bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic Signatures of Bacterial Vaginosis
Authors: Srinivasan Sujatha , Morgan Martin T. , Fiedler Tina L. , Djukovic Danijel , Hoffman Noah G. , Raftery Daniel , Marrazzo Jeanne M. , Fredricks David N.
Published: April 2015

Bacterial vaginosis (BV) is characterized by shifts in the vaginal microbiota from
Lactobacillus
dominant to a microbiota with diverse anaerobic bacteria. Few studies have linked specific metabolites with bacteria found in the human vagina. Here, we report dramatic differences in metabolite compositions and concentrations associated with BV using a global metabolomics approach. We further validated important metabolites using samples from a second cohort of women and a different platform to measure metabolites. In the primary study, we compared metabolite profiles in cervicovaginal lavage fluid from 40 women with BV and 20 women without BV. Vaginal bacterial representation was determined using broad-range PCR with pyrosequencing and concentrations of bacteria by quantitative PCR. We detected 279 named biochemicals; levels of 62% of metabolites were significantly different in women with BV. Unsupervised clustering of metabolites separated women with and without BV. Women with BV have metabolite profiles marked by lower concentrations of amino acids and dipeptides, concomitant with higher levels of amino acid catabolites and polyamines. Higher levels of the signaling eicosanoid 12-hydroxyeicosatetraenoic acid (12-HETE), a biomarker for inflammation, were noted in BV.
Lactobacillus crispatus
and
Lactobacillus jensenii
exhibited similar metabolite correlation patterns, which were distinct from correlation patterns exhibited by BV-associated bacteria. Several metabolites were significantly associated with clinical signs and symptoms (Amsel criteria) used to diagnose BV, and no metabolite was associated with all four clinical criteria. BV has strong metabolic signatures across multiple metabolic pathways, and these signatures are associated with the presence and concentrations of particular bacteria.

IMPORTANCE
Bacterial vaginosis (BV) is a common but highly enigmatic condition that is associated with adverse outcomes for women and their neonates. Small molecule metabolites in the vagina may influence host physiology, affect microbial community composition, and impact risk of adverse health outcomes, but few studies have comprehensively studied the metabolomics profile of BV. Here, we used mass spectrometry to link specific metabolites with particular bacteria detected in the human vagina by PCR. BV was associated with strong metabolic signatures across multiple pathways affecting amino acid, carbohydrate, and lipid metabolism, highlighting the profound metabolic changes in BV. These signatures were associated with the presence and concentrations of particular vaginal bacteria, including some bacteria yet to be cultivated, thereby providing clues as to the microbial origin of many metabolites. Insights from this study provide opportunities for developing new diagnostic markers of BV and novel approaches for treatment or prevention of BV.
Insights into Hydrocarbon Formation by Nitrogenase Cofactor Homologs
Authors: Lee Chi Chung , Hu Yilin , Ribbe Markus W.
Published: April 2015

The L-cluster is an all-iron homolog of nitrogenase cofactors. Driven by europium(II) diethylenetriaminepentaacetate [Eu(II)-DTPA], the isolated L-cluster is capable of ATP-independent reduction of CO and CN
−
to C
1
to C
4
and C
1
to C
6
hydrocarbons, respectively. Compared to its cofactor homologs, the L-cluster generates considerably more CH
4
from the reduction of CO and CN
−
, which could be explained by the presence of a “free” Fe atom that is “unmasked” by homocitrate as an additional site for methanation. Moreover, the elevated CH
4
formation is accompanied by a decrease in the amount of longer hydrocarbons and/or the lengths of the hydrocarbon products, illustrating a competition between CH
4
formation/release and C−C coupling/chain extension. These observations suggest the possibility of designing simpler synthetic clusters for hydrocarbon formation while establishing the L-cluster as a platform for mechanistic investigations of CO and CN
−
reduction without complications originating from the heterometal and homocitrate components.

IMPORTANCE
Nitrogenase is a metalloenzyme that is highly complex in structure and uniquely versatile in function. It catalyzes two reactions that parallel two important industrial processes: the reduction of nitrogen to ammonia, which parallels the Haber-Bosch process in ammonia production, and the reduction of carbon monoxide to hydrocarbons, which parallels the Fischer-Tropsch process in fuel production. Thus, the significance of nitrogenase can be appreciated from the perspective of the useful products it generates: (i) ammonia, the “fixed” nitrogen that is essential for the existence of the entire human population; and (ii) hydrocarbons, the “recycled” carbon fuel that could be used to directly address the worldwide energy shortage. This article provides initial insights into the catalytic characteristics of various nitrogenase cofactors in hydrocarbon formation. The reported assay system provides a useful tool for mechanistic investigations of this reaction while suggesting the possibility of designing bioinspired catalysts based on nitrogenase cofactors.
Phylogenomic Analysis and Predicted Physiological Role of the Proton-Translocating NADH:Quinone Oxidoreductase (Complex I) Across Bacteria
Authors: Spero Melanie A. , Aylward Frank O. , Currie Cameron R. , Donohue Timothy J.
Published: April 2015

