increasing young adult BMI (β = 0.02, P < 0.05).

Conclusions

Heavy childhood TV users tend to become heavy young adult users. The continuation of TV behavior from childhood to young adulthood independently increases BMI.
Bootstrap methods in CFT
Authors: Rastelli Leonardo
Published: March 2016

This contribution collects background material and references for the overview talk that was delivered in the 21st European string workshop and 3rd COST MP1210 meeting, ‘The String Theory Universe’.
Controlled transformations in transparent conducting films fabricated from highly stable hydrophilic dispersions of SWNTs through surface charge manipulation and acid treatment conditions
Authors: Anto Bibin T. , Schwarz Hans‐Christoph , Eiden Stefanie , Schneider Andreas M. , Behrens Peter
Published: March 2016

Single wall carbon nanotubes (SWNTs) are considered to be one of the potential candidates for the production of transparent conducting films (TCFs), which can be used in many applications, e.g., touch panels, displays, and polymer solar cells. However, for making optimum usage of the superior properties of SWNTs, a better understanding on the processing and fabrication of thin films is essential. In this work, the effects of the purification conditions of SWNTs, the stability of their dispersions as a function of pH, and the performance of TCFs fabricated from dispersions of different pH are studied. The figure of merit σdc/σoc for such films can be increased by factor of 2 when the pH of the SWNT dispersion is increased, i.e., the optical and electrical performance is improved significantly. We also report the surface charge‐manipulated transformations in transparent conducting films fabricated from SWNT dispersions of different pH values.
Tandem Arylation/Friedel‐Crafts Reaction of O‐Hydroxy Bisbenzylic Alcohols with Diaryliodonium Salts: One Pot Synthesis of Unsymmetrical 9‐Arylxanthenes
Authors: Mao Song , Hua Zerui , Wu Xunshen , Yang Yang , Han Jianwei , Wang Limin
Published: March 2016

A one‐pot synthesis of 9‐arylxanthenes from easily prepared o‐hydroxy bisbenzylic alcohols and diaryliodonium salts has been reported. O‐hydroxy bisbenzylic alcohols were utilized to generate carbinols in situ with diaryliodonium salts promoted by base. Carbinols were then subjected to Brønsted acid catalyzed cyclization to furnish 9‐arylxanthenes. A variety of symmetrical and unsymmetrical 9‐aryxanthenes have been prepared assisted by base and Brønsted acid under mild conditions with satisfactory yields (up to 95 % yield). Furthermore, the procedure is capable of tolerating a wide range of substrates (36 examples).
Polyiminopyridines based networks as supports to heterogenize iron(II) complexes. Application as efficient and selective ecofriendly catalysts.
Authors: Maya Eva M. , Verde‐Sesto Ester , de la Campa José G. , Iglesias Marta
Published: March 2016

A series of polyiminopyridines (PIPys) were reported and used as supports to prepare heterogenized‐iron catalysts (FePIPys). The resulting PIPys exhibit moderate surface areas (SBET ≈ 200 m2 g−1) and high chemical and thermal stability. The catalytic performance of FePIPys–catalyts was studied in the acetalization of furfural and 5‐hydroxymethyl furfural to yield compounds of potential interest as diesel additives. The structure of the polyiminopyridine support has great influence in the catalytic performance and recyclability; all catalysts maintained the activity and the selectivity after several cycles.
Adjuvant‐Loaded Subcellular Vesicles Derived From Disrupted Cancer Cells for Cancer Vaccination
Authors: Cheung Alexander S. , Koshy Sandeep T. , Stafford Alexander G. , Bastings Maartje M. C. , Mooney David J.
Published: March 2016

Targeted subunit vaccines for cancer immunotherapy do not capture tumor antigenic complexity, and approaches employing tumor lysate are often limited by inefficient antigen uptake and presentation, and low immunogenicity. Here, whole cancer cells are processed to generate antigen‐rich, membrane‐enclosed subcellular particles, termed “reduced cancer cells”, that reflect the diversity and breadth of the parent cancer cell antigen repertoire, and can be loaded with disparate adjuvant payloads. These vesicular particles enhance the uptake of the adjuvant payload, and potentiate the activation of primary dendritic cells in vitro. Similarly, reduced cancer cell‐associated antigens are more efficiently presented by primary dendritic cells in vitro than their soluble counterparts or lysate control. In mice, vaccination using adjuvant‐loaded reduced cancer cells facilitates the induction of antigen‐specific cellular and humoral immune responses. Taken together, these observations demonstrate that adjuvant‐loaded reduced cancer cells could be utilized in cancer vaccines as an alternative to lysate.
Mathematical modeling of cardiac growth and remodeling
Authors: Lee L.C. , Kassab G.S. , Guccione J.M.
Published: March 2016

