bluuebunny/crossref_metadata_2025 huggingface dataset:
Positron emission tomography–CT prediction of occult nodal metastasis in recurrent laryngeal cancer
Authors: Rosko Andrew , Birkeland Andrew , Shuman Andrew , Prince Mark , Bradford Carol , Wolf Gregory , Worden Francis , Eisbruch Avraham , Srinivasan Ashok , Wong Ka Kit , Spector Matthew E.
Published: February 2017

Background

The purpose of this study was to evaluate the predictive value of positron emission tomography (PET)‐CT in identifying occult nodal metastasis in clinically and radiographically N0 patients with recurrent laryngeal cancer undergoing salvage laryngectomy.

Methods

Retrospective review of 46 clinically and radiographically N0 patients with recurrent laryngeal cancer who underwent a PET‐CT examination before salvage laryngectomy with neck dissection from January 1, 2002, to December 31, 2014, was performed.

Results

Two patients (16.7%) had true‐positive PET‐CT results, whereas 10 patients (83.3%) had false‐negative scans, 1 patient (2.9%) had a false‐positive result and 33 patients (97.1%) had a true‐negative PET‐CT. The sensitivity of PET‐CT was 16.7% (95% confidence interval [CI], 3.5% to 46.0%) with a specificity of 97.1% (95% CI, 83.8% to 99.9%), positive predictive value (PPV) of 66.7% (95% CI, 20.2% to 94.4%), and negative predictive value (NPV) of 76.7% (95% CI, 62.1% to 87.0%).

Conclusion

PET‐CT has poor sensitivity and NPV making PET‐CT an imperfect predictor of nodal disease in recurrent laryngeal cancer. © 2017 Wiley Periodicals, Inc. Head Neck 39: 980–987, 2017
Correlating the depth of invasion at specific anatomic locations with the risk for regional metastatic disease to lymph nodes in the neck for oral squamous cell carcinoma
Authors: Brockhoff Hans C. , Kim Roderick Y. , Braun Thomas M. , Skouteris Christos , Helman Joseph I. , Ward Brent B.
Published: February 2017

Background

The purpose of this study was to investigate the critical primary tumor depth of invasion in oral squamous cell carcinoma that would lead to a 20% or greater risk of nodal metastasis.

Methods

An institutional review board approved retrospective review of our head and neck database was performed from 2009 to 2014 and the data were statistically analyzed.

Results

Two hundred eighty‐six patients with a diagnosis of oral squamous cell carcinoma who met our inclusion criteria underwent primary excision and neck dissection. For a depth of invasion of 1 mm or less, there were no patients with a positive node. From 1.1 mm to 2 mm of depth of invasion, there was 1 of 11 patients (9%) who had at least 1 positive node. At 2.1 mm to 3 mm, 5 of 25 patients (20%) had at least 1 positive node.

Conclusion

Depth of invasion and the location of the tumor are 2 important variables to consider when making treatment recommendations to patients with clinical N0 disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 974–979, 2017
Integration of high‐risk human papillomavirus into cellular cancer‐related genes in head and neck cancer cell lines
Authors: Walline Heather M. , Goudsmit Christine M. , McHugh Jonathan B. , Tang Alice L. , Owen John H. , Teh Bin T. , McKean Erin , Glover Thomas W. , Graham Martin P. , Prince Mark E. , Chepeha Douglas B. , Chinn Steven B. , Ferris Robert L. , Gollin Susanne M. , Hoffmann Thomas K. , Bier Henning , Brakenhoff Ruud , Bradford Carol R. , Carey Thomas E. ,   The University of Michigan Head and Neck Specialized Program of Research Excellence (SPORE) Program
Published: February 2017

Background

Human papillomavirus (HPV)‐positive oropharyngeal cancer is generally associated with excellent response to therapy, but some HPV‐positive tumors progress despite aggressive therapy. The purpose of this study was to evaluate viral oncogene expression and viral integration sites in HPV16‐ and HPV18‐positive squamous cell carcinoma lines.

Methods

E6/E7 alternate transcripts were assessed by reverse transcriptase‐polymerase chain reaction (RT‐PCR). Detection of integrated papillomavirus sequences (DIPS‐PCR) and sequencing identified viral insertion sites and affected host genes. Cellular gene expression was assessed across viral integration sites.

Results

All HPV‐positive cell lines expressed alternate HPVE6/E7 splicing indicative of active viral oncogenesis. HPV integration occurred within cancer‐related genes TP63, DCC, JAK1, TERT, ATR, ETV6, PGR, PTPRN2, and TMEM237 in 8 head and neck squamous cell carcinoma (HNSCC) lines but UM‐SCC‐105 and UM‐GCC‐1 had only intergenic integration.

