bluuebunny/crossref_metadata_2025 huggingface dataset:
Annihilation and Reanimation of a Tornado in the Improved Tornado Tube
Authors: Bednarek Stanisław
Published: January 2016

Some new experiments using an improved version of the “tornado tube” are described here. The improved tornado tube consists of two plastic transparent bottles whose openings are connected with a ball valve, available at most hardware stores. After being filled with fluid and inverting, this tube allows demonstration of the generation, annihilation, and reanimation of vortices, or tornados.
The Buoyancy Approach to U-tube Problems
Authors: Binder P.-M. , Magowan M. A.
Published: January 2016

In this note we unify two physical situations treatable with hydrostatics: an object floating on a denser fluid and an open U-shaped tube with two immiscible fluids. We begin by reviewing the problem of a partially floating uniform, rectangular prism of horizontal area A immersed in a denser fluid, with respective densities ρ1 < ρh for the prism and fluid (the subscripts stand for light and heavy): see Fig. 1. We define three horizontal levels within the solid, y0, y1, and y2, corresponding to the bottom, flotation line, and top of the prism. The buoyant force is ρh (y1 − y0)gA upwards, and the weight of the prism is ρ1 (y2 − y0)gA downwards. By Newton's second law, these two forces balance at equilibrium. After dividing by the common horizontal area, one obtains y1−y0y2−y0=ρ1ρh.(1) A detailed derivation can be found for example in Ref. 1, Section 13-7.
Teachers' self-assessed levels of preparation
Authors: White Susan C.
Published: January 2016

Every four years we survey a nationally representative sample of high school physics teachers. We define anyone who teaches at least one physics class to be a “physics teacher.” About 40% of these teachers teach a majority of their classes in subjects other than physics. We also ask teachers to rate how well prepared they felt in various aspects of teaching. The response choices are “not adequately prepared,” “adequately prepared,” and “very well prepared.” The accompanying figure shows the proportion of teachers who reported feeling adequately or very well prepared in the following aspects of teaching: Basic physics knowledge,Other science knowledge,Application of physics to everyday experience,Use of demonstrations,Instructional laboratory design,Use of computers in physics instruction and labs, andRecent developments in physics.
Use of a Mobile Application to Help Students Develop Skills Needed in Solving Force Equilibrium Problems
Authors: Yang Eunice
Published: January 2016

This paper discusses the use of a free mobile engineering application (app) called Autodesk® ForceEffect™ to provide students assistance with spatial visualization of forces and more practice in solving/visualizing statics problems compared to the traditional pencil-and-paper method. ForceEffect analyzes static rigid-body systems using free-body diagrams (FBDs) and provides solutions in real time. It is a cost-free software that is available for download on the Internet. The software is supported on the iOS™, Android™, and Google Chrome™ platforms. It is easy to use and the learning curve is approximately two hours using the tutorial provided within the app. The use of ForceEffect has the ability to provide students different problem modalities (textbook, real-world, and design) to help them acquire and improve on skills that are needed to solve force equilibrium problems. Although this paper focuses on the engineering mechanics statics course, the technology discussed is also relevant to the introductory physics course.
A Geometric Proof of v2f − v2i = 2ad
Authors: Rose Eli
Published: January 2016

In introductory 1-D kinematics, the final and initial velocities (vf and vi) of a particle moving a distance d under constant acceleration a obey the identity: vf2−vi2=2ad.(1) This identity is usually proved algebraically. The purpose of this short note is to present a geometric proof—that is, a proof by picture.
Tunnel pressure waves – A smartphone inquiry on rail travel
Authors: Müller Andreas , Hirth Michael , Kuhn Jochen
Published: January 2016

When traveling by rail, you might have experienced the following phenomenon: The train enters a tunnel, and after some seconds a noticeable pressure change occurs, as perceived by your ears or even by a rapid wobbling of the train windows. The basic physics is that pressure waves created by the train travel down the tunnel, are reflected at its other end, and travel back until they meet the train again. Here we will show (i) how this effect can be well understood as a kind of large-scale outdoor case of a textbook paradigm, and (ii) how, e.g., a prediction of the tunnel length from the inside of a moving train on the basis of this model can be validated by means of a mobile phone measurement.
Photobacterium angustum and Photobacterium kishitanii, Psychrotrophic High-Level Histamine-Producing Bacteria Indigenous to Tuna
Authors: Bjornsdottir-Butler K. , McCarthy S. A. , Dunlap P. V. , Benner R. A.
Published: January 2016