This review provides an overview of the current state of mathematical models of cardiac growth and remodeling (G&R). We concisely describe the experimental observations associated with cardiac G&R and discuss existing mathematical models that describe this process. To facilitate the discussion, we have organized the G&R models in terms of (1) the physical focus (biochemical vs mechanical) and (2) the process that they describe (myocyte hypertrophy vs extracellular matrix remodeling). The review concludes with a discussion of some possible directions that can advance the existing state of cardiac G&R mathematical modeling. WIREs Syst Biol Med 2016, 8:211–226. doi: 10.1002/wsbm.1330

This article is categorized under:

Analytical and Computational Methods > Computational Methods
Propensity Score Analysis of an Enhanced Recovery Programme in Upper Gastrointestinal Cancer Surgery
Authors: Karran A. , Wheat J. , Chan D. , Blake P. , Barlow R. , Lewis W. G.
Published: March 2016

Introduction

The aim of this study was to examine the influence of an enhanced recovery programme (ERP) on outcomes of upper gastrointestinal (UGI) cancer surgery by means of propensity score‐matched analysis.

Methods

Three hundred consecutive patients diagnosed with UGI cancer were studied prospectively before and after the introduction of an ERP. Multiple regression models, including propensity scores, were developed to assess confounding variables associated with undergoing surgery, and the risk adjusted association between treatment and length of hospital stay (LOHS).

Results

After regression for confounding factors, a cohort of 252 patients was available of whom 160 received ERP [median age 66 years (IQR 58–73), 119 male, 81 oesophageal, 79 gastric cancer] and 92 control [66 years (IQR 58–74), 74 male, 58 oesophageal, 34 gastric cancer]. ERP operative morbidity (Clavien–Dindo ≥3) and mortality were 13.8 and 3.1 % compared with 17.4 (p = 0.449) and 2.2 % (p = 0.658) in controls. Median ERP critical care and total LOS were 1 (IQR 0–1) and 13 (IQR 10–17) days, compared with 1 (IQR 1–2, p = 0.009) and 16 (IQR 13–26, p < 0.001) days. Multivariable analysis revealed ERP (HR 1.477, 95 % CI 1.084–2.013, p = 0.013), tumour location (HR 2.420, 95 % CI 1.624–3.606, p < 0.001), operative procedure (HR 1.143, 95 % CI 1.032–1.265, p = 0.010), and operative morbidity (HR 0.277, 95 % CI 0.179–0.429, p < 0.001) to be associated with LOHS.

Conclusion

An ERP in UGI cancer surgery was feasible, safe, and effective.
Feasibility of Nipple‐Sparing Mastectomy with Immediate Breast Reconstruction in Breast Cancer Patients with Tumor‐Nipple Distance Less Than 2.0 cm
Authors: Ryu Jai Min , Nam Seok Jin , Kim Seok Won , Lee Se Kyung , Bae Soo Youn , Yi Ha Woo , Park Sungmin , Paik Hyun‐June , Lee Jeong Eon
Published: March 2016

Background and objective

Debate continues concerning the oncological risk of nipple‐sparing mastectomy (NSM) with immediate breast reconstruction (IBR) if the tumor‐nipple distance (TND) is less than 2.0 cm. In this retrospective study, we analyzed oncological outcomes after NSM with IBR for the treatment of breast cancer to determine the risk posed by NSM in cases in which magnetic resonance imaging (MRI) showed a TND <2.0 cm but intraoperative frozen biopsy results were negative for tumor cells at the nipple base.

Materials and methods

We conducted a retrospective review of patients with breast cancer who underwent NSM with IBR at Samsung Medical Center between 2008 and 2014. Preoperative MRI was done in all cases to define the TND, and frozen biopsy specimens were obtained intraoperatively.

Results

Among the 266 NSMs performed, TND was <2.0 cm in 145 cases (54.5 %) and ≥2.0 cm in 121 cases (45.5 %). Median follow‐up was 25.6 months. There were no significant differences between the two patient groups with respect to disease‐free survival or local recurrence‐free survival.

Conclusion

Our results suggest that NSM can be a feasible treatment option when the intraoperative frozen biopsy is negative for tumor cells even with a TND <2.0 cm in MRI.
US Public Health Preparedness for Zika and Other Threats Remains Vulnerable
Authors: Duchin Jeffrey S.
Published: March 2016

The unanticipated global outbreak of Zika virus infection is the most current but certainly not the last emerging infectious disease challenge to confront the US public heath system. Despite a number of such threats in recent years, significant gaps remain in core areas of public health system readiness. Stable, sustained investments are required to establish a solid foundation for achieving necessary national public health emergency preparedness and response capacity. (Disaster Med Public Health Preparedness. 2016;10:298–299)
Irrational rotation factors for conservative torus homeomorphisms
Authors: JÄGER T. , TAL F.
Published: March 2016

