bluuebunny/crossref_metadata_2025 huggingface dataset:
Antihypertensive Medications in End‐Stage Renal Disease
Authors: Denker Matthew G. , Cohen Debbie L.
Published: April 2015

Hypertension is almost universal in end‐stage renal disease (ESRD) and contributes to the substantial cardiovascular (CV) morbidity and mortality observed in these patients. The management of blood pressure (BP) in ESRD is complicated by a number of factors, including missed dialysis treatments, intradialytic changes in BP, medication removal with dialysis, and poor correlation of BPs obtained in the dialysis unit with those at home and with CV outcomes. Control of extracellular volume with ultrafiltration and dietary sodium restriction represents the principal strategy to manage hypertension in ESRD, and antihypertensive medications are subsequently added if this strategy is inadequate. While reduction in BP with medication improves CV outcomes, few head‐to‐head clinical trials have been performed to firmly establish the superiority of one antihypertensive medication class over another. Therefore, individualization of therapy is necessary, and patient comorbidities must be considered. Angiotensin‐converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and beta‐blockers are reasonable first‐line agents for most patients. ACE inhibitors and ARBs exert cardioprotective effects that are independent of BP reduction. Medications that are removed with dialysis may be preferred in patients who are prone to develop intradialytic hypotension. Intradialytic hypertension can be managed with challenging the patient's dry weight and using nondialyzable medications. Within a class of antihypertensive medications, there may be large variability in drug removal with dialysis, which must be considered upon medication selection. Studies demonstrate that even thrice‐weekly dosing of medication after dialysis has robust BP‐lowering effects, which may be a useful regimen in nonadherent patients.
Effect of sorbitol, single, and multidose activated charcoal administration on carprofen absorption following experimental overdose in dogs
Authors: Koenigshof Amy M. , Beal Matthew W. , Poppenga Robert H. , Jutkowitz L. Ari
Published: April 2015

Objective

To compare the effectiveness of single dose activated charcoal, single dose activated charcoal with sorbitol, and multidose activated charcoal in reducing plasma carprofen concentrations following experimental overdose in dogs.

Design

Randomized, four period cross‐over study.

Setting

University research setting.

Animals

Eight healthy Beagles.

Interventions

A 120 mg/kg of carprofen was administered orally to each dog followed by either (i) a single 2 g/kg activated charcoal administration 1 hour following carprofen ingestion (AC); (ii) 2 g/kg activated charcoal with 3.84 g/kg sorbitol 1 hour following carprofen ingestion (ACS); (iii) 2 g/kg activated charcoal 1 hour after carprofen ingestion and repeated every 6 hours for a total of 4 doses (MD); (iv) no treatment (control).

Measurements and Main Results

Plasma carprofen concentrations were obtained over a 36‐hour period following carprofen ingestion for each protocol. Pharmacokinetic modeling was performed and time versus concentration, area under the curve, maximum plasma concentration, time to maximum concentration, and elimination half‐life were calculated and compared among the groups using ANOVA followed by Tukey's multiple comparisons test. Activated charcoal, activated charcoal with sorbitol (ACS), and multiple‐dose activated charcoal (MD) significantly reduced the area under the curve compared to the control group. AC and MD significantly reduced the maximum concentration when compared to the control group. MD significantly reduced elimination half‐life when compared to ACS and the control group. There were no other significant differences among the treatment groups.

Conclusions

Activated charcoal and ACS are as effective as MD in reducing serum carprofen concentrations following experimental overdose in dogs. Prospective studies are warranted to evaluate the effectiveness of AC, ACS, and MD in the clinical setting.
Diamond film deposited on Mo-Re alloy by hot filament chemical vapor deposition with periodic magnetic field
Authors: Wu Xiaobin , Dai Tagen , Yu Zhiming
Published: April 2015

Molybdenum–rhenium (Mo/Re) alloys were investigated as substrates for thin-film, polycrystalline boron-doped diamond electrodes. Boron-doped semimetallic diamond was deposited on Mo-Re (42.5/57.5 wt. %) substrates by hot filament chemical vapor deposition method with a periodic magnetic field (PMF). Cyclic voltammograms showed the wide window and low baseline current of high-quality boron doped diamond electrodes. Overall, the Mo/Re alloys were suitable substrates for diamond growth. PMF may have a great practical application potential in diamond growth by chemical vapor deposition.
Neural‐network based autocontouring algorithm for intrafractional lung‐tumor tracking using Linac‐MR
Authors: Yun Jihyun , Yip Eugene , Gabos Zsolt , Wachowicz Keith , Rathee Satyapal , Fallone B. G.
Published: April 2015

Purpose:

To develop a neural‐network based autocontouring algorithm for intrafractional lung‐tumor tracking using Linac‐MR and evaluate its performance with phantom and in‐vivo MR images.

Methods:

An autocontouring algorithm was developed to determine both the shape and position of a lung tumor from each intrafractional MR image. A pulse‐coupled neural network was implemented in the algorithm for contrast improvement of the tumor region. Prior to treatment, to initiate the algorithm, an expert user needs to contour the tumor and its maximum anticipated range of motion in pretreatment MR images. During treatment, however, the algorithm processes each intrafractional MR image and automatically generates a tumor contour without further user input. The algorithm is designed to produce a tumor contour that is the most similar to the expert's manual one. To evaluate the autocontouring algorithm in the author's Linac‐MR environment which utilizes a 0.5 T MRI, a motion phantom and four lung cancer patients were imaged with 3 T MRI during normal breathing, and the image noise was degraded to reflect the image noise at 0.5 T. Each of the pseudo‐0.5 T images was autocontoured using the author's algorithm. In each test image, the Dice similarity index (DSI) and Hausdorff distance (HD) between the expert's manual contour and the algorithm generated contour were calculated, and their centroid positions were compared (Δdcentroid).