Scombrotoxin fish poisoning (SFP) remains the main contributor of fish poisoning incidents in the United States, despite efforts to control its spread. Psychrotrophic histamine-producing bacteria (HPB) indigenous to scombrotoxin-forming fish may contribute to the incidence of SFP. We examined the gills, skin, and anal vents of yellowfin (
n
= 3), skipjack (
n
= 1), and albacore (
n
= 6) tuna for the presence of indigenous HPB. Thirteen HPB strains were isolated from the anal vent samples from albacore (
n
= 3) and yellowfin (
n
= 2) tuna. Four of these isolates were identified as
Photobacterium kishitanii
and nine isolates as
Photobacterium angustum
; these isolates produced 560 to 603 and 1,582 to 2,338 ppm histamine in marine broth containing 1% histidine (25°C for 48 h), respectively. The optimum growth temperatures and salt concentrations were 26 to 27°C and 1% salt for
P. kishitanii
and 30 to 32°C and 2% salt for
P. angustum
in Luria 70% seawater (LSW-70). The optimum activity of the HDC enzyme was at 15 to 30°C for both species. At 5°C,
P. kishitanii
and
P. angustum
had growth rates of 0.1 and 0.2 h
−1
, respectively, and the activities of histidine decarboxylase (HDC) enzymes were 71% and 63%, respectively. These results show that indigenous HPB in tuna are capable of growing at elevated and refrigeration temperatures. These findings demonstrate the need to examine the relationships between the rate of histamine production at refrigeration temperatures, seafood shelf life, and regulatory limits.
Alcaligenes faecalis ZD02, a Novel Nematicidal Bacterium with an Extracellular Serine Protease Virulence Factor
Authors: Ju Shouyong , Lin Jian , Zheng Jinshui , Wang Shaoying , Zhou Hongying , Sun Ming
Published: January 2016

Root knot nematodes (RKNs) are the world's most damaging plant-parasitic nematodes (PPNs), and they can infect almost all crops. At present, harmful chemical nematicides are applied to control RKNs. Using microbial nematicides has been proposed as a better management strategy than chemical control. In this study, we describe a novel nematicidal bacterium named
Alcaligenes faecalis
ZD02.
A. faecalis
ZD02 was isolated from
Caenorhabditis elegans
cadavers and has nematostatic and nematicidal activity, as confirmed by
C. elegans
growth assay and life span assay. In addition,
A. faecalis
ZD02 fermentation broth showed toxicity against
C. elegans
and
Meloidogyne incognita
. To identify the nematicidal virulence factor, the genome of strain ZD02 was sequenced. By comparing all of the predicted proteins of strain ZD02 to reported nematicidal virulence factors, we determined that an extracellular serine protease (Esp) has potential to be a nematicidal virulence factor, which was confirmed by bioassay on
C. elegans
and
M. incognita
. Using
C. elegans
as the target model, we found that both
A. faecalis
ZD02 and the virulence factor Esp can damage the intestines of
C. elegans
. The discovery that
A. faecalis
ZD02 has nematicidal activity provides a novel bacterial resource for the control of RKNs.
Heterogeneity in Induction Level, Infection Ability, and Morphology of Shiga Toxin-Encoding Phages (Stx Phages) from Dairy and Human Shiga Toxin-Producing Escherichia coli O26:H11 Isolates
Authors: Bonanno Ludivine , Petit Marie-Agnès , Loukiadis Estelle , Michel Valérie , Auvray Frédéric
Published: January 2016

Shiga toxin (Stx)-producing
Escherichia coli
(STEC) bacteria are foodborne pathogens responsible for diarrhea and hemolytic-uremic syndrome (HUS). Shiga toxin, the main STEC virulence factor, is encoded by the
stx
gene located in the genome of a bacteriophage inserted into the bacterial chromosome. The O26:H11 serotype is considered to be the second-most-significant HUS-causing serotype worldwide after O157:H7. STEC O26:H11 bacteria and their
stx
-negative counterparts have been detected in dairy products. They may convert from the one form to the other by loss or acquisition of Stx phages, potentially confounding food microbiological diagnostic methods based on
stx
gene detection. Here we investigated the diversity and mobility of Stx phages from human and dairy STEC O26:H11 strains. Evaluation of their rate of
in vitro
induction, occurring either spontaneously or in the presence of mitomycin C, showed that the Stx2 phages were more inducible overall than Stx1 phages. However, no correlation was found between the Stx phage levels produced and the origin of the strains tested or the phage insertion sites. Morphological analysis by electron microscopy showed that Stx phages from STEC O26:H11 displayed various shapes that were unrelated to Stx1 or Stx2 types. Finally, the levels of sensitivity of
stx
-negative
E. coli
O26:H11 to six Stx phages differed among the 17 strains tested and our attempts to convert them into STEC were unsuccessful, indicating that their lysogenization was a rare event.
Plasmidic Expression ofnemAandyafC* Increased Resistance of Ethanologenic Escherichia coli LY180 to Nonvolatile Side Products from Dilute Acid Treatment of Sugarcane Bagasse and Artificial Hydrolysate
Authors: Shi Aiqin , Zheng Huabao , Yomano Lorraine P. , York Sean W. , Shanmugam Keelnatham T. , Ingram Lonnie O.
Published: January 2016