Conclusion

HPV integration into cancer‐related genes occurred in 7 of 9 HPV‐positive cell lines and of these 6 were from tumors that progressed. HPV integration into cancer‐related genes may be a secondary carcinogenic driver in HPV‐driven tumors. © 2017 Wiley Periodicals, Inc. Head Neck 39: 840–852, 2017
PRMT5 restricts hepatitis B virus replication through epigenetic repression of covalently closed circular DNA transcription and interference with pregenomic RNA encapsidation
Authors: Zhang Wen , Chen Jieliang , Wu Min , Zhang Xiaonan , Zhang Min , Yue Lei , Li Yaming , Liu Jiangxia , Li Baocun , Shen Fang , Wang Yang , Bai Lu , Protzer Ulrike , Levrero Massimo , Yuan Zhenghong
Published: February 2017

Chronic hepatitis B virus (HBV) infection remains a major health problem worldwide. The covalently closed circular DNA (cccDNA) minichromosome, which serves as the template for the transcription of viral RNAs, plays a key role in viral persistence. While accumulating evidence suggests that cccDNA transcription is regulated by epigenetic machinery, particularly the acetylation of cccDNA‐bound histone 3 (H3) and H4, the potential contributions of histone methylation and related host factors remain obscure. Here, by screening a series of methyltransferases and demethylases, we identified protein arginine methyltransferase 5 (PRMT5) as an effective restrictor of HBV transcription and replication. In cell culture–based models for HBV infection and in liver tissues of patients with chronic HBV infection, we found that symmetric dimethylation of arginine 3 on H4 on cccDNA was a repressive marker of cccDNA transcription and was regulated by PRMT5 depending on its methyltransferase domain. Moreover, PRMT5‐triggered symmetric dimethylation of arginine 3 on H4 on the cccDNA minichromosome involved an interaction with the HBV core protein and the Brg1‐based human SWI/SNF chromatin remodeler, which resulted in down‐regulation of the binding of RNA polymerase II to cccDNA. In addition to the inhibitory effect on cccDNA transcription, PRMT5 inhibited HBV core particle DNA production independently of its methyltransferase activity. Further study revealed that PRMT5 interfered with pregenomic RNA encapsidation by preventing its interaction with viral polymerase protein through binding to the reverse transcriptase–ribonuclease H region of polymerase, which is crucial for the polymerase–pregenomic RNA interaction. Conclusion: PRMT5 restricts HBV replication through a two‐part mechanism including epigenetic suppression of cccDNA transcription and interference with pregenomic RNA encapsidation; these findings improve the understanding of epigenetic regulation of HBV transcription and host–HBV interaction, thus providing new insights into targeted therapeutic intervention. (Hepatology 2017;66:398–415).
Human embryonic stem cell–derived hepatoblasts are an optimal lineage stage for hepatitis C virus infection
Authors: Yan Fang , Wang Yi , Zhang Wencheng , Chang Mingyang , He Zhiying , Xu Jinbo , Shang Changzhen , Chen Tao , Liu Jiang , Wang Xin , Pei Xuetao , Wang Yunfang
Published: February 2017

Maturation of hepatic cells can be gradually acquired through multiple stages of hepatic lineage specification, while it is unclear whether hepatitis C virus (HCV) infection is maturationally lineage‐dependent. We investigated the susceptibility to HCV at multiple stages of human embryonic stem cells, definitive endodermal cells, hepatic stem cells, hepatoblasts (hHBs), and mature hepatocytes. Susceptibility to infection occurred initially at the stage of human hepatic stem cells; however, hHBs proved to have the highest permissiveness and infectivity compared with all other stages. The hHBs' susceptibility to HCV correlated with the translocation of occludin, an HCV receptor, from cytoplasm to plasma membrane of HBs. Vascular endothelial cell growth factor enhanced the HCV susceptibility of hHBs through rearrangement of occludin by dephosphorylation; this minimized hHB polarization and prevented hHBs from further maturation. The transcription profiles of different hepatic lineage stages indicated that expression of innate immune response genes was correlated with hepatic maturation; interferon β played an important role in protecting hHBs from HCV infection. HCV‐infected hHBs were able to engraft and integrate into the livers of Fah–/–Rag2–/– mice and maintained an hHB phenotype for over 12 weeks during the time when HCV antigen was evident. After suppression of interferon β in hHBs, HCV infection was significantly enhanced in the engrafted humanized liver tissue of host mice. Conclusion: Human embryonic stem cell–derived hHBs are the optimal hosts for HCV infectivity; the realization that HCV entry and replication occur primarily at a particular hepatic lineage stage enables us to understand the HCV infection factors, life cycle, and infection dynamics that are facets of the pathogenesis as well as suggesting targets for anti‐HCV treatment. (Hepatology 2017;66:717–735).
Retrospective analysis of placenta previa with abnormal placentation with and without prophylactic use of abdominal aorta balloon occlusion
Authors: Cui Shihong , Zhi Yunxiao , Cheng Guomei , Zhang Kai , Zhang Lindong , Shen Linna
Published: February 2017

Objective

To evaluate the effectiveness of prophylactic abdominal aorta balloon occlusion in cases of placenta previa with abnormal placentation.

Methods

In a retrospective study, data were analyzed for patients who had placenta previa with placenta accreta and underwent elective cesarean delivery (>34 weeks) with or without temporary aortic balloon occlusion at a center in Zhengzhou, China, between October 2015 and September 2016. The primary clinical outcomes were operative time, estimated blood loss, intraoperative blood transfusion volume, hemoglobin, hysterectomy, and hospitalization.