Results:

The algorithm successfully contoured the shape of a moving tumor from dynamic MR images acquired every 275 ms. From the phantom study, mean DSI of 0.95–0.96, mean HD of 2.61–2.82 mm, and mean Δdcentroid of 0.68–0.93 mm were achieved. From the in‐vivo study, the author's algorithm achieved mean DSI of 0.87–0.92, mean HD of 3.12–4.35 mm, as well as Δdcentroid of 1.03–1.35 mm. Autocontouring speed was less than 20 ms for each image.

Conclusions:

The authors have developed and evaluated a lung tumor autocontouring algorithm for intrafractional tumor tracking using Linac‐MR. The autocontouring performance in the Linac‐MR environment was evaluated using phantom and in‐vivo MR images. From the in‐vivo study, the author's algorithm achieved 87%–92% of contouring agreement and centroid tracking accuracy of 1.03–1.35 mm. These results demonstrate the feasibility of lung tumor autocontouring in the author's laboratory's Linac‐MR environment.
Gamma Knife irradiation method based on dosimetric controls to target small areas in rat brains
Authors: Constanzo Julie , Paquette Benoit , Charest Gabriel , Masson‐Côté Laurence , Guillot Mathieu
Published: April 2015

Purpose:

Targeted and whole‐brain irradiation in humans can result in significant side effects causing decreased patient quality of life. To adequately investigate structural and functional alterations after stereotactic radiosurgery, preclinical studies are needed. The purpose of this work is to establish a robust standardized method of targeted irradiation on small regions of the rat brain.

Methods:

Euthanized male Fischer rats were imaged in a stereotactic bed, by computed tomography (CT), to estimate positioning variations relative to the bregma skull reference point. Using a rat brain atlas and the stereotactic bregma coordinates obtained from CT images, different regions of the brain were delimited and a treatment plan was generated. A single isocenter treatment plan delivering ≥100 Gy in 100% of the target volume was produced by Leksell GammaPlan using the 4 mm diameter collimator of sectors 4, 5, 7, and 8 of the Gamma Knife unit. Impact of positioning deviations of the rat brain on dose deposition was simulated by GammaPlan and validated with dosimetric measurements.

Results:

The authors’ results showed that 90% of the target volume received 100 ± 8 Gy and the maximum of deposited dose was 125 ± 0.7 Gy, which corresponds to an excellent relative standard deviation of 0.6%. This dose deposition calculated with GammaPlan was validated with dosimetric films resulting in a dose‐profile agreement within 5%, both in X‐ and Z‐axes.

Conclusions:

The authors’ results demonstrate the feasibility of standardizing the irradiation procedure of a small volume in the rat brain using a Gamma Knife.
Development of PET/MRI with insertable PET for simultaneous PET and MR imaging of human brain
Authors: Jung Jin Ho , Choi Yong , Jung Jiwoong , Kim Sangsu , Lim Hyun Keong , Im Ki Chun , Oh Chang Hyun , Park Hyun‐wook , Kim Kyung Min , Kim Jong Guk
Published: April 2015

Purpose:

The purpose of this study was to develop a dual‐modality positron emission tomography (PET)/magnetic resonance imaging (MRI) with insertable PET for simultaneous PET and MR imaging of the human brain.

Methods:

The PET detector block was composed of a 4 × 4 matrix of detector modules, each consisting of a 4 × 4 array LYSO coupled to a 4 × 4 Geiger‐mode avalanche photodiode (GAPD) array. The PET insert consisted of 18 detector blocks, circularly mounted on a custom‐made plastic base to form a ring with an inner diameter of 390 mm and axial length of 60 mm. The PET gantry was shielded with gold‐plated conductive fabric tapes with a thickness of 0.1 mm. The charge signals of PET detector transferred via 4 m long flat cables were fed into the position decoder circuit. The flat cables were shielded with a mesh‐type aluminum sheet with a thickness of 0.24 mm. The position decoder circuit and field programmable gate array‐embedded DAQ modules were enclosed in an aluminum box with a thickness of 10 mm and located at the rear of the MR bore inside the MRI room. A 3‐T human MRI system with a Larmor frequency of 123.7 MHz and inner bore diameter of 60 cm was used as the PET/MRI hybrid system. A custom‐made radio frequency (RF) coil with an inner diameter of 25 cm was fabricated. The PET was positioned between gradient and the RF coils. PET performance was measured outside and inside the MRI scanner using echo planar imaging, spin echo, turbo spin echo, and gradient echo sequences. MRI performance was also evaluated with and without the PET insert. The stability of the newly developed PET insert was evaluated and simultaneous PET and MR images of a brain phantom were acquired.

Results:

No significant degradation of the PET performance caused by MR was observed when the PET was operated using various MR imaging sequences. The signal‐to‐noise ratio of MR images was slightly degraded due to the PET insert installed inside the MR bore while the homogeneity was maintained. The change of gain of the 256 GAPD/scintillator elements of a detector block was <3% for 60 min, and simultaneous PET and MR images of a brain phantom were successfully acquired.