Hydrolysate-resistantEscherichia coliSL100 was previously isolated from ethanologenic LY180 after sequential transfers in AM1 medium containing a dilute acid hydrolysate of sugarcane bagasse and was used as a source of resistance genes. Many genes that affect tolerance to furfural, the most abundant inhibitor, have been described previously. To identify genes associated with inhibitors other than furfural, plasmid clones were selected in an artificial hydrolysate that had been treated with a vacuum to remove furfural. Two new resistance genes were discovered from Sau3A1 libraries of SL100 genomic DNA:nemA(N-ethylmaleimide reductase) and a putative regulatory gene containing a mutation in the coding region,yafC*. The presence of these mutations in SL100 was confirmed by sequencing. A single mutation was found in the upstream regulatory region ofnemR(nemRAoperon) in SL100. This mutation increasednemAactivity 20-fold over that of the parent organism (LY180) in AM1 medium without hydrolysate and increasednemAmRNA levels >200-fold. Addition of hydrolysates inducednemAexpression (mRNA and activity), in agreement with transcriptional control. NemA activity was stable in cell extracts (9 h, 37°C), eliminating a role for proteinase in regulation. LY180 with a plasmid expressingnemAoryafC*was more resistant to a vacuum-treated sugarcane bagasse hydrolysate and to a vacuum-treated artificial hydrolysate than LY180 with an empty-vector control. Neither gene affected furfural tolerance. The vacuum-treated hydrolysates inhibited the reduction ofN-ethylmaleimide by NemA while also serving as substrates. Expression of thenemAoryafC*plasmid in LY180 doubled the rate of ethanol production from the vacuum-treated sugarcane bagasse hydrolysate.
Genome Content and Phylogenomics Reveal both Ancestral and Lateral Evolutionary Pathways in Plant-Pathogenic Streptomyces Species
Authors: Huguet-Tapia Jose C. , Lefebure Tristan , Badger Jonathan H. , Guan Dongli , Pettis Gregg S. , Stanhope Michael J. , Loria Rosemary
Published: January 2016

Streptomyces
spp. are highly differentiated actinomycetes with large, linear chromosomes that encode an arsenal of biologically active molecules and catabolic enzymes. Members of this genus are well equipped for life in nutrient-limited environments and are common soil saprophytes. Out of the hundreds of species in the genus
Streptomyces
, a small group has evolved the ability to infect plants. The recent availability of
Streptomyces
genome sequences, including four genomes of pathogenic species, provided an opportunity to characterize the gene content specific to these pathogens and to study phylogenetic relationships among them. Genome sequencing, comparative genomics, and phylogenetic analysis enabled us to discriminate pathogenic from saprophytic
Streptomyces
strains; moreover, we calculated that the pathogen-specific genome contains 4,662 orthologs. Phylogenetic reconstruction suggested that
Streptomyces scabies
and
S. ipomoeae
share an ancestor but that their biosynthetic clusters encoding the required virulence factor thaxtomin have diverged. In contrast,
S. turgidiscabies
and
S. acidiscabies
, two relatively unrelated pathogens, possess highly similar thaxtomin biosynthesis clusters, which suggests that the acquisition of these genes was through lateral gene transfer.
Thermal Inactivation of Enteric Viruses and Bioaccumulation of Enteric Foodborne Viruses in Live Oysters (Crassostrea virginica)
Authors: Araud Elbashir , DiCaprio Erin , Ma Yuanmei , Lou Fangfei , Gao Yu , Kingsley David , Hughes John H. , Li Jianrong
Published: January 2016

Human enteric viruses are among the main causative agents of shellfish-associated outbreaks. In this study, the kinetics of viral bioaccumulation in live oysters and the heat stabilities of the predominant enteric viruses were determined both in tissue culture and in oyster tissues. A human norovirus (HuNoV) GII.4 strain, HuNoV surrogates (murine norovirus [MNV-1], Tulane virus [TV]), hepatitis A virus (HAV), and human rotavirus (RV) bioaccumulated to high titers within oyster tissues, with different patterns of bioaccumulation for the different viruses. We tested the thermal stability of each virus at 62, 72, and 80°C in culture medium. The viruses can be ranked from the most heat resistant to the least stable as follows: HAV, RV, TV, MNV-1. In addition, we found that oyster tissues provided protection to the viruses during heat treatment. To decipher the mechanism underlying viral inactivation by heat, purified TV was treated at 80°C for increasing time intervals. It was found that the integrity of the viral capsid was disrupted, whereas viral genomic RNA remained intact. Interestingly, heat treatment leading to complete loss of TV infectivity was not sufficient to completely disrupt the receptor binding activity of TV, as determined by the porcine gastric mucin–magnetic bead binding assay. Similarly, HuNoV virus-like particles (VLPs) and a HuNoV GII.4 strain retained some receptor binding ability following heat treatment. Although foodborne viruses have variable heat stability, 80°C for >6 min was sufficient to completely inactivate enteric viruses in oysters, with the exception of HAV.
Ecological Genomics of the Uncultivated Marine Roseobacter Lineage CHAB-I-5
Authors: Zhang Yao , Sun Ying , Jiao Nianzhi , Stepanauskas Ramunas , Luo Haiwei
Published: January 2016