The proton-translocating NADH:quinone oxidoreductase (complex I) is a multisubunit integral membrane enzyme found in the respiratory chains of both bacteria and eukaryotic organelles. Although much research has focused on the enzyme's central role in the mitochondrial respiratory chain, comparatively little is known about its role in the diverse energetic lifestyles of different bacteria. Here, we used a phylogenomic approach to better understand the distribution of complex I across bacteria, the evolution of this enzyme, and its potential roles in shaping the physiology of different bacterial groups. By surveying 970 representative bacterial genomes, we predict complex I to be present in ~50% of bacteria. While this includes bacteria with a wide range of energetic schemes, the presence of complex I is associated with specific lifestyles, including aerobic respiration and specific types of phototrophy (bacteria with only a type II reaction center). A phylogeny of bacterial complex I revealed five main clades of enzymes whose evolution is largely congruent with the evolution of the bacterial groups that encode complex I. A notable exception includes the gammaproteobacteria, whose members encode one of two distantly related complex I enzymes predicted to participate in different types of respiratory chains (aerobic versus anaerobic). Comparative genomic analyses suggest a broad role for complex I in reoxidizing NADH produced from various catabolic reactions, including the tricarboxylic acid (TCA) cycle and fatty acid beta-oxidation. Together, these findings suggest diverse roles for complex I across bacteria and highlight the importance of this enzyme in shaping diverse physiologies across the bacterial domain.

IMPORTANCELiving systems use conserved energy currencies, including a proton motive force (PMF), NADH, and ATP. The respiratory chain enzyme, complex I, connects these energy currencies by using NADH produced during nutrient breakdown to generate a PMF, which is subsequently used for ATP synthesis. Our goal is to better understand the role of complex I in bacteria, whose energetic diversity allows us to view its function in a range of biological contexts. We analyzed sequenced bacterial genomes to predict the presence, evolution, and function of complex I in bacteria. We identified five main classes of bacterial complex I and predict that different classes participate in different types of respiratory chains (aerobic and anaerobic). We also predict that complex I helps maintain a cellular redox state by reoxidizing NADH produced from central metabolism. Our findings suggest diverse roles for complex I in bacterial physiology, highlighting the need for future laboratory-based studies.
Molecular Mechanism of Flocculation Self-Recognition in Yeast and Its Role in Mating and Survival
Authors: Goossens Katty V. Y. , Ielasi Francesco S. , Nookaew Intawat , Stals Ingeborg , Alonso-Sarduy Livan , Daenen Luk , Van Mulders Sebastiaan E. , Stassen Catherine , van Eijsden Rudy G. E. , Siewers Verena , Delvaux Freddy R. , Kasas Sandor , Nielsen Jens , Devreese Bart , Willaert Ronnie G.
Published: April 2015

We studied the flocculation mechanism at the molecular level by determining the atomic structures of N-Flo1p and N-Lg-Flo1p in complex with their ligands. We show that they have similar ligand binding mechanisms but distinct carbohydrate specificities and affinities, which are determined by the compactness of the binding site. We characterized the glycans of Flo1p and their role in this binding process and demonstrate that glycan-glycan interactions significantly contribute to the cell-cell adhesion mechanism. Therefore, the extended flocculation mechanism is based on the self-interaction of Flo proteins and this interaction is established in two stages, involving both glycan-glycan and protein-glycan interactions. The crucial role of calcium in both types of interaction was demonstrated: Ca
2+
takes part in the binding of the carbohydrate to the protein, and the glycans aggregate only in the presence of Ca
2+
. These results unify the generally accepted lectin hypothesis with the historically first-proposed “Ca
2+
-bridge” hypothesis. Additionally, a new role of cell flocculation is demonstrated; i.e., flocculation is linked to cell conjugation and mating, and survival chances consequently increase significantly by spore formation and by introduction of genetic variability. The role of Flo1p in mating was demonstrated by showing that mating efficiency is increased when cells flocculate and by differential transcriptome analysis of flocculating versus nonflocculating cells in a low-shear environment (microgravity). The results show that a multicellular clump (floc) provides a uniquely organized multicellular ultrastructure that provides a suitable microenvironment to induce and perform cell conjugation and mating.