Conclusions:

Experimental results indicate that a compact and lightweight PET insert for hybrid PET/MRI can be developed using GAPD arrays and charge signal transmission method proposed in this study without significant interference.
Age-Related Changes in Performance and Recovery Kinetics in Masters Athletes: A Narrative Review
Authors: Borges Nattai , Reaburn Peter , Driller Matthew , Argus Christos
Published: April 2015

Despite increasing participation rates in masters sport and extensive research examining age-related changes in performance, little is known about the effect of age on recovery kinetics in masters athletes. This narrative review focuses on the relationship between aging and sport participation, and the effect on both performance and recovery following an exercise bout. Current research suggests the effect of age on performance and recovery may be smaller than originally suggested and that increasing sedentary lifestyles appear to play a larger role in any observed decrements in performance and recovery in masters athletes. Currently, it appears that performance decrements are inevitable with age. However, performance capacities can be maintained through systematic physical training. Moreover, the limited current research suggests there may be an age effect on recovery kinetics following an exercise bout, although further research is required to understand the acute and chronic recovery processes in the masters athlete.
Meager snows spell trouble ahead for salmon
Authors: Service Robert F.
Published: April 2015

Without snowmelt, streams in the western U.S. could reach lethal temperatures.
U.S. lays out its ambitions for leadership in the Arctic
Authors: Gramling Carolyn
Published: April 2015

Climate, marine conservation, and renewable energy priorities as U.S. ascends to chair of Arctic Council.
How the wolf became the dog
Authors: Grimm David
Published: April 2015

Scientists are coming to a consensus about how canines evolved.
Combating emerging viral threats
Authors: Bekerman Elena , Einav Shirit
Published: April 2015

Broad-spectrum antiviral drugs are under development to treat emerging viral diseases such as Ebola and dengue for which no specific, licensed treatments exist
Nanoplasmonic sensing and detection
Authors: Stockman Mark I.
Published: April 2015

Enhanced optical fields in nanoplasmonic systems provide efficient sensing and detection
The fever on the farm
Arresting Contagion Science, Policy, and Conflicts over Animal Disease Control
Alan L. Olmstead and Paul W. Rhode
Harvard University Press, 2015. 477 pp.
Authors: Grace Delia
Published: April 2015

Lessons from America's early efforts to control livestock diseases.
A scar is born: Origins of fibrotic skin tissue
Authors: Sennett Rachel , Rendl Michael
Published: April 2015

A fibroblast lineage is characterized by an inherent ability to form scar tissue in skin

[Also see Research Article by

Rinkevich
et al.

]
Quick Detection of
FKS1
Mutations Responsible for Clinical Echinocandin Resistance in Candida albicans
Authors: Dudiuk Catiana , Gamarra Soledad , Jimenez-Ortigosa Cristina , Leonardelli Florencia , Macedo Daiana , Perlin David S. , Garcia-Effron Guillermo
Published: April 2015

A rapid molecular-based assay for the detection of the
Candida albicans FKS1
gene mutations responsible for resistance to echinocandin drugs was designed and evaluated. The assay consisted of a multiplexed PCR set of 5 tubes able to detect the most commonly described resistance mechanism, including
FKS1
hot spot 1 and hot spot 2 mutations. The performance and specificity of the assay was evaluated using a double-blinded panel of 50
C. albicans
strains. The assay showed a sensitivity of 96% and was able to detect all homozygous mutants included in the collection of strains, demonstrating that it is a robust, quick, and labor-saving method that is suitable for a routine clinical diagnostic laboratory.
Urinary Tract Infection Caused by a Capnophilic Proteus mirabilis Strain
Authors: Trapman Maryse , van Ingen Jakko , Keijman Jeroen , Swanink Caroline M.
Published: April 2015

From a urine sample from a patient with a urinary tract infection, a carbon dioxide-dependent
Proteus mirabilis
strain was isolated. It is important to perform urine cultures in 5% carbon dioxide and an anaerobic atmosphere if bacteria prominent in Gram stains do not grow on routine media in ambient air.
Molecular Assay for Detection of Genetic Markers Associated with Decreased Susceptibility to Cephalosporins in Neisseria gonorrhoeae
Authors: Peterson S. W. , Martin I. , Demczuk W. , Bharat A. , Hoang L. , Wylie J. , Allen V. , Lefebvre B. , Tyrrell G. , Horsman G. , Haldane D. , Garceau R. , Wong T. , Mulvey M. R.
Published: April 2015

The incidence of antimicrobial-resistant
Neisseria gonorrhoeae
continues to rise in Canada; however, antimicrobial resistance data are lacking for approximately 70% of gonorrhea infections that are diagnosed directly from clinical specimens by nucleic acid amplification tests (NAATs). We developed a molecular assay for surveillance use to detect mutations in genes associated with decreased susceptibility to cephalosporins that can be applied to both culture isolates and clinical samples. Real-time PCR assays were developed to detect single nucleotide polymorphisms (SNPs) in
ponA
,
mtrR
,
penA
,
porB
, and one
N. gonorrhoeae
-specific marker (
porA
). We tested the real-time PCR assay with 252 gonococcal isolates, 50 nongonococcal isolates, 24
N. gonorrhoeae
-negative NAAT specimens, and 34
N. gonorrhoeae
-positive NAAT specimens. Twenty-four of the
N. gonorrhoeae
-positive NAAT specimens had matched culture isolates. Assay results were confirmed by comparison with whole-genome sequencing data. For 252
N. gonorrhoeae
strains, the agreement between the DNA sequence and real-time PCR was 100% for
porA
,
ponA
, and
penA
, 99.6% for
mtrR
, and 95.2% for
porB
. The presence of ≥2 SNPs correlated with decreased susceptibility to ceftriaxone (sensitivities of >98%) and cefixime (sensitivities of >96%). Of 24 NAAT specimens with matched cultures, the agreement between the DNA sequence and real-time PCR was 100% for
porB
, 95.8% for
ponA
and
mtrR
, and 91.7% for
penA
. We demonstrated the utility of a real-time PCR assay for sensitive detection of known markers for the decreased susceptibility to cephalosporins in
N. gonorrhoeae
. Preliminary results with clinical NAAT specimens were also promising, as they correlated well with bacterial culture results.
Unravelling the Role of the F55 Regulator in the Transition from Lysogeny to UV Induction of Sulfolobus Spindle-Shaped Virus 1
Authors: Fusco Salvatore , She Qunxin , Fiorentino Gabriella , Bartolucci Simonetta , Contursi Patrizia
Published: April 2015