Results

Among 69 eligible women, 38 had temporary balloon occlusion, and 31 had no balloon occlusion. Operative time, blood transfusion volume, change in hemoglobin, hysterectomy, and length of hospitalization did not differ. Although mean blood loss did not differ, fewer patients in the balloon group than the non‐balloon group had an estimated blood loss of more than 1000 mL (24 [63%] vs 28 [90%]; P=0.009). In terms of different placental types, the estimated blood loss among women with placenta accreta and placenta increta was lower in the balloon group than in the non‐balloon group (P<0.001 and P=0.01, respectively).

Conclusion

Prophylactic balloon occlusion of the abdominal aorta reduced bleeding after cesarean delivery for women with abnormal placentation.
Evaluation of Infiltration Models and Variability of Soil Infiltration Properties at Multiple Scales
Authors: Nie Weibo , Ma Xiaoyi , Fei Liangjun
Published: March 2017

Soil infiltration is characterized by scale dependence, so the accuracy and reliability of indirect methods used to estimate soil infiltration properties from available soil physical data are often below expectations. This study aimed to determine the scale‐dependent relationship between soil infiltration and soil physical properties and to establish pedotransfer functions (PTFs) for estimating normalization factors (FC). Field studies were conducted using double‐ring infiltrometers in the first (sandy loam) and third (clay loam) terraces in Yangling District. Multiple scale variability and relationships were studied by multifractal and joint multifractal techniques. Results indicated that the Kostiakov–Lewis model best described the relationship between cumulative infiltration and time in the study areas, and that the normalization equation for predicting cumulative infiltration was accurate. Joint multifractal analysis showed that the variability of FC in the first terrace was related largely to sand content, soil bulk density, and silt content. FC in the third terrace depended on the contents of sand, silt, initial soil water, and clay at multiple scales. The PTFs that were established based on the results of joint multifractal analysis reliably estimated FC values. Copyright © 2017 John Wiley & Sons, Ltd.
Systematic derivation of implicit solvent models for the study of polymer collapse
Authors: Song Bin , Charest Nathaniel , Alexander Morriss‐Andrews Herbert , Molinero Valeria , Shea Joan‐Emma
Published: February 2017

The conformational states adopted by a polymer chain in water are a result of a delicate balance between intra‐molecular and water‐mediated interactions. Using an explicit representation of the solvent is, however, computationally expensive and it is often necessary to turn to implicit representations. We present a systematic derivation of implicit models of water and study the effect of simplifying the representation of the solvent on the conformations of hydrophobic homopolymers of varying length. Starting from the explicit coarse‐grained single site mW water model, we develop an implicit solvent model that reproduces the free energy of the contact pair between two hydrophobic monomers, an implicit solvent model that captures the free energy of contact pair minima, desolvation barrier, and solvent‐separated minima, and finally, we consider vacuum simulations. We generate potentials of mean force for polymers of various lengths in explicit water, the implicit solvents and vacuum, using umbrella sampling and replica exchange molecular dynamics simulations. Surprisingly, vacuum simulations outperform the implicit solvent simulations, with the implicit model involving a desolvation barrier producing spurious extended polymer conformations. © 2017 Wiley Periodicals, Inc.
Analytical evaluation of the ADAMS™ A1c HA8180T analyzer for the measurement of HbA1c
Authors: Urrechaga Eloísa
Published: February 2017

Background

The ADAMS™ A1c HA‐8180T (ARKRAY, Inc., Kyoto, Japan) is a high pressure liquid chromatography system designed for separation and quantitation of HbA1c, while detecting hemoglobin (Hb) variants and HbA2, with an analysis time of just 3.5 min. The aim was to evaluate the analytical performance of this analyzer for routine HbA1c quantitation.

Methods

Trueness, imprecision, carry over, linearity, the effect of anemia and correlation with ADAMS™ A1c HA‐8180V (in Variant mode) were assessed according to guidelines of the Clinical and Laboratory Standards Institute (CLSI) and manufacturer. The presence of coexisting interfering chemically modified Hb variants was also assessed.

Results

The results were found to be accurate (total error of 1.74%) and precise: within‐run, between‐run, between‐day and total coefficients of variation were 0.71%, 0.77%, 0.36%, and 0.93% at low concentrations, and 0.43%, 0.29%, 0%, and 0.48% at high concentrations of HbA1c. Carry over, linearity, and correlation of methods were excellent. HbA1c measurement was independent of total Hb concentration in a range 40‐214 g/L, and shows no interference from Hb chemically modified commonly observed in this type of analysis, while common Hb variants are detected.

Conclusion

The analyzer is a suitable system for glycemic control in patients with diabetes and the detection of Hb variants.
Comparison of transferrin isoform analysis by capillary electrophoresis and HPLC for screening congenital disorders of glycosylation
Authors: Dave Mihika B. , Dherai Alpa J. , Udani Vrajesh P. , Hegde Anaita U. , Desai Neelu A. , Ashavaid Tester F.
Published: February 2017

Background

Transferrin, a major glycoprotein has different isoforms depending on the number of sialic acid residues present on its oligosaccharide chain. Genetic variants of transferrin as well as the primary (CDG) & secondary glycosylation defects lead to an altered transferrin pattern. Isoform analysis methods are based on charge/mass variations. We aimed to compare the performance of commercially available capillary electrophoresis CDT kit for diagnosing congenital disorders of glycosylation with our in‐house optimized HPLC method for transferrin isoform analysis.