Members of the marine
Roseobacter
clade are major participants in global carbon and sulfur cycles. While roseobacters are well represented in cultures, several abundant pelagic lineages, including SAG-O19, DC5-80-3, and NAC11-7, remain largely uncultivated and show evidence of genome streamlining. Here, we analyzed the partial genomes of three single cells affiliated with CHAB-I-5, another abundant but exclusively uncultivated
Roseobacter
lineage. Members of this lineage encode several metabolic potentials that are absent in streamlined genomes. Examples are quorum sensing and type VI secretion systems, which enable them to effectively interact with host and other bacteria. Further analysis of the CHAB-I-5 single-cell amplified genomes (SAGs) predicted that this lineage comprises members with relatively large genomes (4.1 to 4.4 Mbp) and a high fraction of noncoding DNA (10 to 12%), which is similar to what is observed in many cultured, nonstreamlined
Roseobacter
lineages. The four uncultured lineages, while exhibiting highly variable geographic distributions, together represent >60% of the global pelagic roseobacters. They are consistently enriched in genes encoding the capabilities of light harvesting, oxidation of “energy-rich” reduced sulfur compounds and methylated amines, uptake and catabolism of various carbohydrates and osmolytes, and consumption of abundant exudates from phytoplankton. These traits may define the global prevalence of the four lineages among marine bacterioplankton.
Improved Acetic Acid Resistance in Saccharomyces cerevisiae by Overexpression of the
WHI2
Gene Identified through Inverse Metabolic Engineering
Authors: Chen Yingying , Stabryla Lisa , Wei Na
Published: January 2016

Development of acetic acid-resistant
Saccharomyces cerevisiae
is important for economically viable production of biofuels from lignocellulosic biomass, but the goal remains a critical challenge due to limited information on effective genetic perturbation targets for improving acetic acid resistance in the yeast. This study employed a genomic-library-based inverse metabolic engineering approach to successfully identify a novel gene target,
WHI2
(encoding a cytoplasmatic globular scaffold protein), which elicited improved acetic acid resistance in
S. cerevisiae
. Overexpression of
WHI2
significantly improved glucose and/or xylose fermentation under acetic acid stress in engineered yeast. The
WHI2
-overexpressing strain had 5-times-higher specific ethanol productivity than the control in glucose fermentation with acetic acid. Analysis of the expression of
WHI2
gene products (including protein and transcript) determined that acetic acid induced endogenous expression of Whi2 in
S. cerevisiae
. Meanwhile, the
whi2
Δ mutant strain had substantially higher susceptibility to acetic acid than the wild type, suggesting the important role of Whi2 in the acetic acid response in
S. cerevisiae
. Additionally, overexpression of
WHI2
and of a cognate phosphatase gene,
PSR1
, had a synergistic effect in improving acetic acid resistance, suggesting that Whi2 might function in combination with Psr1 to elicit the acetic acid resistance mechanism. These results improve our understanding of the yeast response to acetic acid stress and provide a new strategy to breed acetic acid-resistant yeast strains for renewable biofuel production.
A Highly Arginolytic Streptococcus Species That Potently Antagonizes Streptococcus mutans
Authors: Huang Xuelian , Palmer Sara R. , Ahn Sang-Joon , Richards Vincent P. , Williams Matthew L. , Nascimento Marcelle M. , Burne Robert A.
Published: January 2016