Sulfolobus
spindle-shaped virus 1 represents a model for studying virus-host interaction in harsh environments, and it is so far the only member of the family
Fuselloviridae
that shows a UV-inducible life cycle. Although the virus has been extensively studied, mechanisms underpinning the maintenance of lysogeny as well as those regulating the UV induction have received little attention. Recently, a novel SSV1 transcription factor, F55, was identified. This factor was able to bind
in vitro
to several sequences derived from the early and UV-inducible promoters of the SSV1 genome. The location of these binding sites together with the differential affinity of F55 for these sequences led to the hypothesis that this protein might be involved in the maintenance of the SSV1 lysogeny. Here, we report an
in vivo
survey of the molecular events occurring at the UV-inducible region of the SSV1 genome, with a focus on the binding profile of F55 before and after the UV irradiation. The binding of F55 to the target promoters correlates with transcription repression, whereas its dissociation is paralleled by transcription activation. Therefore, we propose that F55 acts as a molecular switch for the transcriptional regulation of the early viral genes.

IMPORTANCE
Functional genomic studies of SSV1 proteins have been hindered by the lack of similarity with other characterized proteins. As a result, few insights into their
in vivo
roles have been gained throughout the last 3 decades. Here, we report the first
in vivo
investigation of an SSV1 transcription regulator, F55, that plays a key role in the transition from the lysogenic to the induced state of SSV1. We show that F55 regulates the expression of the UV-inducible as well as the early genes. Moreover, the differential affinity of this transcription factor for these targets allows a fine-tuned and temporal coordinated regulation of transcription of viral genes.
Structural Basis for 2′-5′-Oligoadenylate Binding and Enzyme Activity of a Viral RNase L Antagonist
Authors: Ogden Kristen M. , Hu Liya , Jha Babal K. , Sankaran Banumathi , Weiss Susan R. , Silverman Robert H. , Patton John T. , Prasad B. V. Venkataram
Published: April 2015

Synthesis of 2′-5′-oligoadenylates (2-5A) by oligoadenylate synthetase (OAS) is an important innate cellular response that limits viral replication by activating the latent cellular RNase, RNase L, to degrade single-stranded RNA. Some rotaviruses and coronaviruses antagonize the OAS/RNase L pathway through the activity of an encoded 2H phosphoesterase domain that cleaves 2-5A. These viral 2H phosphoesterases are phylogenetically related to the cellular A kinase anchoring protein 7 (AKAP7) and share a core structure and an active site that contains two well-defined HΦ(S/T)Φ (where Φ is a hydrophobic residue) motifs, but their mechanism of substrate binding is unknown. Here, we report the structures of a viral 2H phosphoesterase, the C-terminal domain (CTD) of the group A rotavirus (RVA) VP3 protein, both alone and in complex with 2-5A. The domain forms a compact fold, with a concave β-sheet that contains the catalytic cleft, but it lacks two α-helical regions and two β-strands observed in AKAP7 and other 2H phosphoesterases. The cocrystal structure shows significant conformational changes in the R loop upon ligand binding. Bioinformatics and biochemical analyses reveal that conserved residues and residues required for catalytic activity and substrate binding comprise the catalytic motifs and a region on one side of the binding cleft. We demonstrate that the VP3 CTD of group B rotavirus, but not that of group G, cleaves 2-5A. These findings suggest that the VP3 CTD is a streamlined version of a 2H phosphoesterase with a ligand-binding mechanism that is shared among 2H phosphodiesterases that cleave 2-5A.

IMPORTANCE
The C-terminal domain (CTD) of rotavirus VP3 is a 2H phosphoesterase that cleaves 2′-5′-oligoadenylates (2-5A), potent activators of an important innate cellular antiviral pathway. 2H phosphoesterase superfamily proteins contain two conserved catalytic motifs and a proposed core structure. Here, we present structures of a viral 2H phosphoesterase, the rotavirus VP3 CTD, alone and in complex with its substrate, 2-5A. The domain lacks two α-helical regions and β-strands present in other 2H phosphoesterases. A loop of the protein undergoes significant structural changes upon substrate binding. Together with our bioinformatics and biochemical findings, the crystal structures suggest that the RVA VP3 CTD domain is a streamlined version of a cellular enzyme that shares a ligand-binding mechanism with other 2H phosphodiesterases that cleave 2-5A but differs from those of 2H phosphodiesterases that cleave other substrates. These findings may aid in the future design of antivirals targeting viral phosphodiesterases with cleavage specificity for 2-5A.
Resection of a large carotid paraganglioma in Carney-Stratakis syndrome: a multidisciplinary feat
Authors: Nicholas Rebecca Spenser , Quddus Ayyaz , Topham Charlotte , Baker Daryll
Published: April 2015

A 39-year-old man was referred to the vascular surgeons with a right-sided cervical mass, palpitations, headaches and sweating. He had presented with abdominal discomfort 12 months earlier. Investigations had revealed a gastrointestinal stromal tumour (GIST) and left adrenalectomy. CT of the neck with contrast demonstrated a large right carotid paraganglioma, extending superiorly from below the carotid bifurcation to encase the internal carotid artery. Genetic screening confirmed the diagnosis of Carney-Stratakis syndrome, an SDH-D germline mutation leading to GIST and multifocal paragangliomas.