Methods

The isoform pattern of 30 healthy controls & 50 CDG‐suspected patients was determined by CE using a Carbohydrate‐Deficient Transferrin kit. The results were compared with in‐house HPLC‐based assay for transferrin isoforms.

Results

Transferrin isoform pattern for healthy individuals showed a predominant tetrasialo transferrin fraction followed by pentasialo, trisialo, and disialotransferrin. Two of 50 CDG‐suspected patients showed the presence of asialylated isoforms. The results were comparable with isoform pattern obtained by HPLC. The commercial controls showed a <20% CV for each isoform. Bland Altman plot showed the difference plot to be within +1.96 with no systemic bias in the test results by HPLC & CE.

Conclusion

The CE method is rapid, reproducible and comparable with HPLC and can be used for screening Glycosylation defects.
Associations of urinary, glomerular, and tubular markers with the development of diabetic kidney disease in type 2 diabetes patients
Authors: Jiang Xu , Zhang Qian , Wang Hua‐Bin , Cui Xiao‐Fan , Liu Rui
Published: February 2017

Objectives

To evaluate the associations of urinary markers (eg albumin), glomerular (eg transferrin [TRF], immunoglobulin G [IgG]), and tubular (eg α1‐microglobulin [α1‐MG], β2‐microglobulin [β2‐MG]) markers with the development of diabetic kidney disease (DKD) in type 2 diabetes patients, as assessed by estimated glomerular filtration rate (eGFR) and albuminuria.

Material and methods

A total of 252 type 2 diabetes patients and 50 nondiabetic controls from Tianjin, China, were selected. Diabetic patients were divided into three groups according to eGFR levels, including groups A, B, and C with eGFR ≥90 (n=94), 60‐89 (n=94), and 30‐59 (n=64) mL/min/1.73 m2. Urine levels of glomerular and tubular markers were detected in first morning urine samples, and their associations with eGFR and albuminuria analyzed.

Results

Urinary levels of IgG, TRF, and β2‐MG were significantly elevated in diabetic patients with normal eGFR compared with nondiabetic control subjects. Urinary levels of all markers increased per eGFR stratum. All kidney damage markers were significantly associated with eGFR in univariate analysis (standard β between −0.35 and −0.28; all P<.001). After adjusting for known confounders, only the tubular markers α1‐MG (standard β=−0.25; P=.013) and β2‐MG (standard β=−0.18; P=.039) retained significant associations with eGFR. All kidney damage markers were significantly associated with albuminuria, independent of age, duration of diabetes, and eGFR (standard β between 0.45 and 0.86; all P<.001).

Conclusion

Only the tubular markers α1‐MG and β2‐MG were associated with eGFR independent of albuminuria, suggesting that they may play an important role in the development of DKD.
MENTAL ASSOCIATION: TESTING INDIVIDUAL DIFFERENCES BEFORE BINET
Authors: MÜLBERGER ANNETTE
Published: February 2017

This paper challenges the historiographical discontinuity established between earlier “anthropometric testing” and the arrival of “psychological testing” with Binet and Simon's intelligence test in 1905. After some conceptual clarifications, it deals with “word association”: a kind of psychological experimentation and testing which became popular over the last two decades of the 19th century. First Galton's exploration are presented, followed by experiments performed at the Leipzig laboratory by Trautscholdt, and then Cattell and Bryant's collective testing. Additionally, I document the use of this method for the study of mental difference through the works of Münsterberg, Bourdon, Jastrow, Nevers and Calkins. The cases I present show how the method gave rise to various measurements and classifications. I conclude that the word association technique triggered reflection on mental “uniqueness”, gender traits and the influence of education, among other topics. Moreover, it prepared the terrain and anticipated some basic attractions and problems intelligence testing would later encounter.
Cardiac MR elastography for quantitative assessment of elevated myocardial stiffness in cardiac amyloidosis
Authors: Arani Arvin , Arunachalam Shivaram P. , Chang Ian C.Y. , Baffour Francis , Rossman Phillip J. , Glaser Kevin J. , Trzasko Joshua D. , McGee Kiaran P. , Manduca Armando , Grogan Martha , Dispenzieri Angela , Ehman Richard L. , Araoz Philip A.
Published: February 2017

Purpose

To evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high‐frequency cardiac MRE technique capable of making noninvasive stiffness measurements.

Materials and Methods

In all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head‐first in the supine position in a 1.5T closed‐bore MR imager. 3D MRE was performed using 5 mm isotropic resolution oblique short‐axis slices and a vibration frequency of 140 Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal‐to‐noise ratio (OSS‐SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude.

Results

Five volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS‐SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P = 0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8).