The ability of certain oral biofilm bacteria to moderate pH through arginine metabolism by the arginine deiminase system (ADS) is a deterrent to the development of dental caries. Here, we characterize a novel
Streptococcus
strain, designated strain A12, isolated from supragingival dental plaque of a caries-free individual. A12 not only expressed the ADS pathway at high levels under a variety of conditions but also effectively inhibited growth and two intercellular signaling pathways of the dental caries pathogen
Streptococcus mutans
. A12 produced copious amounts of H
2
O
2
via the pyruvate oxidase enzyme that were sufficient to arrest the growth of
S. mutans
. A12 also produced a protease similar to challisin (Sgc) of
Streptococcus gordonii
that was able to block the competence-stimulating peptide (CSP)–ComDE signaling system, which is essential for bacteriocin production by
S. mutans
. Wild-type A12, but not an
sgc
mutant derivative, could protect the sensitive indicator strain
Streptococcus sanguinis
SK150 from killing by the bacteriocins of
S. mutans
. A12, but not
S. gordonii
, could also block the XIP (

com
X

-
i
nducing
p
eptide) signaling pathway, which is the proximal regulator of genetic competence in
S. mutans
, but Sgc was not required for this activity. The complete genome sequence of A12 was determined, and phylogenomic analyses compared A12 to streptococcal reference genomes. A12 was most similar to
Streptococcus australis
and
Streptococcus parasanguinis
but sufficiently different that it may represent a new species. A12-like organisms may play crucial roles in the promotion of stable, health-associated oral biofilm communities by moderating plaque pH and interfering with the growth and virulence of caries pathogens.
Feeding of Enterococcus faecium NCIMB 10415 Leads to Intestinal miRNA-423-5p-Induced Regulation of Immune-Relevant Genes
Authors: Kreuzer-Redmer Susanne , Bekurtz Jennifer C. , Arends Danny , Bortfeldt Ralf , Kutz-Lohroff Barbara , Sharbati Soroush , Einspanier Ralf , Brockmann Gudrun A.
Published: January 2016

Probiotics are widely used in human and animal health, but little is known about the mode of action of probiotics. One possible mechanism at the molecular level could be an influence on microRNAs (miRNAs) and the related immune-relevant target genes. Here, we analyzed differential expression of miRNA and potential target genes of ileal and jejunal lymphatic tissues from
Enterococcus faecium
NCIMB 10415-fed piglets versus untreated controls by using next-generation sequencing. We identified miR-423-5p as being greatly affected by the treatment group (2.32-fold;
P
= 0.014). Validation by reverse transcription-quantitative PCR (RT-qPCR) confirmed a significant upregulation of miR-423-5p (2.11-fold;
P
= 0.03) and, additionally, downregulation of the important immune-relevant immunoglobulin lambda light C region (IGLC) (0.61-fold;
P
= 0.03) and immunoglobulin kappa constant (IGKC) (0.69-fold;
P
= 0.04) target genes. Expression analysis of miR-423-5p and IGLC at different age points shows a clear anticorrelated relationship. Luciferase reporter assays with a HeLa cell line verified IGLC as a target of miR-423-5p. The results provided evidence for an effect of feeding of
E. faecium
on the expression of miR-423-5p and on the regulation of the IGLC gene through miR-423-5p. This might be a possible mode of action of
E. faecium
on immune cell regulation in the small intestine.
An International Survey on the Current Use of Electroacupuncture
Authors: Mayor David , Bovey Mark
Published: January 2016

Background

Despite many research publications, it is unclear how widely electroacupuncture (EA) and related modalities are used in everyday practice. It is also uncertain who uses them, for what conditions, and with what results. We aimed to survey practitioners about their use of and training in EA. We also sought to determine how much the open-access English-language database at http://www.electroacupunctureknowledge.com (EAK) is used, or might be used in the future, if updated.

Methods

A survey was developed using several rounds of consultation with a focus group and others. Professional acupuncture membership organisations were contacted to assess their willingness to notify their members. The survey was tested before its launch.

Results

Thirty-four professional organisations agreed to participate, together with two research bodies and six UK training institutes. Potentially, around 50 000 professionals practising acupuncture knew about the survey, to which there were 768 responses. Data were analysed for respondent demographics. Around 70% used EA, but <25% used related electrotherapy modalities. Men were more likely than women to use more than one modality. Only around 7% of respondents used non-traditional acupuncture modalities without prior training. However, awareness and usage of the EAK database was low, although around 80% of respondents stated they might use the database in the future, primarily to improve clinical practice.

Conclusions

To the best of our knowledge, this is the largest survey on EA and related modalities ever conducted. As such, its results are likely to be of interest to acupuncture and other practitioners (whether or not they use EA), patients, policymakers, and funding agencies.
Going home after infant cardiac surgery: a UK qualitative study
Authors: Tregay Jenifer , Wray Jo , Crowe Sonya , Knowles Rachel , Daubeney Piers , Franklin Rodney , Barron David , Hull Sally , Barnes Nick , Bull Catherine , Brown Katherine L
Published: January 2016

Objective

To qualitatively assess the discharge processes and postdischarge care in the community for infants discharged after congenital heart interventions in the first year of life.

Design

Qualitative study using semistructured interviews and Framework Analysis.

Setting

UK specialist cardiac centres and the services their patients are discharged to.

Subjects

Twenty-five cardiologists and nurses from tertiary centres, 11 primary and secondary health professionals and 20 parents of children who had either died after discharge or had needed emergency readmission.