IMPORTANCE
Yeast cells can form multicellular clumps under adverse growth conditions that protect cells from harsh environmental stresses. The floc formation is based on the self-interaction of Flo proteins via an N-terminal PA14 lectin domain. We have focused on the flocculation mechanism and its role. We found that carbohydrate specificity and affinity are determined by the accessibility of the binding site of the Flo proteins where the external loops in the ligand-binding domains are involved in glycan recognition specificity. We demonstrated that, in addition to the Flo lectin-glycan interaction, glycan-glycan interactions also contribute significantly to cell-cell recognition and interaction. Additionally, we show that flocculation provides a uniquely organized multicellular ultrastructure that is suitable to induce and accomplish cell mating. Therefore, flocculation is an important mechanism to enhance long-term yeast survival.
Rebleeding of a neck remnant in a case of ruptured aneurysm initially treated with coils
Authors: Benaissa Azzedine , Pierot Laurent
Published: April 2015

The follow-up and indications for retreatment of intracranial aneurysms treated endovascularly are still a matter of debate. We report the case of a patient with a ruptured aneurysm who was treated twice with coils and regularly followed up with MRI/MR angiography which showed a neck remnant that finally rebled.
Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams
Authors: McCall Alan , Davison Michael , Andersen Thor Einar , Beasley Ian , Bizzini Mario , Dupont Gregory , Duffield Rob , Carling Chris , Dvorak Jiri
Published: April 2015

Purpose

The available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams.

Methods

A survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup.

Results

Following responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric.

Conclusions

The present study showed that many of the National football (soccer) teams’ injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices.
Usefulness of natriuretic peptide for the diagnosis of Kawasaki disease: a systematic review and meta-analysis
Authors: Lin Kuan-Ho , Chang Shy-Shin , Yu Chin-Wei , Lin Shen-Che , Liu Shu-Chun , Chao Hsiao-yun , Lee Meng-tse Gabriel , Wu Jiunn-Yih , Lee Chien-Chang
Published: April 2015

Objective

To examine the diagnostic value of serum B-type natriuretic peptide (BNP) in acute Kawasaki disease (KD).

Design

Systematic review and meta-analysis.

Data sources

A systematic literature search strategy was designed and carried out using MEDLINE, EMBASE and the Cochrane Library from inception to December 2013. We also performed manual screening of the bibliographies of primary studies and review articles, and contacted authors for additional data.

Study eligibility criteria

We included all BNP and NT-pro (N-terminal prohormone) BNP assay studies that compared paediatric patients with KD to patients with febrile illness unrelated to KD. We excluded case reports, case series, review articles, editorials, congress abstracts, clinical guidelines and all studies that compared healthy controls.

Primary and secondary outcome measures

The performance characteristics of BNP were summarised using forest plots, hierarchical summary receiver operating characteristic (ROC) curves and bivariate random effects models.

Results

We found six eligible studies including 279 cases of patients with KD and 203 febrile controls. Six studies examined NT-proBNP and one examined BNP. In general, NT-proBNP is a specific and moderately sensitive test for identifying KD. The pooled sensitivity was 0.89 (95% CI 0.78 to 0.95) and the pooled specificity was 0.72 (95% CI 0.58 to 0.82). The area under the summary ROC curve was 0.87 (95% CI 0.83 to 0.89). The positive likelihood ratio (LR+ 3.20, 95% CI 2.10 to 4.80) was sufficiently high to be qualified as a rule-in diagnostic tool in the context of high pre-test probability and compatible clinical symptoms. A high degree of heterogeneity was found using the Cochran Q statistic.

Conclusions

Current evidence suggests that NT-proBNP may be used as a diagnostic tool for KD. NT-proBNP has high diagnostic value for identifying KD in patients with protracted undifferentiated febrile illness. Prospective large cohort studies are needed to help determine best cut-off values and further clarify the role of NT-proBNP in the diagnosis process of KD.
Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study
Authors: Wang Hao , Robinson Richard D , Cowden Chad D , Gorman Violet A , Cook Christopher D , Gicheru Eugene K , Schrader Chet D , Jayswal Rani D , Zenarosa Nestor R
Published: April 2015

Objectives

To derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes.

Design

Prospective pilot study.

Setting

Single centre study in the USA.

Participants

3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis.

Primary and secondary outcome measures

A crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding.

Results

Four independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97).

Conclusions

The overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes.
Familial transmission of chronic obstructive pulmonary disease in adoptees: a Swedish nationwide family study
Authors: Zöller Bengt , Li Xinjun , Sundquist Jan , Sundquist Kristina
Published: April 2015

Objectives

Familial clustering of chronic obstructive pulmonary disease (COPD) is well established, but the familial risk of COPD has not been determined among adoptees. The aim was to determine whether the familial transmission of COPD is related to disease in biological and/or adoptive parents.

Design

Historic cohort study.

Participants

80 214 (50% females).

Methods

The Swedish Multi-Generation Register was used to follow all Swedish-born adoptees born in 1932–2004 (n=80 214) between 1 January 1964 and 31 December 2010 for COPD (n=1978). The risk of COPD was estimated in adoptees with at least one biological parent with COPD but no adoptive parent with COPD (n=162) compared with adoptees without a biological or adoptive parent with COPD. The risk of COPD was also determined in adoptees with at least one adoptive parent but no biological parent with COPD (n=110), and in adoptees with both affected biological and adoptive parents (n=162).