Conclusion

This study demonstrates the feasibility of 3D high‐frequency cardiac MRE as a contrast‐agent‐free diagnostic imaging technique for cardiac amyloidosis.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2017;46:1361–1367.
Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital
Authors: Teoh Stephanie W. K. , Hattingh Laetitia , Lebedevs Tamara , Parsons Richard
Published: February 2017

Aim

The objectives of this study were to evaluate clinical interventions recorded by pharmacists in an Australian principal referral and specialist women's and newborns' hospital, as well as to identify common medications involved in each specialty area (neonatology, obstetrics and gynaecology), to assess the risks of medication‐related problems (MRPs) likely to have been prevented, and to obtain institution‐specific MRPs for future staff education.

Methods

This retrospective, observational study involved an analysis of all interventions documented by pharmacists from January 2005 to December 2014. The interventions recorded were collated according to ward, medication involved, description of the intervention and the risk classification.

Results

There were a total of 14 085 interventions documented over 10 years; 60.33% made in obstetric patients, 28.71% in gynaecology patients and 10.96% in neonates. The three main intervention types were: (i) dose/frequency/time incorrect (25.70%, n = 3260); (ii) prescribing clarification (21.77%, n = 3066); and (iii) medicine omission (15.21%, n = 2143). An average of 12.02% of the interventions were regarded as high‐risk and 0.85% as extreme‐risk. Of the MRPs documented within each specialty, the prevalence of extreme risk interventions was higher in the neonatal ward.

Discussion

The most common intervention was identifying incorrect medication dose/frequency/time. Common medications involved in the MRPs included: opioids and antihypertensives in gynaecology; parenteral nutrition and gentamicin in neonatology; and opioids and non‐steroidal anti‐inflammatory drugs (NSAIDs) in obstetrics. The medications involved in high and extreme risk MRPs included gentamicin, opioids and NSAIDs.

Conclusion

This study demonstrates that hospital pharmacists contribute to the reduction of MRPs, including some potentially fatal adverse medicine events. These findings also enable targeted, site‐specific education, which is valuable in improving patient safety.
The type and incidence of adverse drug events in ageing medical inpatients and their effect on length of hospital stay
Authors: Paradissis Chariclia , Coombes Ian D. , Donovan Peter , Doran Elizabeth , McKean Mitchell , Barras Michael A.
Published: February 2017

Aims

To determine the proportion of older medical patients who have an adverse drug event (ADE) during admission to hospital and assess the association with hospital length of stay (LOS).

Methods

A retrospective evaluation of eligible patients, aged greater than 65 years, consecutively admitted to a medical ward at the Royal Brisbane and Women's Hospital, Australia. Patient medication charts, medical notes and laboratory results were reviewed using an ADE trigger tool to identify potential ADEs during admission. A clinical panel examined and confirmed any true ADEs and the corresponding causative agents. LOS was compared between patients who did and did not have an ADE.

Results

A total of 164 patients were recruited over 30 days. The trigger tool identified a total of 69 triggers from 40 patients (24.3%) with a potential ADE during admission, of which 12 patients (7.3%) had a true ADE. The main drug categories implicated included cardiovascular, anti‐infective and haematological agents. The group of patients with an ADE had a longer median (25th, 75th percentile) LOS when compared to patients without an ADE: 6.5 (3.75, 11) versus 4 (2, 7) days (p = 0.043).

Conclusion

Approximately 7% of older in‐patients experience an ADE, which has a significant association with an increase in their LOS. To minimise patient harm, undesirable high‐risk drugs should be avoided and vigilant monitoring must occur if they need to be prescribed. An adequately powered, multi‐site study is required and preventative strategies should be further explored.
Hospital pharmacists' beliefs about optimising statin therapy in older inpatients
Authors: Wu Angela , Reeve Emily , Hilmer Sarah , Gnjidic Danijela
Published: February 2017

This study explored hospital pharmacists’ perspectives about optimising statin therapy in older inpatients in Australia. An anonymous questionnaire using standardised questions in the form of five‐point Likert scales to capture pharmacists’ attitudes toward their role in statin optimisation, compliance of statin therapy with existing guidelines, knowledge of statin‐related side effects and clinical recommendations such as starting and ceasing or deprescribing therapy, was administered. A total of 108 hospital pharmacists across Australia completed the questionnaire. Over 90% of hospital pharmacists agreed that they had an important role in managing statin therapy in older inpatients (95% CI: 90.5–98.8%). Less than 40% agreed that statin therapy in older adults was prescribed in accordance with Australian clinical guidelines (95% CI: 27.4–47.6%), and over 90% agreed that there was a need for statin deprescribing guidelines for older adults (95% CI: 85.7–97.6%). Hospital pharmacists believe that they have an important role in optimising statin therapy.
Using domperidone to increase breast milk supply: a clinical practice survey of Australian neonatal units
Authors: Gilmartin Christine E. , Amir Lisa H. , Ter Marene , Grzeskowiak Luke E.
Published: February 2017

Background

Domperidone may be used off‐label to increase breastmilk supply. In the absence of manufacturer dosage recommendations, there is a need to compare the clinical practice guidelines used in Australian hospitals.

Aim

To compare existing clinical practice guidelines regarding the use of domperidone for increasing maternal breastmilk supply within Australian neonatal units (NNUs).

Methods

An electronic survey was distributed from April to July 2015 to relevant staff at each Level III NNU across Australia.