Results

Participants indicated that going home with an infant after cardiac intervention represents a major challenge for parents and professionals. Although there were reported examples of good care, difficulties are exacerbated by inconsistent pathways and potential loss of information between the multiple teams involved. Written documentation from tertiary centres frequently lacks crucial contact information and contains too many specialist terms. Non-tertiary professionals and parents may not hold the information required to respond appropriately when an infant deteriorates, this contributing to the stressful experience of managing these infants at home. Where they exist, the content of formal ‘home monitoring pathways’ varies nationally, and families can find this onerous.

Conclusions

Service improvements are needed for infants going home after cardiac intervention in the UK, focusing especially on enhancing mechanisms for effective transfer of information outside the tertiary centre and processes to assist with monitoring and triage of vulnerable infants in the community by primary and secondary care professionals. At present there is no routine audit for this stage of the patient journey.
Hearing outcome of infants with congenital cytomegalovirus and hearing impairment
Authors: Bilavsky Efraim , Shahar-Nissan Keren , Pardo Joseph , Attias Joseph , Amir Jacob
Published: January 2016

Background

Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of childhood sensorineural hearing loss. Antiviral treatment has been shown to prevent hearing deterioration in these infants. However, studies focused on infants with hearing impairment at birth and on the specific degree of impairment and further improvement or deterioration are lacking.

Objective

To investigate the relationship between hearing status at birth and any change in hearing status at the end of a prolonged follow-up period, after receiving 12 months of antiviral treatment in children born with hearing impairment due to congenital cCMV.

Methods

Clinical, laboratory, radiological and audiological data of all infants with cCMV infection followed in our centre between 2005 and 2013 were reviewed. Treatment with antiviral medication for hearing impairment found during the neonatal period was12 months of gan/valganciclovir. Hearing studies were performed only on infants who had been followed up for more than 1 year after treatment.

Results

Hearing impairment at birth was found in 54 (36.2%) of the 149 infants diagnosed with symptomatic cCMV, and found in 77 affected ears; unilateral in 31 (57.4%) and bilateral in 23 (42.6%). After 1 year of antiviral treatment and a long-term follow-up of the 77 affected ears at baseline, 50 (64.9%) had improved, 22 (28.6%) remained unchanged and 5 (6.5%) had deteriorated. Most improved ears (38/50=76%) returned to normal hearing. Improvement was most likely to occur in infants born with mild or moderate hearing loss and less in those with severe impairment.

Conclusions

We found that infants born with cCMV and hearing impairment, receiving 12 months of antiviral treatment, showed significant improvement in hearing status. The probability of hearing improvement seems inversely related to the severity of the impairment at birth.
Forecasting and control policy assessment for the Ebola virus disease (EVD) epidemic in Sierra Leone using small-world networked model simulations
Authors: Siettos Constantinos I , Anastassopoulou Cleo , Russo Lucia , Grigoras Christos , Mylonakis Eleftherios
Published: January 2016

Objectives

As the Ebola virus disease is still sustained in Sierra Leone, we analysed the epidemic for a recent period (21 December 2014 to 17 April 2015) using a small-world networked model and forecasted its evolution. Policy-control scenarios for the containment of the epidemic were also examined.

Methods

We developed an agent-based model with 6 million individuals (the population of Sierra Leone) interacting through a small-world social network. The model incorporates the main epidemiological factors, including the effect of burial practices to virus transmission. The effective reproductive number (Re) was evaluated directly from the agent-based simulations. Estimates of the epidemiological variables were computed on the basis of the official cases as reported by the Centers for Disease Control and Prevention (CDC).

Results

From 21 December 2014 to 18 February 2015 the epidemic was in recession compared with previous months, as indicated by the estimatedReof ∼0.77 (95% CI 0.72 to 0.82). From 18 February to 17 April 2015, theRerose above criticality (∼1.98, 95% CI 1.33 to 2.22), flashing a note of caution for the situation. By projecting in time, we predicted that the epidemic would continue through July 2015. Our predictions were close to the cases reported by CDC by the end of June, verifying the criticality of the situation. In light of these developments, while revising our manuscript, we expanded our analysis to include the most recent data (until 15 August 2015). By mid-August,Rehad fallen below criticality and the epidemic was expected to fade out by early December 2015.

Conclusions

Our results call for the continuation of drastic control measures, which in the absence of an effective vaccine or therapy at present can only translate to isolation of the infected section of the population, to contain the epidemic.
Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France
Authors: Birgand Gabriel , Leroy Christophe , Nerome Simone , Luong Nguyen Liem Binh , Lolom Isabelle , Armand-Lefevre Laurence , Ciotti Céline , Lecorre Bertrand , Marcade Géraldine , Fihman Vincent , Nicolas-Chanoine Marie-Hélène , Pelat Camille , Perozziello Anne , Fantin Bruno , Yazdanpanah Yazdan , Ricard Jean-Damien , Lucet Jean-Christophe
Published: January 2016

Objective

To assess costs associated with implementation of a strict ‘search and isolate’ strategy for controlling highly drug-resistant organisms (HDRO).