Successful surgical excision required considerable multidisciplinary teamwork between neuroendocrinologists, anaesthetists and surgeons. The tumour was highly vascular and involved the right carotid body, hypoglossal and vagus nerves. Access was challenging and maxillofacial surgical expertise were required for division of the mandible. The patient made a good recovery following speech and swallowing rehabilitation.
Missing choriocarcinoma may be easy but not suspecting it in a high-risk case can be potentially fatal
Authors: Dasari Papa
Published: April 2015

A 27-year-old woman, fourth gravida, with three prior consecutive vesicular moles was diagnosed with a recurrent vesicular mole on ultrasonography (USG) and had very low β-human chorionic gonadotropin (HCG) values. During suction evacuation no vesicles were seen and on repeat USG the patient was diagnosed to have fibroid uterus. She was discharged at request and advised to undergo MRI to rule out choriocarcinoma. The MRI was interpreted as fibroid uterus with degeneration. After 3 weeks of suction evacuation, the patient presented with acute abdomen. She underwent emergency laparotomy for haemoperitoneum and was diagnosed as invasive mole with perforation; total hysterectomy was performed. Her β-HCG after laparotomy was more than 200 000 mIU/L, and the histopathological examination revealed choriocarcinoma. When methotrxate, adriamycin and cyclophosphamide (MAC) therapy was advised, the patient initially received methotrexate monotherapy; after three cycles her β-HCG started rising after an initial drop, and the patient required four cycles of EMACO to achieve remission.
Application of the Safety Attitudes Questionnaire (SAQ) in Albanian hospitals: a cross-sectional study
Authors: Gabrani Adriatik , Hoxha Adrian , Simaku Artan , Gabrani Jonila (Cyco)
Published: April 2015

Objective

To establish the reliability and validity of the translated version of the Safety Attitudes Questionnaire (SAQ) by evaluating its psychometric properties and to determine possible differences among nurses and physicians regarding safety attitudes.

Design

A cross-sectional study utilising the Albanian version of the SAQ and a demographic questionnaire.

Setting

Four regional hospitals in Albania.

Participants

341 healthcare providers, including 132 nurses and 209 doctors.

Main outcome measure(s)

The translation, construct validity and internal validity of the SAQ. The SAQ includes six scales and 30 items.

Results

A total of 341 valid questionnaires were returned, for a response rate of 70%. The confirmatory factor analysis and its goodness-of-fit indices (standardised root mean square residual 0.075, root mean square error of approximation 0.044 and comparative fit index 0.97) showed good model fit. The Cronbach's α values for each of the scales of the SAQ ranged from 0.64 to 0.82. The percentage of hospital healthcare workers who had a positive attitude was 60.3% for the teamwork climate, 57.2% for the safety climate, 58.4% for job satisfaction, 37.4% for stress recognition, 59.3% for the perception of management and 49.5% for working conditions. Intercorrelations showed that the subscales had moderate-to-high correlations with one another. Nurses were more hesitant to admit and report errors; only 55% of physicians and 44% of nurses endorsed this statement (χ2=4.9, p=0.02). Moreover, nurses received lower scores on team work compared with doctors (N 45.7 vs D 52.3, p=0.01). Doctors denied the effects of stress and fatigue on their performance (N 46.7 vs D 39.5, p<0.01), neglecting the workload.

Conclusions

The SAQ is a useful tool for evaluating safety attitudes in Albanian hospitals. In light of the health workforce's poor recognition of stress, establishing patient safety programmes should be a priority among policymakers in Albania.
Do parents play different roles in drinking behaviours of male and female adolescents? A longitudinal follow-up study
Authors: Hung Chao-Chia , Chang Hsing-Yi , Luh Dih-Ling , Wu Chi-Chen , Yen Lee-Lan
Published: April 2015

Objective

Gender differences in the associations between adolescent drinking behaviour, and perceived parental drinking behaviours and attitudes towards underage drinking, were investigated.

Methods

Data were drawn from two cohorts in the Child and Adolescent Behaviours in Long-term Evolution project. We used data from 2009 to 2006, when cohorts 1 and 2, respectively, were in grade 9. No cohort effect was found, so the two cohorts were pooled; 3972 students (1999 boys and 1973 girls) participated in the study. The major variables included adolescent drinking behaviours over the last month, and perceived parental drinking behaviours and parental attitudes towards underage drinking. The effects of the combination of parental drinking behaviours, and attitudes on the drinking behaviours of male and female adolescents, were analysed by logistic regression.

Results

The drinking behaviour of boys was correlated with the drinking behaviours and attitudes of their fathers but not with those of their mothers. Among boys, having a non-drinking father who was against underage drinking (OR=0.27, 95% CI 0.16 to 0.46), a non-drinking father who was favourable towards underage drinking (OR=0.61, 95% CI 0.39 to 0.94), or a drinking father who was against underage drinking (OR=0.44, 95% CI 0.23 to 0.85) significantly decreased the likelihood of alcohol consumption, whereas maternal behaviour and attitude were not significant influences. Among girls, having a non-drinking father who was against underage drinking (OR=0.52, 95% CI 0.30 to 0.91) or a non-drinking father who was favourable towards underage drinking (OR=0.51, 95% CI 0.32 to 0.83) significantly decreased the likelihood of alcohol consumption, as did having a non-drinking mother who was against underage drinking (OR=0.23, 95% CI 0.09 to 0.60).