Results

Responses were received from 16 of 22 (73%) NNUs. All 16 (100%) NNUs considered domperidone their first line pharmacological agent of choice in the management of low milk supply, with 12 (75%) having a clinical guideline. Of the NNUs with a guideline, 11 (92%) recommended a standard maintenance dose of 10 mg three times daily (TDS). Duration of treatment was specified in 10 (83%) guidelines. Seven of 10 (70%) recommend a minimum duration of at least 2 weeks treatment before evaluating a response. Three of 11 (27%) guidelines that recommended 10 mg TDS permitted an increase to 20 mg TDS depending on response. Ten of 12 (83%) guidelines were modified in the previous 2–3 years, with eight revising their maximum dose to 30 mg/day, one limiting treatment duration to 7 days, and one removing the authority of NNU doctors to prescribe domperidone.

Conclusion

While all Australian neonatal units consider domperidone first‐line for pharmacological management of low milk supply, variability across clinical guidelines may suggest a lack of reliable evidence or awareness of evidence on which to base practice.
Safety of continuous antibiotic infusions administered through an Australian hospital in the home service: a pilot study
Authors: Pandya Kedar H. , Eaton Vaughn , Kowalski Stefan , Sluggett Janet K.
Published: February 2017

Background

Few studies have assessed the safety of antibiotic infusions in the hospital in the home (HITH) setting, or the vascular access and ambulatory infusion devices used for delivering these infusions.

Aim

To explore treatments and health outcomes for HITH patients administered continuous antibiotic infusions through an ambulatory infusion device.

Method

Case notes for patients managed by a HITH service affiliated with a large metropolitan hospital were retrospectively audited. Consecutive patients treated for cellulitis, osteomyelitis, endocarditis, diabetic foot infection or septic arthritis between January and September 2014, and receiving intravenous antibiotic therapy through an ambulatory infusion device, were included. Patients were followed until discharge from HITH to determine adverse outcomes related to antibiotic therapy, including administration devices.

Results

The audit recruited 31 patients with a median age of 62 years; 17 (55%) were male. Overall 14 adverse events were experienced by 10 (32%) patients. Of the 14 adverse events, nine (64%) were medication‐related, one (7%) related to a vascular access device and four (29%) were infusion device‐related. Therapeutic failure occurred in four patients; three were re‐hospitalised; and one had their therapy extended. Most patients had an infusion that was identified as not running to completion on at least one occasion at the time of their home visit (81%), or problems with flushing lines or aspirating blood from the vascular access devices (35%).

Conclusion

Adverse events were commonly observed among patients receiving continuous antibiotic infusions in this pilot study. Further research is needed to identify patients at risk of adverse events.
Laryngoscopy during swimming: A novel diagnostic technique to characterize swimming‐induced laryngeal obstruction
Authors: Walsted Emil S. , Swanton Laura L. , van van Someren Ken , Morris Tessa E. , Furber Matthew , Backer Vibeke , Hull James H.
Published: February 2017

Exercise‐induced laryngeal obstruction (EILO) is a key differential diagnosis for respiratory symptoms in athletes and is particularly prevalent in aquatic athletes. A definitive diagnosis of EILO is dependent on laryngoscopy, performed continuously, while an athlete engages in the sport that precipitates their symptoms. This report provides the first description of the feasibility of performing continuous laryngoscopy during exercise in a swimming environment. The report describes the methodology and safety of the use of continuous laryngoscopy while swimming. Laryngoscope, 127:2298–2301, 2017
A new solution31P NMR sample preparation scheme for marine sediments
Authors: Defforey Delphine , Cade‐Menun Barbara J. , Paytan Adina
Published: February 2017

A new approach for the preparation of marine sediment samples for solution31P nuclear magnetic resonance spectroscopy (31P NMR) has been developed and tested. This approach addresses important aspects associated with sample pretreatments for marine sediments, including the effects of sample pretreatment on sedimentary P composition. The method increases the signals of low abundance P species in31P NMR spectra by quantitatively and precisely removing up to 80% of inorganic P (orthophosphate) from sediment samples while causing minimal alteration of the chemical structure of organic P compounds. This method uses a reductive step to solubilize P bound to iron oxyhydroxides, followed by a low pH digestion to extract P from authigenic and biogenic apatite, as well as P bound to calcium carbonate. These P forms combined represent the most abundant inorganic P reservoir in marine sediments. The sample residue is then extracted in an alkaline solvent, 0.25 M NaOH with 0.05 M Na2EDTA, and processed for31P NMR spectroscopy. The method was tested on natural marine sediment samples from different localities with high inorganic P content (>85% molybdate reactive P), and allowed for the detection of orthophosphate monoesters and pyrophosphate in samples for which only an orthophosphate signal could be resolved with an NaOH‐EDTA extraction alone. This new approach will allow the use of31P NMR on samples for which low organic P concentrations previously hindered the use of this tool, and will help answer longstanding question regarding the fate of organic P in marine sediments.
Reconciliation of pH25 and pHinsitu acidification rates of the surface oceans: A simple conversion using only in situ temperature
Authors: Lui Hon‐Kit , Chen Chen‐Tung Arthur
Published: February 2017