Design

Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO.

Setting

Three university hospitals located in northern Paris.

Methods

Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management.

Results

Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean±SD) associated with management of a single case identified within and/or 48 h after admission was €4443±11 552 and €11 445±15 743, respectively (p<0.01). In an outbreak, the total cost varied from €14 864 ±17 734 for an episode with one secondary case (€7432±8867 per case) to €136 525 ±151 231 (€12 845±5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77–94% of total costs, and had the greatest financial impact (R2=0.98, p<0.01).

Conclusions

In HDRO episodes occurring at three university hospitals, interruption of new admissions constituted the most costly measure in an outbreak situation.
Virtual online consultations: advantages and limitations (VOCAL) study
Authors: Greenhalgh Trisha , Vijayaraghavan Shanti , Wherton Joe , Shaw Sara , Byrne Emma , Campbell-Richards Desirée , Bhattacharya Satya , Hanson Philippa , Ramoutar Seendy , Gutteridge Charles , Hodkinson Isabel , Collard Anna , Morris Joanne
Published: January 2016

Introduction

Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations.

Methods

To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel—audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel—interviews, ethnographic observations and analysis of documents within the trust; macrolevel—key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory.

Ethics approval

City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883.

Planned outputs

We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: ‘what to expect in your virtual consultation’.

Discussion

The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We anticipate that this study will contribute to a balanced assessment of when, how and in what circumstances this model might be introduced.
Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors
Authors: Greenwood Nan , Holley Jess , Ellmers Theresa , Mein Gill , Cloud Geoffrey
Published: January 2016

Objectives

Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge.

Design

This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups.

Setting

Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK.

Participants

41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups.

Results

Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups.

Conclusions

Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face.
Trauma teams and time to early management during in situ trauma team training
Authors: Härgestam Maria , Lindkvist Marie , Jacobsson Maritha , Brulin Christine , Hultin Magnus
Published: January 2016

Objectives

To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training.

Design

In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma.

Setting

An emergency room in an urban Scandinavian level one trauma centre.

Participants

A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre.

Primary outcome

HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model.

Results

Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively).

Conclusions

Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload.
Engaging patients through open notes: an evaluation using mixed methods
Authors: Esch Tobias , Mejilla Roanne , Anselmo Melissa , Podtschaske Beatrice , Delbanco Tom , Walker Jan
Published: January 2016

Objectives

(A) To gain insights into the experiences of patients invited to view their doctors’ visit notes, with a focus on those who review multiple notes; (B) to examine the relationships among fully transparent electronic medical records and quality of care, the patient-doctor relationship, patient engagement, self-care, self-management skills and clinical outcomes.

Design

Mixed methods qualitative study: analyses of survey data, including content analysis of free-text answers, and quantitative-descriptive measures combined with semistructured individual interviews, patient activation measures, and member checks.

Setting

Greater Boston, USA.

Participants

Patients cared for by primary care physicians (PCPs) at the Beth Israel Deaconess Medical Center who had electronic access to their PCP visit notes. Among those submitting surveys, 576 free-text answers were identified and analysed (414 from female patients, 162 from male patients; 23–88 years). In addition, 13 patients (9 female, 4 male; 58–87 years) were interviewed.

Results

Patient experiences indicate improved understanding (of health information), better relationships (with doctors), better quality (adherence and compliance; keeping track) and improved self-care (patient-centredness, empowerment). Patients want more doctors to offer access to their notes, and some wish to contribute to their generation. Those patients with repeated experience reviewing notes express fewer concerns and more perceived benefits.

Conclusions

As the use of fully transparent medical records spreads, it is important to gain a deeper understanding of possible benefits or harms, and to characterise target populations that may require varying modes of delivery. Patient desires for expansion of this practice extend to specialty care and settings beyond the physician's office. Patients are also interested in becoming involved actively in the generation of their medical records. The OpenNotes movement may increase patient activation and engagement in important ways.
Do special constables in London feel that they are adequately prepared to meet their first aid responsibilities? A qualitative study
Authors: Chandan Joht Singh , Meakin Richard
Published: January 2016

Objective

This study's aims were to explore the views of special constables in the London metropolitan police force concerning their obligations and skills as first aiders.

Background

The metropolitan police force provides police officers to act as first responders to emergency calls made by the public. Special constables act with the same powers and responsibility as police officers and are required to deal with incidents involving medical emergencies.

Setting

West London Police Station.