We provide an equivalent characterization for the existence of one-dimensional irrational rotation factors of conservative torus homeomorphisms that are not eventually annular. It states that an area-preserving non-annular torus homeomorphism $f$ is semiconjugate to an irrational rotation $R_{\unicode[STIX]{x1D6FC}}$ of the circle if and only if there exists a well-defined speed of rotation in some rational direction on the torus, and the deviations from the constant rotation in this direction are uniformly bounded. By means of a counterexample, we also demonstrate that a similar characterization does not hold for eventually annular torus homeomorphisms.
Conjugacy invariants for Brouwer mapping classes
Authors: BAVARD JULIETTE
Published: March 2016

We give new tools for homotopy Brouwer theory. In particular, we describe a canonical reducing set called the set ofwalls, which splits the plane intomaximal translation areasandirreducible areas. We then focus on Brouwer mapping classes relative to four orbits and describe them explicitly by adding atangleto Handel’s diagram and to the set of walls. This is essentially an isotopy class of simple closed curves in the cylinder minus two points.
Dynamical properties of some adic systems with arbitrary orderings
Authors: FRICK SARAH , PETERSEN KARL , SHIELDS SANDI
Published: March 2016

We consider arbitrary orderings of the edges entering each vertex of the (downward directed) Pascal graph. Each ordering determines an adic (Bratteli–Vershik) system, with a transformation that is defined on most of the space of infinite paths that begin at the root. We prove that for every ordering the coding of orbits according to the partition of the path space determined by the first three edges is essentially faithful, meaning that it is one-to-one on a set of paths that has full measure for every fully supported invariant probability measure. We also show that for every$k$the subshift that arises from coding orbits according to the first$k$edges is topologically weakly mixing. We give a necessary and sufficient condition for any adic system to be topologically conjugate to an odometer and use this condition to determine the probability that a random order on a fixed diagram, or a diagram constructed at random in some way, is topologically conjugate to an odometer. We also show that the closure of the union over all orderings of the subshifts arising from codings of the Pascal adic by the first edge has superpolynomial complexity, is not topologically transitive, and has no periodic points besides the two fixed points, while the intersection over all orderings consists of just four orbits.
Range-renewal structure in continued fractions
Authors: WU JUN , XIE JIAN-SHENG
Published: March 2016

Let$\unicode[STIX]{x1D714}=[a_{1},a_{2},\ldots ]$be the infinite expansion of a continued fraction for an irrational number$\unicode[STIX]{x1D714}\in (0,1)$, and let$R_{n}(\unicode[STIX]{x1D714})$(respectively,$R_{n,k}(\unicode[STIX]{x1D714})$,$R_{n,k+}(\unicode[STIX]{x1D714})$) be the number of distinct partial quotients, each of which appears at least once (respectively, exactly$k$times, at least$k$times) in the sequence$a_{1},\ldots ,a_{n}$. In this paper, it is proved that, for Lebesgue almost all$\unicode[STIX]{x1D714}\in (0,1)$and all$k\geq 1$,$$\begin{eqnarray}\displaystyle \lim _{n\rightarrow \infty }\frac{R_{n}(\unicode[STIX]{x1D714})}{\sqrt{n}}=\sqrt{\frac{\unicode[STIX]{x1D70B}}{\log 2}},\quad \lim _{n\rightarrow \infty }\frac{R_{n,k}(\unicode[STIX]{x1D714})}{R_{n}(\unicode[STIX]{x1D714})}=\frac{C_{2k}^{k}}{(2k-1)\cdot 4^{k}},\quad \lim _{n\rightarrow \infty }\frac{R_{n,k}(\unicode[STIX]{x1D714})}{R_{n,k+}(\unicode[STIX]{x1D714})}=\frac{1}{2k}.\end{eqnarray}$$The Hausdorff dimensions of certain level sets about$R_{n}$are discussed.
Predictors of Heavy Stethoscope Contamination Following a Physical Examination
Authors: Tschopp Clément , Schneider Alexis , Longtin Yves , Renzi Gesuele , Schrenzel Jacques , Pittet Didier
Published: March 2016

BACKGROUND

The degree of bacterial contamination of stethoscopes can vary significantly following a physical examination.

OBJECTIVE

To conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination.

METHODS

Following a standardized examination, the levels of bacterial contamination of 4 regions of the physicians’ hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression.

RESULTS

In total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcus spp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus (either methicillin susceptible or resistant), extended-spectrum β-lactamase–producing Enterobacteriaceae, and Acinetobacter baumannii were recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians’ hands (ρ=0.79; P=.04). The level of patient’s skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination.

CONCLUSIONS

Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient’s skin. Prevention of pathogen dissemination is needed.

Infect Control Hosp Epidemiol 2016;37:673–679