Conclusions

The influences of fathers and mothers on the drinking behaviour of their adolescent children differed by offspring gender.
Clinical value of chest pain presentation and prodromes on the assessment of cardiovascular disease: a cohort study
Authors: Robson John , Ayerbe Luis , Mathur Rohini , Addo Juliet , Wragg Andrew
Published: April 2015

Objectives

The recognition of coronary artery disease (CAD) among patients who report chest pain remains difficult in primary care. This study investigates the association between chest pain (specified, unspecified or musculoskeletal) and prodromes (dyspepsia, fatigue or dyspnoea), with first-ever acute CAD, and increased longer term cardiovascular risk.

Design

Cohort study.

Setting

Anonymised clinical data recorded electronically by general practitioners from 140 primary care surgeries in London (UK) between April 2008 and April 2013.

Participants

Data were extracted for all patients aged 30 years and over at the beginning of the study period, registered in the surgeries.

Main outcome measures

Clinical data included chest pain, dyspepsia, dyspnoea and fatigue, first-ever CAD and long-term cardiovascular risk (QRisk2). Regression models were used to analyse the association between chest pain together with prodromes and CAD and QRisk2≥20%.

Results

354 052 patients were included in the study. 4842 patients had first-ever CAD of which 270 reported chest pain in the year before the acute event. 257 019 patients had QRisk2 estimations. Chest pain was associated with a higher risk of CAD. HRs: 21.12 (16.68 to 26.76), p<0.001; 7.51 (6.49 to 8.68), p<0.001; and 1.84 (1.14 to 3.00), p<0.001 for specified, unspecified and musculoskeletal chest pain. Dyspepsia, dyspnoea or fatigue was also associated with a higher risk of CAD. Chest pain of all subtypes, dyspepsia and dyspnoea were also associated with an increased 10-year cardiovascular risk of 20% or more.

Conclusions

All patients with chest pain, including those with atypical symptoms, require careful assessment for acute and longer term cardiovascular risk. Prodromes may have independent diagnostic value in the estimation of cardiovascular disease risk.
The investigation and management of metabolic myopathies
Authors: Olpin Simon Edward , Murphy Elaine , Kirk Richard James , Taylor Robert William , Quinlivan Rosaline
Published: April 2015

Metabolic myopathies (MM) are rare inherited primary muscle disorders that are mainly due to abnormalities of muscle energy metabolism resulting in skeletal muscle dysfunction. These diseases include disorders of fatty acid oxidation, glyco(geno)lytic muscle disorders and mitochondrial respiratory chain (MRC) disease. Clinically these disorders present with a range of symptoms including infantile hypotonia, myalgia/exercise tolerance, chronic or acute muscle weakness, cramps/spasms/stiffness or episodic acute rhabdomyolysis. The precipitant may be fasting, infection, general anaesthesia, heat/cold or most commonly, exercise. However, the differential diagnosis includes a wide range of both acquired and inherited conditions and these include exposure to drugs/toxins, inflammatory myopathies, dystrophies and channelopathies. Streamlining of existing diagnostic protocols has now become a realistic prospect given the availability of second-generation sequencing. A diagnostic pathway using a ‘rhabdomyolysis’ gene panel at an early stage of the diagnostic process is proposed. Following detailed clinical evaluation and first-line investigations, some patients will be identified as candidates for McArdle disease/glycogen storage disease type V or MRC disease and these will be referred directly to the specialised services. However, for the majority of patients, second-line investigation is best undertaken through next-generation sequencing using a ‘rhabdomyolysis’ gene panel. Following molecular analysis and careful evaluation of the findings, some patients will receive a clear diagnosis. Further functional or specific targeted testing may be required in other patients to evaluate the significance of uncertain/equivocal findings. For patients with no clear diagnosis, further investigations will be required through a specialist centre.
Analysis of biofilm formation by intestinal lactobacilli
Authors: Slížová Magdaléna , Nemcová Radomíra , Mad’ar Marián , Hadryová Jana , Gancarčíková Soňa , Popper Miroslav , Pistl Juraj
Published: April 2015

In this study, the biofilm-forming potential of intestinal Lactobacillus reuteri strains under different culture conditions was characterized by microtiter plate biofilm assays. Moreover, the spatial organization of exogenously applied L. reuteri L2/6 (a pig isolate) at specific locations in gastrointestinal tract of monoassociated mice was investigated by fluorescence in situ hybridization. We did not detect biofilm formation by tested strains in nutrient-rich de Man–Rogosa–Sharpe (MRS) medium. On the contrary, a highly positive biofilm formation was observed in medium with lower accessibility to the carbon sources and lack of salts. The results obtained confirmed the significant role of Tween 80 and the quantity and nature of the sugars in the growth medium in biofilm formation. The omission of Tween 80 in MRS medium favored the formation of biofilm. Abundant biofilm formation was detected in the presence of lactose, galactose, and glucose. However, a gradual increase in sugar concentration triggered a significant decrease in biofilm formation. In addition, conditions related to the gastrointestinal environment, such as low pH and the presence of bile and mucins, highly modulated biofilm production. This effect seems to be dependent on the specificity and properties of the medium used for cultivation. From the evidence provided by this study we conclude that the biofilm formation capacity of L. reuteri is strongly dependent on the environmental factors and culture medium used.
Determining the octant of θ23 at LBNE in conjunction with reactor experiments
Authors: Bora Kalpana , Dutta Debajyoti , Ghoshal Pomita
Published: April 2015