Primary outcome measure

COPD in adoptees.

Results

Adoptees with COPD in at least one biological parent but no adoptive parent were more likely to have COPD than adoptees without a biological or adoptive parent with COPD (standardised incidence ratio, SIR=1.98 (95% CI 1.69 to 2.31)). The familial SIR for adoptees with both a biological parent and an adoptive parent with COPD was 1.68 (95% CI 1.39 to 2.00). Adoptees with at least one adoptive parent with COPD but no biological parent with COPD were not at an increased risk of COPD (SIR=1.12 (95% CI 0.92 to 1.35)).

Conclusions

The findings of the study show that the familial transmission of COPD is associated with COPD in biological but not adoptive parents, suggesting that genetic or early life factors are important in the familial transmission of COPD.
001 KP: THE CURIOUS INCIDENT OF THE QUALITATIVE RESEARCHER IN APPLIED HEALTH RESEARCH
Authors: Shaw S
Published: April 2015

Qualitative research is widely used as a means of understanding and analysing a range of health and care issues. Qualitative researchers are a diverse group who use interpretive approaches to make the world visible (for instance, through case study, interviewing or participant observation). This makes them well-placed to study health care and to apply findings in practice and yet few describe themselves as doing ‘applied health research’. This raises the question as to whether applied qualitative health research is alive and kicking or whether, like the dog in the opening paragraph of Mark Haddon's booka, it's lying on its side with its eyes closed and seemingly dead? In seeking to answer that question, this paper focuses on current challenges facing qualitative researchers working in applied settings.

There is a vibrant community of qualitative researchers who are doing applied health research and who aspire to make a difference to people's lives. High quality research is being undertaken that should not only make a difference but also raise the profile of qualitative health research. However, involvement in applied health research often involves compromises about the ways in which we work. It tends to involve multidisciplinary teams working together for short periods of time on specific problems in the real world, and it often requires researchers to work across disciplines and teams, proactively manage relationships, combine research methodologies and reconsider theoretical or epistemological concerns. Those working in applied health research need to take care not to give up some of the important elements of qualitative research to the methodological hierarchy that mixed-methods designs sometimes presume in which quantitative methods are at the top and qualitative methods are relegated to a largely auxiliary role. They must ensure that methodological and disciplinary differences are confronted and addressed, rather than one subsuming or dominating the other. And they must ensure that theoretically-oriented work features strongly in applied health research: infusing research design, underpinning methodology and informing how data are analysed and interpreted.

Considerable progress has already been made in each of these areas. However, more could be done to ensure that when we do qualitative research we do it to the highest quality and are then confident in the value of our work. In doing so, we can then ensure that applied research is alive and kicking and with us for a long time to come.

aThe Curious Incident of the Dog in the Night-Time, written by Mark Haddon and published by Vintage in 2004.
002 PP: TOWARDS AN ANTHROPOLOGY OF CARE: CANCER CARE PRACTICES IN THE EVERYDAY
Authors: Arteaga Pérez MI
Published: April 2015

A patient affected by cancer is never alone with his/her disease; his/her social surroundings shape and are shaped by the daily practices aiming to manage the disease and its treatments. According to Macmillan Cancer Support reporta, informal caregivers of colorectal cancer patients tend to provide more hours per week of care than those supporting patients affected by other types of cancer (40% of them give at least 20 hours of care versus 25% of all carers). Such care usually requires performing multiple tasks, from emotional support, practical work to advocacy.

Psychosocial studies in oncology have successfully attended to the repercussions of cancer and cancer care in the family unit, emphasising the impact of such experiences and transactions for the mental and physical health of family members. In this abstract, I would like to contribute to that research by explaining how an anthropology of care can shed further light on these dynamics, unfolding the practical, cognitive and emotional aspects of care in the everyday contexts of people affected by cancer.

My argument is that an anthropology of care would illuminate: (1) the generation of embodied knowledge, emotion work and practical tinkering of caregiving practices by which requirements, side effects and consequences of colorectal cancer treatments are addressed, (2) the ways in which patients and their significant others negotiate the temporalities of treatments and the collective identities as supporters and patients during the day to day life, and (3) the ways in which social-cultural and political and economic arrangements shape people's experiences of cancer treatments.

aMore than a million: Understanding the UK's carers of people with cancer—a report by Ipsos Mori for Macmillan Cancer Support.
006 PP: LISTENING TO PARENTS: MIX-METHODS EVALUATION OF THE KEY WORKER ROLE
Authors: Martins A , Aldiss S , Taylor R , Gibson F
Published: April 2015

Understanding how interventions work in the real world of practice has motivated the use of qualitative methods in evaluation of interventions in health care.aA complex intervention may operate differently in practice from the original intention and qualitative research can address how an intervention is used in practice while quantitative research is used to measure outcomes.bThis paper describes the practical application of a mix-methods approach in the evaluation of a nurse specialist key worker role in children's cancer care across the UK with reference to parents' views of the role. Using this study as example, methodological issues are explored about the use of the interview/questionnaire approach in the evaluation, as well as a brief consideration of combining methods.