Seawater pH is frequently measured at 25°C (pH25), and can be converted thermodynamically to pH at the in situ temperature (T), (pHinsitu) using an additional carbonate chemistry parameter, which is the total alkalinity (TA), dissolved inorganic carbon (DIC), or the partial pressure of CO2 (pCO2) of seawater. Although rates of temporal change of pHinsitu (
) and pH25 (
) are both extensively used in studies of ocean acidification, the difference between
and
has not yet been quantified. This study deducts from 816 sets of data of the surface oceans over wide ranges of T (1–31°C) from six time series to reveal that the difference between calculated pHinsitu and pH25 is a1 (T
25°C), where a1 is a nearly constant of −0.0151 pH unit °C−1. We illustrate that
equals (
 + a1
), where
is the rate of temporal change of T. We further show that uneven distributions of sampling points significantly widen the difference between
and
, making the degree of ocean acidification unclear. Distributions of a1 values are modeled for the surfaces of the global oceans at various pCO2 levels, and they closely match the observations from the studied time series. Without the use of an additional carbonate chemistry parameter, the pHinsitu and pH25, as well as
and
can now be converted into each other using only T, facilitating the study of the changing carbonate chemistry of seawater under the influences of increasing atmospheric CO2 concentration.
Extracting phytoplankton physiological traits from batch and chemostat culture data
Authors: Omta A. W. , Talmy D. , Sher D. , Finkel Z. V. , Irwin A. J. , Follows M. J.
Published: February 2017

As the role of phytoplankton diversity in ocean biogeochemistry becomes widely recognized, the description of plankton in ocean ecological models is becoming more sophisticated. This means that a growing number of plankton physiological traits need to be determined for various species and under various growth conditions. We investigate how these traits can be estimated efficiently from common batch culture and chemostat experiments. We use the Metropolis algorithm, a random‐walk Monte Carlo method, to estimate phytoplankton parameter values, along with the uncertainties in these values. First, we fit plankton physiological models to high‐resolution batch culture and chemostat data sets to obtain parameter sets that are as accurate as possible. Then, we subsample these data sets and assess to which extent the accuracy is sacrificed when fewer measurements are taken. Two measurement points within the exponential growth stage of the batch culture data set are sufficient to constrain the maximum protein synthesis rate, the maximum photosynthesis rate, and the chlorophyll‐to‐nitrogen ratio. Two measurements during the stationary phase of the batch culture experiment are then enough to constrain the parameters related to carbon excretion and the photoacclimation time. From the chemostat experiment, only four measured points are needed to constrain the parameters connected with the internal reserve dynamics of phytoplankton. Thus, we demonstrate that traits related to key biogeochemical and physiological processes can be determined with only a few batch culture and chemostat measurements, as long as the measurement points are selected appropriately.
A comparison of methods to estimate abundance and biomass from belt transect surveys
Authors: Chang Jui‐Han , Shank Burton V. , Hart Deborah R.
Published: February 2017

It is becoming increasingly popular to use continuously collected acoustic or optical data to estimate abundance or biomass of fish and invertebrates. However, data from such systems are typically highly spatially autocorrelated and zero‐inflated, and thus simple design‐based estimation techniques are not applicable. Model‐based estimation methods can be used to extrapolate observations along the observed track to larger areas. We tested the precision and accuracy of three model‐based methods using both simulations and field data: Ordinary kriging (OK), Generalized Additive Models with kriged model residuals (GAM + OK), and Generalized Additive Mixed Models with kriged model residuals (GAMM + OK), along with a design‐based method (stratified mean, SM). The GAMM + OK method treats small‐scale variations as random effects, whereas the other approaches aggregate nearby data to reduce autocorrelation and random errors. We found that the GAM + OK method with relatively small aggregation lengths generally gave the best performance of the model‐based methods in terms of both accuracy and precision, followed by GAMM + OK. SM estimates were more accurate and precise than the model‐based estimates in the simulations, but only when the study region was stratified accurately. Based on the simulation and field data analysis results, we selected the GAM + OK method to estimate scallop abundance and biomass for the Georges Bank and the Mid‐Atlantic Bight regions for the years 2011–2015. We also provided SM estimates based on careful stratifications to validate the model‐based estimates.
Clearing the waters: Evaluating the need for site‐specific field fluorescence corrections based on turbidity measurements
Authors: Saraceno John Franco , Shanley James B. , Downing Bryan D. , Pellerin Brian A.
Published: February 2017

In situ fluorescent dissolved organic matter (fDOM) measurements have gained increasing popularity as a proxy for dissolved organic carbon (DOC) concentrations in streams. One challenge to accurate fDOM measurements in many streams is light attenuation due to suspended particles. Downing et al. (2012) evaluated the need for corrections to compensate for particle interference on fDOM measurements using a single sediment standard in a laboratory study. The application of those results to a large river improved unfiltered field fDOM accuracy. We tested the same correction equation in a headwater tropical stream and found that it overcompensated fDOM when turbidity exceeded ∼ 300 formazin nephelometric units (FNU). Therefore, we developed a site‐specific, field‐based fDOM correction equation through paired in situ fDOM measurements of filtered and unfiltered streamwater. The site‐specific correction increased fDOM accuracy up to a turbidity as high as 700 FNU, the maximum observed in this study. The difference in performance between the laboratory‐based correction equation of Downing et al. (2012) and our site‐specific, field‐based correction equation likely arises from differences in particle size distribution between the sediment standard used in the lab (silt) and that observed in our study (fine to medium sand), particularly during high flows. Therefore, a particle interference correction equation based on a single sediment type may not be ideal when field sediment size is significantly different. Given that field fDOM corrections for particle interference under turbid conditions are a critical component in generating accurate DOC estimates, we describe a way to develop site‐specific corrections.
Spectral characterization of tissues in high spectral and spatial resolution MR images: Implications for a classification‐based synthetic CT algorithm
Authors: Wood Abbie M. , Shea Steven M. , Medved Milica , Karczmar Gregory S. , Surucu Murat , Gros Sebastien , Small William , Roeske John
Published: February 2017