We have explored the possibility of resolving the θ23 octant degeneracy present in the newly planned Long-Baseline Neutrino Experiment (LBNE) by combining reactor experiments. Reactor experiments have already measured the third mixing angle θ13 very precisely and this precise measurement of θ13 in turn helps in determining the octant of θ23. We have examined the octant sensitivity with and without data from reactors. Octant sensitivity increases if reactors are added. The comparative study of octant sensitivities of 10 kt and 35 kt liquid argon far detector (FD), with and without the near detector (ND), reveals that the sensitivity increases with an increase in detector mass. Also, the presence of the ND improves the sensitivity. The effect of adding prior on octant determination is also studied in this work.
Planar waveguides in Yb3+-doped tellurite glasses fabricated by ion implantation of oxygen
Authors: Liu Chun-Xiao , Xu Jun , Zhou Zhi-Guang , Fu Li-Li , Zheng Rui-Lin , Li Wei-Nan , Guo Hai-Tao , Lin She-Bao , Wei Wei
Published: April 2015

A planar waveguide is demonstrated in the Yb 3+-doped tellurite glass, using (5+6) MeV O 3+ ion implantation with doses of (4+8)×1014 ions/cm2. The implantation process of O 3+ ions into the Yb 3+-doped tellurite glass is simulated by the stopping and range of ions in matter (SRIM) 2010 code. The dark-mode spectra are measured by the prism-coupling system at λ = 632.8 nm. The reflectivity calculation method and the finite-difference beam propagation method are used to calculate the refractive index profile and the modal profile of transverse electric (TE) mode of the fabricated waveguide, respectively. The absorption spectra show that the transmission properties are not affected by the waveguide fabrication process.
Fractional Cauchy Problem with Caputo Nabla Derivative on Time Scales
Authors: Zhu Jiang , Wu Ling
Published: April 2015

The definition of Caputo fractional derivative is given and some of its properties are discussed in detail. After then, the existence of the solution and the dependency of the solution upon the initial value for Cauchy type problem with fractional Caputo nabla derivative are studied. Also the explicit solutions to homogeneous equations and nonhomogeneous equations are derived by using Laplace transform method.
Technoeconomical Assessment of Optimum Design for Photovoltaic Water Pumping System for Rural Area in Oman
Authors: Kazem Hussein A. , Al-Waeli Ali H. A. , Al-Kabi Atma H. K. , Al-Mamari Asma
Published: April 2015

Photovoltaic (PV) systems have been used globally for a long time to supply electricity for water pumping system for irrigation. System cost drops down with time since PV technology, efficiency, and design methodology have been improved and cost of wattage drops dramatically in the last decade. In the present paper optimum PV system design for water pumping system has been proposed for Oman. Intuitive and numerical methods were used to design the system. HOMER software as a numerical method was used to design the system to come up with optimum design for Oman. Also, REPS.OM software has been used to find the optimum design based on hourly meteorological data. The daily solar energy in Sohar was found to be 6.182 kWh/m2·day. However, it is found that the system annual yield factor is 2024.66 kWh/kWp. Furthermore, the capacity factor was found to be 23.05%, which is promising. The cost of energy and system capital cost has been compared with that of diesel generator and systems in literature. The comparison shows that the cost of energy is 0.180, 0.309, and 0.790 USD/kWh for PV-REPS.OM, PV-HOMER, and diesel systems, respectively, which sound that PV water pumping systems are promising in Oman.
The Chemical Constituents and Pharmacological Actions ofCordyceps sinensis
Authors: Liu Yi , Wang Jihui , Wang Wei , Zhang Hanyue , Zhang Xuelan , Han Chunchao
Published: April 2015

Cordyceps sinensis, also called DongChongXiaCao (winter worm, summer grass) in Chinese, is becoming increasingly popular and important in the public and scientific communities. This study summarizes the chemical constituents and their corresponding pharmacological actions ofCordyceps sinensis. Many bioactive components ofCordyceps sinensishave been extracted including nucleoside, polysaccharide, sterol, protein, amino acid, and polypeptide. In addition, these constituents’ corresponding pharmacological actions were also shown in the study such as anti-inflammatory, antioxidant, antitumour, antiapoptosis, and immunomodulatory actions. Therefore can use different effects ofC. sinensisagainst different diseases and provide reference for the study ofCordyceps sinensisin the future.
Copeptin Testing in Acute Myocardial Infarction: Ready for Routine Use?
Authors: Reinstadler Sebastian Johannes , Klug Gert , Feistritzer Hans-Josef , Metzler Bernhard , Mair Johannes
Published: April 2015

Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.
Biomarkers of Hemodynamic Stress and Aortic Stiffness after STEMI: A Cross-Sectional Analysis
Authors: Reinstadler Sebastian Johannes , Feistritzer Hans-Josef , Klug Gert , Mayr Agnes , Huybrechts Luc , Hammerer-Lercher Angelika , Mair Johannes , Franz Wolfgang-Michael , Metzler Bernhard
Published: April 2015