The nurse specialist key worker role was funded in eighteen Principal Treatment Centres across Scotland, Wales and England. Ninety parents took part in the questionnaire and out of these 20 took part in an individual semi-structured interview.

The information from the questionnaires helped identify the family's needs and the support received; it did not show, however, how contextual constraints and families' individual needs helped shape the way the key worker role was developed and the impact it had on families. The interviews allowed the researcher to pick up on these issues. In particular, the interviews expanded the breadth of understanding on how the key worker supported the families, what activities occurred under what conditions, and who carried out the activities.

The depth of the analysis and understanding of the impact of the key worker role was only achieved by the combination of methods used. The questionnaire allowed the evaluation of the role in specific outcomes and the interviews helped us identify and understand the influencing factors/conditions needed to achieve the outcomes.

aO'Cathain A, Murphy E, Nicholl, J. Why, and how, mixed methods research is undertaken in health services research in England: a mixed methods study.BMC Health Services Research2007;7:85.

bParry-Langdon, N., Bloor, M., Audrey, S.,et al. Process evaluation of health promotion interventions.Policy & Politics2003;31:207–16.
010 PP: EXPLORING THE IMPACT OF A CANCER AWARENESS TRAINING PROGRAMME: A QUALITATIVE STUDY OF COMMUNITY-BASED HEALTH STAFF AND VOLUNTEERS
Authors: Osborne K , Power E
Published: April 2015

Background

Cancer Research UK's cancer awareness training programme, Talk Cancer, aims to equip and empower frontline healthcare staff and volunteers to raise awareness of cancer and promote health behaviour change in their community. Each workshop aims to increase knowledge of cancer prevention, screening and early diagnosis and improve confidence communicating with the public about these areas. This study evaluated the impact of workshops conducted across England between April 2013 and March 2014.

Methods

Fourteen in-depth qualitative telephone interviews were conducted with attendees approximately four months after training. Interview transcripts were thematically analysed and themes independently verified by two researchers.

Findings

After training, attendees reported increased awareness of the importance of early diagnosis and the link between lifestyle behaviours and cancer risk. They reported feeling more open towards cancer and that cancer had become a legitimate topic of conversation. They reported feeling more confident to have conversations about cancer and, for some, this was related to feeling more credible. As a result, attendees felt more able to manage and initiate conversations about cancer. Specifically, many attendees had promoted the importance of early diagnosis and encouraged people to seek help with an unusual or persistent change to their body. Some attendees also said they had visited the GP and made healthy lifestyle changes themselves.

Conclusions

Talk Cancer training increased attendees' cancer awareness, openness towards cancer and confidence in having cancer-related conversations. In particular, attendees became advocates for prompt help-seeking after learning about the importance of early diagnosis. Furthermore, reports of attendees making changes to their own behaviour suggest the training may benefit attendees as well as their communities.
012 PP: GOING BENEATH THE SURFACE IN A LONGITUDINAL QUALITATIVE NARRATIVE STUDY WITH YOUNG ADULTS WITH CANCER
Authors: Pearce S
Published: April 2015

The impact of cancer on young people superimposed on the developmental processes toward adulthood is recognised (NICE 2005). Despite this there has been limited in-depth research to understand the experiences of young adults with cancer.

This study aimed to explore the issues that contribute to the impact of cancer, on young adults' evolving sense of self and identity, by listening to the stories of young adults over one year from the time of diagnosis.

This longitudinal narrative study was grounded in Ricoeur's (1984) notion of narratives as stories of experience. 18 young adults (16 to 30 years of age) took part in the study. Eight of the participants took part in three interviews over a year, 6 participants in two interviews. Data included conversational style interviews using free association; reflection of images taken; and detailed reflexive notes. Regular psychotherapeutic debriefing and an ongoing psychosocial research seminar group at the Tavistock Clinic created the space for reflection and awareness. Data were analysed longitudinally across individual cases; an integrated data framework from all the data was then developed.

One participant is used to illustrate the interplay between the psyche and the social, the internal and external worlds in the year from diagnosis to the end of life. This also illustrates the framework across all the data involving the renegotiation of self over time, expressed in narrative, through the core components of: the inner world, (psyche, emotion and coping); self as embodied; self as relating others, and self as relating to place.