Participants

Fifteen special constables entered and completed the study.

Methods and Outcome Measures

A qualitative study involving semistructured interviews, participant observation, and reflective work. The outcome measures were the themes derived from the ‘thematic framework approach’ to analysis.

Results

Four main themes were identified. (1) ‘Our responsibility?’—Special constables felt they had a responsibility, but were unsure of the origin of this responsibility, with many feeling it stemmed from public expectation. (2) ‘Confidence’—Special constables had mixed feelings regarding their confidence in first aid scenarios and many felt that more could be done to improve their confidence. (3) ‘Training needs’—Many felt the current training system was lacking in several ways including regularity, teaching and content. (4) ‘Personal first aid knowledge’—Special constables were disappointed with their past performances.

Conclusions

Owing to the small size of this study, the conclusions are limited; however, if the findings are confirmed by larger studies, they suggest the need to improve the confidence of special constables in first aid situations.
Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors for controlling hyperglycaemia in patients with type 2 diabetes: protocol for a systematic review and network meta-analysis
Authors: Chen Min , Xie Chun-Guang , Gao Hong , Zheng Hui , Chen Qin , Fang Jian-Qiao
Published: January 2016

Introduction

As a new class of glucose-lowering drugs, sodium-glucose co-transporter 2 (SGLT2) inhibitors are effective for controlling hyperglycaemia, however, the relative effectiveness and safety of 6 recently available SGLT2 inhibitors have rarely been studied. Therefore, we aim to perform pairwise comparisons of the 6 SGLT2 inhibitors.

Methods and analysis

A systematic review and network meta-analysis will be conducted. Clinical studies that examine effectiveness and safety of either canagliﬂozin, dapagliﬂozin, empagliﬂozin, ipragliflozin, tofogliflozin or luseogliflozin will be included. These studies will be systematically retrieved in MEDLINE, EMBASE and the Cochrane Library, from inception to November 2015. Two reviewers will independently screen for eligible studies and then extract data from the studies as well as assess risk of bias. Discrepancies in screening and data extraction will be arbitrated by a third reviewer. A traditional meta-analysis will be performed to combine the effect sizes calculated from head-to-head comparisons with a random effect model. The effect sizes computed from indirect comparisons will be further combined in a network meta-analysis. Heterogeneity will be tested with the Cochrane's Q statistic, and publication bias will be assessed using a funnel plot and the Egger's test.

Ethics and dissemination

Relative effectiveness and harms of the 6 SGLT2 inhibitors will be demonstrated through this systematic review and network meta-analysis. The result of the review will be disseminated through a peer-review journal and conference presentations. Patients, clinicians and policymakers will benefit from this review in selecting a SGLT2 inhibitor for glucose control in patients with type 2 diabetes.

Trial registration number

PROSPERO CRD42015025981.
Chiba study of Mother and Children's Health (C-MACH): cohort study with omics analyses
Authors: Sakurai Kenichi , Miyaso Hidenobu , Eguchi Akifumi , Matsuno Yoshiharu , Yamamoto Midori , Todaka Emiko , Fukuoka Hideoki , Hata Akira , Mori Chisato
Published: January 2016

Purpose

Recent epidemiological studies have shown that environmental factors during the fetal period to early childhood might affect the risk of non-communicable diseases in adulthood. This is referred to as the developmental origins of health and disease (DOHaD) concept. The Chiba study of Mother and Children's Health (C-MACH) is a birth cohort study based on the DOHaD hypothesis and involves multiomics analysis. This study aims to explore the effects of genetic and environmental factors—particularly the fetal environment and postbirth living environment—on children's health, and to identify potential biomarkers for these effects.

Participants

The C-MACH consists of three hospital-based cohorts. The study participants are pregnant women at <13 weeks gestation. Women who underwent an examination in one of the three hospitals received an explanation of the study. The participants consented to completing questionnaire surveys and the collection and storage of biological and house/environmental samples. Participants were provided unique study numbers. All of the data and biological specimens will be stored in the Chiba University Center for Preventive Medical Sciences and Chiba University Center for Preventive Medical Sciences BioBank, respectively.

Findings to date

Consent to participate was obtained from 433 women. Of these women, 376 women completed questionnaires in the early gestational period. The mean age was 32.5 (4.4) years. The mean body mass index (BMI) was 21.1 (3.0) kg/m2. Before pregnancy, 72.3% of the women had a BMI of 18.5–24.9 kg/m2. During early pregnancy, 5.0% of the participants smoked.

Future plans

Primary outcomes are allergy, obesity, endocrine and metabolic disorders, and developmental disorders. Genome-level, metabolome-level, umbilical cord DNA methylation (epigenome), gut microbiota and environmental chemical exposure variables will be evaluated. We will analyse the relationships between the outcomes and analytical variables.