Aim. Increased aortic stiffness might adversely affect cardiac structure, function, and perfusion. Release of biomarkers of hemodynamic stress is thought to be enhanced by these alterations. We aimed to evaluate the association between biomarkers of hemodynamic stress and aortic stiffness assessed at a chronic stage after ST-segment elevation myocardial infarction (STEMI).Methods. Fifty-four patients four months after STEMI were enrolled in this cross-sectional, single-center study. N-terminal pro–B-type natriuretic peptide (NT-proBNP), mid-regional pro–A-type natriuretic peptide (MR-proANP), and mid-regional proadrenomedullin (MR-proADM) levels were measured by established assays. Aortic stiffness was assessed by the measurement of pulse wave velocity using phase-contrast cardiovascular magnetic resonance.Results. NT-proBNP, MR-proANP, and MR-proADM concentrations were all correlated with aortic stiffness in univariate analysis (r=0.378,r=0.425, andr=0.532; allP<0.005, resp.). In multiple linear regression analysis, NT-proBNP (β=0.316,P=0.005) and MR-proADM (β=0.284,P<0.020) levels were associated with increased aortic stiffness independently of age, blood pressure, and renal function. NT-proBNP was the strongest predictor for high aortic stiffness (area under the curve: 0.82, 95% CI 0.67–0.96).Conclusion. At a chronic stage after STEMI, concentrations of biomarkers for hemodynamic stress, especially NT-proBNP, are positively correlated with aortic stiffness. These biomarkers might also be useful as predictors of high aortic stiffness after STEMI.
What Augmented Physical Activity and Empowerment Can Bring to Patients Receiving Total Knee Replacement: Content, Implementation, and Comparative Effectiveness of a New Function-Tailored Care Pathway in a Routine Care Setting
Authors: van der Sluis G. , Goldbohm R. A. , Bimmel R. , Galindo Garre F. , Elings J. , Hoogeboom T. J. , van Meeteren N. L. U.
Published: April 2015

Background. In the routine setting of the 20-bed orthopaedic ward of a regional hospital in Netherlands, we developed, implemented, and evaluated a new, function-tailored perioperative care pathway for patients receiving total knee replacement (TKR), aimed at faster functional recovery by reduction of inactivity and stimulation of self-efficacy of the patients.Methods. To assess effectiveness, we compared, using prospectively collected data from medical files, patient groups beforen=127and aftern=108introduction of the new care pathway with respect to time to recovery of physical functioning during hospitalisation (five milestones), length of hospital stay (LoS), referrals to an inpatient rehabilitation facility, and readmissions. Multivariable regression was used to adjust results for differences between the two groups in preoperatively assessed risk factors for delayed recovery.Results. Comparison of patient groups beforen=127and aftern=108introduction of the tailored care pathway showed that the tailored rehabilitation pathway decreased the time to recovery of physical functioning (from 4.5 to 4.1 days,P<0.05), the mean LoS (from 5.2 days to 4.2 days,P<0.01).Conclusion. We demonstrated that the introduction of a function-tailored care pathway shortens the hospital stay and accelerates the recovery of physical functioning.
Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience
Authors: Winters Brian R. , Mann Gary N. , Louie Otway , Wright Jonathan L.
Published: April 2015

Total pelvic exenteration is a highly morbid procedure performed for locally advanced pelvic malignancies. We describe our experience with three patients who underwent robotic total pelvic exenteration with laparoscopic rectus flap and compare perioperative characteristics to our open experience. Demographic, tumor, operative, and perioperative factors were examined with descriptive statistics reported. Mean operative times were similar between the two groups. When compared to open total pelvic exenteration cases(n=9), median estimated blood loss, ICU stay, and hospital stay were all decreased. These data show robotic pelvic exenteration with laparoscopic rectus flap is technically feasible. The surgery was well tolerated with low blood loss and comparable operative times to the open surgery. Further study is needed to confirm the oncologic efficacy and the suggested improvement in surgical morbidity.
Ministério Público e políticas de saúde: implicações de sua atuação resolutiva e demandista
Authors: Oliveira Luciano Moreira de , Andrade Eli Iola Gurgel de , Milagres Marcelo De Oliveira
Published: April 2015

Neste artigo, são analisadas as possibilidades de contribuição do Ministério Público em favor da efetividade do direito à saúde conforme o uso dos instrumentos de atuação judicial e extrajudicial. Levaram-se em conta as características das políticas de saúde brasileiras e os arranjos institucionais do SUS para examinar os efeitos das diferentes estratégias que vêm sendo utilizadas pelo órgão no desempenho de suas atribuições. Buscou-se, ainda, identificar as características da atuação do Ministério Público de Minas Gerais. Desenvolveu-se estudo interdisciplinar, partindo de revisão da literatura por meio de pesquisas às bases SciELO, Bireme e Capes e consulta a obras de referência. Para identificar a forma de atuação do Ministério Público de Minas Gerais, foram pesquisados os atos normativos da instituição que trataram sobre defesa da saúde publicados na imprensa oficial até 31/12/2012. Também foram examinados dados sobre procedimentos registrados entre 01/01/2008 e 31/12/2012. Constatou-se que a atuação extrajudicial do Ministério Público mostra-se mais adequada do que a judicial para lidar com a complexidade do direito à saúde e das políticas de saúde no Brasil. Identificou-se que o Ministério Público de Minas Gerais prioriza instrumentos de atuação extrajudicial e tem a judicialização como medida de exceção.
Definição terminológica: da teoria à prática
Authors: Alves Ieda Maria
Published: April 2015

Apresentamos, neste trabalho, alguns problemas relativos à elaboração de definições por compreensão em uma língua de especialidade, a Inteligência Artificial. Assim, concluímos que, entre a teoria exposta nas normas terminológicas e o trabalho prático, algumas adequações tornam-se necessárias, em função de uma comunicação mais eficaz e do caráter específico de cada língua de especialidade.