This study demonstrates the value of storytelling over time for making sense, for patient centred practice and getting beneath the surface of experience. The importance of exploring both the ‘said’ and ‘unsaid’; the challenge of ‘being with’ and ‘standing alongside’; and the nature of psychosocial reflexivity all have important implications for empathic and compassionate care .
013 PP: AN ‘ENRICHED LANDSCAPE’ OF QUALITATIVE RESEARCH: DIFFERENT APPROACHES TO THREE PUBLIC HEALTH ISSUES
Authors: Romero D
Published: April 2015

Qualitative methods have much to contribute to public health research. Below are three public health projects that provide a sampling of empirical research for reflection on the varied use of qualitative methods.

Collaborative Community Health Assessment

St. Vincent's Hospital closed in 2010, resulting in loss of an ER, in-patient facilities, a trauma center, and outpatient clinics. There was great concern about potential gaps in health care. Romero et al worked with community partners, elected officials, health and social services providers, residents and others to collect data to assess the impact of the hospital closure, via focus groups, key-informant interviews and a community survey.

L-GEAR Project

US rates of adolescent pregnancy are high among industrialized countries. There is a dearth of qualitative data from adolescents regarding life experiences, educational and career goals, and how their parents' own experiences might influence teens' attitudes and sexual behaviors. We are conducting in-depth interviews (IDIs) with adolescent girls, boys and their parents about their current life circumstances and future goals, and how sexual and childbearing behaviors factor into their lives.

Welfare Policy Analysis

US welfare reform in the 1990s included state “child-exclusion” policies prohibiting additional cash assistance to families with a newborn. We conducted several studies to analyze the policy involving (1) IDIs of women subject to the policy; (2) review of effectiveness evaluations and content analysis vis-à-vis human rights treaties; (3) key-informant interviews with state welfare directors.

These three projects illustrate the wide range of qualitative research methods available to public health and other researchers, including in-depth and key-informant interviews, focus groups, and content analysis. It is clear that their combined use, including quantitative methods such as surveys, have much to offer to provide a deeper understanding of public health issues and related social programs and policies.
003 OP: CHALLENGES IN QUALITATIVE INQUIRY: JUDGEMENTS OF ‘ETHICS’ AND ‘QUALITY’
Authors: Stevenson F , Gibson W , Pelletier C , Park S , Chrysikou V
Published: April 2015

Background

UK-based research conducted within a healthcare setting generally requires approval from the National Research Ethics Service. Research ethics committees are required to assess a vast range of proposals, differing in both topic and methodology. We argue the methodological benchmarks with which research ethics committees are generally familiar and which form the basis of assessments of quality do not fit with the aims and objectives of many forms of qualitative enquiry and their more iterative goals of describing social processes/mechanisms and making visible the complexities of social practices.

Our research

Drawing on the challenges we encountered gaining ethical approval and subsequently conducting a study of junior doctors' decision-making in an Emergency department, we suggest there is an urgent need to re-think the ways that ethical issues are currently conceptualised. In particular, we argue that embedded in the current paradigm is a restricted notion of ‘quality’, which frames how ethics are developed and worked through. Specific, pre-defined outcome measures are generally seen as the traditional marker of quality, which means that research questions that focus on processes rather than on ‘outcomes’ may be regarded as problematic. We illustrate the importance of re-visiting the notion of ethics in healthcare research. Specifically, we consider the need for an alternative ‘iterative’ paradigm and outline how this offers a useful starting point for moving beyond these limited views.

Conclusions

A ‘one size fits all’ standardisation of ethical procedures and approach to ethical review acts against the production of knowledge about healthcare and dramatically restricts what can be known about the social practices and conditions of healthcare. Our central argument is that assessment of ethical implications is important, but that the current paradigm does not facilitate an adequate understanding of the very issues it aims to invigilate.
007 OP: THE USE OF MIXED METHODS IN ASSESSING WELLBEING BENEFITS DERIVED FROM A HERITAGE-IN-HEALTH INTERVENTION WITH HOSPITAL PATIENTS AND CARE HOME RESIDENTS
Authors: Chatterjee HJ , Thomson L
Published: April 2015