Purpose

To characterize the spectral parameters of tissues with high spectral and spatial resolution magnetic resonance images to be used as a foundation for a classification‐based synthetic CT algorithm.

Methods

A phantom was constructed consisting of a section of fresh beef leg with bone embedded in 1% agarose gel. The high spectral and spatial (HiSS) resolution MR imaging sequence used had 1.0 mm in‐plane resolution and 11.1 Hz spectral resolution. This sequence was used to image the phantom and one patient. Post‐processing was performed off‐line with IDL and included Fourier transformation of the time‐domain data, labeling of fat and water peaks, and fitting the magnitude spectra with Lorentzian functions. Images of the peak height and peak integral of both the water and fat resonances were generated and analyzed. Several regions‐of‐interest (ROIs) were identified in phantom: bone marrow, cortical bone, adipose tissue, muscle, agar gel, and air; in the patient, no agar gel was present but an ROI of saline in the bladder was analyzed. All spectra were normalized by the noise within each voxel; thus, all parameters are reported in terms of signal‐to‐noise (SNR). The distributions of tissue spectral parameters were analyzed and scatterplots generated. Water peak height in cortical bone was compared to air using a nonparametric t‐test. Composition of the various ROIs in terms of water, fat, or fat and water was also reported.

Results

In phantom, the scatterplot of peak height (water versus fat) showed good separation of bone marrow and adipose tissue. Water versus fat integral scatterplot showed better separation of muscle and cortical bone than the peak height scatterplot. In the patient data, the distributions of water and fat peak heights were similar to that in phantom, with more overlap of bone marrow and cortical bone than observed in phantom. The relationship between bone marrow and cortical bone for peak integral was better separated than those of peak heights in the patient data. For both the phantom and patient, there was a significant amount of overlap in spectral parameters of cortical bone versus air.

Conclusion

These results show promising results for utilizing HiSS imaging in a classification‐based synthetic CT algorithm. Cortical bone and air overlap was expected due to the short T2* of bone; reducing early echo times would improve the SNR in bone and image data from these early echoes could help differentiate these tissue types. Further studies need to be done with the goal of better separation of air and bone, and to extend the concept to volumetric imaging before it can be clinically applied.
An effective noise reduction method for multi‐energy CT images that exploit spatio‐spectral features
Authors: Li Zhoubo , Leng Shuai , Yu Lifeng , Manduca Armando , McCollough Cynthia H.
Published: February 2017

Purpose

To develop and evaluate an image‐domain noise reduction method for multi‐energy CT (MECT) data.

Methods

Multi‐Energy Non‐Local Means (MENLM) is a technique that uses the redundant information in MECT images to achieve noise reduction. In this method, spatio‐spectral features are used to determine the similarity between pixels, making the similarity evaluation more robust to image noise. The performance of this MENLM filter was tested on images acquired on a whole‐body research photon counting CT system. The impact of filtering on image quality was quantitatively evaluated in phantom studies in terms of image noise level (standard deviation of pixel values), noise power spectrum (NPS), in‐plane and cross‐plane spatial resolution, CT number accuracy, material decomposition performance, and subjective low‐contrast spatial resolution using the American College of Radiology (ACR) CT accreditation phantom. Clinical feasibility was assessed by performing MENLM on contrast‐enhanced swine images and unenhanced cadaver head images using clinically relevant doses and dose rates.

Results

The phantom studies demonstrated that the MENLM filter reduced noise substantially and still preserved the shape and peak frequency of the NPS. With 80% noise reduction, MENLM filtering caused no degradation of high‐contrast spatial resolution, as illustrated by the modulation transfer function (MTF) and slice sensitivity profile (SSP). CT number accuracy was also maintained for all energy channels, demonstrating that energy resolution was not affected by filtering. Material decomposition performance was improved with MENLM filtering. The subjective evaluation using the ACR phantom demonstrated an improvement in low‐contrast performance. MENLM achieved effective noise reduction in both contrast‐enhanced swine images and unenhanced cadaver head images, resulting in improved detection of subtle vascular structures and the differentiation of white/gray matter.

Conclusion

In MECT, MENLM achieved around 80% noise reduction and greatly improved material decomposition performance and the detection of subtle anatomical/low‐contrast features while maintaining spatial and energy resolution. MENLM filtering may improve diagnostic or functional analysis accuracy and facilitate radiation dose and contrast media reduction for MECT.