The role of non-clinical interventions in health and social care is attracting increased interest as the value of community based assets in public health gains support. For the last six years University College London researchers have explored the advantages of a mixed methods approach to assess the therapeutic benefits of museum-focused interventions in healthcare settings including hospital wards and care homes. Using a combination of qualitative grounded theory and thematic analysis together with quantitative measures has resulted in a robust appraisal of the potential of handling and discussing museum objects in terms of positive effects on cognitive stimulation, health and wellbeing. Measures consisting of the Positive and Negative Affect Schedule (PANAS) and Visual Analogue Scales (VAS) taken before and after object handling sessions of around 40 minutes showed increases in positive emotion and decreases in negative emotion with improvements in subjective wellbeing and happiness. Qualitative analysis of audio recordings from the sessions were used to account for how improvements in wellbeing were brought about and revealed that mutual exploration of the objects led to deeper thinking and meaning making, and acted as a distraction from the clinical environment. Interview data gathered from participants, carers, health and social care staff provided a more nuanced understanding of the impact of a non-clinical intervention and led to the development of best practice guidelines for those working in museums and health. The research, which is funded by the Arts and Humanities Research Council, has led to further funding to investigate the value of museum engagement in social prescribing. ‘Museums on Prescription’ will connect socially isolated, vulnerable and lonely older adults, referred through local NHS and Local Authority Adult Social Care services, to partner museums in Central London and Kent. A combination of qualitative and quantitative methods will be used for analysis of interview data and measures of wellbeing and social isolation taken before, during and after 10 weekly, two-hour, museum sessions, and at three and six month telephone follow-ups, to provide insights into non-clinical prescriptions and a psycho-social model of health rather than reliance upon a purely medical model.
008 OP: EXCURSUS ON THE IMMUNE SYSTEM: MELTING HISTORY, STORIES AND MICROBIOME DATA
Authors: Casal A Nunez
Published: April 2015

The microbiome seems to challenge the tenet of a self-contained human nature by recognising the role of microbes along with ecological and lifestyle factors in the shaping of the immune function. Those features, in turn, are specially valuable and timely for critical debates in the social sciences and humanities around notions of biological identity and embodiment as well as for evaluating post-genomics with regards to a molecular-based 20th century biology.

In an attempt to map cross-roads for traffic to and from biology, geopolitics and philosophy, this paper develops a critical cartography of the immune system, to which I refer to as ‘excursus on the immune system', by bringing together the two main elements that conform my research project:

▸ Empirical insights from Lady Montagu's journeys, who in 1718 imported the variolation technique from Turkey to the UK

▸ Ethnographic fieldwork of Dr. Dominguez-Bello's microbiome expedition in the Amazon (2011–2013) as part of the research ‘Microbiomes of Homes across Cultures'

I will particularly focus on how the historical analysis of Montagu's diaries and my field notes articulate with health data resulted from microbiome research. I will also discuss how I supplement the aforementioned methods to secondary research methods, which include attending scientific conferences as both data collection and research training, informal conversations and formal interviews, discourse analysis of media reports and specialised scientific literature on the microbiome, and a digital ethnography of ‘American Gut', a personalised microbiome project.

My preliminary results show that both the environment and microbes refigure immunity as a rather different object rendering notions of the self as bounded, universal and autonomous increasingly difficult to maintain. Moreover, the fact that the environment, not just genetics, produces differences among bodies, immunities and microbes highlights questions of (bio)inequalities as obligatory points of passage for contemporary social studies of science.
Using visual rating to diagnose dementia: a critical evaluation of MRI atrophy scales
Authors: Harper Lorna , Barkhof Frederik , Fox Nick C , Schott Jonathan M
Published: April 2015

Visual rating scales, developed to assess atrophy in patients with cognitive impairment, offer a cost-effective diagnostic tool that is ideally suited for implementation in clinical practice. By focusing attention on brain regions susceptible to change in dementia and enforcing structured reporting of these findings, visual rating can improve the sensitivity, reliability and diagnostic value of radiological image interpretation. Brain imaging is recommended in all current diagnostic guidelines relating to dementia, and recent guidelines have also recommended the application of medial temporal lobe atrophy rating. Despite these recommendations, and the ease with which rating scales can be applied, there is still relatively low uptake in routine clinical assessments. Careful consideration of atrophy rating scales is needed to verify their diagnostic potential and encourage uptake among clinicians. Determining the added value of combining scores from visual rating in different brain regions may also increase the diagnostic value of these tools.
Hyperhomocysteinemia: a missing link to dysfunctional HDL via paraoxanase-1
Authors: Givvimani Srikanth , Kundu Sourav , Pushpakumar Sathnur , Doyle Vivian , Narayanan Nithya , Winchester Lee J. , Veeranki Sudhakar , Metreveli Naira , Tyagi Suresh C.
Published: April 2015

Paraoxanase-1 (PON1) is an HDL-associated enzyme that contributes to the antioxidant and antiatherosclerotic properties of HDL. Lack of PON1 results in dysfunctional HDL. HHcy is a risk factor for cardiovascular disorders, and instigates vascular dysfunction and ECM remodeling. Although studies have reported HHcy during atherosclerosis, the exact mechanism is unclear. Here, we hypothesize that dysfunctional HDL due to lack of PON1 contributes to endothelial impairment and atherogenesis through HHcy-induced ECM re-modeling. To verify this hypothesis, we used C57BL6/J and PON1 knockout mice (KO) and fed them an atherogenic diet. The expression of Akt, ADMA, and DDAH, as well as endothelial gap junction proteins such as Cx-37 and Cx-40 and eNOS was measured for vascular dysfunction and inflammation. We observed that cardiac function was decreased and plasma Hcy levels were increased in PON1 KO mice fed the atherogenic diet compared with the controls. Expression of Akt, eNOS, DDAH, Cx-37, and Cx-40 was decreased, and the expression of MMP-9 and ADMA was increased in PON1 KO mice fed an atherogenic diet compared with the controls. Our results suggest that HHcy plays an intricate role in dysfunctional HDL, owing to the lack of PON1. This contributes to vascular endothelial impairment and atherosclerosis through MMP-9-induced vascular remodeling.
THE THREE-POINT SINUOSITY METHOD FOR CALCULATING THE FRACTAL DIMENSION OF MACHINED SURFACE PROFILE
Authors: ZHOU YUANKAI , LI YAN , ZHU HUA , ZUO XUE , YANG JIANHUA
Published: April 2015

The three-point sinuosity (TPS) method is proposed to calculate the fractal dimension of surface profile accurately. In this method, a new measure, TPS is defined to present the structural complexity of fractal curves, and has been proved to follow the power law. Thus, the fractal dimension can be calculated through the slope of the fitted line in the log–log plot. The Weierstrass–Mandelbrot (W–M) fractal curves, as well as the real surface profiles obtained by grinding, sand blasting and turning, are used to validate the effectiveness of the proposed method. The calculation values are compared to those obtained from root-mean-square (RMS) method, box-counting (BC) method and variation method. The results show that the TPS method has the widest scaling region, the least fit error and the highest accuracy among the methods examined, which demonstrates that the fractal characteristics of the fractal curves can be well revealed by the proposed method.
Buckling and Vibration Analysis of Cold-Formed Steel CHS Members and Frames Using Generalized Beam Theory
Authors: Basaglia Cilmar , Camotim Dinar , Silvestre Nuno
Published: April 2015

This paper reports the results of an investigation on the use of Generalized Beam Theory (GBT) to assess the buckling and vibration behaviors of thin-walled members and frames built from cold-formed steel circular hollow section (CHS) profiles. Initially, the concepts and procedures involved in performing GBT buckling and vibration analyses are presented, paying particular attention to the derivation of the mass tensors that account for the influence of the inertia forces. Then, the formulation, numerical implementation and validation of a GBT-based beam finite element for isolated members are described. Next, the determination of the frame linear stiffness, geometric stiffness and mass matrices, which incorporate the influence of the frame joints, is addressed. Finally, in order to illustrate the application and capabilities of the proposed GBT finite element formulation, numerical results are presented and discussed — they concern the buckling and vibration behaviors of an "L-shaped" frame. For validation purposes, most GBT-based results are compared with values yielded by shell finite element analyses carried out in the code ANSYS.
Designing the Visualization of Information
Authors: Engelbrecht Louis , Botha Adele , Alberts Ronell
Published: April 2015

The construction of an artifact to visually represent information is usually required by Information Visualization research projects. The end product of design science research is also an artifact and therefore it can be argued that design science research is an appropriate research paradigm for conducting Information Visualization research. Design science research requires that, during the Rigor Cycle, the design of the artifacts should be based on a scientific knowledge base. This article provides a knowledge base in the form of design guidelines that can guide the design of the view for an Information Visualization solution. The design principles and guidelines presented in this article are identified by means of a literature review.
Activation of Vitamin D Regulates Response of Human Bronchial Epithelial Cells to Aspergillus fumigatus in an Autocrine Fashion
Authors: Li Pei , Wu Ting , Su Xin , Shi Yi
Published: April 2015

Aspergillus fumigatus (A. fumigatus) is one of the most common fungi to cause diseases in humans. Recent evidence has demonstrated that airway epithelial cells play an important role in combating A. fumigatus through inflammatory responses. Human airway epithelial cells have been proven to synthesize the active vitamin D, which plays a key role in regulating inflammation. The present study was conducted to investigate the impact of A. fumigatus infection on the activation of vitamin D and the role of vitamin D activation in A. fumigatus‐elicited antifungal immunity in normal human airway epithelial cells. We found that A. fumigatus swollen conidia (SC) induced the expression of 1α‐hydroxylase, the enzyme catalyzing the synthesis of active vitamin D, and vitamin D receptor (VDR) in 16HBE cells and led to increased local generation of active vitamin D. Locally activated vitamin D amplified SC‐induced expression of antimicrobial peptides in 16HBE cells but attenuated SC‐induced production of cytokines in an autocrine fashion. Furthermore, we identified β‐glucan, the major A. fumigatus cell wall component, as the causative agent for upregulation of 1α‐hydroxylase and VDR in 16HBE cells. Therefore, activation of vitamin D is inducible and provides a bidirectional regulation of the responses to A. fumigatus in 16HBE cells.